Term
Most common childhood brain tumor?
What does it look like on CT?
Microscopic feature? |
|
Definition
- pilocytic astrocytoma --> good prognosis
- tumor mass w/ cystic space near it, it's usually in the cerebellum
- Rosenthal fibers (eosinophilic wormlike corkscrew seen on H&E) |
|
|
Term
Second most common childhood brain tumor?
Where is it found?
Sx?
Histology? |
|
Definition
- Medulloblastoma (but is most common MALIGNANT tumor) --> poor prognosis
- Exclusively in cerebellum (vermis)
- Headache & cerebellar dysfunction
- Sheets of small blue cells w/ hyperchromatic nuclei & scant cytoplasm |
|
|
Term
| most common childhood brain malignancy? |
|
Definition
| medulloblastoma (see other slide for details) --> always in cerebellar vermis |
|
|
Term
| Childhood brain tumor presenting as hydrocephalus? |
|
Definition
| Ependymoma: it's the 3rd most common brain tumor of childhood (#1&2 are pilocytic astrocytoma & medulloblastoma) |
|
|
Term
| How do you differentiate pilocytic astrocytoma from medulloblastoma on imaging? |
|
Definition
both are in medulla (although pilocytics can be elsewhere), but only pilocytics are accompanied by cystic spaces.
these are the #1 & #2 brain tumors of childhood; medulloblastomas are #1 brain malignancy of childhood |
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|
Term
| Things in NK cells that induce apoptosis |
|
Definition
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Term
|
Definition
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|
Term
| Drugs predisposing to pancreatitis? |
|
Definition
Valproic acid
Didanosine (ddI)
Zalcitabine (ddC)
Pentamidine
Asparaginase (used in leukemias)
Azathioprine
Furosemide
(sulfasalazine) |
|
|
Term
| In patients w/out alcoholism or gallstones (80% of cases), what else can cause pancreatitis? |
|
Definition
-Recent ERCP
- Drugs (diuretics, HIV drugs, valproic acid)
- Infections (mumps, measles, EBV, VZV, Coxsackie, M.pneumonia, TB)
- Hypertriglyceridemia
- Congenital abnormalities (choledochal cyst, Oddi stenosis, pancreatic divisum)
- Surgery
- Hypercalcemia |
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|
Term
Delirium vs Dementia
- Onset
- Consciousness
- Course
- Prognosis
- Memory impairment |
|
Definition
- Onset: Acute in Delirium; Chronic in Dementia
- Consciousness: Waxing & Waning in Delirium; Intact in Dementia
- Course: Fluctuating in Del; Progressive decline in Dem
- Prognosis: Reversible in Del; Irreversible in Dem
- Memory impairment: Globa in Del; Remote sparing in Dem |
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|
Term
| what doesn't change length during sarcomere contraction? |
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Definition
| A band (it's the thick filament); I band & H band does |
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Term
| pulmonary infection: spherule w/ endospores inside |
|
Definition
| Coccidioides immitis (can be disseminated in immunocompromised) |
|
|
Term
| how does Histo appear on biopsy? |
|
Definition
| small oval yeast inside Mø |
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Term
|
Definition
sign of cerebellar dysfunction: nose-to-finger test & heel-to-shin test --> see overshoot/inability to keep heel on shin
(overshoot w. mid-course corrections) |
|
|
Term
| CN that arises from middle cerebellar peduncle |
|
Definition
| CN V (trigeminal) --> may be affected in lacunar stroke of this area presenting as cerebellar dysfunction |
|
|
Term
| CN that arises from dorsolateral aspect of pontomedullary junction |
|
Definition
CN VII (& VIII)
--> located at position of facial colliculus in caudal pons |
|
|
Term
| CN that arises from preolivary sulcus in rostral medulla |
|
Definition
|
