3 star items Flashcards

1
Q

Forebrain development

A

Prosencephalons –>
A. Telencephalon –> Cerebral hemispheres
B. Diencephalon –> thalamus

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2
Q

Midbrain development

A

Mesencephalon –> midbrain

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3
Q

Hindbrain development

A

Rhombencephalon –>
A. Metencephalon–> cerebellum, pons
B. Myelencephalon –> medulla

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4
Q

Anterior hypothalamus nuclei

A

Anterior: thermoregulation (cooling) think AC - damage –> hyperthermia

Suprachiasmatic: circadian rhythms

Pre optic area: secretes GnRH

Supraoptic: secretes ADH, damage –> central DI

Paraventricular: secretes oxytocin, CRH, TRH

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5
Q

Tuberal hypothalamus nuclei

A

Arcuate: secretes GHRH, dopamine, pulsatile GnRH secretion, regulates appetite

Lateral: Regulates hunger, inhibited by Leptin; damage –> anorexia, wt loss

Ventromedial: regulates satiety, stimulated by leptin; damage –> obesity, savage behavior

Dorsomedial: regulates hunger, stimulation –> obesity, savage behavior

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6
Q

Posterior hypothalamus nuclei

A

Posterior: Thermoregulation - warming; damage –> hypothermia

Mammillary: memory; damage –> Wernicke-Korsakoff syndrome

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7
Q

Acetylcholine Synthesis

A

Choline acetyltransferase combines Choline + Acetyl CoA forming ACh

(Enzyme blocked by Vesamicol, can’t back ACh into vesicle)

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8
Q

Draw ACh neurotransmission

A

page 129

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9
Q

Draw out Phenylalanine to Epinephrine pathway

A

page 130

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10
Q

Draw NE neurotransmission

A

page 130

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11
Q

Causes of early cyanosis

A
Persistent truncus arteriosis
Transposition of the great vessels
Tricuspid atresia
Tetraology of Fallot
Total anomalous pulmonary venous return
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12
Q

Atrial fibrillation

A

Irregularly irregular, no p waves

Sx: tachycardia, SOB, fluttering in chest, angina

Cause: left atrial dilation caused by HTN, CVD, HF

Risk clots, PE, stroke, emboli

Tx: new less than 48 hours - synchronized cardioversion
Older than 48 hours - anticoagulation

If asx: digoxin, b-blocker, CCB for rate control
If young and sx: rhythm control - sotalol, amiodarone, flecaimide

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13
Q

Atrial flutter on EKG

A

saw tooth pattern

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14
Q

First degree AV block on EKG

A

prolonged PR interval, greater than 1 big box

Likely to go to second degree

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15
Q

Second degree (Mobitz I) AV block on EKG

A

“Wenckebach”

progressive lengthening of PR before dropping beat

asx, benign

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16
Q

Second degree (Mobitz II) AV block on EKG

A

no precursor warning of dropped QRS
can progress to 3rd degree block

tx: pacemaker

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17
Q

What bacteria is associated with causing AV nodal block?

A

Borrelia burgdorferi - Lyme dz

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18
Q

Third degree AV block on EKG

A

Atria and ventricles beat independently

2/3 are narrow, 1/3 wide QRS

tx: pacemaker

19
Q

Wolff-Parkinson-White (WPW)

A

Bundle of Kent, or other, accessory conduction pathway bypasses AV node causing delta wave

can cause reentry SVT

Tx: procainamide or amiodarone
no adenosine when kicks into SVT

definitive tx: ablate pathway

20
Q

Paroxysmal SVT

A

at or above AV node

narrow QRS

21
Q

Premature ventricular contractions

A

early occurring
widen QRS - bizarre, often notched, greater than 4 boxes
microentry - purkinje fibers

signal originating below AV

22
Q

Ventricular bigeminy vs trigeminy

A

bigeminy: PVC after each sinus beat
trigeminy: 2 sinus beats followed by a PVC

23
Q

Ventricular escape rhythm

A

failure of SA/AV node

absent p wave, slow

24
Q

junctional escape rhythm

A

AV node is the pacemaker

25
Q

Monomorphic VT

A

wide QRS, >100/min

non sustained less than 30 sec
sustained greater than 30 sec

can lead to hemodynamic collapse

shock them

26
Q

Torsades de pointes

A

shifting sinusoidal waves - amplitude changes

lead to v-fib (no identifiable waves, hemodynamic collapse, defibrillate and do CPR)

tx w/ Mg2+ push

27
Q

Rotator Cuff Muscles

A

SItS:

Supraspinatus (first 10-15 degrees of abduction, test with empty can test, positive = pain and weakness)

Infraspinatus - external (lateral) rotation
teres minor - external (lateral) rotation

Subscapularis - internal (medial) rotation

28
Q

What structures can be damaged with anterior shoulder dislocation?

