DIT Day 13
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181 terms
Terms | Definitions |
|---|---|
 RR: LENS SHAPED LESION ON HEAD ON CT SCAN | Epidural Hematoma |
| RR: COMMON UNDERLYING CAUSE OF INTUSSUSCEPTION | Meckels Diverticulum Adenovirus infection causing Peyer's patches |
| RR: NO MILK PRODUCTION IN THE POSTPARTUM PERIOD | Sheehan's Syndrome |
| RR: PIGMENTED HAMARTOMAS IN THE IRIS | Lisch Nodules of neurofibromatosis |
| RR: HOWEL-JOLLY BODIES | DNA remnants in asplenia |
| RR: CANCER A/W ASBESTOS | Mesothelioma Bronchogenic Carcinoma |
| RR: OWL'S EYE INCUSIONS | CMV |
| RR: OWL'S EYE NUCLEUS | Hodgkins Reed Sternberg Cells |
| RR: OWL'S EYE PROTOZOAN | Giardia Lamblia |
| RR: 50 YO MALE WITH NEW UNEXPLAINED SKIN YELLOWING AND NO OTHER SYMPTOMS | Cancer of the head of the Pancreas |
| What category does the drug belong to: Cholestyramine? | Bile Acid Binding Resin (Cholesterol lowering drug) |
| What category does the drug belong to: Venlafaxine? | SNRI |
| What category does the drug belong to: Fluphenazine? | Typical Neuroleptic (increased potency) |
| What category does the drug belong to: Phentolamine? | Reverse Non-Selective alpha blocker |
| What category does the drug belong to: Captopril? | Ace Inhibitor |
| What category does the drug belong to: Trazadone? | Anti-Depressant |
| What category does the drug belong to: Carteolol? | Beta Blocker (Glaucoma tx) |
| What category does the drug belong to: Clarithromycin? | Macrolide |
| What category does the drug belong to: Famotidine? | H2 blocker |
| What category does the drug belong to: Fluvoxamine? | SSRI |
| What category does the drug belong to: 6-mercaptopurine? | AntiCancer drug (inhibits purine synthesis) |
| What category does the drug belong to: Selegiline? | MAOI (parkinsons tx) |
| What category does the drug belong to: Terbinafine? | Anti Fungal (Onymonoch; nail fungus tx) |
| What category does the drug belong to: Clozapine? | Atypical Antipsychotic |
| What type of information does the Ventral Posterior Lateral (VPL) of the thalamus relay? | Somatosensory information from the body |
| What type of information does the lateral geniculate of the thalamus relay? | Visual retinal information to the occipital lobe |
| What type of information does the VPM (ventral posterior medial) of the thalamus relay? | Somatosensory information from the face |
| What type of information does the ventral anterior of the thalamus relay? | Motor basal ganglia to the cortex |
| What is the antidote for copper, gold and arsenic? | Penicillamine |
| What is the antidote for Arsenic, mercury, and gold? | Dimercaprol Succimer |
| What is the antidote for t-PA and streptokinase? | AMinocaproic Acid |
| What is the antidote for digitalis? | Stop digitalis Normalize Potassium levels Lidocaine or anti digitalis fragments |
| What are the 4 main pharmocokinetic equations? | Vd = amt of drug in body / plasma drug conc CL = .7 X Vd / t1/2; LD = Css X Vd; MD = Css X CL |
| Where does fetal erythropoiesis take place? | (Young Liver Synthesizes Blood) Yolk Sac Liver Spleen Bone Marrow |
| What adult bones are involved with erythropoeisis? | Vertebrae Sternum Pelvis Ribs Cranial Bones Tibia and femur |
| What aneurysm causes the eye to look down and out? | Posterior Communicating Artery |
| What aneurysm causes bilateral loss of lateral visual fields? | Anterior Communicating Artery |
| What artery is damaged in Broca's or Wernicke's Aphasia? | Middle Cerebral Artery |
| What artery is damaged when there is unilateral lower extremity sensory and/or motor loss? | Anterior Cerebral Artery |
| What artery is damaged when there is unilateral facial and arm sensory and/or motor loss? | Middle Cerebral Artery |
| What hormones use steroid receptors? | Steroid Hormones Estrogen Progesterone Testosterone Aldosterone Vitamin D Thyroxine T3 T4 Glucocorticoids |
