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Flashcards in Complete Clue Deck (Advance Edit) Deck (1555):
1

When should Intercourse be avoided during Pregnancy?

Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes

2

What is Type 2 RTA?

Proximal RTA: bad Carbonic Anhydrase, lost all HCO3-

3

What is Heavy Chain Disease?

IgA and Multiple Myeloma of the GI tract

4

What is Nihilism?

Feeling of "life is meaningless"

5

What is Forward Typing?

Uses Antibodies to detect Antigens

6

What is associated with Vibrio Vulnificus?

Raw Oyster - common in workers shucking the oysters, cellulitis in swimmer's cuts

7

What is the MOA of Propranolol, Timolol?

B1 and B2 Blockers

8

What is Hand-Foot-Mouth Disease?

Mouth ulcers

Will not eat or drink

Palm and sole rash caused by Coxsackie A

9

What are the 2 kinds of partial seizures?

Simple (aware), complex (not aware)

10

What is an Omphalocele?

Intestines protrude out of the umbilicus covered by peritoneum

11

What is Clanging?

Words that sound alike

12

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)

13

What are the Mimetic drugs?

Pramlintide

14

What is Lewy Body Dementia?

Stiff with visual hallucinations

15

What type of problem is there if serum Ca2+ and Serum PO4- change in same directions?

This is a secondary problem

16

What is the Pool Test?

Fluid in the vagina

17

What are the indications for Odansetron?

Control vomiting in patients undergoing chemo therapy and postoperatively

18

What is Kd?

Concentration of drug that binds 50% of receptors

19

What is associated with H. Aegyptius?

Swollen eyeball with pus

20

What is Overflow Incontinence?

Cannot completely empty bladder

21

How does Gonorrhea present?

Palmar pustules, arthritis/joint pain, urethral discomfor

22

What makes Achalasia unique?

Decreased Peristalsis and increased LES pressure

23

What is the MOA of Pseudoephedrine, phenylephrine?

Sympathomimetic alpha-agonistsnon-prescription nasal decongestants

24

Where does DHT come from?

Testicles at puberty

25

What is Intraductal Papilloma?

Bleeding from the nippleMost common Breast CA

26

How does temporal arteritis present?

Pain with chewing, blind in one eye

27

What diseases have PIE syndrome?

Aspergillus, Loeffler's, Churg-Strauss

28

What is associated with Fusobacterium?

Painful mouth ulcers, gum pus, Vincent's angina

29

What is the MOA of ACE inhibitors?

Inhibits conversion of Ang I to Ang II, decreases Ang II

30

What is Central (neurogenic) diabetes insipidus?

Brain not making or producing enough ADH

31

What is Arnold-Chiari?

Foramen Magnum obstruction

32

What is 1st-order kinetics?

Constant drug percentage metabolism over time depends on drug concentration (rate of elimination is directly proportional to drug concentration)

33

What does Vit B2 do?

FAD cofactor

34

Clues for atypical pneumonia?

Atypical pneumonia: prolonged illness, low fever, usually >40 y/oX-ray: diffuse, H. Influenza, Mycoplasma, Chlamydia

35

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)

36

What will you see with Alpha Thalassemia?

Seen in African Americans and Asian Americans (Chromosome 16- deletion)

37

What are the simple Gram Negative Bugs?

They lack Lipopolysaccharides,"Simple HE"H - H. InfluenzaE - E. Coli

38

What is a Neutrophil?

The Phagocyte (it has Antimicrobials, most abundant)

39

What is the MOA of Glucocorticoids?

Decrease production of Leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2

40

What is Transference?

Patient views doctor as parent

41

Where is the most common site of a Clavicle fracture due to birth?

Middle third of the Clavicle

42

What are the indications for Niacin?

Decrease LDL and TriglyceridesStrong increase HDL

43

What is Perseveration?

Keeps repeating the same words

44

What does the parathyroid cells secrete?

PTH

45

What is associated with Actinomyces?

Face Fistulas, Sulfur Granules

46

What is a Rolling Hiatal Hernia?

Bowel Protruded through a defect in the Diaphragm. This can strangulate the bowel and can cause Atelectasis

47

What is Mesenteric Ischemia?

Abdominal pain of of proportion to physical exam

48

What is the MOA of Diazoxide?

K+ channel opener, hyperpolarizes and relaxes smooth muscle

49

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%)

50

What does the viral load tell you?

Progression of HIV

51

Which enlarged lymph nodes are most likely malignant?

Supraclavicular, Epitrochlear (above the elbow), inguinal

52

What is Velamentous Cord Insertion?

Fetal vessels insert between chorion and amnion

53

What is Common Variable Immuno. Def?

Young adults with B cells that do not work

54

What are the Indications for Oxytocin?

Induces labor and Controls uterine hemorrhage

55

What does Mg2+ do?

PTH and kinase cofactor

56

What are the risk factors for Lung CA?

Smoking, Radon, second hand smoke, pneumoconiosis (except Anthracosis)

57

What is the Adverse Effect for first generation Sulfonylureas?

Disulfiram like effects

58

What is Multiple Myeloma?

Multiple osteolytic lesionsIncreased IgG and kappa light chainsRouleaux formation seen on slide

59

Clues for Typical pneumonia?

Typical pneumonia: short illness, high fever, usually >40 y/o, X-ray: one lobe, Streptococcus Pneumonia

60

What is Polycythemia Vera?

Hematocrit (Hct) >60% Decreased EPO, Budd-ChiariPruritis after bathing

61

What is the MOA of Mimetics?

Decreases Glucagon

62

What is Ascending Cholangitis?

Common bile duct infection due to stones

63

What does Growth Hormone (GH) do?

Stimulates growth, sends Somatomedin to growth plates, Gluconeogenesis by proteolysis

64

What is Anderson's?

Branching enzyme deficiency, long chains of glycogen

65

What is the Sympathetic System?

Fight -or- Flight, speeds stuff up

66

What is a Double Footling Breech?

Two feet sticking outside the cervical OS

67

What vessel has the thickest layer of smooth muscle?

Aorta

68

What is Competitive Inhibition?

Fights for active site, no change in Vmax, potency decreases

69

What does blood type O tell you?

They have no antigens (Universal donor)

70

What does high WBC and B Cells tell you?

Bacterial infection

71

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

72

What diseases are cause by the Ixodes Ticks?

Lyme Disease - bull's eye lesionBabesiosis - Hemolytic AnemiaEhrlichiosis - puncture near eye

73

What does a Dehydrogenase do?

Catalyzes Oxidation-Reduction reactions (gaining or losing an electron)

74

What is Unconjugated Bilirubin?

Fat soluble and indirect Bilirubin

75

What is a transition?

Changes one purine to another purine

76

What is Crigler-Najjar Type I?

Unconjugated bilirubin buildupNewborn or infantsNo UDP-GTPhenobarbital yields no change

77

What organ has the highest AVO2 difference after excercise?

Muscle

78

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)

79

What are the most common places to metastasize to the brain?

From the lung, breast, and skin, present at the White-Grey Junction

80

What is Polyhydramnios?

Too much amniotic fluid (baby can't swallow)

81

What is the function of GnRH?

Stimulates release of LH & FSH

82

What are the risk factors for Esophageal / Gastric CA?

Smoking, alcohol and nitrates

83

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

84

FEV1/FVC in Restrictive lung disease

Normal or elevated

85

What has Waxy Casts?

Chronic Renal Failure

86

What are the only Gram-negative diplococci?

Neisseriamoraxella

87

How does a VIPoma present?

Watery diarrhea

88

What are the indications for the Class IB antiarrhythmic?

Decrease AP duration, acute ventricular Arrhythmias, local anesthesia

89

What defines Diarrhea?

>200 grams of stool per day

90

What defines constipation?

Less than 3 bowel movements per week

91

What defines ALL?

0-15 year old males, bone pain, + PAS stain and +TdT. CALLA antigen positiveT (12;21)

92

What is the MOA of Class IB antiarrhythmic?

Na+ channel blocker

93

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

94

What is a Female Pseudohermaphrodite?

XX with LOW 21-OHase and HIGH Testosterone

95

What are the adverse effects of Acid Resins?

Tastes bad and causes GI discomfortbile decreases absorption of fat soluble vitaminscholesterol gallstones

96

What is Hurler's?

Alph-L-Iduronidase deficiencyworse formGargoylismCorneal cloudingaccumulation of Heparin and Dermatan Sulfate

97

What are the indications for fibrates?

Strong decrease of triglyceridesslight decrease of LDLslight increase in HDL

98

What are the classifications of MHC-2?

HLA-DP, HLA-DQ, HLA-DR

99

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

100

How does Choanal Atresia Present?

Baby turns blue with feeding, pinks up when breast of bottle is removed (blocked nasal passages)

101

What is the job of the Proximal Convoluted Tubule?

Reabsorb Glucose, Amino Acids, Salt, Bicarb. >60-80% Reabsorption occurs here

102

What is Bronchiectasis?

Bad breath, purulent sputum, and hemoptysis

103

What electrolytes does the low volume state have?

Increased total Na+ (NET)Decreased serum Na (dilution effect)Decreased serum K+Increased serum pH

104

In what layers does a pseudo aortic aneurysm occur?

Intima and media layers

105

Who makes the Syncytiotrophoblast?

Mom and baby production of HCG and HPL

106

What is Metorrhagia

Bleeding or spotting in btwn periods

107

How does Spastic Colon present?

Intermittent severe cramps

108

What is selective IgG2 Deficiency?

Seen in patients with recurrent encapsulated infections

109

What diseases have respiratory acidosis?

Obstructive lung diseases

110

What is Prinzmetal's angina?

Coronary Artery Spasm

111

What does high WBC and High PMN's tell you?

Stress demargination. (Stress response - post trauma)

112

What causes a Cleft Palate?

Maxillary shelves did not fuse

113

What is Rouleaux formation?

Seen in Multiple Myeloma (Stacked coin look)

114

What is Neologisms?

New words

115

What is Nephrotic Kidney Disease?

Lostbasement membrange chargeProteinuria >3.5hypercoagulablelipiduria

116

What does a Phosphatase do?

Removes Phosphate from substrate

117

What bug loves the parietal lobe?

Toxoplasma

118

What bug is associated with Cat Scratch?

Bartonella Henselae

119

What is Selective IgA Deficiency?

Seen in transfusion, anaphylaxis, and mucus membrane infections

120

What is the Trough level?

2 hours before next dose (too high - give less often)

121

What is VHL?

Predisposes individuals to bnign and malignant tumors, AVM in the head, and retina (AD inheritance in Chromosome 3)

122

What causes a Cleft Lip?

Medial nasal prominence did not fuse

123

What is the MOA of Reserpine?

Prevents the storage of monoamines in synaptic vesicle

124

What are the 3 tests used to screen for HIV?

ELISA: Detects IgG Ab to p24 AgWestern Blot: ProteinsPCR: Detects Virus (used in babies)

125

What is Materninty Blues?

Postpartum crying and irritability

126

What are the inidications for PPIs?

Peptic ulcer, gastritis, mid-esophageal Reflux and Zollinger-Ellison syndrome

127

What are the Ca2+ channel blockers?

Verapamil, Diltiazem

128

What is Conn's Syndrome?

High Aldosterone (primary tumor), Cpatopril test makes it worse, and increase's secretin hormone

129

What color is stool with a Lower GI Bleed?

Bright Red Blood (Hematochezia)

130

What is Type 5 Hypderlipidemia?

Defective enzyme and receptor (C-II) Elevated VLDL and ChylomicronsAssociated with DM

131

What is the RBC lifespan when there is a problem?

60-90 days (same time as the shelf life of blood bank units)

132

What sound radiates to the back?

Pulmonic stenosis

133

What is the MOA of Prazosin?

Alpha 1-Blocker, vasodilation, decreases TPR

134

What is Sandhoff's?

Hexosaminidase A/B deficiency

135

What is the MOA of Octreotide (Synthetic analog of Somatostatin)?

Decreases release of GH, Gastrin, CCK, Carcinoid, VUP, Glucagon and Insulin

136

How is Smallpox different from Chickenpox?

