Term
During uncal (medial temporal lobe going over tentorium), which:
1) CN gets compressed
2) Artery gets compressed
3) Hemiparesis? |
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Definition
1) CN III
2) Posterior cerebral --> Contralateral homonymous hemianopsia w/ macular sparing
3) ipsilateral or contralateral (b.c. uncus can compress ipsilateral cerebral peduncle, or move brain-stem aside & cause contralateral peduncle to compress against foramen magnum, i.e. Kernohan's notch causing Kernohan-Woltman syndrome)
NOTE: another possibility is the feared Duret Hemorrhages --> stretching & rupture of basilar artery causes brainstem hemorrhage & death |
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Term
| Artery potentially compressed in a subfalcine herniation? |
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Definition
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Term
| What body tissue extracts the most oxygen from blood? |
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Definition
| Heart. The venous blood is 75-80% desaturated |
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Term
| MOA of N-acetylcysteine when given aerosolized to CF pts? |
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Definition
| Cleaves disulfide bonds of mucus glycoproteins --> makes them more fluid |
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Term
1) Rapid onset of non-pulsatile periorbital or temporal pain accompanied by lacrimation, nasal congestion, and ptosis.
2) Bilateral pain in a band-like sensation & head/neck tightness
3) Severe, pulsatile, unilateral head pain exacerbated by activity. Photophobia, phonophobia, & N/V possible. |
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Definition
1) Cluster headache (last 30min-2hrs; same time every day)
2) Tension headache. may last hrs to days
3) Migraine. May or may not be preceded by an aura |
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Term
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Definition
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Term
| cause of croup (laryngotracheobronchitis; "brassy cough") |
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Definition
| parainfluenza 1 (paramyxovirus) |
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Term
| Why does HbF have a higher affinity for O2? |
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Definition
| a single amino-acid substitution (Serine for Histadine) makes it unable to interact w/ 2,3 DPG --> left shifts curve |
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Term
1) What do you need to convert Pyruvate to Lactate?
2) How does this explain lactic acidosis during EtOH intoxication?
3) Which Ketoacid is created using this same cofactor |
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Definition
1) NADH is needed for conversion of pyruvate to lactate
2) EtOH metabolism makes 2 NADH --> converts pyruvate to lactate & inhibits gluconeogenesis
3) Beta-hydroxybutyrate needs NADH for its conversion --> this is the ketoacid most increased in EtOH intoxication
NOTE: Glycolysis NEEDS NAD+ in order to proceed: the step from glyceraldehyde-3-phosphate -> 1,3-BPG...THUS, in EtOH intoxication, both gluconeogenesis by the liver & glycolysis in the peripheral tissues is inhibited AND there is lactic acidosis (which inhibits the electron transport chain via 3 mechanisms --> decreased delivery of pyruvate (in the form of oxaloacetate or acetylCoA), mitochondrial toxin, & inhibits the TCA cycle by NADH negatively regulating the ISOCITRATE->AKG step & AKG->SCoA step |
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Term
| Person comes in w/ acute gouty arthritis & is treated w/ a drug that causes diarrhea & nausea |
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Definition
Colchicine
Acute SE=Diarrhea & GI distress
Chronic SE = marrow suppression, renal dysfuction (hematuria), alopecia, gastritis, peripheral neuropathy |
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Term
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Definition
- Mycobacterium (TB, etc)
- Nocardia
Acid-fast stain is performed via:
- Apply aniline dye (e.g. carbolfuchsin)
- Decolorize w/ acid alcohol (e.g. HCl + EtOH) |
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Term
| How do you differentiate delusional disorder with a paranoid quality from paranoid personality disorder? |
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Definition
Delusional disorder has a single fix: "Someone is out to get me"
Paranoid personality disorder is pervasive in all interactions. "Everyone is out to get me"
Differentiate delusional disorder from paranoid schizophrenia by how crazy the delusion is and if the person can be relatively normal |
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Term
| Differentiated Li-Fraumeni syndrome from inherited Rb defect |
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Definition
Rb (Chr13) = osteosarcomas & Retinoblastomas
p53 (Chr17) = nearly any cancer (esp breast, brain, and adrenal cortex) |
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Term
HIV env gene products?
gag products? |
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Definition
env = gp160. Cleaved to gp120 & gp41. envelope proteins --> responsible for viral attachment to cell
gag = p24 (capsid protein) |
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Term
| Why do you get hypercalcemia w/ sarcoidosis? |
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Definition
| In granulomas (including sarcoidosis), ACTIVATED MACROPHAGES have 1-alpha hydroxylase. This converts 25OH-D3 to 1,25OH-D3 |
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Term
| What do you need functional to absorb D-xylose |
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Definition
you need brush boarder absorptive function
D-xylose is a monosaccharide --> can be absorbed directly w/out aid of pancreatic enzymes |
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Term
Nasal transepithelial potential measurement:
1) what disease is this a diagnostic test for?
