Term
| Chapman - bet spinous and transverse processes of T11 and T12 |
|
Definition
|
|
Term
| Chapman - bet spinous & transverse processes of T12 and L2 |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Chapman - tip of transverse process T11 |
|
Definition
|
|
Term
| DM, diarrhea/steatorrhea, cholelithiasis, hypochlorhydria, wt loss; arise in duodenum, delta cells of pancrease |
|
Definition
|
|
Term
| amoxicillin and ampicillin assoc w/ rash in pts with... |
|
Definition
|
|
Term
| withdrawn, solitude, lack of interest in friends, "loner." takes pleasure in few, if any, activities |
|
Definition
| Schizoid personality disorder |
|
|
Term
| t (9;22), bcr-abl fusion gene, 30-60 yo, males, DEC leukocyte alkaline phosphatase (LAP), high WBC w/ basophilia |
|
Definition
Chronic myelogenous leukemia (CML)
Philadelphia chromosome - forms tyrosine kinase in stuck "on" state - uncontrolled prolif mature granulocytes (esp NTs)
Tx: Imatinib** imp protein kinase inhibitor |
|
|
Term
| MC leukemia in adults ~65, Auer rods |
|
Definition
| Acute myelogenous leukemia (AML) |
|
|
Term
| 50 yo, male, splenomegaly, TRAP+, fried egg appearance |
|
Definition
|
|
Term
| MC leukemia >60, smudge cells, assoc w/ lymphocytosis, hemolytic anemia, thrombocytopenia |
|
Definition
| Chronic lymphocytic leukemia (CLL) |
|
|
Term
|
Definition
Acute lymphocytic leukemia (ALL)
stain +TdT
assoc w/ Down syndrome
Immuno marker - ALL Ag (CALLA) |
|
|
Term
| leukocytosis secondary to infection, INC leukocyte alkaline phosphatase** |
|
Definition
|
|
Term
|
Definition
| bacterial/leukemoid rxn = left shift, high LAP (leukocyte alkaline phosphatase) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| viruses, B pertusis, ALL, CLL |
|
|
Term
|
Definition
| EBV/CMV, CLL/hairy cell, ATLL, mycosis fungoids |
|
|
Term
|
Definition
| synthetic Granulocyte-colony stimulating factor (GCS-F) and granulocyte-monocyte colony stimulating factor - cytokines that INC NTs in neutropenic pts |
|
|
Term
| loss early motor skills, HSM, mental retard, cherry red macular spot, Ashkenazi Jew |
|
Definition
Niemann-Pick
Note: Tay sachs similar except NO HSM |
|
|
Term
|
Definition
| affects bone, liver, spleen CNS |
|
|
Term
| HSV-2 prego, multinuc giant cells |
|
Definition
| Tx: C-section (w/ active primary infection) OR vag birth + acyclovir w/ recurrent infections |
|
|
Term
|
Definition
SE: weight gain, T2DM (HbAIC >6.5)
atypical (2nd gen) anti-psychotic. Others: clozapine, risperidone, ziprasidone, aripiprazole |
|
|
Term
| LLQ pain, fever, leukocytosis |
|
Definition
diverticulitis
complication: macro perforation, large bowel obstruction, abscess & fistula. C fistula = colovesicular fistula --> pneumaturia (gas/air bubbles in urine), recurrent UTI |
|
|
Term
|
Definition
| asymptomatic, may have painless bleeding |
|
|
Term
| abd pain, N, distension, constipation |
|
Definition
|
|
Term
|
Definition
mesenteric ischemia
Complication: bowel infarction |
|
|
Term
|
Definition
excess growth after epiphyseal plates close
(Gigantism - excess growth b4 plates close)
pituitary secretes GH --> liver secrete insulin-like growth factor (IGF-1)** test of choice bc consistently high and doesn't fluctuate like GH
Once Dx acromegaly --> check PRL for pituitary adenoma (1/3 pts) |
|
|
Term
|
Definition
| GH, ACTH, TSH, FSH, LH, PRL |
|
|
Term
|
Definition
| oxytocin, vasopressin (ADH) |
|
|
Term
| keratoconjunctivitis sicca (dry eyes), xerostoma (dry mouth), dysphagia (esp dry food), partoid gland swelling, dental carries |
|
Definition
Sjogren's syndrome - F > M, mid age
INC serum gamma globulins, + ANA, SS-A (Ro) and SS-B (La) - most specific
Tx: symptomatic
Note: INC risk B cell lymphoma |
|
|
Term
| Methanol (windshield wiper, anti-freeze, home-made alcoholic beverage), ethylene glycol poisoning tx |
|
Definition
|
|
Term
| benzodiazepine toxicity tx |
|
Definition
|
|
Term
| short stature, cafe au lait spots, anomalies w/ thumb, radius, GU tract, aplastic anemia (pancytopenia - low WBC, RBC, platelets, bone marrow hypercellularity) |
|
Definition
Fanconi anemia - mut DNA repair gene, X linked auto recess
MC congenital form of aplastic anemia
Risk of AML, myelodysplastic syndrome, sqamous cell CA of head, neck, genitals |
|
|
Term
| multiple hypopigmented macules on face, upper arms, chest, back after sun exposure |
|
Definition
Malassezia furfur (pityrosporum ovale) - "spaghetti & meatball" look (hyphae w/ budding spore)
Tx - selenium sulfide, topical terbinafine or ketoconazole, or oral -azole if hard to tx |
|
|
Term
| rheumatoid arthritis + Coal workers' pneumoconiosis (CWP) |
|
Definition
|
|
Term
| sandblasting, stone cutting, mining, quartz, "egg-shell" calfic in hilar nodes |
|
Definition
Silicosis - alveolar macrophages phagocytose quarts --> rel cytokines, fibrosis
INC risk lung CA & TB |
|
|
Term
| plumbers, ship builders, roofers |
|
Definition
Asbestosis - pleural plaques lower lobe, gold-brown dumbbell-shaped rods
INC risk bronchogenic CA (also seen in smokers) |
|
|
Term
|
Definition
| yrs after asbestos exposure, no relationship to smoking |
|
|
Term
| Coal workers' pneumoconiosis (CWP) aka anthracosis |
|
Definition
| inhaled carbon (coal, tobacco, polluted cities) - upper lobes, CXR - small fibrotic nodules upper lung |
|
|
Term
| Transient myeloprolif disorder |
|
Definition
| mild/asymptomatic in trisomy 21, unreg prolif of megakaryocytic blasts |
|
|
Term
| childhood cerebellar ataxia, spider angiomas, IgA deficiency |
|
Definition
|
|
Term
| child: extreme high fever x 3-5 days --> lacey body rash |
|
Definition
| roseola (HHV-6) - resp droplets |
|
|
Term
| brain abscess HIV (multiple ring-enhancing lesions), congenital infections (triad chorioretinitis, hydrocephaly, intracranial calcif) |
|
Definition
Toxoplasmosis (Toxoplasma gondii) - ingested cysts in undercooked meat, cat feces, reactiv of prev latent dz (AIDS)
occurs late AIDS when CD4 <200
Tx - sulfadiazine w/ pyrimethamine (+ HAART therapy) |
|
|
Term
| 100s-1000s adematous colonic polyps + extraintestinal ie osteomas (benign bone growths esp in skull/mandible), dental abnorm, desmoid tumors, cutaneous lesions (fibromas) |
|
Definition
|
|
Term
| CNS tumors + FAP (familial ademomatous polyposis) |
|
Definition
|
|
Term
| multiple pigmented spots on lips/oral mucosa, multiple GI polyps (hamartomatous) |
|
Definition
|
|
Term
| 100s-1000s adenomatous colonic polyps |
|
Definition
| FAP (familial adenomatous polyposis) |
|
|
Term
| <100 hamartomatous polyps, kids, rare |
|
Definition
| juvenile polyposis syndrome |
|
|
Term
| tan skin, new cardiac murmur, INC transaminases, glucose, elev Fe |
|
Definition
Hemochromatosis - auto recess, INC Fe absorp, Fe deposits on pancreas --> destroys beta islet cells (needed to prod insulin, thus get hyperglycemia) = T1DM
INC Fe, ferritin, transferrin sat, DEC TIBC
Fe deposits in liver --> result in cirrhosis, INC risk hepatocellular CA |
|
|
Term
upper/lower resp Sx (rhinitis, hemoptysis) + glomerulonephritis, positive c-ANCA**
CXR - interstitial lung dz, infiltrates, cavitary nodules |
|
Definition
Wegener's granulomatosis - nephritic syndrome: hematuria, oliguria, mild proteinuria, edema, HTN
necrotizing vasculitis - lungs/kidneys |
|
|
Term
nephritic syndrome (spares upper resp), Dx'd w/ Bx & serum anti-GBM Abs
CXR - normal, or b/l perihilar patchy infiltrates |
|
Definition
|
|
Term
| MC nephrotic syndrome, Bx - IgG and C3 at BM, spike & dome appearance |
|
Definition
| membranonus glomerulonephritis |
|
|
Term
| kid preceded w/ fever, nephrotic syndrome, low serum C3, IgG/C3 in granular pattern on Bx, |
|
Definition
| Post infectious glomerulonephritis |
|
|
Term
| nephritic syndrome occurs 2-3 days after URI, mesangial prolif, painless hematuria |
|
Definition
| Berger's dz (IgA nephropathy) - related to Henoch Schonlein dz |
|
|
Term
most specific test for SLE...
