Block 7 Flashcards

(84 cards)

1
Q

What cutaneous sensory receptors (mechanoreceptors) are found in papillary dermis?

A

Merkel Nerve Endings
Meissner corpuscles

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2
Q

What mechanoreceptors are found in the reticular dermis?

A

Ruffini corpuscles
Free nerve endings

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3
Q

What mechanoreceptors are found in cutaneous (subcutis) tissue?

A

Pacinian corpuscles

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4
Q

Describe the part of the dermis that the Meissner (tactile) corpuscle and Merkel nerve endings are found in?

A

Papillary dermis of mainly glabrous (hairless) skin (i.e. palms, soles, tongue, lips

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5
Q

Merkel nerve endings.

A

sensitive to crude, static touch (e.g, discrimination of shapes and edges)

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6
Q

Meissner corpuscles

A

sensitive to low-frequency vibration (e.g, texture) and light touch

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7
Q

Ruffini corpuscles

A

mainly located in joint capsules and hair-bearing skin; sensitive to pressure and changes in joint angles

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8
Q

Free nerve endings

A

thermoception and nociception

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9
Q

Nociception

A

perception of pain

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10
Q

Pacinian corpuscles

A

sensitive to vibration and pressure

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11
Q

The presence of a black and ulcerated gallbladder mass with invasion of the gallbladder wall and lymphatics suggests what underlying cause?

A

malignancy/ malignant melanoma

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12
Q

Describe the spread of a malignant melanoma?

A

most commonly spread to the lymph nodes, liver, lung, brain and bone,

but can also metastasize to unusual sites (i.e., organs that are not commonly affected by other malignancies [i.e., heart, gallbladder]

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13
Q

Do any of the malignancies associated with MEN metastasize to the gallbladder?

A

no

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14
Q

What are some skin findings in Porphyria Cutanea Tarda?

A

hyperpigmentation and scarring (likely due to previous PCT lesions),

hypertrichosis, skin contraction, and calcification of the forehead (resembling scleroderma)

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15
Q

What are some risk factors for Porphyria Cutanea Tarda?

A

alcohol consumption and exogenous estrogen use

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16
Q

Common side effect of ethambutol?

A

reversible optic neuropathy
red-green color blindness

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17
Q

What is the MOA of ethambutol?

A

inhibition of arabinosyltransferase which subsequently inhibits the synthesis of arabinogalactan, an important mycobacterial cell wall polysaccharide

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18
Q

When does cerebral toxoplasmosis typically become symptomatic?

A

CD4 count < 100 cells/mm3

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19
Q

Symptoms of cerebral toxoplasmosis?

A

fever
headache
MRI showing multiple lesions

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20
Q

What is Progressive multifocal leukoencephalopathy?

A

PML is a demyelinating disease of the CNS caused by the reactivation of JC virus

-mainly seen in patients with severe immunosuppression

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21
Q

What are the symptoms of PML

A
  • Decline in cognitive function
  • Behavioral changes
  • Altered mental status
  • Seizures
  • new-onset motor deficits (e.g. left hemiparesis)
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22
Q

What is one of the most common pulmonary complications in the first 72 hours after surgery?

A

postoperative atelectasis

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23
Q

What are the ways the body reacts to postoperative atelactasis?

A

The body becomes hypoxemic and compensates with hyperventilation.

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24
Q

What does anti-GAD stand for?

