STEP Misc. Flashcards
1
Q
Pathology of hemolytic Uremic Syndrome
A
Infection with enterohemorrhagic Escherichia coli and Shigella dysenteriae from a production of shiga like toxin and shiga toxin respectively
symptoms: microangiopathic hemolytic anemia (fatigue, jaundice, dark urine), thrombocytopenia, renal dysfunction
2
Q
language development at 12months
A
says first words, points to objects, uses several gestures with vocalizing, recognizes names of two objects, looks at them when named
3
Q
language development at 15 months
A
uses three to five words
points to one body part
mature jargoning
4
Q
language development at 18 months
A
uses 10-25 words
points to self
imitates environmental sounds
5
Q
language development at 24 months
A
50+ words, 50% intelligibility, uses 2 word sentences, follows two step commands
6
Q
language development at 36 months
A
uses 200+ words, 3 word sentences, 75% intelligibility, uses pronouns correctly
7
Q
language disorders
A
deficiency in understand and producing language
can result in frustration
8
Q
4 year old child milestones
A
walks down stairs with alternating feet, catches a ball, balances on one foot
draws square, ties a knot, cuts with scissors
able to tell sories
imaginative play/group play
9
Q
language disorders
A
deficiency in understand and producing language
can result in frustration
**obtain a audiology evaluation for any child with a deficient language development
10
Q
etiology of Paget disease of breast
A
ductal carcinoma insitu has malignant cells that migrate into the lactiferous sinuses and nipple skin
accumulation of malignant cells disrupts the normal epithelial barrier
(resembles eczema- erythema and scaling crust around nipple)
- large cells with clear cytoplasm confined to the epidermis
11
Q
MOA of local anesthetics
A
inhibit sodium channels and is most effective in rapidly firing neurons
11
Q
classes of local anesthetics
A
esters (one i)
amides (two i’s)
12
Q
side effect of bupivicaine
A
cardio toxicity
12
Q
order or sensory loss from a local anesthetics
A
pain, temperature, touch, pressure
13
Q
side effect of bupivicaine
A
cardio toxicity
13
Q
order or sensory loss from a local anesthetics
A
pain, temperature, touch, pressure
14
Q
classes of local anesthetics
A
esters (one i)
amides (two i’s)
15
Q
side effect of benzocaine
A
methemoglobinemia
16
Q
special considerations for local anesthetics
A
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
16
Q
signs of riboflavin (vitamin B2) deficiency
A
angular chelitis, stomatitis, glossitis, rash, normocytic anemia
17
Q
signs of niacin deficiency
A
diarrhea, dermatitis, dementia, neurological disturbances
-rash on sun exposed areas
18
Q
classes of local anesthetics
A
esters (one i)
amides (two i’s)
18
Q
special considerations for local anesthetics
A
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
18
Q
signs of niacin deficiency
A
diarrhea, dermatitis, dementia, neurological disturbances
-rash on sun exposed areas
19
signs of folate deficiency
microcytic megalobalastic anemia with increase homocysteine levels with hyperhsegmented neutrophils
19
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
20
signs of vitamin C deficiency
easy bruising petechiae, bleeding gums, anemia, coiled hair
21
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
21
diffuse esophageal spasms and treatment
uncontrolled/uncoordiated contractions of the esophagus with a normal cardiac workup (can present with chest pain and dysphagia or solids and liquids)
calcium channel blockers ( reduce smooth muscle contractility by blocking voltage dependent L-type calcium channels)
22
pericarditis on ECG
diffuse ST segment elevation with reciprocal PR segment depression
23
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
23
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
23
pericarditis on ECG
diffuse ST segment elevation with reciprocal PR segment depression
24
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
24
classes of local anesthetics
esters (one i)
amides (two i's)
25
