Uworld_NTK_Wk4 Flashcards
(148 cards)
1
Q
Aortic regurg ==> ?
A
inrease left ventircular end-distolic volume (PRELOAD) and wall stress, which causes eccentric hypertrophy.
increase ventricular chamber size == increase total stroke volume and helps maintain cardiac output.
2
Q
S/Sx of adrenal crisis?
A
severe hypotension, abdominal pain, vomiting, weakness, and fever.
3
Q
Tx adrenal crisis?
A
aggreive fluid resuscitation, and GLUCOCORTICOID supplement.
(hydrocortisone or dexmethasone)
4
Q
Drug used in Tx of anaphylaxis, severe asthma, and cariax arrest?
A
Epi
5
Q
“hot tub folliculitis” ?
A
superficial psuedomonal infection of hair follicles.
~ pruritic papulopustular rash
~ pool water
6
Q
G (-) rod, oxidase positive, produces green pigment (pyocyanin, pyoverin)
?
A
P. aeruginosa
7
Q
Cat scratch disease bug?
A
Batonella henselae.
vesicular, erythematous, papular lesion; localized.
8
Q
Ovarian torsion typicall involves twisting of what ligament?
A
infundibulopelvic ligament;
often d/t to waight of a large adnexal mass.
9
Q
decrease fetal swallowing or increased fetal urination leads to what?
A
Polyhydramnios
10
Q
What fetal anomalies are ~w/ impaired fetal swallowing?
A
GI obstruction (duodenal, esophageal, or intestinal atresia)
anencephaly
11
Q
Posterior urethal valves in male fetuses can lead to what?
A
decreased fetal urine output and oligohydramios.
Oligohydrminos can lead to compression of the uterus and Potter Sequence.
can also lead to pulmonary hypoplasia.
12
Q
POMC can make what?
A
ACTH
MSH
Beta-endorphin (opioid receptors)
13
Q
What anti-viral has a HSR in pt. who have HLA-B*57:01 allele?
A
Abacavir (like abarca, fuck that guy)
type of NRTI.
fever, malaise, GI Sx, delayed rash.
14
Q
An ADR of metformin is that it increases production of what?
A
metformin increases the intestinal production of lactate (with reduced hepatic metabolism of lactic acid d/t to metformin’s effects to decrease gluconeogenesis).
increases risk of lactic acidosis.
must monitor with serum Cr.
15
Q
What is the murmur heard in ASD with left-to-right shunting?
A
wide and fixed splitting (no change with respiration) of S2.
16
Q
What characterizes diastolic HF?
A
Normal LVEF (>50%)
Normal end-diastolic volume
in the setting of increased LV filling pressures.
Can be d/t increase ventricular wall stiffness from amyloid deposition.
17
Q
How is CO maintain in chronic aortic regurg?
A
increase left ventricular stroke volume.
in acute aortic regurg, increased HR maintains CO
18
Q
Tibial n. may be injured at the popliteal fossa d/t to deep penetrating truma or knee surgery. what is the presentation?
A
- weak foot plantarflexion, inversion and weak toe flexion.
- sensory loss over sole of foot.
19
Q
What skeletal muscle relaxant can cause significant potassium release and life-threatening arrhythmias in pt. at high risk for hyperkalemia, (pt. w/ burns, myopathies, crush injuries and denervation injuries or disease)
A
Succuinylcholine
20
Q
Defect in Acute Intermittent Porphyria?
A
PBG deaminase and aminolevulinate synthase
21
Q
How do you Acute intermittent Porphyria?
A
Glucose and Hemin (IV heme prep) causes negative feedback inhibition of ALA synthase activity
22
Q
What compound is accumulated in acute intermittent porphyria?
A
delta-aminoevuliniv acid (ALA) and Porphobilinogen (PBG)
23
Q
What infectious bacteria requires cholesterol to grow b/c their cell membrane is composed of a single cholesterol-rich phospholipid bi-layer?
