Complete Deck Part 2 Flashcards Preview

Wolfpacc Clues Complete > Complete Deck Part 2 > Flashcards

Flashcards in Complete Deck Part 2 Deck (388):
1

What is the MOA of N-acetylcysteine?

loosen mucus plugs by breaking disulfide bonds

2

What has Epithelial Casts?

Normal sloughing

3

What is INR ratio determined by?

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

4

What are the Water shed areas?

Hippocampus, splenic flexure

5

What is Stress Incontinence?

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

6

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)

7

What is a Vertex Presentation?

Posterior Fontanel (triangle shape) presents first (normal)

8

What is associated with C. Diff

Explosive diarrhea = Pseudomembranous Colitis

9

What are the antileukotriene drugs?

Zileuton, Zafirlukast, montelukast:aspirininduced asthma

10

What are the Purines?

A, G

11

What is a Septic Abortion?

Fever greater than 100.4 F, malodorous discharge

12

What is a Pappenheimer body?

Iron inside cell (sideroblastic anemia)

13

What does Seminal Vesicle give to Sperm?

Food (Fructose) and clothes (semen)

14

What GI diseases are the causes of liquid Dysphagia?

Scleroderma and Achalasia

15

What does IDL do?

It takes TG's from adipose to tissue

16

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

Calcium Bilrubinate stone

17

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

18

What are the Production Anemias?

Diamond-BlackfanAplastic Anemia

19

Where is VLDL made?

Liver

20

What is associated with C. Botulinum?

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

21

What is SIADH?

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

22

What is the Somogyi Effect?

Morning hyperglycemia secondary to evening hypoglycemia

23

What are Identical Twins?

Eggs split into perfect halves "Monochorionic"

24

What is the symptoms of Loeffler Syndrome?

Pulmonary Eosinophilia

25

What is the MOA of H1 Blockers?

Reversible inhibitors of H1 histamine receptors

26

What is associated with Group C Strep?

Pharyngitis

27

What is HPV?

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

28

What is the function of FSH

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

29

What vesels have the most smooth muscle?

Arterioles

30

What are the symptoms of a Low Energy State?

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

31

What are the signs of child abuse?

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

32

What is Nitrazine?

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

33

What is Pyknosis?

Nucleus turns into blobs. (shrinkage)

34

What organs have resistance in parallel?

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

35

What are the indications for Losartan?

HTN

36

What is PIE Syndrome?

Pulmonary Infiltrate with Eosinophilia

37

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

Luteal stage (Has secretory endothelium)

38

What makes Progesteron <10 week gestation?

Corpus Luteum

39

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

40

What is Euthyroid Sick Syndrome?

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

41

What is Albinism?

No Tyr -> Melanin (via Tyrosinase)

42

What is Endometritis?

Postpartum uterine tenderness

43

What is seen with Tin deficiency?

Poor hair growth

44

What does an Isomerase do?

Creates and isomer

45

What is the MOA of Odansetron?

5-HT3 antagonist, powerful central acting antiemetic

46

What is Rotor's?

Defective Bilirubin storage and Elevated Conjugated Bilirubin

47

What vessels have the largest cross-sectional area?

Capillaries

48

How does Lymphogranuloma Venereum present?

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

49

What is Ataxia Telangiectasia?

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

50

What are the side effects of Estrogen?

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

51

What is Stage III of Labor?

Delivery of the placenta

52

What hormones are released from the posterior pituitary?

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

53

What is Anencephaly?

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

54

What is Cholangitis?

Inflamed bile duct

55

What does the Coombs Test Tell you?

Antibody involved

56

What is Dependent Personality Disorder?

Clingy, submissive, low self-confidence, uses regression

57

What hepatitis B labs indicate previous infection and now immunity?

HBcAb+, HBsAb+, HBsAg-

58

What are the physical signs of Alcoholic Cirrhosis?

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

59

What is Bruton's Agammaglobulinemia?

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

60

What are the indications for Sulfalazine?

UC, Crohn's disease

61

What is a Drepanocyte?

