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Flashcards in prometric practice Deck (33):
1

role of ADH (2)

1: responds to high osmolarity
V2 receptors: decrease serum osmolarity, increase urine osmolarity

2: respond to low BP
V2 receptors: vasoconstriction

2

what drains to the popliteal lymph nodes? (2)

1. dorsolateral foot
2. posterior calf

3

rx for cluster headaches

oxygen and sumatriptan

4

rx for migraine abortive?

sumatriptan, NSAID

5

rx for migraine prophylaxis?

propanolol, topiramate, amitryptaline, Ca2+ channel blockers

6

rx for tension headaches

NSAID, analgestics, amitryptaline, acetaminophen

7

acute megakaryocytic leukemia

proliferation of megakaryoBLASTS
(AML M7)

8

ITP etiology

antibodies against GpIIbIIIa
SPLENIC macrophage destruction!

9

ITP blood / bone marrow smear

blood -> thrombocytopenia
marrow -> many mature megakaryocytes

10

TTP & HUS vs. ITP

all three = thrombocytopenia
TTP / HUS: schistocytes
ITP: splenic destruction

11

TTP etiology

deficiency of ADAMSTS-13

large platelet vWF -> abnormal platelet aggregation

microthrombi -->

schistocytes & thrombocytopenia

12

normal anion gap

8-12 mEq/dl

13

what columns are affected by B12 deficiency?

1. dorsal column: SENSORY
2. lateral corticospinal: MOTOR
(spinocerebellar can be too)

14

dry beri beri

B1 thiamine deficiency

peripheral polyneuritis, symmetric muscle wasting

15

vomit pathway

valine
odd chain fatty acids
methionine
isoleucine
threonine

branched amino acids & odd chain fatty acids breakdown into..

methylmalonyl-CoA
---> (methylmalonyl-CoA mutates
succinyl-CoA

-- either TCA, myelin synthesis
or.. heme synthesis!

16

acid/base disturbance after salicylate ingestion

first:
respiratory alkalosis (hyperventilate)

then SUPERIMPOSED by..
metabolic acidosis (anion-gap)

ultimately:
low bicarb (metabolic acidosis)
low pH (acidemia)
low CO2 (still hyperventilate)

17

colchicine used for...

GOUT
(not RA)

18

etanercept used for..

rheumatoid arthritis

19

caudal medulla: location of hypoglossal nuc? where does n. leave?

nuc is dorsal

BUT

n. leaves between medial lemniscus & olive! (ventral)

20

skin ulceration after a vaccine (i.e. tetanus immunization)

due to arthus reaction

edema, necrosis, activation of complement
type III HSR

deposition of antibody, antigen complex

"localized" serum sickness

21

when does serum sickness occur?

5-10 days post-exposure

antibody against foreign protein --> deposits in membranes

fever, urticaria, arthralgia, proteinuria, lymphadenopathy

22

wiskot-aldrich vs. chediak-higashi

wiskot-aldrich
- actin issues
- combined T cell/B cell
- x-linked recessive

chediak-higashi
- microtubule issue
- neutrophil
- autosomal recessive

23

wiskot-aldrich syndrome presentation

x-linked recessive
defect in actin reorganization

WATER
thrombocytopenic purpura
eczema
recurrent infxn

increased risk of malignancy
and autoimmune disease

24

B cell immunodeficiency presenting later in life ~20-30 y/o associate w/ autoimmune & RA?

common variable deficiency

25

Job syndrome presentation

Th17 deficiency due to less STAT3
impaired recruitment of neutrophils

FATED

abnormal facies
abscesses (cold, no neutrophils)
RETAINED TEETH
hyper IgE
dermatologic problems (eczema)

26

chediak-higashi presentation

autosomal recessive
neutrophil problem
defective LYST gene (lysosomal trafficking regulator gene)

microtubule dysfunction in phagosome-lysosome fusion

BALIN

bleeding and bruising (platelet problem)
partial albinism
leukopenia & infiltrative lymphohistiocytosis
recurrent infxn (staph, strep)
PERIPHERAL NEUROPATHY & NEURODEGENERATION

lots of neutrophils, but have giant granules
pancytopenia

27

pre-eclampsia criteria

20wk -> 6 wk postpartum

1. HTN (>140/90)
2. proteinuria (>300mg/24hr)

severe would be
1. HTN (>160/110)
w/ or w/o end-organ damage:
headache, scotoma, oligouria
& HEELP: hemolysis, elevated liver enzymes, low platelets

28

cause of pre-eclampsia

abnormal formation of placental spiral arteries --> maternal endothelial dysfunction

29

key things an infant can do (0-12)

Parents Start Observing

motor:
primitive reflexes disappear
posture: crawl by 8, stand by 10, walk by 12-18
pincer grasp
points

social:
smile by 2mo
stranger anxiety by 6mo
separation anxiety by 9mo

observing:
oriten to voice, name, gestures
object permanence by 9
oratory: mama dada by 10mo

30

key things a toddler can do (12-36 month)

child rearing working

motor
climb stairs, stack cubes, feeds self, kicks

social
recreationg: parallel play
rapproachment: leave but comes back to mom
realization: core gender identity

working:
200 works by 2
(2 zeroes)
2-word sentences

31

key things a preschooler can do (3-5)

Don't Forget they're still Learning

motor
drive (tricycle), draw (copies, stick figure), dexterity (hop on a foot, groom)

social:
freedom: spend time from mom
friends: cooperative play

learning:
1000 words by 3 (3 zeroes)
legends: detailed stories

32

adalimumab

antibody against TNF-a

33

infliximab

antibody against TNF-a