A
Mycoplasma pneumoniae
“walking pneumonia”, can be seen in military recruits.
24
Q
How is obsessive-compulsive personality disorder different compared to OCD?
A
Obsessive-compuslice personality disorder is a LIFELONG pattern of insistence on control, orderliness, and perfection and does not involve compulsions performed in response to intrusive obssions.
25
compulsions that are performed IN RESPONSE to obsession intrusive obsessions is known as ?
OCD
26
What drug, a low doses, can increase renal blood flow, and at a higher dose, also increase cardiac contractility?
Dopamine.
it's a B1 and D1 agonist.
27
What is Stimulus Control in the Tx of Insomnia?
- use bed only for sleep and sex (no reading, TV, eating)
- Go to bed only when sleepy
- Lease bed when unable to sleep and go into another room
- have a fixed wake-up time, including on weekends.
28
How is the chest pain in pericarditis different from chest pain in angina?
Chest pain in pericarditis is SHARP and PLEURITIC, and may be exacerbated by swallowing or relieved by leaning forward.
29
How long post-MI does Dressler's syndrome begin?
one week to a few months.
Dressler Syndrome is thought to be an autoimmune polyserositis.
30
COPD that causes a sufficient hypoxia can lead to what compensation by the body?
Increased EPO production by the cortical cells of the kidney
31
What is the Human multi-drug resistance (MDR1) gene?
The human multidrug resistance (MDR1) gene codes for P-glycoprotein, a transmembrane ATP-dependent efflux pump protein that has a broad specificity for hydrophobic compounds. This protein can both reduce the influx of drugs into the cytosol and can increase efflux from the cytosol, thereby preventing the action of chemotherapeutic agents.
32
What are the 5 catalase-positive organisms?
Patients with CGD develop recurrent bacterial and fungal infections that are predominantly caused by 5 catalase-positive organisms:
- Staphylococcus aureus
- Burkholderia cepacia
- Serratia marcescens,
- Nocardia
- Aspergillus.
33
What is the MOA of Varenicline and what it is used to Tx?
MOA: partial agonist of nicotinic ACh receptors.
use in quitting smoking by reducing nicotine withdrawal and prevents nicotine from binding and inducing the reward response.
34
What smell is ~w/ arsenic poisioning and what do you use to Tx?
"garlic odor".
S/Sx: Abd pain, vomiting, diarrhea, hypotension
Tx w/ Dimercaprol (chelating agent)
35
What drugs binds to inactivated sodium channels and rapidly dissociates? What is the beneficial result of this MOA?
Lidocaine, Class 1-B anti-arrhythmic.
This MOA makes lidocaine effective that suppressing ventricular tachyarrhythmias induced by rapidly depolarizing and ischemic myocardium.
36
What is the factor V Leiden mutation?
mutation that causes factor Va resistance to INACTIVATION by activated protein C.
Common inherited cause of HYPER-Coagulability.
Put on ddX if pt. under 50 years.
37
This patient's fatigue, progressive dyspnea and orthopnea, third diastolic heart sound (S3), and recent myocardial infarction is consistent with what?
decompensated heart failure due to left ventricular systolic dysfunction.
38
What heart sound is caused by a sudden limitation of ventricular movement during rapid passive ventricular filling?
S3.
Can be healthy in peds and young adults.
pt. > 40 S3 heart sound is abnormal and suggest ventricular enlargement.
39
When does S3 occur and what can you have the Pt. do to increase the intensity of S3?
S3 occurs during diastole, shortly after the second heart sound (S2).
Best heard with Bell over apex in the left lateral decubitus position AT THE END OF EXPIRATION!!! (this allow decrease lung volume and brings the heart closer to the chest wall.
40
In pancreatic beta cells, what causes the closure of a K+ channel that leads to membrane depolarization and subsequent insulin release?
ATP.
