Flashcards in Complete Deck Part 2 Deck (388):
What is the MOA of N-acetylcysteine?
loosen mucus plugs by breaking disulfide bonds
What has Epithelial Casts?
What is INR ratio determined by?
Measured PT/ Control PTtherapeutic level is between 2-3Normal level is 1
What are the Water shed areas?
Hippocampus, splenic flexure
What is Stress Incontinence?
Weak pelvic floor muscles, urinating when coughing, laughing, etc. Estrogen effect
What is an Arnold-Chiari Malformation?
Herniation of cerebellum through Foramen MagnumType 1: Cerebellar tonsils (asymptomatic)Type 2: Cerebellar vermis/ medulla -- Hydrocephalus, Syringomyelia (loss of pain and temerature)
What is a Vertex Presentation?
Posterior Fontanel (triangle shape) presents first (normal)
What is associated with C. Diff
Explosive diarrhea = Pseudomembranous Colitis
What are the antileukotriene drugs?
Zileuton, Zafirlukast, montelukast:aspirininduced asthma
What are the Purines?
What is a Septic Abortion?
Fever greater than 100.4 F, malodorous discharge
What is a Pappenheimer body?
Iron inside cell (sideroblastic anemia)
What does Seminal Vesicle give to Sperm?
Food (Fructose) and clothes (semen)
What GI diseases are the causes of liquid Dysphagia?
Scleroderma and Achalasia
What does IDL do?
It takes TG's from adipose to tissue
What type of Gallstone can be seen on X-Ray?
Calcium Bilrubinate stone
What is Legg-Calve-Perthes Disease?
A vascular necrosis of femoral head, more often in young children (4-8 y/o), mildly painful limb that develops insidiously. Range of motion is limited especially internal rotation and abduction, x-ray join effusion
What are the Production Anemias?
Where is VLDL made?
What is associated with C. Botulinum?
Canned food, honey, inhibits ACh release, respiratory failure, stool toxin, treat with Penicillin
What is SIADH?
Too much ADH present causes plasma volume to expand Serum Na+ less than 120
What is the Somogyi Effect?
Morning hyperglycemia secondary to evening hypoglycemia
What are Identical Twins?
Eggs split into perfect halves "Monochorionic"
What is the symptoms of Loeffler Syndrome?
What is the MOA of H1 Blockers?
Reversible inhibitors of H1 histamine receptors
What is associated with Group C Strep?
What is HPV?
ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD
What is the function of FSH
Male: sperm, MIF, inhibin BFemale: Stimulates Estradiol (E2)
What vesels have the most smooth muscle?
What are the symptoms of a Low Energy State?
CNS: Mental retardation, dementiaCV: heart failure, pericardial effusionMuscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
What are the signs of child abuse?
Multiple EcchymosisRetinal HemorrhageEpidural / Subdural HemorrhageSpiral Fractures (twisted)Multiple fractures in different stages of healing
What is Nitrazine?
Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)
What is Pyknosis?
Nucleus turns into blobs. (shrinkage)
What organs have resistance in parallel?
All the rest of the organs (except liver and kidneys)
What are the indications for Losartan?
What is PIE Syndrome?
Pulmonary Infiltrate with Eosinophilia
What stage of the Menstrual Cycle has the highest level of Progesterone?
Luteal stage (Has secretory endothelium)
What makes Progesteron <10 week gestation?
What is assocaited with Salmonella?
Loves to hide in the gallbladder if treated.Do not treat this infection medically, raw chicken and eggs, turtles, rose typhoid spots, H2S (sulfur producing), Sickle Cell patients with Salmonella infection leads to Osteomyelitis
What is Euthyroid Sick Syndrome?
LOW T3 Syndrome and decreased conversion of T4 to T3 (increased T3r)
What is Albinism?
No Tyr -> Melanin (via Tyrosinase)
What is Endometritis?
Postpartum uterine tenderness
What is seen with Tin deficiency?
Poor hair growth
What does an Isomerase do?
Creates and isomer
What is the MOA of Odansetron?
5-HT3 antagonist, powerful central acting antiemetic
What is Rotor's?
Defective Bilirubin storage and Elevated Conjugated Bilirubin
What vessels have the largest cross-sectional area?
How does Lymphogranuloma Venereum present?
Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis
What is Ataxia Telangiectasia?
Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels
What are the side effects of Estrogen?
Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins
What is Stage III of Labor?