|
Term
| CN that arises from superior colliculus (rostral mesencephalon or midbrain) |
|
Definition
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|
Term
| only CN to arise dorsally (& where) |
|
Definition
| trochlear: at the level of the inferior colliculus (rostral mesencephalon of midbrain) |
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|
Term
| branches in corneal reflex |
|
Definition
| V1 (afferent); VII (efferent) |
|
|
Term
Schwannomas: most common location
Sx in this location |
|
Definition
- Cerebellopontine angle --> arise from CN VIII & are called "acoustic neuromas"
- can compress other CN: V, VII, & VIII --> loss of sensation & corneal relfex, loss of facial muscles & corneal reflex, hearing loss/tinnitis & vertigo/nystagmus |
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Term
|
Definition
| K+ blocking drug (Class 3 antiarrhythmic) |
|
|
Term
| PTH, Ca, & Pi in VitD deficiency |
|
Definition
increased PTH
decreased Ca++ & Pi
(can also have bone pain & muscle weakness) |
|
|
Term
| Hypomagnesemia can cause hyper or hypoparathyroid? |
|
Definition
| Hypo (remember it acts opposite of Ca++ if decreased chronically) |
|
|
Term
|
Definition
decoy receptor for RANK-L --> inhibit osteoclasts
it is secreted by osteoblasts |
|
|
Term
| fatigue, weight gain, constipation, slowed relaxation of DTR, dry, coarse skin, bradycardia |
|
Definition
|
|
Term
|
Definition
| Short-acting balanced venous & arterial vasodilator: decreases both preload & afterload --> SV is maintained |
|
|
Term
| name the somatoform disorders (5) & something about each |
|
Definition
- Somatization: multiple organ complaints (including pain, GI, sexual, & neurologic) over years (8+ symptoms over many years)
- Conversion: loss of sensory or motor & "la belle indifference" (example of isolation of affect); adolescence & young adults
- Hypochondriasis: serous illness despite medical evaluation & reassurance
- Body dysmorphic disorder: must cause emotional distress or impaired functioning
- Pain disorder: prolonged pain w/ no physical findings that correlates w/ psychological factors (basically conversion disorder w/ pain); look for secondary gain (e.g. get out of work, drugs, etc) |
|
|
Term
Difference between:
- Malingering
- Factitious
- Conversion
- Somatization |
|
Definition
- Malingering: want secondary gain (e.g. drugs); consciously know they are producing symptoms & why they are doing it
- Factitious: want primary gain (e.g. munchausen's); symptom production is conscious but they don't know why they are doing it
- Conversion: sensory/motor loss & don't care; unconsciously making symptoms & don't know why they are making symptoms
- Somatization: multiple system complaints; unconscious; same as conversion
(the last two are somatoform; Malingering, factitious, & somatoform disorders can all present in the exact same way, what matters is what the patient knows) |
|
|
Term
Atrial muscle or ventricular muscle depolarizes faster?
where is conduction slowest/fastest? |
|
Definition
atrial (~1.1 m/sec vs 0.3 m/sec)
conduction is slowest in AV node & fastest in purkinje system (~0.05 m/sec vs. 2.2 m/sec) |
|
|
Term
| What does CCl4 do in the liver? |
|
Definition
| p450 converts to CCl3 --> free radical injury --> lipid peroxidation & mitochondrial dysfunction/destruction |
|
|
Term
|
Definition
follicular lymphoma (non-Hodgkin)
Causes Bcl-2 overexpression (B-cell lymphoma 2): Bcl-2 (Chr18) put next to immunoglobulin heavy chain enhancer (Chr14) |
|
|
Term
|
Definition
| Philadelphia chromosome: CML (bcr-abl) |
|
|
Term
|
Definition
| Burkitt's lymphoma (c-myc) |
|
|
Term
| Cricopharyngeal motor dysfunction |
|
Definition
|
|
Term
M-protein
- Who has it?
- Functions?