Oxidative metabolism of glucose in pancreatic beta cells generates ATP. ATP-induced closure of the ATP-sensitive K+ channel leads to membrane depolarization and subsequent insulin release.
41
What are dilated, tortuous veins resulting from the impairment of the venous valves and reflux of venous blood called?
Varicose veins.
42
What is the MC complication of varicose veins?
venous statis ulcers
43
What is Phlegmasia alba dolens (painful white leg, "milk leg")??
is a consequence of iliofemoral venous thrombosis occurring in peripartum women. Pregnancy predisposes to deep venous thrombosis due to the pressure of the gravid uterus on deep pelvic veins (producing venous stasis) as well as increased hypercoagulability.
44
Is a red neuron a reversible or irreversible injury?
Irrev.
45
Shinkage of the cell body, eosinophilia of the xyoplasm, pykonosis of the nucleus and loss of NIssl substance that all occur 12-24 hours post-injury ==?
RED NEURON
acute neuronal injury
46
What is the MCC of a pt. with acute retinal hemorrhage?
poorly controlled HYPERTENSION.
Severe hypertension in retinal precapillary arterioles causes endothelial disruption, leakage of plasma into the arteriolar wall, and fibrinous necrosis. The necrotic vessels can then bleed into the nerve fiber layers, causing dot- and flame-shaped hemorrhages.
47
What is the Drug that can DECREASE prostate volume in Pt. with BPH?
5-alpha reductase inhibitors (eg, finasteride, dutasteride) block the conversion of testosterone to dihydrotestosterone in the prostate. These drugs reduce prostate volume in patients with benign prostatic hyperplasia and relieve the fixed component of bladder outlet obstruction.
Alpha adrenergic antagonists (eg, terazosin, tamsulosin) are smooth muscle relaxants that work on the dynamic component of bladder outlet obstruction. They work within days to weeks. However, these drugs do not significantly affect prostate volume (Choice D). 5-alpha reductase inhibitors (eg, finasteride, dutasteride) inhibit the conversion of testosterone to dihydrotestosterone and address the fixed component of bladder outlet obstruction. Over time, they reduce prostate volume but can take up to 6-12 months to achieve maximal effect.
48
What is the Reid Index?
thickness of the mucous gland layer in the bronchial wall submucosa to the thickness of the bronchial wall between the respiratory epithelium and the bronchial cartilage.
Reid Index is a sensitive measurement of mucous gland enlargement. >40% ~ severity and duration of the chronic bronchitis.
49
gastroschisis, a congenital malformation characterized by a defect in the anterior abdominal wall, allowing abdominal viscera to protrude freely with no overlying sac. is d/t ???
Premature involution of the right umbilical vein
50
What disease is caused by defective osteoclasts that cannot resorb bone, usually due to a mutation in carbonic anhydrase? .
osteopetrosis
This ultimately leads to infiltration of the marrow space, causing pancytopenia. In addition to fractures, osteopetrosis is associated with the narrowing of the foramina, which can impinge upon cranial nerves
51
major cause of bloody diarrhea and is transmitted via the fecal-oral route through foods such as poultry and unpasteurized milk?
Campylobacter jejuni
52
HbH Disease is is aka ??
α-Thalassemia intermedia
β-thalassemia is more common in Mediterranean populations while both α- and β-thalassemia are prevalent in African populations.
53
_______ is a pharmaceutical agent that exhibits both class Ia and class III anti-arrhythmic properties by blocking both fast inward Na+ channels and K+ channels, respectively.
Quinidine
Because of its effects on the fast inactivating Na+ current responsible for the rapid initial upstroke of the action potential, quinidine also prolongs phase 0. However, phase 0 contributes very little to the overall duration of the cardiac action potential, and a slight prolongation would be unlikely to contribute significantly to the improvements experienced by this patient.
54
A patient has a short QT syndrome, which means ?
that repolarization is occurring too fast. Slowing repolarization, phase 3, contributes the most to his improvement.
