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wewovino's version from 2017-03-31 04:23

Section

Question Answer
Increase in RBC MASSAbsolute Polycythemia
PCOSHigh Tesosterone,Estrogen, LH / Low FSH
Normal RBC MASS OR Decrease in PLASMA VOLUMERelative erythrocytosis
Hypothyroidism labsTSHIncreased / Free T4Decreased / Total T3Normal
Mitral stenosis left atrium tracing is starting at high pressure
Mitral Regurgitation left atrium tracing is starting normal
LH & FSHfEEDBACK (Picture)
Chronic Granulomatous diseaseNAPD OXIDASE -> Catalase + -> S.Aureus, Burkholderia Cepacia Serratia Marcescens, Nocardia, Aspergillus
Pt with hx of hypertension and high bp has Unilateral MLF lesion due toLacunar Stroke of pontine artery -> Lateral Pons -> CN VI
Normal Aging lung valuesTLC - Unchanged, FVC(Forced air out), Residual volume - Increase, Decrease chest wall compliance BUT Increase in lung compliance
Fat Jeffs Lung volume & capacityRestrictive Lung disease -> Respiratory Rate Increased, FEV1 Decreased, FVC Decreased, ERV Decreased, RV Normal, TLC Decreased~
GranulomaIL-12, TNF-a, Interferon-y
G+ DiploccousS.Penumonia
Shizoaffective vs Shizophreniamania,delusions,hallucinations VS mania, delusions, hallucinations, Depression episodes
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Bone

Question Answer Column 3
Pagets diseaseSerum calcium/phosphorus NORMAL / Excessive Osteoclasts / Activation of RANKL N.kbLamellar bone structure resembling a mosaic pattern/ Prominent cement lines, Haphazard oriented lamellar bone
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
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Diagnosing Cushing Syndrome

Question Answer
Check firstACTH Levels
Normal or Elevated ACTH levels DO WHAT?High Dose dexamethasone test
After Dexamethsone Test -> Suppresed ACTH & Cortisol LevelsPituitary Adenoma
After Dexamethasone Test -> Unchanged ACTH & Cortisol LevelsEctopic ACTH production
Low ACTH levels TO BEGIN WITHAdrenal Adenoma,Adrenal Malignancy, Exogenous Glucocorticosteroid intake
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GI

Question Answer
Eosinophil Infiltration of lamina propria & mucosaCrohns Disease
Granulomas in bowel wall and serosaUlcerative colitis
Loss of vili & increased number of epithelial lymphocytesCeliac disease
Macrophages containing periodic acid-schiff positive bacilli in lamina propriaWhipple Disease(Arthralgia, cardiac, and neurologic)
Normal villi with epithelial cells vacuolated with fatLactase Deficiency
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Thyroid

