RENAL
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RENAL
| Question | Answer |
|---|---|
| Which part of the nephron concentrates urine? | Medulla |
| What is the course of the ureter? | The ureter passes under the uterine artery and under the deferens? |
| What is the 60/40/20 rule? | 60% total body water, 40% ICF, 20% ECF |
| What is Goldblatts kidney? | Flea bitten kidney (blown capillaries) |
| What is Uremia? | Azotemia + symptoms |
| What is Azotemia? | Increase BUN/Cr |
| What is Nephritic Kidney disease? | Increase Size of fenestration -> Vasculitis |
| What is Nephrotic Kidney disease? | Lost BM charge due to deposition on heparinsulfate -> Massive proteinuria and lipiduria |
| What is seen in RPGN? | Cresents |
| What is Post- Strep GN? | Subepithelial, IgG/ C3/C4 deposition, ASO Ab |
| What is Interstitial Nephritis? | Urine Eosinophils or eosinophilic casts |
| What is lupus nephritis? | Subepithelial |
| What is Membrano-glomerulonephritis? | "Deposition of something" |
| What is Membrano-proliferative Glomerulonephritis? | Tram-Tracks(type II has low C3) |
| What is Minimal change disease? | Kids, Fused foot processes, no renal failure, loss of charge barrier |
| What is FSGS | AA, HIV pts |
| What are the vasculitis w/ low C3? | PMS in Salt lake city -> Post-strep GN, Mpgn Type II, Sbe, Serum Sickness, Lupus, Cryoglobulinemia |
| What is the most common cause of kidney stones? | Dehydration |
| What are the most common type of kidney stones? | Calcium Phosphate |
| What type of Kidney stones have coffin-lid crystals? | Triple Phosphate |
| What type of Kidney stones have rosette crystals? | Uric Acid |
| What type of kidney stones have hexagonal crystals? | Cystine |
| What type of kidney stones have envelope or dumbbell shaped crystals? | Oxalate |
| What disease has Aniridia?(absence of iris) | Wilms tumor |
| What disease has Iridocyclitis? (inflammation of uvea) | Juvenile rheumatoid arthritis |
| What is Phimosis? | Foreskin scarred at penis head (foreskin stuck smooshed up) |
| What is Paraphimosis? | Foreskin scarred at penis base (retraction of foreskin -> Strangulates penis) |
| What is Urge incontinence? | Urgency leads to complete voiding -> ~detrustor spasticity -> small bladder vol) |
| What is stress incontinence? | Weak pelvic floor muscles (estrogen effect) |
| What is overflow incontinence? | Runs down leg but cant complete empty of bladder |
| What structures have one way valves? | Urethra, ejaculatory duct |
| What structures have fake sphincters? | Ureters, LES, Ileocecal valve |
| What has WBC casts? | Nephritis |
| What has WBC casts only? | Pyelonephritis (Sepsis) |
| What has WBC casts + eosinophils? | Interstitial nephritis (allergies) |
| What has WBC casts 9 RBC casts? | Glomerulonephritis |
| What has fat casts? | Nephrotic syndrome |
| What has waxy casts? | Chronic renal failure |
| What has tubular casts? | ATN |
| What has Muddy brown casts? | ATN |
| What has Hyaline casts? | Normal sloughing |
| What has epithelial casts? | Normal sloughing |
| What has crescents? | RPGN |
| How do you measure afferent renal function? | Creatinine (or inulin) |
| What do you measure, efferent renal function? | BUN (or PAH) |
| What is the afferent arteriole job? | Filter |
| What happens if you constrict the afferent arteriole? | RPF & GFR goes down, FF(GFR/RPF) stays the same |
| What is efferent arterioles job? | Secrete |
| What happens if you constrict the efferent arteriole? | RPF goes down, GFR goes, FF(GFR/RPF) goes up |
| How do you test afferent arteriole function? | GFR |
| What is normal GFR? | 100 mL /min |
| How do you test efferent arteriole function? | RPF |
| What happens if you increase plasma protein concentration? | RPF stays unchanged, GFR goes down, FF(GFR/RPF) goes down |
| What happens if you decrease plasma protein concentration? | RPF stays unchanged, GFR & FF(GFR/RPF) goes up |
| What is pre-renal failure? | Low flow to kidney (BUN-> Cr >20) |
| What is renal failure? | Damage to glomerulus (BUN -> Cr <20) |
| What is post-renal failure? | Obstruction (havent peed in last 4 days) |
| What is the job of the proximal tubule? | Reabsorb glucose, amino acids, salt, and bicarb |
