When should Intercourse be avoided during Pregnancy?
Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes
What is Type 2 RTA?
Proximal RTA: bad Carbonic Anhydrase, lost all HCO3-
What is Heavy Chain Disease?
IgA and Multiple Myeloma of the GI tract
What is Nihilism?
Feeling of "life is meaningless"
What is Forward Typing?
Uses Antibodies to detect Antigens
What is associated with Vibrio Vulnificus?
Raw Oyster - common in workers shucking the oysters, cellulitis in swimmer's cuts
What is the MOA of Propranolol, Timolol?
B1 and B2 Blockers
What is Hand-Foot-Mouth Disease?
Will not eat or drink
Palm and sole rash caused by Coxsackie A
What are the 2 kinds of partial seizures?
Simple (aware), complex (not aware)
What is an Omphalocele?
Intestines protrude out of the umbilicus covered by peritoneum
What is Clanging?
Words that sound alike
What is exudate?
Effusion of mostly proteinToo much protein: Will have ---Purulent (from Bacteria),Hemorrhagic (from trauma, CA, PE)Fibrinous (from collagen vascular disease), Granulomatous (non-bacterial)
What are the Mimetic drugs?
What is Lewy Body Dementia?
Stiff with visual hallucinations
What type of problem is there if serum Ca2+ and Serum PO4- change in same directions?
This is a secondary problem
What is the Pool Test?
Fluid in the vagina
What are the indications for Odansetron?
Control vomiting in patients undergoing chemo therapy and postoperatively
What is Kd?
Concentration of drug that binds 50% of receptors
What is associated with H. Aegyptius?
Swollen eyeball with pus
What is Overflow Incontinence?
Cannot completely empty bladder
How does Gonorrhea present?
Palmar pustules, arthritis/joint pain, urethral discomfor
What makes Achalasia unique?
Decreased Peristalsis and increased LES pressure
What is the MOA of Pseudoephedrine, phenylephrine?
Sympathomimetic alpha-agonistsnon-prescription nasal decongestants
Where does DHT come from?
Testicles at puberty
What is Intraductal Papilloma?
Bleeding from the nippleMost common Breast CA
How does temporal arteritis present?
Pain with chewing, blind in one eye
What diseases have PIE syndrome?
Aspergillus, Loeffler's, Churg-Strauss
What is associated with Fusobacterium?
Painful mouth ulcers, gum pus, Vincent's angina
What is the MOA of ACE inhibitors?
Inhibits conversion of Ang I to Ang II, decreases Ang II
What is Central (neurogenic) diabetes insipidus?
Brain not making or producing enough ADH
What is Arnold-Chiari?
Foramen Magnum obstruction
What is 1st-order kinetics?
Constant drug percentage metabolism over time depends on drug concentration (rate of elimination is directly proportional to drug concentration)
What does Vit B2 do?
Clues for atypical pneumonia?
Atypical pneumonia: prolonged illness, low fever, usually >40 y/oX-ray: diffuse, H. Influenza, Mycoplasma, Chlamydia
What does giving DDAVP during the Water deprivation tests tell you?
>50% increase (central complete DI),10-50% increase (central partial DI),<10% (psychogenic polydipsia),no change (nephrogenic DI)
What will you see with Alpha Thalassemia?
Seen in African Americans and Asian Americans (Chromosome 16- deletion)
What are the simple Gram Negative Bugs?
They lack Lipopolysaccharides,"Simple HE"H - H. InfluenzaE - E. Coli
What is a Neutrophil?
The Phagocyte (it has Antimicrobials, most abundant)
What is the MOA of Glucocorticoids?
Decrease production of Leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
What is Transference?
Patient views doctor as parent
Where is the most common site of a Clavicle fracture due to birth?
Middle third of the Clavicle
What are the indications for Niacin?
Decrease LDL and TriglyceridesStrong increase HDL
What is Perseveration?
Keeps repeating the same words
What does the parathyroid cells secrete?
What is associated with Actinomyces?
Face Fistulas, Sulfur Granules
What is a Rolling Hiatal Hernia?
Bowel Protruded through a defect in the Diaphragm. This can strangulate the bowel and can cause Atelectasis
What is Mesenteric Ischemia?
Abdominal pain of of proportion to physical exam
What is the MOA of Diazoxide?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
What is Primary Sclerosing Cholangitis?
Anti-smooth muscle antibody (20-50%), bile ducts are scarred from inflammation, there is beading and onion skinning, it's associated with UC and P-ANCA (80%)
What does the viral load tell you?
Progression of HIV
Which enlarged lymph nodes are most likely malignant?
Supraclavicular, Epitrochlear (above the elbow), inguinal
What is Velamentous Cord Insertion?
Fetal vessels insert between chorion and amnion
What is Common Variable Immuno. Def?
Young adults with B cells that do not work
What are the Indications for Oxytocin?
Induces labor and Controls uterine hemorrhage
What does Mg2+ do?
PTH and kinase cofactor
What are the risk factors for Lung CA?
Smoking, Radon, second hand smoke, pneumoconiosis (except Anthracosis)
What is the Adverse Effect for first generation Sulfonylureas?
Disulfiram like effects
What is Multiple Myeloma?
Multiple osteolytic lesionsIncreased IgG and kappa light chainsRouleaux formation seen on slide
Clues for Typical pneumonia?
Typical pneumonia: short illness, high fever, usually >40 y/o, X-ray: one lobe, Streptococcus Pneumonia
What is Polycythemia Vera?
Hematocrit (Hct) >60% Decreased EPO, Budd-ChiariPruritis after bathing
What is the MOA of Mimetics?
What is Ascending Cholangitis?
Common bile duct infection due to stones
What does Growth Hormone (GH) do?
Stimulates growth, sends Somatomedin to growth plates, Gluconeogenesis by proteolysis
What is Anderson's?
Branching enzyme deficiency, long chains of glycogen
What is the Sympathetic System?
Fight -or- Flight, speeds stuff up
What is a Double Footling Breech?
Two feet sticking outside the cervical OS
What vessel has the thickest layer of smooth muscle?
What is Competitive Inhibition?
Fights for active site, no change in Vmax, potency decreases
What does blood type O tell you?
They have no antigens (Universal donor)
What does high WBC and B Cells tell you?
What are the Rapidly Dividing Cells of the Energy State?
Skin: dryNails: BrittleHair: AlopeciaLow Bone Marrow: SuppressedVasculature: Endothelium breaks downLungs: Infection / SOBKidney: PCT effecfted firstGI: N/V/DBladder: Decreased toneSperm: DecreasedGerm Cells: Predisposed to cancerBreasts: AtrophicEndometrium: Amenorrhea
What diseases are cause by the Ixodes Ticks?
Lyme Disease - bull's eye lesionBabesiosis - Hemolytic AnemiaEhrlichiosis - puncture near eye
What does a Dehydrogenase do?
Catalyzes Oxidation-Reduction reactions (gaining or losing an electron)
What is Unconjugated Bilirubin?
Fat soluble and indirect Bilirubin
What is a transition?
Changes one purine to another purine
What is Crigler-Najjar Type I?
Unconjugated bilirubin buildupNewborn or infantsNo UDP-GTPhenobarbital yields no change
What organ has the highest AVO2 difference after excercise?
What are the bugs that cause gastroenteritis within 8 hours of eating the preformed toxin?
Staph Aureus (potato salad)Clostridium Perfringens (holiday turkey/ham)Bacillus Cereus (fried rice syndrome)
What are the most common places to metastasize to the brain?
From the lung, breast, and skin, present at the White-Grey Junction
What is Polyhydramnios?
Too much amniotic fluid (baby can't swallow)
What is the function of GnRH?
Stimulates release of LH & FSH
What are the risk factors for Esophageal / Gastric CA?
Smoking, alcohol and nitrates
What is Slipped Capital Femoral Epiphysis?
Gradual or acute separation of the proximal femoral growth plate with femur head slipping off femoral neck and rotating into inferior-posterior position. Most common during puberty and more in overweight individuals, present with a limp and pain recurring often to the kneeLimited hip internal rotation and outward rotation of lump with hip flexionx-ray: epiphyseal displacement
FEV1/FVC in Restrictive lung disease
Normal or elevated
What has Waxy Casts?
Chronic Renal Failure
What are the only Gram-negative diplococci?
How does a VIPoma present?
What are the indications for the Class IB antiarrhythmic?
Decrease AP duration, acute ventricular Arrhythmias, local anesthesia
What defines Diarrhea?
>200 grams of stool per day
What defines constipation?
Less than 3 bowel movements per week
What defines ALL?
0-15 year old males, bone pain, + PAS stain and +TdT. CALLA antigen positiveT (12;21)
What is the MOA of Class IB antiarrhythmic?
Na+ channel blocker
What is a Duodenal Ulcer?
Pain 20-30 minutes after eating, relieved with food, caused by H. Pylori infection 80-90% of the time and weight gain
What is a Female Pseudohermaphrodite?
XX with LOW 21-OHase and HIGH Testosterone
What are the adverse effects of Acid Resins?
Tastes bad and causes GI discomfortbile decreases absorption of fat soluble vitaminscholesterol gallstones
What is Hurler's?
Alph-L-Iduronidase deficiencyworse formGargoylismCorneal cloudingaccumulation of Heparin and Dermatan Sulfate
What are the indications for fibrates?
Strong decrease of triglyceridesslight decrease of LDLslight increase in HDL
What are the classifications of MHC-2?
HLA-DP, HLA-DQ, HLA-DR
What is Cori's?
Debranching, a-1,6 glucosidase enzyme deficiencyshort branches of glycogenmilder form of von Gierke with normal lactate levelslimit-dextrin's accumulate
How does Choanal Atresia Present?
Baby turns blue with feeding, pinks up when breast of bottle is removed (blocked nasal passages)
What is the job of the Proximal Convoluted Tubule?
Reabsorb Glucose, Amino Acids, Salt, Bicarb. >60-80% Reabsorption occurs here
What is Bronchiectasis?
Bad breath, purulent sputum, and hemoptysis
What electrolytes does the low volume state have?
Increased total Na+ (NET)Decreased serum Na (dilution effect)Decreased serum K+Increased serum pH
In what layers does a pseudo aortic aneurysm occur?
Intima and media layers
Who makes the Syncytiotrophoblast?
Mom and baby production of HCG and HPL
What is Metorrhagia
Bleeding or spotting in btwn periods
How does Spastic Colon present?
Intermittent severe cramps
What is selective IgG2 Deficiency?
Seen in patients with recurrent encapsulated infections
What diseases have respiratory acidosis?
Obstructive lung diseases
What is Prinzmetal's angina?
Coronary Artery Spasm
What does high WBC and High PMN's tell you?
Stress demargination. (Stress response - post trauma)
What causes a Cleft Palate?
Maxillary shelves did not fuse
What is Rouleaux formation?
Seen in Multiple Myeloma (Stacked coin look)
What is Neologisms?
What is Nephrotic Kidney Disease?
Lostbasement membrange chargeProteinuria >3.5hypercoagulablelipiduria
What does a Phosphatase do?
Removes Phosphate from substrate
What bug loves the parietal lobe?
What bug is associated with Cat Scratch?
What is Selective IgA Deficiency?
Seen in transfusion, anaphylaxis, and mucus membrane infections
What is the Trough level?
2 hours before next dose (too high - give less often)
What is VHL?
Predisposes individuals to bnign and malignant tumors, AVM in the head, and retina (AD inheritance in Chromosome 3)
What causes a Cleft Lip?
Medial nasal prominence did not fuse
What is the MOA of Reserpine?
Prevents the storage of monoamines in synaptic vesicle
What are the 3 tests used to screen for HIV?
ELISA: Detects IgG Ab to p24 AgWestern Blot: ProteinsPCR: Detects Virus (used in babies)
What is Materninty Blues?
Postpartum crying and irritability
What are the inidications for PPIs?
Peptic ulcer, gastritis, mid-esophageal Reflux and Zollinger-Ellison syndrome
What are the Ca2+ channel blockers?
What is Conn's Syndrome?
High Aldosterone (primary tumor), Cpatopril test makes it worse, and increase's secretin hormone
What color is stool with a Lower GI Bleed?
Bright Red Blood (Hematochezia)
What is Type 5 Hypderlipidemia?
Defective enzyme and receptor (C-II) Elevated VLDL and ChylomicronsAssociated with DM
What is the RBC lifespan when there is a problem?
60-90 days (same time as the shelf life of blood bank units)
What sound radiates to the back?
What is the MOA of Prazosin?
Alpha 1-Blocker, vasodilation, decreases TPR
What is Sandhoff's?
