Flashcards in Complete Deck Part 3 Deck (391):
What are the basic amino acids?
Lys, Arg, His
What does Vitamin D do?
Helps in calcium absorption from the GI tract
What is an Apt Test?
Detects HbF in the Vagina, detects baby's hemoglobin (Alkali denaturation test)
What is seen in Zinc deficiency?
Dysgeusia, anosmia, Poor wound healing
What cardiomyopathy has Pulsus Alternans?
What is a Monocyte?
The destroyer - macrophage (has hydrolytic enzymes and a coffee bean nucleus)
How do I know the patient has a Vitamin B12 (Cyanocobalamin) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, Neuropathy
What are the indications for Metoclopramide?
Diabetic and post-surgery gastroparesis
What is a Target Cell/ Codocyte?
These have less Hb (seen in Thalassemias or iron deficiency)
What is seen in Diamond-Blackfan Anemia?
They have low RBCs and double jointed thumbs
What is associated with Yersinia Pestis?
Rats & Flease = Bubonic Plague
What is cor-pulmonale?
Pulmonary HTN leads to Right ventricular failure
What is associated with EPEC?
Pathogenic = newborn diarrhea
What is Chlamydia?
Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus)Conjunctivitis
What do Clotting problems cause?
Bleeding into cavities
Waht is associated with S. Saprophyticus?
Female with UTI's (2nd cause), honeymooner's cystitis
What are the adverse effects of fibrates?
Myositis, hepatotoxicity (increase LFT's) cholesterol gallstones
What is Depersonalization Disorder?
"Out of Body" experiences, Deja Vu
What is the most common cause of death in the Low Energy State?
What is assocaited with Campylobacter Jejuni?
Raw chicken and eggs, dog poop, bloody diarrhea, comma, "seagull" shaped buginactivated by gastric juice and can precipitate Guillain BarreTreat with Erythromycin
What are the adverse effects of 1st generation H1 blockers?
Sedation, antimuscarinic, anti-alpha-adrenergic
What do Chylomicrons do?
They take Triglycerides (TG) from GI to liver and endothelium
What diseases have high Monocytes (>15%)?
"STELS"Syphilis: chancre, rash, wartsTB: Hemoptysis, night sweatsEBV: Teen sick for a monthListeria: Sick babySalmonella: Food poisoning
What is Active Transport?
Goes against concentration gradientRequires ATP
What are the diastolic rumbling murmurs?
Tricuspid StenosisMitral Stenosis
What is Face Presentation?
Mentum Anterior preform forceps delivery
What is Zero-order kinetics?
Metabolism independent of concentration (rate of elimination is constant)
What is Mumps?
Parotitis (Red Stenson's Duct)
What does the Bulbourethral/ Cowper's Glands secrete?
Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)
What is Type and Cross?
Blood that is matched by blood type and cross-reacted with the patient's blood for rejection
How do you treat A1 Gestational DM?
What is the rate-limiting enzyme in Glycogenolysis?
Glycogen Phosphorylase. Occurs in the Cytoplasm of Liver and Muscle
What bugs cause Loeffler Syndrome?
"NASSA"N - Necator AmericanusA - Ancylostoma DuodenaleS - SchistosomiasisS - StrongyloidesA - Ascaris Lumbricoides
What has Fat Casts?
What is Paget's disease of the Breast?
Rash and ulcer around the nipple, breast CA
What is the only Crescent Shaped Protozoa?
What produces Currant Jelly stool?
What is associated with R. Akari?
What are Braxton-Hicks Contractions?
Irregular contractions with closed cervix. (preparing for birth)
What is Krabbe's?
Galactocerebrosidase deficiencyperipheral neuropathyoptic atrophygloboid bodiesaccumulation of Galactocerebroside and Psychosine
What are the adverse effects of methylxanthines?
How do I know the patienthas a Vitamin K Deficiency?
Bleeding, Loss of gamma-carboxylation
What is a Meningomyelocele?
Sacral pocket with meninges and nerves in it
What are the Adverse Effects of Osmotic Laxatives?
Diarrhea, dehydration, may be abused by bulimics
What is the color of fluid or a solid on X-ray?
What is the MOA of a Growth Hormone?
Stimulates liver production of insulin-like growth factors and gastric emptying
What is Ferning?
Estrogen crystallizes on slide. (Amniotic fluid)
What are the essential fatty acids?
What is Hunter's?
Iduronate Sulfatase deficiencymilder formXLRno corneal cloudingaggressive behaviorAccumulation of Heparin and Dermatan Sulfate
What does a Western blot detect?
Protein, "snoW, droP"
What are the four Painful Genital Lesions?
