wewovino's version from 2016-11-08 00:07

Corticosteroids sx

Question Answer
Skin/MSKCentral obesity, buffalo hump, Skin Atrophy, Muscle weakness
GI TractPeptic ulcer, GI Bleed
EndocrineHyperglycemia,Hypogonadism, Osteoporosis, HPA axis suppresion
ImmuneInreased Neutrophils -> High risk for infection, Immunosupression, Increase risk of infection, Decrease in Eosinophils,basophils,monocytes, lymphocyte
NervousHypomania,psychosis, sleep disturbances
RespiratoryIncrease surfactant production


Question Answer Column 3
AlcoholsDisruption of cell membranes, Denaturation of proteinsfungal, viral killing except spores
ChlorhexidineDisruption of cell membranes, coagulation of cytoplasmSpores not killed
HydrogenperoxideProduces destructive free radicals that oxidize cellular componentsKills spores
IodineHalogenation of proteins and nucleic acidsKills spores


Question Answer
KOH preparation shows dimorphic(yeast or mold) has large yeast cell and single bud when intubated at 24 degree c it appeared with different look branching tubular cells after outdoor adventure at the great lakesBlastomyces dermatitidis
Pt presents with iron anemia, weight loss, + guaic stool, 3cm mass in colonoscopy and biopsy shows pleomorphic cells with large dark nuclei forming irregular crowded glands with mucusColon cancer
Right sided colon cancer causesBleeding & Iron deficiency anemia
Left sided colon cancer causes(Rectosigmoid)Obstructive Altered bowl habits, constipation, abdominal distention and vomiting
Direct herniaAdult, Medial Inferior epigastric vessels(vein), Rectus abdominis
Indirect herniaLateral to inferior epigastric vessels(artery)
Years to month ischemic injury to brain causes cystic cavity formed byAstrocytes(Glial scar)
Brain macrophagesMicroglia
Superior displacement of the clavicle after fracture is due toSternocleidomastoid muscle
Inferior displacement of the clavicle after fracture due toPectoralis major
Hemocrhomatosis affectsIntestinal Iron absorption -> Ferritin and Transferrin Increased
Pick disease frontotemporal dementiapt acting strangely over couple yrs and saying inappropriate sexual jokes, little regards to social rules, irritable, borderline aggressive at times,minimal verbal output-it is what it is.
prp proteinMutation of the protein causes accumulation of misfolded prions -> Spongiform transformation of gray matter -> CJD
Upper gi endoscopy shows erythema of the antral mucosa with cell infiltrate involving the superficial mucosal layersH.pylori -> Duodenal ulcer -> Iron deficiency due to chronic bleeding OR MALT lymphoma
Gastric ulcer high risk forGastric adenocarcinoma
Korsakoff syndromeInability to form new memories and learning due to thiamine deficiency in alcoholics Confabulation
Sample size mattersLarger the sample the greater the ability to detect difference
Down syndrome trisomy 21Nondisjunction(failure of homologous chromosome to separate) which happens during maternal meiosis I
Chronic Kidney transplant rejectionObliterative fibrous intimal thickening and scattered mononuclear infiltration of surrounding tissues
Acute Kidney transplant rejectionDense mononuclear interstital infiltration
Pt coming to the clinic complaining of back pain and smokes weed and request for disability yet his MRI is negative, and does not seem to be in any form of discomfortDo not sign form without further history and assessment
Oral consumption of glucose leads toIncretinGlucagonlike peptide increase to stimulate insulin release
Which ion flow out of the heart cellPotassium
Slit lampCorneal arcus lipid or lipidemia retinalis
C1 estrase inhibitor deficiency leads to excess cleavage of c2 & c4 can lead toBradykinin associated facial swelling(angioedema), C3a, C5a
Excessive bleeding during oopherectomyLigate suspensery ligament of the ovaries ->Ovarian artery, nerves, lymphatics
Transverse ligament aka cardinal ligamentLigate during Hysterectomy
Cancer pt losing weight is called cachexia is due toTNFa, IL-1&6
Best HCC preventionUniversal vaccination
Schwanoma persistent buzzing in ear and decreased hearingCN VIII Vestibulochoclear (PICTURE)
Pt with a history of recent viral esophagitis, pneumocystic pneumonia is presenting with headaches and progressive confusion and shows latex agglutination test + for soluble polysacharide antigenCryptococcus Neoformans Budding yeast
Budding yeast VS Broad based buddingC.Neoformans VS Blastomycosis
Sputum shows G+ lancet shaped cocci in pairsS.pneumonia Optochin sensitive/Bile soluble/A-hemolytic/ partial green hemolysis
OVeR-PaSOptochin viridians resistant/ S.pneumonia Sensitive
Alcoholics presenting with pneumonia and shows Encapsulated G- grows in pink colored mucoid colonies on MacConkey agarKlebsiela pneumoniea
Non-SeptateMucormycosis, Rhizopus
Germ tubesCandida