Hexosaminidase A/B deficiency
What is the MOA of Octreotide (Synthetic analog of Somatostatin)?
Decreases release of GH, Gastrin, CCK, Carcinoid, VUP, Glucagon and Insulin
How is Smallpox different from Chickenpox?
Smallpox is on the face, same stage of development and fever
What is Diffusion?
From high to low concentration No ATP
What are the Fibrates?
Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate
What is Anthracosis?
Coal workers, extensive fibrosis
What is Conduct Disorder?
Younger than 18 y/o with traits of antisocial disorder: aggressive, disregard for authority/rules, no sense of guilt/remorse, harms animals, illegal activity "bite is worse than bark". Behavioral therapy and antipsychotic
What are the names of the B vitamins?
"The Rich Never Lie about Panning Pyrite Filled Creeks"Vit B1 = ThiamineVit B2 = RiboflavinVit B3 = NiacinVit B4 = Lipoic acidVit B5 = Pantothenic acidVit B6 = PyridoxineVit B7 = BiotinVit B9 = FolateVit B12 = Cobalamin
What 5 bugs cause heart block infections?
"Don't TeLL Chaga"
T- Typhoid Fever (Salmonella Typhi)
L- Lyme Disease
C- Chagas Disease (Whipple's)
What is a Complete Abortion?
Cervix is closed, no fetal remnants, check B-HCG level
What is a "Blue Bloater"?
What are the Indications for ACE inhibitors?
HTN, CHF, post MI and vasodilation
What is the MOA osmotic Laxatives?
Provide osmotic load to draw water outLactulose treats Hepatic encephalopathy: gut flora degrades it into metabolites (lactic acid and acetic acid) that promote Nitrogen excretion as NH4+
What is the treatment for hypercholesterolemia?
What are the adverse effects of Minoxidil?
Hypertrichosis and Pericardial Effusion
What are the adverse effects of adenosine?
flushing, hypotension, and chest pain very short acting
What are the Glucocorticoid drugs?
Hydrocortisone, Triamcinolone, Dexamethasone, Prednisone, Beclomethasone
Adrenal medulla tumor in adults, they will have five P's: Palpitations, Perspiration, Pallor, Pressure (HTN), and Pain (headache)
What is Byssinosis?
Cotton workers, textile workers
What is Chediak Higashi?
Lazy Leukocyte Syndrome(Lysosomes are slow to fuse around bacteria)
What is Korsakoff Psychosis?
Alcoholic Thiamine deficiency. Presents with confusion, Opthalmoplegia, ataxia, memory loss, confabulation and personality changeTx: Vit B1
What type of Kidney Stones have Coffin-Lid Crystals?
Triple Phosphate (Struvite)
What is the difference between carotid body and carotid sinus?
Carotid Body: ChemoreceptorCarotid Sinus: Baroreceptor
What is Meconium?
Green baby poop (first poop)
What does Insulin do?
Pushes glucose into cells and K+ follows
What causes Granuloma Inguinale?
What is the MOA of Carvedilol?
Alpha and B-Blocker
What is the MOA of Levothyroxine (T4)/Triiodothyronine (T3)?
What is Anisocytosis?
RBC's with different sizes
What is Pain Disorder?
Prolonged pain not explained by physical causes
What causes Congenital Blindness?
What is Plummer-Vinson Syndrome?
Esophageal webs, Iron-deficiency anemia, dysphagia
What is Neurofibromatosis?
Cafe' au laut spots (hyperpigmentation)Peripheral nerve tumors, axillary frecklesType 1: Von Recklinghausen's-- Chromosome 17, peripheral, optic glioma, Lisch nodules, scoliosisType 2: Acoustic Neuroma, Central, Chromosome 22, cataracts, bilateral deafness
What is associated with Strep Viridans, Strep Mutans, and Strep Salivarius?
Subacute bacterial Endocarditis, green pigment, Alpha HemolyticStrep Mutans - dental cariesStrep Salivarius - cold agglutinates
What are the adverse effects of Dextromethorphan?
Mild opioid effect so mild abuse potential
What is the most common cause of Epididymitis?
Chlamydia Trachomatis, N. Gonorrhea, E. Coli
What is Charcot's Triad?
Jaundice, Fever (usually with rigors) and RUQ pain
What is seen with Manganese deficiency?
Lose xanthine oxidase function
What is Psychogenic Polydipsia?
Drinking a lot of water, diluting Na in blood
What is seen in newborns with Syphilis in utero infection?
Rhages (lip fissue), Saber shin legs (anterior bowing of the tibia), Hutchinson's Razor teeth,Mulberry Molars
What is the afferent arteriole's job?
Monitor pressure (JG cells-Renin release)
How do you detect a Pulmonary Embolus?
Tachypneaincreased V/Q scanECG may show signs of right heart strain or acute cor pulmonale in cases of Large Pes - large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead IIIS1Q3T3
What is a frameshift mutation?
Insert or delete any number of bases, not divisible by 3, causes misreading of all downstream nucleotides
What is the Isoelectric Point?
The pH at which there is no net charge
What does an opening snap tell you?
Mitral or Tricuspid Stenosis
What is the rate-limiting enzyme in FA synthesis?
Acetyl-CoA Carboxylase (ACC)
What does a Phosphorylase do?
Adds inorganic Phosphate to substrate, No ATP used
What is associated with EHEC?
Hemorrhagic = renal failure
What are the Bile acid resins?
What is associated with Enterococcus?
UTI, infective Endocarditis post GI/GU procedure
What is Voyeurism?
Watching other people without their permission
What does CCK (Cholecystokinin) do?
Stimulates bile release and gallbladder contraction, inhibits gastric motility (closes sphincters), and made by I-cell of duodenum
What does LDL do?
It carries Cholesterol (only one to do this)
What is TORCH Infection?
Toxoplasmosis: Hydrocephalus with generalized intracranial calcification and choriogenesis.Others= HIV, Syphilis, Varicella, B-19HIV= Most infected are asymptomatic, clinical symptoms-- Lymphadenopathy/HepatosplenomegalySyphilis= Osteochondritis and Peridotites; skin rash on palms and soles, snufflesVaricells = Pneumonia (neonatal); limb hypoplasia, cutaneous scar, seizure, MRB-19 = Hydrops FetalisRubella = Cataracts, deafness and heart defects, blueberry muffin spotsCMV = Microcephaly with periventricular calcification, petechia with thrombocytopenia, sensorineural hearing lossHerpes = 1st week: Pneumonia/shock2nd week: Skin vesicles, keratoconjunctivitis3rd week: Acute Meningoencephalitis
What does Dopamine (DA) do?
Inhibits Prolactin (PRL) release
What is Bipolar II?
Depression and Hypomania (no psychosis)
What is the Capacitation reaction?
Allow binding btwn sperm & egg
What is associated with Klebsiella Pneumonia?
Alcoholics, Currant Jelly Sputum, UTI, Lung fissures
What is the Indication for Demeclocycline?
What lysosomal diseases have a Gargoyle face?
What is a Footling Breech/Incomplete breech?
Butt down. Thigh flexed, one toe is sticking out of the cervical OS
What is the MOA of Glitazones/Thiazolidinedione's?
Increases Insulin sensitivity in peripheral tissues. Transaction modulation by Peroxisome Proliferator Activated Receptor Gamma in Nuclus
What makes B-HCG?
What does erythropoietin (EPO) do?
Makes RBC's (prolong RBC life)
What is Erythrasma?
Rash in the skin folds, coral-red under Wood's Lamp
What do stomach chief cells secrete?
What are the Adverse Effects of Sulfasalazine?
Malaise, nausea, Sulfonamide toxicity, reversible Oligospermia
What are the indications for Class IC antiarrhythmic?
Ventricular tachy progressing to V. fib, last resort
What is Tracheomalacia?
Soft cartilage and stridor since birth
What is the MOA of Sulfasalazine?
A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammtory) activated by colonig bacteria
What are the Indications for Biguanides?
First line therapy in Type 2 DM
What is Choledocholithiasis?
Gallstone obstructs the bile duct
What bug loves the frontal lobe?
What is a Platelet?
The clotter (has no nuclei and smallest cells)
How do I know the patient has a Vitamin E Deficiency?
Increased free radical damage, hemolytic anemia, ataxia gait, impaired position and vibration sense
What is Pseudohermaphrodite?
external genitalia problem
What is Niemann-Pick?
Sphingomyelinase deficiencyAreflexiaHepatosplenomegalyfoam cells (Lipid Laden macrophages)
What is Efficacy?
Maximal effect drug can produce regardless of dose (lower w/ non-competitive antagonist)
What are the Indications for Alpha-Glucosidase inhibitors?
NIDDM. (Type 2)
What type of kidney stones have hexagonal crystals?
What does Oxytocin do?
Milk letdown and uterine contractions
What is sinusitis?
Inflammation of the paranasal sinuses, tooth pain worsens upon bending forward
What is duodenal Atresia?
Bilious vomiting with first feeding, double bubble sign on x-ray, associated with Downs Syndrome
What is Multiple Endocrine Neoplasia I?
"Wermer's" 3 P's: Pancreas, Pituitary, Parathyroid adenoma
What GI diseases has a RLQ Sausage mass?
What is a Dohle Body?
PMN Leukocytosis(caused by infections, steroids, tumor)
What does an ejection click tell you?
Aortic or Pulmonic Stenosis
What is associated with Clostridium Perfringens?
Holiday ham and turkey - left out on counter and Clostridium jumps on and waits, enterotoxin causes Gastroenteritis, food gets reheated - bug is loving life, DM patients get Gas Gangrene due to the alpha toxin, also found in soil and feces
What Is Lesch-Nyhan?
HGPRT deficiencygrout neuropathyself-mutilationDystoniaXLRPrange sand crystals in diaper
What is a Bite Cell?
Unstable Hb inclusions (seen in G6PD Deficiency)
What is Antisocial Personality Disorder?
Lie, cheat, steal, destroy property, impulsive without remorse, illegal activity, aggressive towards others. Must be over 18 y/o
What are the Adverse Effects of Odansetron?
Headache, constipation, dizziness
What does Southwestern blot detect?
DNA-binding Proteins (combines south and western blots)
What does a paradoxical S-2 split tell you?
Aortic Stenosis or LBBB
What is Pre-Eclampsia?
Ischemia to the placenta causes HTN greater than 140/90
What is the MOA of FIbrates?
Upregulate LPL, increase triglyceride clearance
What is the Crystallization reaction?
Wall formed after one sperm enters to prevent polyspermy
What does auscaltation of wheezing tell you?
Intrathoracic narrowing (seen on expiration on x-ray)
What are Ideas of Reference?
Believes the media is monitoring you
What does the Citrate shuttle do?
FA transport out of the mitochondria
What conditions cause weight gain?
Obesity, Hypothyroidism, Depression, Cushing's, Anasarca
What does Vit B5 do?
Part of Acetyl-CoA, no known diseases
What is Spina bifida aperta?
Has opening (High AFP)
What is HELLP Syndrome?
Hepatic injury causing:H- HemolysisEL- Elevated Liver EnzymeLP- Low Platelets
What is the MOA of Class IA antiarrhythmic?
Na+ channel blocker
What is the fucntion of LH (Luteinizing hormone)?
Stimulates Testosterone release from the testis, Androgens and Progesterone release from the ovary
What is the Parasympathetic System?
Rest and digest, slows stuff down
When do you see silent thyroiditis?
What are the adverse effects of Reserpine?
What is associated with Paseurella Multocida?
Cat/Dog saliva => Cellulits with lymphadenitis
What is Gigantism?
Childhood form of Acromegaly
What form of Estrogen is highest at Menopause?
E1: Estrone (Made by Fat)E2: Estradiol (Made by the ovaries)E3: Estriol (Made by the placenta)
What are the adverse effects of Losartan?
Fetal renal toxicityHyperkalemia
What is pulse pressure?
Systolic minus diastolic pressure
What is Addison's disease?
Autoimmune destruction of adrenal cortex, causes hyperpigmentation (looks tan), and increased ACTH
What is the muscarinic antagonist drug used for asthma?
What is the function of Prolactin (PRL)?
What is associated with Chlamydia Trachomatis?
Neonatal in-turned eyelashes, Corneal Ulcers
How do I know the patient has a Vitamin D Deficiency?
Rickets (children), Osteomalacia (adults)
What is Zenker's Diverticulum?
Cough up undigested food from above the UES, Halitosis, motor dysfunction problem
What is a Male Hermaphrodite?
XY with no MIF
What is Dissociative Fugue?
