Pathophysiology Flashcards
(591 cards)
1
Q
gastrin: source
A
G cells
(antrum of stomach, duodenum)
2
Q
vitamin B12 deficiency: manifestations
A
macrocytic megaloblastic anemia
hypersegmented PMNs
paresthesias
subacute combined degeneration (dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts)
3
Q
CNI: name
A
olfactory nerve
4
Q
adrenal corticotropic hormone (ACTH): source
A
anterior pituitary
5
Q
gastric adenocarcinoma: characteristics findings
A
Virchow node: involvement of left supraclavicular node
Krukenberg tumor: bilateral metastases to ovaries with abundant mucin-secreting signet ring cells
sister Mary Joseph nodule: subcutaneous periumbilical metastasis
Blumer shelf: palpable mass on digital rectal exam
6
Q
concentric hypertrophy: major causes
A
pressure overload:
hypertension
aortic stenosis
7
Q
BCR-ABL mutation: associated conditions
A
CML
ALL
8
Q
palpable purpura on exam: likely diagnosis
A
vasculitis
9
Q
triceps reflex: associated nerve roots
A
C6-C8
10
Q
vitamin B6 deficiency: manifestations
A
peripheral neuropathy
sideroblastic anemia
convulsions
hyperirritability
11
Q
bulimia nervosa: first-line treatment
A
SSRI (specifically fluoxetine)
12
Q
redman syndrome: cause
A
vancomycin
13
Q
gastrosplenic ligament: connections
A
greater curvature of stomach to spleen
14
Q
first pharyngeal arch: cartilage derivatives
A
maxilla
zygomatic bone
mandible
meckel cartilage
malleus and incus
sphenomandibular ligament
15
Q
glucose-dependent insulinotropic peptide: regulation
A
increased by: fatty acids, amino acids, glucose
16
Q
elevated alpha-fetoprotein (AFP): associated conditions
A
neural tube defect
17
Q
TP53 mutation: associated conditions
A
Li-Fraumeni syndrome
most human cancers
18
Q
zones of adrenal cortex: hormones produced
A
zona glomerulosa: mineralocorticoids (aldosterone)
zone fasciculata: glucocorticoids (cortisol)
zone reticularis: androgens (DHEA)
19
Q
osteomyelitis with history of prosthetic joint replacement: likely pathogen
A
S epidermidis
S aureus
20
Q
A
21
Q
organized epithelioid histiocytes on histology: finding
A
granuloma
22
Q
“double bubble” on abdominal x-ray: condition
A
duodenal atresia
23
Q
anterior midline neck mass: most likely diagnosis
A
thyroglossal duct cyst
24
Q
Heberden vs. Bouchard nodes: location
A
Heberden: DIP
Bouchard: PIP
25
clozapine: feared side effect
neutropenia
26
skeletal muscle: key control variables for autoregulation
lactate
adenosine
K+
27
arm abduction: muscles and nerves responsible by degree of abduction
0-15: supraspinatus (suprascapular)
15-100: deltoid (axillary)
\>90: trapezius (spinal accessory)
\>100: serratus anterior (long thoracic)
28
mucous (myxoid) cyst: presentation
benign ganglion cyst, often at the DIP joints, fluctuant
29
lepromatous vs. tuberculoid leprosy: type of immunity
lepromatous: type 1 (cellular)
tuberculoid: type 2 (immune complex)
30
salicylate toxicity: treatment
sodium bicarbonate
31
cause?
exercise
32
RET mutation: associated conditions
MEN2A
MEN2B
papillary thyroid carcinoma
pheochromocytoma
33
third aortic arch: derivatives
common carotid artery
proximal part of internal carotid artery
34
NSTEMI: type of occlusion
subtotal occlusion
35
NSAIDS vs. ACE inhibitors: effect on glomerular filtration
NSAIDS: inhibit prostaglandins -\> inhibit dilation of afferent arteriole -\> decreased GFR
ACE inhibitors: inhibit ATII -\> inhibits constriction of efferent arteriole -\> decreased GFR
36
HLA-DQ2/DQ8: associated conditions
celiac disease
37
vasoactive intestinal peptide (VIP): source
hypothalamus
38
location of cardiac tamponade
serous pericardium
(between visceral pericardium (or epicardium) and parietal pericardium)
39
dopamine receptors: G-protein class
D1: Gs
D2: Gi
40
vitamin D: name
D3 (cholecalciferol)
D2 (ergocalciferol)
41
minimal change disease: microscopy findings
LM: normal
IF: negative
EM: effacement of podocyte foot processes
42
meningitis CSF findings: bacterial
increased opening pressure
**increased PMNs (neutrophils)**
increased protein
decreased glucose
43
gastrohepatic ligament: connections
liver to lesser curvature of stomach
44
diffuse systemic sclerosis: antibody
anti-Scl-70 (anti-DNA topoisomerase I)
anti-RNA polymerase III
45
first pharyngeal arch: muscle derivatives
muscles of mastication (temporalis, masseter, lateral & medial pterygoids)
mylohyoid
anterior belly of digastric
tensor tympani
anterior 2/3 of tongue
tensor veli palatini
46
condition?
aortic regurgitation
47
evolution of STEMI ECG changes: hyperacute timeframe
peaked T wave
48
diffuse systemic sclerosis: manifestations
widespread skin involvement
early visceral involvement (interstitial fibrosis, pulmonary HTN, renal crisis, CV)
rapid progression
calcinosis and Raynaud phenomenon are mild
49
heart contractility: major determinant
sympathetic tone
50
class I antiarrhythmics: effect on action potential duration
class IA: prolong
class IB: shorten
class IC: minimal effect
51
area of brain responsible for BP control
nucleus solitarius
52
restless leg syndrome: associated conditions
iron deficiency
CKD
53
adrenergic receptors: G-protein class
alpha-1: Gq
alpha-2: Gi
beta-1/2/3: Gs
54
WBC casts in urine: associated conditions
acute interstitial nephritis (AIN)
acute pyelonephritis
transplant rejection
55
HLA-DR4: associated conditions
RA
DM type 1
Addison disease
56
Libman-Sacks endocarditis: associated conditions
SLE
57
fluorescent lamp factory: toxicity risk
mercury poisoning
58
"olive-shaped" mass on abdominal exam: condition
pyloric stenosis
59
Calf pseudohypertrophy
Diagnosis?
