Flashcards in Complete Deck Part 4 Deck (388):
What does Indirect Coombs Test tell you?
The Antibody is freely circulating in the serum
What are the ACE inhibitors?
Captopril, Enalapril, Fosinopril, Lisinopril
What does the Carnitine shuttle do?
FA transport into the mitochondria
What are the Adverse Effects of Glucocorticoids?
Iatrogenic Cushing's syndrome. (Adrenal insufficiency when drug stopped after chronic use)
What is the function of HPL?
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
What is Thought Insertion?
Believes that others are putting thoughts into his head
What is Benign Positional Vertigo?
Sensation of room spinningNausea/VomitingNystagmus without hearing loss or tinnitusOnset of symptoms when change position
What is Inflammatory Diarrhea?
Diarrhea with blood and pus
What does a mutase do?
Relocates a functional group within a moleculre (intrachain)
What is Gaucher's?
Glucocerebrosidase (Beta-Glucosidase) deficiencywrinkled tissue Macrophage'sBone painpancytopenia
What are the Indications for Octreotide?
Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome
What causes non-bacterial Fetal infections?
"TORCHST- ToxoplasmaO - Others (HIV, Measles, B-19)R - RubellaC - CMVH - HSV-2S - Syphilis
What are the adverse effects of the Class IB antiarrhythmic?
CNS stimulation and depressionCardiovascular depressionHyperkalemia increases toxicity
What is Sublimation?
Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior
What is Phimosis?
Foreskin scarred at penis head
How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?
What defines CLL?
50+ y/o males with lymphadenopathysoccer ball nucleiPresent with autoimmune Hemolytic anemia
What does Vit B12 do?
Cofactor for HMT & MMA
What GI disease has an Apple Core on X-Ray?
What are Burr Cell/ Echinocyte?
Seen in Pyruvate Kinase deficiencyLiver diseasePost splenectomy
What does a Synthetase do?
Consumes two substrates, uses ATP
What is a silent mutation?
Changes leave the same amino acid
What does blood type AB tell you?
Have both Antigens (universal recipient)
What are the adverse effects of Diazoxide?
Hypoglycemia (reduces insulin release) and hypotension
What is Delusion?
Fixed false belief for more than one month and no effect to his normal livingTx: Atypical antipsychotic and psychotherapy
How do you know it's an anaerobic infection?
gas and bad odor
What is SHeehan Syndrome?
Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk
What is the most common eye infection in New Born
First day - Clear discharge due to Silver NitrateFirst week - Gonorrhea (purulent discharge)Second week - ChlamydiaThird week - Herpes
What is Cystic Fibrosis?
Defective chloride transportermeconium ileussteatorrheaBronchiectasisChromosome 7
What is the MOA of adenosine?
Increase K+ efflux, hyperpolarizes the cell
What does Vit C do?
Collagen synthesisantioxidanthelps absorb FE++, necessary for Dopamine & hydroxylase for NE
What is assocaited with H. Pylori?
95% causative agent in Duodenal Ulcers
What organs have the most CD4 receptors?
What is the RBC normal lifespan?
What is a Somatotrope?
What is Separation Anxiety Disorder?
Kid screams when mom leaves
What are the adverse effects of H2 blockers?
Prolactin release: Gynecomastia, decreased libido, impotence in malesCimetidine inhibits P450
What are Fibroids (Leiomyoma's)?
Benign uterus smooth muscle tumorsubmucosal type: they bleedSubserosal type: they cause pain
What is Metabolic Syndrome X?
"Pre-DM" due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans
Which cells express MHC-2?
Antigen presenting cells (macrophages, dendritic cells, and neutrophils)
What is Non-competitive Inhibition?
Binds a regulatory site, no change in Km, Efficacy decreases, decreased Vmax
What is Fifth's disease?
Erythema Infectiosum "Slapped Cheeks"B-19 ParvovirusAplastic anemia, in sickle cell patientsHydrops Fetalis
What are the adverse effects of Nesiritide?
What are the adverse effects of Class IC antiarrhythmic?
Prolongs refractory period in AV node Hyperkalelmia increases toxicity
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
What is SCID?
No Thymus (no T-cells)frayed long bones (no B-cells)baby dies by 18 months
What does the Macula Densa do?
