6.22.16 NBME Form 16 Flashcards by Michelle Cho

How do somatostatinomas cause cholelithiasis?

Somatostatin inhibits CKK action on the gallbladder

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What is HELLP syndrome?

Preeclampsia with thrombotic microangiopathy involving the liver

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what lifestyle modification will most likely decrease risk for additional fractures?

wt-bearing exercise

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how else could you describe zero order eliminatino?

capacity-limited elimination

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What is preeclampsia? What causes it?

Pregnancy-induced HTN, proteinuria, and edema in the 3rd trimester, d/t abnormality of maternal-fetal vascular interface in placenta

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CASE: 45yo M –> fever, chills, dysuria, tender enlrged prostate –> what infect?

E coli

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what disorder has paternal imprinting?

Angelman synd

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Why is there peripheral neuropathy with Chediak-Higashi syndrome?

Inability to traffic nutrients to the periphery

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what maneuvers enhance MR?

increase TRP –> squat, hand grip

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highly increased FSH: indicates?

menopause

low estrogen –> lose neg feedback on FSH

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Why are there giant granules in leukocytes in Chediak-Higashi syndrome?

Inability to distribute granules produced by the golgi

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Why is there neutropenia in Chediak-Higashi syndrome?

No way to separate cells d/t defective microtubules

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what is: leukomoid response

increased white blood cell count, or leukocytosis, which is a physiological response to stress or infection (as opposed to a primary blood malignancy, such as leukemia)

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What are the labs that are elevated with HELLP syndrome? (3)

Hemolysis
Elevated LFTs
Low platelets

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Which are most common, primary or mets to bone?

Mets

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mutate/delete chrom 15 –> dx?

Prader-Willi or Angelman synd

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what disorder has maternal imprinting?

Prader-Willi synd

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what struct must be protected during surg remval of ovary?

ureter –> pass inf to ovary

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what produces a continuous murmur?

PDA

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What is the effect of VIP on gastric acid secretion?

Inhibits

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stroke-like episodes, ragged red fibers: what dz?

mito inherited dz

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Marfan synd: what organ systems does it affect?

skeleton
heart
eyes

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what is: heteroplasmy

presence of both normal & mutated mtDNA –> variable expression in mito inherited dz

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what are the systolic murmurs?

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Prader-Willi synd: most common cause

maternal uniparental disomy --> 2 maternally imprinted genes, no paternal gene

differentiate: schizophreniform disorder vs schizophrenia

1-6mo

carrier freq: calc

2pq

What are the s/sx of an insulinoma?

Episodic hypoglycemia with mental status changes and are relieved by glucose

What causes the hemolysis with HELLP?

Platelet deposition in the blood vessels leading to schistocyte formation

clomiphene: drug class

SERM

how does CN V exit skull?

Standing Room Only: V1 - sup orbital fissure V2 - rotundum V3 - ovale

name: holosytolic, high pitched blowing murmur

- MR | - TR

What are the GI findings of a somatostatinoma?

- Achlorhydria (inhibition of gastrin) | - Cholelithiasis and steatorrhea (inhibition of CCK)

ondansetron: use

prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, or surgery

Prader-Willi synd: which gene is missing?

paternal

what is: 0-order elimiatino

constant rate of elimination (regardless of serum [drug])

CASE: | wt-lifter --> lifts 200lb bar --> immed pain in low pain --> radiate down leg --> what is cause of pain?

rupture of intervertebral disc --> impinge on sciatic

what is: psychosis

distorted perception of reality --> charact by --> delusions, hallucination, disorg thinking

what are the diastolic murmurs?

- AR - MS - PR

CASE: run a marathon --> temp of 101.5F --> how will temp return to normal?

sweat evaporate

what is: schizophrenia

>6mo: - delusion - hallucination - disorg speech - disorg, catatonic beh - neg ssx

What are the components of the BAILIN mnemonic for Chediak-Higashi syndrome?

- Bleeding disorders - Albinism - Infections - Leukopenia - Infiltrative lymphohistiocytosis - Neuropathy

What is Chediak-Higashi syndrome? Inheritance pattern?

AR Protein trafficking defect, characterized by impaired phagolysosome formation

What are the two metastatic tumors of bone that are osteoblastic?

Prostate | Breast

what is: transformation

ability to take up naked DNA

what is: 1st order elimination

constant fraction of drug eliminated

What is eclampsia?

seizure induced by HTN from baby

Why is there defective primary hemostasis with Chediak-Higashi syndrome?

