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Auworld 13

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gubavula's version from 2016-09-14 23:59

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Loss of motor & speech skillshypotonic & unable to sit up, deceleration of head growth, wringing of hand movements, affects mainly girls, mutation of MECP2 geneRett Syndrome
Niacin can be obtained in the body throughDiet OR Synthesized endogenously Tryptophan
Pellegra causesCarcinoid Syndrome, Prolonged isoniazid or Hartnup disease
Carotene precursorVitamin A
Failure of obliteration of the process vaginalisHydroceleFluid collection around the testis & Indirect inguinal hernia BOTHpresent as asymptomatic scrotal mass that increase in size during sneezing or laughing
Down Syndrome MOAMeiotic nondisjunction95% / Mosaicism
DiGeorge SyndromeTcell deficiency Poor development in the lymph node Paracortex region
Inulin approximatesGlucose GFR
PAH approximatesRenal Plasma flow
Trigeminal V3 mandibular branch lesionSensory innveration to the face & motor innervation to the muscle of mastication
Muscle of mastication openLateral pterygoid
Muscle of mastication closemasseter, medial pterygoid, temporalis
Unilateral Trigeminal V3 mandibular branch lesionUnopposed action of contralateral side leads to deviation of mandible toward the paralyzed side on opening the mouth Foramen ovale
Foramen rotundumTrigeminal V2 Maxillary
Adult presenting with confusion, nuchal rigidity, headache, nausea low glucose in csf Most Common causeS.Pneumonia -> Lancet Shaped g+cocci in pairs
Adult presenting with confusion, nuchal rigidity, headache, nausea low glucose csf living in military camp 2nd most common causeN.Meningitidis -> Bean shaped G- cocci in pairs
Watershed areas of the brainHippocampus and Purkinje cells of the cerebellum
Cimetidine, Ciprofloxacin, Macrolides(Erythromycin), verapamil SxIncrease concentration of other drugs
Sputum shows no organism and many neutropilsLegionella Pneumonia
Pt with 2 day history of high fever, headache, mild confusion, watery diarrhea, just returned from a cruise in hawaiirecent travel, lung examination shows lower lobe interstitial infiltratesLegionella Pneumonia -> Hyponatremia
What enzyme is upregulated in Acute intermittent porphyriaAbdominal Pain, Neurological manifestations, No photosensitivity, portwine urine, PBG&ALA in urineALA Synthase -> Heme and GlucoseDextrose Inhibits this enzyme
Tb meningitis affectsArachnoid Granulations -> Communicating Hydrocephalus
Hypomethylation meansIncrease Expression
HypermethylationDecrease Expression
HuntingtonCAG trinucleotide mutation -> Decrease gene expression -> Histone deacetylation- Silencing genes necessary for neuronal survival
Thymidine dimerizationDNA Damage induced by ultraviolet radiation
Phentolamine and NorepinephrineMore slanted increase in the chart because it is reversible !Think of the chart~
Proprotein convertase substilisn kexin 9 inhibitorsInhibiting LDL receptor degradation
Fibrates & Omega pillsLower triglyceride levels -> Activating peroxisome proliferator activator receptor alpha -> Reducing hepatic VLDL production & Increased lipoprotein lipase activity
C1 Complement deficiencySusceptibility to encapsulated bacteria & higher risk for SLE
C1 estrase deficiencyAngioedema
Abdominal pain with periodic diarrhea with heme-positive stools Accumulation of epitheloid macrophages without central necrosis, string signNon caseating granuloma CHRONS
Bloody diarrhea abdominal pain low grade fever, mucosa & submucosa inflammation beginning at the rectum in a continuous patternUlcerative Colitis
Pt complains and doubts dr for his appendectomy surgery and lives alone and prefers to work for himself claiming that his previous bosses were always trying to set him up for failureParanoid personality
helicaseUnwinds DNA double helix
TopisomeraseUnwinds supercoil
40 yr old 3 day history of abdominal pain, nausea, vomiting especially after fatty meals, fever, right upper quadrant pain with erythematous distended gallbladder with patchy necrosis(due to distention), leukocytosis(bacteria invade due to inflammation), Inspiration causes painmuphysignAcute calculous cholecystitis -> Intiated by Gall stone outflow obstruction of the cystic duct -> Air or black in ultrasound in the gallbladder
Vitamin B12 deficiencyAccumulation of methylmalonic acid due to problems with methylmalony-CoA mutase enzyme
GERD biopsyElongation of lamina propria papillae with several eosinophils and neutrophils scattered within the squamous epithelium
CMV in HIV or immunocompromised CAUSESRetinitis or Esophageal ulcers
CMV in immunocompromised causesMononucleosis like syndrome fever, malaiase, myalgia, atypical lymphocytosis, elevated liver enzymes(Splenomegaly), NEGATIVE monospot
