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wewovino's version from 2016-11-18 21:32

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Best long term treatment for a pt with absence seizure & tonic clonic seizureValporate
Urge to move legs at night or while no activity and restless with unpleasant sensations. Sensation resolves when starts moving agianRestless leg syndrome -> Tx with Dopamine agonist-Pramipexole or ropinerole
Pt with blurry vision, poorly controlled hypertension and reduced vision in left eye, Funduscopic examination shows flame shaped hemorrhage in the left temporal hemiretinaSame side lesion -> left lateral geniculate body
Boy with bloody diarrhea a week ago is now having renal failure, anemia, thrombocytopeniaHemolytic Uremic syndrome -> Microangiopathic hemolytic anemia
Mycoplasma pneumonia & EBV causes what to rbc'sAutoimmune hemolytic anemia
Severe unilateral throbbing headache, occurs several times a month, photophobia, nausea,vomiting, new drug prescribed to use immediately during the attackSumatriptan ->Postsynaptic serotonin receptor stimulation
Hereditary nonpolyposis colon cancer(lynch syndrome)Nucleotide mismatches that escape repair
MRSA most populated areaAnterior nares(nose)
Familial HypercholestrolemiaHepatocyte under expression of function LDL receptors
Correcting sodium from low to high quickly causesOsmotic demyelination syndrome
Correcting sodium from high to low quickly causesCerebral edema
What substance contribute most to blood vessel development/ AngiogenesisFibroblast growth factor & Vascular endothelial growth factor
Nonpathogenic strain is cultered together with a pathogenic strain leading to nonpathogenic strains to being pathogenicReassortment
Crossover of Gene exchange between two double stranded DNA molecules isRecombination
Ulcerative complicationsRectum always involved, toxic megacolon, Adenocarcinoma
HCM valves involved in obstruction of ventricular outflowMitral valve leaflet and interventrciular septum
Pt present with migratory arthraligia, skin rash exacerbated with sun exposure and kidney failure dxSLE -> Specific dx with Double stranded DNA antibodies found, Anti-Smiths, Anti-SNRPS
DNA Polymerase I responsible forremoval of short fragments of RNA primer, replacement with DNA
DNA polymerase III3-5 proof reading activity
CHF MOADecrease left ventricle contractility,left ventricular output, High end-diastolic pressure, Fluid in pulmonary leads -> Decreased lung compliance increased resistance to lung distention(also seen in pulmonary fibrosis & surfactant deficiency)
Decreased alveolar surface tensionNormal surfactant
Virus showing phospholipid composition meansEnveloped virus such as CMV
Anti nuclear nclusions buss word forherpes or CMV
Furosemide and Ibuprofen contraindicated becauseIbuprofen, naproxen inhibits prostaglandin released by furosemide leading to decrease RBF->GFR->DRUG Delivery leading to blunted diuretic effect
What other drug is contraindicated with Loop diuriticsNSAIDS -> Naproxen, Ibuprofen, Endomethacin
Inflammation with scattered non caseating granulomasCrohns disease
Atrophic intestinal villiCeliac
Collections of neutrophils within crypt luminaUlcerative colitis
Distended macrophages in lamina propriaT.Whippeli
Infiltration of lamina propria with atypical lymphomasMALT lymphoma- H.Pylori
Loss of upper extremity pain and temperature sensations, upper extremity weakness & hyporeflexia, lower extremity weakness and hyperreflexia & KyphoscoliosisSyringomyelia
Syringiomyelia affectsCentral cystic dilation in cervical spinal cord leading to damage to ventral white commissure and anterior horns
SynaptophysinFound in presynaptic vesicles of neurons, neuroendocrine and neuroectodermal cells
Glial fibrillary acidic proteinAstrocytomas, ependymomas, oligodendrocytes
Irreversible COX1&2Aspirin
Reversible Cox1&2Diclonfenac, ibuprofen,indomethacin
Child present with abnormal motor development, spastic paresis of lower extremity, frequent choreartheroid movement, elevated arginine levelsArginase deficiency -> which normally produces Urea & Ornithine
Differ the most between the 2 daughter strands formed at each replication forkJoining of DNA fragments by ligase
Scapula lifts off while pressing outstretched arms outside wall dxLTN injury most commonly seen in pts after mastectomy
Disruption of pigmented neurons in the posterior rostral pons at the lateral floor of the 4th ventricleLocus Ceruleus location -> normally produces Norepinephrine
Endocardial thickening & non-compliant ventricular wallsRestrictive cardiomyopathy
Most common GI sx in CF pts arePancreatic insufficiency
Baby presenting with lethargy, who did not receive any vaccinations with no family hx has large bulging anterior fontanelle, eyes appear driven downward, not able to tract upward, no scalp swellingVitamin K Deficiency -> Impaired clotting factor carboxylation
Intraventricular Hemorrhage in infants presents in premature babies and disappears when full termGerminal Matrix Fragility
Large cell carcinoma of lungs sxGynecomastia, Galactorrhea
Adenocarcinoma of lungs sxClubbing, Hypertrophic osteoarthropathy, Most common in women, and non smokers
Organism resistant to vancomycinMycoplasma & Ureaplasma due to the fact they lack peptidoglycan cell walls
KASSMAuL breathingKetones,Uremia,Sepsis,Salicylates,Methanol,Aldehyde, U, Lactic acidosis
Cheyne StokesBreathing seen in CHF -> Silence triangle silence traingle not s shaped constantly
Ct estrase deficiencyPt usually have a history of angio edema from a young age
ACE inhibitor inducedAngioedema is caused randomly with no prior history and in older pts.
