test #11 3.28 Flashcards Preview

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Flashcards in test #11 3.28 Deck (140)
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1

compare distal and proximal radial n. lesion (i.e. motor & sensory involvement)

proximal lesion (i.e. midshaft of humerus) will injure radian n. & posterior cutaneous branch (which comes off above spiral groove). distal lesion near radial head / lateral epicondyle will not impair arm sensation, ONLY wrist extension (deep branch). no sensory defects

2

lateral and medial branches of median n innervates

sensory innervatino of palmar & dorsral surfaces of distal 3 1/2 digits

3

when an adult attempts to pull a child upward by the arm...

radial head subluxation "nurse-maid elbow", can damage the deep branch of the radial n (paralysis of forearm extensor w/o affecting any sensory)

4

boundaries of guyon's canal? what n. passes through here?

between hook of hamate and pisiform bone (fibroosseus tunnel)

5

fracture of the surgical neck of the humerus damages.. what will be lost (3)

axillary n. paralyzed (1) deltoid (2) teres minor (2) sensation on lateral upper arm

6

immune response to Tb..

macrophage phagocytosis & antigen presentation --> CD4+ T cell stimulate macrophages --> activated macrophages form Langerhans giant cells (multiple nuclei organized peripherally in the shape of a horseshoe)

7

what cell type is primary responsible for Giant cell formation?

CD4+ Th1 cells --> IFN-gamma

8

Th2 cells activate..

mast cells, basophils, eosinophils

9

heavy smoker w/ exertional dyspnea and airspace enlargement on CT likely has...

centriacinar emphysema

10

descirbe pathophhysiology of centriacinar emphysema

oxidative injury to respiratory bronchioles --> activation & recruitment of resident macrophages --> neutrophil release of elastase, proteinase 3, cathepsin G, matrix metalloproteases, proteases, oxygen free-radicals (inhibit a1-antityrpsin). net protease-antiprotease & oxidant-antioxidant imbalance destroy's acinar walls.

11

clara cells histologically are.. located.. secrete..

non-ciliated, secretory constituents of terminal respiratory epithelium. secrete clara cell secretory protein (CCSP), which inhibits neutrophil recruitment and activation, as well as neutrophil-dependent mucin production.

12

what 3 things can reduce pulmonary compliance?

(1) pulmonary fibrosis (2) insufficient surfactant (3) pulmonary edema

13

coenzymes needed for pyruvate dehydrogenase

thiamine pyrophosphate (TPP), lipoic acid, CoA, FAD, NAD (mnemonic: tender love and care for nancy)

14

lipoic acid needed for.. (2)

needed for the (1) decarboxylation of alpha ketoacids and (2) transfer of alkyl groups

15

PDH is needed to.. absence leads to..

converte pyruvate acid to acetyl-CoA in the TCA cycle. w/o PDH or its 5 coenzymes, pyruvate --> lactic acid (lactate dehydrogenase)

16

lipoic acid is an important coenzyme for..

alpha ketoglutarate dehydrogenase and branched-chain ketoacid dehydrogenase

17

citrullinemia

urea cycle disorder that results from deficiency of arginosuccinate synthetase. ATP is cofactor required.

18

homocysteinuria

deficiency in cystathione synthase. characterized by premature atherosclerosis. disposed by 2 pathways: (1) conversion to cysteine by the combined actions of two vitamin B6-requiring enzymes, cystathione synthase and cystathionase and (2) conversion to methionine by a folate & vitamin B12-dependent process.

19

orotic aciduria

results from a defective pyrimidine synthesis resulting from a deficiency of the enzyme orotate phosphoribosyl transferase (requires glutathione as a coenzyme)

20

lipoic acid is a cofactor for which mitochondrial enzymes

(1) PDH (deficiency --> lactic acidosis) (2) alpha-ketoglutarate DH (3) branched-chain ketoacid DH (deficiency results in maple syrup urine disease)

21

karyotype difference between complete vs. partial moles

complete mole: 46XX or XY (of paternal origin).
partial mole: 69XXX or XXY.

22

evacuated uterine contents of complete vs. partial mole

complete: trophoblasts only, "bunch of grapes".
partial: fetus, cord, amniotic membrane, some grossly enlarged villi

23

microscopic appearance of complete vs. partial mole

complete: enlarged edematous villi and trophoblastic proliferation. no fetal tissue.

partial: some enlarged villi w/ trophoblastic proliferation. normal villi and fetal tissue also present.

24

risk of complications w/ complete vs. partial mole

complete: 15-20% risk of malignant trophoblastic disease.

partial: low risk of malignancy (>5%)

25

clinical presentation of complete mole

vaginal bleeding, uterus enlarged out of proportion to gestational age, pre-eclampsia, hyperthyroidism, theca-lutein cysts (hCG driven)

26

clinical presentation of choriocarcinoma

after molar pregnancy, abortion, or normal pregnancy. presents w/ vaginal bleeding & symptoms of metastatic disease (eg cough w/ lung metastases). inappropriately elevated hCG levels

27

missed abortion is...

embryonic death in utero. signs: vaginal bleeding w/ closed cervical os, small uterus, absence of fetal heart tones, & low hCG levels

28

presentation of abruptio placentae

premature placental separation. can occur in 3rd trimester of pregnancy. manifests w/ vaginal bleeding, hypertonic uterus, intense painful contractions

29

ruptured tubal pregnancy presents w/? curretage will reveal?

vaginal bleeding, abdominal pain, signs of hemorrhagic shock. curretage reveals endometrial lining w/ gestational changes. fetus and trophoblast are absent.

30

phencyclidine (1) mode of action (2) symptoms (3) examination findings

(1) hallucinogen (2) agitation, dissociation, hallucinations, VIOLENT BEHAVIOR, memory loss (3) NYSTAGMUS, ataxia