| What is the job of the thick ascending limb? | Make the concentration gradient by reabsorbing Na, K, Cl, Mg, Ca without water |
| What is the job of the early distal tubule? | Concentrate urine by reabsorbing NaCl (hypotonic) |
| What is the job of the late distal tubule and collecting duct? | Final concentration of urine by reabsorbing water, excretion of acid |
| What does the macula dense do? | Measures osmolarity |
| What does the J-G apparatus do? | Measures Volume |
| What is Fanconis syndrome? | Babt w/ defective triple transporter (low Na, Cl, K, w/normal BP) |
| What is psychogenic polydipsia? | No concentrating ability -> cerebral edema |
| What is hepatorenal syndrome? | High urea from liver -> Increase activity of glutaminase -> NH4 -> GABA -> Kidney stops working |
| What is Type 1 RTA? | Distal renal tubular acidosis -> H/K in CD is broken -> High urine pH (UTI, STONES, Li) |
| What is Type 2 RTA? | Proximal RTA -> bad Ca -> Lost all bicarb -> Low urine pH (Multiple Myeloma) |
| What is Type 3 RTA? | RTA I+II -> Normal urine pH (5-6) |
| What is Type 4 RTA? | Infarct J-G -> no renin -> no aldo -> High K (DM, NSAIDS, ACE-I, Heparin) |
| Chronic Pyelonephritis | WBC's, Blunted & scarring of calyces Thyoridization of Kidney |
| Urethritis | Burning on urination |
| Cystitis | Pain, frequency, urgency |
| Pyelonephritis | Costovertebral angle tenderness, flank pain, wbc cast |
DERMATOLOGY
| Question | Answer |
|---|---|
| What are 1st degree burns? | Red (Epidermis) |
| What are 2nd degree burns? | Blisters (hypodermis) |
| What are 3rd degree burns? | Painless neuropathy (dermis) |
| What diseases have “Palm & Sole” rashes? | “TRiCKSSS” (1) Toxic Shock Syndrome, (2) Rocky mountain spotted fever, (3) Coxasacki A: Hand-Foot-Mouth disease, (4) Kawasaki – CAD problem, (5) Scarlet fever, (6) Staph Scaled Skin, (7) Syphilis |
| What is Erythema Multiforme? | Target lesions (viral, durgs) |
| What is Steven Johnson Syndrome? | Erythema Multiforme Major (mouth, eyes, vagina) |
| What is Toxic Epidermal Necrolysis? | Steven Johnson w/ Skin sloghing |
| What is Pemphigus Vulgaris? | Ab against Desmosomes → circular immunofluorescence, in Epidermis, oral lesions, (+) positive Nikolsky sign |
| What is Bullous Pemphigoid? | Ab against Hemidesmosomes → linear immunofluresence, subepidermal, “floating” keratinocytes, eosinophils |
| What is Eczema? | Dry flaky dermatitis in flexor creases “itch that rashes” |
| What is Nummular dermatitis? | Circular eczema |
| What is Spongiotic eczema? | Weeping eczema: Scratching causes oozing “like a sponge” |
| What is Lichenification? | Scratching → thick leathery skin |
| What is Pityriasis Rosea? | Herald patch that follows skin lines (Tx: Sunlight) “Christmas-tree pattern” |
| What is Lichen Planus? | Polygonal pruritic purple papules |
| What is Scabies? | Linear excoritation “Burrows” in webs of fingers, toes, belt line (Sarcoptes scabiei) |
| What does UV-A cause? | Aging |
| What does UV-B cause? | Burns & Cancer |
| What are the ABCD's that indicate worse prognosis of skin cancer? | (1) Asymmetric, (2) Irregular Boarders, (3) Color difference, (4) >4mm in Diameter |
| What does the Clark level tell you? | Invasion of melanoma |
| What does Breslow's classification tell you? | Depth of melanoma |
| Where are Malignant Melanomas usually found? | (1) Males → Back, (2) Females → Legs |
| What is the precursor of a Malignant Melanoma? | Hutchinson's freckle |
| What are the types of Malignant Melanomas? | (1) Superficial Spreading → most common, “Flat-Brown”, (2) Nodular → Worst prognosis, black, dome-shape, (3) Lentigo maligna melanoma → elderly pts, fair-skin, (4) Acral lentigous → AIDS pts, dark skin |
| Where are Squammous Cell Carcinomas usually found? | Flat flaky stuff on lower face, KERATIN pearls |
| What is the precursor of Squamous Cell Carcinoma? | Actinic Keratosis (red scaly plaque) |
| What are the types of Squamous Cell Carcinoma? | (1) Bowen's disease → SCC in situ on uncircumcised penis dorsum, (2) Verrucous Carcinoma → Wart on foot |
| What are Basal Cell Carcinomas usually found? | Pearly papules on upper face, palisading nuclei, good prognosis |
