Flashcards in Combank 5 Deck (95):
T scores greater than -1 are considered?
T scores between -1 and -2.5 are considered?
T scores less than -2.5 are considered?
What is the function of Calcium acetate and when is it used?
It is a phosphorus binder that causes the phosphorus consumed to be excreted in the stool; used to manage hyperphosphatemia in end stage renal failure
In what class of drugs is raloxifene and what does it do? What risk does it carry?
Selective estrogen receptor modulators (SERMs); decrease osteoclast function of estrogen; carries increased risk for DVT
What is Dupuytren's contracture?
A painless thickening and contracture of tissue beneath the skin on the palm of the hand and fingers, one or both hands can be affected. Typically, a painless nodule develops in the connective tissue below the skin on the palm side of the hand. Over time, it thickens into a cord-like band and leads to an inability to extend or straighten the fingers
Classical Dupuytren's contracture most commonly involve which digits?
Fourth and fifth
What are the seronegative spondyloarthropathies which present as joint pain in the absence of rheumatoid factor and ANA?
ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis
Name the condition - a complex immune mediated d/o that presents as inflammatory plaques on the skin characterized by silver scaling plaques
What is adenomyosis and how do patients usually present?
presence of endometrium within the myometrium; usually present with unusually painful and hemorrhagic menses
What is premature ovarian failure?
when a woman shows signs of menopause before 40 years of age
What is placenta accreta?
an abnormal invasion of the chorionic villi into the myometrium of the uterus
The development of an early onset of breast and ovarian cancer is associated with the deletion of what gene?
tumor suppressor gene BRCA1
What type of inheritance pattern does BRCA1 have?
This is a tumor suppressor gene that is associated with the development of retinoblastomas and osteosarcomas
Patients with a genetic mutation of p53 can develop what syndrome?
Li-Fraumeni syndrome; leads to the development of various malignancies at an early age, including breast cancer, sarcomas, brain tumors, and adrenocortical carcinomas
What is the p53 tumor suppressor gene located and what is its function?
located on chromosome 17; normal function of p53 is regulation of the cell cycle at the G1/S checkpoint; p53 delays cell cycle progression and permits opportunity for DNA repair or initiation of apoptosis
What is HER2?
An oncogene that has intracellular tyrosine kinase activity
Breast cancer with positive HER2 expression is treated with?
Treatment with which antibiotic is notorious for causing pseudomembranous colitis?
Pseudomembranous colitis can treated with?
Either metronidazole or oral vancomycin
In order to treat Clostridium difficile should vancomycin be given orally or IV?
How does GERD occur?
tone of the lower esophageal sphincter decreases and gastric material is allowed to reflux back into the esophagus
Why are beta-adrenergic agonists unlikely to contribute to GERD?
b/c they have been demonstrated to maintain the constriction of the lower esophageal sphincter
What substances are capable of decreasing the constrictive tone of the lower esophageal sphincter and consequently increasing the risk for GERD?
fats, alcohol, caffeine, nicotine, nitrates, beta-adrenergic blockers, and calcium channel blockers
Duchene muscular dystrophy has what type of inheritance?
What is Gower's maneuver?
use of arms to help themselves climb up
How is Becker muscular dystrophy different from Duchenne muscular dystrophy?
symptoms present later in life (5-15 years)
What is Gaucher disease?
lysosomal storage disease characterized by hematologic abnormalities, organomegaly and skeletal involvement
What enzyme is elevated in Duchene Muscular Dystrophy?
In what class of drugs are Tamoxifen and raloxifene?
selective estrogen receptor modulators
What is the difference between Tamoxifen and raloxifene?
Tamoxifen increases the risk of endometrial cancer because it is a partial agonist on the endometrium; raloxifene does not increase the risk of endometrial cancer because it is an endometrial antagonist
Elevated alkaline phosphatase is a sign of ?
increased bone turnover
Why do thiazide diuretics induce hyperuricemia?
they increase urate reabsorption
In what drug class does amlopidine belong and what is it used to treat?
long-acting dihydropyridine-type (DHP) calcium channel blocker; used to treat HTN by relaxing arterial smooth muscle
How does amlodipine affect uric acid levels?
decreases serum uric acid by blocking the reabsorption of urate
Rhomboid-shaped, positively birefringent cystals and a WBC count of 10,000 cells/uL are found in?
Straw-colored, normally viscous aspirate with moderal WBCs is characteristic of?
Turbid, runny fluid with high WBCs describes?
joint aspirate of RA
Allopurinol should not be used to treat what condition?
acute gout -- may exacerbate the condition
Enterotoxigenic Escherichia coli (ETEC) causes what type of diarrhea?
copious watery, non-bloody diarrhea; can cause dehydration; travelers
Enteropathogenic Escherichia coli causes what type of diarrhea?
watery, non-bloody diarrhea in infants and children, not associated with fevers
Enterohemorrhagic Escherichia coli causes what type of diarrhea?
causes blood diarrhea, most commonly in children, commonly acquired by eating ground beef or unpasteurized milk (also from petting zoos)
In EHEC the fact that the bacteria does not invade the gastric wall means?
neither fever or white blood cells in a stool sample are present with EHEC
This syndrome is thought of as Familial adenomatous polyposis (FAP) with malignant CNS tumors (predominantly medulloblastomas and astrocytomas)
What is Peutz-Jeghers syndrome?