Seen in Sickle cell Anemia

62

Negative high dose Dex. and High ACTH levels?

Ectopic ACTH- small cell CA of the lungs

63

What are the indications for Clonidine?

HTNSmokingCocaineHeroin withdraw

64

What is Type and Match?

Blood type and Wait

65

What is Wolff-CHaikoff?

Transient hypothyroidism

66

What is Pyloric Stenosis?

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

67

What is Lichen Simplex Chronicus?

Raised white lesions, chronic scratching

68

What is the MOA of Clonidine?

Alpha 2 agonist = decreases peripheral resistance

69

Which part of the Nephron concentrates urine?

medulla

70

What is the Adverse Effect of Insulin?

Hypoglycemia

71

What are the sulfur-containing amino acids?

Cys, Met

72

What is Bartter's Syndrome?

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

73

What is Drug Induced Hypersensitivity?

Eosinophils in the urine

74

What is increased beat-to-beat variability?

Fetal Hypoxia

75

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

76

What causes lateral leg bowing?

Rickets

77

What is Undoing?

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

78

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)

79

What is Myelofibrosis?

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

80

What disease states have increased Anion Gap?

"MUDPILES"MethanolUremiaDKAParaldehyde/PhenoforminINH/ Iron tabletsLactic AcidosisEthylene GlycolSalicylates

81

What is CD8?

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

82

What causes Gonorrhea?

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

83

What are some causes of Folate Deficiency?

Old food, you will see Glossitis with the patient

84

What is Cretinism?

Mom and baby are hypothyroid

85

What do you see in DeQuervain's disease?

Viral origin, painful jaw, hypothyroid

86

What is Epstein's anomaly?

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

87

What murmur has an irregular-irregular pulse?

A fib (no P waves)

88

What is Kleptomania?

Steals for the fun of itTx: Psychotherapy

89

What is a normal BPP?

>8-10

90

What is an Oligodendroglioma?

Fried egg appearance, Nodular Calcification

91

What does high WBC and Bands tell you?

Left shift - they have an infection

92

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

Churg-Straus, Loeffler's, allergic Bronchopulmonary Aspergillosis

93

Waht is Vasa Previa?

Babies blood over OS

94

What is the Average IQ?

85-100

95

What are the indications for Octreotide?

Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

96

What is Loss of Ego Boundaries?

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

97

What is seen in Magnesium deficiency?

Loss of kinase function, hypoparathyroidism

98

What is Vater Syndrome?

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

99

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

100

What is the Most common type of Kidney Stone?

Calcium Phosphate and Calcium Oxalate

101

What is the risk of Amniocentesis?

Abortion (2% risk)

102

What is Potency?

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

103

What is the indication for Methylxanthines?

Asthma

104

What does Galactosemia cause?

Cataracts, mental retardation, liver damage

105

What is a Neuroblastoma?

Adrenal Medulla tumorHypsarrthymiaOpsoclonusIncreased urinary VMA

106

What is Pre-Renal Failure?

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

107

What is the function of PRH?

Stimulates Prolactin (PRL) release

108

What disease has a Selenium deficiency?

Dialted cardiomyopathy

109

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

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

110

What is Small Cell Cancer?

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

111

What is Type B gastritis?

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

112

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

Schatzki's Rings, Stricture, Cancer

113

What is associated with E. Coli?

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

114

FEV1/FVC in Obstructive lung disease

Lower than normal (N: 0.75-0.80)

115

What are the bacteria associated with Colon CA?

Clostridium Melanogosepticus and Streptococcus Bovis

116

What is the Adverse Effect of Alpha-Glucosidase Inhibitors?

GI disturbances and may reduce absorption of iron

117

What does VLDL do?

It takes TG's from liver to adipose

118

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

119

What bug causes Subacute Bacterial Endocarditis?

Steptococcus viridans. (attacks damages valves)

120

What are the indications for the channel blockers?

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

121

What is a transversion?

Changes one purine to a pyrimidine

122

What is Reaction Formation?

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

123

What is the MOA of Nesiritide?