| What hormones use tyrosine kinase receptors? | Insulin IGF 1 FGF PDGF Prolactin Growth Hormone |
| What histological change takes place in the trachea of a smoker? | Metaplasia: Ciliated columnar to squamous |
| A pt is in the ER having anaphylaxis; you make an incision beneath the thyroid cartilage to establish an airway; what structure was cut? | Cricothyroid membrane |
| What structures transverse the diaphragm and at what vertebral angle do they pass? | IVC at T8 Esophagus and Vagus at T10 Aorta, Thoracic Duct, Azygous Vein at T12 |
| What type of cell proliferates during lung damage? | Type II pneumocytes |
| What amniotic fluid measurement is indicative of fetal lung maturity? | Lecithin to Sphingomyelin ratio > 2 |
| A young woman has infertility; recurrent URI's; and dextrocardia; which of her proteins is defective? | Dyenin Arm Defect due to Kartagner's syndrome |
| The following lung capacities are obtained from an elderly smoker: FRC 5.0 L IRV 1.5L IC 2.0L VC 3.5L What is the TLC? | TLC = FRC + IC 5.0 + 2.0 = 7.0 |
| What substances are known for causing methemoglobinemia? | Chloroquine Primaquine; Dapsone Sulfonamides; Local Anesthetics; Metoclopramide; Nitrates |
| A 42 yo woman with fibroids is chronically tired; what is the most likely dx and what changed have occured in the O2 content and saturation? | Hypochromic Microcytic Anemia No change in O2 content or saturation; but not as much Hemoglobin to be saturated |
| A pt is shown to have hypoxia and CXR reveals an enalrged heart; what is the most likely cause of hypoxia? | CHF; lungs are not perfused well enough to get O2 to the rest of the body. |
| What is the differential diagnosis for eosinophilia? | (DNAAACP) Drugs Neoplasms Atopic disease (allergy/asthma/churg strauss) Addisons Acute interstitial nephritis Collagen Vascular disease Parasites (lofflers eosinophilic pneumonitis due to ascaris lumbricoides) |
| A pt presents with an asthma attack; what immunological reaction is taking place that is responsible for the anaphylaxis in the pt? | Mast Cell mediate; antigen cross linking of mast cells and IgE; Type I Hypersensitivity |
| What asthma medication is the inhaled tx of choice for chronic asthma? | Inhaled steroids |
| What asthma medication is the inhaled DOC for acute exacerbations? | Albuterol (with Ipratroprium) |
| What asthma medication has a narrow therapeutic index; drug of last resort? | Theophylline |
| What asthma medication blocks conversion of arachidonic acid to leukotriene? | Zileutin |
| What asthma medication inhibits mast cell release of mediators, used for prophylaxis only? | Cromolyn |
| What asthma medication is an inhaled treatment that blocks muscuranic receptors? | Ipratropium |
| What asthma medication is an inhaled long acting beta 2 agonist? | Salmuterol |
| What asthma medication blocks leukotriene receptors? | Zafirlukast Montelukast |
| A pt has extended expiratory phase; what is the disease process? | Obstructive Lung Disease |
| H&E of a lung biopsy from a plumber shows elongated structures with clubbed ends in tissue; what is the dx and what is he at risk for? | Asbestosis leading to mesothelioma and bronchiogenic carcinoma |
| A preterm infant has difficulty breathing. An xray reveals a diffuse ground glass appearance with air bronchograms; what is the dx and what would've prevented this? | Neonatal Respiratory Distress Syndrome Prevented with tx mother with steroids before birth. |
| A pt develops ARDS from an occupational inhalation of NO2; what histo change is likely to be seen in a pt recovering from ARDS? | Proliferation of type II pneumocytes |
| A CXR shows pleural effusions; what are the clinical findings? | Decreased breath sounds over the effusion Dull resonance Decreased fremitus |