Muscular dystrophy
60
cannon a wave: cause
atria contract against closed tricuspid valve:
complete heart block
ventricular tachycardia
premature ventricular contraction
61
asbestosis: area of lung affected
lower lobes
62
evolution of STEMI ECG changes: 1-2 days
T wave inversion
63
pulmonary hypertension: finding on venous pressure curve
large a wave
64
growth hormone releasing hormone (GHRH): source
hypothalamus
65
stroke in lenticulostriate artery: area of lesion
striatum
internal capsule
66
ventricular pseudoaneurysm: typical location
inferior wall
67
propylthiouracil vs. methimazole: safety in pregnancy
propylthiouracil: safe in pregnancy
methimazole: teratogenic
68
T wave inversion: potential cause
NSTEMI
STEMI
69
STEMI: type of occlusion
total occlusion
70
vitamin C deficiency: manifestations
"scurvy"
swollen gums
easy bruising
hemarthrosis
petechiae
poor wound healing
"corkscrew" hair
71
tooth discoloration: cause
tetracyclines
72
SA node: vascular supply
RCA artery
73
IgA nephropathy: microscopy findings
LM: mesangial proliferation
IF: granular IgA deposits in mesangium
EM: mesangial deposits
74
2nd degree heart block (Mobitz type I): ECG findings
progressively lengthening PR interval
dropped beats
75
posterior pituitary: hormones
vasopressin (anti-diuretic hormone (ADH))
oxytocin
76
free wall rupture: timeframe in ischemia
5-10 days
77
UTI: causes and diagnosis
E coli: leading cause; pink on MacConkey agar; +nitrite
staph saprophyticus: 2nd leading; sexually active women; -nitrite; +urease
Klebsiella: large mucoid capsule; +nitrite; +urease
serratia: red pigment; nosocomial; +nitrite; +urease
enterococcus: nosocomial; -nitrite; -urease
proteus: swarming motility; struvite stones; +nitrite; +urease
pseudomonas: blue-green pigment; +nitrite; -urease
78
poststreptococcal glomerulonephritis vs. IgA nephropathy: timing after strep throat
PSGN: 2-4 weeks after strep throat
IgA: concurrently with strep throat
79
Achilles reflex: associated nerve roots
S1 - S2
80
amyloidosis: glomerular microscopy findings
LM: apple-green birefringence on Congo red stain
81
night terrors: stage of sleep
non-REM stage 3
82
relationship between compliance and pulse pressure
decreased compliance -\> increased pulse pressure
83
lateral wall of LV: vascular supply
LCX artery
84
anterior wall of LV: vascular supply
LAD artery
85
posterior STEMI: ECG findings
ST elevations in V7-V9
anterior ST depressions
86
oxytocin: source
posterior pituitary
87
condition?
mitral regurgitation
88
vasopressin receptors: G-protein class
V1: Gq
V2: Gs
89
thyroid stimulating hormone (TSH): regulation
stimulated by:
TRH
inhibited by:
T4
T3
90
anemia: impact on blood viscosity
decrease
91
kidneys: key control variables for autoregulation
BP (via baroreceptors)
NaCl (via macula densa)
92
duodenal atresia: association
Down syndrome
93
cause?
vasopressors
94
acetylcholine: location of synthesis
basal nucleus of Meynert
95
antisocial personality disorder vs. conduct disorder
antisocial personality disorder: \>= 18 years old
conduct disorder: \<18 years old
96
enzymes requiring thiamine as cofactor
pyruvate dehydrogenase
alpha-ketoglutarate dehydrogenase
transketolase
branched-chain ketoacid dehydrogenase
97
measles: treatment
Vitamin A
98
vitamin B7: name
biotin
99
cortisol: source
adrenal cortex (zona fasciculata)
100
ALK mutation: associated conditions
lung adenocarcinoma
101
TCA toxicity: treatment
sodium bicarbonate
102
corticotropin releasing hormone (CRH): source
hypothalamus
103
Tinel sign: associated conditions
carpel tunnel syndrome
(tingling (pins and needles) after percussion of nerve on wrist)
104
globus sensation: cause
intense stress (e.g., divorce, etc)
105
vitamin B1 deficiency: manifestations
Wernicke encephalopathy (confusion, ophthalmoplegia, ataxia)
Korsakoff syndrome (confabulation, personality changes, memory loss)
dry beriberi (polyneuropathy, symmetric muscle wasting)
wet beriberi (dilated cardiomyopathy, edema)
106
vitamin B5: name
pantothenic acid
107
true ventricular aneurysm: timeframe in ischemia
weeks later
108
coal workers' pneumoconiosis: area of lung affected
upper lobes
109
MMR mutation: associated conditions
Lynch syndrome:
colorectal cancer
endometrial cancer
ovarian cancer
urinary tract
small intestinal
stomach
biliary cancer
110
left supraclavicular lymph node: drainage
abdomen
(may be a sign of cancer in the abdominal cavity)
111
follicle stimulating hormone (FSH): function
estrogen synthesis / follicle growth
spermatogenesis
112
total peripheral resistance: major determinants
vessels (compliance, tone, etc) - primarily arterioles
blood viscosity
113
acute gout: treatment
NSAIDS (particularly indomethacin)
114
prolactin: regulation
tonically inhibited by dopamine from hypothalamus
also inhibited by:
prolactin
stimulated by:
TRH
VIP
oxytocin
115
growth hormone (GH): function
stimulates linear growth (via release of IGF-1 from liver)
116
rapidly progressive glomerulonephritis Type I (Goodpasture syndrome): microscopy findings
LM: crescents
IF: linear deposits
117
ST elevation: timeframe in STEMI
acute
| (returns to normal in 3-7 days)
118
Wilson disease: treatment
penicillamine
119
vitamin A: name
retinal, retinol, retinoic acid
120
waxy casts in urine: associated conditions
ESRD
CKD
121
grey baby syndrome: cause
chloramphenicol
122
benzodiazepine toxicity: treatment
flumazenil
123
subendocardial ischemia: potential complications
stable angina
unstable angina
NSTEMI
124
CIN 1 vs. 2 vs. 3: definition
CIN 1: atypical cells occupy \<1/3 of epithelium
CIN 2: atypical cells occupy 1/3-2/3 of epithelium
CIN 3: atypical cells occupy 2/3-3/3 of epithelium
(extension below epithelium is diagnostic of invasive carcinoma)
125
first pharyngeal arch: nerve derivatives
CN V
126
inferior wall of LV: vascular supply
PDA artery
127
evolution of STEMI ECG changes: \>7 days
T wave returns to normal
128
somatic symptom disorder vs. illness anxiety disorder
somatic symptom disorder: significant anxiety about health in the presence of significant unexplained symptoms
illness anxiety disorder: significant anxiety about health without the presence of significant symptoms
129
cause?
decreased preload
130
Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities
Diagnosis?
McCune-Albright syndrome
131
Kawasaki disease: classic presentation
young, Asian child
involvement of skin, lips, and tongue (red rash, desquamating over palms and soles, strawberry tongue)
132
sixth aortic arch: derivatives
proximal part of pulmonary artery
ductus arteriosus (on left only)
133
Child uses arms to stand up from squat
Diagnosis?