Measures osmolality (osmoles of solute-kg)
What type of people does Hep E like to infect?
Pregnant women (3rd trimester), Asians
What is Lobular Carcinoma?
Cells line up single file, contralateral breast is primary site of CA
Which stage of the Menstrual Cycle has the highest Estrogen levels?
Follicular stage (Has proliferative endothelium)
What is seen in Sickle Cell Anemia?
Crew-cut on x-rayAvascular Necrosis of femur
What is Croup?
Respiratory condition that is usually triggered by an acute viral infection of the upper airway, steeple sign on x-ray, barking cough
What do T cell deficiency patients die of?
Viral infections, fungal, etcexcept bacterial
What can high Cholesterol Cause?
How do tension headaches present?
"Band-like" pain starts in posterior neck, increases throughout the day, sleep disturbance
What are the Big Mama Anaerobes?
Bacteroides fragilisStreptococcus BovisC. MelanagosepticusC. Diff
What is Vascular "multi-infarct" dementia?
Sudden onset, uneven progression of deficits, "stair step" decline
What is Cephalohematoma?
Bleeding under bone (blood does not cross suture lines)
What bugs cause hospital abscesses?
Day 1-3: S. Aureus (lots of O2 present)Day 4-7: S. Viridans - no enzymeDay >7: Anaerobes - PMN's
What is a Paranoid Personality Disorder?
Suspicious about everything, they use projection
What is Selective Mutism?
Kid talks sometimes
What is Schizotypal Personality Disorder?
"Magical Thinking", odd/bizarre behavior, people leave them alone because they are weird but they will interact if approached. Brief psychotic episode
What is Menorrhagia?
Heavy menstrual bleeding
What causes Syphilis?
Treponema Pallidum (Spirochete)
What is the only Gram-positive Endotoxin?
What are the Adverse Effects of Misoprostol?
Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug
What is EC50?
Concentration of drug that produces 50% of maximal response
What is Oppositional Defiant Disorder?
Breaking the rules, defiant, noncompliant, resists authority, "bark is worse than bite". Teach appropriate child management skills
What is Virilization?
Female that is Man like
What are the Microcytic Hypochromic Anemias?
Defect in Hb synthesis (RBC small and pale) "FAST lead"F - Fe DeficiencyA - Anemia of Chronic DiseaseS - Sideroblastic AnemiaT - Alpha and Beta Thalassemia'sL - Lead poisoning
What organ has the highest AVO2 difference during a test?
What is associated with Staph Saprophyticus?
Seen in young girls / women who became sexually active, E. Coli is still the #1 cause of UTI's
What is an Ependymoma?
Rosettes present in the 4th Ventricle, Hydrocephalus
What is Zellweger's?
What does Atrial Natriuretic Peptide do?
Inhibits aldosterone and dilates the afferent arteriole
What is the most common type of Gallstone?
Cholesterol stone (not see on X-ray)
What is associated with N. Gonorrhea?
Pili, Urethritis, Tenosynovitis, Septic arthritis
What is a Xanthoma
Cholesterol build up (common at the elbow or Achilles tendon)
What is Berylliosis?
Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs
What are the indications for Guaifenesin?
Minor upper respiratory tract infections, common cold w/ cough
What diagnosis has secondary hyperparathyroidism?
How does Chancroid present?
Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)"School of Fish" pattern
What is Placenta Abruptio?
Severe pain due to premature separation of the placenta
What produces Currant Jelly Sputum
What are the IgA protease bugs?
S. PneumoniaeH. InfluenzaM. Catarrhalis
What are the GLP-1 Analog drugs?
Exenatide and Liraglutide
What bug is associated with cat pee?
What does PTH do?
Stimulates osteoblast to activate osteoclasts, stimulates the reabsorption of Ca+ and the excretion of phosphate in the kidneys, and activation of vitamin D
What is FSGS?
Most common in IVDA, AA, Hispanics and HIV patients
What is the only statin to undergo renal excretion?
What does hyperresonance tell you?
Air in that region of the lungs`
What has WBC Casts ONLY?
What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?
What is the MOA of PTU and Methimazole?
Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones
What is associated with Corynebacterium Diphtheriae?
Chinese letters under microscope, gray Pseudomembrane, heart block, suffocation = death, ADP Ribosylates EF2, Elek's Test
What is Epididymitis?