Recombinant BNP, increase in cGMP and vasodilation

124

What is Cystosarcoma Phylloides?

Exploding Mushroom

125

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)

126

What is a Stomatocyte?

Seen in liver disease

127

What does Rh- tell you?

Does not have the D Antigen

128

What is associated with Yersinia Enterocolitica?

Presents like appendicitis and Reiter'sBloody Diarrhea

129

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

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

130

What does a Southern blot detect?

DNA, "Snow, Drop"

131

How do you test efferent arteriole function?

Renal plasma flow (RPF) or PAH

132

What adds color to Stool?

Stercobilinogen being oxidized to stercobilin

133

What is a Heinz body?

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

134

What is the difference between DI and SIADH?

DI: diluted urineSIADH: concentrated urine

135

What is a Blast?

Baby hematopoietic cell

136

What are the branched amino acids?

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

137

What is the Indication for Mimetics?

NIDDM. (Type 2)

138

What are the adverse effects of Nitroprusside?

Cyanide Toxicity, hypotension, short acting

139

What is Isolation of Affect?

Isolate feelings to keep on fucntioning

140

What is Hirsutism?

Hairy female (Excess growth in normal male areas)

141

What is associated with Strep Pyogenes?

Rheumatic Fever, PSGN, Impetigo, Pharyngitis, Nec Fasc

142

What is stable angina?

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

143

What are the indications for 1st generation H1 blockers?

Allergy, motion sickness, sleep aid

144

What ion has the least movement at rest?

Chloride

145

What is associated with S. Pneumoniae?

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

146

What is cyclothymia?

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

147

What is Oligohydramnios?

Too little amniotic fluid (baby can't pee)

148

What does the Water Deprivation Test tell you?

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

149

What effects Efficacy?

Vmax

150

What defines AML?

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

151

What organs have resistance in series?

Liver and Kidneys

152

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

No deficiency state

153

What is Type I RTA?

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

154

What is Autocrine?

Works on itself. (except T-cell activation)

155

What is Hypochondriasis?

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

156

What does the JGA do?

Measures volume, secretes renin (low volume state)

157

What is Testicular Feminization (Androgen Insensitivity Syndrome)?

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

158

What does Vit B6 do?

Transaminase cofactor, myelin integrity

159

What is Paraphimosis?

Foreskin scarre at penis baseforeskin will strangulate the gland

160

What is Glioblastoma multiforme?

Pseudopalisading necrosis, worst prognosisintralesional hemorrhage

161

What does Zn2+ do?

Taste buds, hair, sperm function

162

What Diseases have a low LAP?

CML & PNH (paroxysmal nocturnal hemoglobinemia)

163

What is Hyper IgM Syndrome?

High IgM and all other Ig's are low

164

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

Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides

165

What disease has a steeple sign on neck films?

Croup (or Laryngotracheobronchitis)

166

What are the Indications for Insulin?

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

167

What is Type 3 Hyperlipidemia?

Defective ApoE (Elevated ILD)

168

What is the Osler-Weber-Rendu?

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

169

What is a Howell-Jolly Body?

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

170

What is associated with N. Meningitidis?

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

171

What is a Gastric Ulcer?

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

172

What is Type 2 Diabetes Mellitus and associations?

Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans

173

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

Glomerular filtration rate (GFR) or Inulin

174

What is an incomplete Abortion?

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

175

What is seen in Hashimoto's Thyroiditis?

Antimicrosomal antibody and Anti-TPO antibody

176

What is the definition of AIDS?

CD4 count less than 200 or defining illness

177

What is Schizoid Personality Disorder?

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

178

What are the 2nd generation H1 Blockers?

Loratadine, fexofenadine, Desloratadine, Cetirizine

179

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

180

What is Bronze cirrhosis?

Fe deposit in liver

181

What is associated with S. Aureus?

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

182

What is Associated with M. Catarrhalis?

It loves Mucus: it attacks the respiratory tract

183

What is MCD?

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

184

What is Jod-Basedow Disease?

Transient hyperthyroidism due to increased iodine

185

What is the MOA of Nifedipine and verapamil?