Question Answer
Hypothyroidism(Hashimoto thyroiditis)Well developed germinal centers
Subacute thyroiditsAfter flu -> Get hyperthyroid -> Mixed infiltrate with occasional giant cells
Reidels thyroiditsHard painless rock like goiter replaced by fibrous tissue
Papillary CarcinomaGround glass nuceli & orphan annie
Follicular CarcinomaUniform follicles
Medullary CarcinomaParafollicular C Cells, Calcitonin, Amyloid Stroma
Anaplastic carcinomaGiant cells or Megaloblastic cells
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Question Answer
Vitamin D & Renal failure labLow calcium / High PTH
HyperparathyroidismHigh Calcium / High PTH
Ca TumorsHigh Calcium / Low PTH
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
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Question Answer
21hydroxylase deficiencyLow Cortisol & Aldosterone, High ACTH & 17-hydroxyprogesterone Tx - SUPPRESS ACTH
Metyaprone testInhibits production of Cortisol via 11b-hydroxylase -> CAUSE INCREASE in ACTH, 11-deoxycortisol & urinary 17-hydroxycorticosteroid
Female with ambiguous genitalia - clitoral enlargement & High bp 11B-Hydroxylase
Female with normal genitalia & High Bp17A-Hydroxylase
Male with undervirilized -no puberty,& Highbp17A-Hydroxylase
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Question Answer
Enveloped, single stranded RNA virusRubella
Gram positive coccus in chainsGroup B Streptococcus
Enveloped, double stranded DNACMV, HSV, VZV
Obligate intracellular protozaToxoplasma gondii
RhinovirusNonenveloped single strand RNA virus
InfluenzaEnveloped single stranded RNA virus
AdenovirusNonenveloped Double stranded DNA virus
ParvovirusEnveloped single stranded DNA virus
Pregnant women with pain on both feetarthritis, has a baby with pleural effusion pulmonary hypoplasia, ascitesParovirus Nonenveloped single stranded DNA virus
Increased A-fetaprotein, liver mass in a HBV carrier ptHepatocellular Carcinoma due to Viral DNA integration into the host genome
Most common hepatitsHepatitis B -> CIRCULAR DS Enveloped DNA
Progressive Multifocal leukoencephalopathyInfectious demyelinating disorder by JC VirusDD-DNA of polyomavirus in immunocompromised pts
Progressive mutlifocal leukoencephalopathy VS Subacute sclerosing panencephalitisJC Virusdna virus VS Measles(Rubeola)RNA VIRUS
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Question Answer
Brief Psychotic Disorder<1 month
Schizophreniform1 - 6 months
Schizoaffective DisorderThey have shizo + bipolar psychotic symptoms -> Hallucinations, dellusional, mania, depression, ATLEAST 2 weeks of stable mood
Autism VS AspergerBelow normal intelligence VS Normal Intelligence
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Question Answer
Thiamine B1 CofactorDehydrogenases -> Pyruvate dehydrogenase, a-Ketoglutarate dehydrogenase, Isocitrate dehydrogenase, Transketolase
Biotin CofactorCarboxylation -> Propionyl-CoA carboxylase, Acetyl-CoA carboxylase, Pyruvate carboxylase
Homocysteine defect of methylene tetrahydrofolate reductase (THF) FAD cofactorImpaired conversion of Homocysteine to Methionine Remethylation
Young boy presenting with severe chest pain during physical activity, troponin is elevated with st segment elevationHomocystinuria -> Deficiency of cystathionine synthase OR b6(Pyridoxine) deficiency as cofactor -> Cysteine becomes essential -> Elevated methionine is also seen
Niacin deficency due to cofactorb6 -> Pyridoxine deficiency
Pyruvate -> Oxaloacetate cofactor?B7 Biotin - raw egg associations
Propionic acidemia amino acidVOMIT -> Valine,Isoleucine, Threonine, Methionine, Cholestrol & odd chain fatty acids -> NEED B7(biotin) as cofactor
Transamination(Making of amino acid) requires what cofactor in the liverB6 Pyridoxine
Normal phenylalanine levels, neurological abnormalities, microcephaly, elevated prolactin(low dopamine)Cofactor enzyme- Dihydropteridine reductase OR Enzyme Deficiency DOPA -> Dopamine- Dopa decarboxylase OR Enzyme deficiency Phenylalanine -> Tyrosine- Phenylalanine hydroxylase
Succinate to Fumarate -> Succinate Dehydrogenase cofactor?B2 Riboflavin FAD
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Rate limiting ENZYME DEFICIENCY

Question Answer
GlycolysisPFK 1
GluconeogenesisFructose 1-6 Bisphosphatase
TCAIcocitrate dehydrogenase
Glycogen SynthesisGlycogen synthase
GlycogenolysisGlycogen phosphorylase
HMP ShuntG6PD
De Novo Pyrmidine synthesisCarbamoyl Phosphate synthetase II
De Novo Purine synthesisGlutamine PRPP aminotransferase
Urea cycleCarbamoyl Phosphate synthetase I
Fatty acid synthesisAcetyl-Coa Carboxylation Biotin b7
Fatty acid oxidationCarnitine Aceyl transferase I
KetogenesisHMG-Coa synthase
Cholestrol SynthesisHMG-Coa reductase
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Vitamins

