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120 Cards in this Set

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