No past memory at all, even if they see someone from the past - they have no ideaTravel to a new place, usually due to trauma
What is an Allograft?
Human to human transplant
What are the indications for the Class IA antiarrhythmic?
Increase AP duration, icnrease effective refractory period (ERP) QT interval, affect reentrant and ectopic SVT and ventricular tachy
What is Ovarian Hyperstimulation syndrome?
Weight gain and enlarged ovaries after clomiphene use for infertility
What is the first generation Sulfonylureas?
Chlorpropamide and Tolbutamide?
What is the difference between Myeloid and Lymphoid Leukemia's?
Myeloid: increased RBC, WBC, platelets, macrophages (decreased Luymphoid cells) and bone marrow biopsyLymphoid: increased NK, T, B cells (decreased Myeloid cells) and do lymph node biopsy
What are the indications for corticosteroids?
Chronic asthma, COPD
What are the acidic amino acids?
What is the Indication for GLP-1 Analogs?
NIDDM. (Type 2)
What does Fremitus, Egophony and Bronchophony tell you?
Consolidation (pathognomonic for pneumonia)
What diseases have high eosinophils?
"NAACP"N - Neoplasm (Lymphoma)A - Allergy/ AsthmaA - Addison's disease (no cortisol -relative eosinophilia)C - Collagen Vascular diseaseP - Parasites
What does "Penia" tell you?
Low Levels - (Usually due to virus or drugs)
What happens with Rubella infections in utero?
Cataracts, hearing loss, PDA, "blueberry muffin" rash (Rash on face that spreads to trunk)
What is a complete molar pregnancy?
2 Sperm and no egg (46, XX) both are paternal, bunch of graps, dad eats grapes, no embryo(GROSS!)
Where does Testosterone come from?
Adrenal gland and testicles
What antibody shows past Hep A infection?
What hepatitis B labs indicate recent immunization within >2/52wks?
What is Thought Blocking?
What is Chronic Mucocutaneous Candidiasis?
T-cell defect against Candida Albicans and chronic fatigue
What is Budd-Chiari
Hepatic vein obstruction
What does "Cythemia" tell you?
What are the degrees of Vaginal Lacerations?
1st Degree: Skin2nd Degree: Muscle3rd Degree: Anus4th Degree: Rectum
What are the Indications for GH?
GH deficiency in children, Turner syndrome, and Burn victims
What does a Kinase do?
Adds Phosphate group to substrate using ATP
What will Ranson's criteria tell you and what will you see at 48 hours?
Prognosis of Pancreatitis patients BUN >5 mg/dL (decreased RBF)Calcium <8mg/dL (saponification)HCT drops >10% (bleeding into pancreas)sequester > 6 liters of fluid (3rd spacing)Oxygen pO2 <60 mmHg (fluid/protein leak, leads to ARDS)base deficit >4 mEq/L (diarrhea due to no pancreatic enzymes)
What is Cushing's Triad?
HTN, Bradycardia, irregular breathing
What is Seborrheic Dermatitis?
Red rash with oily skin and dry flaky hairline, crusty lesion
What receptors do Steroid Hormones use?
Nuclear membrane receptors (except cortisol cytoplasmic receptor)
What is the MOA of Antileukotriene?
5-lipoxygenase inhibitor -> inhibits conversion of arachidonic acid to leukotriene -> prevents bronchoconstriction and inflammatory cell infiltrate
What lysosomal diseases have a cherry-red macula?
What is a Meduloblastoma?
Pseudorosettes compressing the brain, early morning vomiting
What antibody shows current Hep A infection?
What does Vit B3 do?
What are the essential amino acids?
Phynlalanine, Valine, Threonine(PVT)Tryptophan, Isoleucine, Methionine(TIM)Histidine, Arginine, Leucine, Lysine(HALL)
What is the Dawn Phenomenon?
Morning hyperglycemia secondary to Growth Hormone
What is Hepatorenal Syndrome?
High urea from the Liver leads to: increased Glutaminase, Ammonia, GABA- Kidney shuts down
What is Nevus Flammeus?
Port Wine Stain - Permanent- Unilateral of face or neck- Vascular malformation - Sturge - Weber syndrome - Vasculitis- Mgt: Pulsed laser therapy
What defines CML?
30-50 y/o females t(9;22)Philadelphia Chromosomebcr-abl
What is a Kleihauer-Betke Test?
Detects percentage of fetal blood in maternal circulation (Dilution test)
What is Kallmann's Syndrome?
No GnRH and Anosmia. (They can't smell)
What are the aromatic amino acids?
Phe, Tyr, Trp
What structures have one-way valves?
Urethra and ejaculatory duct
How fast should fundal height change?
Uterus grows 1 cm/week
What GI disease has an Abrupt Cut off on X-Ray?
What is associated with Pseudomonas Aeruginosa?
Otitis Externa, Ecthyma Gangrenosum, loves rubber, Whirlpool Folliculitis, exotoxin (ADP ribosylates EF-2)
What is normal blood loss during a Vaginal Deliver?
What is Achalasia?
Increased LES Pressure (no Auerbach's Plexus), Bird's Beak on X-Ray and also seen in Chagas Disease
What are the most common causes of Oligohydramnios?
Abdominal Muscle Problem: Prune Belly Renal Agenesis: Potters Syndrome
What causes anterior leg bowing?
What are the Intravascular Hemolytic Anemias?
IgM G6PD deficiencycold autoimmune
What are the adverse effects of the Class IA antiarrhythmic?
Quinidine: CinchonismProcainamide: Torsades de Pointes
What does Trypsin cut?
What is a Dandy Walker malformation?
No cerebellum, distended 4th and lateral ventricles
What is Synesthesia?
Where is a Bochdalek Hernia?
Occur more commonly on the posterior left side (diaphragm), most common congenital Diaphragmatic Hernia (CDH)
What is Menetrier's Disease?
Loss of protein through the rugal folds. Causes generalized edema. CMV association in children and H. Pylorus in Adults
What is a True Hermaphrodite?
Internal genitalia problem (has both sexes)
What gives urine its yellow color?
Urobilinogen being oxidized to urobilin
What is a Schistocyte?
Broken RBC (seen in DIC and artificial heart vlaves and others)
What does vasoactive intestinal peptide (VIP) do?
Inhibits secretin, motilin, and CCK, and opens Sphincters
What are the adverse effects of Digoxin?
Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failureQuinidine displaces Digoxin from tissue binding sites
What is Amnesia?
Can't recall important facts
What is Type A gastritis?
Upper GI bleed, autoimmune (anti-parietal cell antibodies), Atrophic / Achlorhydria and increased risk for adenocarcinoma (body & fundus region of the stomach)
What organ has the highest AVO2 difference after a meal?
What is Inflammatory Carcinoma?
Infiltrates Lymphatics, pulls on Cooper's Ligaments "Peau d'Orange"
What is associated with Propionibacterium acnes?
Acne, Progesterone => Propionic acid
What type of immunity does TH2 provide?
Enhances humoral immunity
What is Multiple Myeloma?
Male >40 with lower back painSerum M protein (IgG)Bence-Jones Proteins in the urineRouleaux formationPunched out lesions on x-ray
What is the function of TRH?
Stimulates TSH release
What are some causes of G6PD Deficiency?
Sulfa drugs, mothballs, fava beans, sudden drop in Hb
What is Erythema Toxicum?
White wheal on red area rash has Eosinophils
What is Pseudocyesis
Fake pregnancy with all the signs and symptoms
How does Herpes present?
Primary: Painful grouped vesicles on red baseSecondary: Painful solitary lesion
What is squamous cell CA?
Seen in smokers, high PTH and Ca2+
What is the cell-mediated immune response?
T-cells and Macrophages patrol the tissues looking for non-bacteria
What is a Thyrotrope?
What is seen / causes in Aplastic Anemia?
What is the function of CRH?
Stimulates ACTH release
What is the Gram Positive Capsule?
What does Thyroid Peroxidase (TPO) and Thymosin do?
Help T-cells mature
What is the rate-limiting enzyme in Heme synthesis?
What is Borderline Personality Disorder?
"Perpetual Teenager", splitting (love/hate), projection, acting out, self-mutiliation, unstable relationships, impulsive
What does Rh+ tell you?
Has D Antigen
Can you die during ETOH withdrawal?
What Kidney complications can Lithium cause to the person taking the drug?
Destroy the collecting ducts V2 aquaporin receptors, causing Nephrogenic DI
What is a Biophysical Profile (BPP)?
By US look for:Non-stress testAFIFetal heart toneFetal ActivityBreathing Movement
What do you see in Grave's Disease?
Exophthalmos, Pretibial myxedema, anti-TSH receptor antibodies
What bug loves the hippocampus?
What diseases have metabolic acidosis?
"MUDPILES" and diarrhea
What unstable angina?
Pain at rest (transient clots MCC)
What is a Pinealoma?
Loss of upward gaze, loss of circadian rhythms lead to precocious puberty
What does THF donate methyl groups for?
What is the MOA of Misoprostol?
PGE1 analog, increase production and secretion of gastric mucous barrier, decreased acid production
What is Lichen Sclerosis?
Paper like vulva, itching, CA risk
What is an Eosinophil?
The parasite destroyer and allergy inducer
What is seen in Paroxysmal Cold Auto Autoimmune?
Bleeds after cold exposure Donath-Landsteiner Ab
What does the E Ag tell you?
What is Intussusception?
Currant Jelly Stool, Stacked Coin Enema, sausage shaped mass and knees to chest for comfort
What is Type 1 Hyperlipidemia?
Defective Liver Lipoprotein Lipase (chylomicrons are elevated)
What is Uterus Rupture?
Tearing sensation, halt of delivery
What is associated with (PCP) Pneumocystis Carinii pnemonia?
AIDS and preemies, rusty sputum, silver stains the lungs, increased LDH, Treat with steroids
Why do pregnant women get Anemia?
Due to the dilution effect: RBC rises 30%, but body volume rises 50%
What is associated with Vibrio Cholera?
Rice Water Diarrhea, ADP- Ribosylates Gs = High cAMP, Turning the on... on
What vessel has the highest compliance?
What is the smallest amino acid?
What is a point mutation?
Changes one base
What are Esophageal Varices?
Due to Portal HTN, vomit large amounts of blood when they rupture
What is MGM?
BM spikes, granular/linear supepithelial spikes and closes
What type of kidney stones have Rosette Crystals?
What is Multiple Endocrine Neoplasia II (2A)?
"Sipple's" Pheochromocytoma, Medullary Carcinoma of the Thyroid, Parathyroid Adenoma. (tumor marker RET)
What are Spur Cells / Acanthocytes?
Lipid bilayer disease
How does Irritable Bowel Syndrome (IBS) present?
Alternating diarrhea/ constipationHistory of stressNo abnormalities on colonoscopy
What is Creutzfeldt-Jakob?
Prion induced disease, death within 1 year, post cornea transplant
What bug causes Acute Bacterial Endocarditis?
Staphylococcus aureus (attacks healthy valves)
What are the spore forming Gram-positive bacteria?
What is the function of B-HCG?
Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)
What disease has Iridocyclitis?
What is the Rapid Acting Insulin drug?
What are the Class IB antiarrhythmic?
Lidocaine, Mexiletine, Tocainide
What is Sarcoma Botryoides?
Vaginal CA, looks like a ball of grapes
What is Hidradenoma?
Sweat gland cysts
What is Variable Deceleration?
What is a Traction Diverticulum?
Out pouch between the UES and LES
What are the adverse of Methyldopa?
Sedation and Hemolytic Anemia(+) Coombs test
What is Intellectualization?
Act like a "know it all" to avoid feeling situational emotions, gets all information available to be over-informed
What bugs cause Monocytosis?
"STELS"S - SyphilisT - TBE - EBVL - ListeriaS - Salmonella
What is Spina bifida occulta?
Covered by skin with a tuft of hair
What is PKU?
No Phe -> Tyr (via decreased Tetrahydrobiopterin Cofactor or decreased Phe Hydroxylase)NutraSweet (Aspartame) sensitivitymental retardationpaleblond hairblue eyesmusty odor
What is Wright's Stain?
Detects nucleated fetal RBC in mom's vagina
What is Hemophilia A?
Defective Factor VIII (<40% Activity)Bleed into cavities (head, abd, etc)
What hepatitis B labs indicate infectious state?
What organ has the highest AVO2 Difference at rest?
What is Narcissistic Personality Disorder?
Pompous, no empathy, thinks they deserve everything
What does a Carboxylase do?
Transfers CO2 groups with the help of Biotin
What does Indirect Coombs Test tell you?