Duchenne muscular dystrophy
134
APC mutation: associated conditions
colorectal cancer
familial adenomatous polyposis (FAP)
135
HLA-DR5: associated conditions
Hashimoto thyroiditis
136
cardiac tamponade: presentation
Becks triad (hypotension, distended neck veins, distant heart sounds)
electrical alternans (alternating high and low voltage QRS complexes) or just low-voltage QRS
pulsus paradoxus (fall in BP by \>10 mmHg during inspiration)
increased HR
137
posteromedial papillary muscle rupture: consequences
severe mitral regurgitation -\>
acute heart failure
138
anterior pituitary: hormones
growth hormone (GH)
prolactin (PRL)
luteinizing hormone (LH)
follicle stimulating hormone (FSH)
adrenocorticotropic hormone (ACTH)
thyroid stimulating hormone (TSH)
139
serotonin: location of synthesis
raphe nuclei (medulla, pons)
140
SMAD4 mutation: associated conditions
pancreatic cancer
141
stroke in middle cerebral artery: area of lesion
lateral motor and sensory cortices (face and upper limb)
temporal lobe (including Wernicke area)
frontal lobe (including Broca area)
142
anti-Scl-70 (anti-DNA topoisomerase I): associated conditions
diffuse systemic sclerosis
143
vitamin B6: name
pyridoxine
144
vitamin E: name
tocopherol
tocotrienol
145
KRAS mutation: associated conditions
colon cancer
lung cancer
pancreatic cancer
146
ASA-intolerant asthma: treatment
anti-leukotrienes
147
TSC1 mutation: associated conditions
tuberous sclerosis
148
stroke in anterior inferior cerebellar artery (AICA): area of lesion
lateral pons
(facial nucleus, vestibular nuclei, spinothalamic tract, spinal trigeminal nucleus, sympathetic fibers, middle and inferior cerebellar peduncles, labyrinthine artery)
149
spherocytosis: impact on blood viscosity
increase
150
adrenal medulla: hormones
epinephrine
norepinephrine
151
fatty casts in urine: associated conditions
nephrotic syndrome
hypothyroidism
AKI
152
dystrophin mutation: associated conditions
Duchenne muscular dystrophy
153
FMR1 mutation: associated condition
Fragile X syndrome
154
vitamin K: name
phytomenadione
phylloquinone
phytonadione
menaquinone
155
CNIII: name
oculomotor nerve
156
absent a wave: cause
no organized atrial contraction:
atrial fibrillation
157
c-KIT mutation: associated conditions
gastrointestinal stromal tumor (GIST)
158
scarlett fever vs. Kawasaki disease: presentation
both: children, fever, diffuse red rash, desquamation, strawberry tongue
scarlett fever: sore throat, sandpaper skin
159
salmonella osteomyelitis: empiric treatment
ceftriaxone
160
first aortic arch: derivatives
part of maxilary artery
161
v wave: cause
venous filling
162
berylliosis: area of lung affected
upper lobes
163
subtotal occlusion: potential complications
stable angina
unstable angina
NSTEMI
164
MEN1 mutation: associated conditions
MEN1
165
anti-Ro / SSA: associated conditions
Sjogren syndrome
166
nitroblue tetrazolium dye reduction test abnormality: diagnosis
chronic granulomatous disease
(defect of NADPH oxidase) -\>
susceptibility to catalase-positive organisms
167
evolution of STEMI ECG changes: acute timeframe
ST elevation
168
somatic symptom disorders vs. factitious disorders vs. malingering
somatic symptom disorders: symptoms are unconscious, motivation is unconscious (unexplained symptoms)
factitious disorders: symptoms are intentional, motivation is unconscious (patient consciously creates symptoms to get sympathy)
malingering: symptoms are intentional, motivation is intentional (patient consciously fakes disorder for a specific gain)
169
hypertension: type of hypertrophy
concentric hypertrophy
170
treatment-resistant psychosis: treatment
clozapine
171
meningitis CSF findings: fungal/TB
increased opening pressure
**increased lymphocytes**
increased protein
**decreased glucose**
172
unstable angina: ECG findings
ST depression
173
foramen cecum: what is it?
dimple at the back of the tongue, thought to be a normal remnant of the thyroglossal duct
174
growth hormone (GH): regulation
stimulated by:
GHRH
exercise
deep sleep
inhibited by:
IGF-1
somatostatin
glucose
175
neonatal respiratory distress syndrome: risk factors
prematurity
maternal diabetes (due to increased fetal insulin)
C-section delivery (due to decreased release of fetal glucocorticoids)
176
hyaline casts in urine: associated conditions
nonspecific - often normal
177
movement of essential tremor vs. Parkinson disease
essential tremor: worsened with movement
Parkinson disease: alleviated by movement
178
inferior myocardial infarction: treatment consideration
if bradycardia or AV block are present, do not use beta blockers
if RV is impacted, do not use nitrates
179
ectopic thyroid tissue: most common site
tongue
180
medial vs. lateral epicondylitis: movements that elicit pain
medial epicondylitis: pain with wrist flexion against resistance, passive wrist extension
lateral epicondylitis: pain with wrist extension against resistance, passive wrist flexion
181
Arachnodactyly, lens dislocation (upward and temporal), aortic dissection, hyperflexible joints
Diagnosis?
Marfan syndrome
182
vitamin B3: name
niacin
183
Crohn disease vs. UC: area of GI tract
CD: any portion, usually terminal ileum and colon, skip lesions, rectal sparing
UC: continuous colonic lesion, always rectal involvement
184
osteomyelitis with history of sickle cell disease: likely pathogen
salmonella typhi
S aureus
185
cataplexy: neurotransmitter involved
norepinephrine
186
Dressler syndrome: timeframe in ischemia
weeks later
187
CDKN2A mutation: associated conditions
melanoma
pancreatic cancer
188
evolution of STEMI ECG changes: hours
Q wave
189
condition?
aortic regurgitation
190
brain: key control variables for autoregulation
CO2
pH
191
aortic arch baroreceptors: type of BP sensed
high blood pressure only
| (not good at sensing low BP)
192
PTEN mutation: associated conditions
prostate cancer
breast cancer
endometrial cancer
193
true ventricular aneurysm: typical location
anterior wall
194
second pharyngeal arch: nerve derivatives
CN VII
195
essential tremor: treatment
propranolol
196
carotid sinus baroreceptors: type of BP sensed
both high and low blood pressure
197
primary vs. secondary vs. tertiary intention in wound healing: definitions
primary intention: full approximation of edges of a wound, minimal scar
secondary intention: not possible to join skin, larger scar
tertiary intention: wound is left open initially, and then closed later
198
osteomyelitis with history of IV drug use: likely pathogen
S aureus
pseudomonas
candida
199
anti-La / SSB: associated conditions
Sjogren syndrome
200
homocystinuria: causes and treatment
cystathionine synthase deficiency (treat by decreasing dietary methionine; instead increase cysteine, B6, B12, and folate)
methionine synthase deficiency (treat by increasing dietary methionine)
201
gastrin: regulation
increased by: stomach distention, stomach alkalinization, vagal stimulation
decreased by: pH \<1.5
202
rhabdomyolysis: electrolyte abnormalities
hyperkalemia (released from intracellular space)
hypocalcemia
hyperphosphatemia
203
hypothalamus: hormones
growth hormone releasing hormone (GHRH)
gonadotropin releasing hormone (GnRH)
corticotropin releasing hormone (CRH)
TSH releasing hormone (TRH)
vasoactive intestinal peptide (VIP)
somatostatin (SS)
dopamine (DA)
204
cardiac output: equation
CO = SV \* HR
205
bacterial meningitis in neonates \<6 months: most common causes
strep agalactiae
E. coli
listeria monocytogenes
206
y descent: cause
emptying of the atrium after tricuspid valve opens
207
secretin: regulation
increased by: acid and fatty acids in lumen of duodenum
208
anti-dsDNA: associated conditions
SLE
209
adrenal cortex: hormones
glucocorticoids (cortisol)
mineralocorticoids (aldosterone)
androgens
210
amino acid hormone: hydrophilic/hydrophobic?
could be either
211
Q wave: timeframe in STEMI
hours
| (remains forever)
212
apex of heart: vascular supply
LAD artery
213
third pharyngeal arch: nerve derivatives
CN IX
214
acetaminophen toxicity: treatment
N-acetylcysteine
215
drug-induced pancreatitis: common causes
NRTIs (specifically didanosine)
valproic acid
sulfa drugs (specifically loop and thiazide diuretics)
corticosteroids
216
increased susceptibility to Neisseria infections
deficiencies in MAC complement proteins (C5-C9)
217
Prader-Willi syndrome vs. Angelman syndrome
Prader-Willi: paternal copy of gene is mutated/deleted
Angelman syndrome: maternal copy of gene is mutated/deleted
218
dopamine: location of synthesis
ventral tegmentum
substantia nigra pars compacta
219
condition?
