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wewovino's version from 2017-03-05 07:20

Large Vessel arteritis -> Temporal Giant cell VS Takayasu Arteritis

Question Answer
Less than 50yrsTakayasu Arteritis
Absent OR Weak pulse in upper extremityTakayasu Arteritis
AsianTakayasu Arteritis
Carotid ArteriesTakayasu Arteritis
Jaw claudication,Headache, visual disturbance, flu like symptoms(joint & muscle)Temporal Giant cell
Older than 50yrsTemporal Giant cell
FemalesTemporal Giant cell
Aortic ArchesTemporal Giant cell
Treatment for BOTHCorticosteroids
ESR for BOTHElevated
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Medium Vessel Arteritis -> Muscular Arteries

Question Answer
Necrotizing VasculitisPolyarteritis Nodosa
Fibrinoid necrosis, Lesions of varying age, string of pearls, transmuralPolyarteritis Nodosa
Spares LungsPolyarteritis Nodosa
Young adultsPolyarteritis Nodosa
Associated with Hepatitis BPolyarteritis Nodosa
Asian children <4Kawasaki
Fever, conjunctivitis, Rash palms & soles, lymphnodes enlargedKawasaki
Coronary artery aneurysm, MI in childrenKawasaki
Aspirin txKawasaki
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TCA -> Amytriptyline -> Coma, Convulsions, Cardiotoxicity

Question Answer
Muscuranic acetylchline receptorsTachycardia, delirum,dilated pupils, flushing, decrease sweating, hyperthermia
Alpha 1 adrenergicPeripheral vasodilation -> orthostatic hypotension
Cardiac fast sodium channelsConduction defects, arrythemias
Presynaptic NE & 5-HT neurotransmitter uptakeAnxiolytic effects, seizures, tremors
H1 receptorsSedation, increased appeitite
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Section

