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26 Cards in this Set
- Front
- Back
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What are the findings of Brown-Sequard syndrome?
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Hemisection of the spinal cord.
Findings: 1. Ipsilateral UMN signs below lesion (corticospinal tract) 2. Ipsilateral loss of tactile, vibration, proprioception sense below lesion (dorsal column) 3. Contralateral pain and temperature loss below the lesion (spinothalamic tract) 4. Ipsilateral loss of all sensation at he level of the lesion 5. LMN signs at level of lesion (flaccid paralysis) If lesion above T1, called Horner's syndrome |
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What syndrome is associated with temporal arteritis?
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Ass: polymyalgia rheumatica
Focal granulomatous inflammation Epi: elderly females Sx: unilateral headache, jaw claudication, impaired vision-may lead to irreversable blindness Findings: increased ESR Tx: high dose steroids Affects medium and large arteries |
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What is the typical presentation of a patient with pancreatic insufficiency?
What is the treatment for pancreatic insufficiency? |
Causes: CF, obstructing cancer, chronic pancreatitis
Problems: malabsorption of fat, Vit ADEK Tx: supplement with enzymes? |
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Which conditions are associated with oligohydramnios, and which are associated with polyhydramnios?
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Oligohydramnios: less than 0.5 L amniotic fluid
Associations: placental insufficiency, bilateral renal agenesis, posterior urethral valves Leads to Potter's syndrome Polyhydramnios: more than 1.5-2 L amniotic fluid Associations: esophageal/duodenal atresia causing inability to swallow amniotic fluid, anencephaly |
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What is Potter’s syndrome?
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Bilateral renal agenesis leading to oligohydramnios which causes limb deformities, facial deformitis, and pulmonary hypoplasia. Caused by malformation of the ureteric bud
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In which lysosomal storage disease do you see a cherry red spot on the retina?
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Niemann-Pick disease
Sx: progressive neurodegeneration, hepatosplenomegaly, foam cells Deficient enzyme: sphingomyelinase Inh: AR Also Tay-Sach's disease |
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In which lysosomal storage disease do you see corneal clouding and mental retardation?
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Hurler's syndrome
Sx: gargoylism, airway obstruction, corneal clouding, mental retardation, hepatosplenomegaly Deficient enzyme: alpha-L-iduronidase Inh: AR |
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In which lysosomal storage disease do you see sphingomyelin buildup?
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Niemann-Pick disease
Sx: progressive neurodegeneration, hepatosplenomegaly, foam cells Deficient enzyme: sphingomyelinase Inh: AR |
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In which lysosomal storage disease do you see accumulation of galactocerebroside in the brain?
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Krabbe disease
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In which lysosomal storage disease do you seeaccumulation of glucocerebroside in the brain?
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Gaucher's disease
Sx: hepatosplenomegaly, aseptic necrosis of femor, bone crises, Gaucher's cells (crinkled paper) Deficient enzyme:sphingomyelinase Inh: AR |
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In which lysosomal storage disease do you see no corneal clouding but you do see mental retardation?
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Hunter's syndrome
Sx: mild hurler's with aggressive behavior but no corneal clouding Deficient enzyme: iduronate sulfatase Inheritence: XR |
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In which lysosomal storage disease do you find demyelination affecting peripheral nerves?
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Krabbe's disease
Sx: peripheral neuropathy, developmental delay, optic atrophy, globoid cells Deficient enzyme: galactocerebrosidase Also in metachromatic leukodystrophy (periph and central) |
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In which lysosomal storage disease do you see crinkled paper cytoplasms?
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Gaucher's disease (most common)
Sx: hepatosplenomegaly, aseptic necrosis of femor, bone crises, Gaucher's cells (crinkled paper) Deficient enzyme:sphingomyelinase Inh: AR |
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What are the risk factors for osteosarcoma?