| What are the types of Basal Cell Carcinomas? | (1) Nodular → Waxy nodule w/ central necrosis, (2) Superficial → red scaly plaques, like eczema, (3) Pigmented → looks like melanoma, (4) Sclerosing → yellow waxy plaques |
| What is Acne Rosacea? | Blush all the time, worse w/ stress/ alcohol |
| What is a Brown Recluse Spider Bite? | Painful black necrotic lesion |
| What is Cellulitis? | Warm red skin |
| What is Cutaneous Anthrax? | Painless black necrotic lesion |
| What is a Decubitus Ulcer? | Bedsore |
| What is a DVT? | Blood clot in veins, associated w/ hypercoagulable state |
| What is Erysipelas? | Shiny red, raised, does not blanch, usually on face, associated with Strep. Pyogenes |
| What is Ichtyosis? | Gradual lizard skin |
| What is Miliaria? | “Heat rash” → buring, itching papules on trunk |
| What is Molluscum Contagiosum? | Fleshy papules w/ central “dimple”, Pox virus (can be STI) |
| What is Psoriasis? | Silver Scales on extensors, nail pitting, differentiated too fast, worse w/ stress. (1) Auspitz Sign: Remove scale → pinpoint bleeding, (2) Koebner's phenomenon → lesions at sites of skin trauma |
| What is a Pyogenic Granuloma? | Vascular nodule at site of previous injury |
| What is Seborrheic Dermatitis? | Dandruff in eyebrows, nose, behind ears |
| What is Seborrheic Keratosis? | Rubbery warts with aging, (greasy warts look) |
| What is Thrombophlebitis? | Vein inflammation w/ thrombus |
| What is Vitiligo? | White patches, (anti-melanocyte Ab) |
| What is Xeroderma Pigmentosa? | Bad DNA repair |
| What is Erythema Chronicum? | Lyme disease (solitary lesion that spreads) |
| What is Erythema Infectiosum? | Fifth disease “Slapped cheeks” due to “Parvovirus-B19” |
| What is Erythema Marginatum? | Rheumatic Fever (red margins) |
| What is Erythema Multiforme? | Target lesions due to HSV, Phenytoin, Barbs, Sulfas |
| What is Erythema Multiforme Major? | Steven Johnson Syndrome (>1 mucosal surface) |
| What is Erythema Nodosum? | Fat inflammation (painful red nodules on legs), Sarcoidosis |
| What is Erythema Toxicum? | Newborn benign rash (looks like flea bite w/ eosinophils) |
MUSCLE
| Question | Answer |
|---|---|
| Where is CK-MB found? | Heart |
| Where is CK-MM found? | Muscle |
| Where is CK-BB found? | Brain |
| Why should you wait 30min after a meal before swimming? | All blood in gut and skeletal muscle have ran out of ATP |
| How does a neurogenic muscle disease present? | Distal weakness + fasiculations |
| How does a myopathic muscle disease present? | Proximal weakness + pain |
| What is a light chain composed of? | Actin |
| What is a heavy chain composed of? | Myosin |
| What band of the sarcomere does not change length? | A band |
| Where are the T-tubules located? | (1) Cardiac muscle → Z line, (2) Skeletal muscles → A-I junction |
| What is DMD? | “Dystrophin frameshift”, Gower sign, Calf Pseudohypertrophy |
| What is Becker's MD? | Dystrophin missense, symptoms > 5 y/o |
| What is Myotonic Dystrophy? | (1) Bird's beak face, (2) Can't let go when shake hand |
| What is Mysthenia Syndrome = Lambert-Eaton? | Gets stronger as day goes by, stronger with EMG, not small cell carcinoma associated |
| What is Myasthenia Gravis? | 1) Gets weaker as day goes, 2) stronger with Endrophonium, 3) weaker with EMG, 4) rule out “Thymoma” |
| What is Multiple Sclerosis? | Anti-myelin Antibodies, Young women with vision problems, S/E comes and go |
| What is Metachomatic Leukodystrophy? | (1) Arylsulfatase deficiency, (2) kid with MS presentation |
| What is Ataxia Telangectasia? | (1) Spider Veins, (2) IgA deficiency |
| What is Freidrich's ataxia? | (1) Retinitis Pigmentosa, (2) Scoliosis |
| What is Adrenal Leukodystrophy? | (1) Carnitine shuttle problem, (2) adrenal failure |
| What is Guillane-Barre? | Ascending paralysis, 2 week after URI |
| What is ALS? | Middle-age male w/ fasiculations, descending paralysis, no sensory problems |
| What is Werdnig-Hoffman? | Fasciculations in a newborn, no anterior horns |
| What is Polio? | Asymmetric fasiculations in child, 2 weeks after gastroenteritis |
| What is Choreoathetosis? | Dance-like movements, wringing of hands, quivering voice |
| What is Atonic Cerebral Palsy? | No muscle tone, Floppy |
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