Smallpox is on the face, same stage of development and fever

137

What is Diffusion?

From high to low concentration No ATP

138

What are the Fibrates?

Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate

139

What is Anthracosis?

Coal workers, extensive fibrosis

140

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

141

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

142

What 5 bugs cause heart block infections?

"Don't TeLL Chaga"

D- Diphtheria

T- Typhoid Fever (Salmonella Typhi)

L- Legionella

L- Lyme Disease

C- Chagas Disease (Whipple's)

143

What is a Complete Abortion?

Cervix is closed, no fetal remnants, check B-HCG level

144

What is a "Blue Bloater"?

Chronic Bronchitis

145

What are the Indications for ACE inhibitors?

HTN, CHF, post MI and vasodilation

146

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+

147

What is the treatment for hypercholesterolemia?

Statins

148

What are the adverse effects of Minoxidil?

Hypertrichosis and Pericardial Effusion

149

What are the adverse effects of adenosine?

flushing, hypotension, and chest pain very short acting

150

What are the Glucocorticoid drugs?

Hydrocortisone, Triamcinolone, Dexamethasone, Prednisone, Beclomethasone

151

Whatis Pheochromocytoma?

Adrenal medulla tumor in adults, they will have five P's: Palpitations, Perspiration, Pallor, Pressure (HTN), and Pain (headache)

152

What is Byssinosis?

Cotton workers, textile workers

153

What is Chediak Higashi?

Lazy Leukocyte Syndrome(Lysosomes are slow to fuse around bacteria)

154

What is Korsakoff Psychosis?

Alcoholic Thiamine deficiency. Presents with confusion, Opthalmoplegia, ataxia, memory loss, confabulation and personality changeTx: Vit B1

155

What type of Kidney Stones have Coffin-Lid Crystals?

Triple Phosphate (Struvite)

156

What is the difference between carotid body and carotid sinus?

Carotid Body: ChemoreceptorCarotid Sinus: Baroreceptor

157

What is Meconium?

Green baby poop (first poop)

158

What does Insulin do?

Pushes glucose into cells and K+ follows

159

What causes Granuloma Inguinale?

CalymmatobacteriumGranulomatosisKlebsiella Granulomatis

160

What is the MOA of Carvedilol?

Alpha and B-Blocker

161

What is the MOA of Levothyroxine (T4)/Triiodothyronine (T3)?

Thyroxine replacement

162

What is Anisocytosis?

RBC's with different sizes

163

What is Pain Disorder?

Prolonged pain not explained by physical causes

164

What causes Congenital Blindness?

CMV

165

What is Plummer-Vinson Syndrome?

Esophageal webs, Iron-deficiency anemia, dysphagia

166

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

167

What is associated with Strep Viridans, Strep Mutans, and Strep Salivarius?

Subacute bacterial Endocarditis, green pigment, Alpha HemolyticStrep Mutans - dental cariesStrep Salivarius - cold agglutinates

168

What are the adverse effects of Dextromethorphan?

Mild opioid effect so mild abuse potential

169

What is the most common cause of Epididymitis?

Chlamydia Trachomatis, N. Gonorrhea, E. Coli

170

What is Charcot's Triad?

Jaundice, Fever (usually with rigors) and RUQ pain

171

What is seen with Manganese deficiency?

Lose xanthine oxidase function

172

What is Psychogenic Polydipsia?

Drinking a lot of water, diluting Na in blood

173

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

174

What is the afferent arteriole's job?

Monitor pressure (JG cells-Renin release)

175

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

176

What is a frameshift mutation?

Insert or delete any number of bases, not divisible by 3, causes misreading of all downstream nucleotides

177

What is the Isoelectric Point?

The pH at which there is no net charge

178

What does an opening snap tell you?

Mitral or Tricuspid Stenosis

179

What is the rate-limiting enzyme in FA synthesis?

Acetyl-CoA Carboxylase (ACC)

180

What does a Phosphorylase do?

Adds inorganic Phosphate to substrate, No ATP used

181

What is associated with EHEC?

Hemorrhagic = renal failure

182

What are the Bile acid resins?

CholestyramineColestipolColesevelam

183

What is associated with Enterococcus?

UTI, infective Endocarditis post GI/GU procedure

184

What is Voyeurism?

Watching other people without their permission

185

What does CCK (Cholecystokinin) do?

Stimulates bile release and gallbladder contraction, inhibits gastric motility (closes sphincters), and made by I-cell of duodenum

186

What does LDL do?

It carries Cholesterol (only one to do this)

187

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

188

What does Dopamine (DA) do?

Inhibits Prolactin (PRL) release

189

What is Bipolar II?

Depression and Hypomania (no psychosis)

190

What is the Capacitation reaction?

Allow binding btwn sperm & egg

191

What is associated with Klebsiella Pneumonia?

Alcoholics, Currant Jelly Sputum, UTI, Lung fissures

192

What is the Indication for Demeclocycline?

SIADH

193

What lysosomal diseases have a Gargoyle face?

Gaucher'sHurler's

194

What is a Footling Breech/Incomplete breech?

Butt down. Thigh flexed, one toe is sticking out of the cervical OS

195

What is the MOA of Glitazones/Thiazolidinedione's?

Increases Insulin sensitivity in peripheral tissues. Transaction modulation by Peroxisome Proliferator Activated Receptor Gamma in Nuclus

196

What makes B-HCG?

Placenta (synctiotrophoblast)

197

What does erythropoietin (EPO) do?

Makes RBC's (prolong RBC life)

198

What is Erythrasma?

Rash in the skin folds, coral-red under Wood's Lamp

199

What do stomach chief cells secrete?

Pepsin

200

What are the Adverse Effects of Sulfasalazine?

Malaise, nausea, Sulfonamide toxicity, reversible Oligospermia

201

What are the indications for Class IC antiarrhythmic?

Ventricular tachy progressing to V. fib, last resort

202

What is Tracheomalacia?

Soft cartilage and stridor since birth

203

What is the MOA of Sulfasalazine?

A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammtory) activated by colonig bacteria

204

What are the Indications for Biguanides?

First line therapy in Type 2 DM

205

What is Choledocholithiasis?

Gallstone obstructs the bile duct

206

What bug loves the frontal lobe?

Rubella

207

What is a Platelet?

The clotter (has no nuclei and smallest cells)

208

How do I know the patient has a Vitamin E Deficiency?

Increased free radical damage, hemolytic anemia, ataxia gait, impaired position and vibration sense

209

What is Pseudohermaphrodite?

external genitalia problem

210

What is Niemann-Pick?

Sphingomyelinase deficiencyAreflexiaHepatosplenomegalyfoam cells (Lipid Laden macrophages)

211

What is Efficacy?

Maximal effect drug can produce regardless of dose (lower w/ non-competitive antagonist)

212

What are the Indications for Alpha-Glucosidase inhibitors?

NIDDM. (Type 2)

213

What type of kidney stones have hexagonal crystals?

Cysteine

214

What does Oxytocin do?

Milk letdown and uterine contractions

215

What is sinusitis?

Inflammation of the paranasal sinuses, tooth pain worsens upon bending forward

216

What is duodenal Atresia?

Bilious vomiting with first feeding, double bubble sign on x-ray, associated with Downs Syndrome

217

What is Multiple Endocrine Neoplasia I?

"Wermer's" 3 P's: Pancreas, Pituitary, Parathyroid adenoma

218

What GI diseases has a RLQ Sausage mass?

Intussusception

219

What is a Dohle Body?

PMN Leukocytosis(caused by infections, steroids, tumor)

220

What does an ejection click tell you?

Aortic or Pulmonic Stenosis

221

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

222

What Is Lesch-Nyhan?

HGPRT deficiencygrout neuropathyself-mutilationDystoniaXLRPrange sand crystals in diaper

223

What is a Bite Cell?

Unstable Hb inclusions (seen in G6PD Deficiency)

224

What is Antisocial Personality Disorder?

Lie, cheat, steal, destroy property, impulsive without remorse, illegal activity, aggressive towards others. Must be over 18 y/o

225

What are the Adverse Effects of Odansetron?

Headache, constipation, dizziness

226

What does Southwestern blot detect?

DNA-binding Proteins (combines south and western blots)

227

What does a paradoxical S-2 split tell you?

Aortic Stenosis or LBBB

228

What is Pre-Eclampsia?

Ischemia to the placenta causes HTN greater than 140/90

229

What is the MOA of FIbrates?

Upregulate LPL, increase triglyceride clearance

230

What is the Crystallization reaction?

Wall formed after one sperm enters to prevent polyspermy

231

What does auscaltation of wheezing tell you?

Intrathoracic narrowing (seen on expiration on x-ray)

232

What are Ideas of Reference?

Believes the media is monitoring you

233

What does the Citrate shuttle do?

FA transport out of the mitochondria

234

What conditions cause weight gain?

Obesity, Hypothyroidism, Depression, Cushing's, Anasarca

235

What does Vit B5 do?

Part of Acetyl-CoA, no known diseases

236

What is Spina bifida aperta?

Has opening (High AFP)

237

What is HELLP Syndrome?

Hepatic injury causing:H- HemolysisEL- Elevated Liver EnzymeLP- Low Platelets

238

What is the MOA of Class IA antiarrhythmic?

Na+ channel blocker

239

What is the fucntion of LH (Luteinizing hormone)?

Stimulates Testosterone release from the testis, Androgens and Progesterone release from the ovary

240

What is the Parasympathetic System?

Rest and digest, slows stuff down

241

When do you see silent thyroiditis?

Post-partum patients

242

What are the adverse effects of Reserpine?

Mental depression

243

What is associated with Paseurella Multocida?

Cat/Dog saliva => Cellulits with lymphadenitis

244

What is Gigantism?

Childhood form of Acromegaly

245

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)

246

What are the adverse effects of Losartan?

Fetal renal toxicityHyperkalemia

247

What is pulse pressure?

Systolic minus diastolic pressure

248

What is Addison's disease?

Autoimmune destruction of adrenal cortex, causes hyperpigmentation (looks tan), and increased ACTH

249

What is the muscarinic antagonist drug used for asthma?

Ipratropium

250

What is the function of Prolactin (PRL)?

Milk production

251

What is associated with Chlamydia Trachomatis?

Neonatal in-turned eyelashes, Corneal Ulcers

252

How do I know the patient has a Vitamin D Deficiency?

Rickets (children), Osteomalacia (adults)

253

What is Zenker's Diverticulum?

Cough up undigested food from above the UES, Halitosis, motor dysfunction problem

254

What is a Male Hermaphrodite?

XY with no MIF

255

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

256

What is an Allograft?

Human to human transplant

257

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

258

What is Ovarian Hyperstimulation syndrome?

Weight gain and enlarged ovaries after clomiphene use for infertility

259

What is the first generation Sulfonylureas?

Chlorpropamide and Tolbutamide?

260

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

261

What are the indications for corticosteroids?

Chronic asthma, COPD

262

What are the acidic amino acids?

Asp, Glu

263

What is the Indication for GLP-1 Analogs?

NIDDM. (Type 2)

264

What does Fremitus, Egophony and Bronchophony tell you?

Consolidation (pathognomonic for pneumonia)

265

What diseases have high eosinophils?

"NAACP"N - Neoplasm (Lymphoma)A - Allergy/ AsthmaA - Addison's disease (no cortisol -relative eosinophilia)C - Collagen Vascular diseaseP - Parasites

266

What does "Penia" tell you?

Low Levels - (Usually due to virus or drugs)

267

What happens with Rubella infections in utero?

Cataracts, hearing loss, PDA, "blueberry muffin" rash (Rash on face that spreads to trunk)

268

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!)

269

Where does Testosterone come from?

Adrenal gland and testicles

270

What antibody shows past Hep A infection?

IgG

271

What hepatitis B labs indicate recent immunization within >2/52wks?

HBsAg+

272

What is Thought Blocking?

Stops mid-sentence

273

What is Chronic Mucocutaneous Candidiasis?