- Antibodies to it can cause what? |
|
Definition
- GAS
- Antiphagocytic (binds factor H --> degrades C3 convertase);
- Rheumatic fever |
|
|
Term
| Name 3 manifestations of Aspergillosis: |
|
Definition
- Colonizing: (previous cavitation from TB/sarcoid/emphysema/abscess)
- Hypersensitivity: Asthma
- Invasive aspergillosis: immunosuppressed; can look like TB (hemoptysis, granuloma formation); 45 degree hyphae on biopsy --> can become disseminated
invasive aspergillosis likes to invade vessels --> necrosis |
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|
Term
| Most common pediatric malignancy |
|
Definition
acute lymphoblastic leukemia (80% B-cell; 20% T-cell)
- see blast cells (immature RBCs) in peripheral smear |
|
|
Term
| How do T-cell acute lymphoblastic leukemias (ALL) present? |
|
Definition
mediastinal mass --> dysphagia/dyspnea/SVC-syndrome
(ALL are the most common malignancy of childhood) |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| loss of phenyalanine hydroxylase |
|
Definition
|
|
Term
| Hartnup disease may produce this vitamin deficiency |
|
Definition
| B3 (niacin) --> dermatitis, diarrhea, dementia |
|
|
Term
| Vitamin deficiency: sideroblastic anemia, peripheral neuropathy, dermatitis, convulsions |
|
Definition
B6 (pyroxidine)
Needed for niacin (B3) synthesis from tryptophan, Heme synthesis (ALA-synthase, first step), transamination (AST/ALT), cystathionine synthase, decarboxylation rxns, & glycogen phosphorylase (McArdles) |
|
|
Term
| Vitamin def: Cheilosis, Corneal vascularization |
|
Definition
|
|
Term
| pulmonary capillary wedge pressure is increased w/? |
|
Definition
| increased afterload (e.g. alpha1-agonist administration) |
|
|
Term
| why are antihistamines used for motion sickness? |
|
Definition
| they are antimuscarinics & muscarinics are important receptors in vestibular transduction system |
|
|
Term
| where is the ansa cervicalis |
|
Definition
| C1,2,3 (innervate sternohyoid, omohyoid, sternothyroid) |
|
|
Term
| where does the carotid bifurcate? |
|
Definition
| just inferior to the hyoid bone (4th cervical vertebra) |
|
|
Term
| which artery gives rise to thyrocervical trunk? |
|
Definition
|
|
Term
|
Definition
| ampicillin (resistant to cephalosporins) |
|
|
Term
| what do you administer if someone has been exposed to radiation? |
|
Definition
| potassium iodine --> inhibits uptake of radioactive iodine by wolff-chaikoff effect |
|
|
Term
| Where are glucocorticoids anabolic? |
|
Definition
|
|
Term
| first line pharmacotherapy for essential HTN in general population? |
|
Definition
|
|
Term
| Which hypertensives do you use Beta-blockers for? |
|
Definition
| hypertensives w/ CAD and/or CHF |
|
|
Term
| Which hypertensives do you use ACE-inhibitors for? |
|
Definition
| hypertensives w/ diabetes |
|
|
Term
| What drug do you use in hypertensives w/ BPH? |
|
Definition
| Alpha-1 blockers (prazosin, oxazosin, terazosin, tamsulosin) |
|
|
Term
| pts w/ CGD are @ increased risk for infections w/ these bugs (i.e. they are all catalase +) |
|
Definition
Staph aureus
Pseudomonas cepacia
Serratia marcenscens
Nocardia spp
Aspergillus spp
Candida
E. coli
Salmonella
Klebsiella |
|
|
Term
| Increased in hereditary spherocytosis |
|
Definition
- mean corpuscular hemoglobin concentration (MCHC) b.c. of membrane loss & RBC dehydration
- best diagnostic test is RBC osmotic fragility
- Evidence of hemolysis is also present: increased LDH, reticulocytosis, & decreased haptoglobin |
|
|
Term
| What do you aspirate in aspiration pneumonia? What are the risk factors & the common pulmonary manifestation? |
|
Definition
- oropharyngeal contents --> usually results in pulmonary abscess & "foul smelling sputum"
Risk factors include:
- Altered consciousness: intoxication, etc
- Immunosuppression
- Impaired swallowing
- Poor oral hygiene, dental infections, or gingival disease |
|
|
Term
| what would happen if you aspirate stomach contents? |
|
Definition
|
|
Term
| what 2 vitamins would you have to give a breast-feeding infant |
|
Definition
| Vitamin D (not in breast milk) & Vitamin K |
|
|
Term
|
Definition
Gram+ rod w/ metachromatic granules grown on tellurite agar
produces exotoxin that ADP-ribosylates EF-2 --> pseudomembranous pharyngitis |
|
|
Term
| where is the murmur in HOCM |
|
Definition
| between the hypertrophied IV septum & anterior leaflet of the mitral valve |
|
|
Term
| what is the limiting factor in coronary blood flow? |
|
Definition
|
|
Term
| describe light-microscopy changes to myocardium after MI |
|
Definition
0-4 hrs: no change
4-12: wavy fibers & edema
12-24: contraction bands
1-5 d: neutrophil infiltrate (most susceptible to rupture)
5-10: Mø phagocytosis of dead cells
10-14: granulation tissue & neovascularization
2w-2m: collagen depostion & scar formation |
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|
Term
|
Definition
| same thing as variable expressivity, but w/ mitochondrial inheritance --> it depends on # of defective mitochondria in zygote |
|
|
Term
In males:
- Failure to fuse labioscrotal folds?