Drug Induced lupusHydralazine, Procainamide, Isoniazid, Minocycline, TNF-a inhibitors -> Liver Acetylation
What cytokine causes accumulation of pusIL-8
Leukotriene B4 causesMigration of neutrophils
B-blockerdecreases AVnodal conduction -> Increased AV nodal refractory period
Esophageal dysmotility caused in crEst syndrome MOAFibrous replacement of the muscularis in the lower esophagus
Uncordinated simulatenous muscle contractions in the lower esophagusEsophageal spasm
Pt present with thyroid mass that has spindle shaped cells in a amophorus background with elevated calcitoninMedullary thyroid cancer -> RET mutation
A pt presenting with pink spider like lesions in his oral, nasal mucosa, face, arms, giOsler Weber-Rendu Syndrome
A pt who presents with cutaneous facial angiomas, leptomeningeal meningomas, mentral retardation, seizures, hemiplegia, tram-track calcificationsSturge weber syndrome
Sputum gram staining reveals numerous neutrophils but no bacteriaLegionella pneumophilia
Dating a ptDecline the invitation explaining dating a current patient is un-ethical
4yr old evaluated for difficulty walking, frequent respiratory infections , & high rate of radiation induced genetic informationAtaxia Telangiectasia -> cerebellar atrophy causes ataxia
Pt with poor memorydemetia, urinary incontinence, gait abnormalities ataxia has an MRI of enlarged ventricular system with minimal cortical atrophy. Urinary incontinence is due toNormal pressure Hydrocephalus Stretching of Descending cortical fibers
ConcetricPressure increased ->Chronic hypertension / Aortic Stenosis
EccentricVolume overload -> Aortic or mitral regurgitation or Dilated cardiomyopathy
Intestinal biopsy significant for multiple macrophages loaded with PAS -Positive granules in lamina propriaT.whippelli -> Antibiotics
Buerger diseaseSegmental vasculitis extending into contguous veins and nerves
What factor best predicts the potency of inhaled anesthesiaMinimal alveolar concentration
Solubility of anesthetics in the blood has to do withBlood/gas partition coefficient
Solubility of anesthetics in the body tissuesArteriovenous concentration
Occlusion of the hepatic vein which drains blood from the liverand portal circulation into the systemic circulation with centrilobar congestion & fibrosis of liverBudd Chiari Syndrome
Pt presenting with large volume hematemesis, vomiting bright red blood with palpable spleenPortal vein thrombosis
G6pd isXlinked Recessive
Cocaine affectsPrevents reuptake of Norepinephrine, dopamine, serotonin at the presynaptic junction
Bowel contents appear to be draining to the surface of skinFistulas seen in Crohns
Alcoholic withdrawal Day 1Tremors, insomnia, anxiety
Alcoholic withdrawal Day 2Seizures, Hallucinations
Alcoholic withdrawal Day 2 or moreDelirium, confusion, hypertension, tachycardia
Eukaryocytes have how many originsMultiple
Pt presenting with right sided weakness, nausea, confusion, high bp, with diminished right sided strength & upgoing plantar, contrast ct scan is positive for lesionCharcot Bouchard aneurysms
Long term & prophylaxis treatment for tonic clonic seizure & bipolar disorderValporate
Reed steenberg cells abundant cytoplasm, bilobed or double nuclei and inclusion-like eosinophilic nucleoliHodgkin lymphoma -> worst prognosis
GVHGraft T cell sensitization against host MHC antigens
Slow hepatic acetylatorDrug stays longer in the body leading to SX
Fatty Liver due to AlcoholDecrease free fatty acid oxidation
Renal cell carcinomaGlycogen and lipid accumulation with abundant cytoplasm
G+ cocci grows on blood agar with small colonies with a wide zone of surrounding hemolysis and Pyrrolidonyl arylamidase(PYR) test +S.pyogenes -> MCC of necrotizing fasciiitis
Boy with sickle cell anemia has spleen that is firm and brownVascular occlusion due to congestion
Fat embolism in bone fracture pt leads to renal failure is calledAcute tubular necrosis -> Tubular re-epithelization
Acute tubular necrosis of kidney has 3 phasesInitiation phase, Maintenance phasemost deadly due to arrythemia, recovery phasetubular re-epitheliazation
Calcium stone in the kidney lab values of ptNormal calcium in the serumNormocalcemia, Increased calcium in the urineHypercalciuria
Sarcoidosis, hyperparathyroidismHypercalcuria, Hypercalcemia
Pt who is presenting with erythematous rash with blisters ulcers and weeping drainage at the site of topical analgesic creamEczematous dermatitis -> Spongiosis -> Contact dermatitis -> Type IV hypersensitivity