T-cell defect against Candida Albicans and chronic fatigue

274

What is Budd-Chiari

Hepatic vein obstruction

275

What does "Cythemia" tell you?

High levels

276

What are the degrees of Vaginal Lacerations?

1st Degree: Skin2nd Degree: Muscle3rd Degree: Anus4th Degree: Rectum

277

What are the Indications for GH?

GH deficiency in children, Turner syndrome, and Burn victims

278

What does a Kinase do?

Adds Phosphate group to substrate using ATP

279

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)

280

What is Cushing's Triad?

HTN, Bradycardia, irregular breathing

281

What is Seborrheic Dermatitis?

Red rash with oily skin and dry flaky hairline, crusty lesion

282

What receptors do Steroid Hormones use?

Nuclear membrane receptors (except cortisol cytoplasmic receptor)

283

What is the MOA of Antileukotriene?

5-lipoxygenase inhibitor -> inhibits conversion of arachidonic acid to leukotriene -> prevents bronchoconstriction and inflammatory cell infiltrate

284

What lysosomal diseases have a cherry-red macula?

Tay-sachs, Niemann-Pick

285

What is a Meduloblastoma?

Pseudorosettes compressing the brain, early morning vomiting

286

What antibody shows current Hep A infection?

IgM

287

What does Vit B3 do?

NAD cofactor

288

What are the essential amino acids?

Phynlalanine, Valine, Threonine(PVT)Tryptophan, Isoleucine, Methionine(TIM)Histidine, Arginine, Leucine, Lysine(HALL)

289

What is the Dawn Phenomenon?

Morning hyperglycemia secondary to Growth Hormone

290

What is Hepatorenal Syndrome?

High urea from the Liver leads to: increased Glutaminase, Ammonia, GABA- Kidney shuts down

291

What is Nevus Flammeus?

Port Wine Stain - Permanent- Unilateral of face or neck- Vascular malformation - Sturge - Weber syndrome - Vasculitis- Mgt: Pulsed laser therapy

292

What defines CML?

30-50 y/o females t(9;22)Philadelphia Chromosomebcr-abl

293

What is a Kleihauer-Betke Test?

Detects percentage of fetal blood in maternal circulation (Dilution test)

294

What is Kallmann's Syndrome?

No GnRH and Anosmia. (They can't smell)

295

What are the aromatic amino acids?

Phe, Tyr, Trp

296

What structures have one-way valves?

Urethra and ejaculatory duct

297

How fast should fundal height change?

Uterus grows 1 cm/week

298

What GI disease has an Abrupt Cut off on X-Ray?

Volvulus

299

What is associated with Pseudomonas Aeruginosa?

Otitis Externa, Ecthyma Gangrenosum, loves rubber, Whirlpool Folliculitis, exotoxin (ADP ribosylates EF-2)

300

What is normal blood loss during a Vaginal Deliver?

500 mL

301

What is Achalasia?

Increased LES Pressure (no Auerbach's Plexus), Bird's Beak on X-Ray and also seen in Chagas Disease

302

What are the most common causes of Oligohydramnios?

Abdominal Muscle Problem: Prune Belly Renal Agenesis: Potters Syndrome

303

What causes anterior leg bowing?

Neonatal syphilis

304

What are the Intravascular Hemolytic Anemias?

IgM G6PD deficiencycold autoimmune

305

What are the adverse effects of the Class IA antiarrhythmic?

Quinidine: CinchonismProcainamide: Torsades de Pointes

306

What does Trypsin cut?

Arg, Lys

307

What is a Dandy Walker malformation?

No cerebellum, distended 4th and lateral ventricles

308

What is Synesthesia?

Smells colors

309

Where is a Bochdalek Hernia?

Occur more commonly on the posterior left side (diaphragm), most common congenital Diaphragmatic Hernia (CDH)

310

What is Menetrier's Disease?

Loss of protein through the rugal folds. Causes generalized edema. CMV association in children and H. Pylorus in Adults

311

What is a True Hermaphrodite?

Internal genitalia problem (has both sexes)

312

What gives urine its yellow color?

Urobilinogen being oxidized to urobilin

313

What is a Schistocyte?

Broken RBC (seen in DIC and artificial heart vlaves and others)

314

What does vasoactive intestinal peptide (VIP) do?

Inhibits secretin, motilin, and CCK, and opens Sphincters

315

What are the adverse effects of Digoxin?

Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failureQuinidine displaces Digoxin from tissue binding sites

316

What is Amnesia?

Can't recall important facts

317

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)

318

What organ has the highest AVO2 difference after a meal?

GI tract

319

What is Inflammatory Carcinoma?

Infiltrates Lymphatics, pulls on Cooper's Ligaments "Peau d'Orange"

320

What is associated with Propionibacterium acnes?

Acne, Progesterone => Propionic acid

321

What type of immunity does TH2 provide?

Enhances humoral immunity

322

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

323

What is the function of TRH?

Stimulates TSH release

324

What are some causes of G6PD Deficiency?

Sulfa drugs, mothballs, fava beans, sudden drop in Hb

325

What is Erythema Toxicum?

White wheal on red area rash has Eosinophils

326

What is Pseudocyesis

Fake pregnancy with all the signs and symptoms

327

How does Herpes present?

Primary: Painful grouped vesicles on red baseSecondary: Painful solitary lesion

328

What is squamous cell CA?

Seen in smokers, high PTH and Ca2+

329

What is the cell-mediated immune response?

T-cells and Macrophages patrol the tissues looking for non-bacteria

330

What is a Thyrotrope?

TSH

331

What is seen / causes in Aplastic Anemia?

PancytopeniaAutoimmuneBenzeneAZTChloramphenicolRadiation

332

What is the function of CRH?

Stimulates ACTH release

333

What is the Gram Positive Capsule?

S. Pneumonia

334

What does Thyroid Peroxidase (TPO) and Thymosin do?

Help T-cells mature

335

What is the rate-limiting enzyme in Heme synthesis?

Delta-ALA Synthase

336

What is Borderline Personality Disorder?

"Perpetual Teenager", splitting (love/hate), projection, acting out, self-mutiliation, unstable relationships, impulsive

337

What does Rh+ tell you?

Has D Antigen

338

Can you die during ETOH withdrawal?

Yes

339

What Kidney complications can Lithium cause to the person taking the drug?

Destroy the collecting ducts V2 aquaporin receptors, causing Nephrogenic DI

340

What is a Biophysical Profile (BPP)?

By US look for:Non-stress testAFIFetal heart toneFetal ActivityBreathing Movement

341

What do you see in Grave's Disease?

Exophthalmos, Pretibial myxedema, anti-TSH receptor antibodies

342

What bug loves the hippocampus?

Rabies

343

What diseases have metabolic acidosis?

"MUDPILES" and diarrhea

344

What unstable angina?

Pain at rest (transient clots MCC)

345

What is a Pinealoma?

Loss of upward gaze, loss of circadian rhythms lead to precocious puberty

346

What does THF donate methyl groups for?

Nucleotides

347

What is the MOA of Misoprostol?

PGE1 analog, increase production and secretion of gastric mucous barrier, decreased acid production

348

What is Lichen Sclerosis?

Paper like vulva, itching, CA risk

349

What is an Eosinophil?

The parasite destroyer and allergy inducer

350

What is seen in Paroxysmal Cold Auto Autoimmune?

Bleeds after cold exposure Donath-Landsteiner Ab

351

What does the E Ag tell you?

Transmissibility/ Infectivity

352

What is Intussusception?

Currant Jelly Stool, Stacked Coin Enema, sausage shaped mass and knees to chest for comfort

353

What is Type 1 Hyperlipidemia?

Defective Liver Lipoprotein Lipase (chylomicrons are elevated)

354

What is Uterus Rupture?

Tearing sensation, halt of delivery

355

What is associated with (PCP) Pneumocystis Carinii pnemonia?

AIDS and preemies, rusty sputum, silver stains the lungs, increased LDH, Treat with steroids

356

Why do pregnant women get Anemia?

Due to the dilution effect: RBC rises 30%, but body volume rises 50%

357

What is associated with Vibrio Cholera?

Rice Water Diarrhea, ADP- Ribosylates Gs = High cAMP, Turning the on... on

358

What vessel has the highest compliance?

Veins

359

What is the smallest amino acid?

Gly

360

What is a point mutation?

Changes one base

361

What are Esophageal Varices?

Due to Portal HTN, vomit large amounts of blood when they rupture

362

What is MGM?

BM spikes, granular/linear supepithelial spikes and closes

363

What type of kidney stones have Rosette Crystals?

Uric acid

364

What is Multiple Endocrine Neoplasia II (2A)?

"Sipple's" Pheochromocytoma, Medullary Carcinoma of the Thyroid, Parathyroid Adenoma. (tumor marker RET)

365

What are Spur Cells / Acanthocytes?

Lipid bilayer disease

366

How does Irritable Bowel Syndrome (IBS) present?

Alternating diarrhea/ constipationHistory of stressNo abnormalities on colonoscopy

367

What is Creutzfeldt-Jakob?

Prion induced disease, death within 1 year, post cornea transplant

368

What bug causes Acute Bacterial Endocarditis?

Staphylococcus aureus (attacks healthy valves)

369

What are the spore forming Gram-positive bacteria?

BacillusClostridium

370

What is the function of B-HCG?

Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)

371

What disease has Iridocyclitis?

Juvenile TA

372

What is the Rapid Acting Insulin drug?

Regular Insulin

373

What are the Class IB antiarrhythmic?

Lidocaine, Mexiletine, Tocainide

374

What is Sarcoma Botryoides?

Vaginal CA, looks like a ball of grapes

375

What is Hidradenoma?

Sweat gland cysts

376

What is Variable Deceleration?

Cord Compression

377

What is a Traction Diverticulum?

Out pouch between the UES and LES

378

What are the adverse of Methyldopa?

Sedation and Hemolytic Anemia(+) Coombs test

379

What is Intellectualization?

Act like a "know it all" to avoid feeling situational emotions, gets all information available to be over-informed

380

What bugs cause Monocytosis?

"STELS"S - SyphilisT - TBE - EBVL - ListeriaS - Salmonella

381

What is Spina bifida occulta?

Covered by skin with a tuft of hair

382

What is PKU?

No Phe -> Tyr (via decreased Tetrahydrobiopterin Cofactor or decreased Phe Hydroxylase)NutraSweet (Aspartame) sensitivitymental retardationpaleblond hairblue eyesmusty odor

383

What is Wright's Stain?

Detects nucleated fetal RBC in mom's vagina

384

What is Hemophilia A?

Defective Factor VIII (<40% Activity)Bleed into cavities (head, abd, etc)

385

What hepatitis B labs indicate infectious state?

HBeAg+

386

What organ has the highest AVO2 Difference at rest?

heart

387

What is Narcissistic Personality Disorder?

Pompous, no empathy, thinks they deserve everything

388

What does a Carboxylase do?

Transfers CO2 groups with the help of Biotin

389

What does Indirect Coombs Test tell you?

The Antibody is freely circulating in the serum

390

What are the ACE inhibitors?

Captopril, Enalapril, Fosinopril, Lisinopril

391

What does the Carnitine shuttle do?

FA transport into the mitochondria

392

What are the Adverse Effects of Glucocorticoids?

Iatrogenic Cushing's syndrome. (Adrenal insufficiency when drug stopped after chronic use)

393

What is the function of HPL?

Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)

394

What is Thought Insertion?

Believes that others are putting thoughts into his head

395

What is Benign Positional Vertigo?

Sensation of room spinningNausea/VomitingNystagmus without hearing loss or tinnitusOnset of symptoms when change position

396

What is Inflammatory Diarrhea?

Diarrhea with blood and pus

397

What does a mutase do?

Relocates a functional group within a moleculre (intrachain)

398

What is Gaucher's?

Glucocerebrosidase (Beta-Glucosidase) deficiencywrinkled tissue Macrophage'sBone painpancytopenia

399

What are the Indications for Octreotide?

Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome

400

What causes non-bacterial Fetal infections?

