6.27.16 Flashcards
(107 cards)
1
Q
hypocretin: what is? fx?
A
hypocretin-1 (orexin A), hypocretin-2 (orexin B) –> neuropeptides produced in lat hypo
- promote wakefulness
- inh REM sleep-related phenomena
2
Q
factitious disorder: key feature
A
intentional falsification or inducement of ssx to assume sick role
3
Q
Dx: pseudopalisading tumor cells around areas of necrosis
A
glioblastoma multiforme
4
Q
CA-125: use
A
cancer marker for epithelial ovarian CA –> dx & fu tx
5
Q
varicose vein: comp
A
- superficial venous thrombosis
- venous stasis ulcer –> usu over medial malleolus
NOT thromboembolism
6
Q
Meyer’s loop injury –> leads to?
A
contralat sup quadrantanopia
7
Q
Dx: hypocretin-1 def
A
narcolepsy
8
Q
illness anxiety disorder: key feature
A
fear of having serious illness despite few/no ssx + consistently neg evals
9
Q
cancer antigen 125 (CA-125): assoc dz
A
epithelial ovarian CA
10
Q
Hashimoto thyroiditis: histology
A
- lymphocyte infiltrate w germinal centers
- Hurthle cells (eosinophilic epithelial cells)
11
Q
ethylene glycol ingestion: clinical findings
A
- anion gap metab acidosis
- increased osmolar gap
- calcium oxalate crystals in urine
12
Q
what is: cataplexy
A
- conscious, brief episodes of sudden bilat muscle tone loss –> precipitated by emotion (laugh, joke)
- spont, abnormal facial mvmt w/out emotional trigger
13
Q
Dx: pt from Central/South America –> sz
A
neurocystocercosis
14
Q
what is: dorsal optic radiation
A
upper fibers of optic radiation –> carry info from upper retina (lower contralat visual field)
15
Q
how is isoniazid metab?
A
by acetylation
16
Q
what is the signifiance of glycerol kinase in DKA?
A
gluconeogenesis:
1) adipose –> brkdown TG –> glycerol
2) liver, kidney –> glycerol kinase –> glycerol –> glucose
17
Q
Meyer’s loop: what route?
A
LGN –> temporal lobe –> lingual gyrus of striate cortex
18
Q
what is another name for cobalamin?
A
vitB12
19
Q
Dx: painless thyroiditis
A
Hashimoto thyroiditis
20
Q
what is the most common urea cycle disorder?
A
ornithine transcarbamylase def
21
Q
subacute granulomatous (de Quervain) thryoiditis: onset
A
following viral illness
22
Q
congenital hypothyroid: cause
A
- thyroid dysgenesis
- iodine def
23
Q
cutaneous post calf: drains to what LN?
A
deep inguinal
24
Q
spongiform encephalopathy: histology
A
- vacuoles in gray matter
- no inflamm changes
25
interstitial lung dz: why increased expiratory flow rate?
fibrotic interstitial tissue --> decrease lung vol, increase lung elastic recoil --> increase radial traction (outward pulling) on airway --> airway widen --> decrease airflow resistance --> increase expiratory flow rate
26
Dx: hyperammonemia --> vomit, tachypnea, confuse/coma
urea cycle disorder
27
Blastomyces dermatitidis is endemic to?
SE USA
28
what is: myocardial stunning
reversible contractile dysfx
29
glioblastoma multiforme: gross appearance
areas of necrosis & hemorrhage
30
monoclonal Ab against PD-1: MOA
prevent PD-1 blind PD-L1 --> block T cell inh --> restore cytotoxic response --> tumor cell apoptosis
31
what is: Meyer's loop
lower fibers of optic radiation --> carry info from lower retina (upper contralat visual field)
32
intracranial mass --> dx?
glioblastoma multiforme
33
hypoK: ssx
- muscle weak
- cramp
- possible rhabdomyolysis
34
diabetes during preg --> neonatal comp --> transient hypoglycemia --> pathophys?