most sensitive test for SLE...
most sensitive test for Rx-induced lupus... |
|
Definition
most specific - anti-Smith Ab
most sens - antinuclear Ab (ANA) test
anti-histone Ab |
|
|
Term
| specific test for Sjogren's syndrome |
|
Definition
|
|
Term
|
Definition
Tx - bosentan = inhib endothelin-1 receptor (endothelin - potent constrictor)
pulm HTN caused by vasoconstriction & fibrosis
pulm HTN - loud S2, SOB, fatigue, cough, INC PVR, INC mean pulm arterial pr |
|
|
Term
|
Definition
| Tx - chloroquine - inhib nucleic acid synthesis |
|
|
Term
|
Definition
txs helminth infection, ie pinworm, hookworm, whipworm, ascaris
MOA - bind & disrupt cytoplasmic microtubules |
|
|
Term
|
Definition
broadspec antihelmintic; Txs microfilarial, onchocerciasis (river blindness), strongyloidiasis
MOA - INC Cl- permeability in various nematodes --> hyperpol of parasite membranes, mm paralysis |
|
|
Term
|
Definition
antiparasitic
txs cestodes, trematodes, esp fluke infections ie schistosomiasis, most tapeworm infections (beef, pork, dog, fish)
MOA - INC Ca permeability of tegument (outer covering) of Schistosoma |
|
|
Term
| cerebral edema fr head trauma tx |
|
Definition
mannitol - DEC ICP (INC ICP causes NV, HA, fixed dilated pupils, papilledema)
MOA - osmotic diuretic - draws water into renal tubule by osmosis, outside kidney it draws water fr tissue into blood
Severe INC ICP causes Cushing's triad (HTN, bradycardia, irreg breathing)**
SE: hyponatremia, pulm edema |
|
|
Term
|
Definition
SERM (selective estrogen R modulator)
MOA: estrogen DEC apoptosis of osteoblasts --> INC osteoblastic activity & DEC IL-6 (which stim osteoclasts); antagonist at estrogen-R in breast/endometrium
Tx - osteoporosis |
|
|
Term
|
Definition
SERM - antag on estrogen R at breast, but agonist on bone, brain, liver, endometrium (INC risk endometrial hyperplasia/CA)
Tx - estrogen-R positive breast CA |
|
|
Term
|
Definition
| beingin, epiphysis of long bones, 20-40s, destroys bone, appears cystic, "soap bubble" lesion on xray, bx - multinuc giant cells |
|
|
Term
|
Definition
| malig primary tumor, teenagers, metaphysis of femur, humerus, tibia, Xray - Codman's triangle (periosteum raised d/t tumor) |
|
|
Term
|
Definition
| benign bone tumor, closely related to osteoid osteoma, differs by its ability to grow > 2cm |
|
|
Term
|
Definition
malig tumor, teenagers, xray - periosteal rxn w/ onion skin or sunburst pattern --> aggressive
metaphysis/diaphysis of long bones (ext) |
|
|
Term
|
Definition
benign tumor similar to osteoblastoma, but < 2cm; arise fr osteoblasts, found in femur, tibia
xray - well-demarcated lytic lesion surrounded by sclerosis |
|
|
Term
doxorubicin
anthracycline abx (also daunorubicin) |
|
Definition
MOA - inhib topoisomerase II (prevent DNA repair), ability to intercalate (insert itself) bet DNA base pairs (blocking DNA syn), & ability to generate free radicals (cause cellular damage)
MOST IMP SE: CARDIOTOXICITY -- dilated cardiomyopathy, CHF (elev JVP, DEC ejection fraction, pulm edema), severe alopecia |
|
|
Term
| Ifosfamide, cyclophosphamide (alkylating chemo agents) |
|
Definition
MOA - alkylate N-7 pos guanine --> DNA mismatch, abnormal cross-linking base pairs, breakage of DNA strand
SE - hemorrhagic cystitis**, myelosuppression (DEC WBC), SIADH, cardiac dysfxn
metab by liver --> breakdown product acrolein* = bladder SE, Tx - Mesna (mercaptoethanosulfate) binds inactiv acrolein |
|
|
Term
| Cisplastin (platinum based alkylating agent) |
|
Definition
MOA - create links bet in strands to prevent synthesis (similar to cyclophosphamide)
NEPHROTOXICITY (cleared by kidneys), neurotoxicity (peripheral neuropathy, tinnitis), myelosuppression |
|
|
Term
|
Definition
DNA cleaving abx
MOA - oxidative damage to DNA, breaks strand --> apoptosis
SE - skin lesions (hyperpig, erythema, ulceration), pulm dz most serious (dry cough, rales, PULM FIBROSIS) |
|
|
Term
|
Definition
support for developing sperm
FSH --> stim androgen binding protein (ABP) in Sertoli --> ABP binds testot & maintains high concen in seminiferous tubules to stim spermatogenesis
Sertoli also makes INHIBIN (inhib FSH) |
|
|
Term
|
Definition
LH --> stim Leydig cells --> testot
(if LH INC means defect in Leydig) |
|
|
Term
|
Definition
acute, severe ocular pain, frontal HA, visual halos, eye firm on palpating, ocular erythema, INC OCULAR PRESSURE (by tonometer), damaged ocular nn
push iris closer to lens --> block flow of humor |
|
|
Term
|
Definition
| CN IV palsy - sup oblique - intorts, depresses eye when adducted; pts complain reading or walking down stairs |
|
|
Term
|
Definition
enlarged blind spot (usually normal vision unless very severe), HA, NV
optic disk swelling 2ndary to INC ICP |
|
|
Term
| ptosis w/ depressed abducted eye, pupil dilation, loss of accomodation |
|
Definition
| CN III damage - sup, med, inf rectus, inf oblique, pupillary constriction (sphincter pupillae), lens accomodation (ciliary mm), eyelid opening (palpebrae superioris) |
|
|
Term
|
Definition
| opthalmoplegia w/ opthalmic & maxillary sensory loss - sinuses are venous blood-filled spaces lat to pituitary gland; contains internal carotid aa, CN III, IV, V1, V2, VI |
|
|
Term
|
Definition
painless, gradual vision loss, INC cup-to-disk ratio (optic disc cupping - also seen in closed angle)
atrophy of trabecular meshwork (takes up humor) --> canal of Schlemm for absorp into bloodstream
thus, get DEC resabsorp
gradual vision loss |
|
|
Term
|
Definition
makes aqueous humor; lies post to iris
has B receptors (thus BB help DEC intraocular pr); alpha agonists like epi constrict BV and DEC humor prod |
|
|
Term
|
Definition
ciliary process + ciliary mm: change lens shape (accomodation), reg humor flow
ciliary mm activ byb muscarinic-R agonists (pilocarpine Txs glaucoma by INC humor drainage) |
|
|
Term
|
Definition
acute, painless, monocular loss vision d/t embolus
pale retina w/ cherry-red macula (maintains blood supply fr ciliary aa making it still red) |
|
|
Term
| bilat, painless, lens thickening, opacifications w/ glare, slow progressive vision loss |
|
Definition
cataracts
risk factors: age, smoking, DM, EtOH, HTN, obesity, UV exposure |
|
|
Term
| degen macula w/ blurring or loss central vision but spared peripheral vision, drussen (yellow fat deposits) on fundoscopic |
|
Definition
| age related macular degen |
|
|
Term
| congenital port-wine stain (hemangioma - dark red vasc malformation on eyelids) of V1, V2 distrib; mental retard, glaucoma, hemiparesis, hemianopsia, seizures |
|
Definition
|
|
Term
| hypomelanotic macules ("ash leaf spots"), seizures, mental retard, Shagreen patch (cutaneous nevus), facial angiofibromas |
|
Definition
Tuberous sclerosis
affects eyes, heart, lungs, kidney |
|
|
Term
| cafe au lait spots (6+ hyperpig macules), freckling in groin/axilla, skeletal abnorm, Lisch nodules (hamartomas of iris) |
|
Definition
Neurofibromatosis 1 (MC than NF2)
AD, NF1 gene, chrom 17
NF2 - assoc w/ bilat acoustic neuroma, NF2 gene, chrom 22 |
|
|
Term
| multisys CA syndrome, esp clear-cell renal cell CA, pheochromocytoma, hemangioblastoma |
|
Definition
|
|
Term
| monitoring test for colon CA |
|
Definition
| CEA (carcinoembryonic Ag) - esp epi origin; also INC in lung, pancreatic |
|
|
Term
| monitoring test for pancreatic CA |
|
Definition
|
|
Term
|
Definition
|
|
Term
| marker for fetal development, hepatocellular CA, testicular CA, teratocarcinoma |
|
Definition
|
|
Term
|
Definition
| INC in melanoma pts, esp w/ mets dz |
|
|
Term
| burning/stabbing pain, 10/10 when pressure placed on face, otherwise it's 0/10 |
|
Definition
Dx - trigeminal neuralgia (F, >50s
Tx - anticonvulsant ie carbamazepine (also used for epilepsy & bipolar)
MOA - limit influx Na across membrane |
|
|
Term
| ethylene glycol ingestion (antifreeze, carpet cleaner) |
|
Definition
SE - CNS depression, renal failure w/ metabolic acidosis
toxic metab glycoaldehyde --> glycolic acid (contrib to met acidosis) --> oxalic acid --> deposits as Ca oxalate in various tissues
1-3 hrs - confusion, ataxia, hallucination, sllurred speech, coma
