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Flashcards in Test 85 Deck (66):
1

RVH

Cor pulmonale

caused by pulmonary HTN seen in F 20-40

2

Essential HTN and aortic stenosis cause what type of hypertrophy

LEFT VH

3

Pica

compulsive consumption of nonfood

common in pregnancy

usually ice

4

CGD inheritance

X linked mutation that affects NADPH oxidase

reccurent bacterial and fungal infections

5

dx CGD

ABSENCE of normal BLUE and fluroscent GREEN pigment produced by NITROBLUE TETRAZOLIUM test and DIHYRORHODAMINE flow cytometry

6

Nitroblue tetrazolium testing

Add NBT to sample of pt's neutrophils

properly functioning neutrophils produce ROS that can REDUCE the yellow NBT to DARK BLUE that preceipitates in cells

7

Dihydrorhodamine

assesses production of superoxide radicals by measuring conversion of DHR to RHOdamine which shoiuld come out fluorescent green

8

ADA def

AR

SECOND MC cause of SCID

PROFOUND decrease in B and T cells

9

mutlisubunit complex that acts as terminal enzyme of mitochondrial respiratory chain

Cyt C oxidase

10

MPO

Enzyme found in neutrophil azurophilic granules

catalyzes production of BLEACH from hydrogen peroxide and chlorine

11

Tx HIGH LDL
Hepatitis
myopathy

Statins

HMG CoA reductase

12

Tx LOW HDL
Cutaneous vasodilation (Red flushed face)
hyperglycemia (acanthosis nigricins)
Hyperuricemia/ GOUT
Hepatitis

Niacin

INHIBITS lipolysis in adipose

REDUCES hepatic VLDL synthesis

13

Tx HIGH TG
Gallstones
Myopathy (WORSE w/ Statins)

Fibrates (gemfibrozil, and 'brates)

Upregulate LPL> increase TG clearance

14

Tx high LDL

Gi upset
hypertriglyceridemia
malabsorption

cholestyramine, colestipol, coleselvam

prevent intestinal esorption of bile acids, so liver must use choleseterol to make more

15

MO of Nitrate drugs

Mimic actions of NO

transformed to NO at SM membrane> INCREASED cGMP> DECREASEd intracellular Ca and myosin dephosphorylation

16

Receptor for insulin and ILGF

TK

17

leads to TRANSIENT recurrent pulmonary infiltrates and eventual proximal BRONCHIECTASIS that can complicate asthma

Aspergillus fumigatus


*often occurs in STEROID DEPENDENT asthmatics

18

pulmonary pathogen in pts w/ CF or neutropenia

p. aeruginosa

19

Colchicine

inhibits LEUKOCYTE migration and phagocytosis by blocking TUBULIN polymeratization

20

TX for acute gouty arthritis in ELDERLY pts or those w/ renal failure by INHIBITING phospholipiase A2

Glucocorticoids

21

Zieluton

blocks 5 lipoxygenase and inhibits leukotriene formation

22

Why does urinary pH DECREASE in metabolic acidosis?

Bicar is combletely resorbed from teh tubular fluid

to excrete H you need to the two most important renal buffers (NH3 and H2PO4)

23

CEREBELLAR HEMANGIOBLASTOMAS

CYSTS/CANCER in kidney, liver, pancrease

incrased risk for RCC (can be bilateral)

VHL disease

24

Neurofibromas
optic nerve gliomas
Lisch nodules
cafe au lait spots

NF1

AKA Von Recklinghaunsen's disease

25

bilateral cranial nerve II SCHWANNOMAS

multiple MENINGIOMAS

NF 2

26

cutaneous FACIAL ANGIOMAS and LEPTOMENINGEAL ANGIOMAS

usually inolved V1 and V2 distribution of trigemnial nerve

TRAM TRACK calcifications on skull

Sturge Weber syndrome


think about weber test being on the head....