Question Answer Column 3
B1 ThiamineDecarboxylation of a-keto acids(Carbohydrate metabolism)Beri Berineuropathy, heart failure / Wernicke Korsakoff syndrome
B2 RiboflavinMitochondrial Hydrogen carrierAngular cheilosis, stomatitis, glossitis, Normocytic anemia
B3 NiacinHydrogen receptorDermatits, Dementia, Diarrhea, Neuropathy
B6 Pyridoxine Transamination of amino acidsCheilosis, stomatitis, glossitis
B9 FolateHydroxymethyl/fomyl carrierMegaloblastic anemia, NTD
B12 CobalaminIsomerase & methyltransferase cofactor( DNA & Methionine synthesis)Megaloblastic anemia, Neuropathy
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Kidney

Question Answer
Decrease Renal Plasma flow / Increase Filtration Fraction & GFRConstriction of efferent arteriole
Decreased GFR / No change on RPF / Decreased Filtration fractionHyperproteinemia
Decreased GFR/ No change on RPF / Decreased FFBladder neck obstruction
Decreased GFR/ Decreased RPF / No change FFConstriction of afferent arteriole
Decrease GFR / Increased RPF / Increased FFDilation of efferent arteriole
Low RPF, LOW GFR, HIGH FFHypovolemia(DEHYDRATION) -> afferent dilation & efferent constriction
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RIPE SX

Question Answer
Rifampin SxRed orange or orange body fluids, Hepatotoxic
Isonazid SxNeurotoxicity can be prevented by giving b6, OR Hepatocyte damage OR SLE
Pyrazinamide SxHyperuricemia & Hepatoxicity
Ethambutol SxOptic Neuropathy / Red green color blindness
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Heart

Question Answer Column 3
Extensive valve calcification with impaired leaflet mobilityAortic Stenosis in a 75yr oldHarsh ejection type systolic murmur at the base of heart radiating to neck with S4 due to HCM
Fusion of valve commissures due to repetitive inflammationRheumatic valve disease in earlier ageMitral valve
Infectious vegetations attached to the valve cuspsAortic regurgitation due to infective endocarditisDecrescendo high pitched blowing diastolic murmur that begins after A2
Myxomatous valve degeneration with leaflet prolapseMitral valve prolapseNon ejection click & mid to late systolic murmur
Hypertrophic of basal interventricular septum with subaortic obstructionHCMHarsh crescendo-decresendo murmur heard best at the apex
Holosystolic Murmur best heard at the apex of the heart that radiates to the axillaMitral regurgitationBest indicator of this condition - Presence of audible S3
Presense of midsystolic clickMitral valve prolapseSudden tensing of chordae tendineae
S2 to opening snap time intervalMitral stenosisIndicator of the severity of mitral valve stenosis
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Drug

Question Answer
FluoroquinoloneDNA Gyrase with altered A subunit, Impaired influx/Increased Eflux
AminoglycosideMutated Porin, Mutated Ribosonal subunits protein, Aminoglycoside modyfying agents
Methicillin resistant Staph AureusPenicillin binding protein with reduced antibiotic affinity - Transpeptidases
VancomycinPeptidoglycan cell wall with amino acid modification / Impaired Influx/Increased efflux
Extended spectrum Beta lactamasePlasmid ocngugation with drug resistance gene
MacrolidesRibosome with methylated 16s RNA
RifamycinsMutated RNA polymerase
TetracyclinesInactivated enzyme, impaired influx or increased eflux
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Parkinson

Question Answer
COMT inhibitors / CarbidopaDecreasing peripheral levodopa degradation
Bromocriptine, Pramipexole, ropiniroleDirectly stimulating dopamine receptors
AmantidineEnhancing the effect of endogenous dopamine
Anti-cholinergics(benztropine,trihexyphenidyl) reduce tremorInhibiting central muscarnic receptors
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