AD syndrome of benign hamartomatous polyps in the GI tract; these hamartomas are commonly found in the small and large intestine
What is a unique feature of Peutz-Jeghers syndrome?
hyperpigmented buccal mucosa
Peutz-Jeghers syndrome holds a 50% increased risk of what cancers?
colorectal, breast, and gynecological cancers
Hereditary nonpolyposis coli colon cancer (HNPCC) is also known as?
What is HNPCC (Lynch Syndrome)?
AD mutation of DNA mismatch repair genes that leads to colorectal cancer in approximately 80% of the patients with the genetic mutation
How does Lynch Syndrome differ from FAP?
Lynch syndrome does not correlate with the phenotype of multiple colorectal polyps and can lead to malignancy even in the absence of adenomatosis of the colon and/or rectum
What is Gardner Syndrome?
Familial adenomatous polyposis with the addition of extracolonic manifestations including desmoids, osteomas, and epidermoid cysts
What is the deficient enzyme in Fructose intolerance?
What is the deficient enzyme in Essential Fructosuria?
What is deficient in Galactosemia?
Proglottids are associated with?
tapeworms such as Taenia solium
Pin-shaped helminths describes?
Motile uni-nuclear trophozoites describes mobile protozoa known as?
Central karyosome, "Ring and Dot" describes the cyst of?
What is the DOC for giardiasis?
DOC for tapeworms such as Taenia solium
DOC for Enterobius vermicularis
A biopsy of the jejunum in a patient with celiac disease would show what characteristic?
What should be avoided in patients on metronidazole to prevent a disulfiram like reaction?
GET GAP on the Metro
Metronidazole is used to treat Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes (Clostridium, Bacteroides, Actinomyces) and H. pylori
DOC for metronidazole resistant giardiasis
What is the tumor marker for colorectal cancer?
Serial S-100 is used to track what condition?
What is the tumor marker for ovarian carcinoma?
What is a Krukenberg tumor?
bilateral ovarian metastasis from GI tract adenocarcinoma
What is characteristic of a Krukenberg tumor histologically?
mucin-producing signet ring cells
Where is osteosarcoma usually found, what appearance does it have and what is the prognosis?
found in the metaphysis of long bones; characteristic sunburst appearance; poor prognosis
What is the predisposing factor for development of osteosarcoma?
The tumor suppressor gene Rb normally inhibits what?
G1 to S progression in the cell cycle; if mutation of Rb exists then unrestrained cell growth occurs
How do PPI's (end in -prazole) work?
by blocking the production of acid via inhibition of parietal cell H+/K+ ATPases
What is struma ovarii?
a rare ovarian tumor consisting of ectopic thyroid tissue; causes elevation of thyroid hormones in up to 15% of patients
These cysts form as a result of overstimulation from high hCG levels or hypersensitivity to hCG
Theca lutein cysts also called lutein cysts
What is Meigs' syndrome?
Triad of ovarian fibroma with ascites and pleural effusion
An adnexal mass consisting of hypertrophied myometrial tissue represents a?
leiomyoma -- also known as a fibroid
What ligament is commonly injured during athletics from twisting or hyperextension?
Where does the ACL originate?
posterior aspect of the lateral femoral condyle and inserts on the anteromedial aspect of the tibial plateau
Name the bug: a spore forming, anaerobic Gram-positive rod that causes antibiotic-associated diarrhea and pseudomembranous colitis
This genus of bacteria are aerobic, gram positive rods that also form spores
What is Chadwick's sign and what does it indicate?
bluish hue in the vaginal mucosa; usually the first physical sign of pregnancy in the first few weeks
T/F Warfarin is absolutely contraindicated in pregnancy
T; under pregnancy category X
What are tophi?
chalky white uric acid deposits under the skin found in patients with gout
Cloudy purulent synovial fluid indicates?
How does joint aspiration differ for gout and pseudogout?
Negative birefringence for gout and positive birefringence for pseudogout
What is the DOC for acute gout attacks?
What is used to treat chronic gout and to prevent future attacks by decreasing uric acid production?
How does allopurinol work?
acts on purine catabolism; inhibits the enzyme xanthine oxidase which converts hypoxanthine to xanthine to uric acid
Schistosoma, Clonorchis sinensis and Paragonimus westermani are all?
Taenia solium, Diphylllobothrium latum and Echinococcus granulosus are all?
cestodes (tapeworms); hermaphrodites
Enterobius vermicularis is a?
pinworm (nematode); they are dioecious (separate male and female organisms)