Ca+ channel antagonists

186

What are the continuous Murmurs?

PDA or AVM's

187

What is Bronchoalveolar CA?

Looks like pneumoniadue to pneumoconiosis, nonsmoker

188

How does a Subarachnoid hemorrhage present?

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

189

What is a Gonadotrope?

LH and FSH

190

What is Bronze pigmentation?

Fe deposit in skin

191

What are the indications for Diazoxide?

HTN

192

What is a Female Hermaphrodite?

Impossible because female is the default formation

193

Negative high dose Dex. and low ACTH levels?

Adrenal CA (high cortisol)

194

What disease has Aniridia?

Wilms Tumor

195

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

Peripheral Neuropathy

196

What are the Extravascular Hemolytic anemias?

Spherocytosiswarm autoimmuneParoxysmal cold autoimmuneSickle cell anemia

197

What is Monoclonal Gammopathy of undetermined significance?

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

198

In what layers does a true aortic aneurysm occur?

Intima, media, and adventitia

199

What is a Male Pseudohermaphrodite?

XY with LOW 17-OHase and LOW Testosterone

200

What is Azotemia?

Increased BUN/Creatinine ratiorenal failure

201

What disease does Coxsackie A cause?

Hand-foot-mouth disease

202

What do low Retics tell you?

Decreased production of bone marrow - not working right

203

What is Kleine Rechnung?

Scant bleeding at ovulation

204

What is the MOA of Niacin?

Inhibits lipolysis in adipose tissuereduces hepatic VLDL secretion into circulation

205

What is diastole?

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

206

What is the MOA of Biguanides?

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

207

What is Normal Pressure Hydrocephalus?

Incontinence, ataxia "magnetic gait" dementia

208

What is the Most Common Cause of Kidney Stones?

Dehydration

209

What does Somatostatin (SS) do?

Inhibits growth hormone (GH) release

210

What is the function Oxytocin?

Milk and baby ejection

211

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

Reabsorbs Water

212

What is Hemophilia B?

Factor IX deficiencyBleed into joints (knee, etc)

213

What is a threatened Abortion?

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

214

What disease has multiple lung aneurysms?

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

215

What is the MOA of Bosentan?

Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance

216

Why is Nagele's Rule Inaccurate?

Because it does not start from Ovulation date

217

What is the MOA of Metoclopramide?

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

218

What is a Band?

Baby Neutrophil

219

What is Asbestosis?

Shipyard workers, pipe fitters, brake mechanics, insulation installers

220

What is Chronic Rejection?

Occurs months to years later and fibroblasts are present

221

What does Vit B7 do?

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

222

What is Savage's Syndrome?

Ovarian resistance to LH/FSH

223

How does Factor 13 Deficiency present?

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

224

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

225

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)

226

What are Fraternal Twins?

Multiple eggs fertilized by different sperm

227

What is the efferent arteriole's job?

To secrete

228

What are the Adverse Effects of Demeclocycline?

Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth

229

What are the hyperthyroid diseases?

Grave'sDeQuervain'sSilent ThyroiditisPlummer'sJod-Basedow

230

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

231

What is the MOA of PPIs?

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

232

Who makes the Cytotrophoblast?

Mom production of GnRH, CRH, TRH, and Inhibin

233

What are the indications for N-acetylcysteine?

CF patients and antidote for Acetaminophen overdose

234

What is Goldblatt's Kidney?

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

235

What does MPO deficiency cause?

Catalase positive infections

236

What is Tay-Sachs?

Hexosaminidase A deficiencyHyperreflexia developmental delay"onion skin" Lysosomes

237

What does Growth Hormone (GH) do?

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

238

What is the MOA of Dextromethorphan?

Antitussive (antagonizes NMDA glutamate receptors)

239

What are the indications for digoxin?

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

240

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

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

241

What does a Lyase do?

Cuts C-C bonds w/ ATP

242

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

Recruits water channels to Luminal Membrane in collecting duct

243

What is Asherman's Syndrome?

Uterine scars from multiple D&Cs

244

What are the breakdown products of VLDL?