Pt presents with recurrent seizures that starts as rythymatic jerky movements of his left leg gradually spreading to entire left side of body and frequently loose consiousness, mass in his brain which is composed for engorged purplish cluster, numerous dilated capillaries with endothelial lining separated by connective tissueCavernous Hemangioma
Superior Sulcus tumorPancoast tumors -> Horner syndrome(ptosis,miosis,anhydrosis), shoulder pain(compression of brachial plexus)
Superior vena syndromeMediastinal mass -> No shoulder pain,symmetrical facial swelling & conjunctival edema, upper extremities cough, dyspnea, headaches due to increase icp
Secondary tb pathophysiologyapical lungsAggregration of activated leukocytes
pt with tdT+ cd19 & cd10Precurosor Bcell leukemia
pt with tdT+ cd1, cd2, cd5Precurosr tcell leukemia
pt with tdT+ cd19, cd5CLL -> Mature bcell leukemia
Vinca alkaloids MOAInhibits microtubule polymerization by binding to b-tubulin preventing mitotic spindles in dividing cells
PaclitaxelBinds to microtubules and prevents break down
2week history of decreased vision blurry, distorted, uses bright light to read in a 67 yr old smoker with grayish discoloration of the macula with areas of adjacent hemorrhageWet Age related macular degeneration -> Tx Inhibit vascular endothelial growth factor(ranibizumab, bevacizumab)
Drugs contraindicated in Hypertrophic cardiomyopathyIsosorbide dinitrate, Nitorglycerin,Ace inhibitors, Amlodipine, Nifedipine, Diuritics
HCM best durgMetoprolol
4 yr old with headaches,more severe when lying down and has nonbloody, non bilious occuring in the morning,blurry vision when looking at the mirror, bilateral papilledema & eyelid retraction with inability to gaze upwards DxParinaud Syndrome -> Pineal gland Mass
Pellegra vs HartnupHartnup revelas loss of aromatic amino acids in the urine -> Niacin deficency due to loss of dietary tryptophan
Pt complaining of skin rash and muscle weaknessDermatomyositis -> AntiJo1(specific), Anti-nuclear(non-specific)
Risk factor for pancreatitisAlcoholism, gall stones, hypertriglyceridemia
Lady with turner syndrome wants to conceive and whats the best method?In Vitro fertilization
Class I HLA proteins diseasesAnkylosing Spondylitis -> affects sacroliac joints
Class II HLA proteins diseasesRA, DM I, Celiac disease
Younger pt presents with dull low back pain, morning stifness, limited anterior flexion of the spine, xray significant for sacroiliac jointHLA B27 Ankylosying spondyilitis
Pt has abdominal pain, fever, uterine tenderness, foul smelling vaginal dischargesEPSIS aPORTION -> S.Aureus
According to epidemiological data overdose of which of the following drug groups is related to majority of suicial deathOpiod
Normal colon to Hyperproliferative epithelium(smallpolyp)APC inactivation
Hyperproliferative epithelium(small polyp) to Adenoma(Large polyp)K-ras activation
Adenoma(Large polyp) to Carcinomap53 mutation
Mutation of BRAFMelanoma tx Vemurafenib
Terminal bronchiolesCiliated cells
Goblet cellsUptoo large bronchioles but not terminal bronchioles
Submucosal glandstrachea and bronchi but NOT In bronchioles
A pt with Mi complaining of pleuritic and sharp chest pain on day 4 of hospitlization that increases with cough, swallowing and radiating to neck dx?Postinfarction Pericarditis -> Pericardial inflammation overlying the necrotic segment of myocardium
Dresseler syndromeOccurs weeks to months after MI
Right lower quadrant pain with inflamed and swollen ileum and the involved segment of the intestine is removedChrons Disease -> TH1
2yr old boy with failure to thrive, developmental delay, coarse facial features, corneal clouding hepatosplenomegaly, restrictive joint mobility with deficient phophorylation of mannose residues on certain glycoproteins in the Golgi apparatusI Cell Disease -> Lack of transportation of protein to Lysosomes
Hemoglobin C with a missense mutation-glutamate to lysine on electrophoresis is theSlowest one comparing to -> S & A
Most common cancerous thyroid nodule order isPapillary carcinoma, Follicular carcinoma, Medullary, Anaplastic
Risk factors for thyroid cancerFamily hx of thyroid cancer, neck irradiation
Large overlapping nuclei containing finely dispersed chromatin(Orphan Annie eye) / Numerous intranuclear inclusion bodies & groovesPapillary carcinoma
Pt present with hypoechoic nodule with increase blood flow and cytology of nodule shows clusters of overlapping cells with large nuclei containing sparse and finely dispersed chromatin & numerous intranuclear inclusion bodies and groovesPapillary Carcinoma
Flank pain radiating to the groin with ballotable flank mass that develops within a week of pelvic surgeryUreteric Obstruction leading to Hydronephrosis