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Risk Factors: Paget's disease of the bone, bone infarcts, radiation, familial retinoblasoma
2nd most common primary malignant tumor of bone (multiple myeloma first) Epi: Men 10-120 yo Poor prognosis See sunburst patter on x-ray |
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What diagnostic test allows you to distinguish between primary hyperaldosteronism (Conn’s syndrome) and secondary hyperaldosteronism?
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Conn's has a low plasma renin while secondary has high plasma renin.
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What is the mechanism of action of propylthiouracil? What are its side effects?
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Mech: inhibit organification of iodide and coupling of thyroid hormone synthesis
It also decreases peripheral conversion of T4 to T3 Use: hyperthyroidism Tox: skin rash, agranulocytosis, aplastic anemia |
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What are the possible causes of SIADH? What cancer is known for causing SIADH?
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Causes: ectopic ADH (small cell lung cancer), CNS disorder/trauma, pulmonary disease, drugs (cyclophosphamide)
Sx: water retention, hyponatremia, urine osmolarity>serum osmolarity Very low sodium can lead to seizures, but must be corrected slowly Tx: demeclocycline or water restriction |
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Which branchial arch should make you consider your M’s and T’s?
What structures are derived from this arch? |
1st brachial arch
Cartilage: Meckel's cartilage-mandible, malleus, incus, madibular ligament Muscles: muscles of mastication, mylohyoid, others Nerves: V2 and V3 Arteries: maxillary artery (of external carotid) Abnormalities: Treacher Collins syndrome-1st artch neural creast fails to migrate causing mandibular hypoplasia and facial abnormalities |
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What is the most common precursor of choriocarcinoma?
What are the buzzwords for the gross appearance of this? |
Hydatiform mole
Cystic swelling of chorionic villi and proliferation of chorionic epithelium which presents with abnormal vaginal bleeding. Increased beta-hCG Cluster of grapes appearance with abnormally enlarged uterus Complete moles classically have a "snowstorm" appearance with no fetus during the first sonogram Tx: dilatation and curettage and methotrexate |
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What are the layers of the epidermis beginning with the most superficial layer?
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Surface to base:
Stratum Corneum Stratum Lucidum Stratum Granulosum Stratum Spinosum Stratum Basalis Californians Like Girls in String Bikinis |
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Which vitamin is a constituent of visual pigments?
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Vitamin A
Excess: arthralgias, fatigue, headaches, skin changes, sore throat, alopecia, teratogenic (cleft palate, cardiac abnormalities) Deficiency: night blindness, dry skin Found in liver and leafy vegetables |
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Which vitamin is a constituent of NAD?
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Vitamin B3=Niacin
Derived from tryptophan and synthesis requires B6 Deficiency: pellagra (which can be caused by Hartnup disease (decreased tryptophan abs), malignant carcinoid syndrome (increased trypto metabolism), and INH (decreased B6) Excess: facial flushing Clinical use: treat hyperlipidemia |
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Which vitamin is a constituent of FADH2 and FMN?
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Vitamin B2=riboflavin
Deficiency: cheilosis, corneal vascularization |
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Which vitamin is a constituent of CoA?
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Vitamin B5=pantothenate
Deficiency: dermatits, enteritis, alopecia, adrenal insufficiency |
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Compare the mechanisms of action of methotrexate, 5-fluorouracil, and cyclophosphamide.
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Methotrexate mech:folic acid analog that inhibits dihydrofolate reducates leading to decreased dTMP and decreased DNA and protein synthesis
5-Fluorouracil mech: pyrimidine analog bioactivated to 5F-dUMP which covalently binds folic acid and the complex inhibits thymidylate synthase Cyclophosphamide mech: covalently x-linked interstrand DNA at guanine N-7. Has to be bioactivated by the liver |
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Explain the development of the thyroid gland.
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Thyroid diverticulum arises from the floor of the primitive pharynx and descends into the neck. It is originally connected to the thongue by the thyroglossal duct which should disappear. The foramen cecum is the remnant of the duct
The most common ectopic thyroid tissue site is the tongue |