HerpesChancroid (It makes you cry... H. Ducreyi) Lymphogranuloma VenereumLymphogranuloma Inguinale
What are the indications for Bile Acid Resins?
Slightly increase HDL and triglyceridesDecrease LDL
What is Dubin-Johnson?
Defective Bilirubin storageBLACK LIVERIncreased conjugated bilirubin
Snowman-shape on x-ray?
Total anomalous pulmonary venous return
What is the MOA of H2 blockers?
Reversible block of histamine H2 receptors to decrease H+ secretion by parietal cells
What are the Alpha-Glucosidase Inhibitors?
Acarbose and Miglitol
What is Early Deceleration?
Normal due to head compression
What is Hepatorenal Syndrome?
Build up of liver toxins that cause renal failure
What organ has the lower AVO2 difference?
What bug causes multiple liver abscesses?
What is Conversion?
Neurological manifestations of internal conflict, indifferent to disability, blindness/mutism triggered by a stressor. Patient is unconcerned about his impairmentTx: Psychotherapy
What is a Xanthelasma?
Triglyceride build up and is seen under the eyes (Xanthoma subtype)
What are the indications for Prazosin?
What is Cystinuria?
Defect of AA transporter in PCT and GIm prevents reabsorption of Cysteine, Ornithine, Lysine, Arginine (COLA)Hexagonal (Cysteine) stones in urine (urinary Cyanide nitroprusside test is Dx)
What are the indications for antileukotriene?
Asthma, aspirin induced asthma
What is Regression?
Immature behavior, go back in development
What are the sounds made from diastolic murmurs?
Blowing and rumbling
what is the Central Nervous System?
Brain and spinal cord, Myelination by the oligodendrocytes
What is Laryngomalacia?
Epiglottis rolls in from side to side
Where does a Type A thoracic aortic dissection occur?
Ascending Aorta, (occurs in Cystic medial necrosis and Syphilis)
What diagnosis has primary hyperparathyroidism?
What does a mid-systolic click tell you?
MVP- Mitral valve prolapse
What is a Schwannoma?
CN-8 tumor, unilateral deafness
What does auscultation of stridor tell you?
Extrathoracic narrowing (seen on inspiration on X-Ray)
What is ADHD?
Over activity, short attention span, difficulty in school, must be identified in two different locations (home and school). Tx: First line- methylphenidate and dectroamphetamine; Second line- Atomoxetine (SNRI)
What are the indications for Sulfonylureas?
NIDDM (Type 2)
When is Beta HCG found in Urine?
2 weeks after fertilization
What does auscultation of crackles tell you?
Blowing collapsed alveoli open (restrictive lung disease)
What is a Xenograft?
1 species to another species (pig heart into humans)
What makes Esophageal Spasms Unique?
What is the rate-limiting enzyme in Gluconeogenesis?
Fructose - 1,6 Bisphophatase
What is the most common cause of first trimester maternal death?
What does Vit K do?
ClottingSynthesized by intestinal flora
What serum pH does emesis have?
Alkalotic because you vomit out HCl-
What is the MOA of coricosteroids?
Inhibits leukotriene synthesis -> reduces inflammation and leads to bronchodilation
What bugs can cause walking pneumonia?
"Come My Love for a Walk"0-2 mos: Chlamydia Pneumonia10-30 years old: Mycoplasma Pneumonia>40 years old: Legionella pneumoniaAIDS and PREMIES: Pnemonia Carinii
What is associated with R. Tsutsugamushi?
Chiggers (Mites) = Scrub Typhus
What is the MOA of Hexamethonium?
Nicotinic Ganglionic blocker
What is the rate-limiting enzyme in TCA Cycle?
What are the Gram Negative Capsules?
"Some Killers Have Pretty Nice Capsules"S - SalmonellaK - KlebsiellaH - H. Influenza B (HiB)P - PseudomonasN - NeisseriaC - Citrobacter
What causes Cryoglobulinemia?
"I AM He"I - InfluenzaA - AdenovirusM - MycoplasmaH - Hepatitis B and C
What is the indication for muscarinic antagonist?
What are the Adverse Effects of Octreotide?
Nausea, cramps, steatorrhea
What serum pH does diarrhea have?
Acidosis because stool has bicarb
What are the indications for adenosine?
Dx. and tx. of AV nodal arrhythmias
What is Word Salad?
Unrelated combinations of words
What are the Vasodilators?
Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide
What is Frotteurism?
Rubs penis against fully clothed women
What is the rate-limiting enzyme in Urea cycle?
Carbamoyl Phosphate Synthetase-1 (CPS-1)
What are the Adverse Effects of PTU and Methimazole?
