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Ittuworld 18

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wewovino's version from 2016-11-02 07:05

Aphasia

Question Answer Column 3 Column 4 Column 5
BrocaMessed up speechUnderstandsRight Hemiparesis(Face & upper limb)Furstrated
WernickeFluent but does NOT make senseDo No UnderstandRight superior visual field defectsNot Furstrated
ConductionFluentUnderstands
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Seizures - Focal(1 Hemisphere)

Question Answer Column 3
SimpleNO Loss of consciousness, Motor,sensory, autonomic, psychicCarbamazepine, Gabapentin,Phenobarbital,Phenytoin
ComplexLoss of consciousness, Lip smacking, epigastric rising sensationSame
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Seizures - Complex(2hemisphere)

Question Answer
Tonic clonicLoss of consciousness, Muscle contraction of limbstonic followed by rythmic jerkingclonic biting, urinating: Lamotrigine,levetiracetem,topiramate, valporic acid
MyoclonicNO loss of consiousness, brief jerking movementsSame
AbsenceBlankstareEthosuxiamide
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Question Answer
Cells responsible for forming athersclerosis fibrous capSmooth muscle cells
LOW AFP, LOW Estriol, High B-hcg, High inhibinTrisomy 21
LH stimulates Leydig cells releaseTestosterone
FSH stimulates Sertoli cells releaseInhibin B
Hypertrophic cardiomyopathy increases intensity of murmur whenSudden standing up or valsava maneuver or nitroglycerin administration -> decrease preload
Repurfusion injury and prevention of free radical oxygen species can be done withSuperoxide dismutase, glutathione peroxidase, catalase
CGD -> Catalase + organismsNAPH oxidase
MesodermKidney, muscles, spleen, adrenal cortex
EndodermGI, Liver, pancreas, lungs, thymus, thyroid, parathyroid, middle ear, bladder, urethra
Hepatic abcess in developed countriesS.Aureus Hematogenous route
Hepatic abcess in under-developed countriesE.Histolytica
Presence of fluid filled cavity in the liver with fever chills and right upper quadrant pain dxHepatic abcesss
Getting sun light effect what step in vitamin D synthesis7-dehydrocholestrol -> Cholecalciferol
Liver issues affects what step in vitamin D synthesisCholecalciferol -> 25-hydroxycholecalciferol
Kidney issues affect what step in vitamin D synthesis25-hydroxycholecalciferol -> 1,25-dihydroxycholecalciferol
Pt is presenting with difficulty using forkfinger agnosia & confused, left-right disorientation and unable carry out simple calculationsAcalculia, writeAgraphia or read, bp180/98 with long smoking history dxGerstmann Syndrome -> Dominant parietal lobe stroke -> Angular Gyrus -> Middle cerebral artery
Majority of water reabsorption occurs inProximal tubule
Medial foot lesion presents with lymphadenpathy in theInguinal
Lateral foot lesion presents with lymphadenopathy in theBOTH popliteal & Inguinal
A study testing a new cholesterol measuring test gets 200mg/dl 3 times and compared to the gold standard it is 260mg/dlReliable but not accurate
Chrons extraintestinal manifestationsAnkylosying spondylitis,peripheral arthritislow back pain,joint stifness worse at night
Vitamin K presentationEasy bruising,deep tissue joint bleeding, prolonged bleeding after surgery
Immune thrombocytopenic purpura presentationEpistaxis,gingivial bleeding, petechiae
34 yr old presents with easy bruising, and spontaneous bruising over his legs, fatigue, poor appetite, dull pain, stiffness. Hx of chrons and partial bowel resection. Dx?Bile acid malabosprtion due to terminal ileum resection leading to fat malabsorptionVitamin K deficiency
EccentricDilated
ConcentricLong standing Hypertenison
Hypertensive heart disease & HCM heart contractile function?Normal
Adrenal F Layer High cortisol meansCushing
Adrenal F Layer Low cortisol meansAddison disease -> Exogenous ACTH stimulation test does not increase cortisol levels -> Low Sodium & Bicarbonate, High potassium & chloride
Opposition defiant disorderGets angry for no reason, stubborn, irritable, argues with adults and refuses to follow rules, blames others for her own mistakes, skips class, annoys other purposely, fights with siblings
How is C-peptide is increased in the bodyInsulinoma OR giving drugs such as Sulfonylurea or meglinitides(Glyburide)
34 yr old present with vulvar itching and discharge, she took antibiotics 2 weeks ago for sinusitis, erythematous vulva with discharge shows thick white with budding cellsCandida due to antibiotcs wiping out Gram positive bacteria in the vagina
Candida vaginits causesAntibiotcs, estrogen(pregnancy), Corticosteriod, uncontrolled DM, Immunosuppresion
Bacterial vaginosisElevated pH of vaginal secretions
Pt has a renal mass and gross shows Golden yellow masshigh lipid and glycogen content & Biopsy shows rounded and polygonal cell with abundant clear cytoplasm. Most like originating in?Renal cell carcinoma (Clear cell) -> Epithelium of proximal renal tubule