The Antibody is freely circulating in the serum
What are the ACE inhibitors?
Captopril, Enalapril, Fosinopril, Lisinopril
What does the Carnitine shuttle do?
FA transport into the mitochondria
What are the Adverse Effects of Glucocorticoids?
Iatrogenic Cushing's syndrome. (Adrenal insufficiency when drug stopped after chronic use)
What is the function of HPL?
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
What is Thought Insertion?
Believes that others are putting thoughts into his head
What is Benign Positional Vertigo?
Sensation of room spinningNausea/VomitingNystagmus without hearing loss or tinnitusOnset of symptoms when change position
What is Inflammatory Diarrhea?
Diarrhea with blood and pus
What does a mutase do?
Relocates a functional group within a moleculre (intrachain)
What is Gaucher's?
Glucocerebrosidase (Beta-Glucosidase) deficiencywrinkled tissue Macrophage'sBone painpancytopenia
What are the Indications for Octreotide?
Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome
What causes non-bacterial Fetal infections?
"TORCHST- ToxoplasmaO - Others (HIV, Measles, B-19)R - RubellaC - CMVH - HSV-2S - Syphilis
What are the adverse effects of the Class IB antiarrhythmic?
CNS stimulation and depressionCardiovascular depressionHyperkalemia increases toxicity
What is Sublimation?
Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior
What is Phimosis?
Foreskin scarred at penis head
How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?
What defines CLL?
50+ y/o males with lymphadenopathysoccer ball nucleiPresent with autoimmune Hemolytic anemia
What does Vit B12 do?
Cofactor for HMT & MMA
What GI disease has an Apple Core on X-Ray?
What are Burr Cell/ Echinocyte?
Seen in Pyruvate Kinase deficiencyLiver diseasePost splenectomy
What does a Synthetase do?
Consumes two substrates, uses ATP
What is a silent mutation?
Changes leave the same amino acid
What does blood type AB tell you?
Have both Antigens (universal recipient)
What are the adverse effects of Diazoxide?
Hypoglycemia (reduces insulin release) and hypotension
What is Delusion?
Fixed false belief for more than one month and no effect to his normal livingTx: Atypical antipsychotic and psychotherapy
How do you know it's an anaerobic infection?
gas and bad odor
What is SHeehan Syndrome?
Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk
What is the most common eye infection in New Born
First day - Clear discharge due to Silver NitrateFirst week - Gonorrhea (purulent discharge)Second week - ChlamydiaThird week - Herpes
What is Cystic Fibrosis?
Defective chloride transportermeconium ileussteatorrheaBronchiectasisChromosome 7
What is the MOA of adenosine?
Increase K+ efflux, hyperpolarizes the cell
What does Vit C do?
Collagen synthesisantioxidanthelps absorb FE++, necessary for Dopamine & hydroxylase for NE
What is assocaited with H. Pylori?
95% causative agent in Duodenal Ulcers
What organs have the most CD4 receptors?
What is the RBC normal lifespan?
What is a Somatotrope?
What is Separation Anxiety Disorder?
Kid screams when mom leaves
What are the adverse effects of H2 blockers?
Prolactin release: Gynecomastia, decreased libido, impotence in malesCimetidine inhibits P450
What are Fibroids (Leiomyoma's)?
Benign uterus smooth muscle tumorsubmucosal type: they bleedSubserosal type: they cause pain
What is Metabolic Syndrome X?
"Pre-DM" due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans
Which cells express MHC-2?
Antigen presenting cells (macrophages, dendritic cells, and neutrophils)
What is Non-competitive Inhibition?
Binds a regulatory site, no change in Km, Efficacy decreases, decreased Vmax
What is Fifth's disease?
Erythema Infectiosum "Slapped Cheeks"B-19 ParvovirusAplastic anemia, in sickle cell patientsHydrops Fetalis
What are the adverse effects of Nesiritide?
What are the adverse effects of Class IC antiarrhythmic?
Prolongs refractory period in AV node Hyperkalelmia increases toxicity
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
What is SCID?
No Thymus (no T-cells)frayed long bones (no B-cells)baby dies by 18 months
What does the Macula Densa do?
Measures osmolality (osmoles of solute-kg)
What type of people does Hep E like to infect?
Pregnant women (3rd trimester), Asians
What is Lobular Carcinoma?
Cells line up single file, contralateral breast is primary site of CA
Which stage of the Menstrual Cycle has the highest Estrogen levels?
Follicular stage (Has proliferative endothelium)
What is seen in Sickle Cell Anemia?
Crew-cut on x-rayAvascular Necrosis of femur
What is Croup?
Respiratory condition that is usually triggered by an acute viral infection of the upper airway, steeple sign on x-ray, barking cough
What do T cell deficiency patients die of?
Viral infections, fungal, etcexcept bacterial
What can high Cholesterol Cause?
How do tension headaches present?
"Band-like" pain starts in posterior neck, increases throughout the day, sleep disturbance
What are the Big Mama Anaerobes?
Bacteroides fragilisStreptococcus BovisC. MelanagosepticusC. Diff
What is Vascular "multi-infarct" dementia?
Sudden onset, uneven progression of deficits, "stair step" decline
What is Cephalohematoma?
Bleeding under bone (blood does not cross suture lines)
What bugs cause hospital abscesses?
Day 1-3: S. Aureus (lots of O2 present)Day 4-7: S. Viridans - no enzymeDay >7: Anaerobes - PMN's
What is a Paranoid Personality Disorder?
Suspicious about everything, they use projection
What is Selective Mutism?
Kid talks sometimes
What is Schizotypal Personality Disorder?
"Magical Thinking", odd/bizarre behavior, people leave them alone because they are weird but they will interact if approached. Brief psychotic episode
What is Menorrhagia?
Heavy menstrual bleeding
What causes Syphilis?
Treponema Pallidum (Spirochete)
What is the only Gram-positive Endotoxin?
What are the Adverse Effects of Misoprostol?
Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug
What is EC50?
Concentration of drug that produces 50% of maximal response
What is Oppositional Defiant Disorder?
Breaking the rules, defiant, noncompliant, resists authority, "bark is worse than bite". Teach appropriate child management skills
What is Virilization?
Female that is Man like
What are the Microcytic Hypochromic Anemias?
Defect in Hb synthesis (RBC small and pale) "FAST lead"F - Fe DeficiencyA - Anemia of Chronic DiseaseS - Sideroblastic AnemiaT - Alpha and Beta Thalassemia'sL - Lead poisoning
What organ has the highest AVO2 difference during a test?
What is associated with Staph Saprophyticus?
Seen in young girls / women who became sexually active, E. Coli is still the #1 cause of UTI's
What is an Ependymoma?
Rosettes present in the 4th Ventricle, Hydrocephalus
What is Zellweger's?
What does Atrial Natriuretic Peptide do?
Inhibits aldosterone and dilates the afferent arteriole
What is the most common type of Gallstone?
Cholesterol stone (not see on X-ray)
What is associated with N. Gonorrhea?
Pili, Urethritis, Tenosynovitis, Septic arthritis
What is a Xanthoma
Cholesterol build up (common at the elbow or Achilles tendon)
What is Berylliosis?
Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs
What are the indications for Guaifenesin?
Minor upper respiratory tract infections, common cold w/ cough
What diagnosis has secondary hyperparathyroidism?
How does Chancroid present?
Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)"School of Fish" pattern
What is Placenta Abruptio?
Severe pain due to premature separation of the placenta
What produces Currant Jelly Sputum
What are the IgA protease bugs?
S. PneumoniaeH. InfluenzaM. Catarrhalis
What are the GLP-1 Analog drugs?
Exenatide and Liraglutide
What bug is associated with cat pee?
What does PTH do?
Stimulates osteoblast to activate osteoclasts, stimulates the reabsorption of Ca+ and the excretion of phosphate in the kidneys, and activation of vitamin D
What is FSGS?
Most common in IVDA, AA, Hispanics and HIV patients
What is the only statin to undergo renal excretion?
What does hyperresonance tell you?
Air in that region of the lungs`
What has WBC Casts ONLY?
What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?
What is the MOA of PTU and Methimazole?
Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones
What is associated with Corynebacterium Diphtheriae?
Chinese letters under microscope, gray Pseudomembrane, heart block, suffocation = death, ADP Ribosylates EF2, Elek's Test
What is Epididymitis?
Unilateral scrotal pain decreased by support
What is the Adverse effect of Biguanides?
Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast
What is the Autonomic Nervous System?
Automatic stuff... i.e. breathing, heartbeat
What causes Neonatal Blindness
What is Eclampsia?
HTN with seizures
What is Condylomata Lata?
Flat fleshy warts, ulcerate = secondary syphilis
How much weight should a woman gain during Pregnancy?
1 lb/ week
What is Obsessive-Compulsive Personality Disorder?
Perfectionist, doesn't show feelings, detail oriented, uses isolation
Which cytokine is released when a macrophage is activated?
How does an epidural hematoma present?
Intermittent consciousness (lucid interval)
What has a friction rub while holding breath?
What does biotin donate methyl groups for?
What is associated with H. Influenzae?
Gram-negative Pleomorphic Rod, Factors V and X, 5 carbon Ribose capsule, HiB type causes Meningitis, Epiglottitis, and Sepsis
What is Tuberous Sclerosis?
Ashleaf spots (hypopigmentation)Primary brain tumorsHeart RhabdomyolysisRenal cell CAShagreen spots (leathery)
What is Vernix?
Cheesy baby skin. (protects the baby's skin from the outside world and helps with passage through the birth canal)
What is Postpartum Depression?
Depression post-delivery for more than 2 weeks
What does Vit B1 do?
What does DES taken by Mom cause in her Daughter?
Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions
What are the Osmotic Laxatives?
Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose
What diseases have metabolic alkalosis?
Low volume state: vomiting, diuretics, GI blood loss
What are the Class IA antiarrhythmic?
Quinidine, Procainamide, Disopyramide
What bacteria cause diarrhea <8 hours after introduction?
"CBS"C - ClostridiumB - Bacillus CereusS - Staphylococcus aureus
What is Maple Syrup Urine disease?
Defective metabolism of branched aa (Leu, Iso, Val) -> aa leak out, urine smells like Maple syrup/ burnt sugar, defect of branched chain alpha Keto acid Dehydrogenase
What is Milia?
Neonatal white or pale yellow heads on malar area
What is Toxoplasmosis?
Multiple ring enhancing lesions, loves parietal love, from cat urine and feces
What is Apocrine?
Apex of the cell is secreted
What states have increased Estrogen?
Pregnancy, liver failure, P-450 inhibition, and obesity
What are the adverse effects of Pseudoephedrine, phenylephrine?
HTN, CNS stimulation/ anxiety
What is von Gierke?
G-6 Phosphatase deficiencysevere fasting hypoglycemiahepatomegalyincreased lactase and uric acid levels
What hormones produce Basophila?
"B FLAT": Basophils, FSH, LH, ACTH, and TSH
What is Huntington's?
Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation
What is Oligomenorrhea?
Too few periods
What bug loves the temporal love?
What is an Encephalocele?
Brain tissue herniation
What is Karyolysis?
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually due to anovulation
What has a friction rub while breathing?
What is Hemochromatosis?
Fe deposit in organs
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response
What are the indications for Methyldopa?
What does secretin do?
Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum
When does Implantation occur?
1 week after fertilization
What is Comedocarcinoma?
Multiple focal areas of necrosis (blackheads) DCIS
What is Vestibular Neuritis?
Inflammation of the vestibular portion (CN8), Could be associated with viral infection, characterized by vertigo and dizziness
What is the MOA of Potassium on the heart?
Depresses ectopic pacemaker in hypokalemia
What is a Nephroblastoma?
Abdominal mass due to enlarged "Wilm's Tumor", hemihypertrophy and Aniridia
What is the most common cause of delayed speech developement?
What is the Peripheral Nervous System?
Everything except the brain and spinal cord. Myelination by the schwann cells
What is Imitation?
Replicating another's behavior
What is Cholelithiasis?
Formation of gallstones
What is the most common cause of Vaginal Bleeding in Post-menopausal women?
Can you die during Opiod Withdrawal?
No, just very painful
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
What is Nephritic Kidney Disease?
Inflammation with protein loss <3.5 in urineIncreased size of Fenestrations, RBC casts, HTN
What is your maximum heart rate?
220 minus the person's age
What are the indications for Reserpine?
What is seen in Calcium deficiency?
Poor bone and teeth development
What is Eisenmenger's Syndrome?
Physiological shunt from left to right now changes right to left
What are some PPIs?
What kind of Patients does Staph and Pseudomonas like to attack?