Agranulocytosis, skin rash and Aplastic Anemia
What is Molluscum Contagiosum
Flesh colored papules with a central dimple
What is the indication for Albuterol?
What does Gastrin do?
Stimulates parietal cells to release intrinsic factor (IF) and H+
What is Turner's Syndrome (XO)?
High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve
What murmur has Pulsus Tardus?
How do you predict a due date with Nagele's rule?
Subtract 3 mo. from LMP (last menstrual period)Add 7 days, if her cycle is 28 days (i.e: LMP Jan 7, 2016 would have an estimated date of Oct. 14, 2016)If her cycle is more than 28 days add 1 day for each extra day of the cycle
What is the Acrosomal reaction?
Sperm release enzymes to eat the Corona Radiata
Function of what cells is necessary for the action of Sulfonylureas?
Requires some islet cell function so drugs used less in Type 1 DM
What is Conjugated Bilirubin?
Water soluble and direct Bilirubin
What is the MOA of the Ca2+ blockers?
Decreases conduction velocity of the AV node, increases ERP and PR interval
What is associated with Legionella Pneumoniae?
Found in AC ducts, silver stains lung, CYEAPontiac Fever, Legionnaire'sPneumonia
What are the Megaloblastic Anemias?
Vitamin B-12 Deficiencyfolate deficiencyalcohol
What is Double Depression?
Depression followed by dysthymia
What is familial Hypocalciuria Hypercalcemia?
Patients with decreased calcium excretion
What are some causes of Cold Autoimmune?
MonoMycoplasma infectionAntibody (IgM) bind to RBC's membranecold temp and causes agglutination
What has Muddy Brown Casts?
Acute Tubular Necrosis (ATN)
What are the indications for Bosentan?
What is Circumstantiality?
Digresses but finally gets back to the point
What are the adverse effects of B-blockers?
Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations
What are the Steroid Hormones?
Progesterone, Estradiol (E2), Testosterone, Cortisol, and Aldosterone
What is associated with Bacteroides Fragilis?
Post Op bowel abscess, grows in blood clots
Explain Restrictive Lung Disease:
Restrictive: Interstitial problem that causes trouble breathing in (small stiff lungs)Pulmonary Function Test's: FEV1/FVC greater than 0.8, decrease vital capacityABG: decreased pH, decreased PO2, decreased PcO2 (increased respiratory rate)Chest X-Ray: reticulonodular pattern, ground glass appearanceMost common cause of death is Cor-pulmonaleTreatment: PEEP ventilator, increased O2, increased respiratory time
When performing a high dose dex. Test, if positive...
Patient has a pituitary tumor
What does the Prostate Secrete?
The prostate HAZ it.H- HyaluronidaseA- Acid PhosphataseZ- Zinc
What are the Gram-negative exotoxins?
H. InfluenzaBordatella Pertussis
What is Meniere's Disease?
Same presentation as Labyrinthitis but is a chronic condition with remitting and relapsing episodes
How does Granuloma Inguinale present?
Spreading ulcer, Donovan bodies, due to Klebsiella Granulomatis (rod shaped), oval organism that can be seen in the Cytoplasms of Phagocytes or in tissue of people with grauloma inguinale
What are the Glitazones/Thiazolidinedione's drugs?
Pioglitazone and rosiglitazone
What is Concrete Thinking?
Can't interpret abstract proverbs, only sees the facts
Explain Obstructive Lung Disease:
Obstructive: Airway structure problem that causes trouble breathing out (mucus filled lungs)PFT's: FEV/FVC is less tha 0.8, increased RV; Reid index increased (thick airway)ABD: decreased pH, normal to low PO2, increased PCO2Most common cause of Death is BronchiectasisTreatment: ventilator to increase respiratory rate and expiratory time, increase oxygen only if needed
What is the MOA of Methyldopa?
Alpha 2 agonist = decreases peripheral resistance
What drugs cause Pulmonary Eosinophilia?
Nitrofurantoin and Sulfonamides
What is Hirschprungs Disease?
Failure of innervation to the rectum (No Auerbach's Plexus), lack of meconium passage in the newborn, Neural crest cell migration problem
What is the MOA of Guanethidine?
Interferes with norepinephrine release
What is pseudo-pseudo-hypoparathyroidsm?
G-Protein defect, and there is no calcium problem
What is Malingering?
Fake illness for monetary gain or getting out of jail, avoids medical treatmentTx: Supportive Psychotherapy
What does alpha one anti-trypsin do?
What GI disease has a String Sign on X-Ray?
Pyrloric Stenosis and Crohn's Disease
What is DiGeorge Syndrome?
No Thymus, inferior Parathyroid and low calcium
What is a Meningocele?
Sacral pocket with meninges in it
What does auscultation of rhonchi tell you?
