PastTest Flashcards
Use of Riluzole?
Tx for ALS that modestly increases survival
_____ and ______ are drugs used in the treatment of cancer and can both cause coronary artery vasospasm.
5FU, capecitabine (orally available form of 5FU)
______ presents w/ features of SLE, systemic sclerosis and/or polymyositis. It is associated w/ anti-U1 RNP antibodies.
Mixed connective tissue disorder. Characteristic initial presentation is Raynaud’s phenomenon and myalgia.
This class of immunosuppressants used in organ transplant can cause renal damage (nephrotoxicity) by causing constriction of afferent and efferent renal arterioles.
Calcineurin inhibitors such as cyclosporine. They act by preventing IL-2 transcription.
The dorsal optic radiation linking the LGN to the superior portion of the visual cortex runs in the ______ lobe, while the Meyer’s loop liking the LGN to the inferior portion of the visual cortex runs in the ______ lobe.
parietal, temporal.
______ supplies the vestibular and cochlear nuclei (located in the pons)
Anterior inferior cerebellar artery (AICA)
Schizophrenia symptoms (disorganized speech, delusions, hallucinations, disorganized or catatonic behavior, and negative sxs) lasting 1-6 months =
Schizophreniform disorder. If it is less than a month it is called “brief psychotic disorder.”
When does the centrosome replicate in the cell cycle?
During S phase
Distinguish between TTP, hemolytic uremic syndrome (HUS) and DIC
Difference btwn TTP and DIC is that TTP has a normal PT/PTT and DIC doesn’t. HUS is for kids and TTP is for adults and HUS doesn’t have neurologic changes. All three can have petechiae.
Where does GI absorption of B12 take place?
Terminal ileum. Deficiency causes subacute combined degeneration of the cord and megaloblastic anemia.
Electron microscopy of minimal change will show…
Effacement or flattening of podocyte foot processes.
What is Cri-du-chat syndrome? What causes?
It is a congenital abnormality characterized by the findings on microcephaly, moderate to severe intellectual disability, high-pitched crying/mewing, epicanthal folds and cardiac abnormalities (most commonly VSD). It is caused by a congenital microdeletion of the short arm of chromosome 5.
Which hypertensive agents are preferred for use during pregnancy (i.e. for pre-eclampsia)?
hydralazine, labetalol, methyldopa, nifedipine
Sarcoidosis is characterized by what finding on bronchoalveolar lavage? What other things are characteristic of this disease?
Elevated CD4+/CD8+ ratio. Causes an interstitial lung disease, non-caseating granulomas of affected organs (most commonly lungs), associated w/ uveitis and parotid gland enlargement.
Hemochromatosis or iron overload can cause which two types of cardiomyopathy?
Dilated (more common) cardiomyopathy and restrictive cardiomyopathy.
Deficiency is what enzyme leads to Lesch-Nyhan syndrome?
Deficiency in hypoxanthine-guanine phosphoribosyl transferase. This is an X-linked disorder characterized by retardation and self-mutilation.
Which CN palsy is seen in association w/ idiopathic intracranial cranial hypertension?
CN VI palsy. Causes failure of abduction of the eyes. Note that this condition is most commonly seen in young, obese women, and that the fundoscopy exam will demonstrate papilledema.
What is the “pringle maneuver?”
It is where you clamp the free border of the lesser omentum (aka the hepatoduodenal ligament) and thus constrict the hepatic artery and portal vein. Useful in trauma to assess where peritoneal bleeding is coming from.
Leukemic cells that have thin projections of the cytoplasm will stain positive for what specific marker?
TRAP +. This is describing hairy cell leukemia.
What is TdT a marker of? In what condition is it positive?
TdT is a marker of pre-B and pre-T cells. It is positive in ALL.
Myotonic dystrophy (characterized by hypotonia, muscle wasting, and frontal balding, as well as increased risk of cataract formation and cardiac conduction defects) is characterized by which trinucleotide repeat of which gene?
CTG of DMPK gene
What is the finding of a CT brain in hepatic encephalopathy?
In advanced stage there is cerebral edema that can lead to effacement of sulci and loss of grey-white differentiation.
What is the pathophysiology of adrenoleukodystrophy? How does it present?
It is an X-linked disorder that causes disruption of metabolism of very long chain fatty acids (VLCFAs). This causes them to accumulate in the CNS and adrenal gland. It presents w/ cognitive impairment, gait ataxia, diffuse UMN signs, and adrenal insufficiency.
What is Dejerine-Roussy Syndrome?
This is aka thalamic pain syndrome. It is where there is an ischemic (not sure if it can be another type) infarct of the thalamus that then eventually leads to long-standing, residual pain at the site of sensory sxs when the infarct occurred.
Name the two possible infarct locations that can lead to isolated, contralateral sensory loss.
Thalamus and subcortical white matter
What are the causes of non-gap acidosis?
Hyperalimentation, addison disease, renal tubular acidosis, diarrhea, acetazolamide, spironolactone, saline infusion. Think acronym HARDASS.
What does a characteristic finding of the CSF in MS pts?
Oligoclonal bands of IgG. This finding is specific, but not the most sensitive and as such the gold standard for dx is an MRI showing what matter lesions separated in space and time.
Additionally, myelin basic protein can be increased in the CSF of MS pts, particularly during periods of acute relapse.
What is the name of the drug that can be used in sickle cell pain crises that works by inhibiting ribonucleotide reductase?
Hydroxyurea. It can be also be used for melanoma and CML. It causes severe myelosuppression.
Bilateral schwannomas suggests a defect of what gene?
NF2 (neurofibromatosis type 2) (located on chromosome 22)
Some findings in CJDs in regards to EEG and CSF
EEG can show triphasic spike. CSF may show elevated 14-3-3 protein.
What is the equation for alveolar concentration of O2 (aka the alveolar gas equation)?
PAO2 = FiO2(Patm - PH20) - (PACO2/0.8)
*Note that if inspiring room are and at sea level, FiO2(Patm - PH20) = approximately 150 mm Hg
What is first line treatment for B-blocker overdose? How does it work?
Glucagon. It stimulated cAMP production independent of B-blockade and this leads to positive inotropic and chronotropic effects.
What is retinitis pigmentosa?
Progressive visual loss due to progressive cell death of the rod photoreceptors. Most commonly presents initially w/ difficulty seeing at night.
What is the clinical presentation of progressive supranuclear palsy?
Parkinsonism, cognitive decline, vertical saccades, poor response to levadopa.
What is Beck triad? When is it seen?
Triad of hypotension, distended neck veins and distant heart sounds. It is seen in cardiac tamponade.
Multiple endocrine neoplasia type 2b (MEN2b) is caused by an autosomal dominant mutation in the RET oncogene. How does this disease present? And what is the treatment?
Presentation = medullary carcinoma of the thyroid, mucosal neuroma, marfanoid habitus and pheochromocytoma. Tx = curative or prophylactic thyroidectomy.
What is Bartter syndrome?
It is a congenital cause of hyperaldosteronism w/ adrenal cortex hyperplasia caused by a mutation in NKCC2 gene. This codes for the Na/K/2Cl transporter that is affected by loop diuretics.
What is the etiology of the punched out, lytic bone lesions that are seen in multiple myeloma?
Results from the production of osteoclast activating factors like IL6 and TNF made by the neoplastic plasma cells.