DM, CF, Burn Patients, Neutropenic patients
What does a Transferase do?
Relocates a functional group from one molecule to another
What is associated with P. Mirabilis?
Staghorn Calculus, UTI, Urease Positive, Treat with Norfloxacin
What is Emphysema?
Obstructive diseaseAlpha-1-antitrypsin deficiency
What is PSGN?
Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies
What is Sixth's DIsease?
Roseola, Exanthema Subitum (fever disappears then rash appears)
What is a Lymphocyte?
The warrior - T, B, and NK cells
What disease has a "3" shape on x-ray?
Coarctation of the aorta
What is MPGN
Tram tracks seen (Type II has low C3) on LM
What is Peutz Jegher Syndrome?
Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps
What is Chronic Granulomatous Disease?
NADPH Oxidase deficiency - they have recurrent Staph / Aspergillus infections (Nitro-blue Tetrazolium Stain Negative) or Dihydrorhodamine flow and Cytometry test
What is Type 2B Hyperlipidemia?
Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)
What is the MOA of Nitroprusside?
Direct release of NO, increases cGMP, vasodilator
What is a Tear Drop Cell/ Dacrocyte?
RBC's squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)
What is Decreased beat-to-beat variability?
What does Gastric Inhibitory Peptide (GIP) do?
Increases insulin action, responsible for post-prandial hypoglycemia
What is the difference between norepinephrine and epinephrine?
NE: NeurotransmitterEPI: Hormone
What are the adverse effects of ACE inhibitors?
Hyperkalemia, cough, angioedemacontraindicated in pregnancy (fetal renal malformations)
What is Cataplexy?
Loss of muscle tone due to strong emotions
What does dullness to percussion tell you?
Something between the airspace and chest wall absorbing sound, can be solid or fluid
What hepatitis B labs indicate a chronic carrier state?
HBsAg+, (>6 months), HBsAb (+/-)
What are the Diastolic Blowing murmurs?
Aortic regurgitation, pulmonic regurgitation
What is the MOA of Isoproterenol?
Non-specific, Beta-agonists;relates bronchial smooth muscle (B2)
What does Exocrine mean?
Secreted into a duct
What is Apoptosis?
Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last
What are theh Renin-angio system effectors?
ACE inhibitors and ARBs
What are the most common symptoms of the Low Energy State?
Weakness and SOB
What is Reynold's Pentad?
Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status
What does Ca2+ do?
Neuronal function, atrial depolarization, smooth muscle contractility
What diseases have Granulomas?
"HiTTSS"Hi - Histiocytosis XT - TBT - The -Ella'sS - SarcoidosisS - Syphilis
What is a Complete Breech?
Butt down, thighs, and legs flexed
What is Grey-Turner's Sign?
Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)
What is associated with Francisella Tularensis?
Ulcers at rabbit or deer tick bite siteRx: Streptomycin
What is associated with Bartonella Henselae?
Cat Scratch = Single painful lymph node, Stains silver
What is Avoidant Personality Disorder?
Socially withdrawn, afraid of rejection but wants to fit in
What is a Sister Mary Joseph Nodule?
Ovarian CA that has spread to the umbilicus(Also GI cancers can cause) (Indicates metastasis)
What does the Core Ab tell you?
What is associated with Clostridium Melangosepticus?
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine's
What are the inidcations for Cromolyn?
What is Rationalization?
Make excuses for behavior in advance, (because of...)
What are the indications for Nesiritide?
Acute decompensated heart failure
How do you measure afferent renal function?
Creatinine or Inulin
What is a Spherocyte?
What is Thought Broadcasting?
Believes that everyone can read his thoughts
What is associated with Chlamydia psittaci?
Parakeets and Parrots are the carrier agent
What does high WBC and >5% Blasts tell you?
What does a high WBC and <5% Blasts tell you?
Leukemoid reaction - seen in burn patients or any extreme stress (extreme demargination looks like Leukemia), Metamyelocytes => Myelocytes
What is Displacement?
Take anger out on an object or someone else. Not related with situation
What is Turcot's Syndrome?
Familial Polyposis with Brain Tumors
What is Central Pontine Myelinolysis?
This happens when you correct serum sodium faster than 0.5 mEq/hr. (infarct the PONS- patient can only blink)
How does trigeminal neuralgia (Tic Douloureux) present?
Sharp, shooting face pain, recurrent episodes
What does an AFI <5 indicate?
Oligohydramnios (Cord compression)
What is the rate-limiting enzyme in Glycogenesis?
Glycogen Synthase. Occurs in the Cytoplasm of Liver and muscle
What is Bronze diabetes?
Fe deposit in pancreas
What does Aldosterone do?
Reabsorbs Na+ and three waters
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
What is Late Deceleration?
Due to uteroplacental because the placenta cannot provide oxygen and nutrients
What are the CSF lab values for Meningitis?
PMN's -> BacteriaT cells / Macrophages -> Non-bacterialNormal Glucose -> Viral
What is the Clotting Cascade?
The cascade that stops you when you bleed
What is the MOA of Statins?
Inhibit HMG CoA reductase
What are the Holosystolic murmurs?
Tricuspid RegurgMitral RegurgVSD
What is Stage 1 of Labor?
Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm
What are the Vasculitis associated with LOW C3?
"PMS in Salt Lake City"Post-Strep GNMembranoproliferativeGlomerulonephritis Type IISub Bacterial endocarditisSerum SicknessLupusCryoglobulinemia
What is the MOA of albuterol?
B2 agonist; relaxes bronchial smooth muscle
What is Factitious?
Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.Tx: Supportive psychotherapy
What is Condyloma Acuminata?
Verrucous "cauliflower" warts, koilocytes, due to HPV 6 and 11
What is Osmotic Diarrhea?
High osmolality in the bowel pulling water into the lumen
What defines Hodgkin's Lymphoma?
EBV and may have Reed-Sternberg cells
What is Hemolytic Disease of the Newborn?
Rh+ mom's blood mixes the Rh- fetal blood in first pregnancyNo risk to this childAll pregnancies to follow will be a risk, leading to a fetal demise
What is associated with Chlamydia Pneumonia?
Staccato coughing, parasite with DNA and RNAs:Elementary body (Infectious phase) Reticulate Body (resting phase - can't divide)
What is the only Gram-positive Diplococci?
What is the humoral immune response?
B-cells and PMN's patrol the blood looking for bacteria
What are the Adverse Effects of Infliximab?
Respiratory infection (including reactivation of latent TB) fever, hypotension
What are the indications for HMG-CoA reductase inhibitors?
Strong decrease LDLDecrease TriglyceridesIncrease HDL
What does a Galactokinase deficiency cause?
What is the most common extracellular buffer?
What is associated with Bacillus Cereus?
Fried rice syndrome, preformed toxin
What is Compensation?
Doing something different of what you used to do
What is the color of air on X-ray?
What stage of the menstrual cycle has the highest Temperature?
Ovulatory stage, body temp will rise One degree during ovulation
What bug loves the DCML tract?
What are the indications for 2nd generation H1 Blockers?
Who Makes the Trophoblast?
Waht is the rate-limiting enzyme in Cholesterol syntesis?
HMG CoA Reductase
What makes an adequate sputum sample?
<10 epithelial cells and >25 leukocytes per low power field
What are the indications from Magnesium?
Effective in Torsades and Dig toxicity
What are the adverse effects of Salmeterol?
Tremor and arrhythmia
What is the indication for Isoproterenol?
Bronchoconstriction due to sympathetic tone
What is Pathological Gambling?
Can't stop gambling, affects others
What is the sign of a Clavicle Fracture?
Asymmeteric Moro reflex
What is an Astrocytoma?
Rosenthal fibers - #1 in kids with occipital headache
What is Heavy Chain Disease?
What GI disease has a Bird's Beak on X-Ray?
Achalasia (Think Chagas disease)
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
What are the Indications for Glitazones/Thiazolidinedione's?
NIDDM. (Type 2)
What is Polycystic Ovarian Syndrome?
Increased cysts. No ovulation due to no Progesterone, leads to increased Endometrial CA, they cannot inhibit LH, obese, hairy, acne
What is the CBC for every basculitis?
Decreased: RBC and plateletsIncreased: WBC, T-Cells, Monocytes, Schistocytes, ESR
What is associated with Mycoplasma Pneumoniae?
Bullous myringitis, Ground Glass CXR, P-1 Protein, Erythema Multiforme
What are the risk factors for Primary Liver Cancer?
Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis
What are the Pyrimidines?
C, U, T
What are the Adverse Effects of Desmopressin (DDAVP)/ADH?
Over hydration and allergic reaction
What is a Sliding Hiatal Hernia?
Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax
What is t1/2?
Half-life, the time it takes the body to use half of the drug ingested
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl
What is the thyroid hormone levels during Pregnancy?
Increased TBG - leads to increased total T4 (Bound and free)
What is seen with Varicella (Chickenpox)?
Red macule clear vesicle on red dotPus and scabbingvarious stages of healing
What is Cabot's Ring body?
Seen in Vitamin B12 Deficiency and lead poisoning
What is intra-Renal Failure?
Damaged Glomerulus or tubules; BUN: Creatinine Ratio <20/1
What is Tetralogy of Fallot?
Overriding aorta: Aorta sits on intraventricular Septum giving rise to a VSD, this in turn causes Pulmonary Stenosis and ultimately right heart failure (boot shape x-ray)
What organs do not require insulin to absorb glucose?
"BRICKLE": Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle
What receptors do Protein Hormones use?
Cell membrane receptors
What is an Esophageal Atresia with a TE Fistula (C-Type)?
Baby vomits with first feeding, large gastric bubble and distended abdomen (failure of apoptosis)
What is Metachromatic Leukodystrophy?
Arylsulfatase A defieciencychildhood multiple sclerosis with Ataxia/Dementiaaccumulation of Cerebroside Sulfate
What are the catabolic pathways that create energy? (Occur in the Mitochondria)
Acetyl-CoA production, Beta-oxidation, citric acid cycle, Ketogenesis, Ox Phos
What are Plasma Neoplasms?
They produce many antibodies
What does the Direct Coombs Test tell you?
ANtibody on surface (seen in hemolytic anemia)
What are the Adverse Effects of Metoclopramide?
Increased Parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrheaDrug interaction with digoxin and diabetic agentscontraindicated in small bowel obstruction
What does Glucagon do?
Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis
What is the rate-limiting enzyme in Purine synthesis?
Glutamine - PRPP
What is Alzheimer's disease?
Decreased ach in nucleus basalis of Meynert, bad Apo-E4, Amyloid Plaques, Neurofibrillary Tangles of Tau proteins
What is Essential Thrombocythemia?
Very high platelets increased RBC's and WBC's
What does Antidiuretic hormone (ADH) do?
Conserves water (V2 aquaporin receptors) and vasoconstriction
What does Tracheal deviation tell you?
Moves away from tensionPneumothorax moves towards Atelectasis
What CA risk does VHL have?
What GI disease has a Corkscrew on X-Ray?
Esophageal spasm and Volvus
What is Carcinoid Syndrome (Triad)?
Diarrhea, flushing and wheezing
Can you try a Vaginal Delivery on a woman who had a LOW Transverse C-Section previously?
Yes, 70% are okay, Potential for uterine wall rupture
What is Crohn's Disease?
Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions
What are Loose Associations?
Ideas switch subjects, incoherent
What is Idealization?
They see only the good in someone despite evidence to the contrary
What GI disease has a stacked coin on X-Ray?
What is Tangentiality?
Wanders off the point
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
What are the Indications for Infliximab?
Crohn's Disease, Rheumatoid arthritis
What is the time course of the inflammatory response?
1 hour: swellingDay 1: PMN's show upDay 3: PMN's peakDay 4: Monocytes/Macrophages and T-cells show upDay 7: Monocytes/ Macrophages and T-cells peak, Fibroblasts arriveDay 30: Fibroblasts peakMonth 3-6: Fibroblasts complete scar formation
What has Tubular Casts?
Acute Tubular Necrosis (ATN)
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
What is Karyorrhexis?
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
What are Pencil Cell/ Cigar Cell?
Seen in iron deficiency anemia
What is Primary Biliary Cirrhosis?
Anti-Mitochondrial antibody Bile ducts are destroyedXanthelasmas present and pruritis
What is factitious hypoglycemia?
Exogenous insulin use, labs show elevated insulin and decreased C-peptide
What are the adverse effects of the Ca2+ channel blockers?
Flushing, edema, constipation, CHF, AV block
What disease does Coxsackie B cause?
Endocarditis, DM Type I
When do you give RhoGam?