Delivery of the placenta
What hormones are released from the posterior pituitary?
ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins
What is Anencephaly?
Notochord did not make contact with the brain - only have the medulla
What is Cholangitis?
Inflamed bile duct
What does the Coombs Test Tell you?
What is Dependent Personality Disorder?
Clingy, submissive, low self-confidence, uses regression
What hepatitis B labs indicate previous infection and now immunity?
HBcAb+, HBsAb+, HBsAg-
What are the physical signs of Alcoholic Cirrhosis?
Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren's Contracture
What is Bruton's Agammaglobulinemia?
Kids ( < 1 y/o) with defective tyrosine kinase; they have no antibodies and have x-linked transmission
What are the indications for Sulfalazine?
UC, Crohn's disease
What is a Drepanocyte?
Seen in Sickle cell Anemia
Negative high dose Dex. and High ACTH levels?
Ectopic ACTH- small cell CA of the lungs
What are the indications for Clonidine?
What is Type and Match?
Blood type and Wait
What is Wolff-CHaikoff?
What is Pyloric Stenosis?
Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation
What is Lichen Simplex Chronicus?
Raised white lesions, chronic scratching
What is the MOA of Clonidine?
Alpha 2 agonist = decreases peripheral resistance
Which part of the Nephron concentrates urine?
What is the Adverse Effect of Insulin?
What are the sulfur-containing amino acids?
What is Bartter's Syndrome?
JG cell hyperplasia with renin excess, no increase in blood pressure, defect in kidney's ability to reabsorb potassium
What is Drug Induced Hypersensitivity?
Eosinophils in the urine
What is increased beat-to-beat variability?
What is the MOA of Bismuth and Sucralfate?
Bind to ulcer base, providing physical protection allows bicarbonate ion secretion to reestablish pH gradient in the mucous layer
What causes lateral leg bowing?
What is Undoing?
Doing exact opposite of what you used to do to fix a wrong
What bugs disrupt G Proteins?
Pertussis: Inhibits Gi (Turning the off to off allows for stimulation)Chloera: Stimulates Gs (Keeping the on ... on)E. Coli: Stimulates Gs (Keeping the on ... on)
What is Myelofibrosis?
Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC's) and extramedullary Hematopoiesis
What disease states have increased Anion Gap?
"MUDPILES"MethanolUremiaDKAParaldehyde/PhenoforminINH/ Iron tabletsLactic AcidosisEthylene GlycolSalicylates
What is CD8?
T-killer or T-suppressor cellResponds to MHC-1 complex (self)
What causes Gonorrhea?
Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort
What are some causes of Folate Deficiency?
Old food, you will see Glossitis with the patient
What is Cretinism?
Mom and baby are hypothyroid
What do you see in DeQuervain's disease?
Viral origin, painful jaw, hypothyroid
What is Epstein's anomaly?
Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)
What murmur has an irregular-irregular pulse?
A fib (no P waves)
What is Kleptomania?
Steals for the fun of itTx: Psychotherapy
What is a normal BPP?
What is an Oligodendroglioma?
Fried egg appearance, Nodular Calcification
What does high WBC and Bands tell you?
Left shift - they have an infection
What are the pulmonary infiltrates with eosinophilia (PIE) syndromes?
Churg-Straus, Loeffler's, allergic Bronchopulmonary Aspergillosis
Waht is Vasa Previa?
Babies blood over OS
What is the Average IQ?
What are the indications for Octreotide?
Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
What is Loss of Ego Boundaries?
Where we lose sight and sense of our mind and body and its influences
What is seen in Magnesium deficiency?
Loss of kinase function, hypoparathyroidism
What is Vater Syndrome?
V - Vertebral abnormalityA - AnalTE - Tracheal Esophageal FistulaR - Renal
What is associated with Listeria?
Raw cabbage, hot dogs, cold cuts, and spoiled milk, likes cold environmentMust avoid these foods in pregnancy, also seen in migrant workersCauses: abortions, Meningitis, and heart block
What is the Most common type of Kidney Stone?
Calcium Phosphate and Calcium Oxalate
What is the risk of Amniocentesis?
Abortion (2% risk)
What is Potency?
Amount of drug needed to produce effect (lower w/ comp antagonist)
What is the indication for Methylxanthines?
What does Galactosemia cause?
Cataracts, mental retardation, liver damage
What is a Neuroblastoma?
Adrenal Medulla tumorHypsarrthymiaOpsoclonusIncreased urinary VMA
What is Pre-Renal Failure?
