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Uworldfag22

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wewovino's version from 2016-11-17 10:34

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Hirschsprung disease(constipation, abdominal distention) area of defectSubmucosa of the narrow part of the rectum -> Absence of ganglionic cells
Pt present with new onset of neurological symptoms, anemia with shistiocytes, thrombocytopenia, acute kidney injuryThrombotic thrombocytopenic purpura -> deficiency of ADAMTS13 -> Impaired cleavage of von Williebrand factor causing microvascular thrombi
CF serums lab abnormalityHyponatremia in the serum because salt is lost in the sweat(High sodium & chloride)
Arnold Chiari MalformationPICTURE
Infant with irritability, excessive crying, develpmental delay,skull enlargementDandy walker malformation (PICTURE) -> hypoplasia and absence of cerebellar vermis & cystic dilation of the fourth ventricle with posterior fossa enlargement
Hypovolemia(DEHYDRATION)Low RPF, LOW GFR, HIGH FF due to afferent dilation & efferent constriction
Restlessness and purposeless jerking movements 3 months after have a sore throatAcute rheumatic fever induced syndenham chorea -> antibodies that cross react with basal ganglia
Acute rheumatic fever long term complicationgValvular calcifications
Alkaptonuria deficient pathwayTyrosine 2 Fumarate -> Lack of homogentistic acid dioxygenase
Leucine, Isoleucine, valine increased inMaple Syrup urine disease
Phenylketonuria deficient pathwayPhenylanine 2 Tyrosine -> Phenylalanine hydroxylase
HIV associated esophagitis with punched out ulcersHSV1
HIV associated esophagitis with linear ulcersCMV
Musculataneous nerveelbow flexin, bicep reflex provides sensory innervation toLateral forearm
Pregnancy induced gall stone~Estrogen induced cholestrol hypersecretion and progesterone induced gallbladder hypomotility
Pt with dog bite presenting with g- coccobaccili, with mouse like odorPasteurella multocida
Cat bite most common organismPasteurella multocida
Mitral stenosisIncrease Pulmonary wedge pressure
Aortic and mitral valves affected causesIncreased left ventricular diastolic pressure
Best way to differentiate between indirect and direct herniaInferior Epigastric vessels
Rising sunEpiduralmma
Cresecent moon hemorrhageSubduralcortical veins -> gradual onset hemorrhage
Niacin sxDecreased renal excretion of uric acid -> acute gouty arthritis / flushing / hyperglycemia
Bile acid resinsGI UPSET, Hypertriglyceridemia
CSF of HSVNormal glucose, high protein & lymphocytes
Increased flow velocity through aortic valveDilated cardiomyopathy, pregnancy or thyrotoxicosis
Flu like symptoms, murmur and kidney failureInfective endocarditis due to acute rheumatic fever -> Renal injury due to Circulating immune complex mediated injury
VHLHemangioblastomas, RCC, Pheochromocytoma
Pancreatic tumor causesZolinger elison syndrome
Colcheine binds toMicrotubules which disrupts cytoskeleton
H.Pylori found in thePrepyloric area
Complication of camplobacter jejujniGuillian Bare syndrome -> Demyelination of the peripheral nerves -> endoneural inflammatory infiltrate
Squamous metaplasia to a keratinizing epitheliumVitamin A deficiency seen in CF,pancreatic insufficiency
Vitamin E deficiencyInfertility
MyoclonusHiccups or hypnic jerks(occur when falling asleep)
Prolonged muscle contraction with pain(deviation of head to the right with muscle pain in the neck - spasmodic torticollis) lasting 30-40 minutesDystonia
Kidney disease SERUM lab levelsHigh phosphate, High PTH, Low Calcitrol(Vitamin D)
B-thallasemia impairs what cellular responseInitiation of translation
Microcytic anemia MNEUMONICTAILS
MyelinationIncreases length constant- how far electrical impulse can travel & Decreases Time constant
Multiple sclerosis demyleinationDecreases length constant & Increases time constant
Strongest risk factor for CIN in pts with HIV isImmunosuppression
Strongest risk factor for CIN in NORMAL population isAge of first intercourse
MI pt does not respond to nitroglycrine or aspirin is most likely hasRuptured atherosclerotic plaque with fully obstructive thrombus
Pt presenting with right toe cyanotic,with livedo reticularis(web like lesions on the skin), with normal pulseembolism 2 days after cardiac catherorizationAtheroembolism -> Acute kidney injury(Oliguria,azotemia) -> Biopsy shows Cholestrol clefts in arterial lumen
Pt with unstable angina(complete blockage), presented with right toe cyanosis, right thigh livedo reticularis after a stent placement along with kidney damage dxCholestrol micro emboli -> Cholesgtrol clefts in arterial lumen
Digoxin used for afibDecrease av node conduction by increasing parasympathetic vagal tone
Transmural inflammation with fibrinoid necrosisPolyarteritis Nodosa -> Young adults abdominal pain,peripheral neuropathy, renal problems, hypertension
Granulomatous inflammation of the mediaGiant cell arteritis Older pts with persistent headache,fatigue, muscular pain, visual disturbances
Medial band like calcificationMonckberg medial calcific sclerosis
Absence of cd55Paroxymal nocturnal hemoglobinuria -> Complement mediated hemolysis
Chronic hemolysis leads toHemosiderosis of the kidney(IRON deposition in the kidney)
Muscle biopsy shows transmural inflammation of the mid sized arteries with areas of homogenous eosinophilic arterial wall necrosisPolyarteritis nodosa associated with Viral hepatitis B
Antibiotic reactionMicroscopic polyangitis aka leukocytoclastic angitis