Question Answer
Carotid AfferentGlossopharyngeal ->Lightheadness while butonning shirt
Carotid EfferentVagus
Diastolic Hear failureLeft ventricular end-diastolic pressure & volume Increased & Normal, Ejection fraction Normal
Pancytopenia,splenomegaly,middle aged man, fatigue,weightloss,early satietyHairy Cell leukemia
Bursts of coughing, coughing spell, older man, unvaccinated THINK ofBordetella Petrussis -> G- coccobacillus
Phospholipase C -> formation of Diacylglycerol DAG & inositol triphosphate IP3 leads to formation ofProtein Kinase C
Glucose 6 phosphate -> Ribose 5 phosphate uses G6PD enzymeMakes NADPH used for -> Fatty acid synthesis & Glutathione antioxidant
APC - KRAS - p53Inactivating - Activating - Inactivating cancer mutation
Pts who have panic attack leads to hyperventilationDecrease arterial partial CO2 tension -> Bain not perfused symptoms are -> Dizziness, weakness, blurred vision
High potency Anti-psychotics(Fluphenazine, Haloperidol) SxExtrapyrimidal symptoms -> ~Muscle rigidity, akathasia, parkisonism
Low potency Anti-psychotic(Chlopromazine, Thioridazine) SxSedation, Orthostatic hypotension, Anti-Cholinergic sx
S.Viridians affectsDiseased valves
S.Aureus affectsNormal valves -> IV drug abuse -> Tricuspid
Ashoff bodies in ARF heart isChronic inflammation with giant cells, fibrinoid necrosis with Anikoschkow cellsCaterpillar nucleus
Acute Rheumatic Fever -> JONES CriteriaJoint, Oheart(Pancarditis, Endocarditis(Valve)), Nodes, E Erythema migrans, SyndhamChorea
Thoracic aorta aneurysmTeritary syphilis -> Tree bark apperance -> Aortic regurgitation complication
Abdominal Aorta anurysmbelow renal artery but above the bifuricationAthersclerosis in a 60+ hypertension pt
Increase in malonyl-CoA concentration directly inhibits what?Fatty acid oxidation
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Hyaline arteriosclerosis SEEN in pink & protein leaking: Benign Hypertension, Diabetes
Question Answer
Hyperplastic arteriosclerosis SEEN in Proliferation of smooth musclesMalignant Hypertension
Ectopic pregnancy in the ampula rupture into which surrounding tissue?Pouch of Douglas
Pt is calm with doctor but rude to nurse. Family shows up to visit him and he is nice to the ones there except the one that didnt come to visit himSplitting
During hypotension what is the primary response by kidneyWater conservation
Pt has no hx of sustance abuse and is concerned whether the morphine she is taking for surger will lead to addicitonReassure the pt that herchance of becoming addicted to narcotics is minuscule
Pt presents 10 days after scraping arm on a tree. Primary MOA of edema?Separation of endothelial junctions
Pt with jaundice 3 cm mass head of the pancreas shows numerous anaplastic cells. Cells most likely originated from?Duct epithelium
p53& Rb gene mutation is from what cycleG1 -> S phase
c-perfringesa-toxin
Pt present with two week x of nausea, abdominal pain, vomiting sporadically for the past 4 years, hyperbilirubinemiaAnnular Pancreas
Acute rheumatic fever shares similiar pathophysiology with Idiopathic thrombocytopenic purupura due toType II Hypersensitivity
3 different pts with dilated cardiomyopathy, mitral prolapse, infective endocarditis of mitral valve shares what similar complication ?Increased Risk of Systemic thromboembolism
Stages of GriefDeniel, Anger, Bargaining, Sadness, Acceptance
Lateral portion of dorsal columnVibration
Medial portion of dorsal columnProprioception
Aortic Regurgitation Blood Pressure valuesSystolic pressure Normal(Unhealthy), Diastolic pressure Low
Aortic Stenosis Bood pressure valuesSystolic pressure low, Diastolic pressure Low
Choriod plexuses plexus papillomas are bening tumors that dilates lateral ventricles in children leading toCompression of Caudate nucleus
Hoarsness in pt after thyroidectomyVagus -> Recurrent laryngeal nerve
Dissecting Aneurysm key hallmarkSudden excrutiating pain which began in anterior chest and then within hrs moved to the back and to the abdomen
Any time a pt has a febrile or an ongoing condition leading to hallucination, disorientations, frieghtened restless are signs ofDelirium
Esophageal atresia caused byPosterior deviation of the tracheoespophageal septum
Brain spherical tumor mass in the junction of cortical gray and white matter of the lateral hemisphereMetastatic carcinoma
Ventricular tachycardia -> Decrease SA node automaticityBeta-blockers
A-fib or Aflutter -> Decrease SA node automaticityCalcium channel blocker
OsteoblastAlkaline Phosphatase
OsteoclastTartate Resistant & Hydroxyproline
Coarctation of AortaHigh BP upper extremity/ Low BP lower extremityDecreased blood vessel resistance -> Normal Blood flow top and bottom
IBD is usually associated joint problemsRheumatoid arthritis HLA b27
Prior antibiotic usage accompanying diaarheaPseudomembraneous colitis
Dogs poop ingestionBrucella canis
Dogs bitePasturella multicoda
G+ catalase+ gama-hemolyticS. Epidermidis
Achlasia affectsLower esophageal sphinctor
Superior pancreaticoduodenal artery & Inferior pancreaticoduodenal arteryCeliac Trunk vs SMA -> Occlusion of either would lead to supply by other
OOcysts in diarrhea in AIDS ptisOspOra belli
Vaginal spotting in an elderly womenMalignant Mixed Mullerian tumor
Donor with only kindey will have decreasedGFR & Creatinine clearance
Goodpasture VS PSGN ImmunofluorenceLinear IgG andC3 deposits VS Coarse granular IgG & C3 deposits(Lumpy bumpy)
Slit lamp examinationWilsons disease -> Neurological, Hepatic, Psychiatric
What acquires envelope from the host cell nuclear membranephospholipid aka envelopeCytomegalovirus or Herpesfamily
JA2K or STAT mutationPrimary Myelofibrosissevere fatigue,hepatomegaly, splenomegaly, Polycythemia vera, Essential Thrombocytosis
Deficiency of a-galactosidase ARENAL FAILURE, Neuropathic pain(burning sensation), Angiokeratomas(Non blanching red papules),Cardiovascular problem(LVH,TIA),
DNA Polymerase I has5-3exonuclease activity VS DNA Polymerase III has 3-5exonuclease activity
ALS VS Syringomeylia(Upper & Lower neurons)No sensory Loss vs Sensory loss
Alcoholic pt with Low bp pt with marked balooning & vacuolar degeneration of PCT with Multiple oxalate crystalsToxic Acute tubular Necrosis -> Ethylene gycol posioning
