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65 Cards in this Set

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  • Back
A patient on trazodone would have increased sedation, but would not decrease this stage of sleep.
A. Delta sleep
B. REM sleep
C. Stage 1 sleep
D. Stage 2 sleep
E. Stage 3 sleep
F. Stage 4 sleep
Trazodone is a 5-HT reuptake inhibitor that causes an increase in sedation, but does not decrease stage 4 sleep.
A patient who recently increased his level of exercise.
A. Delta sleep
B. REM sleep
C. Stage 1 sleep
D. Stage 2 sleep
E. Stage 3 sleep
F. Stage 4 sleep
Exercise is associated with an increase in delta sleep
what is bruxism and when does it occur
grinding your teeth

stage 2 sleep
Night terrors occur during this stage of sleep.
A. Delta sleep
B. REM sleep
C. Stage 1 sleep
D. Stage 2 sleep
E. Stage 3 sleep
F. Stage 4 sleep
F. Stage 4 sleep
Long-term memory consolidation occurs during this stage of sleep.
A. Delta sleep
B. REM sleep
C. Stage 1 sleep
D. Stage 2 sleep
E. Stage 3 sleep
F. Stage 4 sleep
Sexual arousal occurs during this stage of sleep
A 12-year-old male child with enuresis.
A. Delta sleep
B. REM sleep
C. Stage 1 sleep
D. Stage 2 sleep
E. Stage 3 sleep
F. Stage 4 sleep
Enuresis is known to occur during delta sleep.
what are 2 drugs that can be used to treat fungal vaginitis and what are their MOA?
oral fluconazole

topical miconazole

MOA is same:
inhibition of ergosterol synthesis leading to altered permeability of the cell membrane
why do you have to monitor PT when a pt on warfarin is given an abx?
they can eliminate gut flora that produce vitamin K

so you should decrease the dose of Warfarin
what insulin is the insulin of choice for a pt in diabetic ketoacidosis?
crystalline zinc insulin
mom brings in child who she has raised as a girl. She recent turned 13 and now has enlargment of the clitoris and typical male genitalia along with male musculature. What enzyme was likely deficient?

penis at 12 syndrome

can't convert testosterone to DHT, don't have large response to test until around 12 then they start looking like boys
a false lumen in the aorta=?

presents as?
aortic dissection

sharp tearing pain in the back
what will tear in whiplash
anterior longitudinal ligament
what is Finkelstein's test
test for DeQuervain dz which is a stenosing tenosynovitis of the thumb

pt forlds thumb into palm, close their fingers over their thumb into a fist then ulnar deviate the wrist.
what axis do the following occur about?

flexion/extension: transverse
side-bending: anterior posterior
rotation: vertical
neonate with downs presents at birth w/ cyanosis and systolic regurgitant murmor of tricuspid insufficiency. Electrocardiogram shows superior left axis deviation, a counterclockwise loop, porlongation of PR, and LVH. Diagnosis?
Complete AV canal defet

endocardial cushion defect produces a large hole near the tircuspid and mitral valves in either the atrial septum or ventricular septum or both
what type of leukemia is associated with DIC? what is the translocation?
promyelocytic (M3) leukemia

what nerve could you cut to decrease gastric secretion
diabetic female with fever, headache, ketoacidosis. there is proptosis and swelling of the right eye. Demarcated black discoloration of nasal turbinates. MRI shows filling of the right maxilalry and ethmoid sinuses and anterior displacement of the right eye b an amorphous orbital mass

What are you most likely to see in tissue from a biopsy of a necrotic turbinate?
A. Branching, gram-positive rods
B. Cigar-shaped yeast cells
C. Double-walled spherules
D. Encapsulated, gram-negative rods
E. Nonseptate hyphae

The best explanation for the development of this infection is
A. abnormal NADPH oxidase
B. decreased serum level of a terminal complement component
C. defective neutrophils
D. hypogammaglobulinemia
E. ketoacidosis
E. Rhinocerebral mucormycosis is a rare opportunistic infection caused by fungi of the order Mucorales, which includes Rhizopus oryzae and Mucor species. Rhizopus oryzae and Mucor species are nonseptate, monomorphic fungi. Under the microscope, they can be distinguished because Rhizopus has roots, and Mucor does not. The mold form is seen in culture and in tissue.