Mucus in the airway (obstructive airway disease)
What is the indication for Osmotic Laxatives?
What is Suppression?
Consciously block memory
What is Placenta Previa?
The placenta is implanted wholly or partially in lower uterine segment
Which of your cells express MHC-1?
All nucleated cells except the immune-privileged cells/tissues, RBC's and Platelets
What are the Indications for Desmopressin (DDAVP)/ADH?
Antidiuresis and Central (pituitary) DI
What are the atypical (no cell wall) Bacteria?
"CLUMsy"C - ChlamydiaL - LegionellaU - UreaplasmaM - Mycoplasma
When performing a low does dexamethasone test, a depression in ACTH levels occur, what does that tell you?
Patient is either depressed, obese, or it's a normal variant, if the low dose Dexamethasone test does not suppress...
What is seen in Warm Autoimmune?
Anti-Rh Ab Dapsone, PTU, antimalarials, and sulfa drugsAntibody (IgG) binds to RBC's membrane in warm temp
What is a nonsense mutation?
Early stop codon
What bug loves the posterior fossa?
Banana-shape on x-ray?
What is a Hyperacute Rejection?
Autoimmune response within 12 hours, preformed antibodies respondedThis is a Type 2 hypersensitivity reaction
What is Sadism?
Gives physical and psychological pain
What is persistent eye drainage since birth usually due to?
What is a Tamponade?
Decreased breathe sounds and blood pressure, distant muffled heart soundsicnreased JVD
What is Whipple's Disease?
Tropheryma Whipplei (T. Whipplei) destroy the GI tractCausing Malabsorption/Arthralgia, PAS (+)
What is Pneumonia?
Consolidation of airway
What are the HMG-CoA reductase inhibitors?
Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin
What is associated with S. Pneumoniae?
Otitis Media, red bulging TM
What is the MOA of Alpha-Glucosidase Inhibitors?
Inhibits intestinal brush border Alpha-Glucosidases, Delays sugar hydrolysis and Glucose absorption from the guy, Decreases postprandial hyperglycemia
What do white diaper crystals suggest?
Excess Orotic acid
Where is a Morgagni Hernia?
Anterior/middle of diaphragm, bowel sounds in thorax, seen on US in uterosurgery to fix immediately after birth
How do you measure efferent renal function?
BUN or PAH
What is Pityriasis Rosea?
Herald Patch that migrates along skin lines in a Christmas Tree appearance
What are the indications for B-blockers
HTN, Angina, MI, Antiarrhythmic
What is Multiple Endocrine Neoplasia III (2B)?
Pheochromocytoma, Medullary Carcinoma of the Thyroid, Mucosal Neuromas/ Marfanoid body habitus. (tumor marker RET)
What is Congenital Hip Dysplasia?
Hip dislocation may be developed in uterus during delivery, found during new born eval, gluteal fold asymmetricThe Barlow/Ortolani maneuver test: there is a palpable "clunk: or click as the hip is dislocated in a posterior-superior direction
What does a Northern blot detect?
RNA, "sNow, dRop"
What is associated with EIEC?
Inflammatory = loose stool
What is Cullen's SIgn?
Bruising around the umbilicusCaused by hemorrhagic pancreatitis (late sign)
What Hepatitis B labs indicate an acute recent infection?
HBcAg+, HBsAg+, (HBcAb+/-)
What is Bernard-Soulier?
Baby with bleeding from skin and mucosa(Big platelets and LOW GP-1b)
What does cortisol do?
Gluconeogenesis by proteolysis and thins the skin, prevents and immune response, and decrease bone mass
What are the most common infections of the Low Energy State?
UTI and respiratory infections
What are the Comma (curved) shaped bugs?
Vibrio, Campylobacter, Listeria, H. Pylori
What is Dysmenorrhea?
PG-F causes painful menstrual cramps. (Teenagers miss school / work)
What is Asperger's?
Good communication skills, impaired relationships, no mental retardation
What is the most common cause of first trimester spontaneous abortions?
What is Familial Polyposis?
100% ridk of Colon Cancer, APC gene defect and annual Colonoscopy start at 5 years of age
What is Parkinson's disease?
Located in the Substantia Nigra, bradykinesia, pill rolling tremor, shuffling gait, Lewy Bodies
What is associated with Bordetella Pertussis?
Whooping cough, ADP ribosylates Gi
When can you tell the sex of the baby by US?
What is Type 1 Diabetes Mellitus?
Anti-islet cell antibody /GAD (Glutamic Acid Decarboxylase) antibody.
What hormones produce Acidophilus?
"GAP": GH, Acidophilus, and Prolactin
What are the most common causes of third trimester spontaneous abortions?
Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix
What is the most common cause of a White Reflex?
What is Truncus arteriosus?
Spiral membrane did not develop, there is one Aortic Pulmonary trunk, mixed blood, needs PDA
What is an Epstein's Pearl?
White pearls on hard palate
What is seen in RPGN?
What does a Synthase do?
Consumes two substrates
What is asthma?
Chronic inflammatory disease of the airwayscharacterized by variable and recurring symptoms, wheezing on expiration, elevated IgE and Eosinophils
What is Autism?
Poor eye contact, repetitive movements, lack of verbal skills and bonding, symptoms since birthTx: Behavioral modification, use antipsychotic if have aggressive behavior
What are Mongolian spots?
Melanocytes on lower back
What is a Factor V - Leiden?
Protein C cannot break down Factor V
What disease has exophthalmos?
When can you first detect fetal heart tones?
What is Multiple Personality Disorder?
They have 5-10 alters, usually associated with incest
What is the job of the TAL of Henle?
Makes the concentration gradient by reabsorbing Na, K, Cl, Mg, and Ca without water. (Impermeable to H2O)
What is the most common Nephrotic disease complication with cancer?
What are CD4 cells?
T-helper cell - Responds to MHC-2 (foreign attack)
What is the APGAR test?
Neonatal Rating Scale (0-10) Greater than 7Test @ 1 minute and 5 minutesA - Appearance (Color)P - PulseG - GrimaceA - ActivityR - Respiration
What symptoms does a "more likely to depolarize" state have?
Brain: Psychosis, seizures, jitterinessSkeletal Muscle: muscle spasms, tetanySmooth Muscle: diarrhea, then constipationCardiac: tachycardia, arrhythmia
Whata re the anabolic pathways that store energy? (occur in the cytoplasm)
Fatty acid synthesis, Glycolysis, HMP shunt, translation
Whata re the indications for Guanethidine?
Which cytokines do T-helper cells stimulate?
All IL's except IL-1
What is seen in newborn with HSV-2 in utero infections?
Temporal Lobe encephalitis, must offer C-section to mom with active lesions
What is the Primary Diabetes Insipidus (DI)?
Too much water (urinates a lot)
What is Merocrine?
Cell is maintained. (exocytosis)
What is the most common cause of primary hypoparathyroidism?
What are the Silver Stainer's?
"HaLV-C"H - H. PyloriL - ListeriaV - VicrioC - Campylobacter
What has WBC Casts and RBC Casts?
What are the 3 kinds of generalized seizures?
Tonic-clonic "Grand Mal"Absence "Petit Mal"Status Epilepticus
What are the side effects of Progesterone?
Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melisma (AKA Chloasma)
What is Ficticious Disorder by Proxy?
Mom makes the child or another person ill for emotional support, noted to move frequently
What is associated with ETEC?
Traveler's Diarrhea = rice water diarrhea
What are the Adverse Effects of Levothyroxine (T4)/Triiodothyronine (T3)?
Tachycardia, heat intolerance, tremors and Arrhythmias
What is the Somatic Nervous System?
Moving your muscles
What state does Estrogen mimic?
The Neuromuscular disease stateEstrogen is a muscle relaxant
What is the most common Nephrotic disease in diabetics?
What is Placenta Accreta?
Placenta is attached to the endometrium
What is Polymenorrhea?
Too many periods
What do you see in CMV in utero infections?
Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications
What diseases have Hemoptysis?
Bronchiectasis, Bronchitis, Pneumonia, TB, Lung CA, Goodpasture's, Wegener's
What are the Immuno-privileged sites?
Areas of the body that have no lymphatic flow, no antigens, and these areas can be transplanted without fear of rejection (brain, cornea, thymus, and testes) they do not express MHC-1
What is the difference between Acute and Chronic Leukemia's?
Acute: started out in the bone marrow, squeezes RBC out of the marrowChronic: started in the periphery, not constrained and will expand
What is Lochia?
Endometrial slough. (normal discharge and uterus after birth)
What does fixed wide S-2 splitting tell you?
What is Cryptorchidism?
Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA
What is the MOA of Class IC antiarrhythmic?
Na+ channel blocker
What is the function of ACTH (Adrenocorticotropic hormone)?
Stimulates Cortisol and Androgen releases from the adrenal gland
What is the indication for Salmeterol?
Long acting agent for prophylaxis
What is the rate-limiting enzyme in Beta Oxidation?
Carnitine Acyltransferase -1 (CAT-1)
What do the IgA protease bugs cause?
Sinusitis, Otitis Media, Pneumonia/Bronchitis
What are the causes of Hyperbilirubinemia?