Unilateral scrotal pain decreased by support
What is the Adverse effect of Biguanides?
Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast
What is the Autonomic Nervous System?
Automatic stuff... i.e. breathing, heartbeat
What causes Neonatal Blindness
What is Eclampsia?
HTN with seizures
What is Condylomata Lata?
Flat fleshy warts, ulcerate = secondary syphilis
How much weight should a woman gain during Pregnancy?
1 lb/ week
What is Obsessive-Compulsive Personality Disorder?
Perfectionist, doesn't show feelings, detail oriented, uses isolation
Which cytokine is released when a macrophage is activated?
How does an epidural hematoma present?
Intermittent consciousness (lucid interval)
What has a friction rub while holding breath?
What does biotin donate methyl groups for?
What is associated with H. Influenzae?
Gram-negative Pleomorphic Rod, Factors V and X, 5 carbon Ribose capsule, HiB type causes Meningitis, Epiglottitis, and Sepsis
What is Tuberous Sclerosis?
Ashleaf spots (hypopigmentation)Primary brain tumorsHeart RhabdomyolysisRenal cell CAShagreen spots (leathery)
What is Vernix?
Cheesy baby skin. (protects the baby's skin from the outside world and helps with passage through the birth canal)
What is Postpartum Depression?
Depression post-delivery for more than 2 weeks
What does Vit B1 do?
What does DES taken by Mom cause in her Daughter?
Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions
What are the Osmotic Laxatives?
Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose
What diseases have metabolic alkalosis?
Low volume state: vomiting, diuretics, GI blood loss
What are the Class IA antiarrhythmic?
Quinidine, Procainamide, Disopyramide
What bacteria cause diarrhea <8 hours after introduction?
"CBS"C - ClostridiumB - Bacillus CereusS - Staphylococcus aureus
What is Maple Syrup Urine disease?
Defective metabolism of branched aa (Leu, Iso, Val) -> aa leak out, urine smells like Maple syrup/ burnt sugar, defect of branched chain alpha Keto acid Dehydrogenase
What is Milia?
Neonatal white or pale yellow heads on malar area
What is Toxoplasmosis?
Multiple ring enhancing lesions, loves parietal love, from cat urine and feces
What is Apocrine?
Apex of the cell is secreted
What states have increased Estrogen?
Pregnancy, liver failure, P-450 inhibition, and obesity
What are the adverse effects of Pseudoephedrine, phenylephrine?
HTN, CNS stimulation/ anxiety
What is von Gierke?
G-6 Phosphatase deficiencysevere fasting hypoglycemiahepatomegalyincreased lactase and uric acid levels
What hormones produce Basophila?
"B FLAT": Basophils, FSH, LH, ACTH, and TSH
What is Huntington's?
Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation
What is Oligomenorrhea?
Too few periods
What bug loves the temporal love?
What is an Encephalocele?
Brain tissue herniation
What is Karyolysis?
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually due to anovulation
What has a friction rub while breathing?
What is Hemochromatosis?
Fe deposit in organs
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response
What are the indications for Methyldopa?
What does secretin do?
Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum
When does Implantation occur?
1 week after fertilization
What is Comedocarcinoma?
Multiple focal areas of necrosis (blackheads) DCIS
What is Vestibular Neuritis?
Inflammation of the vestibular portion (CN8), Could be associated with viral infection, characterized by vertigo and dizziness
What is the MOA of Potassium on the heart?
Depresses ectopic pacemaker in hypokalemia
What is a Nephroblastoma?
Abdominal mass due to enlarged "Wilm's Tumor", hemihypertrophy and Aniridia
What is the most common cause of delayed speech developement?
What is the Peripheral Nervous System?
Everything except the brain and spinal cord. Myelination by the schwann cells
What is Imitation?
Replicating another's behavior
What is Cholelithiasis?
Formation of gallstones
What is the most common cause of Vaginal Bleeding in Post-menopausal women?
Can you die during Opiod Withdrawal?
No, just very painful
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
What is Nephritic Kidney Disease?
Inflammation with protein loss <3.5 in urineIncreased size of Fenestrations, RBC casts, HTN
What is your maximum heart rate?
220 minus the person's age
What are the indications for Reserpine?