Loss of platelets d/t loss of movement out of megakaryocytes

----- What are the findings of a VIPoma? (2) What electrolyte disturbance? -----

- Watery diarrhea - Hypokalemia - Achlorhydria

what is: neg ssx

- flat affect - social withdrawal - lack of motivation - lack of speech, thought

first order elimination: what happens to serum [drug] (Cp)?

decrease exponentially with time

glyceraldehyde 3 phosphate deH: rxn

glycolysis: glyceraldehyde 3 phosphate --> 1, 3-bisphosphoglycerate

how else could you describe 1st order elimination?

flow-dep elimination

Marfan synd: heart ssx

- cystic medial necrosis of aorta --> aortic incompetence, dissecting aortic aneurysms - floppy mitral valve

Marfan synd: eye ssx

lens subluxation --> up & out

LP: go thru what layers?

1) skin 2) fascia, subQ fat 3) supraspinous lig 4) infraspinous lig 5) ligamentum flavum 6) epidural space & fat 7) dura

What are the levels of the following in an insulinoma: - Glucose - insulin - C-peptide

- Decreased glucose - Increased insulin - Increased C-peptide

Marfan synd: skeletal ssx

- tall w long extremities - pectus excavatum - hypermobile joints - arachnodactyly

schizotypal personality: ssx

- paranormal/superstitious beliefs - isolation, discomfort in social sit - odd thinking, beh

disorg schizophrenia: ssx

- disorg speech - inapprop affect - inapprop laugh - poor hygiene - sloppy appearance

what is: contemplation

acknowledge there is a problem but not ready/willing to change

what is: precontemplation

not yet acknowledge there is a problem

What is a VIPoma?

Tumor that causes and excessive vasoactive intestinal peptide to be produced

what are the hormonal changes found in menopause?

- low estrogen - high high FSH - high LH - high GnRH

what is: delusional disorder

>1mo: fixed, persistent untrue belief system

What is seen in the vessels of the placenta with preeclampsia?

Fibrinoid necrosis

CASE: cross-sectional area of aneurysm = 2cm^2 mean velocity of blood flow thru aneurysm = 20cm/sec what is the flow rate (L/min) thru the aneurysm?

``` flow rate = area X velocity Q = VA = (20cm/sec)(2cm^2) = 40cm^3/sec = 2400cm^3/min (1cm^3 = 1ml) = 2400ml/min = 2.4L/min ```

What is the effect of VIP on potassium levels?

Lowers

clomiphene: use

induce ovulation

what is: schizoaffective disorder

>2wk: psychosis + MDE/mania

CASE: | muscle weak & cramp after exercise --> lactate not increase after exercise --> dx?

McArdle Dz --> deficient glycogen phosphorylase --> can't break down glycogen

pudendal N: fx in M

M sexual response: ejaculation

differentiate: brief psychotic disorder vs schizophrenia

Pancreatic endocrine tumors are often a component of what genetic malignancy? What other malignancies are associated with this?

-MEN1 - Parathyroid hyperplasia - Pituitary adenoma - Pancreatic tumors

what is: maternal imprinting

maternal gene: silent | paternal gene: deleted, mutated

What cells do pancreatic endocrine tumors arise from?

Islet cells

Angelman synd: which gene is missing?

maternal

Are most mets to bone osteolytic or osteoblastic?

Osteolytic

What is the difference between osteolytic and osteoblastic lesions?

Osteolytic produces punched out appearance, while osteoblastic causes sclerosis of the bone

CASE: ATNII: increase BP Drug X: increase BP ATNII + X: no change in BP what is Drug X?

partial agonist at ATN II receptor partial agonist in presence of full agonist acts as antagonist

zero order elimination: what happens to serum [drug] (Cp)?

decrease linearly with time

What is Zollenger-Ellison syndrome?

gastrinoma that produces gastrin to increased HCl from parietal cells

Why is there albinism with Chediak-Higashi syndrome?

Melanocyte cannot transfer melanin to the keratinocytes d/t crappy microtubules

what struct is at greatest risk for injury during prostatectomy?

pelvic parasym nerves

fibrillin-1 gene mutation --> dx?

Marfan synd

MR: common cause

- ischemic heart dz - MVP - LV dilation

CASE: F can't conceive --> tx?

clomiphene

what maneuvers enhance TR?

increase RA return --> inspiration

6.22.16 NBME Form 16 Flashcards

(88 cards)