Low flow to kidney; BUN; Creatinine ratio >20/1 in the serum
What is the function of PRH?
Stimulates Prolactin (PRL) release
What disease has a Selenium deficiency?
How do I know the patient has a Vitamin B3 (Niacin) Deficiency?
Pellagra (4 D's: Diarrhea, dermatitis, dementia, death)
What is Small Cell Cancer?
Located at the Carina, Malignant, Cushing's syndrome, SIADH, and SVC syndrome
What is Type B gastritis?
Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)
What GI diseases are the causes of solid and liquid dysphagia?
Schatzki's Rings, Stricture, Cancer
What is associated with E. Coli?
Raw hamburger, ADP- Ribosylates Gs (increased cAMP)Verotoxin, HUS in kids and elderly
FEV1/FVC in Obstructive lung disease
Lower than normal (N: 0.75-0.80)
What are the bacteria associated with Colon CA?
Clostridium Melanogosepticus and Streptococcus Bovis
What is the Adverse Effect of Alpha-Glucosidase Inhibitors?
GI disturbances and may reduce absorption of iron
What does VLDL do?
It takes TG's from liver to adipose
What is Bipolar I?
Mania with or without depression for at least 1 week, as well as period of normal moodTx: First line - Lithium, Lamotrigine or RisperidoneSecond line - Aripripezole, Divalproex, Quetiapine, Olanzapine, Psychotherapy and cognitive behavioralAcute Mania: Hospitalize, mood stabilizer (Lithium), acute antipsychotic (Risperidone) and IM phenothiazine - non compliant
What bug causes Subacute Bacterial Endocarditis?
Steptococcus viridans. (attacks damages valves)
What are the indications for the channel blockers?
WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism
What is a transversion?
Changes one purine to a pyrimidine
What is Reaction Formation?
Unconsciously act opposite to how you feel, "Tears on a clown"
What is the MOA of Nesiritide?
Recombinant BNP, increase in cGMP and vasodilation
What is Cystosarcoma Phylloides?
What is cardiac tamponade?
Pressure equalized in all 4 chambers, quiet Precordium, no pulse or BP, Kussmaul's Sign, Pulsus Pardoxus (Decrease in BP greater than 10 mm Hg with inspiration)
What is a Stomatocyte?
Seen in liver disease
What does Rh- tell you?
Does not have the D Antigen
What is associated with Yersinia Enterocolitica?
Presents like appendicitis and Reiter'sBloody Diarrhea
What are the layers of the Adrenal Cortex and what do they produce?
Zona Glomerulosa (Aldosterone),Zona Fasciculate (Cortisol),Zona Reticularis (Androgens)
What does a Southern blot detect?
DNA, "Snow, Drop"
How do you test efferent arteriole function?
Renal plasma flow (RPF) or PAH
What adds color to Stool?
Stercobilinogen being oxidized to stercobilin
What is a Heinz body?
Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency
What is the difference between DI and SIADH?
DI: diluted urineSIADH: concentrated urine
What is a Blast?
Baby hematopoietic cell
What are the branched amino acids?
"Can't LIVe w/o them", Leu, Ile, Val
What is the Indication for Mimetics?
NIDDM. (Type 2)
What are the adverse effects of Nitroprusside?
Cyanide Toxicity, hypotension, short acting
What is Isolation of Affect?
Isolate feelings to keep on fucntioning
What is Hirsutism?
Hairy female (Excess growth in normal male areas)
What is associated with Strep Pyogenes?
Rheumatic Fever, PSGN, Impetigo, Pharyngitis, Nec Fasc
What is stable angina?
Pain with exertion that is relieved with rest (Athersclerosis MCC)
What are the indications for 1st generation H1 blockers?
Allergy, motion sickness, sleep aid
What ion has the least movement at rest?
What is associated with S. Pneumoniae?
Gram-positive diplococci, rusty sputum, IgA Protease, vaccine covers 23 strains
What is cyclothymia?
Dysthymia with hypomania for more than 2 yearsTx: Lithium, Valproic Acid or Carbamazepine and psychotherapy
What is Oligohydramnios?
Too little amniotic fluid (baby can't pee)
What does the Water Deprivation Test tell you?
If the patient fails to concentrate urine, they do not have Primary DI
What effects Efficacy?
What defines AML?