Alcoholic pt renal failure, oliguria, hypotension, anion gap metabolic acidosisIschemic Acute tubular necrosis
Vision + Nausea + decreased apeptite + HyperkalemiaDigoxin Overdose Do not confuse with spirnolactone or diltizaem
Norpeinephrineinduced extravasation txPhentolamine -> A1 antagonist
Macrophages decrease plaque stability by secretingMetaloproteinases
Cabon monoxide poisioning lab valuesCarboxyhemoglobin - INCREASE, PaO2 - NORMAL, DO NOT worry about Methemoglobin -NORMAL(Another condition)
Myeloid -> AML Stains forMyeloperoxidase AKA Auer Rods
Lymphoid -> ALL stains forTDT+ AKA DNA polymerase
B-ALL markerCD 10, 19, 20
B-ALL t12.21Good prognosis in kids
B-ALL t9.22Bad prognosis in Adults
T-ALL markerCD2-8
T-ALLThymus, Teenager, Mediastinal Mass, Acute lymphoblastic Lymphoma
Acute monocytic leukemiaAffects a pt gingiva & Lack MPO
CLL markerCD5 & CD20 & Smudge cells
Mutiple Myeloma vs HTLV1 Acute Lymphoblastic leukemiaBone lytic lesions(CRAB) vs Blone lytic lesions & RASH
Basophilis, T.9.22, Leukocyte Alkaline phophatase Negative sign forCML
CML txImatinib -> Blocks tyrosine activity
MG pathogensis is similar to Good pasture syndromeType II hyperesensitivity
Active immunizationDPT Vaccine
Passive immunizationDiptheria anti-toxin
Autosomal recessive parents with both parents carrirers will have affected child25% 1/4
Autosomal recessive parents with both parents carriers will have diseased child(Both)75%
Autosomal recessive parents with both parents carriers will have normal child25
Body with ezcetamous rash, musty body odor, gait abnormality, intellectual disabilityPhenylketonuria
Systemic sclerosis or pts with CREST have a high chance forPulmonary hypertension Intimal thickening of pulmonary arterioles
Comatose red nucles located where?Midbrain tegmentum or Pons
Ingested rat poison -> bleeding from everywherescattered ecchymoses how to tx?Fresh frozen plasma -> Just like warfarin toxicity
Pt looks to the right but the left eye does not go to the rightIntranuclear opthalmoplegia -> MLF -> Left Dorsal Pons
HUS Coombs testNegative -> INCREASED indirect bilirubin despite pt not having yellow skin
Stroma Ovarian cancer markerCA-125
Long term & least amount of exacerbations recommend usage of fluticasone(corticosteroid) in asthmatic pts is to preventCellular reaction
Lipid peroxidationFree radical damage
HemochromatosisNOT HEPATIC BUT Increase intestinal Iron absorption
Granulosa ovarian cancer marker (sx thickened endometrium with adnexal mass with yellow & firm cuboidal cells with gland like structure contatining acidophillic materials in microfollicular pattern)Estrogen
TNF-a (steroids,Epi, Nor-epi, glucagon) causes insulin resistance through up regulation ofSerine and threonine residue phosphorylation
History of hypercholestremia for years presents with firm mass palpated in the right upper quadrantPorcellain gallblader -> Increased risk of Gallbladder adenocarcinoma
Cervical cancer risk factor immunosupressed vs imunnocompetentHIV vs High risk strain/Early age of intercourse/ Sexually transmitted diseases
Limb DysmteriaOvershoot, undershoot -> Lesion of cerebellar hemispheres of lateral descending motor systems
Above dentate lineSuperior rectal veins -> Inferior mesenteric vein tributaries
Pt got a transfusion then has fever, chills, chest or back pain, red colored urine(hemoglobinuria)Acute Hemolytic transfusion reaction -> Type II cytotoxicity -> Compliment mediated cell lysis
Pt being treated for allergic rhinitis presents with flushing & mydrasisAntagonism of Muscarinic receptors NOT Stimulation of A1-adrenoreceptors(causes ONLY mydriasis)
Wet, wacky wobblyNormal pressure hydrocehaplus
Pt with no smoking history has lungmass in the lowerlungAdenocarcinoma(More common) & NOT Large cell carcinoma(Not common)
Long term complication of GERDAdenocarcinoma
Ileum affectedChrons cobble stone appearance
Milky plasma -> HypertriglyceridemiaAcute pancreatitis
Pt presenting aplastic crisis(Pure red blood cell aplasia) causesParovirus b 19, Lymphocytic leukemias, thymoma
A rare cause of B12 deficiencyPancreatic Deficiency -> B12 binds to R factor in salivary and requires pancreatic enzymes to cleave R factor in the stomach to attach to intrinsic factor
Most common cause of death in children with sickle cellInfection with encapsulated organisms
Most common cause of death in Adults with sickle cellAcute chest syndrome -> Pain, shortness of breath -> Pneumonia
Metabisulfite testCause sickling of rbcand used to test for sickle cell anemia
Hemoglobin CLySine & Lysine Crystals
Protection of RBC from complementDAF(Decay acclerating factor) & MIRL attachments with the help of GPi
Sucrose testScreening test for PNH
Acidified serum test or flow cytometery to detect lack of CD55(DAF)Confirametery test for PNH
Main cause of death in PNHThrombos is due to destruction of not only RBC but also platelets
Fever every other dayP.vavx & ovale
Fever every dayP. Falciparum
Repurfusion injury leads to free radical formation and which can neutralized bySuperoxide Dismutase
Pituitary Adenoma -> Conns Syndrome pts(No edema & low renin) pts present withNormal Sodium, Low potassium, High bicarbonate
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Receptors

Question Answer
Aortic arch receptortransmits via vagus nerve to solitary nucleus of medulla
responds only to ↑ BP
Carotid sinustransmits via glossopharyngeal nerve to solitary nucleus of medulla
responds to ↓ and ↑ in BP
Hypotension and baroreceptor mechanism↓ arterial pressure → ↓ stretch → ↓ afferent baroreceptor firing → ↑ efferent sympathetic firing and ↓ efferent parasympathetic stimulation → vasocontriction, ↑ HR, ↑ contractility, ↑ BP
Important in the response to severe hemorrhage
Carotid massage mechanism↑ pressure on carotid a → ↑ stretch → ↑ afferent baroreceptor firing →↓ HR
Peripheral chemoreceptorscarotid and aortic bodies - stimulated by ↓ PO2 (<60mmHg), ↑ PCO2, and ↓ pH of blood
Central chemoreceptorstimulated by changes in pH and PCO2 of brain interstitial fluid, which are influenced by arterial CO2.
Do not directly respond to PO2
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