Sepsis, ABO Incompatibility, Hypothyroidism and Breast-feeding
What does a Hydroxylase do?
Adds-OH group onto substrate
What is Mittelschmerz
Pain with ovulation
What is the MOA of Ezetimibe?
Prevents cholesterol reabsorption at small intestine brush border
What is Barrett's Esophagus?
Metaplasia of the lower esophagus increased risk of Adenocarcinoma
How do you diagnose Rheumatic Fever?
JONES CriteriaJ - Joint InvolvementO - MyocarditisN- Nodules, subcutaneousE - Erythema MarginatumS- Sydenham Chorea
What is a missense mutation?
Mistaken amino acid substitution (i.e. SS disease Valine for Glutamic Acid)
What are the adverse effects of HMG-CoA reductase inhibitors?
Hepatotoxicity (increase LFT's)Rhabdo
What is Masochism?
Receives pain (Humiliation)
What other diseases can have exophthalmos?
Horner's and Marfan's
What vessels have the highest capacitance?
Veins and Venules
Waht does the Surface Ag tell you?
Alone it means it's been occupied/ with other markers it means it is a current infection, if present for > 6 months it's chronic
What is seen in iron deficiency?
What is Celiac Sprue?
Found in the JejunumWheat AllergyVillous atrophAnti-gluter-gliadin antibodies
What is uremia?
Azotemia (renal failure) with symptoms
What is Urge incontinence?
Urgency leads to complete voiding detrusor spasticity leads to small bladder volume
What does epinephrine (Epi) do?
Drives gluconeogenesis and glycogenolysis
What bug is associated with cat saliva?
What is a Corticotrope?
What is Ductal Carcinoma?
Worst prognosis Breast CA
What is associated with C. Tetani?
Rusty nail wounds - inhibits GLY release, respiratory failure, Risus Sardonicus, tennis racquet shaped appearance
What is Meig's Syndrome?
Pleural effusion, ovarian fibroma, ascites
What blood level should be monitored in patients taking statins?
Liver enzymes every 3 months and Serum Cr
What is the most common cause of Polyhydramnios?
Neuromuscular problem: Werdnig HoffmanGI problem: Duodenal atresia
What is Hairy Cell Leukemia?
Cells have a fried egg/ Sunburst appearance and TRAP +
What does motilin do?
Stimulates segmentation, primary peristalsis, and migrating motor complexes (MMC)
What is Pneumothorax?
Absent breath sounds on one side
What is Identification?
To be like or to become like another (aspect, property or attribute of another)
What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?
What are the adverse effects of Hydralazine?
Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy
What does an AFI >20 indicate?
What is Somatization?
Psychological trigger gets them sick, but no medical finding (Pain in 4 parts, 2 GI problems)Tx: Psychotherapy
What is the second generation Sulfonylureas?
Glyburide, Glimepiride, and Glipizide
What can you measure to test afferent arteriole's function?
Glomerular filtration rate (GFR) or Inulin
What does a wide S-2 split tell you?
Increases OxygenIncreased right ventricular volumeDelayed pulmonic vlave opening
What are the indications for administering Potassium?
Digoxin toxicity, activated charcoal: binds digoxin in the intestineDigibind: binds to digoxin in the bloodstream
What is Tracheitis?
"Acute URI"Patients look toxicGrey PseudomembraneLeukocytosis
What is the common side effect of the ERCP procedure?
Pacreatitis from blocking the pancreatic duct during the procedure
What amino acid turns yellow on Ninhydrin reaction?
What is the job of the late Distal Tubule and Collecting Duct?
Final concentration of urine by reabsorbing water and excretion of acid
What separates unconjugated bilirubin from albumin?
Sulfur (no Sulfur Rx in pregnancy)
What is Caput Succedaneum?
Bleeding under scalp (edema will cross suture lines)
What are the indications for Levothyroxine (T4)/Triiodothyronine (T3)?
Hypothyroidism and Myxedema
What is an Autograft?
Twin to twin (spare parts)
What are the H2 blockers?
Cimetidine, Ranitidine, Famotidine, and Nizatidine
How does a Subdural Hematoma present?
Headache 4 weeks after trauma, elderly (loose brain)
What GI disease has a RUQ Olive Mass?
How would you know the patient has a Vitamin A (retinoic Acid) Deficiency?
Poor night vision, Hypoparathyroidism, dry skin
What is Histiocytosis X?
Histiocyte proliferation Kid with Eczema, skill lesionsHand-Schuller-Christian disease
What is Body Dysmorphic Disorder?
Imagined physical defect, causing impaired function in a social or occupational activityTx: SSRI
What happens when there is a biotin Deficiency?
Loss of carboxylase function
What is the MOA of Methylxanthines?