| A tall thin male teenager has abrupt onset dyspnea and left sided chest pain. Percussion on the affected side reveals hyperresonance and breath sounds are diminished; what is the dx? | Spontaneous pneumothorax |
| A CXR shows collapse of the middle lobe of the right lung and mass in the right bronchus; pt has history of recurrent pneumonias; what is the dx? | Bronchial Adenocarcinoma |
| A pt of yours develops bronchogenic lung cancer but has never smoked. He is a coal miner. Exposure to what substance has put him at risk for developing lung cance? | Radon |
| What complications can arise from lung cancer? | (SPHERE) Superior Vena Cava Syndrome Pancoast Tumor Horner's Syndrome Endocrine (paraneoplastic syndrome) Recurrent Laryngeal Nerve Symptoms (Hoarseness) Effusions (pleural or pericardial) |
| What is the most common cause of pneumonia in immunocompromised pts? | Pneumocystis Jirovecci |
| What is the most common cause of atypical/walking pneumonia? | Mycoplasma |
| What is the most common causative agent of pneumonia in alcoholics? | Klebsiella |
| What can cause an interstitial pneumonia in bird handlers? | Chlamydia Pstici |
| Pneumonia a/w bats and bat droppings? | Histoplasma |
| Often cause of pneumonia in a pt visiting SW USA? | Coccicioides |
| Pneumonia a/w "currant jelly" sputum? | Klebsiella |
| Q fever is a/w what organism? | Coxiella Burneti |
| A/w pneumonia acquired from ACs? | Legionella |
| Most common cause of pneumonia in children 1 yo and younger? | RSV |
| Most common cause of pneumonia in neonate (B to 28 days old)? | Group B Strep E coli |
| Most common cause of pneumonia in children and young adults (college students; recruits; prison inmates)? | Mycoplasma |
| Common cause of pneumonia in pts with other health problems? | Klebsiella |
| Most common cause of viral pneumonia? | RSV |
| Causes wool-sorter's disease (life threatening pneumonia)? | Bacillus anthracis |
| Endogenous flora in 20% of adults? | Strept Pneumoniae |
| Common bacterial cause of COPD exacerbation? | H. Influenzae |
| Common pneumonia in ventialtor pts and those with cystic fibrosis? | Pseudemonas Aeriginosa |
| Pontiac fever is a/w what organism? | Legionella |
| Examination of a lung at autopsy reveals peripheral lesion with caseous necrosis; dx? | TB |
| A 30 yo comatose man on ventilatory support in the ICU develops an infection and dies; Autopsy reveals pus filled cavity in the right lung; what is the likely etiology? | Aspiration leading to Lung Abscess |
| A 55 yo man who is a smoker and heavy drinker presents with a new cough and flu-like symptoms; gram stain shows no organisms; silver stain of sputum shows gram negative rods; what is the dx? | Legionella Pneumophilia |
| Causes of transudate effusions? | CHF Cirrhosis Nephrotic Syndrome Pulmonary Embolism Fluid Overload |
| Causes of Exudate effusions? | Pneumonia Infections TB Cancer Uremia Connective Tissue Disease |
| RR: MOST COMMON CAUSE OF SIADH | Small Cell Cancer of the lung |
| RR: MOST COMMON TESTICULAR TUMOR | Seminoma |
| RR: MOST COMMON TUMOR OF INFANCY | Strawberry Hemangioma |
| RR: TRANSLOCATION 9;22 AND DRUG USED TO TX | CML tx with Imatinib |
| Kartagener's syndrome triad and underlying defect? | Triad: Sterility; Bronchiectasis; Recurrent infections Dyenin arm defect |
| 3 most common locations of lung cancer mets? | Brain Bone Liver |
| What is the V/Q at the apex of the lung? | 3 |
| What is the V/Q at the base of the lung? | 0.6 |
| What is the V/Q during airway obstruction? | 0 |
| What is the V/Q during blood flow obstruction? | Infinity |
| How does emphysema in smoking differ from emphysema caused by alpha-1-antitrypsin deficiency? | smoking - Centriacinar alpha-1-antitrypsin def - panacinar |
| What is the hallmark sign of COPD? | Decreased FEV1/FVC |