Next - cardiopulm sx, met acidosis - NV, hyperventilation, HTN, tachycardia, pulm edema, resp distress
24-72 h - urinary ca oxalate crystals w/ oliguric/anuric renal failure
Tx - Na bicarb, ethanol, hemodialysis, fomepizole
Note: anion gap = serum Na - (HCO3 + Cl), if >12 = elev... DDx for high AGMA: renal failure, lactic acidosis, DKA, alcoholic ketoacidosis, salicylate/methanol poisoning, ethylene glycol poisoning |
|
|
Term
| CNS depression, high anion gap metabolic acidosis, appears drunk |
|
Definition
| methanol ingestion (without Ca oxalate crystals which is seen in ethylene glycol ingestion) |
|
|
Term
| Type 1 renal tubular acidosis |
|
Definition
| normal anion gap met acidosis (NAGMA) w/ low serum K |
|
|
Term
|
Definition
| gram + (S pneumo, S pyogenes, actinomyces), syphillus |
|
|
Term
| 4th gen cephalosporin (cefepime, cefpirome) |
|
Definition
| Gram + sepsis, pseudomonas |
|
|
Term
| macrolide (erythromycin, azithromycin, clarithromycin) |
|
Definition
| Gram + cocci w/ PCN allergies, atypical pneummonias (myocoplasma, chlamydia, legionella), URIs, STDs |
|
|
Term
| Fluroquinolone (levofloxacin, "xacin") |
|
Definition
| more severe gram pos + and Gram pos - infections ie pseudomonas & Neisseria |
|
|
Term
|
Definition
SABA, others - terbutaline, metaproterenol, pirbuterol, levalbuterol, fenoterol
MOA - stim B-2 adrenoceptors in airway, DEC intracell Ca, hyperpol smooth mm d/t INC K influx (can lead to hypokalemia), DEC myosin activity ==> relaxed bronchial smooth mm
SE - stim sympathetics: tachycardia, palpitations, tremors, diaphoresis, agitation |
|
|
Term
|
Definition
| "stabilizes" membrane of mast cells by interfering w/ Ca influx |
|
|
Term
|
Definition
anticholingergic; combined w/ B2 agonists to Tx acute asthma exacerbations
MOA - inhib Ach by blocking muscarinic R --> inhib secretions of mucosal glands in resp and inhib vagus-nn mediated bronchconstriction |
|
|
Term
|
Definition
DEC airway inflamm by DEC capillary permeability & inhib leukocytes
SE: Cushing's, osteoporosis, DM, glaucoma, cataract, truncal obesity |
|
|
Term
|
Definition
leukotriene R antag
MOA - inhib bronchospasm, vasc permeability, mucosal edema, infiltration of inflamm cells
Tx - aspirin induced asthma |
|
|
Term
|
Definition
inhib hepatic syn of vit K dep clotting factors (II, VII, IX, X) - block extrinsic pathway, also protein C, S, Z
Tx - prophylaxis/Tx of thrombosis & thromboembolism (esp afib, cardiac valve rep, DVT, PE, prev MI)
Monitor PT and INR (2-3); high INR --> risk bleeding
Reversal Tx - Fresh frozen plasma (rapid), vit K (takes longer) |
|
|
Term
| enoxaparin, dalteparin, tinzaparin, fondaparinux (indirect thrombin inhibitor) |
|
Definition
HEPARIN
MOA - bind antithrombin
Use - prophylaxis/Tx of DVT & PE, ACS, prevent clot in catheters, after hip surg
SE: heperin induced thrombocytopenia - platelet degradation d/t immune rxn |
|
|
Term
|
Definition
DEC blood viscosity
Use - intermittent claudication of obstructed aa in limbs
SE - dizziness, HA, NV, dyspepsia |
|
|
Term
| alteplase, reteplase, tenecteplase, streptokinase, urokinase (thrombolytics) |
|
Definition
MOA - conversion of plasminogen to plasmin (thrombolysis)
Use - MI (coronary aa thrombosis), thromboembolic strokes, DVT, PE, clear AV cannula occlusion |
|
|
Term
|
Definition
MOA - inhib syn of thromboaxane A2; prevent platelet aggreg
Use - primary prophylaxis for Acute MI; also analgesic, antipyretic, anti-inflamm
SE: gastric ulcer, bleeding, anemia, Reye's syndrome (kids get acute encelphalopathy & fatty liver), tinnitis |
|
|
Term
|
Definition
made of LPS - outer membrane Gram neg --> major cause septic shock fr Gram neg
Lipid A = most imp part of LPS (don't confuse w/ S aureus's Protein A) --> activ macrophages --> fever, hypoTN, inflamm, coag
Alt C' pathway & coag pathway (DIC) activateed
heat stable, rel IL-1, 6, 8 (fever), TNF-alpha (hemorrhagic tissue necrosis), nitrous oxide (hypoTN/shock), platelet activ factor (hypoTN) |
|
|
Term
|
Definition
| Gram +, rigidity to cell walls, mediates attachment |
|
|
Term
|
Definition
| rel by S aureus; avoid phagocytosis |
|
|
Term
|
Definition
| S pyogenes; evade phagocytosis |
|
|
Term
|
Definition
indirect cholinesterase inhibitor
Tx CNS effects of anticholinergics atropine & scopolamine; also myasthenia gravis, glaucoma |
|
|
Term
|
Definition
muscarinic agonist
Tx urinary retention & ileus |
|
|
Term
|
Definition
indirect cholinesterase inhibitor
unlike physostigmine, doesn't cross BBB
Tx myasthenia gravis, reverse mm relaxant in anesthedia, post op urinary retention |
|
|
Term
|
Definition
muscarinic agonist
Tx DEC intraocular pr in glaucoma |
|
|
Term
hyperviscosity, thrombocytosis
HA, vertigo, pruritis after shower, thrombosis signs, splenomegaly, pleothora of face, INC RBC mass, INC EPO in response to INC RBC, INC H/H, WBC, platelets, leukocyte alkaline phosphatase, bilirubin, B12 |
|
Definition
polycythemia vera - malig prolif of RBCs in bone marrow
erythromelalgia - red, burning ext relieved by aspirin & cold temp; worse w/ warmth
Complications - CVA, MI, DVT, PE
Tx - hydroxyurea, chronic phlebotomy
Primary/PV: low EPO, high RBC, normal SaO2
Hypoxia/Secondary: high EPO, HIGH RBC, low SaO2 (or normal if d/t tumor)
Relative: low plasma vol |
|
|
Term
|
Definition
anti-androgen
Tx - adv prostate CA, hirsutism (also spironolactone)
MOA - block testot & DHT-R on prostate cells (does NOT DEC LH/testot)
SE - gynecomastia, galactorrhea, sexual dysfxn |
|
|
Term
| cabergoline, bromocriptine |
|
Definition
dopamine agonist
Tx - hyperPRL (fr pituitary adenoma) |
|
|
Term
|
Definition
biphosphonate
Tx - osteoporosis, osteolytic lesions fr CA |
|
|
Term
|
Definition
GnRH-R agonist
MOA - DEC LH/FSH --> suppress steroid rel by ovaries/testicles
Tx - adv prostate CA, precocious puberty
If given pulsatile fashion --> will boost LH/FSH and induce ovulation
SE - reversible menopause (hot flashes, vag dryness, breast atrophy, mood lability); gynecomastia/impotence but not galactorrhea |
|
|
Term
|
Definition
| systemic corticosteroid - bind to cytoplasmic GC-R of in all cells --> complex translocated to nuc where it disrupts inflamm mediators; inhib phospholipase A2 (--> arachidonic acid) |
|
|
Term
|
Definition
radial nn palsy --> intoxicated pts "sat night palsy," using crutches
weakness of wrist/finger extensors, can't supinate forearm, loss of thumb abduction (abd pollicus longus), sensory dorsolat hand, dorsal 1st, 2nd, 3rd digit |
|
|
Term
| motor to deltoid & teres minor, sensory over lat shoulder; weakness abductoin, ext rot |
|
Definition
| axillary nn injury fr shoulder dislocation, humeral surgical neck fracture, sleeping prone w/ arms overhead |
|
|
Term
| motor to wrist/finger flexor mm, pronator teres, abd pollicus brevis, opponens pollicis, 1st & 2nd lumbricals, sensory to palmar 1st, 2nd third, lat half 4th |
|
Definition
median nn injury = ext rot thumn, thenar atrophy, ext of hand/fingers
CARPAL TUNNEL SYNDROME |
|
|
Term
| medial epicondyle frx, weakness hand mm, DEC grip strength, hypothenar atrophy |
|
Definition
| ulnar nn = flexor carpi ulnaris, flexor digitorum profundus, 3rd/4th lumbricals, interossei, palmaris brevis, flexor pollicis brevis |
|
|
Term
| humeral fractures, weakness elbow flexion, senosry loss lat forearm |
|
Definition
| muscolocutaneous nn - motor to biceps, brachialis, coracobrachialis, sensory to lat forearm |
|
|
Term
| focal necrosis collecting ducts, inner medulla, papilla d/t ischmia |
|
Definition
| renal papillary necrosis - seen in sickle cell trait/dz d/t renal medullary sickling/vasc obstruction -- medulla vulnerable to sickling bc of its low PaO2, high osmolality, & acidity |
|
|
Term
| edema, inflamm of interstitium w/ sparing glomeruli & BV, induced by Rxs ie abx (PCN - esp methicillin, cephalosporins), NSAIDs, diuretics, PPIs, anticonvulsants, systemic infxn |
|
Definition
acute interstitial nephritis (AIN) - serum/urine (+) eosinophils
rsash, fever, eosinophilia |
|
|
Term
acute renal dysfxn fr DEC renal perfusion/direct toxic injury to parenchyma
