Post-Comsae

Front 1

Cluster A personality disorders

Back 1

paranoid

schizoid

schizotypal

- more likely with first degree relative

- more likely to develop schizophrenia

Front 2

Frozen Shoulder/Adhesive Capsulitis

Back 2

Follows Trauma, Joint immobilization, Hypothyroidism; typically an insult resulting in inflammtion

Front 3

Loss of Eversion and dosiflexion of the foot

Back 3

Common Peroneal (fibular) nerve

- Can be damaged with posterior fibular head

- Waddling gait, swing-out, steppage gait

- dropPED: Peroneal Everts and Dorsiflexes

Front 4

Loss of inversion and plantar flexion

Back 4

Tibial nerve

Front 5

Pityriasis rosea

Back 5

Exanthematous eruption

Primary lesion = herald patch: oval slightly raised 2-5 cm plaque with peripheral scaly appearance

Secondary lesion = Christmas tree pattern 1-2 weeks later

- supportive tx

- HHV 6,7

Front 6

Increases Digoxin Toxicity

Back 6

- Quinidine decreases renal clearance; Lidocain can be utilized for treatment of dysrhythmias caused by digoxin toxicity

- Hypomagnesium, Hypercalcemia, Hyper/Hypokalemia increases digoxin toxicity

(Hypokalemia enhances probability of digoxin binding which will enhance toxicity possibility

Front 7

Somatostatinoma:

which cells

syndrome

what enzyme is most effected by decreased gastrin

Back 7

- Delta cell tumor

- Syndrome: DM, Cholelithiasis, Steatorrhea, Hypochlorphydria dt decreased gastrin

- Pepsin is most effected since gastrin secreted from G cells hits Parietal. Release H. Acidity is needed for pepsinogen to change to pepsin

Front 8

what causes telangiectasia?

Back 8

Chronic liver diseases causes excess estrogen dt the livers inability to properly metabolize it.

- Gynecomastia is also a manifestation

Front 9

Retrograde vs Anterograde amnesia

Back 9

- Retrograde: can't remember stuff right before the amnesia but CAN make new memories

Can regain memory

- Anterograde: loss of the ability to make new memories, leading to a partial or complete inability to recall the recent past; long term memories are still intact

CANNOT regain memory for the ones that were not encoded properly

Front 10

MC ankle ligament tear

Back 10

- Anterior talofibular ligament

- Calcaneofibular ligament

- Posterior talofibular ligament

ATF - Always Tears First

Front 11

effects of OC on breast, ovarian, endometrial cancer

Back 11

- increase breast

- decrease endometrial

- decrease ovarian

- potentially slight increase in cervical cancer

Front 12

Lab studies found in polymyositis

Back 12

elevated creatine kinase, lactate dehydrogenase, aldolase

- Anti-Jo-1 antibodies

Front 13

PUD Benign ulcer on endoscopy

Back 13

- smooth, flat erosion filled with exudate seen on endoscopy; regular rounded edges with a smooth ulcer base filled with exudate

Front 14

PUD treatment

Back 14

H. pylori:

- PPI to reduce gastric acid secretion by inhibiting the HKATP pump in parietal cells

- clarithromycin, Amoxicillin antibiotic

Front 15

Anxietolytic that decreases risk of dependence

Back 15

Buspirone - no sedation, CNS depression, dependence

- good for those with alcoholism and substance abuse

- binds serotonin and dopamine D2 receptors

Front 16

increased CRI

Back 16

Systemic fever, strenuous exercise, OMT

Front 17

Decreases CRI

Back 17

Depression, Chronic fatigue, Chronic infection

Front 18

Crush Syndrome

Back 18

Elevated creatine kinase, myoglobin, phosphate

- myoglobin causes AKI dt ATN

- Hypovolemic shock, hyperkalemia, HF, Arrhythmia, ARD, sepsis, DIC

Front 19

Drug administered for hyperkalemia in a crush patient

Back 19

Calcium gluconate - cardioprotective; doesn't directly effect potassium levels

Front 20

Serotonin Syndrome Symptoms

Back 20

Hyperthermia

Confusion

Myoclonus

CV instability

Flushing

Diarrhea

Seizures

Front 21

Treatment for Serotonin Syndrome

Back 21

Cyproheptadine (5-HT2 Receptor Antagonist)

Front 22

Tricyclic Antidepressant OD

Back 22

Cardiotoxicity

CNS Toxicity

AntiCholinergic Sx

Front 23

Tricyclic Antidepressant OD Treatment

Back 23

Sodium Bicarbonate - raises the pH and makes more drug protein bound and thus less likely to cause problems