27

AD syndrome
cutaneous ANGIOFIBROMAS
HAMARTOMAS
CARDIAC RHABDOMYOMAS

RENAL ANIGIOMYOLIPOMAS

....seizures are major complication

Tuberous sclerosis

28

AD inhertiance of CONGENITAL TELANGIECTASIAS

osler weber rendu syndrome

rupture> epistaxis, GI bleeding, hematuria

29

Increase PT and PTT but DO NOT affect thrombin time

Direct factor XA inhibitors (apixaban, rivaroxaban)

30

Direct thrombin inhibotrs (dabigatran, bivalirudin, dabigatran)

prevent formation of THROMBIN (factor IIa) and lead to prolongation of aPTT, PT and TT

31

binds to ANTITHROMBINa nd causes inactivation of SEVERAL coag factors (THRoMBIN and FACTOR X)

Both PTT and TT are prolonged

Unfractionated heparin

32

Brain tumors in a child

Please take me to....
Animal kindgdom
Magic kingdom
Epcot


i'm dying of a brain tumor

pilocystic astrocytoma
medulloblastoma
ependyoma
craniopharyngioma

33

Cerebellar tumor in a child

Pilocytic astrocytoma (cystic and solid components)

Meduloblastomma (always solid)

34

MC brain tumor in child
arise from astrocytes

ROSENTHAL FIBERS

pilocytic astrocytomas

35

Second MC brain tumor of childhood

solid
composed of sheets of SMALL BLUE cells w/ hyperchromatic nuclei

malignant w/ poor prog

HOME WRIGHT ROSEETESS

Medulooblastoma

36

third MC brain tuor in children

Ependymal lining of 4th ventricle

obstruct CSF

hydrocephalus

PERIVASCULAR ROSSETES

EPENDYOMA

37

MC SUPRATENTORIAL TUMOR IN CHILDHOOD

causes bitemporal hemianopia

craniopharyngioma

38

multiple ring enhancing lesions w/ mass effect in pt w/ HIV

toxoplasmosis

39

tx for toxoplasmosis

pyrimethamine
sulfadizazine

40

cryptococcocal meningitis tx

amphotericin

41

listeria tx

ampicillin

42

CMV tx

gnciclovir

43

second MC cause of ring enhancing lesions w/ mass effect in pt w/ HIV

primary central nervous system lymphoma

B cell ORIGION d/t EBV infection

44

Nephrotic syndrome

INCREASED permeability of glomerular capillary wall

MASSIVE urine protein loss> decrase in serum albumin > DECREASE In OSMOTIC PRESSURE> EDEMA

SHIFT of water into interstitium> RAAS> Na nad Water retention

INCREASED liver lipoprotein syntehsis

45

Cyp450 INducers

Griseolfulvin
Carbamezabine
Phenobarbital (BARBS)
Phenytoin
Barbs)
Rifampin
St. JoHns Wort

46

CYP 450 inhibiotors

CImetidine
Ritonavir
Amiodarone
Cipro
Ketoconoazole
Acute ETOH use
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides

47

What leads to a low Vd (3-5L)?

HIGH MW
HIGH PPB
HIGH charge
hydrophilicity

48

Gastrojejunostomy

IDA

49

Diagnostic for B12 def

Increased methylmalonic Acid

50

decreased in thiamine deficiency

RBC transketaolase levels

51

PE...

HYPOXEMIA
Respiratory alkalosis

52

ANG I to ANG II in HF

HF stimulates SNS and the RAAS to maintain effective intravascular volume

Ang I is converted to ANG II by ACE enzyme in the lungs

53

thunder clap HA seen in pt w/ ADPKD

Intracrnaial berry aneuryms in circle of WILLIS> subarachnoid hemorrhage

54

virus that can mimic RA but is usually self resolving

Parvo B 19

55

Congenital torticolis

noteted by 204 wks of age

child prefers to hold head tilted to one side

result of malposition of the head in utero or BIRTH TRAUMA

56

pathognomonic for acute pyelonephritis

WBC casts in tububules

57

MC cardiac abnormality that predisposes you to NVBE

mitral valve prolapse

58

Retroperitoneal hematoma in a stable pt

pancreatic injury

59

Rup[ture of abdominal aorta

massive nad rapid blood loss > hemorrhagic shock

60

Extrapyramidal SE of antipsychotic meds:

inner restlessness
inability to sit/stand in one positoin

Akathisia

61

involuntary and potentially irreversible movement disorder d/t prolonged antipsychoitc expsure

Tardive dyskonisia

62

relationship betweeen xanthelasma and yellowish eyelid papule

Primary biliary cirrhosis> hypercholesterolemia

63

Differential cyanosis restricted to the LOWER body in a child

PDA

64

Whole body cyanosis in a child

Septal defect
TOF

65

Coaractation of aorat

can limite exercise intolerance but does NOT cause cyanosis in children/adults

66

innervates the stapedius muscle and paralysis of hteis msucle can lead to hyperascusis (icnrased sensitivity to sound)

CN 7