exposed to high maternal glucose levels in utero --> excessive fetal insulin production, islet hyperplasia --> hyperinsulinemia persist for several days after birth
35
epithelial ovarian CA: who?
postmenopause
36
what is another name for vitB12?
cobalamin
37
mitral stenosis: when do you hear the opening snap?
early diastole
38
glans penis: drains to what LN?
deep inguinal
39
conversion disorder: key feature
fxal neurologic symptom disorder:
- neuro ssx incompatible w neuro dz
- acute onset assoc w stress
40
Dx: eczema, intell disability, abnormal gait, musty body odor
PKU
41
tumor --> effect on PD-1?
increase expression of programmed death receptor 1 ligand (PD-L1) --> inh cytotoxic T cell --> downreg immune response against tumor cell
42
what is: optic radiation
LGN axons that project to striate (1ary visual) cortex
43
Tourette disorder: who?
6-15yo M
44
epistaxis: most common location
ant nasal septum --> Kiesselbach plexus
45
optic tract fibers go to?
lat genticulate nucleus
46
what muscles are used to sit up from supine position?
- external abd obliques
- rectus abdominis
- hip flexors
47
congenital hypothyroid: comp
irrev intell disability
48
Dx: hyponia, large ant fontanelle, lrg tongue, reducible umbilical hernia
congenital hypothyroid
49
diabetes during preg --> neonatal comp --> what congenital malformation?
- neural tube defect
- CV anomaly
- caudal regression synd
50
dietary lipid: digested where?
duodenum via pancreatic enzymes
51
rabies vaccine: what type?
inactivated
52
diabetes during preg: neonatal comp
- premature
- fetal macrosomia
- congenital malformation
- resp distress
- transient hypoglycemia
- polycythemia & hyperviscosity
53
Hashimoto thyroiditis: what Ab will you find?
TPO
54
Hashimoto thyroiditis: cause
autoimmune
55
superficial inguinal LN: drains to what LN?
deep inguinal
56
what muscles make up the hip flexors?
- rectus femoris
- iliopsoas
- tensor fascia lata
57
what is: scolex
head of tapeworm w hooklets
58
somatic ssx disorder: key feature
excessive anxiety & preoccupation w >1 unexplained ssx
59
ornithine transcarbamylase def: charact
- hyperammon (medical emergency!)
| - elevated orotic acid in urine
60
PD-1: location
surface of activated T cells
61
what is most common ovarian malig?
epithelial ovarian CA
62
vitB12 def --> trt w folate --> what happen?
- mod improve Hb level
| - can worsen neuro dysfx
63
obstructive sleep apnea --> tx --> nerve stim --> what N? MOA?
hypoglossal N --> electrical stim --> tongue mv forward --> increase oropharyngeal airway diameter --> decrease freq of apneic events
64
what is: cysticeri
neurocystocercosis: fluid-filled larval cysts surrounding the invaginated scolex
65
malingering: key feature
falsification of exaggeration of ssx to obtain external incentives (2ndary gain)
66
testes: drains to what LN?
abd para-aortic (retroperitoneal)
67
how do you differentiate bw tuberculoid vs lepromatous leprosy?
lepromin skin test :
+ --> tuberculoid (strong CD4+ TH1 cell-med immune reponse to myco leprae)
- --> lepromatous (weak TH1 cell-med immune response)
68
DHP CCB: AE
- HA
- flushing
- dizzy
- peripheral edema
69
why is hyperammon a medical emergency?
ammonia --> neurotoxic:
- episodes of vomit
- confuse/coma
- cerebral edema --> tachypnea --> hypervent, resp alk
70
what occurs at Kiesselbach plexus?
anatomosis of:
- ant ethmoidal A
- sphenopalatine
- sup labial
71
what is: Anti-Rh immune globulin
IgG anti-D Ab --> opsonize Rh+ fetal RBC --> cleared by maternal reticuloendothelial macrophages --> prevent maternal Rh sensitization
72
total myocardial ischemia: when is there loss of cardiomyocyte contractility?