muddy brown casts, FENa (fractional excretion of Na) >2% |
|
Definition
acute tubular necrosis - caused ischemia (hypoTN, shock), meds (NSAIDs antimicrobial), radiocontrast, rhabdomyolysis, transfusion rxns
hard to disting fr prerenal dz (dehydration - normal microscopy, FENa <1%) |
|
|
Term
| necrosis skeletal mm - MC secondary to crush injury, prolonged immobility, statin use, myositis, seizure |
|
Definition
| rhabdomyolysis (+) urine dipstick for blood; (+) myoglobinuria fr injured mm |
|
|
Term
| 60s, gross/microscopic hematuria, flank pain, systemic sx wt loss, fever |
|
Definition
renal cell CA
risks: smoking, Von-Hippel Lindau |
|
|
Term
| newborn w/ yellow discoloration skin (hyperbilirubinemia), gen edema, fetal ANEMIA requiring transfusion, heart failure |
|
Definition
erythroblastosis fetalis - hemolytic dz of newborn d/t Rh isoimmunization (Rh (-) mom exposed to fetal RBC that are Rh + and dev Abs to fetal Rh ("D") Ag. Rh - mom becomes "sensitized"
Tx - anti-Rh (D) Ig prevent Rh dz; confers passive immunity, binding fetal cells in maternal circ & prevent sensitization |
|
|
Term
| safe vaccines during pregnancy |
|
Definition
influenza, diphtheria, tetanus toxoid
DO NOT use live attentuated ie varicella, MMR, polio |
|
|
Term
| acute lower abd/pelvic pain + 1+ of the following: urine tenderness, adnexal, cervical motion tenderness |
|
Definition
PID - can also be asymptomatic
acute: >101 F, mucopurulent cervical/vag discharge, NT in vag fluid |
|
|
Term
| dermatitis herpetiformis tx |
|
Definition
| dapsone (diamninodiphenyl sulfone) + gluten free diet |
|
|
Term
| epigastric pain (burning/gnawing), relieved by eating, worse hrs later, nocturnal pain, 30-40s |
|
Definition
duodenal ulcer (PUD)
90% caused by H pylori - urea breath test or Ab test; most diagnostic - endoscopy
MC in blood type O |
|
|
Term
| epigastric pain radiating to back, NV, anorexia |
|
Definition
|
|
Term
| epigastric pain worsened w/ food, older pts |
|
Definition
gastric ulcer
risk - NSAIDs
MC in blood type A |
|
|
Term
| flu-like sx, jaundice, RUQ pain |
|
Definition
|
|
Term
|
Definition
bile acid sequestrant (others: cholestyramine, colesevelam)
MOA - prevent reabsorp of bile by binding to it --> INC hepatic synthesis of BA fr cholesterol |
|
|
Term
|
Definition
MOA - prevent BA reabsorp (DEC LDL), INC VLDL --> INC TRIG (don't use in hyperTRIG pts)
Rxs remain inside intestinal lumen & not absorbed --> constipation, bloating, abd pain, flatulence, elev LFTs, heartburn, impair fat sol vit (ADEK) |
|
|
Term
|
Definition
HMG-CoA reductase inhibitor (-statin)
MOA - DEC LDL
Tx - atherosclerosis - INC stability lesions, DEC vasc inflamm & oxidative stress
SE - diarrhea, nasopharyngitis, arthralgia, elev LFT, myositis, rhabdomyolysis |
|
|
Term
|
Definition
fibric acid deriv (-fibrate)
MOA - DEC TRIG, VLDL, and LDL by INC oxidation of FA in liver & mm
SE - heartburn, myopathy, rash, hypokalemia, high aminotransferase/alkaline phosphatase |
|
|
Term
|
Definition
inhibitor of intestinal sterol absorp
MOA - DEC LDL |
|
|
Term
|
Definition
nicotinic acid, vit B3
MOA - DEC VLDL, LDL, INC HDL**
SE - cutaneous vasodilation & warm sensation, hyperuricemia (can cause gout), acanthosis nigricans d/t hyperglycemia |
|
|
Term
| mm weakness upper ext, worsens as day progresses, relieved by rest. uni ptosis, bilat facial mm weakness, DEC prox mm strength |
|
Definition
Myasthenia gravis - Abs vs Ach-receptors --> no stim at neuromusc end plate that allows entry of Na into skeletal mm to cause contraction
Dx - Tensilon test (edrophonium - short acting
Tx - AchE inhibitor (neostigmine, pyridostigmine, edrophonium) |
|
|
Term
|
Definition
inhib Ach vesicles to fuse w/ terminal membrane --> NO Ach rel into neuromusc jxn --> mm relaxation
Use - spastic muscular disorders, opthlamic (blepharospasm, strabismus), cosmetic |
|
|
Term
| atracurium, rocuronium (-rium or -nium) = non-depol neuromusc blocking drugs |
|
Definition
MOA - block Ach binding to R --> interfere w/ chilingergic transmission --> mm relax
Use - general anesthesia, endotracheal intubation |
|
|
Term
|
Definition
cause - folic acid (B9) and B12 deficit
folic acid activ thymidylate synthase --> reduced by dihydrofolate reductase --> form tetrahydrofolate --> turned into cofactor in conversion of homocysteine to methionine & synthesis of thymidylate (rate limiting step in DNA syn) |
|
|
Term
| fluorouracil (5-FU; thymidylate synthetase inhibitors) |
|
Definition
MOA - block methylation of dUMP (deoxyuridine monophosphate)
Thymidylate synthetase - catalyze methylation rxn that yields dTMP fr dUMP
5-FU - cytotoxic
Use - solid organ CA (colorectal, gastric, pancreatic, breast), skin (basal cell CA) |
|
|
Term
|
Definition
MOA - inhib RNA polymerase
Use - TB, prophylaxis of N meningitidis, H flu, S aureus |
|
|
Term
|
Definition
antifolate
MOA - inhib dihydrofolate reductase (acts to reduce folate to tetrahydrofolate)
Use - ALL, rheum arthritis, psoriasis, ectopic/molar pregnancy
SE - myelosuppression, GI upset |
|
|
Term
|
Definition
| type IV hypersensitivity - T cell mediated |
|
|
Term
| Klumpke's paralysis ("claw hand") |
|
Definition
| injury to C8 and T1; atrophy of intrinsic mm (lumbricals and interossei) --> flexion middle/distail phalanges & hyperextension of metacarpophalangeal jts |
|
|
Term
| Erb palsy ("water's tip") |
|
Definition
| injury C5, C6 --> loss of flexion & lat rot of arm & abduction |
|
|
Term
|
Definition
| injury C5, 6, 7 --> long thoracic nn |
|
|
Term
|
Definition
metronidazole
+ amine test |
|
|
Term
| systolic crescendo-decrescendo murmur at L sternal border, DEC w/ hand grip, but INC w/ valsalva |
|
Definition
| hypertrophic obstructive cardiomyopathy (HOCM) - thickened ventricular septum; auto dom |
|
|
Term
| physiologic S3 - rapid ventric filling |
|
Definition
|
|
Term
| polymyalgia rheumatic assoc w/ |
|
Definition
| giant cell temporal arteritis (same HLA type, pt pop) |
|
|
Term
|
Definition
| most asymptomatic, found incidentally, older pop, d/t loss elasticity & mm tone |
|
|
Term
| chest pain & upper abd pain after severe retching & vomitting, can also occur after endoscopy |
|
Definition
| Boerhaave's syndrome - esophageal rupture |
|
|
Term
| centripital rash (starts palms/soles/wrist/ankles then outward) |
|
Definition
1. Rocky mtn spotted fever - Rickettsia Rickettsii; spring/summer; tick vector (mostly dermacentor); found east of Rockies - dogs/rodents, Tx - doxycycline
2. hand, foot, mouth dz (Coxsackie)
3. Syphillis (Treponema pallidum) |
|
|
Term
| rash starts on face moves down, cough, coryza, conjunctivitis, mucosal white spots (Koplik's spots) |
|
Definition
| Rubeola (measles) - Paramyxoviridae (-) ssRNA, transmit via resp droplets |
|
|
Term
| rash starts on face moves down, preceded by cervical LAD |
|
Definition
|
|
Term
| rose spots on abd; fever, HA, diarrhea |
|
Definition
Typhoid fever
Tx - FQs or cephalosporins |
|
|
Term
| sudden onset HA, N 2 hrs ago. facial droop, non-contrast CT shows 3 cm hyderdense (bright) lesion in frontal cortex |
|
Definition
| example of hemorrhagic stroke (tPA contraindicated!) |
|
|
Term
| mm weakness, L sided hemiparesis in face, arm, leg. non-contrast brain CT shows occlusion of contralat lenticulostriate branches of M1 segment MCA that resulted in 1 cm hypodense lesion in post internal capsule |
|
Definition
| lacunar stroke (subtype ischemic stroke) - small ischemic stroke in small, deep penetrating aa supplying deep structures (putamen, thalamus, caudate, pons, internal capsule, cerebellum), HTN strong factor |
|
|
Term
| abnorm speech, visual disturb 28 hr ago, homonymous hemianopia, facial weakness, L arm drifts down when asked to raise it |
|
Definition
| total anterior circ infarct (subtype ischemic stroke) - MC, MCA blocked, also internal carotid or its bifurcation fr common carotid aa |
|
|
Term
| fever >5 days, fissured lips, erythema & desquamation of palms/soles, bilat conjunctivitis, inflamed red papillae on tongue (strawberry tongue) |
|
Definition