- Failure to fuse urethral folds?
- Faulty positioning of genital tubercle in 5th week of gestation? |
|
Definition
- Bifid scrotum
- Hypospadius
- Epispadius |
|
|
Term
| In CHF, arteriolar resistance is increased b.c. of? |
|
Definition
| Increased angiotensin 2 (RAA system activation) |
|
|
Term
| What is the most common cell type in the pituitary? |
|
Definition
| Somatotrophs (however, lactotroph adenomas are the most common adenoma |
|
|
Term
| Why do you get anemia/cold agglutinins w/ mycoplasma pneumonia? |
|
Definition
| b.c. there is cross-reactivity between some M.pneumoniae antigens & RBCs (lyses & agglutinates RBCs) |
|
|
Term
| Most common cause of death in TCA overdose? |
|
Definition
| cardiac arrhythmias secondary to fast-Na+ channel inhibition (VFIB) |
|
|
Term
Name SE that goes along w/ each characteristic of tricyclics:
- Antimuscarinic
- Anti-Alpha1
- Cardiac fast Na+ channels
- Presynaptic NE & 5HT reuptake inhibition
- H1 activation |
|
Definition
- Anti-SLUD, tachycardia, delirium, mydriasis,
- Orthostatic hypotension
- arrhythmias, death (most common cause w/ TCA overdos)
- Seizures & tremors
- Sedation |
|
|
Term
| where are peyer's patches? |
|
Definition
ileum
(aside, duodenum has Brunner's glands; Jejunum has neither PP or BG) |
|
|
Term
| Thrombocytopenia, Eczema, & recurrent infections |
|
Definition
| Wiskott-Aldrich syndrome (X-linked) |
|
|
Term
| oculocutaneous albinism, peripheral neuropathy, & immunodeficiency |
|
Definition
| Chediak-Higashi (LYST gene) |
|
|
Term
What is defective in Wiskott-Aldrich syndrome?
What are the Ig levels? |
|
Definition
- combined, progressive loss of B & T cells
- Increased IgE & IgA; Decreased IgM |
|
|
Term
|
Definition
optic neuropathy (red-green color blindness), scotoma, & decreased visual acuity --> may reverse w/ discontinuation of drug
"RIP" part of RIPE has hepatotoxicity |
|
|
Term
CBC needs to be checked in the following drugs because?
- Chloramphenicol
- Dapsone
- TMP-SMX |
|
Definition
- aplastic anemia
- agranulocytosis
- megaloblastic anemia |
|
|
Term
| What exits through foramen rotundum? |
|
Definition
|
|
Term
| What goes through foramen spinosum |
|
Definition
| middle meningeal & reccurent (meningeal) branch of V3 |
|
|
Term
| Which CNs go through jugular foramen? |
|
Definition
| IX, X, & XI (also inferior petrosal & sigmoid sinuses & posterior meningeal artery) |
|
|
Term
| What exits through foramen ovale? |
|
Definition
|
|
Term
| Maternal virilization during pregnancy & masculinization of female fetus |
|
Definition
|
|
Term
| Unconjugated or conjugated hyperbilirubinemia in Gilbert's syndrome? |
|
Definition
| unconjugated (deficiency of bilirubin glucuronyl transferases) |
|
|
Term
Define:
- Excitation-contraction coupling
- End-plate potential
which one is decreased in myasthenia gravis? |
|
Definition
- Ability of muscle to contract given depolarization (depends on sarcoplamic-reticulum release of Ca++); may be defective in RYR dysfunction, for example
- depolarization of skeletal muscle caused by release of ACh (decreased in myasthenia gravis) |
|
|
Term
| How do you treat SE w/ myasthenia gravis treatment? |
|
Definition
| myasthenia is treated w/ ACh-esterase inhibitors (e.g. neostigmine) --> cause muscarinic SE --> Tx w/ antimuscarinic drug (e.g. scopolamine) |
|
|
Term
| What are the stop codons? |
|
Definition
| UAA, UAG, UGA (they bind releasing factor 1, not a tRNA) |
|
|
Term
fructose 2,6 bisphosphate is increased by what?