Front 24

Tyramine

- what breaks it down

- what is released dt tyramine

Back 24

- Tyramine causes release of Norepi from nerve terminals

- MAO is normally found in the but and therefore breaks down tyramine; thus inactivating and metabolizing catecholamines

Front 25

Metolazone

Back 25

Thiazide

Front 26

Chlorthalidone

Back 26

Thiazide

Front 27

Bumetanide

Back 27

Loop

Front 28

Top Treatments for HTN

Back 28

Thiazide

ACEinhibitor

ARB

Calcium Channel Blocker

Front 29

Increases CHF survival

Back 29

Beta Blocker

ACEinhibitor

ARB

Aldosterone Antagonist

Front 30

Pollagra

Back 30

Diarrhea

Dermatitis

Disturbances

Niacin deficiency, Nicotinic Acid

Front 31

Gene mutation in Autosomal Recessive Polycystic Kidney Disease

Back 31

PKHD1 - the gene for fibrocystin

* Fibrocystin is found on epithelail cells of renal tubules and bile ducts

* Autosomal Recessive or spontaneous

Front 32

Complication of a newborn with ARPKD

Back 32

Respiratory Distress

Oligohydramnios

Reduced amniotic fluid leads to Potter Syndrome

Front 33

Potter syndrome

Back 33

Flattened Facies, Limb deformities, Pulmonary hypoplasia dt fetal compression

- Due to Oligohydramnios

- PKD, No ureteric bud formation, bilateral renal agenesis, obstructive uropathy causes the oligohydramnios

- cause of death: pulmonary hypoplasia

Front 34

Complication with Autosomal Dominant PKD

Back 34

Cerebral aneurysm - not associated with the recessive!

Front 35

Red ragged fibers

Back 35

Gomori trichome stain of a muscle biopsy of muscle fibers with a blotchy red appearance

- Mitochondrial inheretance

- EM: Increased number of enlarged, abnormally shaped mitochondria

Front 36

Mitochondrial Myopathies

Back 36

- myoclonic epilepsy with ragged red fibers

- Leber optic neuropathy (blindness)

- Mitochondrial encephalopathy with stroke like episodes and lactic acidosis

Front 37

Palpable purpura

Back 37

Henoch-Schonlein Purpura

Front 38

Triad in Henoch-schonlein purpura

Back 38

Palpable purpura on but and legs

Arthralgias

GI: Abdominal pain

Vasculitis secondary to IgA Immune complex deposition (Type III)

- Follows URI

- MC childhood vasculitis

- Mechanism: circulating immune complexes

Front 39

majority of OD in the USA

Back 39

Opioids

( Benzos cause less respiratory distress)

Front 40

Blood supply to the femoral head which will lead to avascular necrosis

Back 40

Ascending Cervical and Retinacular branches of Medial Circumflex artery

- Medial and Lateral Circumflex come from the Deep Femoral Artery, but the DFA is more hidden

- Lateral Circumflex provides only a small amount

Front 41

Where is ADH synthesized

Back 41

Paraventricular and Supraoptic Nuclei of the Hypothalamus; Transported to the POSTERIOR pituitary for storage

Front 42

pH >5.5 (unexpected)

Hypokalemia

Kidney stones

Back 42

Type I RTA

Front 43

Type I RTA

Back 43

pH >5.5 (unexpected)

Hypokalemia

Kidney stones

Defect in alpha intercalated cells to secrete H

Metabolic Acidosis

Dt: Amphotericin B toxicity, analgesic nephropathy, congenital anomalies

Front 44

Urine pH < 5.5

Hypokalemia

Back 44

Type 2 RTA

Front 45

Type 2 RTA

- Defect:

- Causes:

Back 45

Urine pH < 5.5

Hypokalemia

- Defect in PCT HCO3 reabsorption

- Fanconi Syndrome, Carbonic Anhydrase Inhibitors

Front 46

Urine pH <5.5

Hyperkalemia

Back 46

Type 4 RTA

Front 47

Type 4 RTA

Defect:

Causes:

Back 47

Urine pH <5.5

Hyperkalemia

- Decreased aldosterone production

- Cause: diabetic hyporeninism, ACE inhibitors, ARB, NSAIDS, Heparin, Cyclosporine, Adrenal insufficiency or aldosterone reisstence

Front 48

Causes of Metabolic Acidosis with Increased Anion Gap

Back 48

M - Methanol

U - Uremia

D - DKA

P - Propylene glycol

I - Iron tablets, Isoniazid

L - Lactic acidosis

E - Ethylene Glycol

S - Salycilates (late)