| Kawasaki's dz (mucocutaneous lymph node syndrome - vasculitis <5 yo asians) - assoc w/ coronary aa aneurysms, Tx - IV immune globulin (prevent aneurysm) & high dose aspirin (prevent thromboses) |
|
|
Term
| accum homogentisic acid in CT, bones (lead to arthritis) & urine; urine turns black on standing/exposure to air |
|
Definition
| Alkaptonuria - homogentisate oxidase deficit, auto recess |
|
|
Term
| glucose-6-phosphatase deficit (normally cleaves P grp fr glucose so it can exit liver as part of glycogenolysis & glyconeogenesis) |
|
Definition
| Von Gierke's dz - type 1 glycogenosis - MC glucogen storage dz --> accum glycogen in tissue |
|
|
Term
| lysosomal alpha 1,4-glucosidase deficit |
|
Definition
| Pompe dz - accum glycogen in heart, spleen, mm |
|
|
Term
| debranching enzyme 1,6 glucosidase deficit |
|
Definition
| Cori dz - accum glycogen in mm, liver, cardiac |
|
|
Term
|
Definition
| McArdle syndrome --> excess glycogen in mm |
|
|
Term
| galactose-1-phosphate uridyltransferase deficit |
|
Definition
| severe galactosemia - neurodev delay, GI sx, cataracts & recent intro of dietary lactose & galactose |
|
|
Term
|
Definition
| rabbits (or deer), Francisella tularensis: gram neg |
|
|
Term
|
Definition
| NE US; Ixodes deer tick; irreg fevers, chills, hemolytic anemia, hemoglobinuria, RBC intracell parasite - RBC w/ no pigment w/ maltese cross or "diamond ring" Tx - quinine and clindamycin |
|
|
Term
|
Definition
| flu-like illness (fever, HA, myalgia), summer, hikers who remember a tick bite |
|
|
Term
| nonselective beta blockers |
|
Definition
propranolol, pindolol, nadolol, timolol
MOA - block B-1 R in heart (DEC HR, contractility), block B-2 R in airway (bronchoconstriction - dyspnea, nonprod cough, chest tightness, tachypnea, diaphoresis, wheezing); contraindic in asthma & COPD
SE - arrhythmia (bc of DEC conduction thru AV node) |
|
|
Term
| "BEAM" of beta-1 blockers |
|
Definition
betaxolol
esmolol - most rapid onset, SA; arrhythmia - IV
atenolol, acebutolol
metoprolol - severe CNS effects (insomnia, vivid dreams, nightmares) bc crosses BBB |
|
|
Term
|
Definition
permethrin cream applied neck down to toes
Sx: extreme pruritis, papular rash in webs of fingers, groin, nipples, knees, axillary folds |
|
|
Term
| antag ALD-R, block channels reabsorp Na into blood, excretion of K into urine |
|
Definition
K sparing diuretic - spironolactone, eplerenone
SE - hyperkalemia (diarrhea, mm cramps, DEC DTRs), hyponatremia
Spironolactone - antag androgen-R --> use to tx hirsutism (PCOS) & hyperALDism (Conn syndrome)
SE - gynecomastia |
|
|
Term
| inhib Na/Cl transporters distal convoluted tubule --> DEC NaCl reabsorp into blood --> INC Ca reabsorp |
|
Definition
thiazide diuretics - HCTZ, chlorthalidone
SE - hypoNa, allergic rxn, hyperglycemia, hyperuricemia, hyperCa, hyperlipidemia |
|
|
Term
| inhib Na/K/2Cl transporter in thick asc loop Henle --> higher Na in urine & body responds by pumping K into urine (to maintain serum Na levels) |
|
Definition
loop diuretics - furosemide, bumetanide
SE - hypoK+ metabolic acidosis, ototoxcity, allergic rxn, hyperuricemia (gout), hypoMg |
|
|
Term
| male kids, deleted dystrophin gene (no fxn'l dystrophin), Gower's sign (use hands to get up fr floor), calf mm hypertrophy (pseodohypertrophy - mm rep by fat), INC serum CPK |
|
Definition
Duchenne's muscular dystrophy
Dx - mm bx
Tx - corticosteroids, PT |
|
|
Term
| similar to Duchenne but less severe, insufficient dystrophin |
|
Definition
| Becker's muscular dystrophy |
|
|
Term
| pneumocystis jiroveci pneumonia Tx; fever, dry cough, tachypnea, INC LDH, CXR - bilat diffuse infiltrates |
|
Definition
TMP/SMX (or dapsone)
HIV, CD4 <250 |
|
|
Term
| cyrptococcus tx (CD4 <50) |
|
Definition
|
|
Term
| disseminated mycobacterium avium complex (HIV, CD$ <50) |
|
Definition
|
|
Term
| >30, bone marrow reacts w/ myeloperoxidase & sudan black, auer rods |
|
Definition
|
|
Term
| short stature, round face, dental hypoplasia, shortened 4th/5th metacarpal, HYPOCa & HYPERphosphatemia |
|
Definition
| pseudohypoparathyroidism - genetic mut lead to end-rogan defect/resis to PTH (normally INC renal Ca reabsorp, DEC kidney reabsorp of phosphate, INC bone resorp, renal conversion of vit D to active form) |
|
|
Term
| malig prolif plasma cells, overabundant monoclonal paraprotein (M protein); bone pain (lumbar), pathologic fxs, punched-out lesions skulls, vertebrae, ribs, pelvis |
|
Definition
multiple myeloma (MM) - monoclonal paraprotein (M protein), urine monoclonal protein (Bence Jones), hyperCa (stones, bones abd groans, psychic moans), low PTH, normal phosphate
Tx - chemotherapy |
|
|
Term
| Hypercalcemia, hypophosphatemia, low PTH |
|
Definition
Parathyroid hormone-related peptide (PTHrP) - cause hyperCa of malignancy (squamous cell CA lung, renal cell CA, breast CA)
mimics primary hyperthyroidism --> diffuse bone resorp, DEC renal excretion Ca
Tx - underlying malig, biphosphonate (DEC resorp of Ca fr bone) |
|
|
Term
| defective 3rd/4th pharyngeal POUCH --> hypoplasia thymus & parathyroid, hypoparathyroidism, congenital heart dz, craniofacial dysmorphology |
|
Definition
|
|
Term
| HA, tenderness on scalp (temporal), jaw claudication, visual abnorm |
|
Definition
giant cell arteritis - >50 yo, F
Def Dx - temporal aa Bx
Tx - high dose prednisone (can tx b4 bx bc may lead to irreversible blindness!) |
|
|
Term
| MC HA, mm contracture caused by stress, bilat, frontal/occipital, constant pressure, "vise-like" or "band" |
|
Definition
|
|
Term
| uni/bilat HA, pulsating, NV, photophobia, phonobia, assoc w/ aura |
|
Definition
|
|
Term
| uni HA, periorbital, clusters, ipsi lacrimation |
|
Definition
cluster HA
Tx - can use O2 |
|
|
Term
| hierarchy of evidence (most robust of clinical evidence to least) |
|
Definition
| meta-analysis > systemic reviews > randomized control trials > observational studies (cohort, case-control, cross-sectional) > case reports |
|
|
Term
| Dx metabolic acidosis (AGMA vs NAGMA) |
|
Definition
1) look at pH <7.4 = acidemia
2) check PCO2, if <40 = metabolic acidosis (HCO3 will be <23)
3) check anion gap = Na - (Cl + HCO3), if >12 = anion gap metabolic acidosis (AGMA); <12 = non-anion gap met acidosis
AGMA DDx = MUDPILES... methanol, uremia (chronic renal failure), DKA, propylene glucol or paraldehyde, INH or iron, lactic acidosis, ethylene glycol, salicylates
NAGMA DDx = diarrhea, renal tubular acidosis, ureteroenteric fistula, caribonic anhydrase inhibitor use |
|
|
Term
| high cortisol --> wt gain, acne, moon facies, central obesity, abd striae, HTN, buffalo hump, easy bruising, osteoporosis, depression, emotinoal lability; hyperglycemia!; F - irreg menses, hirsutism, M - DEC libido, ED; Lab - elev 24-h urinary free cortisol, glucose, low K |
|
Definition
Cushing's syndrome
Causes - excess pituitary/ectopic ACTH, primary adrenal hypercorticism, exogenous GCs (MCC; like prednisone); Cushing's dz - excess ACTH fr pituitary adenoma of basophilic cells, ACTH-secreting small cell CA of lung or carcinoid tumor |
|
|
Term
| bird/bat droppings, Mississippi and Ohio River Valleys, lung & systemic infections |
|
Definition
| Histoplasma capsulatum - macrophages filled w/ multiple small, round histoplasma |
|
|
Term
| mononucleosis-like dz in immunocompetent & congenital infxn, "owl eye" Cowdry A inclusions |
|
Definition
| Cytomegalovirus - also causes GI infxn, encephalopathy, retinitis (in HIV pts) |
|
|
Term
| transmitted by water sources (shower heads, ACs), Gram neg rod, grows on charcoal yeast extract, urine Ag detection |
|
Definition
Legionella pneumophila
Tx - erythromycin |
|
|
Term
| prothetic heart valve w/ new murmur & presentation of hemolysis (pallor, jaundice, indirect hyperbilirubinemia, HSM, INC LDH, DEC haptoglobin) |
|
Definition
microangiopathic/macroangiopathic hemolytic anemia - forms schistocytes
chronic traumatic hemolysis leads to Fe deficiency anemia d/t chronic hemoglobinuria |
|
|
Term
| RBC stacked like roll of coins |
|
Definition
rouleaux formation = Multiple myeloma
d/t protein-RBC interactions that cause RBC aggregation |
|
|
Term