MRI significant for low lying cerebellar tonsils excluding below the plane of the foramen magnum, into the vertebral canalArnold Chiari I -> Congenital malformation
Cell body rounding(edema), peripheral displacement of the nuclei and dispersion of Nissl substance to the periphery of the cellsAxonal reaction
Dobutamine MOAB1-agonist -> Increase cAMP -> Gs protein-adenylate cyclase activation -> Increase myocardial Contractility
50yr or older pt presenting with Myalgias of shoulder & pelvic gridle, fever, weightlossPolymalgia rheumatica
43 yr old with muscle weakness worst in the hips and shoulders, difficulty rising from chair & combing hair, muscle biopsy shows major histocompatibility complex class I molecule overexpression on the sacrolemma with CD8 lymphocyte infiltrationPolymyositis
Pt complaining of SOB, fibrosis of terminal bronchioles after 8 months of lung transplant DESPITE being on immunosuppresants is significant forChronic transplant rejection -> bronchiolitis obliterans
Over activity of which enzyme causes benzopyrene induced lung cancerMicrosomal monooxygenase ->Cytochrome P450 oxidase system
CHF drug of choiceFurosemide RAPID RELIEF OF SYMPTOMS
Pt is unable to extend finger of the right hand and thumbRadial nerve injury -> Located in Supinator canal
Fracture of the neck of humerusAxillary nerve -> Weakness of deltoid, loss of sensation in the lateral upper arm
Carpal tunnelMedian nerve -> Pregnancy, hypothyroidism -> Weakness of thumb abduction/opposition
Ventricle rupture after MI in a first time ptTypically occurs with 5-14 days after an acute myocardial infarction
Ventricular fibrillation after MIIt is the most common cause of sudden death within 2-3 days of Myocardial infarction
Botulism mneumonic3D's -> Diplopia,Dysphagia,Dysphonia normal nerve conduction velocity but decreased compound muscle action potential -> due to inhibited acetycholine release from presynaptic nerve terminals
Myasthenia gravisDiplopia, ptosis but NOT DYSPHAGIA -> Autoimmune attack agianst postsynaptic nicotonic nerve receptors
Neonate presents with TOF(rvh,pulmonary stenosis,vsd, overriding aorta), Orbital hypertelorism, bifid uvula, cleft palateDigeorge Syndrome -> Chromosome translocation
Nucleotide repeat expansionFriedriech ataxia(GAA), Fragile X(CGG), Myotonic dystrophy(CTG)
HIV+ pt presents with cough, fever, heptaosplenomegaly, weightloss, tounge ulcerHistoplasma Capsulatum . biopsy significant for oval or round yeast withing macrophagesPICTURE
Respiratory acidosis low pH, High CO2, Normal bicarbonateHypoventilation Heroin overdose
COPD Lab valuesLow pH, High CO2, High Bicarbonate
A pt with ADPKD presents with sudden onset headache, nuchal rigidity, normal neurologic examinationSubarachnoid hemorrhage
Jaw claudicationdifficulty chewing most common cause, upper and lower different blood pressure readingsGiant cell50+ or Temporal arteritisfemales less than 40yrs old -> Granulomatous inflammation of the media
Transmural necrotizing inflammation of medium to small sized vessels with smudgy eosinophilic deposit(fibrinoid necrosis)Polyarteritis nodosa
Thrombosing vasculitis of medium and small vessels arteries affecting tibial & radial arteriesBuerger disease(Thrombangitis obliterans)
HIV drug that structurally unrelated to nucleoside and is NOT phosphorylation intracellularly & acts within the cytoplasm of infected cells to inhibit the synthesis of viral DNA from the RNA template(Reverse transcriptase)NNRTI's -> Nevirapine & efavirenz Sx -RASH, SJSyndrome
Emitricitabine & ZidovudineNRTI's
Appe-Green BirefringenceAmyloid depositionAlzheimerz
Mutation in PRPP (Phosphoribosyl synthetase) geneGout (Negatively birefringent crystals)
Protease inhibibitorsPrevents assembly & maturation of the HIV virus
T lymphocytes stimulates a response that results in rapid cell deathCaspases
Most common complication of VZVPostherpetic neuralgia Persistant local pain
Intracellular transaminationB6-Pyrodxine
Pt complaining of reccurent abdominal pain, hepatomegaly, pancreatic calcification'sAlcohol abuse -> Megaloblastic anemia MCV more than 100
Folate deficiency in alcoholics causeDiminished thymidine synthesis
Cystoscopy shows multifocal sessile or papillary tumorsTransittional cell carcinoma
Baby with bulky and greasy stools, poor weight gainAbetalipoproteinemia
B.Anthacis & B.Petrussis similar MOAIncreased Adenylate cyclase cAMP
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