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141 terms

Kreuger's High Yield Board Prep 2011

LECOM
STUDY
PLAY
name of nerve that innervates muscles that abduct and adducts fingers
ulnar
peaked T waves on EKG
hyperkalemia
part of nervous system damaged in ALS
motor neurons
damage to these fibers causes "pie in the sky"
meyers loop
likely dx if amniocentesis shows increased hCG
down's syndrome
likely dx if amniocentesis shows increased alpha fetoprotein
neural tube defect (NTD)
S. aureus Toxic shock syndrome toxins and mechanism
TSST-1 and enterotoxin B (incite host immune factors: TNF, IL1)
genetics of cystic fibrosis
autosomal recessive (deletion of phenylalanine residue) defective cAMP regulated chloride channel
genetics of fragile X syndrome
X linked recessive expansion on CGG trinucleotide repeat
genetics of sickle cell anemia
autosomal recessive missense mutation of hemoglobin B subunit (valine for glutamic acid)
genetics of down syndrome
meiotic nondisjunction of chromosome 21 pair
homocysteine increases in what deficiency
folate deficiency (as well as B12, B6 deficiency)
ligamentous attachment of distal clavicle torn in dislocation
acromioclavicular ligament
some DOCs for tourette's
pimozide (neuroleptic); clonidine; guanfacine
cosyntropin stimulation test checks what
cortisol response to cosyntropin (synthetic ACTH)
parasite causing African "river blindness"
O. volvulus (onchocerciasis)
dog parasite causing blindness
T. canis (toxocariasis)
parasite causing cerebral hypoxia due to sticky RBCs
P. falciparum
parasite causing keratits in contact lens wearers
acanthamoeba
mechanism of cyanide toxicity
binds Fe+3 and cobalt, inactivating cytochrome oxidase, inhibiting oxidative phosphorylation
drug approved for tx of cyanide intoxication
hydroxocobalamin
mechanism of action for hydroxocobalamin
binds cyanide to form cyanocobalamin which undergoes renal excretion
coagulation factors decreased by heparin use
inactivates thrombin and factors IXa and Xa (primarily neutralizing Xa)
drug used for prophylaxis of TB in immunocompromised pt
isoniazid
drug used for prophylaxis in people who have had contact w/ pts w/ TB
isoniazid; rifampin
midshaft humerus crushed from behind, what artery most likely injured?
profunda brachi artery (artery in radial groove)
what drug used to tx giardia causes a disulfuram-like rxn w/ alcohol
metronidazole
auer rod is a clue to what diagnosis
acute promyelocytic leukemia (AML
most likely cause of lymphadenitis from bug bite on lower extremity
wuchereris bancrofti infection (filariasis)
urea positive breath test most likely due to
H. pylori infection
fibrosis of the appendix is most likely due to
chronic inflammation
portacaval anastomosis shunting through the paraumbilical veins seen in alcoholics
caput medusa
why does pt w/ emphysema purse lips when breathing
decreased air trapping by creating positive pressure in lungs during exhalation
pt w/ diabetes insipidus does not respond to desmopressin. this indicates
nephrogenic diabetes insipidus
drug for pt who is afraid of public speaking & being in public
alprazolam
pt is obsessive about details and a perfectionist but not compulsive w/ rituals or anxious. Dx?
obsessive compulsive personality disorder
facial nerve exits the skull via
stylomastoid foramen
T4, T3, and TSH levels in graves disease
elevated T4 and T3 and depressed TSH
muscle overlying thyroid cut in surgical approach
platysma
type of stroke causing vertigo, nausea, tinnitis & syncope
vertebrobasilar
causes of abruptio placentae (premature separation)
trauma, maternal hypertension, clotting abnormalities, cocaine use
cause of placenta accreta (placenta is retained after birth)
placental villi penetrate deep into uterine wall
cause of spontaneous painless bleeding in placenta previa
low implantation of placenta in uterus; mild contractions cause partial separation of placenta overlying os
teratogenic effect of warfarin (vit K antagonist)
nasal cartilage hypoplasia from abnormal osteocalcin due to failed carboxylation of carboxyglutamic acid
when during pregnancy is folic acid most important & how much?
