Paworld 14

gubavula's version from 2016-09-17 16:46


Question Answer
Case fatality for example Methicillin resistant S.Aureus 40fatal cases & 70 Non fatal40/110
Normal Insulin Hormone function in a pt with polyuria, polydipsia, lethargic and confusionDecrease Glycogen secretion
64 yr old with 40 yr smoking history with doppler showing left vertebral artery reveals redrograde (caudal) flow instead of normal anterograde flow Which Artery occluded?Subclavian Steal Syndrome Subclavian artery sx -Arm ischemia(Exercise induced fatigue, Paresthesia,pain) Dizziness, vertigo, Systolic bp difference between affected arm and not normal arm
Tuning for vibration not heard on the auditory meatus of left ear & Vibration is heard louder on the left ear when placed on the middle of foreheadConductive hearing loss of Left ear
Rinne test abnormalSound is not heard best at the audiatory meatus but instead the mastoid process
Weber test abnormalVibration heard louder in one ear
Pathogenicity of Non-pathogenic strain of C.Diptheria but acquires causing pseudomembranous pharyngitisPhage conversion permitting exotoxin production
Polycythemia vera(pruritius after shower, ruddy complexion) MOAIncreased bone marrow sensitivity to growth factors
Prokaryotes(E.coli) mutatin that inhibits binding of certain proteins to its regulatory sequenceOperator Locus
If Inferior mesentric artery is ligated then the next artery supply for collateral supply to prevent ischemiaSuperior Mesentric artery
Increase Drug X increase cardiac output & renal blood flowDopamine
Increase Drug X increase contractility & decrease renal blood flowEpinephrine
Increase Drug X decrease renal blood flow and normal cardiac outputPhenylphrine
Tamoxifen SxEndometrial Hyperplasia & Hot flashes
Pt who has problem having intercourse with gf and feels ashamed because he orgasms in less than a minute BUT does Not have the problem while masturbatingPremature Ejaculation
SSRI causeSexual dysfunction and treatment for premature ejaculation
Cogenital Adrenal Hyperplasia21hydroxylase -> Progesterone-> 11Depxycorticosterone & 17oh progesterone -> 11Deoxycortisol Clitomegaly & partial fusion of labioscrotal folds
Klinefelter lab valuesHIGH serum LH, HIGH serum FSH, LOW serum testosterone, NONE sperm count Gyncomastia, Long legs, firm testes
Difficulty with vision Compresion of the anterior medial lovbe agianst free margin Tentorium cerebellar location What nerve is messed up?Occulomotor
Broad spectrum antibiotic with beta-lactamase(Break down penicillin) produce bacteroide species TxPipercillin&Tazobactam combination
Anterior compartmentDeep peroneal Nerve -> Acute compartment syndrome -> Severe pain,myonecrosis,nerve injury after a fracture and pt is place on closed reduction and immobilization
Lateral compartmentSuperficial peroneal nerve
Deep posterior compartmentTibial nerve
CAAT site on eukaryotesInitiation of transcription
DuloxetineDual Serotonin & Norepinhrine uptake inhibitor -> Depression, Anxiety, Variety of chronic pain Sx Confusion
TamsulosinTx BPH
Development of paramesonephric & mesonephric ducts associated withRenal with uterine abnormalities
Failed Lateral fusion of paramesonephric ductsBicornuate uterus ->Indentation in the center of the fundus
Recurrent pregnacy lossgravida 4 para 0,uterine abnormalitiesHysterosalpingogram, Unfused uterine horns, renal agenesis, abnormal contour to the uterine fundusBicornate uterus
Celiac Disease(Gluten enteropathy) related skin disease seen in 4th or 5th decadeDermatitis Herpatiforms
Colon cancer pt presenting wtih generalized edema, Increased proteinuria, glomerular capillary wall thickening, irregular spikes protruding from the glomerular basement membraneMembranous Glomerulopathy -> DM,Solid tumors, SLE, gold, penicillamine, NSAIDS, Hepatits B&C, malaria & syphilis
+Nikolsyky lesionPemphis vulgaris(Adults) & Staphylococcal Scalded Skin Syndrome(Kids)Exotoxin mediated skin damage
Doxazosin/Prazosin/TerazosinTx of Hypertension & BPH -> A1 blocker
Oral drug given to a pt is sub therapeutic but the rectal is therapeutic. Why?Increased Liver blood flow.