Huntington sx1st degree relative family hx, Choreform movementGrimace & extremity moves without control & progressive dementia, aggressive behaviorThreatening wife with gun,Losing temper, Caudate & Putamen
Cryptococcus neoformans in immunosuppresed HIV+ cd4 count less than 98Meningoencephalitis
Cryptococcus neoformans in immunocompetent ptsPneumonia(Asymptomatic)
Female with axillary lymph nodes showing overexpression of 185Kd glycoprotein MOAHER2/neu oncogene -> Accelerates cell proliferation
Inhibiton & proliferation of what would decrease T lymphocytesCalcineurin -> Calcineuring inhibitors -> Tacrolimus & Cyclosporine
35 yr old AA sickle cell anemia presenting with fever, chills, malaise,elevated wbcs and neutrophilia becomes hypotensive and dies due to?Septiciemia -> 1st S.pneumonia due to asplenia -> 2nd H.Influenza
Sickle cell osteomyelitisS.aureus & E.coli
Treatment resistant shizophrenia (Poorr esponse to atleast 2 trials of antipsychotics)Clozapine
Carbon monoxide poisoning LABSCarboxyhemoglobinHIGH, PaO2Normal, MethhemoglobinNormal
Diarrhea few days after antibiotic use think ofC.Difficile, or Candida
Standard use of equipment for C.Difficle pts areWash hands with soap, Non-Sterile gloves and gown
Any cancer with chromosome 3p-deletionVHL
Wilms tumor presentation usually inKids
Female pt presenting with glomerulonephritis, photosensitive skin rash, arthralgias, false positive VDRL dxSLE -> Greatest risk of having miscarriages
Drumstick or clubbing of the fingersHypoxia -> Bronchiectiasis
Pt presenting with non specific stomach ache and pain, always anxious, has few friends but prefers to stay home, she worried about going to a future party and afraid of looking stupid or embarrassed, very little eye contact with brief answersSocial Anxiety disorder
Lead poisioning affectTheta-aminolevulinate dehydratase & Ferrochelatase
What intracellular substance is most likely to increase immediately after activation to G-protein-dependent phospholipase CCa2
Increased flow rate through the aortic valveAortic Stenosis
Holosystolic murmur over the apexMitral Regurgitation
Thickened and deformed mitral valve cuspsRheumatic heart disease
Heavily calcified mitral annulusWomen older than 60 with myxomatous degeneration of mitral valve
PAH OR InulinGFR
FFGFR/RPF
Agent increases peripheral vascular resistance & Sysolic Bp, Decrease hrPhenylephrine
Predisposing factor for pyelonephritisVesicoureteral reflex
Elderly presents with hx of paresthesia & numbness & back and bilateral thigh pain provoked by walking and leaning on a stroller provides relief is significant for dxSpinal stenosis -> Ligamentum flavum hypertrophy
Pt with HIV infection presenting with abdominal distention and anorexia with ascites and large mass in the small intestine with uniform,round, medium sized tumor cells with basophilic cytoplasm and proliferation fraction of >99%(Ki-67 fraction)High mitotic activity~ DX?EBV
Prominent oral thrush,interstitial pneumonia, severe lymphopenia infant in the first year of lifeVertical transmission of HIV
To stop vertical -transmission of HIV to baby is treat mother prenataly withEnzyme inhibitor drug ART- AntiReTroviral therapy
Adding pt serum with cardiolipin, letchin & cholestrol focculation is observed meansYou have antibodies of Spirochete -> Confirm with FTA-ABS TEST
Screening for SyphilisVDRL & RPR
College student having hallucinations during finals and examination shows high bp, tachycardia, paranoia, restlessness, hypervigilence, sweating & pressured speechAmphetamine induced psychotic disorder
Pt with prominent hx of sarcoidosis can also have sarcodosis lesions in the pituitary stalk leading inhibiton of dopamineIncrease Prolactin & Gyncomastia
Femoral bone neck fracture causes osteonecrosis affectingMedial collateral artery
Strawberry hemangiomaFirst increases in size and then regress
Carbamazepine MOAReducing sodium channels
Attack rate among potato salad(Poisoned Potato salad ppl / Total ppl who had potato salad) X 100
Atopic asthma what cells damage the bronchial epitheliumEosinophils Bilobed cells with granules DO NOT CONFUSE with reed steenberg
Pt with sudden onset palpitations, had similar episode a yr ago & resolved spontaneously after a drug given but then caused flushing, burning in chest(broncho spasm), SOB, iv DrugAdenosine tx for PSVT
Elderly with decreased left ventricular cavity size, sigmoid shaped ventricular system, increased collagen within the ventricle, brownish perinuclear cytoplasmic inclusions(Lipofusion pigment due to lipid oxidation)Normal aging
Unvaccinated Baby presenting with rash,cough,congestion,red eyes, rash started on face and spread to trunk, conjunctival injection dxMeasles ->Vitamin A beneficial in tx
A newborn infant appears dehydrated, had bilious vomiting, normal appearing duodenum but absent large section of duodenum and jejunum and distal ileum winding around thin vascular stalk dxIntestinal atresia (Apple peel atresia)-> ~Vascular occlusion of SMA