*** Adding Acid

Front 49

Causes of Metabolic Acidosis with Normal Anion Gap

Back 49

HARD ASS

Hyperalimentation

Addison Disease

RTA

Diarrhea

Acetazolamide

Spironolactone

Saline Infusion

Front 50

Shifts K out of Cells = Hyperkalemia

Back 50

- Cell Lysis

- Low Insulin (High blood sugar)

- Beta Blockers

- Acidosis

- Digoxin

Front 51

Shifts K into cells = Hypokalemia

Back 51

- Insulin (INto Cells)

- Beta AGONIST

- Alkylosis

- Cell Creation/Cancer

Front 52

Electrolyte: that decreases DTRs, lethargy, bradycardia, hypotension, Cardiac arest, Hypocalcemia

Back 52

Increased Mg

Front 53

Electrolyte: causes tetany

Back 53

Decreased Ca, Mg

Front 54

What is elevated and decreased in Poststrep GN?

Back 54

Elevated Antistrptolysin O for just strep pharyngitis, not impetego.

- Elevated Anti-DNAse B for BOTH

- Decreased Complement (C3) levels

Front 55

Mutation on Chromosome 17

Back 55

NF-1 - tumor suppressor gene that causes neurofibromatomas

Front 56

Mutation on Chromosome 3p

Back 56

VHL gene

Front 57

Mutation on Chromosome 13 that's a tumor supporesor

Back 57

RB - lead to retinoblastoma and osteosarcoma

Front 58

Mutation on Chromosome 11 Tumor suppressor

Back 58

WT-1: Wilm's Tumor

Front 59

What does the ureteric bud give rise to?

Back 59

Collecting system of the kidney: Collecting tubules, ducts, major and minor calyces, renal pelvis and ureters

Front 60

What does the metaneprhic mesoderm (blastema) give rise to?

Back 60

Glomeruli, Bowman's space, proximal tubules, loop of henle, Distal convoluted Tubule

Front 61

3 rate limiting enzymes of Glycolysis

Back 61

Hexokinase/Glucokinase

Phosphofructokinase-1

Pyruvate Kinase

Front 62

Rate Limiting for De Novo Pyrimidine synthesis

Back 62

carbamoyl phosphate syntheatase-2

Front 63

Rate Limiting de novo purine synthesis

Back 63

Glutamine PRPP amidotransferase

Front 64

Rate limiting Glycolysis

Back 64

PFK-1 (Phosphofructokinase-1)

Front 65

Rate Limiting Gluconeogenesis

Back 65

Fructose-1,6-Bisphosphatase

Front 66

Rate limiting Glycogen Synthesis

Back 66

Glycogen Synthase

Front 67

Rate limiting Glycogenolysis

Back 67

Glycogen Phosphorylase

Front 68

Rate Limiting TCA Cycle

Back 68

Isocitrate Dehydrogenase

Front 69

Rate Limiting Hexose Monophosphate Shunt

Back 69

Glucose-6-Phosphate Dehydrogenase

Front 70

Retroperotoneal Organs

Back 70

A DUCK PAIR

A - Aorta and IVC

D - Duodenum (2-4)

U - Ureters

C - Colon (ascending, descending)

K - Kidneys

P - Pancrease (head, not tail)

E - Esophagus (thoracic past diaphragm)

A - Adrenals

R - Rectum

Front 71

Enzymes for Gluconeogenesis

Back 71

Glucose-6-Phosphatase

Fructose 1,6 bisphosphatase

Pyruvate carboxylase + BIotin

PEP carboxykinase

Front 72

What are the two main nitrogen transporters in the blood?

Back 72

alanine and glutamine

Front 73

What are teh major regulatory enzymes of the TCA?

Back 73

Citrate Synthase

Isocitrate Dehydrogenase (rate limiting)
alpha-Ketoglutarate dehydrogenase (highly regulated)

Front 74

What is the landmark for the pudendal nerve block?

Back 74

Palpate the Ischial Spine

Front 75

Uncoupling agents:

Back 75

increase permeability of the inner mitochondrial membrane and decrease the proton gradient thus produce heat

- 2,4 Dinitrophenol (used for weight loss)

- Aspirin OD

- Termogenin in brown fat (hibernation)

Front 76

Position of ease for nursemaid elbow

Back 76

Flexion of elbow, Adduction, and pronation

Front 77

Mechanism of injury during nusemaid elbow?

Back 77

Longitudinal traction on a pronated, extended elbow

Front 78

Treatment position for nursemaid elbow

Back 78

Flex elbow to 160 and supinate

Front 79

H2S positive, Black colonies on Hektoen Agar

Back 79

Salmonella typhi

Front 80

Green colonies on Hektoin Agar

No Hydrogen Sulfide

Back 80

Shigella

Front 81

Contaminated Peanut Butter

Back 81

Salmonella

Front 82

q

Back 82

q