15-30 y/o males Sudan StainAuer Rods, (CD30)T (15;17) - D M3 AML subtypetreat with ATRA
What organs have resistance in series?
Liver and Kidneys
How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?
No deficiency state
What is Type I RTA?
Distal RTA: H/K in collecting duct is broken, high urine pH
What is Autocrine?
Works on itself. (except T-cell activation)
What is Hypochondriasis?
They worry about having a serious illness (specific disease) they seek medical attention. For constant reassuranceTx: Psychotherapy
What does the JGA do?
Measures volume, secretes renin (low volume state)
What is Testicular Feminization (Androgen Insensitivity Syndrome)?
Males with defective / bad DHT receptor, they are XY with a blind pouch vagina
What does Vit B6 do?
Transaminase cofactor, myelin integrity
What is Paraphimosis?
Foreskin scarre at penis baseforeskin will strangulate the gland
What is Glioblastoma multiforme?
Pseudopalisading necrosis, worst prognosisintralesional hemorrhage
What does Zn2+ do?
Taste buds, hair, sperm function
What Diseases have a low LAP?
CML & PNH (paroxysmal nocturnal hemoglobinemia)
What is Hyper IgM Syndrome?
High IgM and all other Ig's are low
What is Waterhouse-Friderichsen syndrome (WSF) or Hemorrhagic Adrenalitis or Fulminant Meningococcemia?
Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides
What disease has a steeple sign on neck films?
Croup (or Laryngotracheobronchitis)
What are the Indications for Insulin?
DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes
What is Type 3 Hyperlipidemia?
Defective ApoE (Elevated ILD)
What is the Osler-Weber-Rendu?
AVM (Atrial-Venous Malformation)in lung, GI, CNSthe AVM sequesters platelets and causes acquired Telangiectasia's
What is a Howell-Jolly Body?
The spleen or bone marrow should have removed nuclei fragments.(Seen in Hemolytic Anemia, spleen trauma, and CA)
What is associated with N. Meningitidis?
DIC, Pili, Only bug that releases toxin in the log phase
What is a Gastric Ulcer?
Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss
What is Type 2 Diabetes Mellitus and associations?
Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans
What can you measure to test afferent arteriole's function?
Glomerular filtration rate (GFR) or Inulin
What is an incomplete Abortion?
Cervix is open, fetal remnantsTx: D&C to prevent placenta infection
What is seen in Hashimoto's Thyroiditis?
Antimicrosomal antibody and Anti-TPO antibody
What is the definition of AIDS?
CD4 count less than 200 or defining illness
What is Schizoid Personality Disorder?
Recluse, they don't want to interact with others, emotional coldness
What are the 2nd generation H1 Blockers?
Loratadine, fexofenadine, Desloratadine, Cetirizine
What is the most common cause of no red reflex?
Cataracts - Increased incidence with high glucose or galactose, Rubella, Failure of light stimulating the retina by 3 months of life and if this does not occur the child will be blind
What is Bronze cirrhosis?
Fe deposit in liver
What is associated with S. Aureus?
Cellulitis, Dairy products, Gold pigment, Endocarditis, Styes, Hordeolum (on eyelid)
What is Associated with M. Catarrhalis?
It loves Mucus: it attacks the respiratory tract
What is MCD?
Most common nephrotic in kids, fused foot processes, no renal failure, loss of charge barrier
What is Jod-Basedow Disease?
Transient hyperthyroidism due to increased iodine
What is the MOA of Nifedipine and verapamil?
Ca+ channel antagonists
What are the continuous Murmurs?
PDA or AVM's
What is Bronchoalveolar CA?
Looks like pneumoniadue to pneumoconiosis, nonsmoker
How does a Subarachnoid hemorrhage present?
"Worst headache of my life", hx. of Berry aneurysm
What is a Gonadotrope?
LH and FSH
What is Bronze pigmentation?
Fe deposit in skin
What are the indications for Diazoxide?
What is a Female Hermaphrodite?
Impossible because female is the default formation
Negative high dose Dex. and low ACTH levels?
Adrenal CA (high cortisol)
What disease has Aniridia?
How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?
What are the Extravascular Hemolytic anemias?
Spherocytosiswarm autoimmuneParoxysmal cold autoimmuneSickle cell anemia
What is Monoclonal Gammopathy of undetermined significance?
Old Person with Gamma Spike (from years of building up)
In what layers does a true aortic aneurysm occur?
Intima, media, and adventitia
What is a Male Pseudohermaphrodite?