| remnant nuclear material in RBCs that should've been removed by spleen |
|
Definition
| Howell-Jolly bodies = hyposplenia/asplenia |
|
|
Term
| large surface area to vol ratio --> DEC concen Hgb; hemoglobinized central area, outer border dark red, pallor ring separating them |
|
Definition
| "bulls eye" or target cells, codocytes = Fe defic anemia & hemoglobinopathies (INC cell membrane) ie liver failure & splenectomy |
|
|
Term
|
Definition
| macrocytes = fol/B12 defic, alcoholism, chronic liver failure, myelodysplastic syndromes, hypothyroidism |
|
|
Term
| abd pain, fever, hepatomegaly, NV, jaundice; spread thru water/food contaminated w/ feces; outbreaks in Middle East, S America, Africa, India, China |
|
Definition
Hepatitis E
Dx - anti-HEV IgM Abs, stool microscopy
Tx - self-limiting, not become chronic |
|
|
Term
| paresthesia in ulnar nn distrib, (+) Adson's test (weak/absent pulse while moving UE thru ROM & pt rotates head toward involved side while taking deep inspiration and holding it) |
|
Definition
| Thoracic outlet syndrome - compression of brachial plexus, subclavian a/v |
|
|
Term
| numbness median nn distrib (thumb, index, middle, radial half of ring finger); (+) Tinel's, Phalen's, & Reverse Phalen's |
|
Definition
|
|
Term
| long standing RA w/ gen edema, nephrotic syndrome; congo red stain shows apple-green birefringence |
|
Definition
renal amyloidosis - seen in long standing infections in dev countries (TB), causes nephrotic syndrome; industrial countries - RA
Renal & hepatic involvement MC |
|
|
Term
| Kimmelstiel-Wilson nodules on bx |
|
Definition
|
|
Term
| "tram-track" pattern on bx, low serum C3 levels |
|
Definition
| membranoproliferative nephropathy |
|
|
Term
|
Definition
| minimal change dz = MCC nephrotic syndrome in kids |
|
|
Term
|
Definition
|
|
Term
|
Definition
| liver, gallbladder, spleen |
|
|
Term
|
Definition
| adrenals, kidney, middle GI/GU tract |
|
|
Term
|
Definition
|
|
Term
|
Definition
| uterus, cervix, penis, prostate, LE |
|
|
Term
|
Definition
1-34 yo unintentional injury
35-74 CA
65+ cardiovascular |
|
|
Term
| ST depression >1mm in 2+ leads; chest pain that began on exertion, PMH COPD, smoking, HTN, INC HR, BP, obese, lungs CTA, distant heart sounds; chest pain, ST depression, + troponins |
|
Definition
NSTEMI - subendocardial infarct
Cause - INC in partial occlusion of coronary aa (newly ruptured plaque w/ partially occluding thrombosis), or INC O2 demand in setting of partial coronary aa occlusion (person w/ atherosclerosis who runs a marathon) |
|
|
Term
| diffuse ST elev, inspiratory chest pain relieved by leaning forward, friction rub |
|
Definition
|
|
Term
| chest pain, ST depressions without enzymatic evidence (troponins) |
|
Definition
|
|
Term
| crushing substernal chest pain, ST elev |
|
Definition
STEMI
atypical presentation - diabetics, females |
|
|
Term
| autoAbs vs nicotinic post-synaptic acetycholine-R |
|
Definition
myasthenia gravis - asymmetric mm weakness in ext, dysarhtria, dysphagia, cranial mm weakness; repeated use worsens, improves w/ rest; visual disturb, ptosis
Note - nicotinic-R only on skeletal mm, muscarinic-R on cardiac/smooth mm & glands |
|
|
Term
| demyelination of white matter |
|
Definition
|
|
Term
| OMM - stretching soft tissues in multiple vectors technique; employs separation of origin & insertion & deep pressure |
|
Definition
|
|
Term
| painless hematuria, flank pain, flank mass; 50-70s, wt loss anemia |
|
Definition
renal cell CA - 95% kidney neoplasm
cigarette smoking INC risk
assoc w/ von-Hippel Lindau dz (mut chrom 3)
Can invade vena cava, ascites, LE edema, hematogenous spread
Dx - CT/MRI, CXR to r/o tumor into hilar LN, Histo - clear cell ca
Tx - surg** pref |
|
|
Term
| dilation of renal tubules, common w/ age |
|
Definition
|
|
Term
| hemoglobinuria (dark urine) at first morning void, improves thruout day |
|
Definition
paroxysmal nocturnal hemoglobinuria, rare
nocturnal hemolysis, hemoglobinuria |
|
|
Term
| hypomenorrhea or secondary amenorrhea w/ infertility; multiple D&Cs |
|
Definition
Asherman syndrome - intrauterine adhesions (or synechiae), defective basal layer (thus endometrium can't regenerate & prolif)
etiology - direct endometrial trauma (inflamm, scarring, adhesion) |
|
|
Term
| hyperplastic overgrowth of endometrial glands, common cause of irreg menses bleeding, intermenstrual spotting, > 40s |
|
Definition
endometrial polyp
risk - obesity, HTN
histo - benign, rarely undergo malig |
|
|
Term
|
Definition
aka uterine fibroid - MC uterine tumor
leiomyomata - benign, rarely undergo malig
menorrhagia (INC menses bleed), secondary dysmenorrhea; hormone sensitive tumors |
|
|
Term
| dysmenorrhea, dysparenunia, dyschezia (painful bowel movement); pains starts b4 menses & ceases once menses stops*** hallmark |
|
Definition
| endometriosis - cause infertility fr pelvic adhesions |
|
|
Term
| islands w/in myometrium (endometrial glands & stroma w/in myometrium); menorrhagia, dysmenorrhea, symmetric enlarged uterus |
|
Definition
|
|
Term
|
Definition
endometrial hyperplasia (precursor to endometrial CA) -- overgrowth of endometrial sromal or glandular cells
cause - unooposed estrogen (absence of proges)
risk factors - chronic anovulation (PCOS), obesity, estrogen-prod tumors (granulosa-theca cell tumors), exogenous estrogens |
|
|
Term
| relay info fr dorsal column to cerebrum, regulate consciousness |
|
Definition
|
|
Term
| regulate somatic response to heat |
|
Definition
|
|
Term
| interpret somatosensory information |
|
Definition
| primary senosry cortex in postcentral gyrus; homunculus w/ distal organs (foot/leg) medially & prox organs (face) laterally |
|
|
Term
|
Definition
| hippocampus; lesions here cause anterograde amnesia (inability to form new memories); spatial navigation |
|
|
Term
|
Definition
| post pituitary - contains axons fr hypothalamic supraoptic (ADH) & paraventricular (oxytocin) nuclei |
|
|
Term
| receives input fr optic nn (CNII) and relays it to visual cortex |
|
Definition
lateral geniculate nucleus (of thalamus)
lesions --> homonymous visual defect |
|
|
Term
| receive input fr basal ganglia (substantia nigra & globus pallidus) & relay it to motor cortex and help in planning movements |
|
Definition
| ventral ant & lat nuclei (motor input) |
|
|
Term
| receives auditory input fr inferior colliculus (midbrain) & superior olive and relays it to auditory cortex in temporal lobe |
|
Definition
medial geniculate nucleus (hearing)
lesion affects ability to localize sound |
|
|
Term
| receives somatosensory info (touch, pain, temp & proprioception) fr body via spinothalamic and dorsal columns & relays it to senosry homunculus |
|
Definition
ventral post lat nucleus (somatosensory info)
subdivision of ventral post nuc
lesions cause extreme sensitivity of body to minimally painful stimuli or pain fr non-noxious stimmuli |
|
|
Term
| receives somatosensory info fr face & relays it to sensory homunculus |
|
Definition
ventral post medial nucleus (facial somatosensory infO)
lesions prod hypersensitivity to pain in face |
|
|
Term
| receives input fr multiple somatosensory regions & plays role in regulating attention |
|
Definition
pulvinar nucleus (attention)
lesions prod contralat hemispatial neglect & attention deficits |
|
|
Term
|
Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Chapman - clavicles just lateral to where they cross the ribs |
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Definition
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Term
|
Definition
nonbenzo hypnotic
SE - abnormal sleep behaviors (binge eating, walking, phone calls, no recollection) |
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Term
|
Definition
atypical antipsychotic
SE - QT prolongation --> torsades de pointes (PVT); Tx - magnesium |
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Term
|
Definition
benzo
Tx - insomnia
metab "Outside the Liver" = oxazepam, temazepam, lorazepam... safer to use in liver failure |
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Term
|
Definition
nonbenzo hypnotic