Acute heart failureTransudate accumulating in the alveolar lumen
Drug that causes prolongation of action potentialClass 1a sodium channel blockerDisopyramide, Quinidine, Procainamide
Drug that causes shortening of action potentialClass 1b sodium channel blockerLidocaine & Mexiletine
Sickle cell pts hemoglobin will aggregate upon whatOxygen unloading, low ph, High levels of 2-3bisphosglycerate
Young boy presenting with severr chest pain during physical activity,toponin is elevated with st segment elevationHomocystinuria due to cystathionine synthase deficiency OR B6 deficiency as cofactor -> Cysteine becomes essential -> Elevated methione is also seen
Pt presenting with muscle weakness, high bp, low potassium, high renin & aldosteroneRenin secreting tumor -> Juxtaglomerular cell tumor
Hypertension pt with low renin & high aldosteroneAldosterone producing tumor or Bilateral adrenal hyperplasia
Hypertension pt with high renin & high aldosteroneRenovascular hypertensionRAS,Malignant hypertension, Renin secreting tumor(Juxtoglomerular tumor), Diuritic use
Heavy alcoholic person whos bleeding which resolved within 30 minutes of pressure, distended paraumblical veinscirrhosis, most significant for poor prognosisProlonged Pt because it is made by the liver
Indication of poor prognosis in liver cirrhosisProlonged PT OR Hypoalbuinemia or Bilirubin levels
Drunk dr giving out ordersCall supervisor right away
A pt who traveled recently from latin america is presenting with fever, faint erythematous maculopapular lesions on chest & abdomenROSE SPOTS, with hepatospleomegaly, watery diarrhea that is now bloodySalmonella typhi
baby presenting with hypotension & dehydration, low sodium, high potassiumCongenital adrenal hyperlasia -> 21hydroxylase deficiency -> Low Cortisol & Aldosterone, High ACTH & 17-hydroxyprogesterone
Hyperthyroidism key signsPretibial myxedemalower leg skin thickening and induration, Exopotholamas
Long term complications of renal diseaseRenal osteodystrophy
Varicose veinsDue to venous valves
Pts on BZD which cause sedation should not be put on other drugs likeH1 histamine antagonists
Lecovrin also called folinic acid can over come side effects of Methotrexate but not what other drug?5Flurouracil
Pituitary adenomaDECREASED GnRH, LH , Testosterone
Serum contains IgG4 antibodies to the phospholipase A2 receptor(PLA2R) a transmembrane proteinMembranous nephropathy
Which substance is secreted from endothelium to ~inhibit platelet aggregationProstacyclin
Pt complaining of redness and pain in the right arm with hx of superficial thrombphlebitis and physical examination shows erythema and tenderness extending linear in the right armTrousseau syndrome -> means visceral cancer in the pt
CoNSCoaglase-Negative Staphylococci tx Vancomycin
Pt complains of recurrent headache that is constant unbearable, on the right of the head, pain begins on the right eye & nostrils and lasts about 30minutes, with right eye tearing with nasal congestion DXCluster Headache
ParvoB19 replicates inErythrocytes
memorize
Minimal change disease abnormal in what? Electron miscroscopy-> Diffuse podocyte foot process effacement and fusion
Question Answer
What best explains auto-radiogram findings in the different tissues(lungs spleen adipose etc)Alternate RNA splicing
Pt presents with depression, suicidal ideation, alcohol abuse, intense sadness, emptyness, engage in unsafe sexual activities all after a month long relationship breakup PIM significant for intense mood swings since adolescent, splitting behaviorBorderline personality disorder
Hiv pt with superficial candida development of fungal infection (oral,cutaneous,vulvaginitis) is due to lowT-lymphocytes
HIV pt with hematologic malignancy has candida infection(systemic) development of fungemia is a systemic candida due to lowNeutrophils
Malignant lymph node characteristicMonoclonal T-cell receptor rearrangement -> Monoclonal lymphocytic proliferation is strong
Post menopausal women with fatigue, palpitations, low hemoglobin, blood smear shows pale microcytesOccult blood loss leading to Iron deficiency due to malignancy
Contralateral Homonymous hemianopia with macular sparingPosterior cerebral artery occlusion (PICTURE)
Radical prostatectomy causes damage toProstate plexus -> leading to Erectile dysfunction
Cremastric reflex is usually damagedduring testicular torsion OR L1-L2 spinal injury
Over expression of BCL 2 normally inhibits what?Cell death cascade(Apoptosis)
Follicular lymphoma is aB cell tumor - CD19,20,79,21,10 -> Translocation of 14,18
Every time GFR halves(decreased kidney function)Serum creatinine doubles
Most common benign liver tumorCavernous Hemangioma -> Blood filled vascular spaces of variable size lined by a single epithelial layer
Pt with end stage renal disease hospitalized for hemodialysis starts bleeding around the catheter exist site that is difficult to controlUremic platelet dysfunction -> Toxins impair platelet aggregration & adhesion -> Everything normal except BT
Renal mass composed of fat, smooth muscle, blood vesselsRenal Angiomyolipomas
Bilateral Renal angiomyolipomas are associated withTuberous sclerosis ->Brain hamartomas & ashleaf spots
memorize

Hernia

HerniaSite of potrusionLower borderMedial borderlateral border
DirectHesselbach traingleInguinal ligamentRectus abdomins muscleInferior epigastric vessels
IndirectDeep inguinal ringInguinal ligamentInferior epigastric vesselsn/a
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