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gubavula's version from 2016-10-13 05:23

Anesthesia

Question Answer
Halogenated hepatitis Fever, nausea, jaundice,icterus, hepatomegaly, ELEVATED AST/ALT/ BILIRUBIN (Centrilobular hepatic necrosis)Halothane,enflurane,isoflurane,sevoflurane, desiflurane
Ketamine sxDisassociate amnesia (Conscious but not aware),tachycardia, high BP & ICP, Hallucination
Midzolam sxLow BP & Respiration
NO sxMegaloblastic anemia
Propofolol sxHypotension during induction of anestheia
Succhinylcholine sxMalignant hyperthermiamuscle rigidity, Hyperkalemia
VancuroniumProlong paralysis, Hepatotoxic
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Question Answer
AcyclovirIncorporation into newly replicating viral DNA
Protease inhibitorsInhibiton of viral protease activity
OseltamivirInhibiton of virion release from infected cells
EnfuvirtidePrevention of viral entry into the target cells
InterlekinUpregulation of interferon synthesis in the target cells
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Question Answer
Excessive release of preformed thyroid hormonesThyroiditis
Hyperexcitable brainstem lociPanic disorder
Increased production of 5-hydroxyindoleacetic acidCarcinoid Syndrome
Increased release of catecholaminesPheochromoctoma
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Reuptake of inhibiton of norepinephrine at the synaptic clefts

 

Question Answer
G6PD presents as anemia, jaundice, dark urine which occurs after an infection or certain drugs due to lack of NADPH and presents similary asGlutathione Reductase deficiency which causes inability to use NADPH
Ace inhibitors do what to the kidney?Dilates efferent
Overdose of Vitamin DMental staus change, muscle weakness, constipation, polyuria, polydipsia, hypercalcemia
What increases insulin resistance in preganacyHuman placental lactogen
Boy presenting to the ER after a trauma is later found to have milky plasma that is creamy appearing upon standingFamilial Chylomicronemia Syndrome -> Complication is Acute pancreatitis -> Lipoprotein lipase deficiency
Prolonged expiration with prominent bilateral wheezing with hyperinflated lungs with a flattened diaphragmCOPD -> Tx for IMMEDIATE RELIEF is cAMP accumulation in smooth muscle cells Beta agonists
Pt with pulsus paradoxus but dont have pericardial disease can be havingCOPD or Asthma
A pt who had blood transfusion but started presenting with difficulty breathing, chills, pain in chest and back, urine is brownAcute hemolytic reaction -> Type 2 Complement mediated cell lysis -> Pt Anti-ABO antibodies bind antigens transfused donor erythrocytes leading to complement acitvation
Lumbar puncture for CSF fluid drawn from whereIliac crest L3-L4 OR L4-L5
Hypotension pt get rapid Infusion of normal saline in a pt leads toIncreases end-diastolic sarcomere length -> Increase stroke volume -> Increased cardiac output
Unfractioned Heparin is the only onethat works on the thrombin and factors -> Meaning breaks clot and prevents future clot
Biliary stone occurs due to decrease activity ofCholecystokinin
95% confidence intervalMean +or- 1.96XSD /SQUARE root of N
Reed steenberg belongs to what tissue?Lymphoid tissue -> Germinal centers
Poor long term prognosis in PSGNAdult onset
InducerCPRGQ Carbamazepine, Phenytoin, Phenobarbital, Rifampin, Chronic Alcohol, Griseofulvin, Quinidine
Pt iwth fatigue for several months,20lbweight loss with mucosal pallor,hepaotmegaly, splenomegaly, gain of function mutation of STAT proteinPrimary
Babeseiosis transmissionIsodes Ticks Lyme Disease