60 sec
73
what strongly suggests rabies encephalitis?
exposure --> w/in wks --> agitation & spasm --> progress to coma
74
epithelial ovarian CA: histology
- epithelial cell anaplasia
- invasion of ovarian stroma
- mult papillary formations w cell atypia
75
congenital hypothyroid: onset
asymp at birth --> dev ssx after maternal T4 wanes
76
superficial inguinal LN: drains what?
all skin from umbilicus down --> including anus (blow dentate/pectinate line)
Except: testes, glans penis, post calf
77
amlodipine: drug class
DHP CCB
78
Anti-Rh immune globulin: given to who? when admin?
Rh- F:
- 28wk gestation
- immed postpartum
79
dietary lipid: absorbed where?
jejunum
80
what drugs inh dihydrofolate reductase?
- trimethoprim
- methotrexate
- pyrimethamine
81
Dx: acute renal fail, proximal tubular cell ballooning, vacuolar degen
acute tubular necrosis
82
temporal lobe lesion --> can damage what part of visual pathway?
Meyer's loop
83
neurocystocercosis: diagnostic findings
- CT/MRI: cyst, scolex
| - eosinophilia
84
urea cycle: rate limiting enzyme
carbamoyl phosphate synthetase
85
PKU: mode of inheritance
AR
86
can cholescystectomy pt tolerate fatty food? why?
yes: no gallbladder ==> bile constant released into duodenum
87
congenital hypothyroid: ssx
- constipation
- lethargy
- hypotonia
- macroglossia
- umbilical hernia
- lrg ant fontanelle
88
what is the most important hip flexor?
iliopsoas
89
subacute granulomatous (de Quervain) thryoiditis: histology
inflamm infiltrate w macrophage & giant cells
90
obstructive sleep apnea: pathogenic mech
neuromusc weakness
91
differentiate: vitB12 vs folate def
vitB12: megaloblastic anemia + neuro dysfx
folate: megaloblastic anemia
92
acute tubular necrosis: histology
proximal tubule cells:
- vacuolar degen
- ballooning
93
congenital hypothyroid: tx
levothyroxine by age 2wk
94
thiazide diuretic: AE? how?
decrease intravasc fluid vol --> stim aldos --> increase excrete K, H --> hypoK, metab alk
95
sex hormones --> effect on bone growth
- bone growth
| - epiphyseal plate closure
96
pyrimethamine: use
- malaria
| - toxoplasmosis
97
what is: CA-125
protein expressed by epithelial cells lining Mullerian organs (ovary, FT) & peritoneum
98
what is: PrP
prion protein --> CJD, bovine spongiform encephalopathy
99
DHP CCB: drugs
"-dipine" suffix: amlodipine, nifedipine
100
PKU: ssx
- intell disability
- gait, posture abnormality
- eczema
- musty body odor
101
dorsal optic radiation: what route?
LGN --> parietal lobe --> cuneus gyrus of striate cortex
102
what is the main source of rabies in the USA?
bat
103
glioblastoma multiforme: histology
pseudopalisading tumor cells around areas of necrosis
104
Dx: painful thyroiditis
subacute granulomatous (de Quervain) thryoiditis
105
differentiate: trimethoprim vs methotrexate vs pyrimethamine
- trimethoprim: bact
- methotrexate: human cell
- pyrimethamine: some protozoa
106
ornithine transcarbamylase def: pathophys
excess carbamoyl phosphate --> stimulate pyrimidine syn --> orotic acid accum
107
differentiate: chronic tic disorder vs Tourette
chronic tic disorder: >1yr --> 1 or more motor or verbal tics (but not both)
Tourette: >1yr --> mult motor tics + at least 1 verbal tic