Use - sleep initiation & sleep maintenance (staying aslp) disorder |
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Term
|
Definition
benzo
Tx - insomnia, fast acting, shortest duration |
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Term
| acute attacks abd pain, precip by smoking, stress, rxs, INC aminolevulinic acid & porphobilinogen, females |
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Definition
| acute intermittent porphyria - porphobilinogen deaminase deficiency |
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Term
| tachycardia, paroxysmal HTN, palpitations, diaphoress, INC plasma/urine catcholamines |
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Definition
pheochromocytoma
tx - phenoxybenazmine |
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Term
| flushing, abd pain, diarrhea, INC urinary 5-HIAA |
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Definition
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Term
| normal stages female sex development |
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Definition
| thelarche (breast), pubarche (pubic hair), growth spurt, adrenarche (INC activity adrenals), menarche (1st menses) |
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Term
| PG analog used to guard vs NSAID-induced gastric/duodenal injury |
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Definition
misoprostol
SE - diarrhea
DO NOT use in IBD (cause flares) or pregos (cause uterine contractions) |
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Term
| cross-links to form polymer that binds to gastric mucosa |
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Definition
sucralfate - binds to mucosal ulcers/erosions to prevent further injury
Use - multi-rx regimen for H pylori ulcer (w/ amoxicillin, clarithromycin, PPI) |
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Term
|
Definition
anti-spasmodic (anti-cholinergic)= dicyclomine, hyoscamine
Use - IBS
SE - anorexia, blurry vision, constipation, confusion, dry momuth, sedation, urinary retention |
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Term
|
Definition
macrolide = erythromycin
Use - DEC gastric motility, gastroparesis (autonomic neorpathy secondary to DM, neuro dz, infections, amyloidosis, vagus nn injury, anorexia) |
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Term
| anti-transglutaminase, gliadin, endomysium Abs |
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Definition
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Term
|
Definition
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Term
|
Definition
| primary biliary cirrhosis |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
| rash followed by regional LAD, exposed to cats or fleas |
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Definition
| Bartonella henselae = cat-stratch dz |
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Term
| hunters eating rabbits, squirrels |
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Definition
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Term
| cate feces, infected meat, transmitted mother to fetus, LAD, mm pain, ocular, CNS dz |
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Definition
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Term
| fever, chills, HA, LAD, found in rodents |
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Definition
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|
Term
| bilat loss pain and temp, cape-like pattern |
|
Definition
syringomyelia - affects ventral white commissure of spinothalamic tract
assoc w/ Arnold-Chiari malformation |
|
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Term
| unsteady gait, DEC DTRs, loss proprioception, Argyll Robertson pupils |
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Definition
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|
Term
| ipsi hemiparesis, loss proprioception & vibratory sense, contra loss pain & temp, flaccid paralysis |
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Definition
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Term
| assymetrical mm weakness, leads to flaccid paralysis, absent DTR |
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Definition
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Term
| symmetrical, asc paralysis, absent DTRs |
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Definition
|
|
Term
Charcot's triad: RUQ pain, fever, jaundice
leukocytosis, conjug hyperbilirubinemia, elev alk phosphatase, GGT |
|
Definition
cholangitis - complication of choledolithiasis (gallstone dz)
Tx - IV abx, fluids, ERCP w/ sphincterotomy / stone removal
more serious - Reynold's pentad: Charcot's triad + hypoTN + AMS |
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Term
| jaundice, pruritis, assoc w/ ulcerative cholitis |
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Definition
| primary sclerosing cholangitis |
|
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Term
| jaundice, fever, pruritis, xantholesmas/xanthomatas |
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Definition
| primary biliary cirrhosis |
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Term
| asymptomatic, may have RUQ pain & jaundice |
|
Definition
| choledocholithiasis (gallstone in CBD) |
|
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Term
| afferent (sensory) limb & efferent (motor limb) of reflex are femoral nn |
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Definition
patellar reflex (L3-4) - contraction of quadriceps mm
Others: femoral nn - patellar DTR, tibial nn - achilles DTR |
|
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Term
| femoral (afferent) - genitofemoral (efferent) reflex |
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Definition
cremasteric reflex (L1 reflex center) - stroke inner thigh --> elev strotum
Clinical - absent in testicular torsion |
|
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Term
| afferent (sensory) limb & efferent (motor limb) are tibial nn |
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Definition
| achilles DTR (S1-S2) - contraction gastrocnemius mm |
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Term
| bulging pale, immobile tympanic membrane, loss of light reflex, DEC hearing |
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Definition
Otitis media - S pneumo (MC), H flu, M. catarrhalis
Tx - amoxicillin (PO) |
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Term
|
Definition
cirpofloxacin + hyrocortisone - ear suspension
Cause - P aeruginosa (MC), S epidermidis, S aureus; proteus & candida (esp w/ hearing aids)
Initial step - clean ear canal |
|
|
Term
| malig/necrotizing otitis externa tx |
|
Definition
surgical debridement
oral metronidazole - anaerobes |
|
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Term
| affected structures fr lateral impact to knee |
|
Definition
ACL, MCL, lat meniscus = "unhappy triad"
Dx - MRI |
|
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Term
| medial longitudinal fasciculus (MLF) |
|
Definition
path that connects abducens & oculomotor nuc
lesion (MLF syndrome or internuclear opthalmoplegia) --> nystagmus of abducting eye
Tested in multiple sclerosis
Normal: look left, abducens (CN VI) stim ipsi (L) lat rectus to look left (ABduct), also sends axons & activ contralat oculomotor nn (CN III) so R eye looks left (ADduct) = both eyes gaze same direction
Paralysis of medial rectus mm of ADducting eye upon lat gaze & contralat nystagmus (of ABducting eye) |
|
|
Term
| hypermobile joints, retinal detachment, flattened bridge nose, flat cheekbones, cleft palate |
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Definition
|
|
Term
| marfanoid habitus, mental retardation, osteoporosis, lens subluxation, tight joints |
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Definition
|
|
Term
| cause of spontaneous abortions <12 wks gestation |
|
Definition
half due to chromosomal anomalies of fetus - monosomy X (45,X) MC chromosomal abnorm - turner syndrome