"TORCHST- ToxoplasmaO - Others (HIV, Measles, B-19)R - RubellaC - CMVH - HSV-2S - Syphilis

401

What are the adverse effects of the Class IB antiarrhythmic?

CNS stimulation and depressionCardiovascular depressionHyperkalemia increases toxicity

402

What is Sublimation?

Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior

403

What is Phimosis?

Foreskin scarred at penis head

404

How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?

Scurvy

405

What defines CLL?

50+ y/o males with lymphadenopathysoccer ball nucleiPresent with autoimmune Hemolytic anemia

406

What does Vit B12 do?

Cofactor for HMT & MMA

407

What GI disease has an Apple Core on X-Ray?

Colorectal Cancer

408

What are Burr Cell/ Echinocyte?

Seen in Pyruvate Kinase deficiencyLiver diseasePost splenectomy

409

What does a Synthetase do?

Consumes two substrates, uses ATP

410

What is a silent mutation?

Changes leave the same amino acid

411

What does blood type AB tell you?

Have both Antigens (universal recipient)

412

What are the adverse effects of Diazoxide?

Hypoglycemia (reduces insulin release) and hypotension

413

What is Delusion?

Fixed false belief for more than one month and no effect to his normal livingTx: Atypical antipsychotic and psychotherapy

414

How do you know it's an anaerobic infection?

gas and bad odor

415

What is SHeehan Syndrome?

Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk

416

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

417

What is Cystic Fibrosis?

Defective chloride transportermeconium ileussteatorrheaBronchiectasisChromosome 7

418

What is the MOA of adenosine?

Increase K+ efflux, hyperpolarizes the cell

419

What does Vit C do?

Collagen synthesisantioxidanthelps absorb FE++, necessary for Dopamine & hydroxylase for NE

420

What is assocaited with H. Pylori?

95% causative agent in Duodenal Ulcers

421

What organs have the most CD4 receptors?

Blood vesselsbraintesticlescervixrectum

422

What is the RBC normal lifespan?

120 days

423

What is a Somatotrope?

Growth hormone

424

What is Separation Anxiety Disorder?

Kid screams when mom leaves

425

What are the adverse effects of H2 blockers?

Prolactin release: Gynecomastia, decreased libido, impotence in malesCimetidine inhibits P450

426

What are Fibroids (Leiomyoma's)?

Benign uterus smooth muscle tumorsubmucosal type: they bleedSubserosal type: they cause pain

427

What is Metabolic Syndrome X?

"Pre-DM" due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans

428

Which cells express MHC-2?

Antigen presenting cells (macrophages, dendritic cells, and neutrophils)

429

What is Non-competitive Inhibition?

Binds a regulatory site, no change in Km, Efficacy decreases, decreased Vmax

430

What is Fifth's disease?

Erythema Infectiosum "Slapped Cheeks"B-19 ParvovirusAplastic anemia, in sickle cell patientsHydrops Fetalis

431

What are the adverse effects of Nesiritide?

Hypotension

432

What are the adverse effects of Class IC antiarrhythmic?

Prolongs refractory period in AV node Hyperkalelmia increases toxicity

433

What is a Basophil?

The allergy helper (IgE receptor - histamine release)

434

What is SCID?

No Thymus (no T-cells)frayed long bones (no B-cells)baby dies by 18 months

435

What does the Macula Densa do?

Measures osmolality (osmoles of solute-kg)

436

What type of people does Hep E like to infect?

Pregnant women (3rd trimester), Asians

437

What is Lobular Carcinoma?

Cells line up single file, contralateral breast is primary site of CA

438

Which stage of the Menstrual Cycle has the highest Estrogen levels?

Follicular stage (Has proliferative endothelium)

439

What is seen in Sickle Cell Anemia?

Crew-cut on x-rayAvascular Necrosis of femur

440

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

441

What do T cell deficiency patients die of?

Viral infections, fungal, etcexcept bacterial

442

What can high Cholesterol Cause?

Atherosclerosis

443

How do tension headaches present?

"Band-like" pain starts in posterior neck, increases throughout the day, sleep disturbance

444

What are the Big Mama Anaerobes?

Bacteroides fragilisStreptococcus BovisC. MelanagosepticusC. Diff

445

What is Vascular "multi-infarct" dementia?

Sudden onset, uneven progression of deficits, "stair step" decline

446

What is Cephalohematoma?

Bleeding under bone (blood does not cross suture lines)

447

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

448

What is a Paranoid Personality Disorder?

Suspicious about everything, they use projection

449

What is Selective Mutism?

Kid talks sometimes

450

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

451

What is Menorrhagia?

Heavy menstrual bleeding

452

What causes Syphilis?

Treponema Pallidum (Spirochete)

453

What is the only Gram-positive Endotoxin?

Listeria

454

What are the Adverse Effects of Misoprostol?

Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug

455

What is EC50?

Concentration of drug that produces 50% of maximal response

456

What is Oppositional Defiant Disorder?

Breaking the rules, defiant, noncompliant, resists authority, "bark is worse than bite". Teach appropriate child management skills

457

What is Virilization?

Female that is Man like

458

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

459

What organ has the highest AVO2 difference during a test?

Brain

460

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

461

What is an Ependymoma?

Rosettes present in the 4th Ventricle, Hydrocephalus

462

What is Zellweger's?

Neonatal Seizures

463

What does Atrial Natriuretic Peptide do?

Inhibits aldosterone and dilates the afferent arteriole

464

What is the most common type of Gallstone?

Cholesterol stone (not see on X-ray)

465

What is associated with N. Gonorrhea?

Pili, Urethritis, Tenosynovitis, Septic arthritis

466

What is a Xanthoma

Cholesterol build up (common at the elbow or Achilles tendon)

467

What is Berylliosis?

Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs

468

What are the indications for Guaifenesin?

Minor upper respiratory tract infections, common cold w/ cough

469

What diagnosis has secondary hyperparathyroidism?

Renal failure

470

How does Chancroid present?

Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)"School of Fish" pattern

471

What is Placenta Abruptio?

Severe pain due to premature separation of the placenta

472

What produces Currant Jelly Sputum

Klebsiella

473

What are the IgA protease bugs?

S. PneumoniaeH. InfluenzaM. Catarrhalis

474

What are the GLP-1 Analog drugs?

Exenatide and Liraglutide

475

What bug is associated with cat pee?

Toxoplasmosis

476

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

477

What is FSGS?

Most common in IVDA, AA, Hispanics and HIV patients

478

What is the only statin to undergo renal excretion?

Pravastatin

479

What does hyperresonance tell you?

Air in that region of the lungs`

480

What has WBC Casts ONLY?

Pyelonephritis

481

What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?

Selective B1-Blockers

482

What is the MOA of PTU and Methimazole?

Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones

483

What is associated with Corynebacterium Diphtheriae?

Chinese letters under microscope, gray Pseudomembrane, heart block, suffocation = death, ADP Ribosylates EF2, Elek's Test

484

What is Epididymitis?

Unilateral scrotal pain decreased by support

485

What is the Adverse effect of Biguanides?

Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast

486

What is the Autonomic Nervous System?

Automatic stuff... i.e. breathing, heartbeat

487

What causes Neonatal Blindness

Chlamydia

488

What is Eclampsia?

HTN with seizures

489

What is Condylomata Lata?

Flat fleshy warts, ulcerate = secondary syphilis

490

How much weight should a woman gain during Pregnancy?

1 lb/ week

491

What is Obsessive-Compulsive Personality Disorder?

Perfectionist, doesn't show feelings, detail oriented, uses isolation

492

Which cytokine is released when a macrophage is activated?

IL-1

493

How does an epidural hematoma present?

Intermittent consciousness (lucid interval)

494

What has a friction rub while holding breath?

Pericarditis

495

What does biotin donate methyl groups for?

Carboxylation

496

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

497

What is Tuberous Sclerosis?

Ashleaf spots (hypopigmentation)Primary brain tumorsHeart RhabdomyolysisRenal cell CAShagreen spots (leathery)

498

What is Vernix?

Cheesy baby skin. (protects the baby's skin from the outside world and helps with passage through the birth canal)

499

What is Postpartum Depression?

Depression post-delivery for more than 2 weeks

500

What does Vit B1 do?

Dehydrogenasestransketolase (PPP)cofactors

501

What does DES taken by Mom cause in her Daughter?

Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions

502

What are the Osmotic Laxatives?

Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose

503

What diseases have metabolic alkalosis?

Low volume state: vomiting, diuretics, GI blood loss

504

What are the Class IA antiarrhythmic?

Quinidine, Procainamide, Disopyramide

505

What bacteria cause diarrhea <8 hours after introduction?

"CBS"C - ClostridiumB - Bacillus CereusS - Staphylococcus aureus

506

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

507

What is Milia?

Neonatal white or pale yellow heads on malar area

508

What is Toxoplasmosis?

Multiple ring enhancing lesions, loves parietal love, from cat urine and feces

509

What is Apocrine?

Apex of the cell is secreted

510

What states have increased Estrogen?

Pregnancy, liver failure, P-450 inhibition, and obesity

511

What are the adverse effects of Pseudoephedrine, phenylephrine?

HTN, CNS stimulation/ anxiety

512

What is von Gierke?

G-6 Phosphatase deficiencysevere fasting hypoglycemiahepatomegalyincreased lactase and uric acid levels

513

What hormones produce Basophila?

"B FLAT": Basophils, FSH, LH, ACTH, and TSH

514

What is Huntington's?

Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation

515

What is Oligomenorrhea?

Too few periods

516

What bug loves the temporal love?

HSV

517

What is an Encephalocele?

Brain tissue herniation

518

What is Karyolysis?

Nucleus dissolves

519

What is Dysfunctional Uterine Bleeding?

Diagnosis of exclusion, usually due to anovulation

520

What has a friction rub while breathing?

Pleuritic

521

What is Hemochromatosis?

Fe deposit in organs

522

What is an Acute Rejection?

Occurs 4 days to months later. T-cell and macrophage response

523

What are the indications for Methyldopa?

HTN

524

What does secretin do?

Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum

525

When does Implantation occur?

1 week after fertilization

526

What is Comedocarcinoma?

Multiple focal areas of necrosis (blackheads) DCIS

527

What is Vestibular Neuritis?

Inflammation of the vestibular portion (CN8), Could be associated with viral infection, characterized by vertigo and dizziness

528

What is the MOA of Potassium on the heart?

Depresses ectopic pacemaker in hypokalemia

529

What is a Nephroblastoma?

Abdominal mass due to enlarged "Wilm's Tumor", hemihypertrophy and Aniridia

530

What is the most common cause of delayed speech developement?

Hearing loss

531

What is the Peripheral Nervous System?

Everything except the brain and spinal cord. Myelination by the schwann cells

532

What is Imitation?

Replicating another's behavior

533

What is Cholelithiasis?

Formation of gallstones

534

What is the most common cause of Vaginal Bleeding in Post-menopausal women?

Endometrial CA

535

Can you die during Opiod Withdrawal?

No, just very painful

536

What are the symptoms of Amniotic Fluid Emboli?

Mom just delivered Baby and mom has SOB, due to PE, leads to death

537

What is Nephritic Kidney Disease?

Inflammation with protein loss <3.5 in urineIncreased size of Fenestrations, RBC casts, HTN

538

What is your maximum heart rate?

220 minus the person's age

539

What are the indications for Reserpine?

HTN

540

What is seen in Calcium deficiency?

Poor bone and teeth development

541

What is Eisenmenger's Syndrome?

Physiological shunt from left to right now changes right to left

542

What are some PPIs?

Omeprazole, Lansoprazole

543

What kind of Patients does Staph and Pseudomonas like to attack?

DM, CF, Burn Patients, Neutropenic patients

544

What does a Transferase do?

Relocates a functional group from one molecule to another

545

What is associated with P. Mirabilis?

Staghorn Calculus, UTI, Urease Positive, Treat with Norfloxacin

546

What is Emphysema?

Obstructive diseaseAlpha-1-antitrypsin deficiency

547

What is PSGN?

Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies

548

What is Sixth's DIsease?

Roseola, Exanthema Subitum (fever disappears then rash appears)

549

What is a Lymphocyte?

The warrior - T, B, and NK cells

550

What disease has a "3" shape on x-ray?

Coarctation of the aorta

551

What is MPGN

Tram tracks seen (Type II has low C3) on LM

552

What is Peutz Jegher Syndrome?

Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps

553

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

554

What is Type 2B Hyperlipidemia?

Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)

555

What is the MOA of Nitroprusside?

Direct release of NO, increases cGMP, vasodilator

556

What is a Tear Drop Cell/ Dacrocyte?

RBC's squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)

557

What is Decreased beat-to-beat variability?

Acidemia

558

What does Gastric Inhibitory Peptide (GIP) do?

Increases insulin action, responsible for post-prandial hypoglycemia

559

What is the difference between norepinephrine and epinephrine?

NE: NeurotransmitterEPI: Hormone

560

What are the adverse effects of ACE inhibitors?

Hyperkalemia, cough, angioedemacontraindicated in pregnancy (fetal renal malformations)

561

What is Cataplexy?

Loss of muscle tone due to strong emotions

562

What does dullness to percussion tell you?

Something between the airspace and chest wall absorbing sound, can be solid or fluid

563

What hepatitis B labs indicate a chronic carrier state?

HBsAg+, (>6 months), HBsAb (+/-)

564

What are the Diastolic Blowing murmurs?

Aortic regurgitation, pulmonic regurgitation

565

What is the MOA of Isoproterenol?

Non-specific, Beta-agonists;relates bronchial smooth muscle (B2)

566

What does Exocrine mean?

Secreted into a duct

567

What is Apoptosis?

Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last

568

What are theh Renin-angio system effectors?

ACE inhibitors and ARBs

569

What are the most common symptoms of the Low Energy State?

Weakness and SOB

570

What is Reynold's Pentad?

Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status

571

What does Ca2+ do?

Neuronal function, atrial depolarization, smooth muscle contractility

572

What diseases have Granulomas?

"HiTTSS"Hi - Histiocytosis XT - TBT - The -Ella'sS - SarcoidosisS - Syphilis

573

What is a Complete Breech?

Butt down, thighs, and legs flexed

574

What is Grey-Turner's Sign?

Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)

575

What is associated with Francisella Tularensis?

Ulcers at rabbit or deer tick bite siteRx: Streptomycin

576

What is associated with Bartonella Henselae?

Cat Scratch = Single painful lymph node, Stains silver

577

What is Avoidant Personality Disorder?

Socially withdrawn, afraid of rejection but wants to fit in

578

What is a Sister Mary Joseph Nodule?

Ovarian CA that has spread to the umbilicus(Also GI cancers can cause) (Indicates metastasis)

579

What does the Core Ab tell you?

Past infection

580

What is associated with Clostridium Melangosepticus?

Colon CA

581

What is a Neuroblastoma?

Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine's

582

What are the inidcations for Cromolyn?

Asthma prophylaxis

583

What is Rationalization?

Make excuses for behavior in advance, (because of...)

584

What are the indications for Nesiritide?

Acute decompensated heart failure

585

How do you measure afferent renal function?

Creatinine or Inulin

586

What is a Spherocyte?

Old RBC

587

What is Thought Broadcasting?

Believes that everyone can read his thoughts

588

What is associated with Chlamydia psittaci?

Parakeets and Parrots are the carrier agent

589

What does high WBC and >5% Blasts tell you?

Leukemia

590

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

591

What is Displacement?

Take anger out on an object or someone else. Not related with situation

592

What is Turcot's Syndrome?

Familial Polyposis with Brain Tumors

593

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)

594

How does trigeminal neuralgia (Tic Douloureux) present?

Sharp, shooting face pain, recurrent episodes

595

What does an AFI <5 indicate?

Oligohydramnios (Cord compression)

596

What is the rate-limiting enzyme in Glycogenesis?

Glycogen Synthase. Occurs in the Cytoplasm of Liver and muscle

597

What is Bronze diabetes?

Fe deposit in pancreas

598

What does Aldosterone do?

Reabsorbs Na+ and three waters

599

What is Chronic Pelvic Pain?

Endometriosis until proven otherwise

600

What is Late Deceleration?

Due to uteroplacental because the placenta cannot provide oxygen and nutrients

601

What are the CSF lab values for Meningitis?

PMN's -> BacteriaT cells / Macrophages -> Non-bacterialNormal Glucose -> Viral

602

What is the Clotting Cascade?

The cascade that stops you when you bleed

603

What is the MOA of Statins?

Inhibit HMG CoA reductase

604

What are the Holosystolic murmurs?

Tricuspid RegurgMitral RegurgVSD

605

What is Stage 1 of Labor?

Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm

606

What are the Vasculitis associated with LOW C3?

"PMS in Salt Lake City"Post-Strep GNMembranoproliferativeGlomerulonephritis Type IISub Bacterial endocarditisSerum SicknessLupusCryoglobulinemia

607

What is the MOA of albuterol?

B2 agonist; relaxes bronchial smooth muscle

608

What is Factitious?

Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.Tx: Supportive psychotherapy

609

What is Condyloma Acuminata?

Verrucous "cauliflower" warts, koilocytes, due to HPV 6 and 11

610

What is Osmotic Diarrhea?

High osmolality in the bowel pulling water into the lumen

611

What defines Hodgkin's Lymphoma?

EBV and may have Reed-Sternberg cells

612

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

613

What is associated with Chlamydia Pneumonia?

Staccato coughing, parasite with DNA and RNAs:Elementary body (Infectious phase) Reticulate Body (resting phase - can't divide)

614

What is the only Gram-positive Diplococci?

Streptococcus Pneumonia

615

What is the humoral immune response?

B-cells and PMN's patrol the blood looking for bacteria

616

What are the Adverse Effects of Infliximab?

Respiratory infection (including reactivation of latent TB) fever, hypotension

617

What are the indications for HMG-CoA reductase inhibitors?

Strong decrease LDLDecrease TriglyceridesIncrease HDL

618

What does a Galactokinase deficiency cause?

Cataracts

619

What is the most common extracellular buffer?

Bicarb

620

What is associated with Bacillus Cereus?

Fried rice syndrome, preformed toxin

621

What is Compensation?

Doing something different of what you used to do

622

What is the color of air on X-ray?

Black "radiolucent"

623

What stage of the menstrual cycle has the highest Temperature?

Ovulatory stage, body temp will rise One degree during ovulation

624

What bug loves the DCML tract?

Treponema

625

What are the indications for 2nd generation H1 Blockers?

Allergies

626

Who Makes the Trophoblast?

Baby

627

Waht is the rate-limiting enzyme in Cholesterol syntesis?

HMG CoA Reductase

628

What makes an adequate sputum sample?

<10 epithelial cells and >25 leukocytes per low power field

629

What are the indications from Magnesium?

Effective in Torsades and Dig toxicity

630

What are the adverse effects of Salmeterol?

Tremor and arrhythmia

631

What is the indication for Isoproterenol?

Bronchoconstriction due to sympathetic tone

632

What is Pathological Gambling?

Can't stop gambling, affects others

633

What is the sign of a Clavicle Fracture?

Asymmeteric Moro reflex

634

What is an Astrocytoma?

Rosenthal fibers - #1 in kids with occipital headache

635

What is Heavy Chain Disease?

Increased IgA

636

What GI disease has a Bird's Beak on X-Ray?

Achalasia (Think Chagas disease)

637

What is Carcinoid syndrome?

Flushing, wheezing, diarrhea

638

What are the Indications for Glitazones/Thiazolidinedione's?

NIDDM. (Type 2)

639

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

640

What is the CBC for every basculitis?

Decreased: RBC and plateletsIncreased: WBC, T-Cells, Monocytes, Schistocytes, ESR

641

What is associated with Mycoplasma Pneumoniae?

Bullous myringitis, Ground Glass CXR, P-1 Protein, Erythema Multiforme

642

What are the risk factors for Primary Liver Cancer?

Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis

643

What are the Pyrimidines?

C, U, T

644

What are the Adverse Effects of Desmopressin (DDAVP)/ADH?

Over hydration and allergic reaction

645

What is a Sliding Hiatal Hernia?

Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax

646

What is t1/2?

Half-life, the time it takes the body to use half of the drug ingested

647

What is the job of the early distal tubule?

Concentrate urine by reabsorbing NaCl

648

What is the thyroid hormone levels during Pregnancy?

Increased TBG - leads to increased total T4 (Bound and free)

649

What is seen with Varicella (Chickenpox)?

Red macule clear vesicle on red dotPus and scabbingvarious stages of healing

650

What is Cabot's Ring body?

Seen in Vitamin B12 Deficiency and lead poisoning

651

What is intra-Renal Failure?

Damaged Glomerulus or tubules; BUN: Creatinine Ratio <20/1

652

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)

653

What organs do not require insulin to absorb glucose?

"BRICKLE": Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle

654

What receptors do Protein Hormones use?

Cell membrane receptors

655

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)

656

What is Metachromatic Leukodystrophy?

Arylsulfatase A defieciencychildhood multiple sclerosis with Ataxia/Dementiaaccumulation of Cerebroside Sulfate

657

What are the catabolic pathways that create energy? (Occur in the Mitochondria)

Acetyl-CoA production, Beta-oxidation, citric acid cycle, Ketogenesis, Ox Phos

658

What are Plasma Neoplasms?

They produce many antibodies

659

What does the Direct Coombs Test tell you?

ANtibody on surface (seen in hemolytic anemia)

660

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

661

What does Glucagon do?

Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis

662

What is the rate-limiting enzyme in Purine synthesis?

Glutamine - PRPP

663

What is Alzheimer's disease?

Decreased ach in nucleus basalis of Meynert, bad Apo-E4, Amyloid Plaques, Neurofibrillary Tangles of Tau proteins

664

What is Essential Thrombocythemia?

Very high platelets increased RBC's and WBC's

665

What does Antidiuretic hormone (ADH) do?

Conserves water (V2 aquaporin receptors) and vasoconstriction

666

What does Tracheal deviation tell you?

Moves away from tensionPneumothorax moves towards Atelectasis

667

What CA risk does VHL have?

RCC

668

What GI disease has a Corkscrew on X-Ray?

Esophageal spasm and Volvus

669

What is Carcinoid Syndrome (Triad)?

Diarrhea, flushing and wheezing

670

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

671

What is Crohn's Disease?

Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions

672

What are Loose Associations?

Ideas switch subjects, incoherent

673

What is Idealization?

They see only the good in someone despite evidence to the contrary

674

What GI disease has a stacked coin on X-Ray?

Intussusception

675

What is Tangentiality?

Wanders off the point

676

What is Graft vs. Host Disease?

When the graft attacks the body (T-Killer cells and macrophages responded)

677

What are the Indications for Infliximab?

Crohn's Disease, Rheumatoid arthritis

678

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

679

What has Tubular Casts?

Acute Tubular Necrosis (ATN)

680

What is the risk of Chorionic Villus Sampling?

Fetal limb defects. (Done at 9-12 weeks)

681

What is Karyorrhexis?

Nucleus fragments

682

What is Waldenstrom Macroglobulinemia?

IgM and Hyperviscosity of the blood

683

What are Pencil Cell/ Cigar Cell?

Seen in iron deficiency anemia

684

What is Primary Biliary Cirrhosis?

Anti-Mitochondrial antibody Bile ducts are destroyedXanthelasmas present and pruritis

685

What is factitious hypoglycemia?

Exogenous insulin use, labs show elevated insulin and decreased C-peptide

686

What are the adverse effects of the Ca2+ channel blockers?

Flushing, edema, constipation, CHF, AV block

687

What disease does Coxsackie B cause?

Endocarditis, DM Type I

688

When do you give RhoGam?

1st Dose: Week 28 gestation2nd Dose: 72 hours post-deliveryAny time a procedure would mix mom and fetal blood

689

What are the IgA Nephropathies?

HSPBerger'sAlport Syndrome

690

What is Paracrine?