Hepatits B surface antibody POSITIVE MEANSPrior Hepatits b vaccination
Pt who is under water depriviation or dehydrated concentrated and diluted kidneyConcentrated(1400) - Collecting Duct / Diluted(110) - Distal convoluted tubule and loop of henle
Pt who is under normal state concentrated and diluted kidneyConcentrated(1400) - Loop of henle/ Diluted(110) - Distal convoluted tubule
Ulnar -> carpal tunnel syndromeWrist Adduction & flexion problem
Muscultaneous nerveElbow flexion
Intrascalene nerve blockShoulder & upper arm anesthesia procedures -> Can cause diaphragmatic paralysis(C3-C5) -> Avoid in Chronic lung disease & contralateral phrenic nerve dysfunction
Hematgenous osteomyelitisAffects children(boys), affect long bone metaphysis, high fever & malaise, refrains from using his leg with no pain or joint effusions -> Due to slow flowing blood
Hematgenous osteomyelitis in adults affects what boneVertebral bodies
Ewing sarcoma affects what part of boneLong bone diaphysis and affect children 10-15yr old
16yr old girlchildbearing age presenting with fatigue, pale conjunctivaeanemia, decreased endurance in sports, regular menses past 6 months, low hemoglobinIron deficiency anemia -> Low ferritin, High transferrin, Low MCV, Normal Folate
Vegetarians have folate or vitb12 deficiencyVitamin B12 because vegetables have a lot of folate
Normal MCV -> Low reticulocyte countLeukemia, Aplastic anemia, Anemia of chronic diseases
Normal MCV -> High reticulocyte countHemorrhage, HemolysisG6PD, Spherocytosis, Autoimmune, Microangiopathic
Patients serum fails to agglutinate horse erythrocytes(Heterophil antibody)Negative Monospot test -> CMV
Patients serum agglutinate horse erythrocytes(Heterophil antibody)Positive Monospot test -> EBV
Constriction of UreterGFR DOWN, FF DOWN, RPF NORMAL
Constriction of efferent arteryGFR UP, FF UP
Multiple Myeloma(CRAB)Low PTH & Vitamin D, High Urine calcium, Normal PTHrP
Accumulation of blood urea nitrogenRenal failure, Heart failure, Dehyrdation
Increased activity of GABA neurotransmitterHepatic encephalopathy
Increased load of nitrogenous substances absorbed by the gutHepatic encephalopathy due to GI bleeding & increased dietary protein
Pulmonary EmbolismAn area of perfusion defect without ventilation defect -> Inflammation & Atelectasis
Pneumonia and pulmonary edemaAn area of ventilation defect without perfusion defect
Potter syndrome babies will most likely have WHAT right after birthRespiratory distress due to pulmonary hypoplasia due to lack of amniotic fluid
Pt has a hard time dorsiflexion and lacks sensory at the dorsum of the footSciatic Nerve -> Common peroneal nerve ->Neck of the fibula trauma
Atrial myxoma histopathologicScattered cells within a mucopolysacharide stroma
Baby with two day history of sneezingAutonomic, tachypnea, tremors/Hypertonia/seizuresNeurologic, diarrheagastrointestinalNeonatal abstinence syndrome -> Opiate withdrawal (Mothers with poor mental health andno prenatal care) -> Methadone
Opiate withdrawalMorphine or Methadone
Opiate overdose treatmentNaloxone
MilirioneUsed to treat CHF and causes vasodilation -> phosphodiaesterase 3 enzyme inhibitor -> Increase cAMP leads to calcium influx increase myocardial cells -> Decrease right atrial pressure, Renal blood flow and perfusion increased
Hepatocyte swelling with Hepatocyte necrosis/cellular swelling/ cytoplasmic emptying/balooning degenerationAcute Hepatitis 2 days of anorexia,nausea,fdark colored, return from a mexico trip, 34 yr old,right upper quadrant abdominal pain
Nodular RegenerationSign of cirrhosis due to chronic hepatitis
Hepatocyte apoptosis - cellular shrinkage and nuclear fragmentation with intense eosinophilaCouncilman bodies
NorepinephrineA1 & B1 agonist -> Constriction
Ride sided colon cancer mass lesion on the ascending colonOccult bleeding & Iron deficiency anemia
Left sided colon cancersAbdominal pain , distention & nausea
Irritable bowel syndromeConstipation alternates with diarrhea
Rectosigmoid cancerGrossly bloody stool without fever
Ulcerative colitisRecurrent grossly bloody stool and low grade fever
Rectal adenocarcinomaTenesmuspainful defecation on straining and small caliber stool
Elderly pt presents with acute right sided weakness slurred speech, severe headache, nausea, hx of poorly controlled hypertension,right flaccid hemiplageia and lower facial weakness, right hemisensory loss, dysarthriaHypertensive Basal ganglia hemorrhage -> Lenticulostriate arteries
TCA & Gluconeogenesis connectionTCA succinyl-CoA -> Succinate makes GTP which is required for the function of phosphoenolpyruvate in gluconeogenesis
