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79 Cards in this Set
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- 3rd side (hint)
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vessels that are the main autoregulators of bp
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arterioles
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At autopsy, a patient's heart, lungs, and kidneys were found to have pale sections. From what did the patient die? Why pale?
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Hypotension (bp <60)
Pale = ischemic infarct |
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Patient's lungs and kidney were found to have deep red areas. What is most likely to be seen on biopsy?
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Hyaline arteriosclerosis
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MCC bleeding into tissue
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HTN
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3 factors contributing to clot formation? Which is the #1 control
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stasis, Vascular injury, hypercoaguability
#1 = stasis |
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MCC spontaneous clot formation
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factor 5 Leiden deficiency
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MCC subdural hematoma
which vein/artery? present acutely or chronically? |
trauma
vein = bridging vein present chronically |
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in what organs does most venoconstriction occur (in response to hypovolemia) - what happens to those organs?
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skin and GI
skin = poor turgor GI = loss of bowel sounds/ileus |
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what happens to bld flow in GI when stressed out?
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decr
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MCC epidural hematoma
which vein/artery? present acutely or chronically? |
Trauma
artery = middle meningial present acutely |
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receptors (2nd messengers) on:
arteries arterioles veins |
arteries: alpha 1 (IP3/DAG)
arterioles: beta 2 (cAMP) veins: alpha 1 (IP3/DAG) |
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ways to get a transudate (2 general reasons, 7 specifics)
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inc hydrostatic pressure of vessel (not pumping forward = HF, not peeing = renal failure, neither heart nor kidney working = hypothyroid)
decr oncotic pressure of vessel (decr intake = kwashiorkor, liver didn't make it = cirrhosis, pee it out = nephrotic, leak out of GI = menetriers) |
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types of exudates and their meanings
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purulent = bacteria
granulomatous = nonbacteria caseous = TB fibrinous = collagen vasc dz hemorrhagic = trauma, cancer |
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3 organs with resistance in series - fxn?
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liver - detoxifies
kidney - filtrates spleen - remove RBC and encapsulated organisms |
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when does heart extract most O2?
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systole (doing most work)
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3 ways to get fistula
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congenital heart dz (PDA or AVM)
trauma (in leg) iatrogenic |
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2 syndromes assoc with AVM (and organs involved)
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osler-weber-rendu (lungs)
VHL (abd and brain) |
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regulation of vessel radius (ie dilation) in:
CNS lungs muscles CV skin GI renal |
CNS - inc CO2, decr O2
Lungs - inc O2 muscles - inc CO2, decr pH cv - inc adenosine skin - inc temp, inc CO2 gi - inc food (esp fats) renal - inc PGE2, inc dopamine, inc ANP |
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MCC atrial arrhythmias
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ischemia
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patient comes in and says, "when i wake in the morning, i always have a headache" - what kind is it?
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cluster
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MC vascular issue in pts (etiology?)
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migraines (vasodilation)
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when person stands up, by how much should bp change? which direction? pulse? which direction?
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bp - 5-10 mmHg (decr)
HR - 5-10 beats/min (inc) |
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first thing to respond when pt stands up? followed by? followed by?
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carotid sinus (w/in 2 sec)
NE from solitary nucleus (2sec - 20min) kidney (>20min) |
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at what age should we begin to remove tonsils if they're a problem? why?
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after 2y/o - b/c CN9 is right next to the tonsils before age 2 and if cut CN9, will never be able to control the HR
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best way to prevent reflex tachycardia in MI, angina or aortic dissection?
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b1 blocker
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MCC autonomic dysfunction overall?
in newborns? in parkinsonism? in elderly? |
overall: DM
newborns: riley-day parkinsonism: shy-dragger elderly: sick sinus |
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ions inc/decr in low volume state:
Na K H Cl urine pH serum pH TPR |
Na - decr (dilutional)
K - decr H - kicked out Cl - decr (dilutional) urine pH - decr serum pH - inc TPR - inc |
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2 ways to get decr volume w/ inc Na
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DI
Neglected elderly (not drinking enough) |
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3 ways to have low vol w/ acidosis
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Diarrhea
DKA RTA2 |
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MCC hyponatremia
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low volume
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MCC hypokalemia
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low volume
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MCC hypochloremia
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low volume
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MCC high TPR
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low volume
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MCC metabolic alkalosis
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low volume
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what are you at inc risk for when you are in a low volume state (due to the alkalosis)
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kidney stones
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why do ACEI cause coughing while ARBs don't?
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ARBs still have ATII around so can brkdn bradykinin - ACEI will block the conversion to ATII so can't brkdn bradykinin = cough
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Only ARB that doesn't cause angioedema
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Candesartan
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If missing C1 esterase, what complication can you get with ACEI and ARB?
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angioedema
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thromboangitis obliterans, necrotizing vasculitis
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buerger's
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d-dimers
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DIC
primarily due to what? |
sepsis
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MCC renal failure in kids?