1st Dose: Week 28 gestation2nd Dose: 72 hours post-deliveryAny time a procedure would mix mom and fetal blood
What are the IgA Nephropathies?
What is Paracrine?
Works on its neighbor. (except sweat gland)
What does "Cytosis" tell you?
What is Justification?
Making excuses for behavior afterwards
What are the Biguanides drugs?
What are the glycogenic amino acids?
His, Met, Val
What are the indications for Hydralazine?
Severe HTN, 1st line treatment for HTN in pregnancy
What are the hormones with disulfide bonds?
"PIIG": Prolactin, Insulin, Inhibin, GH (growth hormone)
How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?
What does Vit B9 do?
Nuclear division (Synthesis of Nitrogenous bases for RNA and DNA)
What is Glanzmann's?
Baby with bleeding from skin and mucosa (LOW GP-2b3a)
What is Exhibitionism?
Exposure to others
How does the Sympathetic System behave?
Opposite of Parasympathetic:ConstipationUrinary retentionMydriasis - "Eyes wide with fright"TachycardiaBronchodilateEjaculation "Shoot"Xerophthalmia (dry eyes)Xerostomia (Dry mouth)
What is the Mechanism of Action of Sulfonylureas?
Closes K+ channel in the pancreatic Beta cell membrane, Reduces K+ efflux & increases Ca (2+) influx, and cell depolarize to increase secretion of insulin
What does the Progesterone Challenge Test tell you?
Vaginal bleeding if she has estrogen. If she does not bleed, she has no E2 or ovariesIncreased FSH: Ovary problemDecreased FSH: Pituitary problem
What are the classifications of MHC-1?
HLA-A, HLA-B and HLA-C
How does chlamydia present?
Cervicitis (Yellow pus), conjunctivitis, PID
What is Total Anomalous Pulmonary return?
All pulmonary veins enter into the right atrium (Snowman x-ray)
What is the rate-limiting enzyme in Ketogenesis?
HMG CoA Synthase
What is Herpes?
ds DNA virus
What is the Stage II of Labor?
Continues after the cervix is dilated to 10 cm until the delivery of the baby
What is the difference between Heterochromatin and Euchromatin?
Hererochromatin = tightly coileddarkerTranscriptionally inactiveEuchromatin = loose (10nm fibers)lighter
What are the LIVE Vaccines?
"Bring Your Own Very Small Virus and MMR"B - BCGY - Yellow FeverO - OPV (Sabin) = oral polioV - VaricellaS - SmallpoxV - RotavirusM - Measles = RubeolaM - MumpsR - Rubella = German 3 day measles
What murmur has a regular-irregular pulse?
What disease has a Thumb Sign on neck films?
What is Restrictive Lung disease?
small still lungs, can't get air in
What symptoms does a "less likely to depolarize" state have?
Brain: lethargic, mental status changes, depressionSkeletal Muscle: weakness, SOBSmooth Muscle: constipation then diarrheaCardiac: hypotension, bradycardia
What are the indications for Ezetimibe?
What are the Class IC antiarrhythmic?
Flecainide, Encainide, Propafenone
What is the effect of Alcohol on the fetus?
FASSmooth philtrumshortpolyclonalmidface hypoplasiathin superior Vermilion border
What is the Mechanism of Action of Insulin?
Pushes K+ into the cell,Liver: Increases Glucose storage as Glycogen, Increases Triglyceride synthesis.Muscle: Increases protein and glycogen synthesis.Adipose Tissue: Improves Triglycerde storage by activating Lipoprotein Lipase, Decrease circulating Free Fatty Acids
What causes Chancroid?
What is Telephone Scatologia?
What is the MOA of ARBS?
Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II
What is a Missed Abortion?
Cervix is closed, no fetal remnantsTx. D&C
What type of kidney stones have envelope or dumbbell-shaped crystals?
What does the E Ab tell you?
What is the cause of large babies?
DM or twin-twin transfusions
What are the indications for Nitroprusside?
Hypertensive emergency, CHF, Angina
What is the MOA of cromolyn?
Prevents release of mediators from mast cells
What is Bismuth and Sucralfate used for?
Increase ulcer healing, traveler's diarrhea
What is a SIderoblast?
Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)
What is the MOA of Bile Acid resins?
Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more
What are the sympathoplegics?
Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine
What is the MOA of Salmeterol?
B2 agonist; relaxes bronchial smooth muscle
What is Bronchitis?
Increased sputum production "Blue Bloater"
What is Type 2A Hyperlipidemia?
Defective LDL-Clathrin Pit or B-100 (LDL are elevated)
What will you see with Anemia of Chronic Disease?
What will you see with Sideroblastic Anemia?
Decreased dALA synthase common with blood transfusions
What are the adverse effects of Hexamethonium?
Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
What is the MOA of the K+ channel blockers?
Increase AP duration, increase effective refractory period (ERP), increase QT interval
What is Plummer-Vinson Syndrome?
esophageal webbing at the UES, spoon nails from iron deficiency anemia
What is Cholestasis?
Obstructed bile ductHigh Alk Phos (if in the common bile duct)
What is transposition of the great arteries?
Aorticopulmonary septum did not spiral, most common congenital cyanotic heart disease in the first month of life (Neural crest cell migration problem)
What is Trichotillomania?
They pull out their own hair and eat it
What is McCune-Albright?
Precocious sexual development, polyostotic fibrous dysplasia "whorls of connective tissue", "coast of Maine" pigemented skin macules
What is associated with Vibrio Parahaemolyticus?
Raw Fish, Gs Stimulation via ADP- ribosylation = HIGH cAMP, Turns the on... on
How fast should B-HCG rise?
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
What are the indications for Methacholine?
Asthma challenge test
What are some causes of Vitamine B12 deficiency?
TapewormsVeganismType A gastritisPernicious Anemia
What does Vit D do?
Mineralization of bones and teeth
What are the newborn screening tests?
"Please Check Baby Before Going Home"P - PKUC - CAH/ CFB - Biotinidase/ Beta- ThalassemiaG - GalactosemiaH - Hypothyroidism/ Homocystinuria
What are the most common causes of mental retardation in the US?
FAS, Fragile X and Down's Syndrome
What is Wiskott-Aldrich?
Low IgM, Low PlateletsHigh IgAEczemaPetechiaeX-linked
What is achondroplasia (Laron Dwarf)?
Patient with abnormal FGF receptors in exremities. (abnormal FGF3)
What is Hemosiderosis?
Fe overload in bone marrow
What is Poikilocytosis?
RBC's of different shapes
What are the Adverse Effects of Mimetics?
Hypoglycemia, Nausea, Diarrhea
What can high Triglycerides Cause?
What is the MOA of a muscarinic antagonist?
competitively block muscarinic receptors preventing bronchoconstriction
What are the methylxanthines?
What is the function of T3 and T4?
Growth and differentiation
What is Histrionic Personality Disorder?
Theatrical, sexually provocative, use repression
What diseases have Respiratory Alkalosis?
Restrictive Lung diseaseAnxietyPregnancyGram neg sepsisPE
What does Fe2+ do?
Hb function, electron transport
What is RhoGam?
What is Pyromania?
Sets fires for the fun of it
How does DKA present?
Kussmaul respirations, fruity breath (acetone), and altered mental status
What is assocaited with Strep Bovis?
Colon Cancer, black pigment
What hepatitis B labs indicate non-infectious state?
What bugs cause Bloody Diarrhea?
"CASES": Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella
What are the only arteries with deoxygenated blood?
Pulmonary and umbilical arteries
What are the Long Acting Insulin drugs?
Ultralente, Glargine, and Protamine
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification around lymph nodes
What sound radiates to the axilla?
How is Major Depression diagnosed?
Need 5 of 8 "SIGECAPS" for over 2 weeksSleep disturbance: wake in early or wake up lateInterest/ libido lossGuiltEnergy LossConcentration LossAppetite LossPsychomotor AgitationSuicidal Ideation (hopelessness)
What does somatostatin do?
Inhibits secretin, motilin, and CCK
What is the Adverse Effect of Sulfonylureas?
Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy
What is the MOA of N-acetylcysteine?
loosen mucus plugs by breaking disulfide bonds
What has Epithelial Casts?
What is INR ratio determined by?
Measured PT/ Control PTtherapeutic level is between 2-3Normal level is 1
What are the Water shed areas?
Hippocampus, splenic flexure
What is Stress Incontinence?
Weak pelvic floor muscles, urinating when coughing, laughing, etc. Estrogen effect
What is an Arnold-Chiari Malformation?
Herniation of cerebellum through Foramen MagnumType 1: Cerebellar tonsils (asymptomatic)Type 2: Cerebellar vermis/ medulla -- Hydrocephalus, Syringomyelia (loss of pain and temerature)
What is a Vertex Presentation?
Posterior Fontanel (triangle shape) presents first (normal)
What is associated with C. Diff
Explosive diarrhea = Pseudomembranous Colitis
What are the antileukotriene drugs?
Zileuton, Zafirlukast, montelukast:aspirininduced asthma
What are the Purines?
What is a Septic Abortion?
Fever greater than 100.4 F, malodorous discharge
What is a Pappenheimer body?
Iron inside cell (sideroblastic anemia)
What does Seminal Vesicle give to Sperm?
Food (Fructose) and clothes (semen)
What GI diseases are the causes of liquid Dysphagia?
Scleroderma and Achalasia
What does IDL do?
It takes TG's from adipose to tissue
What type of Gallstone can be seen on X-Ray?
Calcium Bilrubinate stone
What is Legg-Calve-Perthes Disease?
A vascular necrosis of femoral head, more often in young children (4-8 y/o), mildly painful limb that develops insidiously. Range of motion is limited especially internal rotation and abduction, x-ray join effusion
What are the Production Anemias?
Where is VLDL made?
What is associated with C. Botulinum?
Canned food, honey, inhibits ACh release, respiratory failure, stool toxin, treat with Penicillin
What is SIADH?
Too much ADH present causes plasma volume to expand Serum Na+ less than 120
What is the Somogyi Effect?
Morning hyperglycemia secondary to evening hypoglycemia
What are Identical Twins?
Eggs split into perfect halves "Monochorionic"
What is the symptoms of Loeffler Syndrome?
What is the MOA of H1 Blockers?
Reversible inhibitors of H1 histamine receptors
What is associated with Group C Strep?
What is HPV?
ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD
What is the function of FSH
Male: sperm, MIF, inhibin BFemale: Stimulates Estradiol (E2)
What vesels have the most smooth muscle?
What are the symptoms of a Low Energy State?
CNS: Mental retardation, dementiaCV: heart failure, pericardial effusionMuscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
What are the signs of child abuse?
Multiple EcchymosisRetinal HemorrhageEpidural / Subdural HemorrhageSpiral Fractures (twisted)Multiple fractures in different stages of healing
What is Nitrazine?
Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)
What is Pyknosis?
Nucleus turns into blobs. (shrinkage)
What organs have resistance in parallel?
All the rest of the organs (except liver and kidneys)
What are the indications for Losartan?
What is PIE Syndrome?
Pulmonary Infiltrate with Eosinophilia
What stage of the Menstrual Cycle has the highest level of Progesterone?
Luteal stage (Has secretory endothelium)
What makes Progesteron <10 week gestation?
What is assocaited with Salmonella?
Loves to hide in the gallbladder if treated.Do not treat this infection medically, raw chicken and eggs, turtles, rose typhoid spots, H2S (sulfur producing), Sickle Cell patients with Salmonella infection leads to Osteomyelitis
What is Euthyroid Sick Syndrome?
LOW T3 Syndrome and decreased conversion of T4 to T3 (increased T3r)
What is Albinism?
No Tyr -> Melanin (via Tyrosinase)
What is Endometritis?
Postpartum uterine tenderness
What is seen with Tin deficiency?
Poor hair growth
What does an Isomerase do?
Creates and isomer
What is the MOA of Odansetron?
5-HT3 antagonist, powerful central acting antiemetic
What is Rotor's?
Defective Bilirubin storage and Elevated Conjugated Bilirubin
What vessels have the largest cross-sectional area?
How does Lymphogranuloma Venereum present?
Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis
What is Ataxia Telangiectasia?
Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels
What are the side effects of Estrogen?
Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins
What is Stage III of Labor?
Delivery of the placenta
What hormones are released from the posterior pituitary?
ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins
What is Anencephaly?
Notochord did not make contact with the brain - only have the medulla
What is Cholangitis?
Inflamed bile duct
What does the Coombs Test Tell you?
What is Dependent Personality Disorder?
Clingy, submissive, low self-confidence, uses regression
What hepatitis B labs indicate previous infection and now immunity?