IDL and LDL

245

What is the difference between Plasma and Serum?

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

246

What is Gilbert's Syndrome?

Stress induced elevatedUnconjugated BilirubinIncreased load saturates Glucuronyl Transferase

247

What is Secretory Diarrhea?

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

248

How does Diverticulosis Present?

Gross blood

249

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

250

What is Fructosemia?

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

251

What is Pellagra?

Niacin (B3) deficiencyDermatitis, Diarrhea, Dementia, Death

252

What are the corticosteroid drugs?

Beclomethasone, Prednisone

253

What does the surface Ab tell you?

Vaccination has occurred

254

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

255

How does Von Willebrand Disease (VWD) present?

Heavy menstrual bleeding

256

What is the receptor problem with Midgets?

Patient with decreased Somatomedin receptor sensitivity

257

What is Dysthymia?

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

258

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

Chokes with each feeding and is Congenital

259

How do cluster headaches present?

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

260

What should you rule out when child abuse is suspected?

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

261

What is a Compound Presentation?

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

262

Egg-shape on x-ray?

Transposition of the great arteries

263

What makes Progesterone in >10 weeks gestation?

Placenta

264

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

265

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

Increase Insulin and Decrease Glucagon release

266

What are the Urease Positive Bugs?

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

267

What are the K+ channel blockers?

Sotalol, Ibutilide, Bretylium, Amiodarone

268

Where does a Type B thoracic aortic dissection occur?

Descending Aorta, (occurs in trauma and Atherosclerosis)

269

What is Boerhaave Syndrome?

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

270

What is a Sinciput Presentation?

Anterior Fontanel (Diamond shape) presents first

271

What is associated with Coxiella Burnetii?

Dusty Barn = Q fever

272

What is Placenta Percreta?

Placenta perforates through serosa

273

What is the cause of Asymmetrically Small babies?

In Late onset: Poor maternal nutrition and vascular disease

274

What is normal blood loss during a C-section?

1000 mL

275

What is the fucntion of AFP?

Regulates intravascular volume

276

What is Basophilic Stippling?

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

277

What is a Lactotrope?

PRL -- Prolactin

278

What disease has a chromium deficiency?

Diabetes

279

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

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

280

How do migraines present?

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

281

What diseases provide malarial protection?

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

282

What is Epididymitis?

Chlamydia Trachomatis. Unilateral scrotal pain decreased by support

283

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

Beriberi, Wernicke's Encephalopathy, Wenicke-Korsakoff Syndrome

284

What is the Psychogenic Polydipsia?

Pathologic water drinking will have low plasma osmolality

285

What is Chorioamnionitis?

Fever, uterine tenderness, decreased fetal HR

286

What is the MOA of Demeclocycline?

ADH antagonist

287

What is the MOA of Methacholine?

Muscarinic receptor agonist

288

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)

289

What is Rubella (German 3-day Measles)

Trunk rashLymphadenopathy behind earsthey don't look sick

290

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

Provides skin pigmentation

291

What sound radiates to the neck?

Aortic stenosis

292

What are the glycogenic & ketogenic amino acids?

"PITT" Phe, Iso, Thr, Trp

293

What is Bronchiolitis?

Athma in kids less than 2 years old

294

What is Sturge-Weber?

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

295

What is the function of GRH?

Stimulates GH release

296

What is the MOA of Hydralazine?

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

297

What is Cholecystitis?

Inflammation of the gallbladder

298

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

299

What will you see in Beta Thalassemia?

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

300

What serum pH does the low volume state have?

Alkalotic (due to H+/K+ exchanger)

301

What is associated with R. Prowazekii?

Lice = Starts on body

302

What is Gastroschisis?

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

303

What is the MOA of Minoxidil?

K+ channel opener, hyperpolarizes and relaxes smooth muscle

304

What are the adverse effects of Ezetimibe?

Rare increase LFT's

305

What are the adverse effects of Niacin?

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

306

What is a Beastophile?

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

307

What is the rate-limiting enzyme in Pyrimidine synthesis?