A

Axillary nerve (test sensation of deltoid before and after reduction)

Posterior circumflex artery

Supraspinatus tendon

Anterior glenohumoral ligaments and glenoid labrum separation from articular surface of anterior glenoid neck - Bankart Lesion

Posterolateral humeral head defect - impact against anterior rim of glenoid - Hill-Sachs lesion

29
Q

Osteoarthritis presentation

A

wear and tear dz - articular cartilage
–> eburnation, osteophytes

Bouchard’s nodes - osteophytes of PIP
Heberden’s nodes - osteophytes of DIP

Fingers, knees, hips, spine

Cause: age, obesity, joint trauma - repetitive use

Pain in joint AFTER use
Noninflammatory, no systemic sx

30
Q

Treatment of OA

A

Acetaminophen - scheduled more effective, COX inhibitor
NSAIDs
COX-2I
topical capsaicin cream
Intraairticular glucocorticoid injections once every 4-6 mo
Intraairticular hyaluronan injections
Opioids - risk of falls/fractures in elderly
Tramadol
Joint replacement

31
Q

NSAIDs drugs used to tx OA

A

Aspirin - irreversible inhibitor of COX1
SE: GI bleeds, ulcers, tinnitus, hyperventilation, acute renal failure

Diclofenac
Ibuprofen
Indomethacin
Meloxicam - COX2 more selective
Nabumetone
Naproxen

COX-1/2 inhibitors
SE: acute renal failure, acute interstitial nephritis, fluid retention, aplastic anemia
MC: Gi upset

32
Q

Zonula occludens

A

tight junctions

claudins, occludens

33
Q

Zona adheres

A

intermediate junctions
-basal layer
link actin cytoskeleton of neighboring cells
-e-cadherins (Ca2+ dependent)

34
Q

Macula adherens

A

desmosome
desmoglein
resist shearing forces
simple and stratified epithelium, muscle cells

35
Q

gap junctions

A

cardiac cells

36
Q

Hemidesmosomes

A

connect to BM

integrins

37
Q

HLA-B27

A

seronegative spondyloarthropathies

“PAIR”

38
Q

HLA-DR3, -DR4

A

T1DM - autoimmune destruction of beta cells

39
Q

Branches of Celiac Trunk

A
  1. Left gastric A.
  2. Splenic A. - large, tortuous
  3. Common hepatic a.
    a. gastroduodenal a.
    - -i. right gastro-omental A to greater curvature
    - -ii. anterior superior pancreaticoduodenal a. to anterior head of pancreas and proximal duodenum

b. right gastric a.
c. proper hepatic a.
- -i. right hepatic
- —a. cystic a
- -ii. left hepatic

40
Q

Physiologic Dead space

A

anatomical dead space - air in airways
Functional dead space (e.g. apices)
-capable of gas exchange but no gas exchange occurs

Vd = Vt x (PaCO2 - PexpCO2)/PaCO2
dead space = tidal volume x percent of tidal volume in dead space

41
Q

Label lung volumes diagram

A

page 452

42
Q

Draw Out Coronary Artery Anatomy

A

Page 209

Right coronary A branches:
-SA nodal branch
-R. marginal branch of RCA
-80% AV nodal branch, Posterior interventricular branch
“right dominant”

Left coronary A branches:
-Anterior interventricular branch (aka LAD)
-Circumflex branch of LCA
-20% AV nodal/Posterior interventricular branch off circumflex
“left dominant”

43
Q

Potter sequence

A

Failure of ureteric bud to develop
-> b/l renal agenesis

“POTTER”
Pulmonary hypoplasia
Oligohydramnios
Twisted skin
Twisted face
Extremity deformities
Renal agenesis
44
Q

Horseshoe kidney

A

Inferior pole fuses -> U shape

Stuck on IMA – low in abdomen

Assoc w/ turners syndrome