Vol. 2 Flashcards

1
Q

Mesolimbic action of DA antagonists

A

antipsychotic effect

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2
Q

DA effect on prolactin

A

Blocks prolactin

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3
Q

Anterior Mediastinal Masses

A

4 T’s: Thymoma, Teratoma, Thyroid Neoplasm, Terrible Lymphoma

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4
Q

Seminoma Beta-hCG and AFP

A

AFP always nl

beta-hCG elevated in 1/3

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5
Q

What are the nonseminomatous GCTs

A

Yolk sac tumor
Choriocarcioma
Embryonal Carcinoma
Mixed GCT (Teratoma)

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6
Q

Nonseminomatous GCTs AFP and hCG

A

AFP elevated

hCG elevated

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7
Q

Kawasaki dz sxs

A
>5d fever
b/l nonexudative conjunctivitis (limbal sparing)
mucositis
cervical LAD
Rash
Extremity skin changes
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8
Q

Kawaski dz labs

A

Elev. CRP and ESR, leukocytosis with neutrophilia, sterile pyuria

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9
Q

Baby with inspissated meconium test

A

Sweat chloride testing

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10
Q

Trich discharge appearance

A

yellow-green, frothy, foul

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11
Q

Addison’s sxs

A

fatigue, hyperpigmentation, low BP, low Na, high K, eosinophilia

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12
Q

Addison tests

A

early morning cortisol, ACTH, cosyntropin test

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13
Q

Cosyntropin test is what

A

ACTH analog, test for cortisol rise within an hour

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14
Q

Tests for Cushing’s dz

A

24 hr free cortisol and low dose dexamethasone suppression test

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15
Q

Hazard ratio

A

Ratio of event rate occuring in tx group compared to event rate in the non-tx group

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16
Q

Intention-to-Treat

A

Compares initial randomized group regardless of eventual tx

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17
Q

Lead-time bias

A

Diagnosing dz earlier so survival looks artificially prolonged

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18
Q

Osteomyelitis appearance

A

Central lytic bone defect with surrounding sclerosis (Brodie’s abscess)
Commonly confused with Ewing’s

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19
Q

Ewing’s sarcoma location

A

metaphysis and diaphysis of femur (#1), then tibia and humerus

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20
Q

Ewing’s sarcoma mets to

A

lung and lymph

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21
Q

Ewing’s sarcoma age and gender

A

White males 1st/2nd decade

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22
Q

Ewing’s sarcoma sxs

A

Pain, swelling, erythema, warmth, fevers, leukocytosis, anemia, ESR

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23
Q

Ewing’s sarcoma appearance

A

Lamellated appearance and onion skin periosteal rxn. Endosteal scalloping.
“Onion skinning”
“Moth-eaten” is the worst

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24
Q

Ewing’s sarcoma tx

A

Surgery, rads, and multi drug chemo

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25
Q

3 major mechanical complications of MI

A

Papillary muscle rupture, LV free wall rupture, IV septum rupture

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26
Q

Meconium ileus where

A

Ileum

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27
Q

pH of candida

A

nl pH (3.8-4.2)

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28
Q

Bacterial vaginosis pH

A

pH>4.5 (bad)

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29
Q

Trich pH

A

pH>4.5 (bad)

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30
Q

Causes of PEA

A

5 H’s and T’s

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31
Q

5 H’s and T’s

A

Hyper/hypoK, hypoxia, hypovolemia, H+ ions, hypothermia

Tension ptx, tamponade (cardiac), toxins (narcs, benzos), thrombosis (pulm. or coronary), trauma

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32
Q

beta-thal Hb electrophoresis

A

inc. HbA2 (more alpha chains)

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33
Q

alpha-thal Hb electrophoresis

A

nl Hb

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34
Q

RDW

A

nl in thal, elevated in iron def.

