March 31 Flashcards Preview

1 USMLE-rx > March 31 > Flashcards

Flashcards in March 31 Deck (41):
1

What are the characteristics of Cushings syndrome?

Weight gain
Moon facies
Poor wound healing--caused by inhibition of collagen synthesis by glucocorticoids
Facial plethora

2

What disease is characterized by "starry sky" appearance seen on histo?

Burkitts lymphoma

Field of lymphocytes is interrupted by occasional phagocytic macrophage

3

What is the cause of X-linked hyper-IgM syndrome and how does it present?

Caused by CD40 ligand deficiency---unable to class switch so get increased IgM

Pt presents with recurrent pyogenic fungal infections--pneumocytitis is common

Normal or elevated IgM with major decrease in IgG, IgA, and IgE

4

Freely circulating IgM is capable of binding how many viral particles? What about an IgM bound to a B-cell?

Free-10--because it is a pentamer
Bound-2

5

What is the structure that forms the smooth part of both ventricles?

Bulbus cordis

6

Pathological grief includes....

Excessive, intense or prolonged grief
As well as grief that is delayed, inhibited or denied

7

B-hCG shares the identical alpha subunit of what other 3 hormones?

TSH
LH
FSH

Its the B subunit that makes these hormones different

8

What is Hartnup disease and how does it present?

AR disease that is a deficiency of neutral amino acid (tryptophan) transporters in proximal renal tubular cells and on enterocytes

Get neutral aminoaciduria and decreased absorption from the gut--leading to decreased tryptophan for conversion to niacin

Presents with pellagra-like symptoms--Diarrhea, Dementia and Dermatitis

9

What is decreased in both obstructive and restrictive lung disease?

Vital capacity

10

What are the functions of IL-1-6, 8, 10 and 12?

IL-1: Fever
IL-2: Stimulates T cells
IL-3: Stimulates Bone marrow
IL-4: Stimulates IgE production
IL-5: Stimulates IgA production
IL-6: Stimulate aKute-phase protein production---C-reactive proteins
"Hot T-Bone stEAK"

IL-8: Neutrophils are recruited to clear infections
"Clean up on aisle 8"

IL 10: AtTENuate the immune response

IL-12: Induces differentiation of T cells into Th1 cells and activates NK cells

11

What is the function of the sub thalamic nucleus, which is commonly damage with lacunar strokes causing hemiballisum?

Causes excitation of the internal segment of the globus pallidus which inhibits the thalamus leading to decreased motor cortex activation and movement

Therefore, when it is damage with stroke there is no longer inhibition of the thalamus which leads to the abnormal movements seen with hemiballisum

12

What are the treatment options for hodgkin lymphoma, which presents with a localized, single group of nodes and reed-sternberg cells?

Vincristine
Vinblastine
Bleomycin
Doxorubicin

13

What enzyme is deficient in Hunter syndrome, XR disorder that presents with developmental delay, gargoylism, airway obstruction, hepatosplenomegaly (all are features of Hurler syndrome which is more severe form of Hunters--Hurlers also presents with corneal clouding), and aggressive behavior WITHOUT corneal clouding?

Iduronate sulfates with accumulation of Heparan sulfate and dermatan sulfate

Hurler syndrome is caused by a-L-iduronidase deficiency and is AR disease

14

What are the most severe features of poliovirus?

Respiratory failure due to respiratory muscle paralysis
Paraplegia
Quadriplegia

15

What is the classic triad of Wiskott-Aldrich syndrome and what are the findings with this disease?

WATER--Wiskott-Aldrich
Thrombocytopenia
Eczema
Recurrent infections

Decreased to normal IgG and IgM
Increased IgE and IgA

Fewer and smaller platelets

XR and T cells unable to reorganize actin cytoskeleton

16

What is the cause of adult T-cell lymphoma that shows T-cells with multilobulated "cloverleaf" nuclei and presents with cutaneous lesions?

HTLV--provirus

17

What rotator cuff muscle is responsible for in aiding the deltoid in in abduction of the arm (especially first 15 degrees)?

Supraspinatus

SITS
-Supraspinatus
-Infraspinatus
-Teres minor
-Subscapularis

18

Methylmalonic acid is increased in ______ deficient due to its function to convert MMA to succinyl CoA.

Vit B12--cobalamin

19

What is Cinchonism and what is it seen with?

headache and tinnitus that can occur with class 1A anti-arrhythmics

20

What translocation is associated with Ewing's sarcoma?

11;22

Blue anaplastic cells

21

What 2 test are specific for chronic granulomatous disease and what is defective in CGD?

Dihydrorhodamine--decreased green fluorescence
Nitroblue tetrazolium dye-- get a negative test because there is a lack of reactive O2 species

Defect of NADPH oxidase--> decreased reactive O2 species and decreased respiratory burst in neutrophils

More susceptible to Catalase + species

22

What disease presents with the triad of cerebellar defects (ataxia), spider angiomas (telangiectasia), and IgA deficiency?

Ataxia-telangiectasia

23

What artery does the vertebral artery come off of?

Subclavian

24

Where is the classic location of a schwannoma?

Cerebellopontine angle

25

What lab values will be seen with vit D deficiency?

Decreased serum Ca and PO4
Increased PTH

26

What is the major component of eosinophils?

Major basic protein

27

What substance leads to platelet aggregation and vasoconstriction in the setting of a DVT?

Increased thromboxane A2

28

______ is commonly elevated in patients with hepatocellular carcinoma?

a-fetoprotein

29

Pt with hereditary spherocytosis are most likely to present with elevated ________

Reticulocyte count -- RBCs are being destroyed at increased rate therefore bone marrow wants to increase amount of RBCs

30

What is the cell that is affected in vitiligo and where are they derived from?

Melanocytes derived from neural crest cells

31

When the tricuspid valve in affected in IV drug users what usually occurs and what type of murmur is present?

Tricuspid regurgitation -- Holosystolic, high pitched blowing murmur heard loudest at tricuspid area and radiates to right sternal border

32

What is the triad of graft-v-host disease and how long after transplant does rxn occur?

Dermatitis
Hepatitis
Gastroenteritis

Occurs wks post transplant

33

What are the characteristic cells seen with testicular seminoma?

Large cells in lobules with watery cytoplasm--"fried eggs"

34

What nerve trunk of the brachial plexus is affected with erb palsy and what muscle are affected?

Upper trunk- C5-C6

Deltoid
Supraspinatus
Infraspinatus
Biceps brachii

35

What vein comes off the portal system and feeds into the esophageal vein?

Left gastric vein --coronary vein

36

What antibiotic that is 1st line tx for uncomplicated UTIs can present with Megaloblastic anemia--enlarged RBCs and hypersegmented neutrophils?

TMP-SMX--MOA is inhibition of nucleotide synthesis

37

What are the X-linked recessive diseases?

"Oblivious Female Will Often Give Her Boys Her x-Linked Disorders"

Ornithine transcarbamylase deficiency
Fabry disease
Wiskott-Aldrich syndrome
Ocular Albinism
G6PD deficiency
Hunter syndrome
Bruton agammaglobulinemia
Hemophilia A and B
Lesch-Nyhan syndrome
Duchenne (and Becker) muscular dystrophy

38

What is the most common benzodiazepine used for delirium tremens caused by ETOH withdrawal?

Chlordiazepoxide

39

What surface marker is present on hematopoietic stem cells?

CD34

40

Normal pressure hydrocephalus can be caused by blockade of what venous drainage system?

Superior sagital sinus

41

What is 1st line tx for uncomplicated UTI when pt has sulfa allergy?

Nitrofurantoin