Cd 20 marker txRituximab
Pt put on naproxen for chronic back pain but now presents with bloody emesis, lightheaded, gastric mucosal erythemaPredicatable drug reaction of NSAIDS
Pt on trip complaining abdominal cramps, nausea, vomiting, profuse watery diarrhea, resolved without treatmentTravelers diarrhea -> Vibro Cholera
Extensive stromal fibrosis extending beyond the thyroid capsule, hard, Non-TenderRiedel Thyroiditis
Mononuclear parenchymal infiltration with well developed germinal centersHashimoto Thyroiditis -> Hypothyrodism like presentation
Mixed cellular infiltration with occasional multinucleated giant cellsSubacute granulomatous thyroiditis -> de Quervain -> Hyperthyroidism -> Tender and usually after flue like illness
Chronic myentric ischemiacomplaining of abdmonial pain after eating shares similar pathophysiology withStable angina
Carcinoid heart diseaseBilateral leg swelling, abdominal distention, endocardial thickening and dense fibrous deposits on tricuspid and pulmonary valve stenosis right sided heart failure with NORMAL left side of the heart
Infant with cleft lipDefect of fusion of maxillary prominence & intermaxillary segment -> 5-6th week
Cleft palateDefect of fusion of palatal processes
Pt with a hx of afib & CHF is presenting with nausea,decreased appetite, & vision difficulties,elevated potassium, lethargy confusion is due toDigoxin toxicity
Protein that promotes chromatin compaction and found outsideHistone H1
Child abuse case and what is the next best step in management?Seek permission from the parents to interview the child alone
Oxygen disassociation curve to the leftDecreased H(Increased pH), Decreased 2,3BPG, Decreased temperature Hypothermia
Oxygen disassociation curve to the rightIncreased H(Decreased pH), Increased 2,3BPG, Increased temperature Hypoventilation, Severe anemia, High altitude, Exercise
Young women complains of deep voice, facial hair, missing period for months, clitoromegaly with a large adnexal mass & large ovarian cystSertoli Leydig tumor -> Tubular structures line by round sertoli cells and surrounded by a fibrous stroma
CMLMessenger RNA transcript containing BCR and ABL exons
Optic tract or radiation lesionsHomonymous hemianopia (Temporal and corner of eye on top of nose)
Meyers loop lesionsPie in the sky
Dorsal optic radiation lesionsPie on the floor
HCG pulsatile therapy mimics what physiologic event?LH surge
LeuprolideGnRh Therapy for infertility
Optic chiasmBitemporal hemianopia
Acute renal rejectionCell mediated immunity -> Diffuse lymphoctytic infiltration of the renal vasculature tubules and interstium -> TYPE II
Cervical cancer predisposing factorLack of barrier contraception
Infant with menigitis with g- coccobaccili grows in sheep blood agarH.Influenza(Blood loving) -> Staphylococci helps grow H.influenza -> X factorHematin, V factorNAD+
Pt with persistent fever, night sweats, fatigue, with CML, PRESENTS WITH HEADACHE, scant nasal discharge and a problem with left eye orbtal swelling and cellulitisAspergillus fumigatus -> Hyphae branching at acute angles with septations
FLAT black to brown pigmented maculesJunctional nevus
Nodular pigment lesions with uniform round cells with inconspicuous nucleoli and few mitotic figuresCompound nevus
Colchicine used in acute gout for pts who cant handle NSAIDS MoaInhibit Leukocyte migration and phagocytosis by blocking~ tubulin polymerization
CorticosteroidsInhibits conversion of Phosolipids to arachnoidic acid
ZileutonInhibits conversion of arachnoidic acid to leukotrienes
Ischemic injury to the brain leads to Liquefactive necrosisLysosomal digestion of the tissue
Enzyme deficiency G6PD sxPt african american who is on Dapsone presents with blood smear with RBC fragments , bite cells, spherocytes & anemia
Akathasia txDecrease dosing of anti-psychotic medication the pt is on OR B-blockers or BZD
Pt with PMH for Hypertension is presenting for prenatal care at 30 weeks for the first time has a baby with oligohydraminos,underdeveloped face is most likely due toTaking ACE inhibitors while pregnant can affect babys kidney
For normal development of kidney in babies you needAngiotensin II
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Ovarian neoplasms

Question Answer Column 3
EpithelialSerous cystadenocarcinomaMost common, Psammoma bodies
EpithelialMucinous cystadenocarcinomaPseudomyxoma peritonei, Mucin producing epithelial cells
Germ cellDysgerminomaAdolesecents, Increased b-hcg & lDH, Histology fried egg appearance
Germ cellEndodermal sinusIncrease AFP, Aggressive, Schiller Duval bodies resemble glomeruli
StromaGranulosa cellIncrease Estrogen & Inhibin, Call exner bodies coffee bean nuclei
StromaSertoli LeydigIncreased Androgens(Hirsutism, clitomegaly, voice deepening)
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