| What is the hallmark sign of restrictive lung disease? | Decreased TLC Normal or slightly increased FEV1/FVC |
| Which lung tumors arise centrally and are linked to smoking? | Squamous Cell Cancer small cell cancer |
| What lung tumors arise peripherally and are less linked to smoking? | Adenocarcinoma Large Cell Carcinoma |
| How does the body compensate for hypoxia at high altitude? | Increased ventilation Increased erythropoeitin Increased Mitochondrial activity Increased renal excretion of bicarbonate |
| Cause of pneumonia a/w Gram + cocci in clusters? | S aureus |
| Cause of pneumonia a/w Gram + cocci in pairs? | S pneumo |
| Cause of pneumonia a/w Gram - rods in 80 yo? | E coli |
| Cause of pneumonia a/w Gram + cocci in neonate? | Grp B strep |
| Cause of pneumonia a/w Gram - rods in neonate? | E coli |
| What are common causes of ARDS? | Shock Infection Toxic Gas inhalation Acute pancreatitis Aspiration Heroine Overdose Increase O2 consumption |
| A 75 yo pt with a 60 pack a year history comes to teh office complaining of difficulty standing up from his bed when he wakes in the morning and difficulty raising his arms in the morning to wash his hair; what do you suspect? | Lambert-Eaton Syndrome due to Small Cell Cancer |
| What is pulsus paradoxus? | Systemic BP drops by more than 10 mmHg with inspiration. |
| What causes pulsus paradoxus? | Asthma COPD Cardiac Tamponade |
| What immunosuppressant is a/w being a precursor of 6-mercaptopurine? | Azathioprine |
| What immunosuppressant is a/w being able to prevent nephrotoxicity with mannitol diuresis? | Cyclosporine |
| What immunosuppressant is a/w an antibody that binds to CD3 on T cells? | Muromonab |
| What immunosuppressant is a/w an antibody that binds to IL-2 receptors on activated T Cells? | Daclizumab |
| What immunosuppressant is a/w inhibiting inosine monophosphate dehydrogenase? | Mycophenylate |
| What immunosuppressant is a/w inhibiting calcineurin leading to the loss of IL 2 production and the blockage of T cell differentiation and activation? | Cyclosporine |
| What immunosuppressant is a/w inhibiting FK-binding protein leading to the loss of IL-2 production? | Tacrolimus |
| What immunosuppressant is a/w being used for lupus nephritis? | Mycophenylate |
| What immunosuppressant is a/w being metabolized by xanthine oxidase, there fore allopurinol can increase its toxicity? | Azathioprine |
| What genetic syndrome is a/w a 1000 fold increased risk of developing skin cancer? | Xeroderma Pigmentosa |
| What genetic syndrome is a/w Alcoholics leading to a B1 deficiency and neurological deficits? | Pyruvate dehydrogenase deficiency |
| What genetic syndrome is a/w abnormal collagen type 1 synthesis? | Osteogenesis Imperfecta |
| What genetic syndrome is a/w an absence of HGPRTase? | Lesch-Nyan Syndrome |
| What genetic syndrome is a/w a deficiency of aldolase B? | Fructose Intolerance |
| What genetic syndrome is a/w defective excision repair leading to thymidine dimer formation? | Xeroderma Pigmentosa |
| What genetic syndrome is a/w a deficiency of cystathionine synthase? | Homocystinuria |
| What genetic syndrome is a/w Heinz bodies? | G6PD |
| What genetic syndrome is a/w must/mousy odor, albinism, MR, and eczema? | PKU |
| What genetic syndrome is a/w Galactose-1-P uridyl transferase deficiency leading to MR, HSM, and cataracts? | Galactosemia |
| What genetic syndrome is a/w being treated by avoiding NutraSweet and increasing dietary tyrosine? | PKU |
| What genetic syndrome is a/w a deficiency of tyrosinase? | Albinism |
| What genetic syndrome is a/w hyperextensible skin, loose joints, and bleeding tendency? | Ehlers-Danlos Syndrome |
| What genetic syndrome is a/w decreased NADPH due to lack of HMP enzyme? | G6PD |
| What genetic syndrome is a/w an inherited defect in tubular amino acid transporter? | Cystinuria |