55
Phenylketonuria results from a defect in the enzyme phenylalanine hydroxylase, which requires ____ as a cofactor.
BH4
BH4 is also a cofactor in the conversion of tyrosine to L-dopa, as well as the synthesis of serotonin from tryptophan.
56
What drug class is known to produce the greatest reduction in triglyceride levels
fibrates (Gemfibrozil)
57
A patient is presenting with nausea/vomiting and midepigastric tenderness, and is confirmed by marked elevation in lipase and peri-pancreatic fluid collection. This suggests what?
acute pancreatitis,
58
______ patients are frequently ego-syntonic. They are not distressed by their condition and consider themselves normal.
Anorexic
In contrast, bulimic patients are often ego-dystonic, such that they seek help and are distressed by their eating disorder.
59
evidence of starvation from her history of skipping meals, and is likely purging through vomiting as evidenced by her knuckle calluses (“Russell’s sign”) and hypokalemic alkalosis.
anorexia
60
Food restriction vs. no food restriction: While both types of eating disorders may exhibit purging, food restriction is unique to _____________.
anorexia nervosa.
61
What tumor appears as small, round, blue cells. It is most common in young adolescent boys, where it commonly affects the pelvis and metaphysis of long tubular bones. It is classically associated with an “onion-skin” appearance on radiographic imaging, which represents reactive periosteum. It presents as pain or tenderness of the bone (usually worse at night) along with “swelling” that is actually tumor mass.
Ewing's Sarcoma
62
Ewing sarcoma is classically associated with what translocation.
t(11;22) translocation
63
what are the basic amino acids?
Lysine
Histidine
Arginine
All are POSITIVE (+) at physiological pH
64
What is the underlying pathophysiology of mitral valve prolapse, MVP?
myxomatous degeneration of the mitral valve. MVP can occur in isolation without any regurgitant blood flow but frequently mild MR will occur.
MVP = mitral regrug.
65
What is the classic X-ray findings of Asbestosis?
irregular linear densities in the lower lobes of the lungs would be expected on chest X-ray.
66
patient is suffering from “Monday disease,” which is seen with _______ exposure.
nitroglycerin
67
What drug is a vasodilator used in moderate to severe hypertension. Side effects associated with hydralazine include reflex tachycardia, angina, fluid retention, and lupus-like syndrome.
Hydralazine
68
What Tx are used for induction chemotherapy in acute myelogenous leukemia (AML).
Cytarabine and daunorubicin
A peripheral blood smear in AML will often demonstrate the presence of blast forms; the diagnosis is confirmed on bone marrow biopsy. Induction chemotherapy would be inappropriate for this patient at this time, though it may be necessary if his CML progresses to the blast crisis phase.
69
What drugs comprise one of the more frequently employed regimens used for the treatment of chronic lymphocytic leukemia (CLL)
Fludarabine, cyclophosphamide, and rituximab
70
Sumatriptan is a medication frequently used for abortive therapy of migraine headaches. What is a contraindication to sumatriptan use?
history of ischemic heart disease.
Triptans inhibit pain pathways by stimulating vasoconstriction via inhibiting the release of vasoactive peptides. Given the vasoconstrictive mechanism, triptan therapy is not recommended for patients with a history of ischemic stroke, ischemic heart disease, Prinzmetal's angina, and uncontrolled hypertension.
71
What 2 microbes create infections that has pseudoappendicitis characterized by fever, vomiting, diarrhea, and right lower quadrant pain with imaging studies showing a normal appendix?
Y. enterocolitica and the related C. jejuni are associated with pseudoappendicitis.
only Y. enterocolitica is associated with erythema nodosum.
72
What microbe is ~w/ associated pseudoappendicitis AND erythema nodosum.
only Y. enterocolitica is associated with erythema nodosum.