Works on its neighbor. (except sweat gland)

691

What does "Cytosis" tell you?

High levels

692

What is Justification?

Making excuses for behavior afterwards

693

What are the Biguanides drugs?

Metformin

694

What are the glycogenic amino acids?

His, Met, Val

695

What are the indications for Hydralazine?

Severe HTN, 1st line treatment for HTN in pregnancy

696

What are the hormones with disulfide bonds?

"PIIG": Prolactin, Insulin, Inhibin, GH (growth hormone)

697

How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?

Angular Cheilosis

698

What does Vit B9 do?

Nuclear division (Synthesis of Nitrogenous bases for RNA and DNA)

699

What is Glanzmann's?

Baby with bleeding from skin and mucosa (LOW GP-2b3a)

700

What is Exhibitionism?

Exposure to others

701

How does the Sympathetic System behave?

Opposite of Parasympathetic:ConstipationUrinary retentionMydriasis - "Eyes wide with fright"TachycardiaBronchodilateEjaculation "Shoot"Xerophthalmia (dry eyes)Xerostomia (Dry mouth)

702

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

703

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

704

What are the classifications of MHC-1?

HLA-A, HLA-B and HLA-C

705

How does chlamydia present?

Cervicitis (Yellow pus), conjunctivitis, PID

706

What is Total Anomalous Pulmonary return?

All pulmonary veins enter into the right atrium (Snowman x-ray)

707

What is the rate-limiting enzyme in Ketogenesis?

HMG CoA Synthase

708

What is Herpes?

ds DNA virus

709

What is the Stage II of Labor?

Continues after the cervix is dilated to 10 cm until the delivery of the baby

710

What is the difference between Heterochromatin and Euchromatin?

Hererochromatin = tightly coileddarkerTranscriptionally inactiveEuchromatin = loose (10nm fibers)lighter

711

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

712

What murmur has a regular-irregular pulse?

PVC

713

What disease has a Thumb Sign on neck films?

Epiglottitis

714

What is Restrictive Lung disease?

small still lungs, can't get air in

715

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

716

What are the indications for Ezetimibe?

Decrease LDL

717

What are the Class IC antiarrhythmic?

Flecainide, Encainide, Propafenone

718

What is the effect of Alcohol on the fetus?

FASSmooth philtrumshortpolyclonalmidface hypoplasiathin superior Vermilion border

719

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

720

What causes Chancroid?

Haemophilus Ducreyi

721

What is Telephone Scatologia?

Phone Sex

722

What is the MOA of ARBS?

Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II

723

What is a Missed Abortion?

Cervix is closed, no fetal remnantsTx. D&C

724

What type of kidney stones have envelope or dumbbell-shaped crystals?

oxalate

725

What does the E Ab tell you?

Low transmissibility

726

What is the cause of large babies?

DM or twin-twin transfusions

727

What are the indications for Nitroprusside?

Hypertensive emergency, CHF, Angina

728

What is the MOA of cromolyn?

Prevents release of mediators from mast cells

729

What is Bismuth and Sucralfate used for?

Increase ulcer healing, traveler's diarrhea

730

What is a SIderoblast?

Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)

731

What is the MOA of Bile Acid resins?

Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more

732

What are the sympathoplegics?

Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine

733

What is the MOA of Salmeterol?

B2 agonist; relaxes bronchial smooth muscle

734

What is Bronchitis?

Increased sputum production "Blue Bloater"

735

What is Type 2A Hyperlipidemia?

Defective LDL-Clathrin Pit or B-100 (LDL are elevated)

736

What will you see with Anemia of Chronic Disease?

Decreased TIBC

737

What will you see with Sideroblastic Anemia?

Decreased dALA synthase common with blood transfusions

738

What are the adverse effects of Hexamethonium?

Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

739

What is the MOA of the K+ channel blockers?

Increase AP duration, increase effective refractory period (ERP), increase QT interval

740

What is Plummer-Vinson Syndrome?

esophageal webbing at the UES, spoon nails from iron deficiency anemia

741

What is Cholestasis?

Obstructed bile ductHigh Alk Phos (if in the common bile duct)

742

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)

743

What is Trichotillomania?

They pull out their own hair and eat it

744

What is McCune-Albright?

Precocious sexual development, polyostotic fibrous dysplasia "whorls of connective tissue", "coast of Maine" pigemented skin macules

745

What is associated with Vibrio Parahaemolyticus?

Raw Fish, Gs Stimulation via ADP- ribosylation = HIGH cAMP, Turns the on... on

746

How fast should B-HCG rise?

Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed

747

What are the indications for Methacholine?

Asthma challenge test

748

What are some causes of Vitamine B12 deficiency?

TapewormsVeganismType A gastritisPernicious Anemia

749

What does Vit D do?

Mineralization of bones and teeth

750

What are the newborn screening tests?

"Please Check Baby Before Going Home"P - PKUC - CAH/ CFB - Biotinidase/ Beta- ThalassemiaG - GalactosemiaH - Hypothyroidism/ Homocystinuria

751

What are the most common causes of mental retardation in the US?

FAS, Fragile X and Down's Syndrome

752

What is Wiskott-Aldrich?

Low IgM, Low PlateletsHigh IgAEczemaPetechiaeX-linked

753

What is achondroplasia (Laron Dwarf)?

Patient with abnormal FGF receptors in exremities. (abnormal FGF3)

754

What is Hemosiderosis?

Fe overload in bone marrow

755

What is Poikilocytosis?

RBC's of different shapes

756

What are the Adverse Effects of Mimetics?

Hypoglycemia, Nausea, Diarrhea

757

What can high Triglycerides Cause?

Pancreatitis

758

What is the MOA of a muscarinic antagonist?

competitively block muscarinic receptors preventing bronchoconstriction

759

What are the methylxanthines?

Theophylline

760

What is the function of T3 and T4?

Growth and differentiation

761

What is Histrionic Personality Disorder?

Theatrical, sexually provocative, use repression

762

What diseases have Respiratory Alkalosis?

Restrictive Lung diseaseAnxietyPregnancyGram neg sepsisPE

763

What does Fe2+ do?

Hb function, electron transport

764

What is RhoGam?

Anti-D IgG

765

What is Pyromania?

Sets fires for the fun of it

766

How does DKA present?

Kussmaul respirations, fruity breath (acetone), and altered mental status

767

What is assocaited with Strep Bovis?

Colon Cancer, black pigment

768

What hepatitis B labs indicate non-infectious state?

HBeAg-

769

What bugs cause Bloody Diarrhea?

"CASES": Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella

770

What are the only arteries with deoxygenated blood?

Pulmonary and umbilical arteries

771

What are the Long Acting Insulin drugs?

Ultralente, Glargine, and Protamine

772

What is Sarcoidosis?

Non-caseating granulomas, eggshell calcification around lymph nodes

773

What sound radiates to the axilla?

Mitral regurgitation

774

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)

775

What does somatostatin do?

Inhibits secretin, motilin, and CCK

776

What is the Adverse Effect of Sulfonylureas?

Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy

777

What is the MOA of N-acetylcysteine?

loosen mucus plugs by breaking disulfide bonds

778

What has Epithelial Casts?

Normal sloughing

779

What is INR ratio determined by?

Measured PT/ Control PTtherapeutic level is between 2-3Normal level is 1

780

What are the Water shed areas?

Hippocampus, splenic flexure

781

What is Stress Incontinence?

Weak pelvic floor muscles, urinating when coughing, laughing, etc. Estrogen effect

782

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)

783

What is a Vertex Presentation?

Posterior Fontanel (triangle shape) presents first (normal)

784

What is associated with C. Diff

Explosive diarrhea = Pseudomembranous Colitis

785

What are the antileukotriene drugs?

Zileuton, Zafirlukast, montelukast:aspirininduced asthma

786

What are the Purines?

A, G

787

What is a Septic Abortion?

Fever greater than 100.4 F, malodorous discharge

788

What is a Pappenheimer body?

Iron inside cell (sideroblastic anemia)

789

What does Seminal Vesicle give to Sperm?

Food (Fructose) and clothes (semen)

790

What GI diseases are the causes of liquid Dysphagia?

Scleroderma and Achalasia

791

What does IDL do?

It takes TG's from adipose to tissue

792

What type of Gallstone can be seen on X-Ray?

Calcium Bilrubinate stone

793

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

794

What are the Production Anemias?

Diamond-BlackfanAplastic Anemia

795

Where is VLDL made?

Liver

796

What is associated with C. Botulinum?

Canned food, honey, inhibits ACh release, respiratory failure, stool toxin, treat with Penicillin

797

What is SIADH?

Too much ADH present causes plasma volume to expand Serum Na+ less than 120

798

What is the Somogyi Effect?

Morning hyperglycemia secondary to evening hypoglycemia

799

What are Identical Twins?

Eggs split into perfect halves "Monochorionic"

800

What is the symptoms of Loeffler Syndrome?

Pulmonary Eosinophilia

801

What is the MOA of H1 Blockers?

Reversible inhibitors of H1 histamine receptors

802

What is associated with Group C Strep?

Pharyngitis

803

What is HPV?

ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD

804

What is the function of FSH

Male: sperm, MIF, inhibin BFemale: Stimulates Estradiol (E2)

805

What vesels have the most smooth muscle?

Arterioles

806

What are the symptoms of a Low Energy State?

CNS: Mental retardation, dementiaCV: heart failure, pericardial effusionMuscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation

807

What are the signs of child abuse?

Multiple EcchymosisRetinal HemorrhageEpidural / Subdural HemorrhageSpiral Fractures (twisted)Multiple fractures in different stages of healing

808

What is Nitrazine?

Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)

809

What is Pyknosis?

Nucleus turns into blobs. (shrinkage)

810

What organs have resistance in parallel?

All the rest of the organs (except liver and kidneys)

811

What are the indications for Losartan?

HTN

812

What is PIE Syndrome?

Pulmonary Infiltrate with Eosinophilia

813

What stage of the Menstrual Cycle has the highest level of Progesterone?

Luteal stage (Has secretory endothelium)

814

What makes Progesteron <10 week gestation?

Corpus Luteum

815

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

816

What is Euthyroid Sick Syndrome?

LOW T3 Syndrome and decreased conversion of T4 to T3 (increased T3r)

817

What is Albinism?

No Tyr -> Melanin (via Tyrosinase)

818

What is Endometritis?

Postpartum uterine tenderness

819

What is seen with Tin deficiency?

Poor hair growth

820

What does an Isomerase do?

Creates and isomer

821

What is the MOA of Odansetron?

5-HT3 antagonist, powerful central acting antiemetic

822

What is Rotor's?

Defective Bilirubin storage and Elevated Conjugated Bilirubin

823

What vessels have the largest cross-sectional area?

Capillaries

824

How does Lymphogranuloma Venereum present?

Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis

825

What is Ataxia Telangiectasia?

Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels

826

What are the side effects of Estrogen?

Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins

827

What is Stage III of Labor?

Delivery of the placenta

828

What hormones are released from the posterior pituitary?

ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins

829

What is Anencephaly?

Notochord did not make contact with the brain - only have the medulla

830

What is Cholangitis?

Inflamed bile duct

831

What does the Coombs Test Tell you?

Antibody involved

832

What is Dependent Personality Disorder?

Clingy, submissive, low self-confidence, uses regression

833

What hepatitis B labs indicate previous infection and now immunity?

HBcAb+, HBsAb+, HBsAg-

834

What are the physical signs of Alcoholic Cirrhosis?

Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren's Contracture

835

What is Bruton's Agammaglobulinemia?

Kids ( < 1 y/o) with defective tyrosine kinase; they have no antibodies and have x-linked transmission

836

What are the indications for Sulfalazine?

UC, Crohn's disease

837

What is a Drepanocyte?

Seen in Sickle cell Anemia

838

Negative high dose Dex. and High ACTH levels?

Ectopic ACTH- small cell CA of the lungs

839

What are the indications for Clonidine?

HTNSmokingCocaineHeroin withdraw

840

What is Type and Match?

Blood type and Wait

841

What is Wolff-CHaikoff?