mitral stenosis
220
anterior vs. posterior pituitary: embryologic origin
anterior: oral ectoderm (Rathke pouch)
posterior: neuroectoderm
221
CK-MB: timeframe of elevation in NSTEMI
increases 4-6 hours after MI
normalizes within 2-3 days
222
endocrine pancreas: hormones
insulin
glucagon
somatostatin
223
somatostatin: source
D cells
| (pancreatic islets, GI mucosa)
224
glucose-dependent insulinotropic peptide: source
K cells
| (duodenum, jejunum)
225
tamponade: timeframe in ischemia
5-10 days
226
posteromedial papillary muscle: vascular supply
PDA artery
227
second aortic arch: derivatives
stapedial artery
hyoid artery
228
polycythemia: impact on blood viscosity
increase
229
meningitis CSF findings: glucose
bacterial: decreased
fungal/TB: decreased
viral: normal
230
Crohn disease vs. UC: microscopy
CD: noncaseating granulomas, lymphoid aggregates
UC: crypt abscesses and ulcers, no granulomas
231
aortic regurgitation: type of hypertrophy
eccentric hypertrophy
232
histamine receptors: G-protein class
H1: Gq
H2: Gs
233
stroke in posterior inferior cerebellar artery (PICA): symptoms
lateral medullary (Wallenberg) syndrome
dysphagia, hoarseness, decreased gag reflex, hiccups
234
AV dissociation: finding on venous pressure curve
cannon a wave
235
complications of ischemia: weeks later
Dressler syndrome
true ventricular aneurysm
LV thrombus
236
aortic arch baroreceptors: cranial nerve
CN X (vagus)
237
cholecystokinin: regulation
increased by: fatty acids, amino acids
238
gonadotropin releasing hormone (GnRH): source
hypothalamus
239
iron toxicity: treatment
deferoxamine
240
CNII: function
visual acuity
241
fat soluble vitamins
ADEK
242
sixth pharyngeal arch: muscle derivatives
all intrinsic muscles of larynx except cricothyroid
243
vitamin E deficiency: manifestations
hemolytic anemia
acanthocytosis
muscle weakness
decreased position and vibration sensation
ataxia
244
right ventricular infarction: clinical hallmarks
elevated JVP
hypotension
245
membranoproliferative glomerulonephritis Type I: microscopy findings
LM: "tram tracks" due to mesangial ingrowth and GBM splitting
IF: subendothelial deposits due to IgG and C3
246
small vessel vasculitis: types
Behcet syndrome
cutaneous small-vessel vasculitis
eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
granulomatosis with polyangiitis (Wegener)
IgA vasculitis
microscopic polyangiitis
mixed cryoglobulinemia
247
osteomyelitis with history of cat/dog bite: likely pathogen
pasteurella multocida
248
condition?
mitral regurgitation
249
serotonin syndrome vs. neuroleptic malignant syndrome manifestations
both have: high fever, hypertension, tachycardia, agitation, sweating, increased muscle tone
SS has: hyperreflexia, clonus, hyperactive bowel sounds
NMS has: hyporeflexia, norma/hypoactive bowel sounds
250
high blood pressure: sensed by which baroreceptors?
aortic arch and carotid sinus
251
mechanisms to decrease preload
remove volume
increase HR
pool blood in veins (nitrates)
252
cholecystokinin: source
I cells
| (duodenum, jejunum)
253
vitamin B2 deficiency: manifestations
cheilosis (inflammation of lips, scaling/fissures at corners of mouth)
corneal vascularization
254
complications of ischemia: first 4 days
arrhythmia
255
causes of torsades de pointes: electrolyte abnormalities
hypokalemia
hypomagnesemia
hypocalcemia
256
giant v wave: cause
tricuspid regurgitation
257
liver failure: mechanism of edema
decreased plasma proteins (oncotic pressure)
258
bruxism: stage of sleep
non-REM stage 2
259
temporal arteritis: classic presentation
elderly female
headache
pain on chewing
high ESR
260
dermatitis herpetiformis: first-line Tx
dapsone
261
neural crest cells: embryologic derivatives
melanocytes
PNS ganglia (cranial, dorsal root, autonomic)
adrenal medulla
schwann cells
bones of the viscerocranium (maxilla, mandible, etc)
outflow tract of the heart (aorticopulmonary septum)
262
cortisol: regulation
stimulated by: ACTH from pituitary (via CRH from hypothalamus)
inhibited by: cortisol (via negative feedback on ACTH and CRH production)
263
complications of ischemia: 5-10 days
free wall rupture
tamponade
papillary muscle rupture
ventricular pseudoaneurysm
septal rupture
fibrinous pericarditis
264
squamous cell carcinoma of lung: associated paraneoplastic syndromes
hypercalemia (due to PTHrP)
265
total occlusion: potential complications
STEMI
266
polyarteritis nodosa: size of vessels involved
medium vessels
267
N-myc mutation: associated conditions
neuroblastoma
(derived from neural crest)
(most commonly in adrenal gland)
268
LAD: territory
anterior wall
anterior septum
apex
anterolateral papillary muscle
269
FXN mutation: associated condition
Friedreich ataxia
270
3rd degree heart block: ECG findings
no association between P waves and QRS complexes
271
HER2 mutation: associated conditions
breast carcinoma
gastric carcinoma
272
NSTEMI: ECG findings
ST depression
T wave inversion
273
tricuspid regurgitation: finding on venous pressure curve
giant v wave
274
multiple myeloma: impact on blood viscosity
increase
275
NF2 mutation: associated conditions
neurofibromatosis type 2
276
Crohn disease vs. ulcerative colitis: presence of extra-intestinal manifestations
CD: more likely
UC: less likely
277
AV node: vascular supply
RCA artery
278
diabetic glomerulonephropathy: microscopy findings
LM: Kimmelstiel-Wilson nodules (nodular sclerosis), mesangial expansion, GBM thickening
279
lipofuscin: appearance
yellow-brown deposits in multiple organs found in elderly
(part of a normal aging process)
280
aortic stenosis: type of hypertrophy
concentric hypertrophy
281
condition?