What is seen in Calcium deficiency?
Poor bone and teeth development
What is Eisenmenger's Syndrome?
Physiological shunt from left to right now changes right to left
What are some PPIs?
What kind of Patients does Staph and Pseudomonas like to attack?
DM, CF, Burn Patients, Neutropenic patients
What does a Transferase do?
Relocates a functional group from one molecule to another
What is associated with P. Mirabilis?
Staghorn Calculus, UTI, Urease Positive, Treat with Norfloxacin
What is Emphysema?
Obstructive diseaseAlpha-1-antitrypsin deficiency
What is PSGN?
Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies
What is Sixth's DIsease?
Roseola, Exanthema Subitum (fever disappears then rash appears)
What is a Lymphocyte?
The warrior - T, B, and NK cells
What disease has a "3" shape on x-ray?
Coarctation of the aorta
What is MPGN
Tram tracks seen (Type II has low C3) on LM
What is Peutz Jegher Syndrome?
Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps
What is Chronic Granulomatous Disease?
NADPH Oxidase deficiency - they have recurrent Staph / Aspergillus infections (Nitro-blue Tetrazolium Stain Negative) or Dihydrorhodamine flow and Cytometry test
What is Type 2B Hyperlipidemia?
Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)
What is the MOA of Nitroprusside?
Direct release of NO, increases cGMP, vasodilator
What is a Tear Drop Cell/ Dacrocyte?
RBC's squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)
What is Decreased beat-to-beat variability?
What does Gastric Inhibitory Peptide (GIP) do?
Increases insulin action, responsible for post-prandial hypoglycemia
What is the difference between norepinephrine and epinephrine?
NE: NeurotransmitterEPI: Hormone
What are the adverse effects of ACE inhibitors?
Hyperkalemia, cough, angioedemacontraindicated in pregnancy (fetal renal malformations)
What is Cataplexy?
Loss of muscle tone due to strong emotions
What does dullness to percussion tell you?
Something between the airspace and chest wall absorbing sound, can be solid or fluid
What hepatitis B labs indicate a chronic carrier state?
HBsAg+, (>6 months), HBsAb (+/-)
What are the Diastolic Blowing murmurs?
Aortic regurgitation, pulmonic regurgitation
What is the MOA of Isoproterenol?
Non-specific, Beta-agonists;relates bronchial smooth muscle (B2)
What does Exocrine mean?
Secreted into a duct
What is Apoptosis?
Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last
What are theh Renin-angio system effectors?
ACE inhibitors and ARBs
What are the most common symptoms of the Low Energy State?
Weakness and SOB
What is Reynold's Pentad?
Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status
What does Ca2+ do?
Neuronal function, atrial depolarization, smooth muscle contractility
What diseases have Granulomas?
"HiTTSS"Hi - Histiocytosis XT - TBT - The -Ella'sS - SarcoidosisS - Syphilis
What is a Complete Breech?
Butt down, thighs, and legs flexed
What is Grey-Turner's Sign?
Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)
What is associated with Francisella Tularensis?
Ulcers at rabbit or deer tick bite siteRx: Streptomycin
What is associated with Bartonella Henselae?
Cat Scratch = Single painful lymph node, Stains silver
What is Avoidant Personality Disorder?
Socially withdrawn, afraid of rejection but wants to fit in
What is a Sister Mary Joseph Nodule?
Ovarian CA that has spread to the umbilicus(Also GI cancers can cause) (Indicates metastasis)
What does the Core Ab tell you?
What is associated with Clostridium Melangosepticus?
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine's
What are the inidcations for Cromolyn?
What is Rationalization?
Make excuses for behavior in advance, (because of...)
What are the indications for Nesiritide?
Acute decompensated heart failure
How do you measure afferent renal function?
Creatinine or Inulin
What is a Spherocyte?
What is Thought Broadcasting?
Believes that everyone can read his thoughts
What is associated with Chlamydia psittaci?
Parakeets and Parrots are the carrier agent
What does high WBC and >5% Blasts tell you?
What does a high WBC and <5% Blasts tell you?
Leukemoid reaction - seen in burn patients or any extreme stress (extreme demargination looks like Leukemia), Metamyelocytes => Myelocytes
What is Displacement?