| What genetic syndrome is a/w treatment with decreased methionine and increased cystine and Vit B6? | Homocystinuria |
| What genetic syndrome is a/w a deficiency in homogentisic acid oxidase? | Alkaptonuria |
| What genetic syndrome is a/w hypoglycemia, jaundice and cirrhosis? | Fructose intolerance |
| What genetic syndrome is a/w self-mutilation, gout, aggression, and choreoathetosis? | Lesch Nyan Syndrome |
| What genetic syndrome is a/w blocked degradation of branched chain amino acids? | Maple Syrup Urine Disease |
| What genetic syndrome is a/w bloating cramps and osmotic diarrhea? | Lactic Intolerance |
| What genetic syndrome is a/w being tx with Acetazolamide to alkalinize the urine? | Cystinuria |
| What genetic syndrome is a/w a deficiency that results in combined B and T cell deficiency? | Adenasine Deaminase deficiency |
| What genetic syndrome is a/w tx with decreased fructose and sucrose intake? | Fructose intolerance |
| What genetic syndrome is a/w a tx of increased intake of ketogenic nutrients (fats)? | Pyruvate Dehydrogenase Deficiency |
| What genetic syndrome is a/w Dark brown urine, organs, and connective tissue; benign disease? | Alkaptonuria |
| What genetic syndrome is a/w multiple fractures and blue sclera? | Osteogenesis Imperfecta |
| What genetic syndrome is a/w tx by excluding galactose and lactose from the diet? | Galactosemia |
| What are the essential amino acids? | (PVT TIM HALL) Phe Val Thr Trp Ile Met His Arg Leu Lys |
| What is the MOA of lactulose? | Pulls ammonia from the gut so that you can excrete it. |
| What amino acid is a precursor to histamine? | Histadine |
| What amino acid is a precursor to prophyrin, heme? | Glycine |
| What amino acid is a precursor to NO? | Arginine |
| What amino acid is a precursor to GABA? | Glutamate |
| What amino acid is a precursor to S-adenosyl-methionine (SAM)? | Methionine |
| What amino acid is a precursor to creatine? | Arginine |
| Compare Carbamoyl phsphat I (CPI) to carbamoyl phosphate II (CPII)? | CPI: Urea cycle; Mitochondria; N from ammonia CPII: Pyrimidine synth; Cytosol; N from Glutamine |
| What is the rate limiting enzyme for urea cycle? | Carbamoyl Phosphate Synthetase I |
| What is the rate limiting enzyme for hexose monophosphate pathway? | G6PD |
| What is the rate limiting enzyme for fatty acid synthesis? | Acetyl-CoA carboxylase |
| What is the rate limiting enzyme for beta oxidation of fatty acids? | Carintine Acyl transferase |
| What is the rate limiting enzyme for ketone body synthesis? | HMG CoA synthase |
| What is the rate limiting enzyme for cholesterol synthesis? | HMG CoA reductase |
| What is the rate limiting enzyme for bile acid synthesis? | 7-alpha-hydroxylase |
| What is the rate limiting enzyme for heme synthesis? | Aminolebunilate Synthase |
| What deficiency causes familial hypercholesteremia? | Deficiency of LDL receptors |
| A pt with PKU should have a diet low in phenylalanine; what other dietary modifications should a patient with PKU make? | Increase Tyrosine Replace tetrahydrobiopterin cofactor |
| A full term neonate becomes mentally retarded and hyperactive and has a musty odor; what is the dx? | PKU |
| A 2 yo girl has an increase in abdominal girth, failure to thrive, and skin/hair depigmentation; dx? | Kwashikor |
| A middle aged man has dark spots in his sclera and notes that his urine turns black when left sitting for a period of time; dx? | Alkaptonuria |
| A pt has a genetic disease in which the tx includes protein restriction to prevent mental retardation, ketoacidosis, and death; what is the dx? | Maple Syrup Urine Disease |
| What is the tx for homocystinuria? | Decrease methianine Increase Cysteine Add Vitamin B6 and folate |
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