Combank Assessment #2 P2 Flashcards Preview

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Flashcards in Combank Assessment #2 P2 Deck (80):
1

How does PCOS present clinically?

increased LH, decreased FSH, increased testosterone, increased androgens and increased estrogens; manifests clinically with amenorrhea, infertility, obesity and hirsutism

2

How does PCOS cause infertility?

elevated LH levels and elevated LH:FSH ratio; high levels of LH cause down regulation of the LH receptors at the ovaries this prevents the LH surge needed to trigger ovulation during the menstrual cycle

3

How is schistosomiasis acquired and how may it present?

exposure to contaminated water; can present with severe itching after exposure to the skin

4

What is the DOC for shistosomiasis and how does it work?

Praziquantel; causes calcium influx that depolarizes the tough outer tegument of the worm leading to paralysis and death

5

Mebendazole and albendazole both inhibit?

beta-tubulin polymerization, which inhibits microtubule formation thereby damaging the structural integrity of helminthic parasites

6

This is an NSAID that closes a PDA

Indomethacin

7

This is a prostaglandin PGE1 analog used to keep the PDA open

Alprostadil

8

What are first line medications to treat PTSD?

SSRIs

9

Transmural inflammation with "creeping fat" is hallmark of which inflammatory bowel disease?

Crohn's disease

10

Crypt abscesses (clusters of neutrophils within damaged epithelium) are a distinguishing characteristic of which inflammatory bowel disease?

ulcerative colitis

11

What is the MOA of Doxepin?

first generation TCA; blocks reuptake of NE and serotonin at the synapse

12

What is the classic presentation of DiGeorge syndrome?

a triad of conotruncal cardiac abnormalities, hypocalcemia and thymic hypoplasia

13

What is a well known paraneoplastic syndrome of small cell lung cancer which causes hyponatremia?

SIADH

14

In what portion of the nephron does ADH act on?

collecting tubule

15

Polymyalgia rheumatica most commonly presents in what population of patients?

females over the age of 50 years old

16

How does polymylgia rheumatica present?

causes myalgias and stiffness of the shoulder and hip girdle muscles; commonly associated with giant cell arteritis

17

What causes panlobular emphysema and how does it present??

involves entire respiratory lobule; occurs in patients with alpha 1 antitrypsin deficiency which leads to destruction of lung elastin

18

Smoking causes what kind of emphysema?

centrilobular emphysema

19

What is DIC and what characterizes it?

a complicated d/o that involves both excess bleeding and widespread thrombosis; fibrinogen is decreased while fibrin split products are increased

20

The ventral posterior medial nucleus of the thalamus receives sensory information from?

face; thalamus then sends this information to the primary sensory cortex

21

The ventral posterior lateral nucleus of the thalamus receives sensory input from?

the body and projects it to the primary sensory cortex

22

What should be checked when oral potassium fails to increase serum levels of potassium in a hypokalemic patient?

check for an underlying hypomagnesemia condition; this is b/c magnesium is a cofactor in potassium channel function within the kidney, acting to close channels in the absence of aldosterone, in cases of low serum Mg, these channels can remain open causing potassium wasting

23

What is Still's murmur?

a benign pediatric murmur that commonly presents in healthy children 2-8 y.o.; typically heard as a mid-systolic murmur of musical quality between the apex of the heart and left sternal border

24

Where are indirect inguinal hernias located?

lateral to the inferior epigastric artery

25

Where are direct inguinal hernias located?

medial to the epigastric artery

26

Indirect hernias result from?

a patent processus vaginalis -- this can lead to formation of a hydrocele

27

What type of hernia is most common in women and what does it result from?

femoral hernias are most common in women; these result from a defect in the femoral canal

28

Direct inguinal hernias involve penetration into?

Hesselbach's Triangle

29

What is sensitivity?

% of known positives that actually test positive

30

How do you calculate sensitivity?

true positive / [true positives + false negatives]

31

How do you calculate specificity?

true negatives / [true negatives + false positives]

32

Tuberous sclerosis has what inheritance pattern?

autosomal dominant

33

Ash leaf spots (hypopigmented macules) are associated with?

Tuberous sclerosis

34

What is the most common manifestation of tuberous sclerosis in the kidneys?

Angiomyolipoma

35

Tetany is a sign of?

hypocalcemia

36

Which syndrome has an increased association with horseshoe kidney development?