Young pt with fever throat pain, with immature hematopoeitic cells(blasts) in peripheral blood smearT-cell ALL -> Mediastinal mass ->Respiratory sx, dysphagia, superivor vena cava syndrome
Young pt with fever, CD10, 9, 20+, no mediastinal massB-cell ALL
Psammoma Bodies Meningioma 2nd in adultsPICTURE
Kids brain tumorPilocytic astrocytoma(Cystic & solid), Meduloblastoma, Ependyoma
AdultGlioblastoma Mulitforme, Meningioma, Schwanoma,
Least vulnerable to infarctionSpleen F& Liver
EBV is + forHeterophile antibodies that react with antigens or horse or sheep erythroytes
Pt red blood cells are incubated in a hypotonic solution with glycerol, hemoglobin, is releasedHereditary Spherocytosis -> Pigmented gall stones due to hemolysis
Aplastic crisisParovivrus B19
Aplastic anemiaEBV -> hereditary Spherocytosis
Still born fetus with closely set eyes, proboscis(primitive nasal structure), autopsy revels fused cerebral hemispheres with absent forbrain fissure and single intracranial ventriclesHoloprosencephaly -> Field defect - One embrylogic disturbance leads to multiple malformations
During fasting what enzyme is increasedHormone sensitive lipase (Triglycerides are broken down to glucose and ketones with the help of this enzyme)
48 hr without foodfasting urine is significant for ketones and serum is significant for glucose due to what enzyme?Hormone sensitive lipase
Lumbar and thoracicOstoarthritis
Cervical painRheumatoid
Pt with multiple joint pain, bilateral knee pain, blue black spots on sclera, darkening of auricular helices, urine turns black on sitting Alkaptonuria -> Homogentisic acid dioxygenase deficiency -> Homogentisic acid to maleylacetoacetate -> Acid accumulated in the connective tissue
Requirement for hospice carePrognosis less than 6 months
Dysuria, fever, chills, confusion, low bp, tachycardia, warm extremeities, rapid and shallow breathing-> SepsisTNF-a(macrophages), IL-6, IL-1
NF2Tinnitus vertigo, hearing loss
Turner syndromeSomatic Mosaicism 45X/ 46XX
Containment of TB in a pt who was exposed two years ago is due toCD4+T lymphocytes & macrophages
Severe headache and neck pain after a motor accident, develops sudden dizziness, nystagmusvestibular nucleus and left facial numbness, partial ptosis, miosis of the left eyeHornor syndrome, reduced sensation in pain & temperature of the left side of face and the right side of the bodyspinal trigeminal nucleus & spinothalamic tract, ataxic and leans to the left when walksinferior cerebral peduncleLateral Medullary Wallenberg syndrome -> Posterior Inferior cerebellarartery -> Vertebral artery
Conjugate gaze deviation toward the side of the stroke, Aphasia, Homonymous hemianopsia(optic radiations)Middle cerebral artery
Missed HiB vaccine causesepiglotischerry red, meningitis, sepsis
Pt with penis ulcer with no pain initially and then few weeks later turned painful and cell scrapings shows cytoplasmic inclusion bodiesChlamydia trachomatis
Chlamydia vs Herpes differentiationCytoplasmic Inclusions VS Intranuclear inclusions
Essential amino acid in Phenylketonuriatremulous,eye deviation, leg and arm shaking, fair skinned with blue eyes, musty odorTyrosine
Excess amino acid in Phenylketonuria tremulous, eye deviation, leg and arm shaking, fair skinned with blue eyes, musty odorPhenylalanine
Excess amino acid Phenylalanine in Phenylketonuria leads to inhibition of what enzyme that leads to AlbinismTyrosinase
Excess amino acid Phenylalanine in Phenylketonuria but normal phenylalanine hydroxylase is due toLack of BH4
COPD increaseNeutrophils, macrophages, CD8+T lymphocytes -> Protease cause alveolar damage, reduced ciliary motion & increased mucus
Pt with menorrhea, nose bleeds, with low MCV & FerritinvWF