E. Rhinocerebral mucormycosis usually occurs in patients with underlying conditions, such as diabetic ketoacidosis, neutropenia, organ transplantation, and immunosuppressive therapy. The standard therapy of mucormycosis consists of high doses of amphotericin B and surgical resection of localized infection. It has an extremely poor prognosis.
What is the mechanism of indirect ME?
Reciprocal inhibition

uses the reflex relaxation of the agonist muscle (the biceps in this patient) when the antagonist muscle (the triceps) is contracted.
What is the activation force for the following:

Facilitated positional release:
compression in cervical region

could be torque in the lumbar region
if you have a rib dysfunction what should you check before tx
thoracic spine
what is the test for occult blood in stool
what drug can do the following and what is its MOA

Reduce triglyceride levels
Reduce Very low density lipoprotein (VLDL) levels
Modest reduction of Low density lipoprotein (LDL) levels
Moderate increase in High density lipoprotein (HDL) levels

activator of Peroxisome proliferator-activated receptor-alpha (PPARα) a nuclear receptor that is involved in metabolism of carbohydrates and fats, as well as adipose tissue differentiation. This increase in the synthesis of lipoprotein lipase thereby increases the clearance of triglycerides.
ejection click is associated with what heart problem
pumonic valve stenosis
clonorchis sinesis is a parasite that causes problems where in the body?
it is a liver fluke that infects the bilary passages
what drug OD is assoc with combativeness, impulsiveness, agitation, ataxia, hyper-salivation, muscle rigidity, paranoia, and psychosis?
pt who is on immunosuppresant meds and gets TB. what do you want to tx her with?
gotta give her the whole 9 yards

Isoniazid, rifampin, pyrazinamie, ethambutol
what vessel supplies blood to the occipitallobe
what is Hidradenitis suppurativa?
staph infection of the apocrine sweat glands

most commonly occurs in the axilla
in tension pnueomothorax which way will the trachea deviate?
away from the injury
what is talipes equinis?

equinis: foot is plantar flexed (toe walking)

calcaneus (foot is dorsiflexed)
infant with uncomplicated pregnancy suddenly starts in respiratory distress after delivery. He has decreased bilateral breath sounds, abdomen is flat, CXR shows shift of mediastinum to the right. Diagnosis?
Diaphragmatic hernia

flat abdomen=scaphoid belly, abdominal contents are in the chest
what structure is embryologically related to the left atrium and can can be a source of ectopic foci leading to atrial flutter
Pulmonary vein
a pt has bronze skin, chest pain, elevated AST and alk phos. CXR shows what?

what metal is high in this? what do you do for tx?
Enlarged heart

Iron (this is hemochromotosis)

this glyocgen storage dz causes hepatomegaly, severe hypoglycemia, hyperlipidemia, and hyperuricemia. What enzyme is deficient?
this is von Gierke

colestipol moa?
Binds bile acids and reduces bile acid reabsorption

can't absorb dietary cholesterol and leads to taking up plasma cholesterol to resynthesize bile acids

side effects: bloating, constipation, malabsorption of other drugs)
where do sperm acquire motility?
Laboratory analysis shows a blood glucose of 300 mg/dL. The activity of which of the following is typically decreased in untreated cases of type 1 DM?
A. A kidney tubule amino acid transport system
B. Branched-chain alpha-ketoacid dehydrogenase
C. Hormone-sensitive lipase
D. Lipoprotein lipase
E. Phosphoenolpyruvate-carboxykinase
D. Lipoprotein lipase

n such a catabolic state, anabolic enzymes will be functioning at lower than normal levels of activity. Lipoprotein lipase is one such anabolic enzyme that is positively regulated by insulin. It resides on capillary walls, in particularly high concentrations on the capillaries of the adipocytes, and in cardiac and skeletal muscles. Normally, it functions to degrade triacylglycerols that are part of the circulating chylomicrons and very low density lipoprotein (VLDL). This releases unesterified fatty acids and glycerol. The fatty acids can be taken up by muscle for fuel or stored in the adipocytes as fat. Due to the low activity of this enzyme in type 1 diabetes, there is an accumulation of chylomicrons and VLDL in the blood, resulting in hypertriglyceridemia. Moreover, these lipids are not available to be used as fuel or to be stored in the adipocytes, resulting in weight loss
Typically in untreated cases of type 1 DM, the reaction catalyzed by which one of the following enzymes will proceed at a faster than normal rate?
A. Glucokinase
B. 3-hydroxy-3-methylglutaryl CoA (HMG CoA) synthase
C. Muscle glucose 6-phosphatase
D. Muscle hexokinase
E. Phospholipase A2
3-hydroxy-3-methylglutaryl CoA (HMG CoA) synthase

the mitochondrial isozyme of HMG CoA synthase is the rate-limiting step in ketone body formation
a horizontally flexed clavicle will be restricted in what motion?