Inhibit Phosphodiesterase -> decreases cAMP hydrolysis promoting bronchodilation
How does a Somatostatinoma present?
What are the types of VWD?
Type 1 (AD): Decreased VW FActor ProductionType 2 (AD): Decreased VW Activity(+ Ristocetin Aggregation test)Type 3 (AR): No VWF
What does Calcitonin do?
Inhibits Osteoclasts and binds to calcium
What is Countertransference?
Doctor views patient as child
What does Sudan Black Stain test for?
Steatorrhea (fat malabsorption), patient seen with chronic pale, greasy, malodorous diarrhea and no evidence of infection
What tests are used for following Pancreatitis?
Amylase (sensitive) breaks down Carbohydrates and Lipase (specific) breaks down Triglycerides
What is Postpartum Psychosis
Hallucinations, suicidal/infaticidal thoughts
What color is stool with an Upper GI Bleed?
Black (Dark Red) (Melena)
What are the most common signs of the Low Energy State?
Tachypnea and Dyspnea
What is the Adverse Effect of Glitazones/Thiazolidinedione's?
Weight gain, edema, hepatotoxicity, increases LDL and triglycerides, CHF and Contraindicated
What is the MOA of Octreotide?
Long-acting somatostatin analog
What is Plummer's Syndrome?
What is aspergillosis?
Mold, compost piles, associated with peanuts
How does Diverticulitis present?
Pain in LLQ, no visible blood and may cause peritonitis
What has WBC Casts?
What are the cholesterol Absorption blockers?
What murmurs occur during systole?
Holosystolic or pansystolic
What is Acting out?
expression of impulse, "Temper Tantrums"
What is the Intermediate Acting Insulin drug?
NPH and Lente
What is Schatzki's Ring?
Esophageal webs in the lower EsophagusDysphagia (mucosal tissue)
What is McArdle's?
Myophosphorylase deficiency(skeletal muscle Glycogen Phosphorylase)muscle cramps w/ exercise, increased Glycogen in muscle only, blood glucose NLSecond wind phenomenon
What is inevitable Abortion?
Cervix is open, baby is intact
What is pseudo-hypoparathyroidism?
Bad kidney, PTH receptor, decreased urinary, cAMP
What is hemochromatosis?
Iron deposits in organsleads to hyperpigmentation, bronze diabetes, and arthritis
What do B cell deficiency patients die of?
What are the adverse effects of Guanethidine?
Contraindicated in patients taking TCA's
What affects Potency?
What does blood type A tell you?
They have the A antigen and B antibodies
What does Vit B4 do?
Glycolysis, no known diseases
What is Illusion?
What is Repression?
Subconsciously block memory
What is Thought Withdrawal?
Believes that others are taking thoughts out of his head
What does S-2 splitting tell you?
Normal on inspirationPulmonic valve closing later
What is open-angle glaucoma?
Overproduction of fluid, painless Ipsilateral dilated pupil, gradual tunnel vision, optic disc cupping
What is Pseudomembranous Colitis?
Overgrowth of C. DiffDue to normal flora being killed off from long term antibiotic use
What are the indications for H2 blockers?
Peptic ulcer, gastritis and esophageal reflux
What is a Necrophile?
Someone who has sex with corpses
What is associated with R. Rickettsii?
Ticks = Rocky Mountain spotted fever
What is associated with Shigella?
Day care outbreaks, seizures, destroys the 60S ribosome, infects M-cells
What is Post-Renal Failure?
What is a Bezoar?
Mass of non-digestible product (i.e. Hair) causing an occlusion at the pylorus
What is a Hemangioblastoma?
In the cerebellum, associated with VHL
What will you see with Iron Deficiency Anemia?
Increased TIBC associated with menses, GI bleeding, and Koilonychia
How do I know the patient has a Vitamin B5 (Pantothenic Acid) Deficiency?
No deficiency state
What is a fetish?
High attraction for inanimate objects
What is a possible cause if pulse rises more than 10 bpm in repositioning from lying to sitting?
What does the Hep B Core Ag tell you?
Gone before patient has symptoms (present from 0-2 months)
What is Mallory-Weiss?
Tearing of the lower esophageal sphincter (LES), associated with chronic vomiting, cough up a little blood and possible visible varices
What is Cushing's disease?
High ACTH due to pituitary tumor or Small cell carcinoma of the lungs
What is a Craniopharyngioma?
Motor oil biopsy, tooth enamel, Rathke's Pouch, ADH problem, Bitemporal Hemianopsia
What Does Vit E do?
Antioxidantacts as an tagonist to Vit K in high levels
What are the Foot Ulcer Risk Factors?