hemorrhage
282
toxins: mechanism of edema
increased capillary permeability
283
follicle stimulating hormone (FSH): source
anterior pituitary
284
vitamin B12: site of absorption
terminal ileum
285
Takayasu arteritis: classic presentation
young, Asian female
weak pulses in one arm
BP difference between arms
bruits over arteries
high ESR
286
inferior septum of heart: vascular supply
PDA artery
287
second pharyngeal arch: muscle derivatives
muscles of facial expression
stapedius
stylohyoid
platysma
posterior belly of digastric
288
prolactin: source
anterior pituitary
289
thyroid: hormones
thyroxine (T4)
triiodothyronine (T3)
calcitonin
290
cholinergic receptors: G-protein class
M1: Gq
M2: Gi
M3: Gq
291
cardiac output: major determinants
preload
afterload
contractility
heart rate
292
transmural ischemia: potential complications
STEMI
293
gastrocolic ligament: connections
greater curvature of stomach to transverse colon
294
fourth aortic arch: derivatives
left: aortic arch
right: proximal part of right subclavian artery
295
SMN1 mutation: associated condition
spinal muscular atrophy
296
CD55/59 negative RBCs on flow cytometry: diagnosis
paroxysmal nocturnal hemoglobinuria
297
c diff: treatment
oral vancomycin
298
heart rate: major determinant
sympathetic tone
299
poststreptococcal glomerulonephritis: microscopy findings
LM: enlarged and hypercellular glomeruli
IF: "starry sky" granular appearance due to IgG, IgM, and C3
EM: subepithelial humps
300
RBC casts in urine: associated conditions
glomerulonephritis
hypertensive emergency
contact sports
301
heart: key control variables for autoregulation
CO2
adenosine
NO
302
somatostatin: regulation
increased by: acid
decreased by: vagal stimulation
303
evolution of STEMI ECG changes
peaked T wave (hyperacute)
ST elevation (acute)
Q wave (hours)
T wave inversion (1-2 days)
ST segment returns to baseline (3-7 days)
T wave returns to normal (\>7 days)
Q wave remains
304
luteinizing hormone (LH): source
anterior pituitary
305
VHL mutation: associated conditions
von Hippel-Lindau disease
306
fibrinous pericarditis: timeframe in ischemia
5-10 days
307
DCC mutation: associated conditions
colon cancer
308
NF1 mutation: associated conditions
neurofibromatosis type 1
309
loop vs. thiazide vs. K-sparing diuretics: labs
loop: hypokalemia, **hypocalcemia**, hypomagnesemia
thiazide: hypokalemia, **hypercalemia**, hyperuricemia, hyperglycemia, hyperlipidemia
K-sparing: **hyperkalemia**
310
vitamin A deficiency: manifestations
night blindness
dry scaly skin
Bitot spots (due to corneal squamous metaplasia)
corneal degeneration
immunosuppression
311
CYP450 inducers
phenytoin
phenobarbital
rifampin
carbamazepine
griseofulvin
St. Johns wort
312
Paget disease of bone: labs
Ca: normal
phosphate: normal
alk phos: increased
PTH: normal
313
splenorenal ligament: connections
spleen to left pararenal space
314
iron: site of absorption
duodenum
315
meningitis CSF findings: protein
bacterial: increased
fungal/TB: increased
viral: normal/increased
316
PKD2 gene: chromosome
chromosome 4
(15% of autosomal dominant polycystic kidney disease)
317
hepatoduodenal ligament: connections
liver to duodenum
318
GABA: location of synthesis
nucleus accumbens
319
systolic blood pressure: major determinant
stroke volume
320
T wave inversion: timeframe in STEMI
1-2 days
| (returns to normal in \>7 days)
321
ejection fraction: equation
EF = SV / EDV
322
cause?
decreased contractility
323
condition?
aortic stenosis
324
Alport syndrome: microscopy findings
EM: "basket-weave" due to irregular thickening of GBM
325
third pharyngeal arch: cartilage derivatives
greater horn of hyoid
326
LCX artery: territory
lateral wall of left ventricle
anterolateral papillary muscle
327
second pharyngeal arch: cartilage derivatives
stapes
styloid process
lesser horn of hyoid
stylohyoid ligament
328
vitamin K deficiency: manifestations
neonatal hemorrhage
increase PT and aPTT
329
thyroid stimulating hormone (TSH): function
release of T4 and T3 from thyroid
330
left main STEMI: ECG findings
ST elevation in aVR
diffuse ST depressions elsewhere
331
infectious vs. malignant process: lymph node findings
infectious: soft, mobile, painful
malignant: hard, non-mobile, non-tender
332
kawasaki disease: treatment
IV immunoglobulin
aspirin
333
acute stress disorder vs. post-traumatic stress disorder: timeline
acute stress disorder: \<1 month
post-traumatic stress disorder: \>1 month
334
heart failure: mechanism of edema
increased capillary hydrostatic pressure
335
lateral collateral ligaments of the foot: weakest (and most easily injured)
anterior talofibular ligament
336
CO poisoning: mechanism of toxicity
CO has an extremely high binding affinity for heme, displacing O2
337
zones of the liver: causes of damage
zone I: viral hepatitis, injected toxins (cocaine)
zone II: yellow fever
zone III: ischemia, alcoholic hepatitis, metabolic toxins (ethanol, acetaminophen, rifampin, etc)
338
fourth/sixth pharyngeal arches: cartilage derivatives
arytenoids
cricoid
corniculate
cuneiform
thyroid
339
coal workers' pneumoconiosis: appearance on CXR
small, rounded nodules in upper lobes
340
biceps and brachioradialis reflexes: associated nerve roots
C5-C6
341
flow equation (for blood)
ΔP = CO \* TPR
342
Kawasaki disease: feared complication
coronary artery aneurysm
343
anterior septum of heart: vascular supply
LAD artery
344
HLA-DR3: associated conditions
Graves disease
SLE
DM type 1
Hashimoto thyroiditis
Addison disease
345
hemochromatosis: treatment
deferoxamine
phlebotomy
346
meningitis CSF findings: viral
**normal**/increased opening pressure
increased lymphocytes
**normal**/increased protein
**normal glucose**
347
positive technetium-99-pertechnetate scan: diagnosis?
Meckel diverticulum
348
PDA artery: territory
inferior wall of LV
inferior septum of heart
posteromedial papillary muscle
349
decreased alpha-fetoprotein (AFP): associated conditions
Down syndrome
trisomy 18
350
osteomyelitis with no significant history: likely pathogen
S aureus
351
anterolateral papillary muscle: vascular supply
LAD artery + LCX artery
352
sixth pharyngeal arch: nerve derivatives
CN X (recurrent/inferior laryngeal branch)
353
osteomyelitis with history of vertebral involvement: likely pathogen
M tuberculosis (Pott disease)
S aureus
354
cause?
increased afterload
355
vitamin B3 deficiency: manifestations
diarrhea
dermatitis
dementia
356
CNI: function
olfaction
357
mitral regurgitation: type of hypertrophy
eccentric hypertrophy
358
papillary muscle rupture: timeframe in ischemia
5-10 days
359
mechanisms to increase preload
add volume (blood transfusion, IV fluids)
slow HR
constrict veins (sympathetic stimulation, alpha-1)
360
stroke in basilar artery: area of lesion
pons, medulla, lower midbrain
corticospinal and corticobulbar tracts
ocular cranial nerve nuclei, paramediam pontine reticular formation
361
WT1 gene: chromosome
chromosome 11
| (Wilms tumor)
362
Elastic skin, hypermobility of joints, increased bleeding tendency
Diagnosis?