XY with LOW 17-OHase and LOW Testosterone
What is Azotemia?
Increased BUN/Creatinine ratiorenal failure
What disease does Coxsackie A cause?
What do low Retics tell you?
Decreased production of bone marrow - not working right
What is Kleine Rechnung?
Scant bleeding at ovulation
What is the MOA of Niacin?
Inhibits lipolysis in adipose tissuereduces hepatic VLDL secretion into circulation
What is diastole?
Heart ventricles fillingincreased blood to Coronary arteriesless extraction of oxygenPhase 4 and 5 Korotkoff
What is the MOA of Biguanides?
Decrease Gluconeogenesis, Increase Glycolysis, and Increase peripheral Glucose uptake. (Insulin sensitivity)
What is Normal Pressure Hydrocephalus?
Incontinence, ataxia "magnetic gait" dementia
What is the Most Common Cause of Kidney Stones?
What does Somatostatin (SS) do?
Inhibits growth hormone (GH) release
What is the function Oxytocin?
Milk and baby ejection
What is the job of the Thin Descending Loop of Henle?
What is Hemophilia B?
Factor IX deficiencyBleed into joints (knee, etc)
What is a threatened Abortion?
Cervix is closed, baby is intact, treat with bed rest
What disease has multiple lung aneurysms?
Osler-Weber-Rendu (AD Ped disease -- thin vessels in nose, GI, and lungs)
What is the MOA of Bosentan?
Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance
Why is Nagele's Rule Inaccurate?
Because it does not start from Ovulation date
What is the MOA of Metoclopramide?
D2 receptor antagonist; increase resting tone, contractility LES tone, motility
What is a Band?
What is Asbestosis?
Shipyard workers, pipe fitters, brake mechanics, insulation installers
What is Chronic Rejection?
Occurs months to years later and fibroblasts are present
What does Vit B7 do?
Carboxylation (Avidin in egg whites (raw) binds Biotin)
What is Savage's Syndrome?
Ovarian resistance to LH/FSH
How does Factor 13 Deficiency present?
Umbilical stump bleeding(this is the first time a baby has to stabalize a clot)
What are the B cell Non-Hodgkin's Lymphomas?
Follicular: t(14;18) and bcl-2Burkitt: t(8;14), c-myc, Starry sky, Macrophagesin american kids: abdominal massin african kids: jaw mass
What are the Stress Hormones and when do they appear?
Immediately Epinephrine, Glucagon (20 minutes), Insulin & ADH (30 minutes), Cortisol (2-4 hours), and growth hormone (24 hours)
What are Fraternal Twins?
Multiple eggs fertilized by different sperm
What is the efferent arteriole's job?
What are the Adverse Effects of Demeclocycline?
Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth
What are the hyperthyroid diseases?
What are the Macrophages called in areas of the body?
Blood: MonocytesBrain: MicrogliaLung: Type 1 PneumocytesLiver: Kupffer cellsSpleen: RES cellsLymph: Dendritic cellsKidney: Mesangial cellsPeyer's Patch: M cellsSkin: Langerhan cellsBone: Osteoclast cellsConnective Tissue: Histiocytes, Giant cells, Epithelioid cells
What is the MOA of PPIs?
Irreversibly inhibit H+/K+ ATPase in stomach parietal cellsDecreases proton secretion by parietal cells
Who makes the Cytotrophoblast?
Mom production of GnRH, CRH, TRH, and Inhibin
What are the indications for N-acetylcysteine?
CF patients and antidote for Acetaminophen overdose
What is Goldblatt's Kidney?
Flea-bitten kidney (ruptured capillaries from high blood pressure)
What does MPO deficiency cause?
Catalase positive infections
What is Tay-Sachs?
Hexosaminidase A deficiencyHyperreflexia developmental delay"onion skin" Lysosomes
What does Growth Hormone (GH) do?
Stimulates Insulin Growth Factor-1 (IGF-1) release from the liver
What is the MOA of Dextromethorphan?
Antitussive (antagonizes NMDA glutamate receptors)
What are the indications for digoxin?
CHF (increase contractility)A fib (decrease conduction at the AV node)depression of the SA node
How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?
TOF Babies... Turns blue with crying and has No feeding issues
What does a Lyase do?
Cuts C-C bonds w/ ATP
What is the MOA of Desmopressin (DDAVP)/ADH?
Recruits water channels to Luminal Membrane in collecting duct
What is Asherman's Syndrome?