A

Anti-glutamic acid decarboxylase antibodies

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25
Anti-GAD antibodies are characteristic of Type 1 or Type 2 diabetes?
Type 1 diabetes
26
What doe anti-GAD) target?
pancreatic islet cells, leading to the destruction of insulin-producing beta cells and impaired insulin secretion
27
Pathophysiology of why there is accumulation of islet amyloid polypeptide in T2DM?
Pancreatic proteolytic enzymes that convert proinsulin and proamylin into insulin and amylin are not able to keep up with the high levels of production which leads to accumulation of proamylin
28
Another name for islet amyloid polypeptide?
proamylin
29
Pathophysiology by which PID can lead to infertility?
tubal scarring which leads to tubal occlusion and loss of ciliary action
30
What drug is used as an alternative to vancomycin to treat MRSA bacteremia?
Daptomycin
31
What are some major side effects of daptomycin use?
Elevations in creatine phosphokinase (CPK) and rhabdomyolysis
32
Hematuria and rhomboid crystals in the urine are consistent with what type of nephropathy?
urate
33
The acidification of urine can help prevent the formation of what type of stones in the urine?
calcium phosphate and struvite stones
34
What is the most common cause of death in patients with Friedreich ataxia?
heart failure
35
Friedrich ataxia symptoms?
* ataxia and weakness * loss of deep tendon reflexes * pallhypesthesia * dysarhtria * skeletal deformities * cardiomyopathy/ arrythmia * aspiration pneumonia due to dysphagia
36
Pallhypesthesia meaning.
decreased perception of vibration commonly caused by lesion affecting the dorsal spinal tract and polyneuropathies
37
What is a pneumatocele?
cystic air-filled space in the lung parenchyma associated with cute infections (e.g., Staphylococcal or Pneumocystis pneumonia), chest trauma, and barotrauma from mechanical ventilation
38
Pelvic ring fracture is a common cause of what type of nerve injury?
obturator nerve injury
39
Obturator nerve injury provides sensory cutaneous innervation to a small area of the medial thigh and motor innervation to what group of muscles (specifically the action of this group of muscles.)
hip adductor muscles in the medial compartment of the thigh
40
What is the most common cause of watershed infarcts?
systemic hypotension
41
Strokes with a watershed distribution are more prevalent in what type of patients?
patients undergoing cardiac surgery as a result of global systemic hypoperfusion (especially while on cardiopulmonary bypass).
42
How do watershed infarcts caused by systemic hypotension appear?
Symmetrical infarcts in the watershed regions of the brain and wedge shaped occur occipitally at the border of the posterior cerebral artery and middle cerebral artery causing bilateral visual loss
43
How does atherothrombosis of the brain appear?
affects an entire area supplied by a cerebral blood vessel and can manifest with unilateral stroke-like symptoms (vision loss, weakness, numbness, slurred speech)
44
In the rare case that atheromatous micro emboli causes a watershed infarct does it appear as unilateral or bilateral?
unilateral
45
Why would asbestosis lead to an increased A-a gradient?
Patients with asbestosis may develop ILD with parenchymal fibrosis, which impairs the diffusion of oxygen across the alveolocapillary membrane
46
What is a complication of ingestion of the drug carbamazepine by a pregnant patient? (Moreso what is inhibited by this drug)
inhibits folate absorption
47
What risk does a pregnant woman taking thalidomide at risk for?
limb malformation
48
What is phocomelia
a teratogenic limb defect caused by maternal use of thalidomide from genetic inheritance
49
What is micromelia?
growth defect characterized by abnormally small limbs
50
What type of patients can steatohepatitis be observed it?
Patients with surplus, protein malnutrition, toxin-induced liver damage, or other underlying diseases
51
Dilation of alveolar capillaries and serous exudate with abundant bacteria would be found how many days and in what phase of pneumonia?
arises withing 24-48 hours of infection congestion phase
52
What is the classic finding in the gray hepatization stage of pneumonia?
fibrinopurulent leukocytic exudate with lysed erythrocytes
53
How many days after a case of pneumonia can gray hepatization be found?
5-7 days
54
Left ventricular outflow obstruction (LVOT) increases with maneuvers that decrease or increase venous return. Give examples.
decrease venous return (standing from squatting)
55
Left ventricular outflow obstruction (LVOT) decreases with maneuvers that decrease or increase afterload.
increase afterload (fist clenching)
56
Williams syndrome occurs with what chromosomal deletion?
chromosome 7q deletion
57
Characteristics of Williams syndrome?
* mental retardation * broad forehead * wide mouth * full cheeks and lips * long, smooth philtrum (elfin facies) * hypersociability * good verbal skills
58
Most common cardiac malformation associated with Williams syndrome?
supraventricular aortic stenosis
59
Why is the cardiac abnormality in Williams syndrome seen?
loss of the elastin gene that occurs with microdeletion of the long arm of chromosome 7
60
The characteristic of good verbal skills and friendliness towards Stranges seen in Williams syndrome are thought to result from deletion of what gene?
GTF2I gene
61
Lung development in-utero is stimulated by the stretch caused by what flowing through the lungs?
amniotic fluid
62
Why can you confirm the diagnosis of of migratory thrombophlebitis by taking a CT scan of the abdomen?
Can confirm the diagnosis of Trousseau syndrome
63
What setting is Trousseau syndrome often seen in?
visceral malignancy (classically, pancreatic adenocarcinoma) due to production of procoagulants by the malignant cells
64
What is Trousseau syndrome?
form of superficial thrombophlebitis that is recurrent and migratory and referred to as Trousseau syndrome if related to underlying malignancy
65
Where is vinyl chloride typically found?
a chemical that, especially plumbers, are exposed to when working with polyvinyl chloride (PVC) pipes
66
What condition is exposure to vinyl chloride typically associated with?
liver angiosarcoma and increases the risk of brain and lung cancer along with leukemia and lymphoma
67
What are some chemical exposures related to hepatic angiosarcoma?
vinyl chloride, arsenic, and thorium dioxide
68
A strong risk factor for urothelial cancer is prolonged exposure to what chemicals?
aromatic amines like benzidine Other risk factors: nicotine abuse, arsenic exposure, cyclophosphamide use
69
Exposure to ionizing radiation is associated with what type of cancer?
papillary thyroid cancer
70
Nitrosamines are found in what?
certain foods like smoked meats
71
Nitrosamines are most associated with what type of cancer?
gastric cancer
72
What are aflatoxins produced by?
Aspergillus flavus a fungus it can grow on improperly stored nuts and rice
73
What type of cancer are aflatoxins associated with?
hepatocellular carcinoma
74
What is radon?
radioactive gas that forms as byproduct from decay of uranium, thorium, and radium
75
What type of cancer is radon associated with?
lung cancer
76
What type of congenital cardiac malformations is Edwards syndrome associated with?
VSD
77
What is the most common location for peptic ulcer performation?
anterior duodenum
78
How do ulcers of the posterior duodenum present?
massive bleeding (hematemesis) from the adjacent gastroduodenal artery
79
What are the most commonly implicated organisms found that lead to spontaneous bacterial periotonitis?
E.coli, Klebsiella, and streptococcus
80
A development of pain and fever in a patient with pre-existing ascites suggests what condition?
spontaneous bacterial peritonitis (SBP)
81
Most common cause of SBP?
Most common cause of spontaneous bacterial peritonitis is E.coli
82
What is the most common congenital cardiac anomaly seen in Down Syndrome?
atrioventricular septal defect
83
Common 2 signs of Parvovirus B19 in a patient with SCD
In sickle cell patients with parvovirus B19 often have both decreased reticulocyte count and anemia
84
What are the signs of splenic vaso-occlusion in patient with SCD?
Increased reticulocyte count with anemia