Carbamoyl Phosphate Synthetase-2 (CPS-2)

308

What is seen in Spherocytosis?

Defective Spherin or AnkyrinPositive Osmotic Fragility testHigh level of MCHCteardrops

309

What is Otitis Media?

Fluid in the middle ear

310

What is the most common transplant?

Blood transfusion

311

What are the effects of 2nd generation H1 Blockers?

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

312

Boot-shape on x-ray?

RVH

313

What causes increased PTT and Bleeding Time?

Von Willebrand disease and SLE

314

How do you treat A2 Gestational DM?

Insulin

315

What are the adverse effects of Isoproterenol?

Tachycardia (B1)

316

What is the Treatment for Pre-Eclampsia?

Delivery, MgSO4 (seizures), Hydralazine (BP)

317

What are the adverse effects of Clonidine?

Drowsiness, dry mouth, and rebound HTN after abrupt withdraw

318

What is the Treatment for Eclampsia?

4mg MgSO4 IV (Seizure prophylaxis)

319

How do you monitor Baby's Heart Rate?

Doppler or scalp electrode

320

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

RBC is being destroyed peripherally

321

What is Fanconi Syndrome?

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

322

What is seen why Molybdenum deficiency?

Lose xanthine oxidase function

323

How do you monitor the Uterus?

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

324

What is Hartnup's?

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

325

What is a Frank Breech?

Butt down, thigh flexed, legs extended (Pancake)

326

What has high LAP?

Leukemoid reaction

327

What is Subgaleal Hemorrhage?

Prolonged jaundice in newborns due to birthing trauma

328

What disease has pulsus bisferiens?

IHSS- Idiopathic Hypertrophic Subaortic Stenosis

329

What is Intermittent Explosive Disorder?

Loses self-control, disproportional to circumstances?

330

What Bacteria cause UTI's and Prostatitis?

E. ColiProteusKlebsiellaPseudomonas

331

What can cause Cushing's syndrome?

High cortisol produced from an adrenal tumor

332

What bug is associated with cat feces?

Toxocara Cati

333

What is Fabry's

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

334

What are the indications for Nifedipine and verapamil?

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

335

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

HBeAb+, HBcAb+, HBsAg-

336

What is Amyloidosis and what stain is used?

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

337

What is Job's Syndrome?

Seen in red headed femalesthey are stuck in the IgE stage

338

What has Hyaline Casts?

Normal sloughing

339

What is Conduct Disorder Personality Disorder?

Younger than 15 years old who have Antisocial personality disorder

340

What are the SYmptoms of Pre-eclampsia?

Headaches, changes in vision, and epigastric pain

341

What is Childhood Disintegrative Disorder?

Kid stops talking and walking. (They lose all their milestones)

342

Which hormones have the same Alpha Subunits?

LH, FSH, TSH, and B-HCG

343

What murmur has a water hammer pulse?

Aortic regurgitation

344

What is the MOA of Infliximab?

Monoclonal antibody to TNF-alpha

345

What is Pompe's?

Lysosomal a-1, 4-glucosidase deficiencyDie early/young due to heart failure

346

What is the Peak level?

4 hours after dose (too high - decrease dose)

347

What do Platelet problems cause?

Bleeding from skin and mucosa

348

What bugs cause Meningitis?

0-2 months: "baby BEL" B - Group B strep E - E. Coli L - Listeria2 months to 10 years old: S. Pneumoniae N. Meningitidis10-21 years old: N. Meningitidis21 years and up: S. Pneumoniae

349

How does the Parasympathetic System behave?

"DUMBBELS"DiarrheaUrinationMiosis "Constrict"BradycardiaBronchoconstrictionErection "Point"LacrimationSalivation

350

What does Vit A do?

Night vision, CSF production, PTH cofactorantioxidants

351

What is an Incomplete Molar Pregnancy?

2 Sperm + 1 egg (69, XXY) mom "cooks the parts" has embryo parts

352

What is Adenomyosis?

Growth of the Endometrium, Myometrium, and patients will have an enlarged "boggy" uterus with cystic areas

353

What is the function of Cortisol in Pregnancy?

