4-12-2015 #2

wumimimu's version from 2015-04-13 12:12


Question Answer
What does wet AMD look like on fundoscope exam?Abn blood vessels; Subretinal fluid or hemorrhage; grey subretinal membrane, neovascularization
What is the treatment for dry and less advanced wet AMDAntioxidant vitamins and zinc
What are approved VEGF inhibitors used in treatment of wet AMD?ranibizumab or pegaptanib
What determines the intensity of AS murmur?The difference in pressure gradient between LV and aorta (larger gradient, louder mumur)
Waterhouse Friedrichson syndrome?Adrenal gland destruction, DIC , and shock
What are holosystolic mumurs associated withTricuspid and mitral regurgitation, and VSD
What are normal max/min pressures in the diff heart chambers?LA: 8/0 LV: 25/4; pulmonary artery: 25/9; LA: 12/2 LV:130/9 Aorta: 130/70
Normal origin and insertion of PCL and ACL?PCL: posterior intercondylar region of tibia to medial epicondyle; ACL: anterior region of intercondylar tibia to lateral epicondyle of femur
How do you treat antipsychotic induced Parkinsonism?Benztropine or trihexyphenidyl; or amantadine
Why should dopamine and dopamine agonists not be used to treat antipsychotic induced parkinsonims?They can precipitate psychosis!!!
What are some other drugs that can cause drug-induced parkinsonism?Metoclopromide! and prochlorperazine (gastric motility agents and antiemetics)
In what blotting procedure would you use a double-stranded DNA probe?SouthWestern; aims to identify DNA binding proteins
What are the sx of atrial myxoma?Constitutional sx (tumor produces IL-6), positional cardiovascular sx (dyspnea/syncope), mid diastolic rumbling murmur, embolic sx, and a large pedunculated mass in LA
What do atrial myxomas look like histologicaly?Scattered cells with mucopolysaccharide stroma, abn blood vessels (tumors produce a lot of VEGF) and hemorrhaging
What are phylloquinone and menaquinone?Vit K from green vegetables and gut bacteria respectively
What are the earliest microscopic changes in MI?hypereosinophilic cytoplasm of myocytes, edema, punctate hemorrhage, and wavy fibers
When do microscopic changes become visible after an Acute MI?Earliest at 4 hours;
Which class 3 antiarrythmic has the least potential to cause prolonged QT>Amiodarone
What are the hallmark ocular findings in WErnicke;s?Horizontal nystagmus; bilateral abducens nerve palsy, and complete opthalmoplegia
How does leptin inhibit food intake?Inhibits the production of Neuropeptide Y (appetite stimulant) in the hypothalamus (arcuate fasciculus); and stimulated POMC production, higher levels of a-MSH, which inihibits food intake
Parinaud syndrome results in what?Palsy of upward gaze and convergence; tumor of the pineal gland
What are the sx of pineal germinomas?(Germinomas are the most common pineal gland tumor); precocious puberty (BHCG production), obstructive hydrocephalus, and parinaud syndrome
How does optic neuritis present?Painful eye movements, central scotoma, and visual disturbances
When do the sx of MS get worse?After heat exposure
Visceral obestity is an important determinant of whatINsulin resistance
How does chronic mesenteric ischemia present?Epigastric or periumbilical pain that occurs 30-60 minutes after eating; weight loss bc people stop eating
What is the pathophys of chronic mesenteric ischemia?Atherosclerosis of the celiac, SMA, or IMA which leads to intestinal hypoperfusion and pain with meals; mcuosa is atrophied and villi are lost
How would you diagnose chronic mesenteric ischemia?Mesentetric duplex ultrasonography or angiography (gold standard)
What is early sepsis characterized by?Increased cardiac output, peripheral vasodilation, and warm extremities
What is advanced sepsis characterized by?Stroke volume and cardiac output decrease, and distal hypoperfusion becomes evident (cold/clammy extremities, delayed capillary refill, altered mental status, and decreased urine output)
Patients with Neuropsych sx of Wilson's disease will have what PE finding?Keyser-Fleishcer rings on slit lamp exam
What gene is mutated in Wilson's disease?ATP7B on chromosome 13
What is the most common cause of SCD in patient with acute MI?Ventricular fibrillation (usually occurs in the prehospital phase, and is the first arrythmia to appear)
What is the most common cause of death in MI patients during the "in hospital" phase?Ventricular failure
What can cause injury to the obturator nerve?Anterior hip dislocation and pelvic surgery
What can cause injury to the femoral nerve?Pelvic fracture, or mass involving the illiopsoas/illiacus muscle (like a retroperitoneal hematoma!)
What can injure the Superior and inferior gluteal nerves? (L4-S1) and (L5-S2); posterior hip dislocation and buttocks injection
What areas of sensation does the femoral nerve innervate?Anterior thigh, lower medial thigh, medial leg
What areas of sensation does the common peroneal nerve innervateThe lateral leg and the dorsum of the foot
What can long standing carcinoid syndrome cause?RIght sided valvular heart disease
What is the most common appendiceal tumor?Carcinoid tumor
What is first line treatment for gonococcal urethritis?Ceftriaxone or fluoroquinolone
What is the first line treatment for Chlamydial urethritis?one dose azithromycin or daily doxycycline