Pt presenting with bizzare behavior after moving away from home for school for the past two months, no longer socializes, believes the cafteria food is poisioned delusion and hair is dirty with clothes dishieveld, mumbles to himselfdisorganized speechSchizophreniform Disorder
Adjustment disorderIncreased anxiety, depression, disturbed behavior, >3 but <6 months
Alzhemiers affectsAtrophy of the cortex -> Temporoparietal lobes & Hippocampus
Most likely proliferation of parietal cellPathologist shows enlargement of gastric rugal folds & Parietal cell hyperplasia
Cornybacteria diptheria best treatement in orderDiptheria Antitoxin(Passive immunization) -> Best for the prognosis, Penicillin or erythromycin(Antibiotics), DPT Vaccine
Rheumatic fever first few decades of lifeMitral Regurgitation -> blowing holosystolic murmur over the cardiac apex radiating to the axilla
Rheumatic fever middle aged or older ptsMitral stenosis -> opening snap beginning of diastole with low pitched mid diastolic rumbling mumur at the cardiac apex
Painless indurated nodule on vulva with heart & neurological manifestationsGUMMA
Large gray wartlike growths typically appearing the genital or perineal regionCondylomata lata
Painless ulceration with raised indurated bordersChancre
Condylomata accuminataSeen in hpv pts having warts
Inguinal ulcers, abscesses, fistulas, inguinal swelling, rod shaped inctracytoplasmic inclusions(donovan bodies)Granuloma Inguinale
Early localized phaseFlu like symptoms with erythema chronicum migrans TX - Doxycycline
Early Disseminated lyme diseaseFacial palsy, av node block TX- Ceftriaxone
Late lyme diseaseArthritissinge knee joint, subacute encephalopathydecreased memory, somnolence, mood changes
Clipping renal artery leads to hypertrophy or hyperplasiaReduce blood flow artery lead to activation of Rening-angiotension system -> Hypertrophy & Hyperplasia of smooth muscle(juxtoglomerular) cells of the afferent glomerular arterioles -> Makes renin
Pt with intermittent abdominal pain,over the counter nsaids for pain sometimes, ulcer in the distal duodenum with fasting serum gastrin concentration is at the upper limit and rises in response to intravenous secretinZolinger Ellison Syndrome
Secretin NORMALRelease Bicarbonate and inhibit release of gastrin from gastric g cells
Secretin AbnormalIncrease in Gastrin from gastrinomas(ZE)
Proximal duodenal ulcerH.Pylori -> Lack of inhibiton by somatostatin leads to reduction in DELTA cells which release somatostatin
On physical examination he holds his right upper extremity at his side with his elbow extended and forearm pronated with pain during motion, history of falling while walking with older sister, no bruises or edemaRadial head subluxation -> Annular ligament injury
Cephalosporin resistant organismsListeria MonocytogenesAmpicillin, Methicillin resistant staphylococcus, Enterococci, Mycoplasma, Chlamydia
Young Infants(5weeks) with fever, iritability, and csf pleocytosis is due toListeria Monocytogenes
4yr old caucasian female with recurrent skin infection & respiratory infections, light skin & silvery hairAlbinism, Horizontal nystagmusperipheral neuropathy & Mictrotubluegiant cytoplasmic granules in neutrophils and monocytesChediak-Higashi Syndrome
3yr old who was recently migrated to the US has not begun to speak or walk, severe intellectual disability, died 6 months later due to refractory seizures leading to respiratory failure, ~pallor of substantia nigra, locus ceruleus, vagal nucleus dorsalisPhenylketonuria -> Phenylanine Hydroxylase deficiency -> musty or mousy odor
3 yr old boy fever and stiff neck and despite treatment at the hospital for meningitis mom wants to take son home and refuses treatment What to do no now?Obtain a court Injunction to mandate continued treatment
Cornybacterium Diptheria pathogenecityImpairment of protein synthesis by ADP-ribosylation of EF-2
If pt presents with metabolic alkalosis(High ph & Low CO2) TO FIND OUT THE CAUSE check what?Urine Chloride -> Low urine chlorideVomiting/nasogastric aspiration or Prior diuritic use
Metabolic alkalosis high chloride in urineBreakdown with hypervolemia or Hypovolemia -> HypervolemiaHyperaldosteronism/Cushing Disease/ Ectopic ACTH
h.influenza the one that cuases otits media in kids isNon-Typable which does not produce capsule
pt who presents no symtpoms but mom said he has a problem metabolizing sugar. urine sample is POSITIVEfor copper reduction test(Fructose & galactose only) & NEGATIVE glucose oxidase dipstick testing is negative(glucose only)Fructokinase deficiency
HPV E6 & E7 proteins functionInhibition of p53 & RB leading to inhibiton of cell cycle regulation and evading apoptosis
Uracil is only found in RNA and is involved withPrimase starts transcription
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