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Flashcards in UWorld_2.10 Deck (17)
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1

Valproate during pregnancy ==> ?

  • neural tube defects due to inhibition of folic acid absorption @ intestine
    • meningocele, spina bifida, etc.

2

Congenital coarctation of aorta association/presentation

  • turner syndrome
  • bicuspid aortic valve
  • high BP proximal to coarctation (usually @ upper extremities) + low BP distal (usually @ lower extremities)

3

Congenital duodenal atresia association + presentation

  • Down's syndrome
  • presentation
    • bilous vomiting w/out abdominal distention on first day of life
    • peristaltic waves visible in abdomen
    • hx of polyhydramnios

4

Congenital renal agenisis association + presentation

  • Potter Syndrome
  • Presentation
    • oligohydramnios
    • flattened facial features

5

Ebstein's anomaly association/presentation

  • "Ebstein's anomaly" = "atrialization" of R ventricle due to downward displacement of tricuspid valve
  • associated w/mother use of lithium during early pregnancy

6

Immunologic rxn to pulmonary TB

  • CD4+ Th1 lymphocytes + macrophages contain TB w/in caseous granuloma

7

Rabies encephalitis presentation

  • generalized sx: malaise, anorexia, mild fever, HA, N/V
  • agitation, disorientation
  • pharyngospasm
  • photophobia
  • dysphagia + hypersalivation ==> "mouth foaming"
  • rabies virus activates nicotinic acetylcholine receptors ==> sx

8

Rabies virus characteristics

  • ssRNA
  • bullet-shaped capsule
  • glycoprotein spikes bind nicotinic acetylcholine receptors
  • begins as local infection, then binds ACh receptors on peripheral nerve to travel to CNS

9

Viral cellular receptors:

CMV

EBV

HIV

Rhinovirus

  • CMV = Cellular integrins
  • EBV = CR2 (CD21)
  • HIV = CD4 and CXCR4/CCR5
  • Rhinovirus = ICAM1 (CD54)

10

young male w/gait instability + pes cavus, kyphoscoliosis, hammertoes ==> dx?

Friedrich's ataxia

11

Characteristics/associations w/Friedrich's ataxia

  • AR
  • Trinucleotide repeat on chromosome 9
  • sx/associations
    • lower extremity ataxia, gait instability
    • skeletal abnormalities: pes cavus, hammertoes, kyphoscoliosis
    • hypertrophic cardiomyopathy ==> cardiac arrhythmias or CHF
    • DM may develop

12

Results of immunoflourescence/light microscopy/EM in PSGN

  • IF: granular deposits of IgG, IgM, and C3 @ mesangium and GBM
  • LM: hypercellular glomeruli = PMNs, macs, prolif of mesangium/endothelium
  • EM: supepithelial humps = deposition of antibody-antigen complexes

13

Damage to radial nerve ==>

  • "wrist drop" = fingers cannot be extended

14

Damage to median nerve ==>

  • limited hand flexion
  • limited opposition of thumb

15

Holosystolic murmur that increases in intensity on inspiration ==> dx?

Tricuspid regurgitation

16

Pathogenesis of atherosclerosis

  1. chronic injury/inflammation ==> endothelial cell injury ==> increased endothelial cell permeability/dysfxn +/- exposure of subendothelial collagen
    1. increased perm ==> mac/lymphocyte migration into vessel walls + LDL cholesterol ==> foamy (lipid-laden) macrophages
      1. macrophages/lymphocytes ==> maintenance of inflammation + migration/proliferation of SMCs  into intima
    2. subendothelial exposure ==> promotion of platelet aggregration
  2. eventually, formation of collection of foamy macs w/necrotic core surounded by fibrous cap + SMCs

17

Low disease prevelance impacts which biostatistical measure of a binary (P or N) diagnostic test?

Positive Predictive Value

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