thus it prefers to be posterior
where is the chemoreceptive trigger zone for vomiting located anatomically?
area postrema of floor of fourth ventricle
list what dz process is assoc with the following heart sounds:

diastolic murmur:
midsystolic click:
fourth heart sound:
third heart sound:
systolic ejection murmur:
wide split S2:
diastolic murmur: aortic regugitation

midsystolic click: mitral valve prolapse

fourth heart sound: chronic hypertension

third heart sound: heart failure

systolic ejection murmur: mitral regurgitation

wide split S2: pulmonary stenosis
what is metrorrhagia?

what is menometrorrhagia?
uterine bleeding, usually of normal amount, occurring at completely irregular intervals. The period of flow is sometimes prolonged.

menometrorrhagia: excessive uterine bleeding occurring both during the menses and at irregular intervals.
where does fetal erythropoiesis occur at 3-8 weeks?



3-8: yolk sac

6-30: liver

9-28: spleen

28-adult: bone marrow
what structure in the brain is damaged in Korsakoff syndrome?
AIDs pt with lymphoma will have nucleic acid from what virus
newborn with difficulty swallowing. What cranial bone would you see dysfunction at?

Where does the associated nerve exit the skull

hypoglossal canal (CN XII)
pt with posterior column defect, what clinical test would confirm the diagnosis

examination shows you need to have vision, proprioception and sensation to stand. You have them close their eyes, knocking out vision. So if they don't have proprioception and sensation which will be messed up in a posterior column deficit, they will fail
what is the difference btw classic and common migraine
Classic: has an aura

common: doesn't and is more common
mom was an IV drug user in 3rd trimester. kids comes out and at one month has jaundice, lethargy, and failure to thrive
Hep B
extensive bowel surgery + steatorrhea
short bowel syndrome
where are the tenderpoints for inhalation and exhalation ribs located
Inhalation: Angle

Exhalation: mid axillary
which coagulation factor will be decreased in a pt with von Willebrand dz?
factor VIII.

The concurrent deficiency in factor VIII is due to the fact that the vWF serves as a plasma carrier for factor VIII
furgusson angle is btw 25-30. What does it mean if it is less? Greater?
Less: lumbosacral strain

more: lumbosacral instability
2-6 yo with high direct bilirubin
Congenital biliary atresia
DOC for PTSD with trouble sleeping

causes less insomnia than fluoxetine
what do statins, niacin, and fibrates do respectively
Statin: decrease LDL

Niacin: increase HDL

fibrates: decrease TGs
what type of follicle is the first to have an antrum
secondary follicle
secreted by S cells Its secretion is stimulated by acid entering the duodenum, which inhibits stomach motility and causes secretion of bicarbonate ion from the pancreas.
On osteopathic examination, a patient is found to have an increased parasympathetic tone, which stimulates the release of an inhibitory parasympathetic hormone.

what is an inhibitory parasympathetic transmitter that causes decreased contraction of sphincters.
Vasoactive intestinal polypeptide (VIP)
what determines if a pt has pulmonary edema (what pressure)
A. Cestode
B. Leishmania
C. Nematode
D. Trematode
E. Trypanosome

describe what each is
The correct answer is D. This patient with squamous cell (rather than the more usual transitional cell) carcinoma of the bladder was most likely infected by the blood trematode (fluke) Schistosoma haematobium, which has a predilection for living in bladder veins. The body often reacts to the organism with inflammation and fibrosis of the bladder wall and squamous metaplasia (from which a squamous cell carcinoma can arise) of the bladder mucosa.

The cestodes (choice A) are (often intestinal) tapeworms, such as Taenia and Echinococcus.

The leishmania (choice B) are amastigote hemoflagellates that cause cutaneous and mucocutaneous leishmaniasis.

The nematodes (choice C) are (often intestinal) roundworms, such as Ascaris and Enterobius.

The trypanosomes (choice E) are hemoflagellates that cause African sleeping sickness and Chagas disease.
where is the most common location for ischemic colitis
Splenic flexture

where the superior mesenteric a ends and the inferior starts--aka a watershed region
what is still disease
variant of RA with prominent systemic sx, negative RF and NA

causes fever of unknown illness, joint pain, fatigue and sore throat