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120 Cards in this Set
- Front
- Back
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small(<1 cm) erythematous epidermal lesions with adherent scale that are the result of chronic sun exposure
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actinic keratosis
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actininc keratosesprogress to ...
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invasive squamous cell carcinoma
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males with ... present a age 2-4 years with early virilization, increased linear growth, and elevated levels of 17-hydroxyprogesterone and androgens
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classic, non-salt-wasting 21-hydroxylase deficiency
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females with .... present with ambiguous genitalia at birth
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classic 21-hydroxylase deficiency
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trt for congenital adrenal hyperplasia
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low doses of GCS to supress excessive ACTH secretion and reduce stimulation of adrenal cortex
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digital clubbing os often associated with ...
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prolonged hypoxia
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combination of subdural hematoma with bilateral retinal hemorrahges in an infant
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shaken baby syndrome
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deforming joint disease(psoriatic arthritis) is a potential complication in a patient with ...
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psoriasis
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mononuclear, parenchymal infiltration with well-developed germinalcenters is a characteristic histological finding of ...
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Hashimoto's thyroiditis
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yellowish macules/papules found on the medial eyelids
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xanthelasmas(type of xanthoma)
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dermal accumulations of macrophages containing cholesterol and triglycerides are generally associated with ...
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hyperlipidemia/dyslipidemia
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most common cause of hyperlipidemia
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LDL receptor abnormality
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... is most common in children and usually affects the metaphysis of long bones due to the slower blood flow and capillary fenestrae in this region
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hematogenous osteomyelitis
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during wound healing, excessive matrix metallproteinase activity and myofibroblast accumulation in the wound margins can result in ...
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contracture
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whickening and hyperpigmentation of skin in the flexural areas
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acanthosis nigricans
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osteoarthritis usually involves the .... joints whereas rheumatoid arthritis typically affects the ... and ... joints
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OA - distal interphalangeal joints; RA - metacarpophalangeal and proximal interphalangeal joints
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medullary thyroid cancer, pheochromocytoma, mucosal neuromas, and marfanoid habitus
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MEN 2B
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"water-hammer" pulses and head-bobbing with each heart beat (de Musset sign) are characteristic findings in patients with ...
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aortic regurgitation
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... is a calcium channel blocker that slows depolarization of cardiac slow-response tissure(SA and AB nodes) by decreasing the calcium ion influx that occurs during phase 0 and the latter part of phase 4
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verapamil
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verapamil decreases the amount of intracellular Ca available within cardiomyocytes(fast-response tissue), which can reduce ...
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myocardial contractility
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most inhaled particles that lodge bronchial tree are removed via proximal transport of mucus by ...
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ciliated epithelial cells(mucocilliary clearence)
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mucus-secreting cells are present to the level of ..., after which club cells become the prominent secretory cell type
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larger bronchioles
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there are 4 major causes of hypoemia(low PaO2):...
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alveolar hypoventilation; ventialtion-perfusion mismatch; diffusion impairment; right-to-left shunting
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the A-a gradient is normal with .... and helps to distinguish it from other forms of hypoxemia
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alveolar hypoventilation
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nitric oxide is synthesized from .... by nitric oxide synthase
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arginin
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target of verapamil and other Ca channel blockers
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V-gated L-type Ca channels
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skeletal muscle is resitant to the effect of Ca channel blockers because it does not require an influx of extracellular Ca for excitation-contraction coupling, whereas cardiac and smooth muscle depend on extracellular Ca entering the cell via ... for excitation-contraction coupling
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V0gated L-type Ca channels
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noraml pressures in the right atrium
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0 - 8 mmHg
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noraml pressures in the right ventricle
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4 - 25 mmHg
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noraml pressures in the pulmonary artery
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9 - 25 mmHg
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noraml pressures in the left atrium
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2 - 12 mmHg
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noraml pressures in the left ventricle
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9 - 130 mmHg
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noraml pressures in the Aorta
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70 - 130 mmHg
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the Fick principle can be used to calculate the ...
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cardiac output
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Fick principle
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cardiac output = O2 consumption/AV O2 difference
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maximal resistance of the lower resp tract is in the ...
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2nd-5th generation airways
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most important mediator of coronary vascular dilation in large arteries and pre-arteriolar vessels
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nitric oxide
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acts as a vasodilatory element in the small coronary arterioles
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adenosine
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three variables affect the total oxygen content of blood: ...
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Hg concentration; O2 saturation(SaO2); partial presusre of O2 dissolved in blood(PaO2)
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the law of conservation of mass applied to steady state flow
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total flow = flow V* Cross sectional Area = constant; Vol(in) = A1*V1 = Vol(out) = A2 * V2
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most of blood supply to the heart occurs during ... - duration of which is a critical factor in determining coronary blood flow
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diastole
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... is most potent cerebral vasodilator
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pCO2
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... decreases cerebral vascular resistance leading to increased cerebral perfusion and increased intracranial pressure
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CO2
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pO2 and pCO2 in patients with COPD
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pO2 - decreased; pCO2 -inreased
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... is a muscarinic cholinergic agonist that acts by inducing bronchial smooth muscle contraction and increased bronchial mucous production
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metacholine
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... can be used to induce bronchoconstriction in patients with asthma, thereby allowing demonstration of the disease on spirometry
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methacholine challenge test
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in cardiac pacemaker cells, phase 0 depolarization is mediated by an inward flux of ...