IVCIt is formed by the union of the common iliac veins(right & left iliac veins) -> Returns venous blood to the heart from the lower extremities, portal system and abdominal and pelvic viscera
Prolong QRS prolongation without effect on QT interval durationFlecanide
Excess copper in wilsons disease causes injury byBinding to sulfhydryl groups of cellular proteins
K sparing diuriticsAmiloride, Trimeterene, Spirnolactone -> Do not give it with ACE inhibitors
Jervell and Lange-Nielsen syndromeBilateral sensorinueal hearing loss with prolonged QT syndrome
Osteoporosis risk factorsCaucasian, female,afvanced age, smoking, glucocorticosteroids
Osteoporosis lab valuesNORMAL calcium,phosphorus, PTH
Low calcium & High PTH DXRenal failure or Vitamin D deficiency
High calcium & High PTH DXHyperparathyroidism
High calcium & Low PTH dxCalcium producing tumors
Low calcium & PTH dxHypoparathyroidism
Normal calcium & Normal PTH dxOsteoporosis
Pt complaining of firm non-tender swelling and fullness of aurical space and a mass in the right parotid gland(parotid gland tumor)Compression of the facial nerve -> affection muscle of expression -> Facial droop
Sheehan syndromeIschemic necrosis of pituitary gland
Pt with right sided hemiparesis, loss of proprioception & vibratory sense below c8ipsilateral corticospinal tract injury & dorsal columns & loss of pain & temperature sensation on the left sidecontralateral spinothalamic tractBrown-Sequard syndrome Hemisection of the right side of the cord
Triad of fever, neuroogic sx, renal failure,anemia, thrombocytopenia in the setting of a GI illness, Normal PT & PTT but abnormal BT, schistiocytesThrombotic Thrombocytopenia purpura -> Renal Biopsy - Platelet rich thrombi in glomeruli & arterioles
Anaplastic tumorNo resemblence to the tissue origin, pleomorphic cells, with large, hyperchromatic nuclei that grow in disorganized fashion, numerous abnormal mitoses and giant tumor cells
Pancreatic Alpha, Beta, delta cells produceGlucagon,Insulin,Somatostatin
Renal peritubular cells produceErythropoetin
Duodenal S cells pIncrease blood hormone of secretin increasing what?Bicarbonate
CholecystikininIncrease pancreatic Bicarb secretion & decrease H secretion I cells small intestine
RB protein HyperphosphorylatedInactive
RB protein HypohosphorylatedActive
Decreased Executive dysfunction, personality changes, lack of motivation social behavior changes in a right handed person after being struck on the headLeft Frontal lobe damage
Gait instability and ataxiaCerebellum
Kids brain tumorPilocystic astrocytomacystic & solid, MedulloblastomaPosterior fossa-cerebellum, Ependyoma, Craniopharyngioma
Neoplastic polypsSerrated, adenomatous, tubular, villious,tubuovillious
Propfolol is a lipophilic drug will redistribute to lower blood flow areas such asSkeletal muscle, Fat, bone
Pt presenting with painful rash with a history of Diabetes Mellitus and normocytic normochromic anemia has coalescing erythematous lesions with crusting and scaling at the borders and central areas of bronze colored induration with superficial necrolysisNecrolytic migratory erythemaGlucagonoma -> Elevated Glucagon
Rare sx of LithiumAcne
Aplastic anemia bone marrowPICTURE -> EBV
Huntington MOAAtrophy of caudate nucleus leading to dilation of frontal horns of the lateral ventricles -> showing gliosis &neuronal loss
High Altitude respiratory lab valuesHypoxia causes hyperventilation -> High pH, Low Oxygen, Low PCo2, Low Bicarbonate
Vitmain B12 deficiencyDeficts of Dorsal columnsloss of position/vibration, Spinocereberallar tractataxia, Lateral corticospinal tractspastic paresis (PICTURE)
S. Aureus has Protein A that is part of it peptidoglycan cell wall that works byBinding of Fc portion of IgG preventing complement activation impairing opzonization and phagocytosis
MS MOAOligodendrocyte depeletionalso seen in PML -> Demyelination of axons, lipid laden macrophages containing myelin breakdown
Pt presenting with transient visual changes"loss of vision for a minute" while bending forward or lifting objects, with persistent headaches, obese, Increased bpIdiopathic intracranial hypertension Impaired optic nerve axoplasmic flow causing papilledema -> Picture shows blurred disc margins and elevation of optic disc
Optic nerve inflammationMultiple sclerosis

Cushing Syndrome

Question Answer
ACTH LOWAdrenal adenoma, adrenal malignancy, Steroids intake
ACTH Normal or elevated with high dose dexamethasone test -> Suppression of ACTH & CortisolsPituitary adenoma
ACTH Normal or elevated with high dose dexamethasone test -> ACTH & Cortisol levels unchangedEctopic ACTH production

HIV drug sx

Question Answer
ZidovudaineBonemarrow suppression
InteGRAse inhibitor(ralteGRAvir)Myopathy
Protease inhibitors(NAVIRS)Insulin resistance,dyslipidemia,lipodystrophy
NNRTI(Efavirenz)Neuropsychiatric effects, teratogenicity, Rash