1st month when neural tube forms (closes day 22); 400 micrograms per day
most common cause of mental deficiency
maternal alcohol abuse
teratogenic effect of smoking and mechanism
IUGR (intrauterine growth restriction); nicotine constricts uterine blood vessels
teratogenic effect of exogenous progestin exposure during pregnancy
hypospadias
teratogenic effect of mothers exposed to DES diethylstilbestrol
female babies develop adenocarcinoma of the vagina
teratogenic effect of tetracycline
yellow teeth
teratogenic effect of streptomycin
deafness
teratogenic effect of valproic acid
neural tube defects, facial, heart and limb abnormalities
teratogenic effect of maternal rubella (german measles)
deafness, cataracts, cardiac defects
teratogenic effect of maternal toxoplasmosis infection
intracranial calcifications & chorioretinitis
baby has wide spaced, peg-shaped upper central incisors, and abnormal face shape. what was mother infected w/
syphilis (hutchinson teeth)
vitamin deficient in pt whose anemia improves w/ B12 supplementation but still has peripheral neuropathy
Folate
dermatome of upper lateral region of arm
C5 dermatome
dermatome of palmar pad of thumb
C6 dermatome
dermatome of pad of middle finger
C7 dermatome
dermatome of pad of little finger
C8 dermatome
dermatome of skin on medial aspect of elbow
T1 dermatome
neoplasms associated w/ EBV
lymphomas & nasopharyngeal carcinoma
characteristic pain in small bowel obstruction
crampy abdominal pain w/ crescendo-decrescendo pattern
characteristic pain in mesenteric infarct
pain that is out of proportion to physical findings
what causes hematemesis to appear like "coffee grounds"
conversion of hemoglobin to hematin by hydrochloric acid
cause of hematemesis in a bulimic patient
mallory-weiss tear (esophageal)
cause of massive hematemesis in an alcoholic
ruptured esophageal varices
most common causes of hematemesis in pregnancy
GERD, gastritis, and ulcers
MOA of amphotericin B (& nystatin)
binds ergosterol in membrane causing leakage of intracellular contents from fungal cell
MOA of flucytosine
inhibits thymidylate synthase (conversion of dUMP to dTMP) step of fungal DNA synthesis
MOA of ketoconazole (and other azoles)
inhibits fungal p450 enzyme (14 alpha demethylase) blocking demethylation of lanosterol to ergosterol
MOA of caspofungin
inhibits fungal cell wall 1,3 D glucan synthesis
MOA of terbinafine
inhibits fungal squalene epoxidase decreasing ergosterol synthesis
MOA of griseofulvin
disrupts fungal mitotic spindle inhibits mitoses (fungistatic)
infection causing skin ulceration 2-3 weeks after exposure to contaminated "fish tank" or "swimming pool"
mycobacterium marinum
infection causing skin ulceration w/ lymphagenic spreading pattern after "gardening" wound
sporothrix schenchkii
most frequent cause of human fungal infection. Characteristic blastoconida and budding yeast (psuedohyphae)
candidia albicans
thick gelatinous, encapsulated 5-10 micometers yeast (india ink halo) causing meningioencephalitis and its route of infection
cryptococcus neoformans; inhalation (common in AIDS)
septae hyphae w/ acute angle branching forming brown fungal balls in pulmonary cavities
aspergillus fumigatus
nonseptae, irregularly wide (6-50 micrometers) fungal hyphae w/ frequent right angle branching in sinuses and lungs
zygomycosis (mucormycosis)
infection causing fever and hemolytic anemia from tick bite, forms characteristic "maltese cross" tetrads in RBCs
babesia microti
sandfly protozoa causing chronic inflammatory cutaneous, visceral, or mucous membrane infection by infecting macrophages
leishmania species (donovani)
slender bloodstream parasites causing large, red, rubbery chancre to form at site of african tsetse fly bite followed by "sleeping sickness"
trypanosoma brucei
protozoa causing acute myocarditis following triatomine (reduviid) bug bite dug to amastigote pseudocyst formation
trypanosoma cruzi (chagas disease)
worm that penetrates skin, travels to lungs then up the trachea, then is swallowed where it infects the duodenal crypts causing diarrhea. endemic to southeast USA
strongyloides stercoralis
seizure illness from ingested eggs or rare pork, w/ characteristic "scolex hooklets". think of what?
taenia solium (neurocysticercosis)
nematode from rare pork that forms cysts in skeletal muscle
trichinella spiralis (trichinosis)
necrotizing vasculitis that affects the lungs and kidneys; PR3-cANCA positive
wegener's granulomatosis
immunological non-infectious necrotizing vasculitis of small to medium muscular arteries sparing the pulmonary circulation, associated w/ hep B
polyarteritis nodosa (PAN)
difference btwn wegener's granulomatosis and polyarteritis nodosum (PAN)
wegener's affects lungs, PAN does not
most important piece of information determining type of tx of lung cancer
are mediastinal nodes involved? if no, then surgical resection; if yes the radiation and chemo
major predisposing risk factor for hepatocellular carcinoma
cirrhosis
viral risk factor for hepatocellular carcinoma
Hep B, Hep C
deficiency associated w/ hepatocellular carcinoma
a1-antitrypsin deficiency
mineral disorder associated w/ hepatocellular carcinoma
hereditary hemochromatosis
fungal toxin associated w/ hepatocellular carconoma
aspergillus aflatoxin B1 (causes p53 mutation)
chemical associated w/ hepatic angiosarcoma
vinyl chloride
receives lymph from the gluteal region, lower abdominal wall, perineum, and superficial regions of the lower limb ands superficial tissues of penis and clitoris
superficial inguinal nodes
receives lymph from glans penis or glans clitoris, labia minora & inferior vagina
deep inguinal nodes
lymph from testes drains to
preaortic & lateral aortic
hostility, defiance, and disobedience toward authority figures that lasts beyond 6 months
oppositional defiant disorder
classic triad of impaired attention, impulsivity and excessive motor activity
ADHD
small gram negative bacteria that multiply in host endothelial cell cytoplasm, manifesting vasculitis
rickettsia
infection causing high fever, myalgias, nausea, headache and rash appearing first on wrists and ankles, 1-2 weeks after tick bit in america. Dx? Tx?