73
What are Gottron's papules?
flat-topped, erythematous, hyperkeratotic papules usually overlying the metacarpophalangeal or interphalangeal joints.
74
What Diz presents as:
symmetric proximal muscle weakness, the distinctive feature of this disease, as well as the characteristic heliotrope rash, which is reddish-purple in color with a mask-like distribution involving the cheeks, nasal bridge, and eyelids, and Gottron's papules
juvenile dermatomyositis, a rare autoimmune myopathy.
75
What are the abnormal labs found in juvenile dermatomyositis, a rare autoimmune myopathy?
Elevated serum concentrations of muscle-derived enzymes; reflecting the presence of muscle inflammation:
- creatine phosphokinase
- aldolase
- aminotransferase
- aspartate aminotransferase
- lactic acid dehydrogenase
76
myasthenia gravis has Auto-Antibodies vs?
against the nicotinic acetylcholine receptor on the post-synaptic neuromuscular junction,
Which is a Ligand-gated non-selective cation channel.
This means that the channel is activated when acetylcholine binds to its receptor, and that BOTH sodium and potassium can pass through the open channel.
77
muscarinic acetylcholine receptors, found throughout the ANS, are what types of receptors?
G-protein coupled receptors
78
Patient’s history of progressive cognitive decline, aphasia, apraxia, and agnosia are highly suggestive of what disease process?
Alzheimer’s Disease
79
How is Alzheimer’s Disease characterized microscopically?
accumulation of amyloid plaques and neurofibrillary tangles.
80
Selective atrophy of the frontal and temporal lobes of the cerebral cortex = ?
Pick's Disease
81
Spongiform encephalopathy = ?
These findings are suggestive of one of the prion diseases (Creutzfeldt-Jakob disease, Fatal Familial Insomnia, kuru, and Gerstmann-Sträussler-Scheinker syndrome). Patients with these diseases tend to present with progressive combinations of ataxia, rapidly progressive dementia, and myoclonus. They may be inherited, sporadic, or acquired.
82
Markedly enlarged lateral ventricles in the absence of increased cerebrospinal fluid pressure = ?
These findings are characteristic of normal pressure hydrocephalus (NPH). Patients with this disease tend to present with a frontal gait, urinary incontinence, and dementia (wet, wobbly, wacky). The patient has only one of three symptoms of NPH, making an alternative diagnosis more likely.
83
Diffuse Lewy body inclusions within cortical neurons = ?
suggestive of Lewy Body dementia. Patients with this disease tend to present with delirium, hallucinations, psychosis, dementia, and extrapyramidal symptoms.
84
What is the ectopic implantation and proliferation of endometrial glands and stromal tissue outside of the uterine endometrial lining?
Endometriosis
85
How do women present with endometriosis?
Women with endometriosis most commonly present in their 20s and 30s with infertility and the “3 Ds”: dysmenorrhea (painful menses), dyspareunia (painful sexual intercourse), and dyschezia (painful defecation). Since these lesions are hormonally responsive, symptoms may intensify cyclically and worsen leading up to menstruation.
86
What are the most common sites of endometriosis?
most common sites of endometriosis include:
adnexa, rectouterine pouch of Douglas, bowel, bladder, and perineum.
87
Acute bacterial peritonitis = ???
Acute bacterial peritonitis is inflammation of the perineum, caused by ascitic fluid that has been infected. Patients present with abdominal pain, fever, abdominal distention, and peritoneal signs.
88
angiofibroma = ?
angiofibroma is a benign vascular tumor that is typically found in adolescent males. Presenting symptoms include recurrent nosebleeds and unilateral nasal obstruction.
89
What structure goes through the Foramen Rotundum?
(cranial nerve V2, Maxillary)
90
What structure goes through the Foramen Spinosum?
The foramen spinosum transmits the middle meningeal artery into the cranial vault.