Ehlers-Danlos syndrome
363
pathogens that cause osteomyelitis
S aureus (most common)
Neisseria gonorrhea (sexually active)
salmonella typhi (sickle cell disease)
S epidermidis (prosthetic joint replacement)
M tuberculosis (vertebral involvement)
Pasteurella multocida (dog/cat bite)
pseudomonas (IV drug use)
candida (IV drug use)
364
HLA-C: associated conditions
psoriasis
365
parathyroid: hormones
parathyroid hormone (PTH)
366
delirium: neurotransmitter abnormalities
dopamine excess
acetylcholine suppression
367
anti-histone antibody: associated conditions
drug-induced lupus
368
low blood pressure: sensed by which baroreceptors?
carotid sinus only
(aortic arch not good at sensing low BP)
369
silicosis: area of lung affected
upper lobes
370
mechanisms to decrease afterload
decrease mean BP
treat aortic valve disease or hypertrophic cardiomyopathy
371
meningitis CSF findings: cell type
bacterial: PMNs (neutrophils)
fungal/TB: lymphocytes
viral: lymphocytes
372
pancreatic adenocarcinoma: associated paraneoplastic syndromes
Trousseau syndrome (migratory superficial thrombophlebitis)
nonbacterial thrombotic endocarditis
373
2nd degree heart block (Mobitz type II): ECG findings
unchanging PR interval (usually normal but can be prolonged)
dropped beats
374
BRAF mutation: associated conditions
melanoma
non-Hodgkin lymphoma
papillary thyroid cancer
hairy cell leukemia
375
remains elevated for weeks after MI: which cardiac biomarker?
troponins
376
normalizes in 2-3 days after MI: which cardiac biomarker?
CK-MB
377
arrhythmia: timeframe in ischemia
first 4 days
378
condition?
heart failure
379
cauda equina syndrome: presentation
lower motor neuron lesions in lower extremities (loss of knee and ankle reflexes)
saddle anesthesia
loss of bladder and anal sphincter control
380
mean arterial pressure: equation
MAP = DBP + 1/3 \* (SBP - DBP)
MAP = DBP + 1/3 \* PP
MAP = (2 \* DBP + SBP) / 3
381
stroke in anterior inferior cerebellar artery (AICA): symptoms
lateral pontine syndrome
paralysis of face, decreased lacrimation, decreased salivation, decreased taste from anterior 2/3 of tongue
382
limited systemic sclerosis: manifestations
CREST syndrome
calcinosis cutis
Raynaud phenomenon
esophageal dysmotility
sclerodactyly
telangiectasia
383
vitamin B9 deficiency: manifestations
macrocytic megaloblastic anemia
glossitis
hypersegmented PMNs
NO neurologic symptoms
384
cause?
decreased compliance
385
anti-Jo-1: associated conditions
polymyositis
dermatomyositis
386
vasopressin (anti-diuretic hormone (ADH)): source
posterior pituitary
387
HLA-A3: associated conditions
hemochromatosis
388
opioid toxicity: treatment
naloxone
389
anti-CCP: associated conditions
RA
390
epithelial casts in urine: associated conditions
renal tubular necrosis
viral disease (CMV nephritis)
391
membranoproliferative glomerulonephritis Type II: microscopy findings
LM: "tram track" due to mesangial ingrowth and GBM splitting
IF: intramembranous deposits due to C3 only
392
secretin: source
S cells
| (duodenum)
393
vitamin B5 deficiency: manifestations
dermatitis
enteritis
alopecia
adrenal insufficiency
394
infection: mechanism of edema
increased capillary permeability
395
stroke volume: equation
SV = EDV - ESV
396
pulse pressure: equation
PP = SBP - DBP
397
GnRH: function
stimulates release of FSH and LH from the anterior pituitary
398
PKD1 gene: chromosome
chromosome 16
(85% of autosomal dominant polycystic kidney disease)
399
variceal bleeding prophylaxis: treatment
non-selective beta blockers
400
medium-vessel vasculitis: types
Buerger disease (thromboangiitis obliterans)
Kawasaki disease (mucocutaneous lymph node syndrome)
polyarteritis nodosa
401
Buerger disease: classic presentation
male smoker
gangrene and autoamputation of digits
Raynaud phenomenon
tender nodules over course of veins
402
exuberant callus formation: association
corticosteroid-induced osteoporosis
403
stroke in anterior cerebral artery: area of lesion
medial motor and sensory cortices (lower limbs)
404
flushing, diarrhea, tricuspid regurgitation, pulmonic stenosis
diagnosis?
carcinoid syndrome
405
Buerger disease (thromboangiitis obliterans): size of vessels involved
medium vessels
406
high blood viscosity: causes
polycythemia
multiple myeloma
spherocytosis
407
cause?
increased contractility
408
troponins: timeframe of elevation in NSTEMI
increases 2-4 hours after MI
stays elevated for weeks
409
prolactin: function
stimulates milk production
inhibits ovulation/spermatogenesis (via inhibition of GnRH release)
410
VIP: function
stimulates release of prolactin from anterior pituitary
411
hydrocephalus: types
communicating hydrocephalus: decreased CSF absorption
normal pressure hydrocephalus: idiopathic and affects elderly; causes classic triad of urinary incontinence, gait apraxia, and cognitive dysfunction (wet, wobbly, and wacky)
non-communicating hydrocephalus: structural blockage
412
TSC2 mutation: associated conditions
tuberous sclerosis
413
fourth pharyngeal arch: nerve derivatives
CN X (superior laryngeal branch)
414
glomus tumor: associated conditions
neurofibromatosis type 1
415
CRH: function
stimulates release of ACTH from anterior pituitary
416
eccentric hypertrophy: major causes
volume overload:
aortic regurgitation
mitral regurgitation
cardiomyopathies
417
gold mining factory: toxicity risk
mercury poisoning
418
c wave: cause
tricuspid valve closure
419
silicosis: appearance on CXR
"eggshell" calcification of hilar lymph nodes
may have numerous small opacities
420
condition?
mitral stenosis
421
DMPK mutation: associated condition
myotonic dystrophy
422
unstable angina: type of ischemia
subendocardial ischemia
423
stable angina: type of ischemia
subendocardial ischemia
424
small cell lung cancer: associated paraneoplastic syndromes
Cushing syndrome (due to ACTH)
hyponatremia (SIADH)
cerebellar degeneration (anti-Hu antibodies)
encephalomyelitis (anti-Hu antibodies)
Lambert-Eaton myasthenic syndrome (presynaptic Ca channel antibodies)
425
vitamin B12: name
cobalamin
426
acute vs. chronic alcohol use: effect on CYP450
acute: inhibition of CYP450
chronic: induction of CYP450
427
PKHD1 gene: chromosome
chromosome 6
(autosomal recessive polycystic kidney disease)
428
stroke in posterior inferior cerebellar artery (PICA): area of lesion
lateral medulla
(nucleus ambiguus, vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, sympathetic fibers, inferior cerebellar peduncle)
429
Crohn disease vs. UC: gross morphology
CD: transmural inflammation, fistulas, cobblestone mucosa
UC: mucosal/submucosal only, loss of haustra
430
Gout, intellectual disability, self-mutilating behavior in a boy
Diagnosis?
