test #44 5.4 Flashcards Preview

UWorld mixed > test #44 5.4 > Flashcards

Flashcards in test #44 5.4 Deck (222)
Loading flashcards...
1

kidney is entirely derived from..

metanephros

metanephric diverticulum (ureteric bud -- collecting duct system)

metanephric mesenchyme (glomeruli & tubules)

2

when does the metanephros develop

5-6th week of gestation

3

most common cause of unilateral fetal (antenatal) hydronephrosis

ureteric bud = initially solid cord, then canalizes (done by 10th wk)

metanephros can produce urine before ureteric bud canalizes --> hydronephrosis

last segment to canalize: ureteropelvic junction (between kidney and ureter)

4

cause of antenatal hydronephrosis obstruction

most common:
-ureteropelvic junction (last to recanalize)

other:
-vesicoureteral junction
-posterior urethral valve (membrane in posterior urethra)

5

when is a fetus able to make urine

8-10th wk

6

pilocytic astrocytoma on imaging

usu in cerebellum, but can't be in cerebral hemisphere

cystic component w/ a tumor nodule.

nodule: active part of tumor

7

most common malignant brain tumor in children

medulloblastoma

exclusively cerebellum

8

histology of medulloblastoma

small, blue cells. hyperchromatic nuclei, scant cytoplasm

can see homer-right rosettes

9

histology of ependymoma

perivascular rosettes w/ rod-shaped blepharoplasts (basal ciliary bodies) near nucleus

10

odds ratio vs relative risk

odds ratio: ad/bc

relative risk: [a/(a+b) / c/(c+d) ]

given chart:
a b
c d

11

expressing support in interview

express concern independent of understanding.

express concern & interest for patient by acknowledging what the patient says. does NOT claim to know how the patient feels

12

facilitation in interview

interviewer encourages patient to talk more about experience. asking "and then what happened"

13

empathy in interview

expression of understanding of experience.

try to "walk in the shoes" to vicariously experience feelings, thoughts, actions.

differs from support, bc tries to project into the experience.

"i can imagine how that experience affected your perspective on life"

14

reflection in interview

when physicial repeats what patient tells him, i.e. by summarizing

"so, you're telling me you were molested as a kid"

15

confrontation in interview

interviewer draws attention to discrepancy in response

"although you say you were disturbed, you sound unaffected as you describe it"

16

mitral valve problems in rheumatic fever

early: mitral valve regurgitation
late: mitral valve stenosis

17

death with rheumatic fever

early: myocarditis

late: valvular heart disease --> valvular issues!

18

diffuse fibrous thickening & distortion of mitral valve leaflets.

commissural fusion at leaflet edges

stenotic orifice w/ diastolic murmur

all suggest

rheumatic fever mitral valvular disease

mitral stenosis --> atrial dilation --> atrial mural thrombus --> stroke

19

most common cardiac manifestation of rheumatoid arthritis

fibrinous pericarditis

20

almost all causes of mitral valve STENOSIS are caused by...

chronic rheumatic heart disease

21

infective endocarditis of mitral valve tends to be..

destructive and regurgitant

22

mitral valvular calcinosis

usually does not impair valve function

usu in women > 60w/o w/ myxomatous floppy mitral valve or elevated left ventricular pressure

23

ASD on ausculation

wide fixed S2 splitting.

does not change w/ respiration

24

split S1?

suggests delayed closure of tricuspid valve, due to right bundle branch block

25

mid-systolic crescendo-decrescendo

aortic stenosis

26

early diastolic decrescendo murmur

aortic regurgitation

27

late systolic crescendo murmur w/ mid-systolic click

mitral valve prolapse

click: sudden tensing of chordae tendinae

most frequent valvular lesion

28

holosystolic high pitched blowing murmur

mitral regurgitation

29

holosystolic harsh murmur, loudest in tricuspid area, accentuated w/

VSD

30

presystolic accentuation

intensity of diastolic murmur before louder just before S1

or when diastolic murmur appears just prior to S1

can result from mitral/tricuspid valve stenosis OR physiological increased flow through valves