what does it do? |
|
Definition
- insulin (increases activity of PFK-2: converts Fructose-6-phosphate to Fructose-2,6-bisphosphate)
- It increases the action of PFK-1: converts Fructose-6-phosphate --> Fructose-2,6-bisphosphate (rate limiting step in glycolysis) |
|
|
Term
| how do you differentiate NMS from serotonin syndrome? |
|
Definition
NMS has muscle rigidity, not myoclonus
Both have: Hyperthermia, generalized rigidity, autonomic instability, altered mental status |
|
|
Term
- Ways to acquire campylobacter jejuni? (2)
- Describe the disease(s) you can get
- culture? |
|
Definition
- 1) Domestic animals (fecal-oral)
2) contaminated food: undercooked poultry, unpastuerized milk
- inflammatory diarrhea; associated w/ guianne barre
- campy agar, 42 degrees, urease negative, curved G- rod |
|
|
Term
| How do you get V.parahemolyticus? |
|
Definition
| raw oysters (gastroenteritis) --> Tx w/ fluoroquinolones or sulfonamides |
|
|
Term
| Px of anal squamous cell cancer |
|
Definition
- usually in immunocompromised (AIDS)
- 50% are ulcerated
- Painful, pruritic, & rectal bleeding
- ASSOCIATED W/ HPV (16, 18, 31) |
|
|
Term
|
Definition
- enlarged parotid glands (25%)
- irregular menses
- eroded tooth enamel
- caluses or scars on back of hands/knuckles |
|
|
Term
| Attributable risk percent (ARP) formula |
|
Definition
ARP = (risk in exposed - risk in unexposed)/risk in exposed
also: ARP = (RR-1)/RR |
|
|
Term
|
Definition
| eosinophilic inclusion in substantia nigra seen in Parkinsons disease |
|
|
Term
|
Definition
| eosinophilic inclusions seen in pyramidal neurons of hippocampus & cerebellar Purkinje cells in Rabies |
|
|
Term
| Brain cancer w/ psammoma bodies |
|
Definition
|
|
Term
|
Definition
| occurring during childbirth |
|
|
Term
| Tx for GBS in mom's vagina? |
|
Definition
ampicillin @ delivery (intrapartum ampicillin)
(aside: you culture @ 35-37 weeks to see if the mom has an infection) |
|
|
Term
| Where is air resistance maximal? |
|
Definition
| 2nd-5th segmental bronchi (medium-small bronchi >2mm) |
|
|
Term
DUMBELS of organophosphate poisoning
How do you treat it? |
|
Definition
D: diarrhea, diaphoresis
U: urination
M: miosis
B: bronchospasm, bronchorrhea (increased secretions), bradycardia
E: emesis
L: lacrimation
S: salivation
- Tx w/ 2-PAM (pralidoxime): must administer w/in 6-8 hrs |
|
|
Term
| Purine analog resistant to adenosine deaminase used to Tx hairy cell leukemia |
|
Definition
|
|
Term
|
Definition
| Fibrinogen (acute phase protein synthesized by liver when it's stimulated by IL1, IL6, & TNF-alpha released by neutrophils & Mø) |
|
|
Term
| Common pigment accumulated inside cells in aging? |
|
Definition
| - Lipofuscin (from lipid peroxidation) |
|
|
Term
|
Definition
| exogenous pigment endocytosis of macrophages in lungs; caused by phagocytosis of inhaled carbon or coal dust |
|
|
Term
Marker for:
- Epithelial-derived cells (carcinomas)
- Myeloid cells
- Mesenchymal cells
- Neuroendocrine cells |
|
Definition
- Cytokeratin
- Myeloperoxidase (MPO)
- Vimentin
- Chromogranin A & neuron-specific enolase |
|
|
Term
| HER2/neu signals through? |
|
Definition
tyrosine kinase
(present in up to 30% invasive breast cancers) |
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|