Lesch-Nyhan syndrome
431
AFB: meaning
acid-fast bacillus
432
a wave: cause
atrial contraction
433
fourth pharyngeal arch: muscle derivatives
most pharyngeal constrictors
cricothyroid
levator veli palatini
434
autosomal dominant vs. recessive polycystic kidney disease: time of presentation
ADPKD: 40-50 years old
ARPKD: infancy
435
ventricular tachycardia: finding on venous pressure curve
cannon a wave
436
focal segmental glomerulosclerosis: microscopy findings
LM: segmental sclerosis and hyalinosis
IF: negative, or nonspecific deposits
EM: effacement of podocyte foot processes
437
thyroid stimulating hormone (TSH): source
anterior pituitary
438
c-MYC mutation: associated conditions
Burkitt lymphoma
439
ST depression: potential cause
unstable angina
NSTEMI
440
large a wave: cause
increased atrial contraction pressure:
tricuspid stenosis
pulmonary hypertension
441
subluxation of the lens: causes (and direction)
Marfan syndrome: upward and outward
homocystinuria: downward and inward
442
evolution of STEMI ECG changes: 3-7 days
ST segment returns to baseline
443
growth hormone (GH): source
anterior pituitary
444
fibrillin mutation: associated condition
Marfan syndrome
445
vitamin C: name
ascorbic acid
446
afterload: major determinants
blood pressure
stiffness of aortic valve
447
condition?
aortic stenosis
448
1st degree heart block: ECG findings
prolonged PR interval
no dropped beats
449
right coronary artery: territory
SA node
AV node
450
HLA-B8: associted conditions
Addison disease
myasthenia gravis
Graves disease
451
granular "muddy brown" casts in urine: associated conditions
acute tubular necrosis (ATN)
452
Kaposi sarcoma: treatment
combination HAART
453
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Diagnosis?
Kartagener syndrome
454
decrease in blinking frequency: associated condition
Parkinson disease
455
HLA-B27: associated conditions
psoriatic arthritis
ankylosing spondylitis
reactive arthritis
IBD-associated arthritis
456
meningitis: common causes by age
0-6mo: GBS, E coli, listeria
6mo-6yr: S pneumo, N meningitis, H flu type b, GBS, enteroviruses
6-60 yr: N meningitidis, S pneumo, enteroviruses, HSV
\>60yr: S pneumo, N meningitidis, H flu type b, GBS, listeria
457
nephrotic syndrome: mechanism of edema
decreased plasma proteins (oncotic pressure)
458
Kawasaki disease (mucocutaneous lymph node syndrome): size of vessels involved
medium vessels
459
ventricular pseudoaneurysm: timeframe in ischemia
5-10 days
460
low blood viscosity: causes
anemia
461
vitamin B2: name
riboflavin
462
direct inguinal hernia: iatrogenic cause
damage to iliohypogastric or ilioinguinal nerves
(often during appendectomy surgery)
463
giant cell (temporal) arteritis: size of vessels involved
large vessels
464
meningitis CSF findings: opening pressure
bacterial: increased
fungal/TB: increased
viral: normal/increased
465
NSTEMI: type of ischemia
subendocardial ischemia
466
vitamin B1: name
thiamine
467
large-vessel vasculitis: types
giant cell (temporal) arteritis
Takayasu arteritis
468
lymphatic blockage: mechanism of edema
increased interstitial oncotic pressure
469
WT1 mutation: associated conditions
Wilms tumor (nephroblastoma)
470
burn: mechanism of edema
increased capillary permeability
471
stroke in posterior cerebral artery: area of lesion
occipital lobe
472
LV thrombus: timeframe in ischemia
weeks later
473
c-ANCA (PR3-ANCA): associated conditions
granulomatosis with polyangiitis (Wegener)
474
zinc factory: toxicity risk
cadmium poisoning
475
septal rupture: timeframe in ischemia
5-10 days
476
vitamin B12 deficiency: diagnosis
high methylmalonic acid
477
fixed splitting of S2: diagnosis
ASD
478
479
BRCA mutation: associated conditions
breast cancer
ovarian cancer
pancreatic cancer
480
osteopetrosis: labs
Ca: normal/increased
phosphate: normal
alk phos: normal
PTH: normal
481
norephinephrine: location of synthesis
locus ceruleus
482
BCL-2 mutation: associated conditions
follicular large B cell lymphoma
diffuse large B cell lymphoma
483
tricuspid stenosis: finding on venous pressure curve
large a wave
484
poor R wave progression on ECG: association
anterior ischemia
485
spots with a blue-white center on buccal mucosa
diagnosis?
Koplik spots
| (likely measles)
486
hydroxychloroquine in psoriasis
HCQ can worsed psoriasis rashes
487
anti-Smith: associated conditions
SLE
488
anti-microsomal antibody: associated conditions
Hashimoto thyroiditis
489
yellow vision: cause
digoxin
490
TSH releasing hormone (TRH): source
hypothalamus
491
cause?
increased preload
492
osteomyelitis with history of sexual activity: likely pathogen
neisseria gonorrhea
493
JAK2 mutation: associated conditions
chronic myeloproliferative disorders
494
anti-centromere antibody: associated conditions
limited systemic sclerosis
495
x descent: cause
atrial relaxation
496
vitamin B9: name
folate
497
CNII: name
optic nerve
498
essential amino acids
PVT TIM HaLL
phenylalanine
valine
tryptophan
threonine
isoleucine
methionine
histidine
leucine
lysine
499
tension in LV: determinants
tension = (pressure \* radius) / 2\*wall thickness
500
Rb mutation: associated conditions
retinoblastoma
osteosarcoma
501
hyperkalemia: treatment
insulin
beta agonist
502
healthy until 6 months of age, followed by frequent infections: process?
maternal antibodies are protective until about 6 months
think Brutons agammaglobulinemia
503
p-ANCA (MPO-ANCA): associated conditions
microscopic polyangiitis
eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
504
patellar reflex: associated nerve roots
L2-L4
505
Takayasu arteritis: size of vessels involved
large vessels
506
vitamin D deficiency: manifestations
rickets (children) - deformity, "bowlegs"
osteomalacia (adults) - bone pain, muscle weakness
507
membranous nephropathy: microscopy findings
LM: GBM thickening
IF: granular deposits
EM: "spike and dome" subepithelial deposits
508
oxytocin: function
causes uterine contractions during labor
ejection of milk from breast ductules
509
atrial fibrillation: finding on venous pressure curve
absent a wave
510
adrenal cortex vs. medulla: embryologic origin
cortex: mesoderm
medulla: neural crest
511
stable angina: type of occlusion
subtotal occlusion
512
mechanisms to increase afterload
raise mean BP
obstruct outflow of LV
513
STEMI: type of ischemia
transmural ischemia
514
osteoporosis: labs
Ca: normal
phosphate: normal
alk phos: normal
PTH: normal
515
anticholinesterase poisoning: treatment
atropine
516
unstable angina: type of occlusion
subtotal occlusion
517
peaked T wave: timeframe in STEMI
hyperacute
518
Turner syndrome: manifestations
short stature
streak ovaries
wide chest
coarctation of aorta
webbed neck
horseshoe kidney
amenorrhea
519
STEMI: ECG findings
ST elevation
T wave inversion
Q wave
peaked T wave
520
CYP450 inhibitors
valproic acid
isoniazid
cimetidine
erythromycin
clarithromycin
ciprofloxacin
omeprazole
metronidazole
amiodarone
grapefruit juice
521
HLA-DR2: associated conditions
MS
SLE
Goodpasture syndrome
hay fever
522
carotid sinus baroreceptors: cranial nerve
CN IX (glossopharyngeal)
523
third pharyngeal arch: muscle derivatives
stylopharyngeus
524
peptide hormone: hydrophilic/hydrophobic?
hydrophilic
525
diastolic blood pressure: major determinant
total peripheral resistance
526
limited systemic sclerosis: antibody
anti-centromere
527
p53 gene: chromosome
chromosome 17
528
steroid hormone: hydrophilic/hydrophobic?
hydrophobic
529
Blue sclera
Diagnosis?