Take anger out on an object or someone else. Not related with situation
What is Turcot's Syndrome?
Familial Polyposis with Brain Tumors
What is Central Pontine Myelinolysis?
This happens when you correct serum sodium faster than 0.5 mEq/hr. (infarct the PONS- patient can only blink)
How does trigeminal neuralgia (Tic Douloureux) present?
Sharp, shooting face pain, recurrent episodes
What does an AFI <5 indicate?
Oligohydramnios (Cord compression)
What is the rate-limiting enzyme in Glycogenesis?
Glycogen Synthase. Occurs in the Cytoplasm of Liver and muscle
What is Bronze diabetes?
Fe deposit in pancreas
What does Aldosterone do?
Reabsorbs Na+ and three waters
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
What is Late Deceleration?
Due to uteroplacental because the placenta cannot provide oxygen and nutrients
What are the CSF lab values for Meningitis?
PMN's -> BacteriaT cells / Macrophages -> Non-bacterialNormal Glucose -> Viral
What is the Clotting Cascade?
The cascade that stops you when you bleed
What is the MOA of Statins?
Inhibit HMG CoA reductase
What are the Holosystolic murmurs?
Tricuspid RegurgMitral RegurgVSD
What is Stage 1 of Labor?
Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm
What are the Vasculitis associated with LOW C3?
"PMS in Salt Lake City"Post-Strep GNMembranoproliferativeGlomerulonephritis Type IISub Bacterial endocarditisSerum SicknessLupusCryoglobulinemia
What is the MOA of albuterol?
B2 agonist; relaxes bronchial smooth muscle
What is Factitious?
Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.Tx: Supportive psychotherapy
What is Condyloma Acuminata?
Verrucous "cauliflower" warts, koilocytes, due to HPV 6 and 11
What is Osmotic Diarrhea?
High osmolality in the bowel pulling water into the lumen
What defines Hodgkin's Lymphoma?
EBV and may have Reed-Sternberg cells
What is Hemolytic Disease of the Newborn?
Rh+ mom's blood mixes the Rh- fetal blood in first pregnancyNo risk to this childAll pregnancies to follow will be a risk, leading to a fetal demise
What is associated with Chlamydia Pneumonia?
Staccato coughing, parasite with DNA and RNAs:Elementary body (Infectious phase) Reticulate Body (resting phase - can't divide)
What is the only Gram-positive Diplococci?
What is the humoral immune response?
B-cells and PMN's patrol the blood looking for bacteria
What are the Adverse Effects of Infliximab?
Respiratory infection (including reactivation of latent TB) fever, hypotension
What are the indications for HMG-CoA reductase inhibitors?
Strong decrease LDLDecrease TriglyceridesIncrease HDL
What does a Galactokinase deficiency cause?
What is the most common extracellular buffer?
What is associated with Bacillus Cereus?
Fried rice syndrome, preformed toxin
What is Compensation?
Doing something different of what you used to do
What is the color of air on X-ray?
What stage of the menstrual cycle has the highest Temperature?
Ovulatory stage, body temp will rise One degree during ovulation
What bug loves the DCML tract?
What are the indications for 2nd generation H1 Blockers?
Who Makes the Trophoblast?
Waht is the rate-limiting enzyme in Cholesterol syntesis?
HMG CoA Reductase
What makes an adequate sputum sample?
<10 epithelial cells and >25 leukocytes per low power field
What are the indications from Magnesium?
Effective in Torsades and Dig toxicity
What are the adverse effects of Salmeterol?
Tremor and arrhythmia
What is the indication for Isoproterenol?
Bronchoconstriction due to sympathetic tone
What is Pathological Gambling?
Can't stop gambling, affects others
What is the sign of a Clavicle Fracture?
Asymmeteric Moro reflex
What is an Astrocytoma?
Rosenthal fibers - #1 in kids with occipital headache
What is Heavy Chain Disease?
What GI disease has a Bird's Beak on X-Ray?
Achalasia (Think Chagas disease)
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
What are the Indications for Glitazones/Thiazolidinedione's?
NIDDM. (Type 2)
What is Polycystic Ovarian Syndrome?
Increased cysts. No ovulation due to no Progesterone, leads to increased Endometrial CA, they cannot inhibit LH, obese, hairy, acne
What is the CBC for every basculitis?