Transient hypothyroidism

842

What is Pyloric Stenosis?

Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation

843

What is Lichen Simplex Chronicus?

Raised white lesions, chronic scratching

844

What is the MOA of Clonidine?

Alpha 2 agonist = decreases peripheral resistance

845

Which part of the Nephron concentrates urine?

medulla

846

What is the Adverse Effect of Insulin?

Hypoglycemia

847

What are the sulfur-containing amino acids?

Cys, Met

848

What is Bartter's Syndrome?

JG cell hyperplasia with renin excess, no increase in blood pressure, defect in kidney's ability to reabsorb potassium

849

What is Drug Induced Hypersensitivity?

Eosinophils in the urine

850

What is increased beat-to-beat variability?

Fetal Hypoxia

851

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

852

What causes lateral leg bowing?

Rickets

853

What is Undoing?

Doing exact opposite of what you used to do to fix a wrong

854

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)

855

What is Myelofibrosis?

Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC's) and extramedullary Hematopoiesis

856

What disease states have increased Anion Gap?

"MUDPILES"MethanolUremiaDKAParaldehyde/PhenoforminINH/ Iron tabletsLactic AcidosisEthylene GlycolSalicylates

857

What is CD8?

T-killer or T-suppressor cellResponds to MHC-1 complex (self)

858

What causes Gonorrhea?

Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort

859

What are some causes of Folate Deficiency?

Old food, you will see Glossitis with the patient

860

What is Cretinism?

Mom and baby are hypothyroid

861

What do you see in DeQuervain's disease?

Viral origin, painful jaw, hypothyroid

862

What is Epstein's anomaly?

Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)

863

What murmur has an irregular-irregular pulse?

A fib (no P waves)

864

What is Kleptomania?

Steals for the fun of itTx: Psychotherapy

865

What is a normal BPP?

>8-10

866

What is an Oligodendroglioma?

Fried egg appearance, Nodular Calcification

867

What does high WBC and Bands tell you?

Left shift - they have an infection

868

What are the pulmonary infiltrates with eosinophilia (PIE) syndromes?

Churg-Straus, Loeffler's, allergic Bronchopulmonary Aspergillosis

869

Waht is Vasa Previa?

Babies blood over OS

870

What is the Average IQ?

85-100

871

What are the indications for Octreotide?

Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

872

What is Loss of Ego Boundaries?

Where we lose sight and sense of our mind and body and its influences

873

What is seen in Magnesium deficiency?

Loss of kinase function, hypoparathyroidism

874

What is Vater Syndrome?

V - Vertebral abnormalityA - AnalTE - Tracheal Esophageal FistulaR - Renal

875

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

876

What is the Most common type of Kidney Stone?

Calcium Phosphate and Calcium Oxalate

877

What is the risk of Amniocentesis?

Abortion (2% risk)

878

What is Potency?

Amount of drug needed to produce effect (lower w/ comp antagonist)

879

What is the indication for Methylxanthines?

Asthma

880

What does Galactosemia cause?

Cataracts, mental retardation, liver damage

881

What is a Neuroblastoma?

Adrenal Medulla tumorHypsarrthymiaOpsoclonusIncreased urinary VMA

882

What is Pre-Renal Failure?

Low flow to kidney; BUN; Creatinine ratio >20/1 in the serum

883

What is the function of PRH?

Stimulates Prolactin (PRL) release

884

What disease has a Selenium deficiency?

Dialted cardiomyopathy

885

How do I know the patient has a Vitamin B3 (Niacin) Deficiency?

Pellagra (4 D's: Diarrhea, dermatitis, dementia, death)

886

What is Small Cell Cancer?

Located at the Carina, Malignant, Cushing's syndrome, SIADH, and SVC syndrome

887

What is Type B gastritis?

Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)

888

What GI diseases are the causes of solid and liquid dysphagia?

Schatzki's Rings, Stricture, Cancer

889

What is associated with E. Coli?

Raw hamburger, ADP- Ribosylates Gs (increased cAMP)Verotoxin, HUS in kids and elderly

890

FEV1/FVC in Obstructive lung disease

Lower than normal (N: 0.75-0.80)

891

What are the bacteria associated with Colon CA?

Clostridium Melanogosepticus and Streptococcus Bovis

892

What is the Adverse Effect of Alpha-Glucosidase Inhibitors?

GI disturbances and may reduce absorption of iron

893

What does VLDL do?

It takes TG's from liver to adipose

894

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

895

What bug causes Subacute Bacterial Endocarditis?

Steptococcus viridans. (attacks damages valves)

896

What are the indications for the channel blockers?

WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism

897

What is a transversion?

Changes one purine to a pyrimidine

898

What is Reaction Formation?

Unconsciously act opposite to how you feel, "Tears on a clown"

899

What is the MOA of Nesiritide?

Recombinant BNP, increase in cGMP and vasodilation

900

What is Cystosarcoma Phylloides?

Exploding Mushroom

901

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)

902

What is a Stomatocyte?

Seen in liver disease

903

What does Rh- tell you?

Does not have the D Antigen

904

What is associated with Yersinia Enterocolitica?

Presents like appendicitis and Reiter'sBloody Diarrhea

905

What are the layers of the Adrenal Cortex and what do they produce?

Zona Glomerulosa (Aldosterone),Zona Fasciculate (Cortisol),Zona Reticularis (Androgens)

906

What does a Southern blot detect?

DNA, "Snow, Drop"

907

How do you test efferent arteriole function?

Renal plasma flow (RPF) or PAH

908

What adds color to Stool?

Stercobilinogen being oxidized to stercobilin

909

What is a Heinz body?

Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency

910

What is the difference between DI and SIADH?

DI: diluted urineSIADH: concentrated urine

911

What is a Blast?

Baby hematopoietic cell

912

What are the branched amino acids?

"Can't LIVe w/o them", Leu, Ile, Val

913

What is the Indication for Mimetics?

NIDDM. (Type 2)

914

What are the adverse effects of Nitroprusside?

Cyanide Toxicity, hypotension, short acting

915

What is Isolation of Affect?

Isolate feelings to keep on fucntioning

916

What is Hirsutism?

Hairy female (Excess growth in normal male areas)

917

What is associated with Strep Pyogenes?

Rheumatic Fever, PSGN, Impetigo, Pharyngitis, Nec Fasc

918

What is stable angina?

Pain with exertion that is relieved with rest (Athersclerosis MCC)

919

What are the indications for 1st generation H1 blockers?

Allergy, motion sickness, sleep aid

920

What ion has the least movement at rest?

Chloride

921

What is associated with S. Pneumoniae?

Gram-positive diplococci, rusty sputum, IgA Protease, vaccine covers 23 strains

922

What is cyclothymia?

Dysthymia with hypomania for more than 2 yearsTx: Lithium, Valproic Acid or Carbamazepine and psychotherapy

923

What is Oligohydramnios?

Too little amniotic fluid (baby can't pee)

924

What does the Water Deprivation Test tell you?

If the patient fails to concentrate urine, they do not have Primary DI

925

What effects Efficacy?

Vmax

926

What defines AML?

15-30 y/o males Sudan StainAuer Rods, (CD30)T (15;17) - D M3 AML subtypetreat with ATRA

927

What organs have resistance in series?

Liver and Kidneys

928

How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?

No deficiency state

929

What is Type I RTA?

Distal RTA: H/K in collecting duct is broken, high urine pH

930

What is Autocrine?

Works on itself. (except T-cell activation)

931

What is Hypochondriasis?

They worry about having a serious illness (specific disease) they seek medical attention. For constant reassuranceTx: Psychotherapy

932

What does the JGA do?

Measures volume, secretes renin (low volume state)

933

What is Testicular Feminization (Androgen Insensitivity Syndrome)?

Males with defective / bad DHT receptor, they are XY with a blind pouch vagina

934

What does Vit B6 do?

Transaminase cofactor, myelin integrity

935

What is Paraphimosis?

Foreskin scarre at penis baseforeskin will strangulate the gland

936

What is Glioblastoma multiforme?

Pseudopalisading necrosis, worst prognosisintralesional hemorrhage

937

What does Zn2+ do?

Taste buds, hair, sperm function

938

What Diseases have a low LAP?

CML & PNH (paroxysmal nocturnal hemoglobinemia)

939

What is Hyper IgM Syndrome?

High IgM and all other Ig's are low

940

What is Waterhouse-Friderichsen syndrome (WSF) or Hemorrhagic Adrenalitis or Fulminant Meningococcemia?

Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides

941

What disease has a steeple sign on neck films?

Croup (or Laryngotracheobronchitis)

942

What are the Indications for Insulin?

DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes

943

What is Type 3 Hyperlipidemia?

Defective ApoE (Elevated ILD)

944

What is the Osler-Weber-Rendu?

AVM (Atrial-Venous Malformation)in lung, GI, CNSthe AVM sequesters platelets and causes acquired Telangiectasia's

945

What is a Howell-Jolly Body?

The spleen or bone marrow should have removed nuclei fragments.(Seen in Hemolytic Anemia, spleen trauma, and CA)

946

What is associated with N. Meningitidis?

DIC, Pili, Only bug that releases toxin in the log phase

947

What is a Gastric Ulcer?

Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss

948

What is Type 2 Diabetes Mellitus and associations?

Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans

949

What can you measure to test afferent arteriole's function?

Glomerular filtration rate (GFR) or Inulin

950

What is an incomplete Abortion?

Cervix is open, fetal remnantsTx: D&C to prevent placenta infection

951

What is seen in Hashimoto's Thyroiditis?

Antimicrosomal antibody and Anti-TPO antibody

952

What is the definition of AIDS?

CD4 count less than 200 or defining illness

953

What is Schizoid Personality Disorder?

Recluse, they don't want to interact with others, emotional coldness

954

What are the 2nd generation H1 Blockers?

Loratadine, fexofenadine, Desloratadine, Cetirizine

955

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

956

What is Bronze cirrhosis?

Fe deposit in liver

957

What is associated with S. Aureus?

Cellulitis, Dairy products, Gold pigment, Endocarditis, Styes, Hordeolum (on eyelid)

958

What is Associated with M. Catarrhalis?

It loves Mucus: it attacks the respiratory tract

959

What is MCD?

Most common nephrotic in kids, fused foot processes, no renal failure, loss of charge barrier

960

What is Jod-Basedow Disease?

Transient hyperthyroidism due to increased iodine

961

What is the MOA of Nifedipine and verapamil?

Ca+ channel antagonists

962

What are the continuous Murmurs?

PDA or AVM's

963

What is Bronchoalveolar CA?

Looks like pneumoniadue to pneumoconiosis, nonsmoker

964

How does a Subarachnoid hemorrhage present?

"Worst headache of my life", hx. of Berry aneurysm

965

What is a Gonadotrope?

LH and FSH

966

What is Bronze pigmentation?

Fe deposit in skin

967

What are the indications for Diazoxide?

HTN

968

What is a Female Hermaphrodite?

Impossible because female is the default formation

969

Negative high dose Dex. and low ACTH levels?

Adrenal CA (high cortisol)

970

What disease has Aniridia?

Wilms Tumor

971

How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?

Peripheral Neuropathy

972

What are the Extravascular Hemolytic anemias?

Spherocytosiswarm autoimmuneParoxysmal cold autoimmuneSickle cell anemia

973

What is Monoclonal Gammopathy of undetermined significance?

Old Person with Gamma Spike (from years of building up)

974

In what layers does a true aortic aneurysm occur?

Intima, media, and adventitia

975

What is a Male Pseudohermaphrodite?

XY with LOW 17-OHase and LOW Testosterone

976

What is Azotemia?

Increased BUN/Creatinine ratiorenal failure

977

What disease does Coxsackie A cause?

Hand-foot-mouth disease

978

What do low Retics tell you?

Decreased production of bone marrow - not working right

979

What is Kleine Rechnung?

Scant bleeding at ovulation

980

What is the MOA of Niacin?

Inhibits lipolysis in adipose tissuereduces hepatic VLDL secretion into circulation

981

What is diastole?