vWD bleding form skin & mucosal sitesgingivae, nasal mucosa, gastrointestinal tract, endometrium
vWD released fromEndothelial
vWD bins toCollagen
vWD carriesFactor VIII
BRCAFunction is for DNA repair
ProtooncogenesRAS(Cholangiocarcinoma, pancreatic adenocarcioma), MYC(burkitt), ERBB1(Lung adenocarcinoma), ERBB2(breast), ABL(cml), BRAF
Tumor SuppresorsBRCA, APC, TP53, RB, WT1, VHL
A pt with Chrons disease who has intestin resected many times, watery diarrhea,weight loss is due toShort bowel syndrome -> Loss of intestinalabsorptive area -> Vitamin b12 deficiency
Nitroglycerin leadscGMP-> Myosin dephosphorylation
Inferior part of the heartPosterior descending artery supplied by the Right Coronary artery
Most deoxygenated bloodCoronary sinus
Most common causes of retinits in HIV pts with cd 4 less than 50CMV -> Tx with ganciclovir
PDAAbnormal connection between main pulmonary artery & aorta
PDA SymptomsLower extremity cyanosis and normal upper extremity
PDA MoaLigamentum arteriousm didnt form ->Machine like murmur
ASD,VSDFULL body cyanosis
External hemorrhoidInferior rectal nerve -> Pudendal nerve
Baby brown fat has moreMitochondira than white fat
8yr old with rapid, irregular movements of hands,making unintentional funny faces Syndenham chorea, fever,new III.VI systolic murmur heart and several circular faintly erythematous lesions in the abdomen Erythema marginatumGroup A strep -> Acute Rheumatic fever -> Cross-reactivity of antibodies against bacterial and host antigens
Abdominal pain with chalky white lesions on mesentry, fat cell distruction and calcium depositionAcute pancreatitis
To diagnose Mycoplasma pneumonia look for cold agglutuninAbility to agglutinate erythrocyte in vitro at low temperatures
Hemolytic anemia labs+ Coombs test, Elevated reticulocytes & Lactate dehydrogenase
Mycoplasma pneumonieae featurePhosolipid bilayer unlike other organism with peptidoglycan wall
Boy with fatigue,abdominal distenstion, bruises easily, pallorPancytopenia, several ecchymoses, massive splenomegaly, hepatomegaly dx?Gaucher Disease B-glucocerebrosidase deficiency
Gaucher disease crumbled or lipd laden macrophagesPICTURE
Pt with multiple myelomaback pain, fatigue,tenderness over lower back, hypercalcemia has increased risk of?Amyloidosis
1 week old boy with poor feeding & lethargy with unusal flexion of the left wrist and thumb and extension of fingers with cuff blood pressure measurement Trousseau sign, chest reveals decreased soft tissue attenuation in the right anterior mediastenum lack of thymic shadowDigeorge syndrome ->Missing third pharyngeal puch
Essential tremorVentral intermediate nucleus of the thalamus
ParkinsonGlobus Palidus interna, Subthalamic nuclei, Substantia nigra
SSRI MOA 1st line for anti-depressantInhibition of serotonin reuptake by Blockade of serotonin transporter
SLE LABSDecreased levels of complements C3 and C4, Increased immune complexes, ANA & Anti-dsDNA + & anti-Sm +, Anemia, Leukopenia,thrombocytopenia
SLE sxPhotosensitive facial butterfly distribution rash, occasional pain and swelling of hand joints, superficical ulcer on hard palate
CHF best way to hear murmurPt lies on one side lateral decubitus position and at the end expiration
High altitue physiology headache,fatigue, nausea dizziness, sleep disturbancesNormal or High pH, Low CO2, Low O2, Hyperventilation
Pt with painful ulcer on penis, ulcer consist of irregular borders with grey exudates, enlarge inguinal lymph node. Dx?H.Influenza -> Chancroid
Pt with painless ulcerated penis lesion, without lymphadenopathy, intracytoplasmic cystsGranuloma Inguinale(Donovan bodies)
Hemophilia A & B Oral bleeding started one hour later(Coagulation problem)Only abnormal PTT