2) what indicates a positive result?
3) what is the mechanism of this result? |
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Definition
1) Cystic fibrosis (may have to use if sweat test is normal in a person w/ a mild form of CF). ASIDE: CF is suspected when there are recurrent sinopulmonary infections and/or family Hx
2) Increased negative transepithelial potential difference is a positive result (suggestive of CF)
3) Increased Na+ resorption because Cl cannot be pumped out by the CFTR ATPase |
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Term
| triad of pineal germinoma |
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Definition
1) Precocious puberty (beta-HCG production)
2) Aqueductal compression --> non-communicating hydrocephalus
3) Parinaud syndrome from compression of tectal area of midbrain --> impaired upward gaze |
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Term
Loss of many people to follow up indicates what type of bias?
A) selection bias
B) Ascertainment bias
C) Observer bias |
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Definition
selection bias
Ascertainment & Observer bias are misclassification of the outcome due to flaws in the study design |
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Term
| What receptors does Clozapine act on? What is the major side-effect concern? |
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Definition
- D4 (most antipsychotics work on D2 & cause parkinsonian-like SE/EPS)
- Agranulocytosis (also causes excessive salivation, aka "wet-pillow syndrome" from excess 5HT) |
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Term
| CD marker for monocyte-macrophage lineage? |
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Definition
CD14
NOTE: cells in granulomas w/ lots of cytoplasm & adjacent to caseation (if it exists) are macrophages. You got the question wrong b.c. you thought they were talking about lymphocytes. Lymphocytes don't have a lot of cytoplasm |
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Term
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Definition
- JVD
- Hypotension
- Muffled heart sounds
Also: pulses paradoxis
**These are signs for cardiac tamponade**
(NOTE: Kussmaul's sign is minimal to 0 w/ tamponade b.c. blood in the pericardial cavity compresses the thinner right ventricular wall preferentially --> when inspiration occurs, the negative thoracic pressure releaves this compression & minimizes the sign. HOWEVER, JVD is present, and is probably profound) |
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Term
Name nerve damaged & motor/sensory manifestation:
1) Shoulder dislocation/fracture of proximal humerus
2) Fracture to midshaft of humerus; saturday night palsy; improper crutch use
3) Head & shoulder violently stretched apart (not Erb's palsy)
4) Axillary lymph node dissection
5) suddenly grabbing something while falling |
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Definition
1) Axillary nerve injury: deltoid & teres minor dysfunction; flattened deltoid; sensory loss over deltoid
2) Radial nerve; BEST: brachioradialis, extensors of wrist/fingers, Supinator, Triceps; Sensory loss over posterior arm & hand; wrist drop
3) Musculocutaneous; Biceps, brachialis, coracobrachialis; Loss of sensation over lateral forearm
4) Long thoracic; Winged scapula
5) C8-T1; loss of hand muscles (claw hand); atrophy of thenar & hypothenar eminences; loss of sensation of medial forearm & hand |
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Term
| Describe the path of the middle meningeal? |
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Definition
| branch of maxillary --> enters skull via foramen spinosum --> courses deep to the pterion (area where frontal, parietal, temporal & sphenoid bones meet eachother) |
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Term
| Vincristine/Vinblastine SE |
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Definition
Vincristine is notorious for peripheral neuropathy
Vinblastine: BMS, GI upset, Alopecia
Overall: Vincristine has more neurologic manifestations, Vinblastine has more cytotoxic SE |
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Term
| Tx for nonspecific urethritis? |
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Definition
| Ceftriaxone (for gonorrhea) + Azithromycin or Doxycycline (for Chlamydia) |
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Term
| Why is liver so resistant to infarction? |
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Definition
because of dual blood supply
(ASIDE: transplatns, however, are the exception to the rule and are susceptible to infarction) |
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Term
1) AA in maple-syrup urine disease?
2) Enzyme defective? What cofactor does it use? |
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Definition
1) Isoleucine, Leucine, Valine
2) Alpha-ketoacide dehydrogenase; Requires TTP (decarboxylation & addition of SCoA)
(see later flashcard for picture) |
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Term
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Definition
Note TTP (thiamine, B1) is needed for this reaction. This is the enzyme that is defective in Maple-Syrup urine disease.
MSUD: person can't degrade Isoleucine, Leucine, Valine past the alpha-ketoacid step |
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Term
| What is the metanephric mesoderm? |
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Definition
This is the clump of tissue that becomes the kidney. It is induced by the ureteric bud (growing out of the mesonephric duct)
The metanephric mesoderm makes all of the glomerulus & tubules except for the collecting ducts.
The ureteric bud makes everything from the late collecting ducts down (i.e. CD, Minor calyx, major calyx, renal pelvis, ureter) |
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Term
Focal numbness/tingling that resolves spontaneously in a person w/out diabetes, atherosclerosis, seizures, or anxiety?
What do you treat them with? |
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Definition
Transient ischemic attack
Treat w/ low-dose aspirin |
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