Damage can lead to Epidural Hematoma
91
What structure goes through the Foramen Ovale?
mandibular branch of the trigeminal nerve (cranial nerve V3)
92
The ___________ is the exit point of the ophthalmic branch of the trigeminal nerve (cranial nerve V1).
superior orbital fissure
93
The alveolar canal houses what nerve?
The alveolar canal houses the posterior superior alveolar nerve, a branch of the maxillary division of the trigeminal nerve that innervates the upper rear molars
94
What defect results in cystic dilation of the renal tubular epithelium in both the renal cortex and medulla?
autosomal dominant polycystic kidney disease (ADPKD).
presents as flank pain and gross hematuria, ultimately progressing to renal failure.
95
What are the extra-renal manifestations of ADPKD?
berry aneurysms (saccular dilations of cerebral arteries, commonly found at bifurcations of the Circle of Willis), hepatic cysts, and mitral valve prolapse.
96
What is the mutation ~w/ ADPKD?
PKD1 gene, encoding polycystin-1. This protein facilitates cohesion between renal tubular epithelial cells as well as other cells throughout the body.
leads to chronic renal failure by age 50.
97
Patients with _____________ present with polyuria and extreme thirst due to an inability to concentrate urine.
diabetes insipidus
98
What is Central diabetes insipidus?
Central diabetes insipidus = LACK of ADH
99
What is Nephrogenic diabetes insipidus?
Nephrogenic diabetes insipidus = deficient renal response to ADH.
100
If osmolarity improves following administration of synthetic antidiuretic hormone, what type of diabetes insipidus is it?
Central diabetes insipidus
101
What is the net effect of ADH?
The net effect of this pathway is the insertion of aquaporin channels on the apical membrane, thereby rendering principal cells permeable to water.
102
In the collecting tubule, __________ acts on principal cell V2 receptors to activate adenylate cyclase, thereby increasing cyclic adenosine monophosphate (cAMP) production, which in turn activates protein kinase A (PKA).
ADH
103
How does Lithium adverse affect the actions of ADH?
Lithium can impair the activation of adenylate cyclase by ADH in this pathway, thereby preventing aquaporin insertion and rendering principal cells relatively impermeable to water. Principal cells are also the site of aldosterone-mediated reabsorption of sodium.
104
What cells are fucked in Nephrogenic diabetes insipidus
Principal cells;
insertion of aquaporin channels on the apical membrane
&
also the site of aldosterone-mediated reabsorption of sodium.
105
What type of error is also known as: false-negative result (i.e., failing to reject a false null hypothesis)
type II error.
The probability of avoiding a type II error is referred to as power and equals (1 - β). Power depends on multiple factors, including the size of the effect, the precision with which the effect can be measured, the sample size, and the level of significance desired. A sample size that is too small results in low power and thus a high probability of a type II error.
106
What are the S/Sx of Opiate drug OD?
lack of responsiveness, diminished respiratory rate, shallow breathing, pinpoint pupils, and hypoactive bowel sounds.
107
Acidemia with a low arterial pH of 7.1 and elevated PCO2 (> 48mmHg) , the acidemia is most likely
Acute respiratory acidosis
| Diminished respiratory rate and tidal volume
108
What are the compensations done by the kidneys in the setting of respiratory acidosis?
the kidneys compensate by conserving HCO3-. This process is accompanied by an increase in H+ excretion as H2PO4- (titratable acid) and NH4+.
109
What is Seborrheic keratosis?
Benign skin lesion that occurs frequently in older men and located on the head, neck and truck and ext.
Histo: Hyperkeratosis with keratin-filled horn cysts and melanin pigmentation.
110
What is Actinic keratosis?
A premalignant lesion, comprised of atypical dysplastic keratinocytes, usually occurs in sun-damaged skin and is associated with hyperkeratosis.
Clinically, lesions have a tan-brown-red color with a rough, sandpaper-like consistency, and cutaneous horn formation.