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calcium
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a holosystolic murmur that increases in intensity on inspiration most likely represents ...
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tricuspid regurgitation
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... exerts a permissive effect on many hormones to elp improve the response to a variety of stressors
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cortisol
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cortisol increases vascular and bronchial smooth muscle reactivity to .... and increases glucose release by the liver in response to ...
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catecholamines; glucagon
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opening snap fllowed by a diastolic fumbling murmur that is heard best over the apex of the heart
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mitral valve stenosis
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on the ventricular pressure-volume loop, .... occurs at the point between isovolumic relaxation and diastolic filling
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mitral valve opening
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... and ... reduce the rate of spontaneous depolarization in cardiac pacemaker cells
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acetylcholine and adenosine
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the action potential of pace maker cells includes phases 0,3, and 4; .. consits of spontaneous depolarization and occurs due to the closure of K+ channels, the slow influx of Na+, and the opening of T- and L-type Ca++ channels
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phase 4
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reduction in the slope of the curve depiciting lung volume versus distending pressure indicates decreased ...
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lung compliance
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a chronic .... would increase cardiac output because of increased sympathetic stimulation to the heart, decreased total peripheral resistance, and incresed venous return
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arteriovenous shunt
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occurs in the small muscular pulmonary arteries in order to divert flow away from underventilated regions of the lung toward more weel-ventilated areas
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hypoxic pulmonary vasoconstriction
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... is a common autosomal recessive disease that usually results from a mutation in the CFTR gene on chromosome 7
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cystic fibrosis
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... is a transmembrane ATP-gated chloride channel
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CFTR protein
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in patients with ... compensatory activation of the renin-angiotensin-aldosterone pathway and sympathetic nervous system results in increased afterload, excess fluid retention, and deletorious cardiac remodeling
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heart failure
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Ca++ effu prior to myocyte relaxation is accomplished through the use of ... mechanisms
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Ca++-ATPase and Na+/Ca++ exchange
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in lungs, prefusion greatly increases from the ... to ...; ventilation increaes slightly from the ... to ...; V/Q ration decreases from ... to ...
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from apex to base; from apex to base; from apex to base
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.... causes cerebral vasoconstriction and decreased cerbral blood flow
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hypocapnia
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... are associated with hyperventilation and decreased pCO2
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panic attacks
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.... occurs in otherwise healthy individulas undergoing conditioning in etreme heat and humidity due to thermoregulation failure
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exertional heat stroke
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... is due to inadequate fluid and salt replacement
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heat exhaustion
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suspect .... in an HIV-infected patient with an altered mental status, EBV DNA in the CSF, and a solitary, weakly ring-enhancing periventricular mass on MRI
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primary CNS lymphoma
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.... should be suspected in patients with resting tremor of 4-6 Hz that is asymetric and associated with rigidity
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parkinson's disease
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... is an anticholinergic mediaction sometimes used in the trt of Parkinson's disease, generally in younger patients where tremor is primary symptom
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trihexyphenidyl
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presenting symptom of Parkinson's disease
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resting tremor
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damage to the .... causes contralateral loss of pain and temperature sensation beginning two levels below the level of the lesion
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lateral spinothalamic tracts
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the most common site of hypertensive hemorrhages is ...
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the putamen
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... mainly affects the temporal lobe of the brain and may present acutely(<1 week duration) with focal neurological findings
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herpes simplex encephalitis
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.. characterized by ascending weakness, bulbar symptoms(dysarthria, dysphasia) and respiratory sompromise after antecedent illness such as respiratory of GI infection(especially Campylobacter jejuni)
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Guillain-Barre syndrome
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trt for Guillain-Barre syndrome includes
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IV Ig nad palsmapheresis
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... is recommedned for solitary brain metastasis in patients with good perfomance status and stable etracranial disease
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surgical resection
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trt for patients with multiple metastases
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whole brain radiation trt
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atrophy of caudate nucleus is a characteristic feature of ...
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huntington's diesease
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CSF analysis in patietns with Guillain-Barre syndrome
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elevated protein level with normal cell count(albuminocytologic dissociation)
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acute confusion, extreme hyperthermia >40.5C, tachycardia,and coagulopathic bleeding after heavy work under direct sunlight are most likely due to ...
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exertional heat stroke
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.... are due to microatheroma and lipohyalinosis in small penetrating arteries of the brain; they often affect the internal capsule and result in pure motor dysfunction
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lacunar stroke
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Cushing reflex(hypertension, bradycardia, respiratory depression) is a worrisome finding suggestive of ...