Decreases immune rejection of the baby out of mom and for lung maturation

354

What are the Indications for Glucocorticoids?

Addison's disease; inflammation; immune suppression; asthma

355

What has WBC casts and eosinophils?

Interstitial Nephritis (Allergies)

356

What is seen in Copper deficiency?

Menky Kinky Hair Syndrome

357

What are the Systolic Ejection Murmurs?

Aortic Stenosis, Pulmonic Stenosis, Hypertrophic Cardiomyopathy

358

What is Isocarboxazid?

Atypical depression: Hypersomnia, anxiety, sensitivity to rejection, hypochondriasis

359

What is Necrosis?

Non-programmed cell death. Nucleus destroyed first

360

What is the 1st generation H1 Blockers?

Diphenhydramine, Dimenhydrinate, Chlorpheniramine

361

How does Syphilis present?

Primary: Painless Chancre (1-6 weeks)Secondary: Rash and Condyloma Lata (After 6 weeks)Tertiary: Neurological and Cardiac issues, in Bone (after 6 years)

362

What are the hypothyroid diseases?

Hashimoto's, Riedel's, Cretinism, Euthyroid SIck syndrome, Wolff-Chaikoff

363

What is obstructive lung disease?

Mucus filled lungs, cannot get air out

364

What are the anabolic & catabolic pathways? (Occurs in both Cytoplasm and Mitochondria)

"HUG" Heme synthesisUrea cycleGluconeogenesis

365

What are the indications for the Ca2+ channel blockers?

SVT/ prevent nodal arrhythmias

366

What is Type 4 Hyperlipidemia?

Defective Adipose Lipoprotein Lipase, elevated VLDL

367

What are Hallucinations?

False sensory perception with absence of external stimuli, seen commonly in ETOH withdraw and cocaine intoxication

368

What valves make noise at the end of diastole?

Mitral and Tricuspid

369

What is Closed-angle glaucoma?

Obstruction of canal of Schlemm, there is a sudden onset pain, emergency

370

What is the Platelet lifespan?

7 days

371

What is Ulcerative Colitis?

Starts at the rectum and ascends,1%/year risk for CAIBD with Pseudopolyps, hematochezia, Lead pipe colon and Toxic Megacolon

372

What is Pick's Disease?

Frontal lobe atrophy, disinhibition

373

What is Endometriosis?

Painful cyclical heavy menstrual bleeding"Powder burns and chocolate cysts" due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)

374

What is a Pedophile?

Attracted to children sexually, watching child pornography

375

What disease process is present when both Serum Ca2+ and Serum Phosphate (PO4-) are decreased?

Vitamin D deficiency

376

What does Cu2+ do?

Collagen Synthesis

377

What is the rate-limiting enzyme of Glycolysis?

PFK-1

378

How do I know the patient has a Vitamin B9 (Folate) Deficiency?

Megaloblastic anemia, hypersegmented neutrophils, neural tube defects

379

What is Essential Fructosuria?

Fructokinase deficiencyExcrete fructose in blood/urine (still have hexokinase)

380

What is a "Pink Puffer"?

Emphysema

381

What is Gardener's Syndrome

Familial Polyposis with Bone Tumors

382

What is the rate-limiting enzyme in the HMP shunt?

Glucose-6-Phosphate Dehydrogenase (G-6PD)

383

What are the T-cell Non-Hodgkin Lymphomas?

Mcosis Fungoides: total body rashSezary Syndrome: Cerebreform cells in the blood

384

What bug causes multiple Cerebral Abscesses?

Citrobacter

385

What is Labyrinthitis?

Inflammation of the Cochlear portion of the inner ear, present with hearing loss and tinnitus

386

What is Nephrogenic diabetes insipidus?

ADH (V2 aquaporin) is blocked or broken. Lithium association and Demeclocycline

387

What is Meningioma?

Located parasagittalPsammoma bodies presentwhirling patternbest prognosis

388

What happened if your pulse drops more than 10 bpm on standing?

Autonomic dysfunction