111
What are 2 markers (antibodies) associated with Sjögren syndrome?
SS-A (Ro) and SS-B (La). These are both autoantibodies against ribonucleoproteins, with SS-B being more specific (70%) for diagnosis.
112
Anti-centromere Antibodies are present in what syndrome?
CREST Syndrome: (limited scleroderma), which is manifested by calcinosis, Raynaud phenomenon (digital vasoconstriction in response to cold temperatures), esophageal dysmotility, sclerodactyly, and telangiectasias.
113
Anti-dsDNA (choice B) is associated with what?
systemic lupus erythematosus (SLE), which is an autoimmune disease characterized by vasculitis, rash, renal disease, hemolytic anemia, and neurologic disturbances. SLE patients may also have arthralgias, but would not have parotid gland involvement.
114
lung mass and can cause hypercalcemia by producing circulating PTH-related protein (paraneoplastic syndrome) is what type of neoplasm?
Squamous cell lung cancer
115
What is special about the Clearance of a substance that is freely filtered?
Clearance of a substance that is freely filtered and maximally secreted cannot increase since it is already maximal.
116
What is a natural fructose polymer that filters freely across the glomerular filtration barrier and then is excreted without either being secreted or reabsorbed; its clearance is used as a measure of glomerular filtration rate (GFR).
Inulin
117
What is PAH (Kidney)?
PAH is freely filtered from plasma at the glomerulus and then the remainder enters the peritubular system and is actively taken up by organic acid transporters (OATs) in the proximal tubule and secreted into the tubule lumen. PAH clearance is near 100% complete (there is a small error in calculation that is generally considered insignificant) and is often used experimentally to estimate renal plasma flow (RPF) and renal blood flow (RBF).
118
Patients with Goodpastures disease can present with hematuria and what type of kidney damage?
Patients can present with hematuria and develop rapidly progressive (crescentic) glomerulonephritis.
119
What type of HSR is Graves disease (special type)
Type II, non-cytotoxic hypersensitivity, the change in thyroid function without causing cell death.
120
What should be on the ddX in a pt. without a known infectious lung disease, who devs. hemoptysis; and hematuria possible.
Goodpastures
121
Neonate presenting with hepatosplenomegaly, periventricular brain calcification, petechial hemorrhages (“blueberry muffin baby”), and hydrops.
==?????
Congenital CMV infection
122
Lymphoproliferative disease is associated with what?
EBV infections in AIDS patients
123
human immunodeficiency virus (HIV) and human herpesvirus-8 coinfections is associated with what?
Kaposi sarcoma; sarcoma of endothelial cells.
124
______________ is a condition caused by Epstein-Barr virus (EBV) infections in AIDS patients and is associated with hyperproliferation of the lingual epithelia. EBV, although it belongs to the same family as CMV, is not associated with in utero infections.
Hairy oral leukoplakia
125
Salicylates cause what type of acid-base disorder?
How?
Salicylates cause an acute respiratory alkalosis.
Salicylates stimulates the respiratory centers and increases ventilation, causing the patient to “blow off” CO2 to produce the respiratory alkalosis.
126
metabolic acidosis without respiratory compensation and would be more likely in what stage of salicylate poisoning.
chronic salicylate poisoning.
127
gram-negative, non-lactose fermenting, nonH2S producing bacilli that optimally grows at 25.0°C-28.0°C. Transmitted to patients via the oral route, most commonly from contaminated, unpasteurized milk, pork and occasionally, from blood transfusion.
???
Yersinia enterocolitica ~ Pseudoappendicitis
128
What ventricle forms most of the anterior wall of the heart?
right ventricle forms most of the anterior wall of the heart and extends from approximately the right border of the sternum to approximately 2 inches to the left of the sternum at the level of the third, fourth, and fifth intercostal spaces.
129
fatigue, peripheral edema, S3 heart sounds, and by exertional and nocturnal dyspnea == ???