rocky mountain spotted fever (rickettsia rickettsii); doxycycline
infection causing high fever, myalgias, nausea, headache and rash, 1-2 weeks after flea bites in rat infested area
typhus (rickettsia typhi)
tx of acute asthma in the emergency department
oxygen & albuterol
FEV1sec/FVC in COPD
decreased
FEV1sec/FVC in restrictive lung disease
normal to increased
while viral conjunctivitis can be caused by coxsackievirus, enterovirus, EBV, HSV and HZV, most cases of "pink eye" are caused by
adenovirus
common agents of chronic ear infections
pseudomonas aeruginosa, S. pneumoniae, H. influenze, S. aureus, M. catarrhalis
hyaline mold associated w/ chronic sinusitis
aspergillus
infection causing stridor, drooling, and pharyngitis in a child w/ questionable immunization
haemophilus influenzae type b (epiglottitis)
parental and fetal serotypes in erythroblastosis fetalis
mother is Rh negative, father is Rh positive, baby inherits Rh positive from father
mechanism of erythroblastosis fetalis
mother makes anti Rh agglutinins that diffuse through placenta and cause hemolysis in baby (type II)
signs of erythroblastosis fetalis
jaundiced & anemic at birth (NOT parvovirus B19. this causes hydrops fetalis)
Tx of neonate w/ erythroblastosis fetalis
repeated transfusions w/ Rh negative blood
Tx of mother to prevent erythroblastosis fetalis
Rh immunoglobulin globin, an anti-D antibody that prevents B cell antibody production; give at 28-30 weeks gestation
failure to maintain self-tolerance resulting in anti bodies to self constituents w/ facial rash exacerbated by UV light
SLE
cytokine mediators of fever
TNF, IL1 and PGE2
indirect mediator of bronchospasm in allergic pts via activation of sensory nerves
bradykinin
stimulates the leydig (interstitial) cells of the testes to produce testosterone by inducing formation of sterol carrier proteins that shuttle cholesterol to the outer mitochondrial membrane
LH
this hormone stimulates the sertoli cells to synthesize androgen binding protein, aromatase, growth factors and inhibins
FSH
function of progestin in oral contraceptives
causes negative feedback on the pulsing of GnRH by hypothalamus
Hemophilia A is lacking
factor VIII
Hemophilia B is lacking
factor 9
lab value abnormality in both hemophilia A and B
prolonged PTT (intrinsic pathway)
mechanism of DIC in mother when fetus dies
tissue factor released from dead fetus enters maternal circulation
HPV types associated most w/ cervical cancer
16 and 18
mechanism by which HPV causes cervical cancer
E6 protein inactivates p53 suppressor gene and E7 protein binds Rb suppressor gene
vertebral level of splenic flexure
T12 vertebral body
persistent PDA manifests as what in adults
pulmonary hypertension resulting in right heart failure (eisenmenger's syndrome)
enzyme deficiency causing gout (as well as lesch-nyhan syndrome)
hypoxanthine guanine phosphoribosyl transferase (HGPRT)
large aggregations of urate crystals surrounded by an intense inflammatory reaction of macrophages, lymphocytes, and large foreign body giant cells
gouty tophi
microscopic appearance of gout crystals
long needle shaped negatively birefringent
Tx of acute gout
indomethacin, colchicine, glucocorticoids
most common primary infection site of cryptococcus & coccidioides
lungs
cranial nerve signaling accommodation and pupillary constriction
CN 3 from edinger-westphal nucleus
schwannoma occuring at the cerebellopontine angle, attached to the vestibular branch of CN8, presenting w/ tinnitus & hearing loss
acoustic neuroma
cell that produces primary structure affected by multiple sclerosis
oligodendrocytes (myelin)
DOC for adult w/ campylobacter infection
tetracyclines
deficiency resulting in lack of inhibition of leukocyte elastase causing emphysema
a1 antitrypsin