Decreased: RBC and plateletsIncreased: WBC, T-Cells, Monocytes, Schistocytes, ESR
What is associated with Mycoplasma Pneumoniae?
Bullous myringitis, Ground Glass CXR, P-1 Protein, Erythema Multiforme
What are the risk factors for Primary Liver Cancer?
Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis
What are the Pyrimidines?
C, U, T
What are the Adverse Effects of Desmopressin (DDAVP)/ADH?
Over hydration and allergic reaction
What is a Sliding Hiatal Hernia?
Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax
What is t1/2?
Half-life, the time it takes the body to use half of the drug ingested
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl
What is the thyroid hormone levels during Pregnancy?
Increased TBG - leads to increased total T4 (Bound and free)
What is seen with Varicella (Chickenpox)?
Red macule clear vesicle on red dotPus and scabbingvarious stages of healing
What is Cabot's Ring body?
Seen in Vitamin B12 Deficiency and lead poisoning
What is intra-Renal Failure?
Damaged Glomerulus or tubules; BUN: Creatinine Ratio <20/1
What is Tetralogy of Fallot?
Overriding aorta: Aorta sits on intraventricular Septum giving rise to a VSD, this in turn causes Pulmonary Stenosis and ultimately right heart failure (boot shape x-ray)
What organs do not require insulin to absorb glucose?
"BRICKLE": Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle
What receptors do Protein Hormones use?
Cell membrane receptors
What is an Esophageal Atresia with a TE Fistula (C-Type)?
Baby vomits with first feeding, large gastric bubble and distended abdomen (failure of apoptosis)
What is Metachromatic Leukodystrophy?
Arylsulfatase A defieciencychildhood multiple sclerosis with Ataxia/Dementiaaccumulation of Cerebroside Sulfate
What are the catabolic pathways that create energy? (Occur in the Mitochondria)
Acetyl-CoA production, Beta-oxidation, citric acid cycle, Ketogenesis, Ox Phos
What are Plasma Neoplasms?
They produce many antibodies
What does the Direct Coombs Test tell you?
ANtibody on surface (seen in hemolytic anemia)
What are the Adverse Effects of Metoclopramide?
Increased Parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrheaDrug interaction with digoxin and diabetic agentscontraindicated in small bowel obstruction
What does Glucagon do?
Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis
What is the rate-limiting enzyme in Purine synthesis?
Glutamine - PRPP
What is Alzheimer's disease?
Decreased ach in nucleus basalis of Meynert, bad Apo-E4, Amyloid Plaques, Neurofibrillary Tangles of Tau proteins
What is Essential Thrombocythemia?
Very high platelets increased RBC's and WBC's
What does Antidiuretic hormone (ADH) do?
Conserves water (V2 aquaporin receptors) and vasoconstriction
What does Tracheal deviation tell you?
Moves away from tensionPneumothorax moves towards Atelectasis
What CA risk does VHL have?
What GI disease has a Corkscrew on X-Ray?
Esophageal spasm and Volvus
What is Carcinoid Syndrome (Triad)?
Diarrhea, flushing and wheezing
Can you try a Vaginal Delivery on a woman who had a LOW Transverse C-Section previously?
Yes, 70% are okay, Potential for uterine wall rupture
What is Crohn's Disease?
Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions
What are Loose Associations?
Ideas switch subjects, incoherent
What is Idealization?
They see only the good in someone despite evidence to the contrary
What GI disease has a stacked coin on X-Ray?
What is Tangentiality?
Wanders off the point
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
What are the Indications for Infliximab?
Crohn's Disease, Rheumatoid arthritis
What is the time course of the inflammatory response?
1 hour: swellingDay 1: PMN's show upDay 3: PMN's peakDay 4: Monocytes/Macrophages and T-cells show upDay 7: Monocytes/ Macrophages and T-cells peak, Fibroblasts arriveDay 30: Fibroblasts peakMonth 3-6: Fibroblasts complete scar formation
What has Tubular Casts?
Acute Tubular Necrosis (ATN)
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
What is Karyorrhexis?
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
What are Pencil Cell/ Cigar Cell?
Seen in iron deficiency anemia
What is Primary Biliary Cirrhosis?