signs of benzodiazepine overdose and treatment
ataxia, AMS, lethargy, slight respiratory depression
treatment: flumazenil ( inhibits alcohol dehydrogenase)
26
cocaine overdose signs and treatment
tachycardia, hypertension, pupillary dilation, agitation, hallucinations
treatment: bentos, Mixed a/b receptors blocker
27
opioid overdose signs and treatment
AMS, pupillary constriction, lethargy, respiratory depression and respiratory acidosis, constipation
treatment: naloxone
28
features of fragile X syndrome
prominent forehead, intellectual disability, large everted ears, long narrow face, MVP
29
pathogenesis of fragile X syndrome
X-linked dominant trinucleotide repeats of the CGG in the FMR1 gene that causes HYPERMETHYLATION and decreased gene expression
30
how does MVP sound
late systolic crescendo murmur with a mid systolic click
31
Down syndrome cardiac complication
endocardial cushion defect (ASD)
32
Duchenne muscular dystrophy defect
dilated cardiomyopathy
33
Friedrich ataxia cardiac complication
hypertrophic cardiomyopathy
34
homocystineura cardiac complication
increased risk of myocardial infarction and stroke
35
marfan syndrome cardiac complication
aortic dissection, aortic aneurysm, aortic regurgitation, MVP
36
pomp disease cardiac complications
cardiomegaly, hypertrophic cardiomyopathy
37
digeorge syndrome cardiac complication
conotruncal abnormalities (ToF, truncus arteriosis)
38
runer syndrome cardiac complications
bicuspid aortic valve, coarctation of the aorta
39
williams syndrome cardiac complications
supravalvular aortic stenosis
40
ASD
wide flexed splitting of A2
41
cardiac complications in alcohol exposure in utero
ASD, PDA, ToF, VSD
42
congenital rubella cardiac complications
PDA, pulmonary artery stenosis
43
cardiac complications from poorly controlled maternal diabetes
transposition of the great vessels, VSD
44
lithium exposure cardiac complications
ebstein anomaly ( enlarged atria)
45
hypertrophic cardiomyopathy murmur intensity
increases with reduced preload and decreases with increased preload
- increased preload will precent the approximation of the IV septum and the mortal calve during systole
46
squatting
increases preload
47
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
47
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
47
classes of local anesthetics
esters (one i)
amides (two i's)
47
hand grip
increases afterload
47
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
48
familial adenomatous polyposis
AD loss of function mutation in APC suppressor gene on chromosome 5
polyps after puberty and 100% of ppl will develop colorectal cancer
can also have Desmond tumors, brain tumors, and osteomas
49
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
49
KRAS mutations are implicated in
spontaneous colorectal adenomas that give unregulated intracellular signaling
50
explain the spontaneous colorectal progression for colorectal adenomas
loss of APC gene leads to decreased interceulalr adhesion and increased proliferation
KRAS mutation leads to unregulated intracellular signaling
loss of TP53 leads to tumor formation
50
juvenilie polyposis syndrome is caused by
autosomal dominant mutations in SMAD
have hermartosous polyps before the age of 5
51
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
51
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
51
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
51
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
51
classes of local anesthetics
esters (one i)
amides (two i's)
52
juvenilie polyposis syndrome is caused by
autosomal dominant mutations in SMAD
have hermartosous polyps before the age of 5
52
explain the spontaneous colorectal progression for colorectal adenomas
loss of APC gene leads to decreased interceulalr adhesion and increased proliferation
KRAS mutation leads to unregulated intracellular signaling
loss of TP53 leads to tumor formation
53
peutz-jeghers syndrome
AD mutation in STK11
-hyperpigmentaed macules on the mouth, lips, hands, and genitalia with an increased risk of breast and gi cancers.