Sex Hormones(Estrogen)Initially leads to precocious puberty, tall stature but later leads to premature closure of the epiphysis plate
HHV8Tumor arise from primitive mesenchymal cells
Tetrology of fallot severity is based onRight ventricular out flow obstruction
Unique to daughter strand that is synthesized in the opposite direction of the growing replication forkSynthesis of multiple short DNA fragments
How to get peripheral resistance calculation?Resistance in each vessel / Number of vessels 2/4 -> 0.5
Right ventricular myocardial infarction (hypotension/distended jugular veins/ clear lungs)Cardiac output low / Pulmonary wedge pressure Low / Central venous pressure high
Left ventricular myocardial infarctionCardiac ouput low / Pulmonary wedge pressure high (Pulmonary edema) / Central venous pressure high
Rasburicase in tumor lysis syndrome MOAConverting uric acid into more soluble metabolites
Allopurinol in tumor lysis syndrome MOAInhibiting uric acid formation during cell lysis
Folinic acidSupplying necessary cofactors blocked by a chemotherapeutic agent
MesnaSupplying a thiol group to inactivate toxic metabolites
Mitral stenosis left atrium tracing is starting at high pressure
Mitral Regurgitation left atrium tracing is starting normal
62yr women cough & dyspnea, copious amounts of pale tan-colored fluid(bronchorrhea), columnar mucin secreting cells that line the alveolar spaces without invading stroma or vessels(Well differentiated)Adenocarcinoma in SITU Malignant neoplasm
Cough dyspnea chestpain with hemorrhagic (red) infarct seen on light microscopy of lungsPulmonary infarction due to pulmonary emoblism
Chest xray with coin lesion, mature hyaline cartilage mixed with connective tissue, smooth muscle, fatHamartomas Benign neoplasm
pt presenting with 1-day history of sever dyspneaACUTE, worsening throughout the day,20 pack smoking history, PaO2 54LOW, PaCO2 26LOWAlveolar HYperventilation
Alpha -helical regions with residues valine, alanine, isoleucine, phenylanine, tryptophan, methionine, prolineProtein responsible in anchor the protein to the phospholipid bilayer of the cell membrane
Chronic rejection of lung(Months to years)Chronic Obliterans syndrome -> Small airways -> Sx Dyspnea & wheezing
Meckels diverticulumTrue diverticulum Mucosa,submucosa, muscular layers
Zenker DiverticulumFalse diverticulum mucosa,submucosa
Sickle cell traitAsymptomatic she has relative protection from plasmodium falciparum BUT NOT MALARIA -> HbA is always higher than HbS
Sickle cell anemiaSymptomatic Vasoocclusive and painful crises(Dehydration, cold weather), High reticulocyte, Normal mean corpuscular volume
Coarse erythrocyte basophilic stippling and microcytic hypochromic anemiaLead poisoning
Obstructive lung disease increased what?Residual volume (RV) / Total lung capacity (TLC) ratio
Difficulty breathing,abdominal cramps, after starting ceftriaxoneAnaphylactic shock -> Treat with Epinephrine
Eating contaminated raw oysters lead toVibrio Cholera -> Watery Diarrhea
5 yr old presenting with somnolence, lethargy(Hyperuremia), Oliguria(Kidney problem), History of bloody diarrhea few days ago(E.coli), Increased blood urea nitrogen & Creatinine, several fragmented erythrocytesHemolytic Uremic Syndrome -> E.Coli -> From eating Undercooked beef
Pt 30 yr old comes in for tubual ligation because she is "tired of using contraceptives & does not wish to have children~, pt is also married for 10 years. Best response?Review the risks & benefits of tubual ligation and alternate birth control methods
A physician who works night shift job at another clinic comes in for a morning shift and forgets to check the lab values on a pt that leads to pt going into coma What is most likely reason for the physician to forget to check lab values?Physician fatigue due to sleep deprivation(Night shift job)
Pain that started periumblical and then worsened and localized to the right quadrant tenderness with guardingAppendicitis
Landmark used to to identify appendix during an appendectomy?Teniae coli
When a pt wbc are incubated with mycobacterial antigens, large amounts of interferon-gamma is detected in blood sample due toT-Lymphocytes
A 26 yr old with 3 day history of dysuria & uretheral discharge 2 weeks after sexual intercourse. Physical signs show mucoid discharge with gentle milking of the penis, gram stain shows numerous neutrophils with intracellular diplococciNeisseria Gonnorhea -> "Numerous neutrophils with intracellular diplococci" -> Thayer MartinSelective -> Antibiotic containing medium
Pt neuromuscular blockade is assessed by electrically peripheral nerve 4 times is quick succession & observing the muscular response test is called?Train of four stimulation
Fast acting depolarizing neuromuscular blocking agent causing signal reduction in all 4 twiches during train of four stimulationSuccinylcholine