Anti-Mitochondrial antibody Bile ducts are destroyedXanthelasmas present and pruritis
What is factitious hypoglycemia?
Exogenous insulin use, labs show elevated insulin and decreased C-peptide
What are the adverse effects of the Ca2+ channel blockers?
Flushing, edema, constipation, CHF, AV block
What disease does Coxsackie B cause?
Endocarditis, DM Type I
When do you give RhoGam?
1st Dose: Week 28 gestation2nd Dose: 72 hours post-deliveryAny time a procedure would mix mom and fetal blood
What are the IgA Nephropathies?
What is Paracrine?
Works on its neighbor. (except sweat gland)
What does "Cytosis" tell you?
What is Justification?
Making excuses for behavior afterwards
What are the Biguanides drugs?
What are the glycogenic amino acids?
His, Met, Val
What are the indications for Hydralazine?
Severe HTN, 1st line treatment for HTN in pregnancy
What are the hormones with disulfide bonds?
"PIIG": Prolactin, Insulin, Inhibin, GH (growth hormone)
How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?
What does Vit B9 do?
Nuclear division (Synthesis of Nitrogenous bases for RNA and DNA)
What is Glanzmann's?
Baby with bleeding from skin and mucosa (LOW GP-2b3a)
What is Exhibitionism?
Exposure to others
How does the Sympathetic System behave?
Opposite of Parasympathetic:ConstipationUrinary retentionMydriasis - "Eyes wide with fright"TachycardiaBronchodilateEjaculation "Shoot"Xerophthalmia (dry eyes)Xerostomia (Dry mouth)
What is the Mechanism of Action of Sulfonylureas?
Closes K+ channel in the pancreatic Beta cell membrane, Reduces K+ efflux & increases Ca (2+) influx, and cell depolarize to increase secretion of insulin
What does the Progesterone Challenge Test tell you?
Vaginal bleeding if she has estrogen. If she does not bleed, she has no E2 or ovariesIncreased FSH: Ovary problemDecreased FSH: Pituitary problem
What are the classifications of MHC-1?
HLA-A, HLA-B and HLA-C
How does chlamydia present?
Cervicitis (Yellow pus), conjunctivitis, PID
What is Total Anomalous Pulmonary return?
All pulmonary veins enter into the right atrium (Snowman x-ray)
What is the rate-limiting enzyme in Ketogenesis?
HMG CoA Synthase
What is Herpes?
ds DNA virus
What is the Stage II of Labor?
Continues after the cervix is dilated to 10 cm until the delivery of the baby
What is the difference between Heterochromatin and Euchromatin?
Hererochromatin = tightly coileddarkerTranscriptionally inactiveEuchromatin = loose (10nm fibers)lighter
What are the LIVE Vaccines?
"Bring Your Own Very Small Virus and MMR"B - BCGY - Yellow FeverO - OPV (Sabin) = oral polioV - VaricellaS - SmallpoxV - RotavirusM - Measles = RubeolaM - MumpsR - Rubella = German 3 day measles
What murmur has a regular-irregular pulse?
What disease has a Thumb Sign on neck films?
What is Restrictive Lung disease?
small still lungs, can't get air in
What symptoms does a "less likely to depolarize" state have?
Brain: lethargic, mental status changes, depressionSkeletal Muscle: weakness, SOBSmooth Muscle: constipation then diarrheaCardiac: hypotension, bradycardia
What are the indications for Ezetimibe?
What are the Class IC antiarrhythmic?
Flecainide, Encainide, Propafenone
What is the effect of Alcohol on the fetus?
FASSmooth philtrumshortpolyclonalmidface hypoplasiathin superior Vermilion border
What is the Mechanism of Action of Insulin?
Pushes K+ into the cell,Liver: Increases Glucose storage as Glycogen, Increases Triglyceride synthesis.Muscle: Increases protein and glycogen synthesis.Adipose Tissue: Improves Triglycerde storage by activating Lipoprotein Lipase, Decrease circulating Free Fatty Acids
What causes Chancroid?
What is Telephone Scatologia?
What is the MOA of ARBS?
Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II
What is a Missed Abortion?
Cervix is closed, no fetal remnantsTx. D&C
What type of kidney stones have envelope or dumbbell-shaped crystals?
What does the E Ab tell you?