54
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
54
classes of local anesthetics
esters (one i)
amides (two i's)
55
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
55
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
56
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
57
class II antiarrythmics MOA
amiodarone, dofetilide, and sotalol
they block potassium channels which inhibits outward depolarizing currents during phase 3 prolonging ventricular repolarization
more common in dofetilide and sotalol
57
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
58
prolonged ventricular depolarization on ECG
wide QRS --> torasdes
59
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
59
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
59
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
59
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
59
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
60
classes of local anesthetics
esters (one i)
amides (two i's)
61
pathogenesis of squamous cell carcinoma
loss of TP53 tumor suppressor gene
61
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
62
pathogenesis of melanoma
activating mutation in BRAF
63
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
63
classes of local anesthetics
esters (one i)
amides (two i's)
63
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
64
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
64
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
65
precursor ot melanoma
dysplastic nevus or lentigo maligna
65
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
66
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
66
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
67
nevus histology
rete rige bridging, shouldering, and lamellar fibrosis
68
lentigo maligna histology
blue black stained skin with malignant melanocytes that grow along the stratum basalt without invasion below the epidermis
69
pathogenesis of basal cell carcinoma
loss of function in the PTCH1 tumor suppresor gene which activated sonic hedgehog signaling pathway
70
classes of local anesthetics
esters (one i)
amides (two i's)
70
pathogenesis of basal cell carcinoma
loss of function in the PTCH1 tumor suppresor gene which activated sonic hedgehog signaling pathway
70
70
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
70
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
70
pathogenesis of psoriasis
mutation of the major histocompatibility complex receptor subtype
70
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
70
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
70
cocaine overdose signs and treatment
tachycardia, hypertension, pupillary dilation, agitation, hallucinations
treatment: bentos, Mixed a/b receptors blocker
71
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
71
signs of benzodiazepine overdose and treatment
ataxia, AMS, lethargy, slight respiratory depression
treatment: flumazenil ( inhibits alcohol dehydrogenase)
71
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
71
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
72
many round cells with multiple mitoses with clear cytoplasmic vacuoles scalloping the nucleus
liposarcomas
(most common soft tissue sarcoma)
73
fibroblast based malignancy that is characterized by anapestic spindle cells that may grow in an organized herringbone or a disorganized cellular fashion
fibrosarcoma
73
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
74
benign skeletal muscle tumors with fascicles of polygonal cells with a vacuolated cytoplasm and a peripherally placed nucleus
rhabdomyomas
74
mobile subcutaneous nodules that are composed of mature fat cells without pleomorphism
lipoma
75
painful bull and erosions with oral involvement and extension of lesions with direct pressure
pemphigus vulgaris
76
immunofluresence of pemphigus vulgaris will show
IgG and C3 deposits in a net like or chicken wire pattern along the epidermis
76
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
77
bullous pemphigoid
IgG and C3 deposits along the basement membrane (tense bullae-hemidesmosome)
77
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
77
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
77
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
77
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
77
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
77
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
77
classes of local anesthetics
esters (one i)
amides (two i's)
77
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
78
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
78
bullous pemphigoid
IgG and C3 deposits along the basement membrane (tense bullae-hemidesmosome)
78
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
79
immunoflouresence around dermal blood vessels
porphyria cutaena tarda or henoch schonlein purpura
80
granular deposition of IgA in the upper papillary dermis
dermatitis herpatiformis (itchy vesicles on the elbows, knees and butt)
81
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
81
sympathetic innervation to the eye
stellate ganglion and sympathetic chain - at the apex of the lung
82
ciliary ganglion
carried by the oculomotor nerves and regulates parasympathetic input to the iris and lens
82
otic ganglion
parasympathetic innervation to the parotid gland
near the mandibular nerve
83
alcohol related cerebellar degeneration
cerebellar degeneration to the purkinje cells in the cerebellar vermis from long time alcohol use that leads to
wide based gait ataxia, postural tremor of the hands, truncal instability, blurred vision, falls
84
Hypertrophic Cardiomyopathy has angina because
increased muscle mass increases the O2 demand
there is microvascular dysfunction that decreases O2 supply (poorly developed myocardial capillary networks)
EPICARDIAL CORONARY ARTERIES ARE NORMAL
84
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
85
DNA gyrase
aka type II topoisomerase
removes supercoils
86
helicase
unwind double helix
86
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
86
classes of local anesthetics
esters (one i)