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35
Q

Disseminated Mycobacterium Avium Complex sxs

A

Fever, cough, abd. pain, diarrhea, night sweats, weight loss

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36
Q

Lead poisoning acute findings

A

Basophilic stippling, arthralgias, neurologic, abd. pain, constipation

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37
Q

Lead poisoning chronic findings

A

Same as acute + fatigue, insominia, htn, NEPHROPATHY, reproductive problems, microcytic anemia

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38
Q

Didanosine side effect

A

Pancreatitis

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39
Q

Abacavir toxic

A

related hypersensitivity syndrome

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40
Q

Any NRTIs toxicity

A

lactic acidosis

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41
Q

Any NNRTIs toxicity

A

SJS

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42
Q

Nervirapine toxicity

A

Liver Failure

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43
Q

Indinavir toxicity

A

Induced nephropathy

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44
Q

Cavernous sinus thrombosis sxs

A

HA and b/l periorbital edema, CN III, IV, V, and VI deficits

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45
Q

OSA gold std. dx

A

nocturnal polysomnography

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46
Q

How to control confounding

A

Matching: make both groups have the same number of confounding pts

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47
Q

Fluphenazine effect on body temp.

A

Can cause hypothermia by decreasing shivering

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48
Q

When to give Yellow fever vaccine

A

Sub-Saharan Africa and equatorial S. America

49
Q

Syphilis tx for preggers

A

Desensitize to Penicillin then ues

50
Q

Syphilis txs

A

Penicillin, if allergic, doxycycline for 14 d

51
Q

Beck’s Triad

A

Tamponade: Hypotension, Distended Neck Veins, Muffled Heart Sounds

52
Q

Normal osmolarity

A

290 mOsm/kg

53
Q

How to tx SIADH with sodium

A

Don’t use NS, they’ll hold the water and get rid of Na, must use hypertonic

54
Q

Lithium effects on pregnancy

A

Ebstein anomaly, CV malformation, septal defects

55
Q

Compartment syndrome pressure

A

> 30 mmHg

56
Q

Limbs get ischemia-perfusion injury at what point?

A

4-6 hrs

57
Q

Autism on MRI

A

inc. total brain volume

58
Q

OCD on MRI

A

orbitofrontal and striatum changes

59
Q

Panic disorder on MRI

A

dec. amygdala vol.

60
Q

PTSD on MRI

A

dec. hippocampus volume

61
Q

Schizophrenia

A

Inc. cerebral ventricles

62
Q

FSH or LH levels higher?

A

FSH, longer half life

63
Q

Premature Ovarian Failure dx

A

FSH elevation in s/o >3 mo amenorrhea in women

64
Q

Chronic liver dz and Tdap

A

Give Tdap once instead of Td, then Td q10yrs afterwards

65
Q

Chronic liver dz and pneumococcal vaccine

A

PPSV23 for younger pts

66
Q

Erythema multiforme and Nikolsky sign

A

Negative, like impetigo

67
Q

When to electrically cardiovert trachyarrthmia

A

When hemodynamic instability

68
Q

Type 2 heparin-induced thrombocytopenia heparin exposure length

A

heparin exposure >5 d

69
Q

Type 2 heparin-induced thrombocytopenia clotting

A

plts down, but prothrombotic

70
Q

Type 2 heparin-induced thrombocytopenia tx

A

direct thrombin inhibitors (argatroban, bivalirudin) or fondparinux

71
Q

Type 2 heparin-induced thrombocytopenia dx

A

Serotonin release assay

72
Q

Multiple Myeloma sxs

A

Lytic bone lesions, Marrow plasmacytosis, Urine and serum monocolonal proteins, Renal failure, hyperCa, hyperviscosity

73
Q

Botulism sources

A

Environmental dust and raw honey, California, Pennsylvania, Utah

74
Q

Botulism presentation

A

Descending flaccid paralysis

75
Q

Neonatal polycythemia labs

A

Hct>65%

76
Q

Neonatal polycythemia etiology

A

Mat DM, HTN, smoking, IUGR, delayed cord clamping

77
Q

Neonatal polycythemia scs

A

resp. distress, cyanosis, hypoglycemia

78
Q

Acute rheumatic fever cause

A

Group A Strep (strep pyo)

79
Q

Major for Rheumatic Fever

A

JONES criteria (Joints, Carditis, Subq Nodules, Erythema marginatum, Syndenham’s chorea)

80
Q

Renal changes in pregnancy

A

GFR inc. and BUN and Cr dec.