HBcAb+, HBsAb+, HBsAg-
What are the physical signs of Alcoholic Cirrhosis?
Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren's Contracture
What is Bruton's Agammaglobulinemia?
Kids ( < 1 y/o) with defective tyrosine kinase; they have no antibodies and have x-linked transmission
What are the indications for Sulfalazine?
UC, Crohn's disease
What is a Drepanocyte?
Seen in Sickle cell Anemia
Negative high dose Dex. and High ACTH levels?
Ectopic ACTH- small cell CA of the lungs
What are the indications for Clonidine?
What is Type and Match?
Blood type and Wait
What is Wolff-CHaikoff?
What is Pyloric Stenosis?
Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation
What is Lichen Simplex Chronicus?
Raised white lesions, chronic scratching
What is the MOA of Clonidine?
Alpha 2 agonist = decreases peripheral resistance
Which part of the Nephron concentrates urine?
What is the Adverse Effect of Insulin?
What are the sulfur-containing amino acids?
What is Bartter's Syndrome?
JG cell hyperplasia with renin excess, no increase in blood pressure, defect in kidney's ability to reabsorb potassium
What is Drug Induced Hypersensitivity?
Eosinophils in the urine
What is increased beat-to-beat variability?
What is the MOA of Bismuth and Sucralfate?
Bind to ulcer base, providing physical protection allows bicarbonate ion secretion to reestablish pH gradient in the mucous layer
What causes lateral leg bowing?
What is Undoing?
Doing exact opposite of what you used to do to fix a wrong
What bugs disrupt G Proteins?
Pertussis: Inhibits Gi (Turning the off to off allows for stimulation)Chloera: Stimulates Gs (Keeping the on ... on)E. Coli: Stimulates Gs (Keeping the on ... on)
What is Myelofibrosis?
Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC's) and extramedullary Hematopoiesis
What disease states have increased Anion Gap?
"MUDPILES"MethanolUremiaDKAParaldehyde/PhenoforminINH/ Iron tabletsLactic AcidosisEthylene GlycolSalicylates
What is CD8?
T-killer or T-suppressor cellResponds to MHC-1 complex (self)
What causes Gonorrhea?
Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort
What are some causes of Folate Deficiency?
Old food, you will see Glossitis with the patient
What is Cretinism?
Mom and baby are hypothyroid
What do you see in DeQuervain's disease?
Viral origin, painful jaw, hypothyroid
What is Epstein's anomaly?
Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)
What murmur has an irregular-irregular pulse?
A fib (no P waves)
What is Kleptomania?
Steals for the fun of itTx: Psychotherapy
What is a normal BPP?
What is an Oligodendroglioma?
Fried egg appearance, Nodular Calcification
What does high WBC and Bands tell you?
Left shift - they have an infection
What are the pulmonary infiltrates with eosinophilia (PIE) syndromes?
Churg-Straus, Loeffler's, allergic Bronchopulmonary Aspergillosis
Waht is Vasa Previa?
Babies blood over OS
What is the Average IQ?
What are the indications for Octreotide?
Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
What is Loss of Ego Boundaries?
Where we lose sight and sense of our mind and body and its influences
What is seen in Magnesium deficiency?
Loss of kinase function, hypoparathyroidism
What is Vater Syndrome?
V - Vertebral abnormalityA - AnalTE - Tracheal Esophageal FistulaR - Renal
What is associated with Listeria?
Raw cabbage, hot dogs, cold cuts, and spoiled milk, likes cold environmentMust avoid these foods in pregnancy, also seen in migrant workersCauses: abortions, Meningitis, and heart block
What is the Most common type of Kidney Stone?
Calcium Phosphate and Calcium Oxalate
What is the risk of Amniocentesis?
Abortion (2% risk)
What is Potency?
Amount of drug needed to produce effect (lower w/ comp antagonist)
What is the indication for Methylxanthines?
What does Galactosemia cause?
Cataracts, mental retardation, liver damage
What is a Neuroblastoma?
Adrenal Medulla tumorHypsarrthymiaOpsoclonusIncreased urinary VMA
What is Pre-Renal Failure?
Low flow to kidney; BUN; Creatinine ratio >20/1 in the serum
What is the function of PRH?
Stimulates Prolactin (PRL) release
What disease has a Selenium deficiency?
How do I know the patient has a Vitamin B3 (Niacin) Deficiency?
Pellagra (4 D's: Diarrhea, dermatitis, dementia, death)
What is Small Cell Cancer?
Located at the Carina, Malignant, Cushing's syndrome, SIADH, and SVC syndrome
What is Type B gastritis?
Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)
What GI diseases are the causes of solid and liquid dysphagia?
Schatzki's Rings, Stricture, Cancer
What is associated with E. Coli?
Raw hamburger, ADP- Ribosylates Gs (increased cAMP)Verotoxin, HUS in kids and elderly
FEV1/FVC in Obstructive lung disease
Lower than normal (N: 0.75-0.80)
What are the bacteria associated with Colon CA?
Clostridium Melanogosepticus and Streptococcus Bovis
What is the Adverse Effect of Alpha-Glucosidase Inhibitors?
GI disturbances and may reduce absorption of iron
What does VLDL do?
It takes TG's from liver to adipose
What is Bipolar I?
Mania with or without depression for at least 1 week, as well as period of normal moodTx: First line - Lithium, Lamotrigine or RisperidoneSecond line - Aripripezole, Divalproex, Quetiapine, Olanzapine, Psychotherapy and cognitive behavioralAcute Mania: Hospitalize, mood stabilizer (Lithium), acute antipsychotic (Risperidone) and IM phenothiazine - non compliant
What bug causes Subacute Bacterial Endocarditis?
Steptococcus viridans. (attacks damages valves)
What are the indications for the channel blockers?
WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism
What is a transversion?
Changes one purine to a pyrimidine
What is Reaction Formation?
Unconsciously act opposite to how you feel, "Tears on a clown"
What is the MOA of Nesiritide?
Recombinant BNP, increase in cGMP and vasodilation
What is Cystosarcoma Phylloides?
What is cardiac tamponade?
Pressure equalized in all 4 chambers, quiet Precordium, no pulse or BP, Kussmaul's Sign, Pulsus Pardoxus (Decrease in BP greater than 10 mm Hg with inspiration)
What is a Stomatocyte?
Seen in liver disease
What does Rh- tell you?
Does not have the D Antigen
What is associated with Yersinia Enterocolitica?
Presents like appendicitis and Reiter'sBloody Diarrhea
What are the layers of the Adrenal Cortex and what do they produce?
Zona Glomerulosa (Aldosterone),Zona Fasciculate (Cortisol),Zona Reticularis (Androgens)
What does a Southern blot detect?
DNA, "Snow, Drop"
How do you test efferent arteriole function?
Renal plasma flow (RPF) or PAH
What adds color to Stool?
Stercobilinogen being oxidized to stercobilin
What is a Heinz body?
Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency
What is the difference between DI and SIADH?
DI: diluted urineSIADH: concentrated urine
What is a Blast?
Baby hematopoietic cell
What are the branched amino acids?
"Can't LIVe w/o them", Leu, Ile, Val
What is the Indication for Mimetics?
NIDDM. (Type 2)
What are the adverse effects of Nitroprusside?
Cyanide Toxicity, hypotension, short acting
What is Isolation of Affect?
Isolate feelings to keep on fucntioning
What is Hirsutism?
Hairy female (Excess growth in normal male areas)
What is associated with Strep Pyogenes?
Rheumatic Fever, PSGN, Impetigo, Pharyngitis, Nec Fasc
What is stable angina?
Pain with exertion that is relieved with rest (Athersclerosis MCC)
What are the indications for 1st generation H1 blockers?
Allergy, motion sickness, sleep aid
What ion has the least movement at rest?
What is associated with S. Pneumoniae?
Gram-positive diplococci, rusty sputum, IgA Protease, vaccine covers 23 strains
What is cyclothymia?
Dysthymia with hypomania for more than 2 yearsTx: Lithium, Valproic Acid or Carbamazepine and psychotherapy
What is Oligohydramnios?
Too little amniotic fluid (baby can't pee)
What does the Water Deprivation Test tell you?
If the patient fails to concentrate urine, they do not have Primary DI
What effects Efficacy?
What defines AML?
15-30 y/o males Sudan StainAuer Rods, (CD30)T (15;17) - D M3 AML subtypetreat with ATRA
What organs have resistance in series?
Liver and Kidneys
How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?
No deficiency state
What is Type I RTA?
Distal RTA: H/K in collecting duct is broken, high urine pH
What is Autocrine?
Works on itself. (except T-cell activation)
What is Hypochondriasis?
They worry about having a serious illness (specific disease) they seek medical attention. For constant reassuranceTx: Psychotherapy
What does the JGA do?
Measures volume, secretes renin (low volume state)
What is Testicular Feminization (Androgen Insensitivity Syndrome)?
Males with defective / bad DHT receptor, they are XY with a blind pouch vagina
What does Vit B6 do?
Transaminase cofactor, myelin integrity
What is Paraphimosis?
Foreskin scarre at penis baseforeskin will strangulate the gland
What is Glioblastoma multiforme?
Pseudopalisading necrosis, worst prognosisintralesional hemorrhage
What does Zn2+ do?
Taste buds, hair, sperm function
What Diseases have a low LAP?
CML & PNH (paroxysmal nocturnal hemoglobinemia)
What is Hyper IgM Syndrome?
High IgM and all other Ig's are low
What is Waterhouse-Friderichsen syndrome (WSF) or Hemorrhagic Adrenalitis or Fulminant Meningococcemia?
Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides
What disease has a steeple sign on neck films?
Croup (or Laryngotracheobronchitis)
What are the Indications for Insulin?
DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes
What is Type 3 Hyperlipidemia?
Defective ApoE (Elevated ILD)
What is the Osler-Weber-Rendu?
AVM (Atrial-Venous Malformation)in lung, GI, CNSthe AVM sequesters platelets and causes acquired Telangiectasia's
What is a Howell-Jolly Body?
The spleen or bone marrow should have removed nuclei fragments.(Seen in Hemolytic Anemia, spleen trauma, and CA)
What is associated with N. Meningitidis?
DIC, Pili, Only bug that releases toxin in the log phase
What is a Gastric Ulcer?
Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss
What is Type 2 Diabetes Mellitus and associations?
Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans
What can you measure to test afferent arteriole's function?
Glomerular filtration rate (GFR) or Inulin
What is an incomplete Abortion?
Cervix is open, fetal remnantsTx: D&C to prevent placenta infection
What is seen in Hashimoto's Thyroiditis?
Antimicrosomal antibody and Anti-TPO antibody
What is the definition of AIDS?
CD4 count less than 200 or defining illness
What is Schizoid Personality Disorder?
Recluse, they don't want to interact with others, emotional coldness
What are the 2nd generation H1 Blockers?
Loratadine, fexofenadine, Desloratadine, Cetirizine
What is the most common cause of no red reflex?
Cataracts - Increased incidence with high glucose or galactose, Rubella, Failure of light stimulating the retina by 3 months of life and if this does not occur the child will be blind
What is Bronze cirrhosis?
Fe deposit in liver
What is associated with S. Aureus?
Cellulitis, Dairy products, Gold pigment, Endocarditis, Styes, Hordeolum (on eyelid)
What is Associated with M. Catarrhalis?
It loves Mucus: it attacks the respiratory tract
What is MCD?
Most common nephrotic in kids, fused foot processes, no renal failure, loss of charge barrier
What is Jod-Basedow Disease?
Transient hyperthyroidism due to increased iodine
What is the MOA of Nifedipine and verapamil?
Ca+ channel antagonists
What are the continuous Murmurs?
PDA or AVM's
What is Bronchoalveolar CA?
Looks like pneumoniadue to pneumoconiosis, nonsmoker
How does a Subarachnoid hemorrhage present?
"Worst headache of my life", hx. of Berry aneurysm
What is a Gonadotrope?
LH and FSH
What is Bronze pigmentation?
Fe deposit in skin
What are the indications for Diazoxide?
What is a Female Hermaphrodite?
Impossible because female is the default formation
Negative high dose Dex. and low ACTH levels?
Adrenal CA (high cortisol)
What disease has Aniridia?
How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?
What are the Extravascular Hemolytic anemias?
Spherocytosiswarm autoimmuneParoxysmal cold autoimmuneSickle cell anemia
What is Monoclonal Gammopathy of undetermined significance?
Old Person with Gamma Spike (from years of building up)
In what layers does a true aortic aneurysm occur?