amides (two i's)
86
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
86
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
86
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
86
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
86
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
87
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
87
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
87
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
87
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
87
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
88
helicase
unwind double helix
89
single stranded DNA binding protein
stabilization of unwound template strands
90
primase
aka RNA polymerase
synthesizes RNA primer
90
DNA polymerase III
DNA synthesis (5-->3' polymerase)
proofreading (3'-->5' exonuclease acitvity)
91
DNA polymerase I
removes RNA primer (5'-->3' exonuclease) and replaces with DNA
92
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
93
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
93
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
93
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
93
classes of local anesthetics
esters (one i)
amides (two i's)
93
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
93
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
93
primase
aka RNA polymerase
synthesizes RNA primer
93
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
93
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
94
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
94
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
94
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
95
DNA ligase
joins Okazaki fragment on lagging strand
96
DNA polymerase I
removes RNA primer (5'-->3' exonuclease) and replaces with DNA
prokaryotic polymerase
97
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
97
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
97
primase
aka RNA polymerase
synthesizes RNA primer
98
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
98
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
98
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
98
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
98
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
98
classes of local anesthetics
esters (one i)
amides (two i's)
98
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
98
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
98
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
98
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
99
ovarian cancer marker
CA-125
ascites and ovarian mass
100
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
100
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
100
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
100
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
101
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
101
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
101
primase
aka RNA polymerase
synthesizes RNA primer
102
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
102
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
102
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
102
classes of local anesthetics
esters (one i)
amides (two i's)
102
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
102
caclinurein inhibitors
immunossupressive agents that inhibit calcinurien
cyclosporine and tacrolimus
102
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
103
classes of local anesthetics
esters (one i)
amides (two i's)
103
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
103
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
104
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
104
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
104
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
104
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
104
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
104
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
104
primase
aka RNA polymerase
synthesizes RNA primer
104
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
104
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
104
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
105
adverse effects of calcineurin inhibitors
dose dependent rise in BUN and creatinine levels and obliterative vasculopathy or the efferent and afferent arteries
106
mammalian target of rapamycin inhibitors
sirolimus
107
inhibitors of de novo purine synthesis
azathioprine or mycophenolate mofetil
they inhibit purine synthesis and act as an immunosuppressant agent
108
azathioprine side effects
N/V
109
adverse of prednisone
avascular necrosis of the femoral head, osteoporosis, hyperglycemia, and physiatrics disturbances.
110
abdominal pain with fecal vomiting (brown fluid from the nasogastric tube) is indicative of
small bowel obstruction
111
metaclopromide can be used to treat small bowl obstruction but is contraindicated in who
people with Parkinson's disease
(it is a dopamine antagonist so it would exacerbate Parkinson's issues)
112
alkaptonuria
autosomal recessive defect in homogentisic acid deoxygenate which leads to impaired tyrosine metabolism
causes urine to become black with oxidized
can lead to ochronocosis (blue-black pigmentation of the eyes, ears, and nose) or ochronotic osteoarthropthy ( which is pigment deposition in the bones with pain)
113
incursions in parkinsons disease
alpha synuclein filaments in the cytoplasm
(loss of dopamine in the substantial nigra)
resistance to flexion/extension, resting tremor
114
tissue ischemia causes what cells to be intracellular and what cells to be extracellular
intracellular: Na+, Ca+, HCO3
extracellular: K+
sodium potassium pump doesn't work
Ca+ intracellular is a hallmark of tissue injury
115
where are the juxtaglomerular cells located and what do they secrete
they are located by the afferent arteriole of the glomerulus (encircle it)
they produce renin in response to decreased tubular NaCL, decreased pressure in the afferent arteriole and sympathetic stimulation
116
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