2 month histroy of pruritic skin rash over elbows & Knees, history of abdominal discomfort, flatulence, volumnious greasy stools, papulovesicular skin rash in groups with erosion and excoriationsDermatitis Herpetiformis -> Increased intestinal intraepithelial lymphocytes
Romberg test(Stand with his feet close together arms to sides, and eyes closed)Test for proprioception
Anytime High PTHLow Phosphate / High Calcium
Robertson pupils(Syphils) due to damageDamage to mid brain tectum
Pt who is treated with an antibiotics for cellulitis presents with severe abdominal cramps, diarrhea, delirious, agitated, High blood pressure, hyperthermia, tachycardia, hyperreflexiaSerotonin Syndrome caused by Linezolid
Pt who has CHF presents with disturbed color preception, anorexia, nausea comiting, and diarrheaDigoxin Toxicity -> Most serious complication Arrythemia
Kallmann syndrome(Tall, young, no masculinity, poorly developed secondary sexual characterisitcs~Absence of GnRH neurons in the Hypothalamus due to defective migration & Anosmia -> Central hypogonadism
Pt has palpitations with light headiness, felt palpitations in the past with no family history, No chestpain, dyspnea, Short P-R interval & Slurred & broad upstroke of QRS called delta waveWolff Parkinson white syndrome -> Atrioventricular conduction tract bypassing the AV node
Long QT syndrome Prolonged QTProlonged repolarization due to myocyte ion channel abnormality
Atrial fibrillation Absent P wavesRapid electrical impulses originating in the pulmonary veins
Hypertrophic scar or disfigured scar is due toElevated TGF-b -> Increased fibroblast
Elastin featuresNon Polar(glycine,valine), Interchain cross links involving lysine(Alpha1 -Antitrypsin)
CollagenDisulfide bridges, post translational hydroxylation, glycosylation of procollagen molecules, Triple Helix
Phenytoin, CarbamazepineAxonal propagation of the action potential
Calcium in the brainNeeded for fusion and release of neurotransmiter vesicles into the synaptic cleft
GabapentinInhibting presynaptic voltage gated calcium channels
LevetiractemActs downstream by disrupting vesicle fusion
Pulmonary embolus CAUSEVentilation perfusion mismatch
Pulmonary Fibrosis, Hyaline membrane disease CAUSEDiffusion impairment
PaO2Oxygen in the artery
PA02Onxygen in the alveoli
Psychotic drugs + Antidepressants + benzodiazepinesFALL RISK
4yr old boy with 3 days of fever,irritability, oral lesions, painful ulcers on the tongue & gingiva,swollen gums, cervical lymphadenopathyHSV1 -> Primary Infection - Herpetic Gingivostomatits -> Peak age 6month -5years
Verapamil calcium channel blocker on heart effect?Slowed diastolic depolarization
Hypermethylated meansHeterochromaton -> Not expressed -> Low transcription activity
Toxic epidermal necrolysisLamotrigine, Carbamazepine, Phenobarbital, Phenytoin
Mucicarmine StainCryptococcus neformans
Isoflurane increased lab value?Cerebral blood flow
Isoflurane decreased lab valueGFR, RPF, Hepatic blood flow, ejection fraction, mucociliary clearance
Pentose Pathway -> Unable to generate NAPHG6P Deficiency unable to convert Glucose-6-phosphate-> Ribose-5-phosphate
Pentose Pathway -> Convert Fructose-6-phosphate to ribose-5-phosphateTransketolase
Pagets diseaseSerum calcium/phosphorus NORMALLamellar bone structure resembling a mosaic pattern
Vitamin D deficiencyLow urinary calciumOsteoid matrix accumulation around trabecula
OsteopetrosisAccumulation of woven bone& skeletal thickeningSpongiosa filling medullary canals with no mature trabeculae
Hyper parathyroidismLow phosphate, High calcium, CalciuriaSubperiosteal resorption with cystic degeneration
OsteoporosisNormal lab valuesTrabecular thinning with fewer interconnections
Women who presents with acute vision disturbance,dimming vision, dull ache in the left eye, jaw claudication, hip muscle aches(polumyalgia rheumatica), Best initial test?Giant cell arteritis ESR OR C-reactive protein
Retroperitoneal OrgansSuprarenalglands, Aorta & inferior vena cava, Duodenum, Pancreas(head & body), Ureters & bladder, Colon, Kidneys, Esophagus, Rectum


Question Answer
Brief psychotic disorder>1Day & <1month sudden onset full return to function
Schizophreniform disorder>1month &<6months same symptoms as schizophrenia,
Schizophrenia>6months atleast one month of active symptoms but also has residual periods
SchizoaffectiveActive phase symptoms of schizophrenia for atleast 2week lifetime history delusions or hallucinations in the absence of prominent mood symptoms
Delusional1 or more delusions for more than a month with no other psychotic symptoms


Question Answer
Posterior descending arteryPosterior walls & Inferior walls of the ventricle
Posterior descending arteryPosteromedial papillary muscleMitral regurgitation
Right marginalAnterior wall of right ventricle
Left circumflexLateral & posterior wall of left ventricle / Anterolateral papillary muscle
Left anterior descending arteryAnterior wall of left ventricle / Anterolateral papillary muscle
LAD BRANCHESDiagonal artery