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Step Wrong Qs > May 6 > Flashcards

May 6 Flashcards

1
Q

Atherosclerotic renal artery stenosis (RAS)

A

From diffuse systemic atherosclerosis
Kidney feels hypovulemia, lowers glomerular filtration pressure.
Increased Angiotensin II (predominately. Constricts EFFERENT to restore GFR).

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2
Q

ACE inhibitors

A

lower angiotensin II (efferent arteriolar dilation).

If they have RAS, GFR drops and renal failure happens

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3
Q

True vs false diverticuli

A

True: meckel’s, normal appendix
False: zenker’s

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4
Q

MEckel’s diverticuli

A

Remenant of vitalline duct (young kids).
True so mucosa, subM, muscularis
2%, 2 feet from IC valve. 2 inches, 2% symptomatic. Male 2X>female
Clincal: bleeding, young child, intestinal obstruction. Q

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5
Q

Permissiveness drug action

A

When one drug does nothing unless coupled with another

May seem like synergy.

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6
Q

Turner syndrome

A

45, X
Normal fetal ovarian development. Follicles die out by age 2.
Pubic hair but no breast or menses.
Premature ovarian failure (high LH and FSH).
Bicuspid aortic valve, coarctation of aorta. (Short brad chest).

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7
Q

Cancer risk in Down syndrome

A

Acute lymphoblastic leukemia (ALL)

Acute myelogenous leukemia (AML)

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8
Q

Deficiency in what causes inability to clear Myobacterium tuberculosis

A

Interferon signaling. Infected Macrophages secrete IL12

IL12 activates T cells and NK cells to produce IFN-y.

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9
Q

Depersonalization/derealization disorder

A

Persistant depesonalization or derealization

Intact reality testing

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10
Q

Insulin effect on glycogen

A

Incrrease synthesis
Via receptor tyrosine kinase -> activates protein phosphotase.
Protein phophatase -> activated glycogen synthase.

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11
Q

Prinzmetal angina

A 
Episodic angina (at night and rest). 
ST elevation (tiny bit of ischemia). 
Dihydroergotamine can induce it. (Constricts vascular smooth muscle to treat migrane)
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12
Q

Best treatment for specific phobias?

A

Exposure behavioral therapy

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13
Q

Isonaizid

A

For: M. Tuberculosis
Inhibits mycolic acid synthesis
Must be processed by mycobacterial catalase peroxidase. (Method of resistance).
Also, mycolic acid syntehsis enzmye mutation = resistance

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14
Q

Number needed to harm

A

1/Attributable risk

Attribuable risk =adverse event rate (treatment) - adverse event rate (placebo)

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15
Q

Adrenergi effectorsf

A

Epinephrine; Systolic BP up, dbp down, HR up, contractility up, RBFlow down.
Pheylephrine SBP up, DBP up, HR down. Contractility 0, RBF down.
Dopamine: sbp up. DBP 0, HR up. Contractility up. RBF down.

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16
Q

Brunner glands

A

Submucosal glands in duodenum.

Hypertrophied with excess acid/ulceration (from excess secretin)

17
Q

Transesophageal ecchocardium (TEE)

A

Anterior wall of esophagus: Left atrium.

Posterior wall of esophagus: Descending aorta.

18
Q

EAr canal sensation (external uaditory canal)

A

Posterior = vagus (via Auricular branch)

Everywhere else = V3 (auriculotemporal)

19
Q

How to prevent gynecomastia in andregen deprivation therapy for prostate cancer

A

Tamoxifen. Prevent estrogen from getting into breast tissue.

20
Q

Pseudomonas aeruginaosa

A 
Nonlactose fermenting
Oxidase positive
Motile
Gram-negative rod
Most comomon cuse of malignant otitis externa
21
Q

Aortic regurgitation

A

Early diastolic murmur on left sternal border.

22
Q

PCOS treatment

A

Weight loss
Estrogen/progesterone pills
(If you want to get prognant: Clomiphene SERM used)

23
Q

Paraaminohippuric acid (PAH)

A

Filtered AND secreted.

Secreted by carrier protein-mediated method. (Can be saturated at high blood)

24
Q

Lead poisoning

A

Poor kids.
developmental regression, behavioral problems.
Anemia (From inhibition of ferrochelatase and aminolevulinic acide dehydratase (ALA) from heme synthesis.
Elevated Zink protoporyrin levels.
ALA increased

25
Q

Psuedomonas aeruginosa

A 
Papulopustular rash
Pruritic
Pool water/hot tob
Gram neagtive rod, oxidase positive. 
Produce green pgiment (pyocyanin) durng culture.
26
Q

Renin AND aldosterone increased

A

Secondary hyperaldosteronism (Renovascular disease, malignant hypertension, and renin-secreting tumors (from juxtumerular))

27
Q

Side effects of Sotalol

A 
What? Beta-adreergic bocking AND class III antiarryhtmic (K blocking)
Used for A fib
Bradycardia, torasades de point (due to QT prolongation)
28
Q

Intussception

A

young kids: structural casue or viral

Adults: foreing body/tumor, meckel diverticulum

29
Q

Hyaline arterioscelrosis

A

Untreated/poorly controlled hypertension or diabetes.
Leak of plasma proteins “galssy” in subendothelial space.
Stain pink with acid-schiff (PAS)

30
Q

Hodkin lymphoma

A

Reed-sternberg cells “owl eyes”

Background of lymphocytic infiltrates.

Step Wrong Qs (10 decks)

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