116
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
117
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
117
primase
aka RNA polymerase
synthesizes RNA primer
117
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
117
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
117
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
117
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
117
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
117
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
118
in ARDS what is suggestive of lung immaturity
phospholipid levels (most indicative) - lecithin and phsophatidyglycerol
sphingomyelin and surfactant proteins B and C have a small contribution to ARDS)
118
classes of local anesthetics
esters (one i)
amides (two i's)
118
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
118
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
119
fragility fracture
fracture from low level trauma like falling from standing height
indicative or significant bone loss and osteoporosis
120
what can cause fragility fractures in a vigorously active woman
hypogonadtrvphic hypogonadism caused by vigorous excercise, low BMI or stress
causes decreases GnRH, FSH, and LH with decreased estrogen and accelerated bone loss
120
homocystinuria
autosomal recessive defect in cystathionine beta synthase which leads to the buildup of methionine and homocysteine
will have marfanoid features, intellectual disability, hypercoagualbility, and downward subluxation
121
why can heparin be used in pregnancy
it has a larger molecular weight and cant cross the placenta
121
what features allow placental transfer of drugs
uncharged and lipholphilic, unbound to plasma proteins like albumin, low molecular weight
122
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
122
classes of local anesthetics
esters (one i)
amides (two i's)
122
primase
aka RNA polymerase
synthesizes RNA primer
122
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
122
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
122
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
122
why can heparin be used in pregnancy
it has a larger molecular weight and cant cross the placenta
122
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
122
what features allow placental transfer of drugs
uncharged and lipholphilic, unbound to plasma proteins like albumin, low molecular weight
122
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
122
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
122
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
122
what can cause fragility fractures in a vigorously active woman
hypogonadtrvphic hypogonadism caused by vigorous excercise, low BMI or stress
causes decreases GnRH, FSH, and LH with decreased estrogen and accelerated bone loss
122
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
122
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
123
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
124
neisseria honorrhea causes gonorrhea with what virulence factor
pilli (this also is what gives it it variance- no vaccination)
125
CMV retinitis
cotton wool spots and retinal hemorrhage
(white opaque patches with hemorrhage at the retinal periphery)
usually in HIV patients with a CD4 count less than 50
125
treatment of CMV retinitis
ganciclovir which inhibits DNA chain elongation
inhibits DNA polymerase
can also use focarnet, or valancivlovir all of which interfere with DNA replication
126
special considerations for local anesthetics
if pt is allergic to ester compound use amide
if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)
126
Lynch syndrome
AD mutation that leads to defective DNA mismatch repair with microsatilliate instability
-colorectal cancer, endometrial cancer, ovarian cancer
MSH2,MLH1, MSH6
126
medications used to treat BRAF positive melanomas
dabrafenib and vemurafenib which are BRAF inhibitors
126
CMV retinitis
cotton wool spots and retinal hemorrhage
(white opaque patches with hemorrhage at the retinal periphery)
usually in HIV patients with a CD4 count less than 50
126
wernicke encephalopathy
mammillary body atrophy
**encephalopahty, oculomotor dysfunction, ataxia
126
cocaine overdose signs and treatment
tachycardia, hypertension, pupillary dilation, agitation, hallucinations
treatment: bentos, Mixed a/b receptors blocker
126
ways RNA viruses can change genetic material
shift: reassortment that produces viral progeny and produces pandemics
drift: point mutations
127
DNA ligase
joins Okazaki fragment on lagging strand
127
recombination
gene exchange that occurs from 2 double stranded DNA molcueles from crossing over
127
127
pemphigus vulgas pathogenesis
autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other
wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane
127
classes of local anesthetics
esters (one i)
amides (two i's)
127
signs of vitamin B6 deficiency
peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis
127
primase
aka RNA polymerase
synthesizes RNA primer
127
mammalian target of rapamycin inhibitors
sirolimus
127
benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue
Desmond tumors
127
patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options
amioderone, defetilide, flecainide, and sotalol
127
biopsy of actinic keratosis shows
hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)
127
vitamin E deficiency
biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia
127
signs of benzodiazepine overdose and treatment
ataxia, AMS, lethargy, slight respiratory depression
treatment: flumazenil ( inhibits alcohol dehydrogenase)
127
type 1 pneumocytes vs. type 2
type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium
127
adverse effects of calcineurin inhibitors
dose dependent rise in BUN and creatinine levels and obliterative vasculopathy or the efferent and afferent arteries
127
128
what can cause fragility fractures in a vigorously active woman
hypogonadtrvphic hypogonadism caused by vigorous excercise, low BMI or stress
causes decreases GnRH, FSH, and LH with decreased estrogen and accelerated bone loss
128