IsonazidAcetylation
Gilbert syndromeGlucornidation
Pt with lung mass presenting with dizziness, dysartharia and bilateral limb ataxia. Biopsy shows extensive cerebellar purkinje cell degenerationSubacute cerebellar degneration -> Paraneoplastic syndrome -> Autoimmune
Food seeking behaviorVentromedial nucleus
Broken speechBroca -> Frontal cortex
Condition with increased risk for athersclerosis developmentFamilial Hypercholesterolemia & Familial dysbetalipoproteinemia
Biopsy in an HIV pt shows spindle cells with surrounding blood vessel proliferationHHV8 Kaposi sarcoma
Protruberant mass with dyspastic mucosal cells with variable degree of gland formationAdenocarcinoma
Multiple ulcers and mucosal erosions with cytomegalic cells with inclusion bodiesCytomegalovirus
Non-ulcerative inflammation with basophilic clusters seen on the surface of intestinal mucosal cellsCryptosporidium
Pt with complete mole what should be closely monitored after dilation and curtageb-HCG -> Choriocarinoma or Invasive moleP
CEA markercolorectal cancer
Pt with parenteral nutrition due to small bowel resection presents withupper quandrant abdominal pain, nausea and vomiting edema of gallballader wall and gallastones leads toDecreased cholecystokinin release due to lack of enteral stimulation leading biliary stasis
Liver disease gallstones(Cirrhosis)Impairs cholestrol to bile acid conversion leading to supersaturation of the bile with cholestrol
Normal individuals release of cholesystokininEnteral passage of fat & amino acids into duodenum triggers release of cholecystokinin
DobutamineBeta agonist, Increased HR and contractility -> Increase oxygen consumption
Sickle cellValine subsitituion for glutamic acid
Brain shows neuronal shrinkage and intense cytplasmic eosinophiliaIrreversible death -> If pt survives you would see Glial hyperplasia/scar(Astrocytes)
EBVCD21,19
Parvovirus B19Binds to RBC's
BruisesPetechie(dot), Purpura(Penny), Echymosis(baseball)
Women presents with recurrent transient pulmonary infiltrates, hx of asthma and is taking inhaled glucocorticosteroids, eosinophilia, colonization of?Allergic bronchopulmonary aspergillosis -> Immunocompromised -> Aspergillosis
IL-2 blockerSirolimus for kidney transplant rejection
Antibody agianst CD 20Rituximab
Inhibits 26s proteasome and used for multiple myelomaBortezomib
Baby presenting with developmental delay, failure to thrive, episodic seizure, opthalmoplegia, hypotonia, increased lactate level dxPyruvate dehydrogenase deficiency -> Build up of pyruvate -: lactic acidosis TX - Give Ketogenic diet Lysine or leucine
Brain tumor causing midline shift and located withing cerebral hemisphereswith necrosis and hemorrhage headaches, nausea, progressive weakness, seizuresGlioblastoma -> Most common adult
Adenocarnioma of ascending colon is resistant to anti-EGFRKras mutation
Pancoast tumor affects right shoulderpain radiating to ipsilateral arm, right sided potosis, anhydrosis, miosis - pupils become symmetric with 2 mm on the right and 4 mmon the left (horner syndrome) with a smoking historyAutonomic ganglia
Pt PT is unchanged despite giving protein C Factor V leiden mutation
Coronary sinus drains intoRight atrium
Coronary sinus Dilation leads to increased right sided heart pressure due toPulmonary Hypertension
2 day old infant withgreen inspissated(Dry)fecal mass obstructing the dital ileumMeconium ileus is specific finding forCystic fibrosis -> Most common cause of death is Pneumonia/Bronchectiasis, Corpulmonale
Selective b-blocker (BEAM)Affects cardiac myocytes & juxtoglomerular cells BUT NOT vascular smooth muscle
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