Uterine scars from multiple D&Cs
What are the breakdown products of VLDL?
IDL and LDL
What is the difference between Plasma and Serum?
Plasma: No RBC'sSerum: No RBC's or Fibrinogen
What is Gilbert's Syndrome?
Stress induced elevatedUnconjugated BilirubinIncreased load saturates Glucuronyl Transferase
What is Secretory Diarrhea?
Water pushed from cells into the gastric lumen (increased cAMP)
How does Diverticulosis Present?
What is Rett's
Only in girls, decreased head growth, lose motor skills, hand-wringing, they are normal until 5 months of ageTx: Behavioral therapy and physiotherapy
What is Fructosemia?
"Fructose intolerance" (Aldolase B deficiency)kidney and liver damageoccurs in infants after introduction of fruits, honey, and juices
What is Pellagra?
Niacin (B3) deficiencyDermatitis, Diarrhea, Dementia, Death
What are the corticosteroid drugs?
What does the surface Ab tell you?
Vaccination has occurred
When will you see Plummer's Disease?
Patients with benign adenoma and or patients over 50 yrs. old. In an iodine scan, it looks like a nodular patter
How does Von Willebrand Disease (VWD) present?
Heavy menstrual bleeding
What is the receptor problem with Midgets?
Patient with decreased Somatomedin receptor sensitivity
What is Dysthymia?
Low level sadness >2 years, looks like depressionTx: Psychotherapy and SSRI
What is a Tracheoesophageal (TE) Fistula (H-Type)?
Chokes with each feeding and is Congenital
How do cluster headaches present?
Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse with lying down
What should you rule out when child abuse is suspected?
Osteogenesis Imperfecta, bleeding disorders, Fifth's disease and Mongolian spots
What is a Compound Presentation?
Arm or hand on head, vaginal delivery. (Mean's Prolapse of fetal extremity with presenting part)
Egg-shape on x-ray?
Transposition of the great arteries
What makes Progesterone in >10 weeks gestation?
Can you try a Vaginal Delivery on a woman who has had a Classic Horizontal C-Section previously?
No, they must have C-Section for all future pregnancies
What is the MOA of GLP-1 Analogs (glucagon like peptides)?
Increase Insulin and Decrease Glucagon release
What are the Urease Positive Bugs?
"Urease PPUNCHSB"P - ProteusP - PseudomonasU - UreaplasmaN - NocardiaC - CryptococcusH - H. PyloriS - Staphylococcus SaprophyticusB - Brucellosis
What are the K+ channel blockers?
Sotalol, Ibutilide, Bretylium, Amiodarone
Where does a Type B thoracic aortic dissection occur?
Descending Aorta, (occurs in trauma and Atherosclerosis)
What is Boerhaave Syndrome?
Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion
What is a Sinciput Presentation?
Anterior Fontanel (Diamond shape) presents first
What is associated with Coxiella Burnetii?
Dusty Barn = Q fever
What is Placenta Percreta?
Placenta perforates through serosa
What is the cause of Asymmetrically Small babies?
In Late onset: Poor maternal nutrition and vascular disease
What is normal blood loss during a C-section?
What is the fucntion of AFP?
Regulates intravascular volume
What is Basophilic Stippling?
Lots of immature cells increased mRNA (seen in lead poisoning)
What is a Lactotrope?
PRL -- Prolactin
What disease has a chromium deficiency?
What is the function of TSH (Thyroid stimulating hormone)?
Stimulates release of T3 and T4 from the thyroid.T3= TriiodothyronineT4= Thyroxine
How do migraines present?
Auro, photophobia, numbness and tingling, throbbing headache, nausea
What diseases provide malarial protection?
Sickle Cell Anemia: African descentG-6PD: Mediterranean's
What is Epididymitis?
Chlamydia Trachomatis. Unilateral scrotal pain decreased by support
How would you know the patient has a Vitamin B1 (Thiamine) Deficiency?
Beriberi, Wernicke's Encephalopathy, Wenicke-Korsakoff Syndrome
What is the Psychogenic Polydipsia?
Pathologic water drinking will have low plasma osmolality
What is Chorioamnionitis?
Fever, uterine tenderness, decreased fetal HR
What is the MOA of Demeclocycline?
What is the MOA of Methacholine?
Muscarinic receptor agonist
What is transudate?