Poor glycemic control (HbA1C >7), smoking, bony abnormalities, previous ulcers
What GI disease has a Thumb Print on X-Ray?
What is Silicosis?
Sandblasters and glassblowers
What is Tropical Sprue?
Found in the distal iliumCaused by bacterial or viral, amoeba or parasitic infectionVillous atrophy
What are the adverse effects of corticosteroids?
Osteoporosis, Cushingoid reaction, psychosis, glucose intolerance, infection, HTN, cataracts
What is Holocrine?
The whole cell is secreted. (except sebaceous gland)
What is Acromegaly?
Growth hormone tumor producing increased IGF-1 causing: bone growth in adults, coarse facial features, large furrowed tongue, deep husky voice, jaw protrusion
When is B-HCG found in Blood?
8-10 days after fertilization
What does Chymotrypsin cut?
Phe, Tyr, Trp
What is Backward Typing?
Used Antigens to detect Antibodies
What are the ketogenic amino acids?
What are the Adverse Effects of GLP-1 Analogs?
Nausea, Vomiting and Pancreatitis
What makes Scleroderma Unique?
Can have a decreased LES pressure or and increased LES pressure
What is epiglottitis?
inflammation of the epiglottisthumb sign on x-rayexcessive drooling
Waht is associated with Brucella?
Seen in farmers/ Vets, Animal placentas are the vector, Spiking fever 5 times a day
What GI disease has Barium Clumping on X-Ray?
What are the Short Acting Insulin drugs?
Aspart and Lispro
What is seen in Measles (Rubeola)?
CCCK: Cough, Coryza (runny nose), Conjunctivitis, Koplik SpotMorbilliform blotchy rash
What is an Insulinoma?
Insulin secreting tumor, labs show increased insulin and C-peptide
What ion has the greatest movement at rest?
What is seen with Fluoride deficiency?
Poor teeth and bone growth
What hepatitis B labs indicate immunization >2/52 weeks?
What valves make noise at the end of systole?
Aortic and Pulmonic
What is Riedel's Struma?
"Woody" connective tissue in neck, death due to suffocation and must rule out CA
What is the MOA of Digoxin?
Direct inhibition of Na+/K= ATPase leads to indirect inhibition of Na+/Ca2+ exchanger, positive inotrope, stimulates vagus nerve
What does a Thio do?
Breaks S bonds
What is Hungry Bone Syndrome?
Removal of PTH and the bone sucks in calcium
What do high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, memory loss
What is Shoulder Dystocia?
Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)
What structures have Fake sphincters?
Ureters, LES, Ileocecal valve
What does Endocrine mean?
Secreted into bood
What are the indications for Misoprostol?
Prevents NSAID-induced peptic ulcers, maintenance of a Patent Ductus ArteriosusInduce labor
What is the Indication for PTU and Methimazole?
What are the expectorants?
What does an epimerase do?
Creates an epimer, which differs around one chiral carbon
What is the MOA of Guaifenesin?
Removes excess sputum but does not suppress cough reflex
What are the indications for Pseudoephedrine, Phenylephrine?
Reduces Hyperemesis, edema, nasal congestion, and opens obstructed Eustachian tubes
What has Crescents?
What are wide sutures due to?
Hypothyroidism and Down's Syndrome
What is a Transvestite?
Dress up as opposite sex, no identity crisis
What does SAM donated methyl groups for?
All other reactions
When do valves make noise under normal physiology?
When the valves close
What is systole?
Ejection of blood from the heart, Decreased blood flow to Coronary arteries, more extraction of Oxygen Phase 1 Korotkoff
What is Homocystinuria?
No Homocysteine -> Cysteine(Cystathionine Synthase Deficiency)or Homocysteine Methyltransferase(Methionine Synthase) Deficiency or decreased Affinity of Cystathionine Synthase for Pyridoxal PhosphateIncreased Homocysteine in urinMarfanoid Habitusdownward dislocation of lensincreased risk stroke/MI
What is associated with Bacillus Anthracis?
Black Eschar, Wool Sorter's Lung diseaseD-Glu, boxcar-like spore, treat with Cipro
What type of immunity does TH1 provide?
Enhances cell mediated immunity
What are the adverse effects of Prazosin?
What is the most common cause of post-coital Vaginal Bleeding?
What are the Leopold Maneuvers?
To determine the position of the babyFeel the fundusFeel the baby's neckFeel the pelvic inletFeel the baby's head
What is the function of Inhibin?
Inhibits FSH so there is no menstruation
What is a Transsexual?
Gender Identity crisis
What are the Survival Hormones?
Cortisol: permissive under stress. TSH: permissive under normal
What is the cause of Symmetrically small babies?
In Early onset: Chromosomal Abnormalities or TORCHES