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brainstem compression
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the symptoms of .... include headache, nausea/vomiting, and mental status changes; papilledema and focal neurologic deficits may be seen on examination
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intracranial hypertension
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.... presents with worsening focal back pain, bilateral lower-extremity weakness, sensory loss, and gait ataxia
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neoplastic epidural spinal cord compression
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in the acute phase of spinal ord injury, patients can develop ... with absence of reflexes and flaccid paralysis
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spinal shock
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most common cause of vertigo; triggered by changes in head position, and the diagnosis is confirmed with the Dix-Hallpike meneuver(vertigo nad nystagmus o quickly lying back into a supine position with the head rotated 45 degrees)
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benign paroxysmal positional vertigo
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a lesion in the .... is characterized by unilatral motor waekness of the face, arm, and leg without any higher cortical dysfunction or visual field abnormalities
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posterior limb ofthe internal capsule
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lob ar hemorrahge os more often associated with ...
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amyloid angiopathy
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eyes may deviate toward the side of hemiparesis in patients with ..., helping to differentiate it from other sites of intracranial hemorrhage
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thalamic hemorrhage
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... presents with severe lower back pain with unilateral radiculopathy, saddle anesthesia, hyporefleia, profound asymetric motor weakness, and late-onset bowel nad bladder dysfunction
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cauda equina syndrome
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... presents with severe back pain with a lesser degree of radiculopathy, perianal anesthesia, hyperreflexia, mild bilateral motor weakness, and early-onset bowel and bladder disturbances
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conus medullaris syndrome
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management of cauda equina s./conus medullaris s.
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emergency MRI; IV GCS; neurosurgical evaluation
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... is common among chronic alcohol abusers; symptoms include gait instability, truncal ataxia, difficulty with rapid alternating movements, hypotonia, and intention tremor
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cerebellar dysfunction
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... is commonly associated with burst fracture of the vertebra and is characterized by total loss of motor function below the lvel of lesion with loss of pain and T on both sides below the lesion and with intact proprioception
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anterior cord syndrome
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... is thought to result from decreased CSF absorption or transient increases in intracranialpressure htat cause premanent ventricular enlargement without chronically increasing intracranial pressure
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normal pressure hydrocephalus
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dementia, gait disturbances, and incontinence
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normal pressure hydrocephalus
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trt of choice for myastenia gravis
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oral anticholinesterase
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... is characterized by fluctuating cognitive impairment, recurrent visual hallucinations and motor features of Parkinsonism
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lewy body dementia
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the behavioral variant of .... is differentiated from other dementing illnesses by early personality changes nad compulsive behaviors, earlier age, and strong hereditary component
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frontotemporal dementia
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.... typically presents as a symmetric, distal, sensory neuropathy that spreads in a stocking-glove pattern; common causative agents include platinum-based medications(cisplatin), taxanes(paclitaxel)m and Vinca alkaloids(vincristine)
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chemotherapy-induced peripheral neuropathy
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common causes of unilateral foot drop
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L5 radiculopathy(may also have weak foot inversion and plantar flexion) an compression peroneal neuropathy
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... is the test of choice to support the clinical diagnosis of multiple sclerosis
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MRI
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effective and rapid method used to abort an acute attack of cluster headache
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100% oxygen(trt of choice)
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nontraumatic subarachnoid hemorrhage is most commonly due to ruptured ...
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saccular or berry aneurism
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thiamine deficiency can cause ....
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wernicke's encephalopathy
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... may be induced iatrogenically in susceptible patients by administration of glucose without thiamine
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wernicke's encephalopathy
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chronic thiamine deficiency can cause ..., characterized by irreversible amnesia, confabulation, and apathy
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Korsakoff's syndrome
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... results from rupture of bridging veins
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subdural hematoma
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... results from the rupture of the middle meningeal artery
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epidural heamtoma
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... is characterized by rapidly progressive dementia, myoclonus and sharp, tiphasic, synchronous discharge on EEG
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Creutzfeldt-Jacob disease
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... is a prokinetic agent used to trt nauseam vomiting, and gastroparesis; patients taking this medication should be monitored closely for the development of drug-induced extrapyramidal symptoms
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metoclopramide
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preferable trt for exertional heat stroke
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ice water immersion
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trt for normal pressure hydrocephalus
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large volume lumbar puncture - ventriculoperitoneal shunting
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fatigable muscle weakness that primarily involves the exraocular and bulbar musculature is most consistent with ...
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myasthenia gravis
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approimately 15% of patients with .... have coexisting thymoma, thus,screening CT of the chest is generally recommended
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myasthenia gravis
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... is characterized by an urge to move the legs sn is accompanied by dysesthesias that are worsened by inactivity nad improved with movement
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restless legs syndrome
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trt for restless legs syndrome
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iron supplementation(for iron deficiency); dopamine agonists(eg, pramipexole) or alpha-2-delta Ca channel ligands(gabapentin)
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.... is the most frequent precipitant of Guillain-Barre syndrome
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campylobacter jejuni
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lumbar spinal stenosis is most commonly caused by ...
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degenrative joint disease
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in lumbar spinal stenosis pain is relieved by ...
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flexion of the spine
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