Heart ventricles fillingincreased blood to Coronary arteriesless extraction of oxygenPhase 4 and 5 Korotkoff

982

What is the MOA of Biguanides?

Decrease Gluconeogenesis, Increase Glycolysis, and Increase peripheral Glucose uptake. (Insulin sensitivity)

983

What is Normal Pressure Hydrocephalus?

Incontinence, ataxia "magnetic gait" dementia

984

What is the Most Common Cause of Kidney Stones?

Dehydration

985

What does Somatostatin (SS) do?

Inhibits growth hormone (GH) release

986

What is the function Oxytocin?

Milk and baby ejection

987

What is the job of the Thin Descending Loop of Henle?

Reabsorbs Water

988

What is Hemophilia B?

Factor IX deficiencyBleed into joints (knee, etc)

989

What is a threatened Abortion?

Cervix is closed, baby is intact, treat with bed rest

990

What disease has multiple lung aneurysms?

Osler-Weber-Rendu (AD Ped disease -- thin vessels in nose, GI, and lungs)

991

What is the MOA of Bosentan?

Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance

992

Why is Nagele's Rule Inaccurate?

Because it does not start from Ovulation date

993

What is the MOA of Metoclopramide?

D2 receptor antagonist; increase resting tone, contractility LES tone, motility

994

What is a Band?

Baby Neutrophil

995

What is Asbestosis?

Shipyard workers, pipe fitters, brake mechanics, insulation installers

996

What is Chronic Rejection?

Occurs months to years later and fibroblasts are present

997

What does Vit B7 do?

Carboxylation (Avidin in egg whites (raw) binds Biotin)

998

What is Savage's Syndrome?

Ovarian resistance to LH/FSH

999

How does Factor 13 Deficiency present?

Umbilical stump bleeding(this is the first time a baby has to stabalize a clot)

1000

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

1001

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)

1002

What are Fraternal Twins?

Multiple eggs fertilized by different sperm

1003

What is the efferent arteriole's job?

To secrete

1004

What are the Adverse Effects of Demeclocycline?

Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth

1005

What are the hyperthyroid diseases?

Grave'sDeQuervain'sSilent ThyroiditisPlummer'sJod-Basedow

1006

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

1007

What is the MOA of PPIs?

Irreversibly inhibit H+/K+ ATPase in stomach parietal cellsDecreases proton secretion by parietal cells

1008

Who makes the Cytotrophoblast?

Mom production of GnRH, CRH, TRH, and Inhibin

1009

What are the indications for N-acetylcysteine?

CF patients and antidote for Acetaminophen overdose

1010

What is Goldblatt's Kidney?

Flea-bitten kidney (ruptured capillaries from high blood pressure)

1011

What does MPO deficiency cause?

Catalase positive infections

1012

What is Tay-Sachs?

Hexosaminidase A deficiencyHyperreflexia developmental delay"onion skin" Lysosomes

1013

What does Growth Hormone (GH) do?

Stimulates Insulin Growth Factor-1 (IGF-1) release from the liver

1014

What is the MOA of Dextromethorphan?

Antitussive (antagonizes NMDA glutamate receptors)

1015

What are the indications for digoxin?

CHF (increase contractility)A fib (decrease conduction at the AV node)depression of the SA node

1016

How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?

TOF Babies... Turns blue with crying and has No feeding issues

1017

What does a Lyase do?

Cuts C-C bonds w/ ATP

1018

What is the MOA of Desmopressin (DDAVP)/ADH?

Recruits water channels to Luminal Membrane in collecting duct

1019

What is Asherman's Syndrome?

Uterine scars from multiple D&Cs

1020

What are the breakdown products of VLDL?

IDL and LDL

1021

What is the difference between Plasma and Serum?

Plasma: No RBC'sSerum: No RBC's or Fibrinogen

1022

What is Gilbert's Syndrome?

Stress induced elevatedUnconjugated BilirubinIncreased load saturates Glucuronyl Transferase

1023

What is Secretory Diarrhea?

Water pushed from cells into the gastric lumen (increased cAMP)

1024

How does Diverticulosis Present?

Gross blood

1025

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

1026

What is Fructosemia?

"Fructose intolerance" (Aldolase B deficiency)kidney and liver damageoccurs in infants after introduction of fruits, honey, and juices

1027

What is Pellagra?

Niacin (B3) deficiencyDermatitis, Diarrhea, Dementia, Death

1028

What are the corticosteroid drugs?

Beclomethasone, Prednisone

1029

What does the surface Ab tell you?

Vaccination has occurred

1030

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

1031

How does Von Willebrand Disease (VWD) present?

Heavy menstrual bleeding

1032

What is the receptor problem with Midgets?

Patient with decreased Somatomedin receptor sensitivity

1033

What is Dysthymia?

Low level sadness >2 years, looks like depressionTx: Psychotherapy and SSRI

1034

What is a Tracheoesophageal (TE) Fistula (H-Type)?

Chokes with each feeding and is Congenital

1035

How do cluster headaches present?

Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse with lying down

1036

What should you rule out when child abuse is suspected?

Osteogenesis Imperfecta, bleeding disorders, Fifth's disease and Mongolian spots

1037

What is a Compound Presentation?

Arm or hand on head, vaginal delivery. (Mean's Prolapse of fetal extremity with presenting part)

1038

Egg-shape on x-ray?

Transposition of the great arteries

1039

What makes Progesterone in >10 weeks gestation?

Placenta

1040

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

1041

What is the MOA of GLP-1 Analogs (glucagon like peptides)?

Increase Insulin and Decrease Glucagon release

1042

What are the Urease Positive Bugs?

"Urease PPUNCHSB"P - ProteusP - PseudomonasU - UreaplasmaN - NocardiaC - CryptococcusH - H. PyloriS - Staphylococcus SaprophyticusB - Brucellosis

1043

What are the K+ channel blockers?

Sotalol, Ibutilide, Bretylium, Amiodarone

1044

Where does a Type B thoracic aortic dissection occur?

Descending Aorta, (occurs in trauma and Atherosclerosis)

1045

What is Boerhaave Syndrome?

Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion

1046

What is a Sinciput Presentation?

Anterior Fontanel (Diamond shape) presents first

1047

What is associated with Coxiella Burnetii?

Dusty Barn = Q fever

1048

What is Placenta Percreta?

Placenta perforates through serosa

1049

What is the cause of Asymmetrically Small babies?

In Late onset: Poor maternal nutrition and vascular disease

1050

What is normal blood loss during a C-section?

1000 mL

1051

What is the fucntion of AFP?

Regulates intravascular volume

1052

What is Basophilic Stippling?

Lots of immature cells increased mRNA (seen in lead poisoning)

1053

What is a Lactotrope?

PRL -- Prolactin

1054

What disease has a chromium deficiency?

Diabetes

1055

What is the function of TSH (Thyroid stimulating hormone)?

Stimulates release of T3 and T4 from the thyroid.T3= TriiodothyronineT4= Thyroxine

1056

How do migraines present?

Auro, photophobia, numbness and tingling, throbbing headache, nausea

1057

What diseases provide malarial protection?

Sickle Cell Anemia: African descentG-6PD: Mediterranean's

1058

What is Epididymitis?

Chlamydia Trachomatis. Unilateral scrotal pain decreased by support

1059

How would you know the patient has a Vitamin B1 (Thiamine) Deficiency?

Beriberi, Wernicke's Encephalopathy, Wenicke-Korsakoff Syndrome

1060

What is the Psychogenic Polydipsia?

Pathologic water drinking will have low plasma osmolality

1061

What is Chorioamnionitis?

Fever, uterine tenderness, decreased fetal HR

1062

What is the MOA of Demeclocycline?

ADH antagonist

1063

What is the MOA of Methacholine?

Muscarinic receptor agonist

1064

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)

1065

What is Rubella (German 3-day Measles)

Trunk rashLymphadenopathy behind earsthey don't look sick

1066

What is the fucntion of MSH (melanocyte-stimulating hormones)?

Provides skin pigmentation

1067

What sound radiates to the neck?

Aortic stenosis

1068

What are the glycogenic & ketogenic amino acids?

"PITT" Phe, Iso, Thr, Trp

1069

What is Bronchiolitis?

Athma in kids less than 2 years old

1070

What is Sturge-Weber?

Port wine stain (big purple spot) on foreheadangioma of retinaEpilepsyMental retardation

1071

What is the function of GRH?

Stimulates GH release

1072

What is the MOA of Hydralazine?

increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction

1073

What is Cholecystitis?

Inflammation of the gallbladder

1074

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

1075

What will you see in Beta Thalassemia?

Seen in Mediterranean's(chromosome 122- point mutation)

1076

What serum pH does the low volume state have?

Alkalotic (due to H+/K+ exchanger)

1077

What is associated with R. Prowazekii?

Lice = Starts on body

1078

What is Gastroschisis?

Wall defect lateral to midline - off center, abdominal wall with no sac covering

1079

What is the MOA of Minoxidil?

K+ channel opener, hyperpolarizes and relaxes smooth muscle

1080

What are the adverse effects of Ezetimibe?

Rare increase LFT's

1081

What are the adverse effects of Niacin?

Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia

1082

What is a Beastophile?

Someone who has sex with animals, women prefer dogs, they can smell their estrogen

1083

What is the rate-limiting enzyme in Pyrimidine synthesis?

Carbamoyl Phosphate Synthetase-2 (CPS-2)

1084

What is seen in Spherocytosis?

Defective Spherin or AnkyrinPositive Osmotic Fragility testHigh level of MCHCteardrops

1085

What is Otitis Media?

Fluid in the middle ear

1086

What is the most common transplant?

Blood transfusion

1087

What are the effects of 2nd generation H1 Blockers?

Far less sedating than the 1st generation because of decreased entry into the CNS

1088

Boot-shape on x-ray?

RVH

1089

What causes increased PTT and Bleeding Time?

Von Willebrand disease and SLE

1090

How do you treat A2 Gestational DM?

Insulin

1091

What are the adverse effects of Isoproterenol?

Tachycardia (B1)

1092

What is the Treatment for Pre-Eclampsia?

Delivery, MgSO4 (seizures), Hydralazine (BP)

1093

What are the adverse effects of Clonidine?

Drowsiness, dry mouth, and rebound HTN after abrupt withdraw

1094

What is the Treatment for Eclampsia?

4mg MgSO4 IV (Seizure prophylaxis)

1095

How do you monitor Baby's Heart Rate?

Doppler or scalp electrode

1096

What do high Retics (>1%) tell you?

RBC is being destroyed peripherally

1097

What is Fanconi Syndrome?

Due to old Tetracycline useProduces Urine phosphates, Glucose, and Amino Acids

1098

What is seen why Molybdenum deficiency?

Lose xanthine oxidase function

1099

How do you monitor the Uterus?

Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)

1100

What is Hartnup's?

No tryptophan-cannot make niacin or seratoninPresents like PellagraGenetic, not nutritional disorder

1101

What is a Frank Breech?

Butt down, thigh flexed, legs extended (Pancake)

1102

What has high LAP?

Leukemoid reaction

1103

What is Subgaleal Hemorrhage?

Prolonged jaundice in newborns due to birthing trauma

1104

What disease has pulsus bisferiens?

IHSS- Idiopathic Hypertrophic Subaortic Stenosis

1105

What is Intermittent Explosive Disorder?

Loses self-control, disproportional to circumstances?

1106

What Bacteria cause UTI's and Prostatitis?

E. ColiProteusKlebsiellaPseudomonas

1107

What can cause Cushing's syndrome?

High cortisol produced from an adrenal tumor

1108

What bug is associated with cat feces?

Toxocara Cati

1109

What is Fabry's

alpha-galactosidase A deficiencyattacks baby's kidneys and heartXLRaccumulation of CeramideTrihexoside

1110

What are the indications for Nifedipine and verapamil?

HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud's

1111

What hepatitis B labs indicate that the patient is in the window period?

HBeAb+, HBcAb+, HBsAg-

1112

What is Amyloidosis and what stain is used?

Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)