81
Q

best way to trend liver failure

A

PT

82
Q

Human monocytic Ehrlichosis labs

A

Leukopenia and Thrombocytopenia, inc. LDH and liver enzymes

83
Q

Human monocytic Ehrlichosis sxs

A

RMSF without the spots

84
Q

Human monocytic Ehrlichosis tx

A

Doxy

85
Q

Riluzole tx

A

Glutamate inhibitor for ALS

86
Q

Clomiphene use

A

Estorgen antagonists increases FSH and GnRH release

87
Q

Prolactin and GnRH

A

prolactin blocks GnRH

88
Q

Toxo in AIDS imaging

A

multiple ring enhancing lesions in brain CT

89
Q

Toxo in AIDS ppx

A

bactrim

90
Q

Toxo in AIDS tx

A

Sulfadiazine and pyrimethamine diagnostic and therapeutic

91
Q

Behcet’s dz sxs

A

Mouth ulcers and genital ulcers and eye inflamm.

92
Q

Behcet’s dz tx

A

Steroids

93
Q

Non-alcoholic fatty liver disease histo

A

Macrovesicular Fat deposition and Peripheral nucleus, looks like AFLD

94
Q

Quadruple screen timing

A

15-20 weeks (second trimester)

95
Q

Second trimester wks

A

wk 13-27

96
Q

Trisomy 18 Quadruple screen

A

Everything down except nl Inhibin A (so AFP, hCG, and estriol down)

97
Q

Trisomy 21 Quadruple screen

A

Inhibin A and hCG inc. and AFP and estriol dec.

98
Q

NTD/abd. wall defect Quadruple screen

A

everything nl except AFP which is inc.

99
Q

UTI abx contraindicated

A

Tetracyclines, fluoroquinolones, bactrim

100
Q

Bruton’s agammaglobulinemia defect

A

tyrosine kinase defect in B cells

101
Q

Bruton’s agammaglobulinemia sxs

A

Pyogenic infections after 9 mo., PNA and otitis media, S/ pneumo, and H. flu, males more often

102
Q

Bruton’s agammaglobulinemia labs

A

No B cells

103
Q

Common variable immunodeficiency sxs

A

Milder, later age (15-35 yrs old), nl B cell count, dec. Ig counts, no sex predom.

104
Q

DKA labs

A

Bicarb

105
Q

DKA sxs

A

common abd. pain

106
Q

HHNK sxs

A

AMS, serum osm >320

107
Q

Hamman sign

A

Crunching on auscultation

108
Q

Esphageal perforation tx

A

Only surgery if significant leakage, otherwise abx and supportive care

109
Q

Esophageal perf. pleural

A

Effusion very high amylase >2500

110
Q

Pseudogout crystals

A

Positively birefringent crystals, rhomboid? from articular chondrocalcinosis

111
Q

Heberden nodes

A

DIP in OA

112
Q

Post partum labs

A

Low grade fever and leukocytosis nl., foul smelling lochia and uterine tenderness is endometritis

113
Q

Aplastic crisis in sickle cells

A

Not pancytopenia, just low reticulocytes

114
Q

Breath-holding spells dx

A

Evaluation CBC and ferritin

115
Q

Chikungunya fever location

A

Central and S. america

116
Q

Chikungunya fever sxs

A

high fevers and severe polyarthralgias

117
Q

Chikungunya fever tx

A

supportive care

118
Q

Chikungunya fever labs

A

Lymphoenia and Thrombocytopenia