Congestive heart failure (CHF)
130
What drug has strong negative inotropic effects, which can exacerbate a patient's underlying heart failure.
Verapamil (CCB)
131
What is the major cause of Mitral Regurg?
Rheumatic Heart Disease
132
a holosystolic apical murmur that radiates to the axilla and is often accompanied by a thrill. == ??
Mitral regurg
133
Medial medullary syndrome: ???
- Caused by occlusion of the anterior spinal artery.
- Lesion of pyramid (corticospinal tracts): contralateral spastic paresis of body.
- Lesion of medial lemniscus: contralateral loss of tactile and vibration sensation and conscious proprioception of body.
- CN XII fibers/nucleus: ipsilateral flaccid paralysis of tongue; tongue deviates to side of lesion.
134
What intracellular organism canNOT make ATP?
Chlamydiae
135
If infarction involves papillary muscles, these may rupture. This complication is followed by what?
valvular dysfunction and may manifest with signs of mitral regurgitation and acute congestive heart failure (CHF). Signs of acute CHF include dyspnea, orthopnea, and fluid in the lungs but not muffled heart sounds.
136
needlestick injury to healthcare providers occur when?
Needlestick injuries have been related to certain work practices such as using the needle on a patient (i.e., administering a shot, drawing blood, etc.), recapping, disposing of needle in sharps container, time between use of needle and disposal as well as transferring a body fluid between containers. According to the CDC, studies of needlestick injuries have shown that up to 48% of all needlestick injuries occurred when using the needle on a patient. All of the other answer choices are associated with a lower percentage of needlestick injuries.
137
in addition to forming the epithelium of the epidermis, the embryonic ectoderm also forms what?
the skin appendages such as hair follicles and sweat glands. The epithelial cells from these appendages can serve as the source of new epithelial cells for the epidermis. Even though the dermis itself is derived from mesoderm, the ectodermal skin appendages migrate into the dermis during their development.
138
hyperchloremic, normal anion gap acidosis, commonly caused by ???
loss of bicarbonate in feces with diarrhea.
139
What organism is the most common cause of urinary tract infections and cystitis.
E. coli, a gram-negative rod
140
What neurological disorder has been related to thymoma and thymic hyperplasia?
Myasthenia has been related to thymoma and thymic hyperplasia.
141
How do you distinguish Lambert-Eaton from myasthenia gravis?
It is a paraneoplastic process commonly associated with small cell carcinoma, but can occur in the absence of malignancy. It is caused by antibodies directed against presynaptic calcium channels at the neuromuscular junction.
Affected individuals have proximal muscle weakness and autonomic dysfunction.
There is no clinical improvement with anticholinesterase agents.
Electrophysiologic studies show enhanced neurotransmission with repetitive stimulation. Strength improves with repeated testing, in contrast to MG.
142
What is the direct reason for cyanosis?
bluish color of the skin and mucous membranes that results from the presence of deoxygenated Hb in the blood vessels, especially the capillaries.
143
Why are Pt. who have servere anemia, not cyanotic?
even those pt with severe anemia have widespread hypoxia in their tissues, their Hb concentration is too low. At least 5 g of deoxygenated Hb must be present in each 100 mL of blood to produce overt cyanosis.
144
What are the S/Sx of severe anemia?
Tachycardia
High stroke volume
wide pulse pressure
Cold hands
145
In severely anemic patients, what happens to the resting CO?
In severely anemic patients, resting CO is increased significantly; this is often called a hyperkinetic circulatory state.
146
microvilli contain a core of ____________ and act to increase the absorptive surface area of epithelial cells.
actin microfilaments.
Myosin, including non-muscle myosin in epithelial cells, is associated with actin microfilaments and thus contribute to the function of microvilli.
147
What are microvilli composed of?
Actin Microfilaments
148
Abnormal binding of what to the actin microfilaments contributes to microvilla dysfunction?
Myosin