An effusion with mostly waterIf too much water: Heart or Renal failure....Or not enough protein: Cirrhosis (can't make protein), and Nephritic Syndrome (spilling out protein in urine)
What is Rubella (German 3-day Measles)
Trunk rashLymphadenopathy behind earsthey don't look sick
What is the fucntion of MSH (melanocyte-stimulating hormones)?
Provides skin pigmentation
What sound radiates to the neck?
What are the glycogenic & ketogenic amino acids?
"PITT" Phe, Iso, Thr, Trp
What is Bronchiolitis?
Athma in kids less than 2 years old
What is Sturge-Weber?
Port wine stain (big purple spot) on foreheadangioma of retinaEpilepsyMental retardation
What is the function of GRH?
Stimulates GH release
What is the MOA of Hydralazine?
increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction
What is Cholecystitis?
Inflammation of the gallbladder
What determines the prognosis of Cancer?
Depth of invasion, any choice that has to do with depth - the deeper it is= the worse the prognosis
What will you see in Beta Thalassemia?
Seen in Mediterranean's(chromosome 122- point mutation)
What serum pH does the low volume state have?
Alkalotic (due to H+/K+ exchanger)
What is associated with R. Prowazekii?
Lice = Starts on body
What is Gastroschisis?
Wall defect lateral to midline - off center, abdominal wall with no sac covering
What is the MOA of Minoxidil?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
What are the adverse effects of Ezetimibe?
Rare increase LFT's
What are the adverse effects of Niacin?
Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia
What is a Beastophile?
Someone who has sex with animals, women prefer dogs, they can smell their estrogen
What is the rate-limiting enzyme in Pyrimidine synthesis?
Carbamoyl Phosphate Synthetase-2 (CPS-2)
What is seen in Spherocytosis?
Defective Spherin or AnkyrinPositive Osmotic Fragility testHigh level of MCHCteardrops
What is Otitis Media?
Fluid in the middle ear
What is the most common transplant?
What are the effects of 2nd generation H1 Blockers?
Far less sedating than the 1st generation because of decreased entry into the CNS
Boot-shape on x-ray?
What causes increased PTT and Bleeding Time?
Von Willebrand disease and SLE
How do you treat A2 Gestational DM?
What are the adverse effects of Isoproterenol?
What is the Treatment for Pre-Eclampsia?
Delivery, MgSO4 (seizures), Hydralazine (BP)
What are the adverse effects of Clonidine?
Drowsiness, dry mouth, and rebound HTN after abrupt withdraw
What is the Treatment for Eclampsia?
4mg MgSO4 IV (Seizure prophylaxis)
How do you monitor Baby's Heart Rate?
Doppler or scalp electrode
What do high Retics (>1%) tell you?
RBC is being destroyed peripherally
What is Fanconi Syndrome?
Due to old Tetracycline useProduces Urine phosphates, Glucose, and Amino Acids
What is seen why Molybdenum deficiency?
Lose xanthine oxidase function
How do you monitor the Uterus?
Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)
What is Hartnup's?
No tryptophan-cannot make niacin or seratoninPresents like PellagraGenetic, not nutritional disorder
What is a Frank Breech?
Butt down, thigh flexed, legs extended (Pancake)
What has high LAP?
What is Subgaleal Hemorrhage?
Prolonged jaundice in newborns due to birthing trauma
What disease has pulsus bisferiens?
IHSS- Idiopathic Hypertrophic Subaortic Stenosis
What is Intermittent Explosive Disorder?
Loses self-control, disproportional to circumstances?
What Bacteria cause UTI's and Prostatitis?
What can cause Cushing's syndrome?
High cortisol produced from an adrenal tumor
What bug is associated with cat feces?
What is Fabry's
alpha-galactosidase A deficiencyattacks baby's kidneys and heartXLRaccumulation of CeramideTrihexoside
What are the indications for Nifedipine and verapamil?
HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud's
What hepatitis B labs indicate that the patient is in the window period?
HBeAb+, HBcAb+, HBsAg-
What is Amyloidosis and what stain is used?
Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)
What is Job's Syndrome?
Seen in red headed femalesthey are stuck in the IgE stage
What has Hyaline Casts?
What is Conduct Disorder Personality Disorder?
Younger than 15 years old who have Antisocial personality disorder
What are the SYmptoms of Pre-eclampsia?
Headaches, changes in vision, and epigastric pain
What is Childhood Disintegrative Disorder?
Kid stops talking and walking. (They lose all their milestones)
Which hormones have the same Alpha Subunits?