Turner Syndrome (XO)

37

Major hormone responsible for gallbladder contraction and pancreatic enzyme secretion

CCK

38

CCK is produced by endocrine cells that line the mucosa of the small intestine in response to?

ingested fats and proteins

39

Secretin is produced by cells in the small intestine in response to?

acidity that results from the secretion of chyme into the small intestine

40

Pepsinogen secreted by the chief cells of the stomach is converted to the active form of pepsin in what conditions?

low gastric pH; thus hydrochloric acid is responsible for the conversion of pepsinogen to pepsin, which breaks down proteins in food

41

When is trypsinogen secreted into the duodenum?

when the pancreas is stimulated by CCK

42

Which enzyme acts to convert trypsinogen into the active form of trypsin in the small intestine?

enteropeptidase

43

What is primarly lateral sclerosis?

a benign condition that manifests as a disturbance of upper motor neurons

44

What is Patau syndrome?

a trisomy 13 that leads to rocker-bottom feet, microphthalmia, microcephaly, cleft lip, holoprosencephaly and polydactyly

45

What is Edwards syndrome?

a trisomy of chromosome 18 that results in mental developmental delay, rocker-bottom feet, micrognathia, clenched hands, and congenital heart disease

46

Microdeletions of chromosome 5 leads to what syndrome?

cri-du-chat syndrome - results in microcephaly, mental developmental delay and a high pitched cry or mewing

47

What characterizes Williams syndrome?

Elfin facies, mental retardation, hypercalcemia, and extreme friendliness towards strangers; due to a deletion on chromosome 7

48

Risk factors for endometrial hyperplasia and endometrial adenocarcinoma are factors that?

increase exposure of the endometrial lining of the uterus to unopposed estrogen throughout one's life

49

This drug induces the expression of insulin-responsive genes

Rosiglitazone

50

Pancreatic head tumors most commonly present with?

pain, obstructive jaundice, dark urine, steatorrhea, clay colored stools and weight loss

51

Which vaccines are egg-based?

MMR, influenza vaccine, yellow fever vaccine

52

What are the three major branches that originate from the celiac trunk (a major branch of the abdominal aorta)?

left gastric artery, common hepatic artery, splenic artery

53

Sheehan syndrome -- ischemic necrosis of the anterior pituitary is a complication of?

massive blood loss during delivery

54

What is the DOC for Chagas Disease?

Nifurtimox

55

S3 is associated with what type of cardiomyopathy?

dilated cardiomyopathy

56

What is Leigh syndrome?

caused by pyruvate dehydrogenase deficiency; cannot convert pyruvate to acetyl coA so excess pyruvate becomes lactate causing lactic acidosis; patients present with poor feeding, developmental delay, seizures, abnormal eye movements, ataxia and mental delays

57

Diffuse large B cell lymphoma has what age of onset? what manifestation is a common presenting symptom?

onset during 7th to 8th decades of life; extranodal manifestations are a common presenting symptom and can lead to enlarging mass seen in the testicle

58

What causes a varicocele?

dilatation of the pampiniform plexus of the spermatic veins

59

What is known as a "bag of worms"?

varicocele

60

What is a hydrocele?

collection of peritoneal fluid in the tunica vaginalis - a layer that surrounds the testes and spermatic cord

61

What is a unique finding of a hydrocele during examination?

fluid in the hydrocele transilluminates

62

Tay-Sachs disease involves a deficiency in what enzyme?

Hexosaminidase A -- leads to accumulation of GM2 ganglioside

63

What enzyme is deficient in Niemann-Pick disease?

Sphingomyelinase

64

Epidermis, nerves, and melanocytes all stem from what embryological layer?

Ectoderm

65

What is Korsakoff psychosis characterized by?

amnesia, hallucinations, and confabulation due to thiamine deficiency; it is associated with alcoholism

66

A blowing holosystolic murmur loudest at the left 4th intercostal space is descriptive of?

VSD

67

Trichomonas vaginalis causes what type of discharge?

foul-smelling greenish discharge

68

How is trichomonas vaginalis best visualized?

via a wet mount slide

69

What is the indicated treatment for Trichomonas, Giardia, Gardnerella, anaerobes

Metronidazole

70

Name the cluster A personality disorders

paranoid, schizoid, schizotypal

71

Name the cluster B personality disorders

antisocial, borderline, histrionic, narcissistic

72

Name the cluster C personality disorders

avoidant, dependent, obsessive-compulsive

73

What disease is characterized by hemangioblastomas of the CNS, retina, pancreas, kidneys and adrenal glands?

Von-Hippel-Lindau disease

74

Von Hippel Lindau disease is due to error on what chromosome?

Chromosome 3

75

What is the most common primary renal tumor in children? what chromosome is affected?

Wilm's tumor; chromosome 11

76

La Crosse virus a member of the Bunyaviradae family causes?

California encephalitis

77

What does retroperitoneal mean?

located between the posterior parietal peritoneum and posterior abdominal wall

78

Primary retroperitoneal structures include....

adrenal glands, kidneys, ureters, bladder, aorta, IVC and rectum

79

Secondary retroperitoneal structures include....

head, neck, and body of pancreas, ascending colon, descending colon, duodenum (except first portion)

80

What does secondary retroperitoneal mean?

structures that were once suspended by mesentery but migrated posterior