Osteogenesis imperfecta
530
falciform ligament: connections
liver to anterior abdominal wall
531
vitamin B9 (folate): site of absorption
small bowel
532
Tourette syndrome vs. chronic motor tic disorder vs. vocal tic disorder
Tourette syndrome: motor + vocal tics
chronic motor tic disorder: only motor tics
vocal tic disorder: only vocal tics
533
water soluble vitamins
B1, 2, 3, 5, 6, 7, 9, 12
C
534
TRH: function
stimulates release of TSH from anterior pituitary
535
sleep disturbance and vivid dreams in PTSD: treatment
alpha-1 blockers (prazosin in particular)
536
GHRH: function
stimulates release of GH from anterior pituitary
537
myostatic reflex pathway
tapping of tendon causes stretch of muscle
spindle afferent fibers sense the muscle strech via innervation of the intrafusal fibers
spindle afferent fibers carry the signal to alpha-motor neurons, which innervate the extrafusal fibers, causing muscle contraction
538
gag reflex: nerves involved
CN IX: afferent (ipsilateral)
CN X: efferent (bilateral)
539
immunoglobulin allotype: clinical relevance
allotypes of minor amino acid sequence differences in the constant domain of the antibody
allotypes are heritable, so they can be used to determine paternity cases
540
DMD: type of mutation
frameshift
541
portal systemic anastomoses: clinical signs and veins involved
esophagus: esophageal varices (left gastric -\> esophageal vein -\> azygos vein)
umbilicus: caput medusae (paraumbilical vein -\> epigastric veins in abdominal wall)
rectum: anorectal varices (superior rectal -\> middle/inferior rectal)
542
Mallory-Weiss tear: common presentation
patient with history of alcoholism or bulimia
profuse vomiting followed by bloody vomiting
543
structures perforating the diaphragm: vertebral levels
T8: IVC (through central tendon)
T10: esophagus, vagus
T12: aorta, thoracic duct, azygos vein (under median arcuate ligament)
544
petechiae: hematologic cause
thrombocytopenia
545
lactose intolerance: diagnosis
post-lactose hydrogen breath test
546
low serum ceruloplasmin: diagnosis
Wilson diease
547
beta-blocker overdose: treatment
glucagon
548
competitive vs. noncompetitive inhibitors: effect on Km
competitive: increased
noncompetitive: no change
549
competitive vs. noncompetitive inhibitors: effect on Vmax
competitive: no change
noncompetitive: decrease
550
cerebrocerebellum vs. spinocerebellum vs. vestibulocerebellum: signs of degeneration
cerebrocerebellum: dysdiadochokinesia, intention tremor, limb ataxia, dysarthria
spinocerebellum: truncal ataxia
vestibulocerebellum: nystagmus, problems with pursuit
551
sarcoma vs. carcinoma: route of metastasis
sarcoma: hematogenously
carcinoma: lymphatics
(except renal cell carcinoma, hepatocellular carcinoma, choriocarcinoma, follicular thyroid carcinoma - these spread hematogenously)
552
schizophrenia spectrum disorders: differentiating features
schizophrenia: positive and negative symptoms for \>6 months
schizophreniform disorder: schizophrenia presentation for 1-6 months
brief psychotic disorder: schizophrenia presentation for \<1 month
schizoaffective disorder: schizophrenia presentation with mood disorder
delusional disorder: delusions only
schizotypal personality disorder: less frequent/severe delusions
553
Medicare parts A,B,C,D: services covered
A: hospital care, nursing homes / hospice
B: outpatient services
C: privately-adminstered replacement
D: prescription drug coverage
554
transplant rejection vs. graft-versus-host disease: presentation
transplant rejection: widespread thombosis of graft vessles (hyperacute - minutes); vasculitis of graft vessels (acute - weeks to months); arteriosclerosis (chronic - months to years)
GvHD: rash, jaundice, diarrhea, hepatosplenomegaly (more common in bone marrow and liver transplants)
555
HIV transmission during pregnancy: prophylaxis
zidovudine (NRTI)
556
Li-Faumeni syndrome: associated mutations
TP53
557
tuberous sclerosis: associated mutations
TSC1
TSC2
558
tension pneumothorax: presentation
trachea deviates away from affect lung
increased intrathoracic pressure -\>
mediatinal displacement -\>
kinking of IVC -\>
decreased venous return -\>
decreased cardiac output
559
leukemia in a child: likely diagnosis
acute lymphoblastic leukemia
560
Down syndrome: associated conditions
ASD
Hirschsprung disease
AML/ALL
Alzheimer disease
duodenal atresia
561
villous vs. tubular polyp: malignancy potential
villous: high malignancy potential
tubular: low malignancy potential
tubulovillous: intermediate malignancy potential
562
iatrogenic causes of acute tubular necrosis (ATN)
antibiotics: aminoglycosides, beta-lactams, rifampin, vancomycin
antivirals: acyclovir, cidofovir, tenofovir, foscarnet
chemotherapy: cisplatin
other: radiocontrast dyes, IVIg
563
Leber hereditary optic neuropathy: inheritance
mitochondial
| (transmitted via mother)
564
TB: prophylaxis treatment
isoniazid monotherapy
565
carotid sheath: location of structures
common carotid artery: medial
internal jugular vein: lateral
vagus nerve: posterior
566
"fried egg" appearance on CNS histology: diagnosis
oligodendroglioma
567
probeniced: drug interactions
probeniced inhibits the organic anion transporter in the proximal convoluted tubule
OAT is also important for elimination of other drugs, particularly penicillins, which may required decreased doses
568
iliohypogastric nerve: roots
T12-L1
569
genitofemoral nerve: roots
L1-L2
570
lateral femoral cutaneous nerve: roots
L2-L3
571
obturator nerve: roots
L2-L4
572
femoral nerve: roots
L2-L4
573
sciatic nerve: roots
L4-S3
574
common fibular (peroneal) nerve: roots
L4-S2
575
tibial nerve: roots
L4-S3
576
superior gluteal nerve: roots
L4-S1
577
inferior gluteal nerve: roots
L5-S2
578
pudendal nerve: roots
S2-S4
579
iliohypogastric nerve: innervation
T12-L1
sensory: suprapubic region
motor: transversus abdominis, internal oblique
580
genitofemoral nerve: innervation
L1-L2
sensory: scrotum / labia majora, medial thigh
motor: cremaster
581
lateral femoral cutaneous nerve: innervation
L2-L3
sensory: anterior/lateral thigh
motor: none
582
obturator nerve: innervation
L2-L4
sensory: medial thigh
motor: thigh adductors
583
femoral nerve: innervation
L2-L4
sensory: anterior thigh, medial leg
motor: leg extenders
584
sciatic nerve: innervation
L4-S3
sensory: none (splits into common peroneal and tibial nerves)
motor: hamstring muscles
585
superficial fibular (peroneal) nerve: innervation
sensory: dorsum of foot (except webspace between hallux and 2nd digit)
motor: foot everters/plantarflexors
586
deep fibular (peroneal) nerve: innervation
sensory: webspace between hallux and 2nd digit
motor: tibialis anterior (foot inversion and dorsiflexion)
587
tibial nerve: innervation
L4-S3
sensory: sole of foot
motor: foot flexors
588
superior gluteal nerve: innervation
L4-S1
sensory: none
motor: gluteus medius/minimus
589
inferior gluteal nerve: innervation
L5-S2
sensory: none
motor: gluteus maximus
590
pudendal nerve: innervation
S2-S4
sensory: perineum
motor: external urethral/anal sphincters
591