LH, FSH, TSH, and B-HCG
What murmur has a water hammer pulse?
What is the MOA of Infliximab?
Monoclonal antibody to TNF-alpha
What is Pompe's?
Lysosomal a-1, 4-glucosidase deficiencyDie early/young due to heart failure
What is the Peak level?
4 hours after dose (too high - decrease dose)
What do Platelet problems cause?
Bleeding from skin and mucosa
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
How does the Parasympathetic System behave?
"DUMBBELS"DiarrheaUrinationMiosis "Constrict"BradycardiaBronchoconstrictionErection "Point"LacrimationSalivation
What does Vit A do?
Night vision, CSF production, PTH cofactorantioxidants
What is an Incomplete Molar Pregnancy?
2 Sperm + 1 egg (69, XXY) mom "cooks the parts" has embryo parts
What is Adenomyosis?
Growth of the Endometrium, Myometrium, and patients will have an enlarged "boggy" uterus with cystic areas
What is the function of Cortisol in Pregnancy?
Decreases immune rejection of the baby out of mom and for lung maturation
What are the Indications for Glucocorticoids?
Addison's disease; inflammation; immune suppression; asthma
What has WBC casts and eosinophils?
Interstitial Nephritis (Allergies)
What is seen in Copper deficiency?
Menky Kinky Hair Syndrome
What are the Systolic Ejection Murmurs?
Aortic Stenosis, Pulmonic Stenosis, Hypertrophic Cardiomyopathy
What is Isocarboxazid?
Atypical depression: Hypersomnia, anxiety, sensitivity to rejection, hypochondriasis
What is Necrosis?
Non-programmed cell death. Nucleus destroyed first
What is the 1st generation H1 Blockers?
Diphenhydramine, Dimenhydrinate, Chlorpheniramine
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)
What are the hypothyroid diseases?
Hashimoto's, Riedel's, Cretinism, Euthyroid SIck syndrome, Wolff-Chaikoff
What is obstructive lung disease?
Mucus filled lungs, cannot get air out
What are the anabolic & catabolic pathways? (Occurs in both Cytoplasm and Mitochondria)
"HUG" Heme synthesisUrea cycleGluconeogenesis
What are the indications for the Ca2+ channel blockers?
SVT/ prevent nodal arrhythmias
What is Type 4 Hyperlipidemia?
Defective Adipose Lipoprotein Lipase, elevated VLDL
What are Hallucinations?
False sensory perception with absence of external stimuli, seen commonly in ETOH withdraw and cocaine intoxication
What valves make noise at the end of diastole?
Mitral and Tricuspid
What is Closed-angle glaucoma?
Obstruction of canal of Schlemm, there is a sudden onset pain, emergency
What is the Platelet lifespan?
What is Ulcerative Colitis?
Starts at the rectum and ascends,1%/year risk for CAIBD with Pseudopolyps, hematochezia, Lead pipe colon and Toxic Megacolon
What is Pick's Disease?
Frontal lobe atrophy, disinhibition
What is Endometriosis?
Painful cyclical heavy menstrual bleeding"Powder burns and chocolate cysts" due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)
What is a Pedophile?
Attracted to children sexually, watching child pornography
What disease process is present when both Serum Ca2+ and Serum Phosphate (PO4-) are decreased?
Vitamin D deficiency
What does Cu2+ do?
What is the rate-limiting enzyme of Glycolysis?
How do I know the patient has a Vitamin B9 (Folate) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, neural tube defects
What is Essential Fructosuria?
Fructokinase deficiencyExcrete fructose in blood/urine (still have hexokinase)
What is a "Pink Puffer"?
What is Gardener's Syndrome
Familial Polyposis with Bone Tumors
What is the rate-limiting enzyme in the HMP shunt?
Glucose-6-Phosphate Dehydrogenase (G-6PD)
What are the T-cell Non-Hodgkin Lymphomas?
Mcosis Fungoides: total body rashSezary Syndrome: Cerebreform cells in the blood
What bug causes multiple Cerebral Abscesses?
What is Labyrinthitis?
Inflammation of the Cochlear portion of the inner ear, present with hearing loss and tinnitus
What is Nephrogenic diabetes insipidus?
ADH (V2 aquaporin) is blocked or broken. Lithium association and Demeclocycline
What is Meningioma?
Located parasagittalPsammoma bodies presentwhirling patternbest prognosis