Intima, media, and adventitia
What is a Male Pseudohermaphrodite?
XY with LOW 17-OHase and LOW Testosterone
What is Azotemia?
Increased BUN/Creatinine ratiorenal failure
What disease does Coxsackie A cause?
What do low Retics tell you?
Decreased production of bone marrow - not working right
What is Kleine Rechnung?
Scant bleeding at ovulation
What is the MOA of Niacin?
Inhibits lipolysis in adipose tissuereduces hepatic VLDL secretion into circulation
What is diastole?
Heart ventricles fillingincreased blood to Coronary arteriesless extraction of oxygenPhase 4 and 5 Korotkoff
What is the MOA of Biguanides?
Decrease Gluconeogenesis, Increase Glycolysis, and Increase peripheral Glucose uptake. (Insulin sensitivity)
What is Normal Pressure Hydrocephalus?
Incontinence, ataxia "magnetic gait" dementia
What is the Most Common Cause of Kidney Stones?
What does Somatostatin (SS) do?
Inhibits growth hormone (GH) release
What is the function Oxytocin?
Milk and baby ejection
What is the job of the Thin Descending Loop of Henle?
What is Hemophilia B?
Factor IX deficiencyBleed into joints (knee, etc)
What is a threatened Abortion?
Cervix is closed, baby is intact, treat with bed rest
What disease has multiple lung aneurysms?
Osler-Weber-Rendu (AD Ped disease -- thin vessels in nose, GI, and lungs)
What is the MOA of Bosentan?
Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance
Why is Nagele's Rule Inaccurate?
Because it does not start from Ovulation date
What is the MOA of Metoclopramide?
D2 receptor antagonist; increase resting tone, contractility LES tone, motility
What is a Band?
What is Asbestosis?
Shipyard workers, pipe fitters, brake mechanics, insulation installers
What is Chronic Rejection?
Occurs months to years later and fibroblasts are present
What does Vit B7 do?
Carboxylation (Avidin in egg whites (raw) binds Biotin)
What is Savage's Syndrome?
Ovarian resistance to LH/FSH
How does Factor 13 Deficiency present?
Umbilical stump bleeding(this is the first time a baby has to stabalize a clot)
What are the B cell Non-Hodgkin's Lymphomas?
Follicular: t(14;18) and bcl-2Burkitt: t(8;14), c-myc, Starry sky, Macrophagesin american kids: abdominal massin african kids: jaw mass
What are the Stress Hormones and when do they appear?
Immediately Epinephrine, Glucagon (20 minutes), Insulin & ADH (30 minutes), Cortisol (2-4 hours), and growth hormone (24 hours)
What are Fraternal Twins?
Multiple eggs fertilized by different sperm
What is the efferent arteriole's job?
What are the Adverse Effects of Demeclocycline?
Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth
What are the hyperthyroid diseases?
What are the Macrophages called in areas of the body?
Blood: MonocytesBrain: MicrogliaLung: Type 1 PneumocytesLiver: Kupffer cellsSpleen: RES cellsLymph: Dendritic cellsKidney: Mesangial cellsPeyer's Patch: M cellsSkin: Langerhan cellsBone: Osteoclast cellsConnective Tissue: Histiocytes, Giant cells, Epithelioid cells
What is the MOA of PPIs?
Irreversibly inhibit H+/K+ ATPase in stomach parietal cellsDecreases proton secretion by parietal cells
Who makes the Cytotrophoblast?
Mom production of GnRH, CRH, TRH, and Inhibin
What are the indications for N-acetylcysteine?
CF patients and antidote for Acetaminophen overdose
What is Goldblatt's Kidney?
Flea-bitten kidney (ruptured capillaries from high blood pressure)
What does MPO deficiency cause?
Catalase positive infections
What is Tay-Sachs?
Hexosaminidase A deficiencyHyperreflexia developmental delay"onion skin" Lysosomes
What does Growth Hormone (GH) do?
Stimulates Insulin Growth Factor-1 (IGF-1) release from the liver
What is the MOA of Dextromethorphan?
Antitussive (antagonizes NMDA glutamate receptors)
What are the indications for digoxin?
CHF (increase contractility)A fib (decrease conduction at the AV node)depression of the SA node
How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?
TOF Babies... Turns blue with crying and has No feeding issues
What does a Lyase do?
Cuts C-C bonds w/ ATP
What is the MOA of Desmopressin (DDAVP)/ADH?
Recruits water channels to Luminal Membrane in collecting duct
What is Asherman's Syndrome?
Uterine scars from multiple D&Cs
What are the breakdown products of VLDL?
IDL and LDL
What is the difference between Plasma and Serum?
Plasma: No RBC'sSerum: No RBC's or Fibrinogen
What is Gilbert's Syndrome?
Stress induced elevatedUnconjugated BilirubinIncreased load saturates Glucuronyl Transferase
What is Secretory Diarrhea?
Water pushed from cells into the gastric lumen (increased cAMP)
How does Diverticulosis Present?
What is Rett's
Only in girls, decreased head growth, lose motor skills, hand-wringing, they are normal until 5 months of ageTx: Behavioral therapy and physiotherapy
What is Fructosemia?
"Fructose intolerance" (Aldolase B deficiency)kidney and liver damageoccurs in infants after introduction of fruits, honey, and juices
What is Pellagra?
Niacin (B3) deficiencyDermatitis, Diarrhea, Dementia, Death
What are the corticosteroid drugs?
What does the surface Ab tell you?
Vaccination has occurred
When will you see Plummer's Disease?
Patients with benign adenoma and or patients over 50 yrs. old. In an iodine scan, it looks like a nodular patter
How does Von Willebrand Disease (VWD) present?
Heavy menstrual bleeding
What is the receptor problem with Midgets?
Patient with decreased Somatomedin receptor sensitivity
What is Dysthymia?
Low level sadness >2 years, looks like depressionTx: Psychotherapy and SSRI
What is a Tracheoesophageal (TE) Fistula (H-Type)?
Chokes with each feeding and is Congenital
How do cluster headaches present?
Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse with lying down
What should you rule out when child abuse is suspected?
Osteogenesis Imperfecta, bleeding disorders, Fifth's disease and Mongolian spots
What is a Compound Presentation?
Arm or hand on head, vaginal delivery. (Mean's Prolapse of fetal extremity with presenting part)
Egg-shape on x-ray?
Transposition of the great arteries
What makes Progesterone in >10 weeks gestation?
Can you try a Vaginal Delivery on a woman who has had a Classic Horizontal C-Section previously?
No, they must have C-Section for all future pregnancies
What is the MOA of GLP-1 Analogs (glucagon like peptides)?
Increase Insulin and Decrease Glucagon release
What are the Urease Positive Bugs?
"Urease PPUNCHSB"P - ProteusP - PseudomonasU - UreaplasmaN - NocardiaC - CryptococcusH - H. PyloriS - Staphylococcus SaprophyticusB - Brucellosis
What are the K+ channel blockers?
Sotalol, Ibutilide, Bretylium, Amiodarone
Where does a Type B thoracic aortic dissection occur?
Descending Aorta, (occurs in trauma and Atherosclerosis)
What is Boerhaave Syndrome?
Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion
What is a Sinciput Presentation?
Anterior Fontanel (Diamond shape) presents first
What is associated with Coxiella Burnetii?
Dusty Barn = Q fever
What is Placenta Percreta?
Placenta perforates through serosa
What is the cause of Asymmetrically Small babies?
In Late onset: Poor maternal nutrition and vascular disease
What is normal blood loss during a C-section?
What is the fucntion of AFP?
Regulates intravascular volume
What is Basophilic Stippling?
Lots of immature cells increased mRNA (seen in lead poisoning)
What is a Lactotrope?
PRL -- Prolactin
What disease has a chromium deficiency?
What is the function of TSH (Thyroid stimulating hormone)?
Stimulates release of T3 and T4 from the thyroid.T3= TriiodothyronineT4= Thyroxine
How do migraines present?
Auro, photophobia, numbness and tingling, throbbing headache, nausea
What diseases provide malarial protection?
Sickle Cell Anemia: African descentG-6PD: Mediterranean's
What is Epididymitis?
Chlamydia Trachomatis. Unilateral scrotal pain decreased by support
How would you know the patient has a Vitamin B1 (Thiamine) Deficiency?
Beriberi, Wernicke's Encephalopathy, Wenicke-Korsakoff Syndrome
What is the Psychogenic Polydipsia?
Pathologic water drinking will have low plasma osmolality
What is Chorioamnionitis?
Fever, uterine tenderness, decreased fetal HR
What is the MOA of Demeclocycline?
What is the MOA of Methacholine?
Muscarinic receptor agonist
What is transudate?
An effusion with mostly waterIf too much water: Heart or Renal failure....Or not enough protein: Cirrhosis (can't make protein), and Nephritic Syndrome (spilling out protein in urine)
What is Rubella (German 3-day Measles)
Trunk rashLymphadenopathy behind earsthey don't look sick
What is the fucntion of MSH (melanocyte-stimulating hormones)?
Provides skin pigmentation
What sound radiates to the neck?
What are the glycogenic & ketogenic amino acids?
"PITT" Phe, Iso, Thr, Trp
What is Bronchiolitis?
Athma in kids less than 2 years old
What is Sturge-Weber?
Port wine stain (big purple spot) on foreheadangioma of retinaEpilepsyMental retardation
What is the function of GRH?
Stimulates GH release
What is the MOA of Hydralazine?
increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction
What is Cholecystitis?
Inflammation of the gallbladder
What determines the prognosis of Cancer?
Depth of invasion, any choice that has to do with depth - the deeper it is= the worse the prognosis
What will you see in Beta Thalassemia?
Seen in Mediterranean's(chromosome 122- point mutation)
What serum pH does the low volume state have?
Alkalotic (due to H+/K+ exchanger)
What is associated with R. Prowazekii?
Lice = Starts on body
What is Gastroschisis?
Wall defect lateral to midline - off center, abdominal wall with no sac covering
What is the MOA of Minoxidil?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
What are the adverse effects of Ezetimibe?
Rare increase LFT's
What are the adverse effects of Niacin?
Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia
What is a Beastophile?
Someone who has sex with animals, women prefer dogs, they can smell their estrogen
What is the rate-limiting enzyme in Pyrimidine synthesis?
Carbamoyl Phosphate Synthetase-2 (CPS-2)
What is seen in Spherocytosis?
Defective Spherin or AnkyrinPositive Osmotic Fragility testHigh level of MCHCteardrops
What is Otitis Media?
Fluid in the middle ear
What is the most common transplant?
What are the effects of 2nd generation H1 Blockers?
Far less sedating than the 1st generation because of decreased entry into the CNS
Boot-shape on x-ray?
What causes increased PTT and Bleeding Time?
Von Willebrand disease and SLE
How do you treat A2 Gestational DM?
What are the adverse effects of Isoproterenol?
What is the Treatment for Pre-Eclampsia?
Delivery, MgSO4 (seizures), Hydralazine (BP)
What are the adverse effects of Clonidine?
Drowsiness, dry mouth, and rebound HTN after abrupt withdraw
What is the Treatment for Eclampsia?
4mg MgSO4 IV (Seizure prophylaxis)
How do you monitor Baby's Heart Rate?
Doppler or scalp electrode
What do high Retics (>1%) tell you?
RBC is being destroyed peripherally
What is Fanconi Syndrome?
Due to old Tetracycline useProduces Urine phosphates, Glucose, and Amino Acids
What is seen why Molybdenum deficiency?
Lose xanthine oxidase function
How do you monitor the Uterus?
Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)
What is Hartnup's?
No tryptophan-cannot make niacin or seratoninPresents like PellagraGenetic, not nutritional disorder
What is a Frank Breech?
Butt down, thigh flexed, legs extended (Pancake)
What has high LAP?
What is Subgaleal Hemorrhage?
Prolonged jaundice in newborns due to birthing trauma
What disease has pulsus bisferiens?
IHSS- Idiopathic Hypertrophic Subaortic Stenosis
What is Intermittent Explosive Disorder?
Loses self-control, disproportional to circumstances?
What Bacteria cause UTI's and Prostatitis?
What can cause Cushing's syndrome?
High cortisol produced from an adrenal tumor
What bug is associated with cat feces?
What is Fabry's
alpha-galactosidase A deficiencyattacks baby's kidneys and heartXLRaccumulation of CeramideTrihexoside
What are the indications for Nifedipine and verapamil?
HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud's
What hepatitis B labs indicate that the patient is in the window period?
HBeAb+, HBcAb+, HBsAg-
What is Amyloidosis and what stain is used?
Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)