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HUS
occurs after what? |
gastroenteritis
eating hamburger swallowing e.coli (EHEC, O157:H7) |
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vWF esterase deficiency
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TTP
associated w/ what kind of changes? |
neurologic
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3 IgA nephropathies
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Berger's
Henoch-Schonlein Purpura Alports |
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vasculitis w/ NL platelets
skin changes over lower extremities |
henoch-schonlein purpura
assoc w/ what GI problem? |
intusseception
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deafness that runs in the family
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alports
other symptoms? |
cataracts
renal failure 20-30yrs later in life |
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treebark appearance
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syphilis
what else can syphilis lead to? how? |
aortic dissection - eats vaso vasorum
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pulseless dz
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Takayasu
what can it do to the aorta? |
attack the vaso vasorum and cuase aortic dissection
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only vasculitis w/ inc platelet count
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kawasaki
4 associations? |
mucocytis (strawberry tongue, red eyes, cracked lips/nose)
red rash all over diffuse cervical lymph nodes fever for >3days |
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MCC of MI in coronary bypass in kids
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kawasaki
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pANCA (2dzs)
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PAN
Churg-Strauss |
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MCC complication of temporal arteritis
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blindness
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HLA B27 association
bamboo spine |
ankylosing spondylitis
other B27 associations |
Reiter's syndrome
psoriasis arthritis |
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vasculitis w/ cANCA assn - ssaddle nose deformity
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Wegener's
what 3 systems are affected? |
lungs
kidneys sinuses |
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MCC crescents in kidneys?
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Goodpasture's
#2? |
Wegener's
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anti-glomerular basement Ab
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Goodpastures
2 systems involved? |
lungs
kidneys |
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severe asthma in child
pulmonary infiltrate w/ eosinophilia pANCA |
Churg-Strauss
other causes of pulm infiltrate w/ eosinophilia? |
allergic bronchogenic aspergillus
loeffler's |
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5 parasites that cause loeffler's
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NASSA
Nectar americanus Ascaris lumbricoides Strongyloides Schistosoma Anglostoma duodenal |
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post infectious arthritis
HLA-B27 association |
Reiter's syndrome
what bugs/syndromes is this associated with? |
chlamydia
shigella yersinia IBD |
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silver plaque on skin - affects DIP - sausage digits - pencil in cup on x-ray- can be associated w/ gout
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psoriatic arthritis
what if there's no arthritis, what's the genetic association? |
HLA B13
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anti centromere Ab
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CREST
what does this stand for? |
Calcinosis
Raynaud's Esophageal dysmotility Scleroderma Telangiectasias |
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anti-smooth muscle Ab
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scleroderma
what organs are affected? |
skin
GI bld vessels (onionskinning in kidney) |
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antitopoisomerase Ab
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progressive systemic sclerosis
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antiribonucleoprotein
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Mixed Connective Tissue Dz
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anti IgG Ab (to the Fc portion)
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Rheumatoid Arthritis
what other factor can be present |
rheumatoid factor - debilitating
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attacks the synovium
can cause atlas weakness symmetrical involvement |
rheumatoid arthritis
Rx? |
MTX or TNF receptor blockers (etanercept, ebetacept)
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uveitis or iridocyclitis and arthritis
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juvenile arthritis
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Rheumatoid arthritis + leukopenia + splenomegaly
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Felty's
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Rheumatoid arthritis + GI ulcerations
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Becet's
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Rheumatoid arthritis + xerophthalmia + xerostomia
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sjogren's
Abs? if w/o RA? |
Abs: Rho, La, SSA
w/o RA: Sicca |
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2 wks after vaccine - usually MMR
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serum sickness
complement level? |
low
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kidney issue 2 wks after strep throat or skin infection
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PSGN
strain of strep? complement level? |
strain 12
low complements |
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heart issue associated w/ tooth extraction?
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subacute bacterial endocarditis
which bacteria and which valves? |
s. viridans
previously damaged valves (mitral) |
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splinter hemorrhages, spots on toes/fingers that are painful, spots on palms/soles that are painless
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subacute bacterial endocarditis
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anti smith, anticardiolipin, anti ds DNA
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SLE
what if drug induced? |
anti-histone
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Ab responsible for false VRDL test?
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cardiolipin
what can it lead to if pregnant? |
spontaneous abortions
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2 kidney issues w/ subepithelial humps
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PSGN
SLE |
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type of MPGN w/ low complement
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type 2
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IgM problem w/ acute inflammation
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cryoglobulinemia
what can cause it? |
I AM HE
Influenza Adenovirus Mycoplasma Hepatitis B EBV |
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immune complex issues w/ low complement (6 of em)
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PSGN
Serum sickness Subacute bacterial endocarditis SLE MPGN Cryoglobulinemia |
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