What is the cause of large babies?
DM or twin-twin transfusions
What are the indications for Nitroprusside?
Hypertensive emergency, CHF, Angina
What is the MOA of cromolyn?
Prevents release of mediators from mast cells
What is Bismuth and Sucralfate used for?
Increase ulcer healing, traveler's diarrhea
What is a SIderoblast?
Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)
What is the MOA of Bile Acid resins?
Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more
What are the sympathoplegics?
Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine
What is the MOA of Salmeterol?
B2 agonist; relaxes bronchial smooth muscle
What is Bronchitis?
Increased sputum production "Blue Bloater"
What is Type 2A Hyperlipidemia?
Defective LDL-Clathrin Pit or B-100 (LDL are elevated)
What will you see with Anemia of Chronic Disease?
What will you see with Sideroblastic Anemia?
Decreased dALA synthase common with blood transfusions
What are the adverse effects of Hexamethonium?
Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
What is the MOA of the K+ channel blockers?
Increase AP duration, increase effective refractory period (ERP), increase QT interval
What is Plummer-Vinson Syndrome?
esophageal webbing at the UES, spoon nails from iron deficiency anemia
What is Cholestasis?
Obstructed bile ductHigh Alk Phos (if in the common bile duct)
What is transposition of the great arteries?
Aorticopulmonary septum did not spiral, most common congenital cyanotic heart disease in the first month of life (Neural crest cell migration problem)
What is Trichotillomania?
They pull out their own hair and eat it
What is McCune-Albright?
Precocious sexual development, polyostotic fibrous dysplasia "whorls of connective tissue", "coast of Maine" pigemented skin macules
What is associated with Vibrio Parahaemolyticus?
Raw Fish, Gs Stimulation via ADP- ribosylation = HIGH cAMP, Turns the on... on
How fast should B-HCG rise?
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
What are the indications for Methacholine?
Asthma challenge test
What are some causes of Vitamine B12 deficiency?
TapewormsVeganismType A gastritisPernicious Anemia
What does Vit D do?
Mineralization of bones and teeth
What are the newborn screening tests?
"Please Check Baby Before Going Home"P - PKUC - CAH/ CFB - Biotinidase/ Beta- ThalassemiaG - GalactosemiaH - Hypothyroidism/ Homocystinuria
What are the most common causes of mental retardation in the US?
FAS, Fragile X and Down's Syndrome
What is Wiskott-Aldrich?
Low IgM, Low PlateletsHigh IgAEczemaPetechiaeX-linked
What is achondroplasia (Laron Dwarf)?
Patient with abnormal FGF receptors in exremities. (abnormal FGF3)
What is Hemosiderosis?
Fe overload in bone marrow
What is Poikilocytosis?
RBC's of different shapes
What are the Adverse Effects of Mimetics?
Hypoglycemia, Nausea, Diarrhea
What can high Triglycerides Cause?
What is the MOA of a muscarinic antagonist?
competitively block muscarinic receptors preventing bronchoconstriction
What are the methylxanthines?
What is the function of T3 and T4?
Growth and differentiation
What is Histrionic Personality Disorder?
Theatrical, sexually provocative, use repression
What diseases have Respiratory Alkalosis?
Restrictive Lung diseaseAnxietyPregnancyGram neg sepsisPE
What does Fe2+ do?
Hb function, electron transport
What is RhoGam?
What is Pyromania?
Sets fires for the fun of it
How does DKA present?
Kussmaul respirations, fruity breath (acetone), and altered mental status
What is assocaited with Strep Bovis?
Colon Cancer, black pigment
What hepatitis B labs indicate non-infectious state?
What bugs cause Bloody Diarrhea?
"CASES": Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella
What are the only arteries with deoxygenated blood?
Pulmonary and umbilical arteries
What are the Long Acting Insulin drugs?
Ultralente, Glargine, and Protamine
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification around lymph nodes
What sound radiates to the axilla?
How is Major Depression diagnosed?
Need 5 of 8 "SIGECAPS" for over 2 weeksSleep disturbance: wake in early or wake up lateInterest/ libido lossGuiltEnergy LossConcentration LossAppetite LossPsychomotor AgitationSuicidal Ideation (hopelessness)
What does somatostatin do?
Inhibits secretin, motilin, and CCK