most 1st trimester spont abortions - autosomal trisomy (21, 13, etc) |
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Term
| second trimester pregnancy loss - maternal prob |
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Definition
| maternal anatomic anomaly = bicornuate uterus (incomplete lateral fusion of mullerian ducts - communicating uterine cavities, single cervix - V shape) --> lack of room for dev fetus |
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Term
| caudal regression syndrome (sacral agenesis)* pathognomotic for |
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Definition
|
|
Term
| Exudative pleural effusion |
|
Definition
cloudy, HIGH protein, LDH when compared to serum levels
Light's Criteria (1 or more = exudative):
1) pleural:serum protein ratio > 0.5
2) pleural:serum LDH >0.6
3) pleural LDH > 2/3 normal upper limit serum LDH
Cause - malignancy, collagen vasc dz, infection, trauma, pneumonia, pulm thromboembolism |
|
|
Term
| Transudative pleural effusion |
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Definition
DEC protein content & LDH compared to serum levels
Cause - CHF, nephrotic syndrome, thromboembolism, liver cirrhosis |
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Term
| rxn to medication, rash, low-grade fever, acute renal failure (INC Cre), started new Rxs |
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Definition
| Acute interstitial nephritis (AIN) |
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Term
|
Definition
| Kimmelstiel-Wilson nodules - pathognomotic* for diabetic nephropathy |
|
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Term
| crescentic glomerular deposits |
|
Definition
rapidly progressive glomerulonephritis (RPGN) - acute kidney failure
Cause - SLE, Wegener's granulomatosis, Goodpasture syndrome |
|
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Term
|
Definition
IgA nephropathy or Berger's dz - MC GN worldwide
gross hematuria days after URI/GI infection |
|
|
Term
| weakness/paralysis thumb opposition, pronation, flexion of fingers, thenar atrophy** |
|
Definition
median nn palsy
cause - carpal tunnel, supracondylar fracture distal humerus |
|
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Term
|
Definition
radial nn injry
cause - fractured midshaft humerous |
|
|
Term
| claw hand, radial deviation of wrist |
|
Definition
ulnar nn palsy
cause - fractured medial epicondyle |
|
|
Term
Wernicke encephalopathy - ataxia, opthalmoplegia, memory impairment
Korsakoff - anterograde/retrograde amnesia, confabulation |
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Definition
|
|
Term
| angular cheilitis (inflamm mouth corners), glossitis (inflamm tongue), seborrheic dermatitis |
|
Definition
| riboflavin (B2) deficiency |
|
|
Term
| pellagra (dermatitis, dementia, diarrhea, death) |
|
Definition
|
|
Term
| INC Fe & ferritin (stored Fe), DEC TIBC, INC transferrin saturation (serum Fe/TIBC, tan skin, fatigue, DEC libido, arthralgia |
|
Definition
Hemochromatosis - INC aminotransferases
Tx - phlebotomy. if untx'd --> cirrhosis, hepatocellular CA |
|
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Term
| >60, men, painless LAD, lymphocytosis, neutropenia, thrombocytopenia, anemia, splenomegaly, Bx - CD5 positive, smudge cells |
|
Definition
| CLL (chronic lymphocytic leukemia) |
|
|
Term
| kid: aniridia (absent iris), GU malformation, mental retardation, abd pain/mass, HTN, hemihypertrophy, hematuria |
|
Definition
Wilms tumor (nephroblastoma) - MC renal malig in kids 3-4 yo, WAGR syndrome (Wilms tumor, Aniridia, GU malformation, mental Retardation)
Dx - US, f/u with abd/chest CT to assess mets
Tx - nephrectomy, chemo, radiation |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| pseudomembranous colitis caused by C dieff & staph enterocolitis tx |
|
Definition
|
|
Term
| Gram + cocci, H flu, E coli, Proteus, Serratia, Klebsiella |
|
Definition
| IV cefoxitin - 2nd gen cephalosporin |
|
|
Term
| Gram + cocci, E coli, Proteus mirabalis, Klebsiella tx |
|
Definition
| IV cefazolin - 1st gen cephalosporin |
|
|
Term
| coffee-ground emesis & melena |
|
Definition
Upper GI bleed - above ligament of Treitz
MCC - peptic ulcer dz
Dx - upper endoscopy
Tx - IV fluid |
|
|
Term
| running, standing tip-toes, walking up/down stairs with support, building tower 4+ blocks, recog names, 2-4 word sentences, cups, spoons, make believe, defiant behavior |
|
Definition
|
|
Term
|
Definition
infliximab - monolonal Ab vs TNF-alpha
Use - RA, sporiasis, Crohn's, UC, ankylosing spondylitis
Etanercept - binds TNF-alpha & prevents interaction w/ R
**Check for TB before use |
|
|
Term
| reversibly inhibits cyclooxygenase |
|
Definition
naproxen
Use - ankylosing spondylitis, osteoarthritis, RA, acute gout, dysmenorrhea, tendonitis/bursitis
SE - GI upset |
|
|
Term
| irreversibly inhibits cyclooxygenase |
|
Definition
aspirin - ASA
Use - prevent stroke, MI, anti-platelet, anti-inflamm
SE - dyspepsia, erosive gastritis, peptic ulcers
DO NOT use in kids (Reye's) |
|
|
Term
| low cerum C3, IF - IgG & C3 granular pattern, lumpy bumpy on EM, occurs 1-3 wks after infection, asso cw/ Grp A strep |
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Definition
| Poststreptococcal/postinfectious GN |
|
|
Term
| type II hypersensitivity in lungs/kidneys, hemoptysis prior to nephritic syndrome, IF - IgG & C3 in linear pattern in GBM |
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Definition
|
|
Term
| nephritic syndrome, hearing loss |
|
Definition
|
|
Term
| OMM technique that DEC sympathetic tone |
|
Definition
|
|
Term
INC bone turnover d/t INC osteoclasts & osteoblasts, bone pain, HA, skull deformities, fractures, INC alk phosphatase
Xray - mosaic pattern w/ alt areas of thickened bone and radioluscency |
|
Definition
Paget's dz (osteitis deformans) - affects skull, femur, tibia, spine, pelvis
Etio - preceding paramyxovirus infection, elderly
Complications - hearing loss, high-output heart failure d/t INC formation AV shunts, osteosarcoma
Tx - symptomatic, biphosphate, calcitonin to slow osteoclastic resorp |
|
|
Term
| defective synthesis type I collagen, present in infancy/childhood w/ multiple fractures after minimal trauma, blue sclerae, hearing loss, dental imperfections |
|
Definition
| osteogenesis imperfecta (brittle bone dz) - audo dom |
|
|
Term
| replacement of medullary bone w/ fibrous tissue, spontaneous fractures causing bone pain, swelling, deformity at muliple sites |
|
Definition
polyosteotic fibrous dysplasia
assoc w/ McCune-Albright syndrome - young girls; charac by precocious puberty, short stature, cafe au lait & Port of Main spots (irreg pigmented patches of skin) |
|
|
Term
| primary malignant tumor of bone; bone pain, swelling, fracture, INC alk phosphatase, xray - lift of periosteum by tumor (Codman triangle) and "sunburst pattern" |
|
Definition
| osteosarcoma - males, 10-20 yo |
|
|
Term
| hyperthermia, diaphoresis, "lead pipe" mmuscular rigidity, AMS, metabolic acidosis, autonomic dysfxn, myoglobinuria, low Fe, recently started antipsychotic (haloperidol) |
|
Definition
Neuroleptic malignant syndrome - life-threatening occurs in first 10 days tx of high potency typical antipsychotic (haloperidol, fluphenazine)
Tx - stop med, IV fluids, if continues -- dantrolene, bromocriptine, amantadine (optional) |
|
|
Term
| AMS, hyperthermia, myoclonus, hyperreflexia, HTN, tachycardia, dilated pupils, tremor |
|
Definition
|
|
Term
| hyperthermia after general anesthesia inhalants & succinylcholine |
|
Definition
| malignant hyperthermia - auto dom |
|
|
Term
| involuntary movement of ext, face, tongue, lips, trunk |
|
Definition
| tardive dyskinedia - occurs yrs after antipsychotic tx |
|
|
Term
pruritis, jaundice, fatigue, wt loss, RUQ pain, fever, inflamm intrahepatic/extrahepatic bile ducts. Dx - cholangiography: bead-like pattern
INC aminotransferase, alk phosphatase, bilirubin |
|
Definition
Primary sclerosing cholangitis
MC risk factor = ulcerative colitis
Tx - liver transplant |
|
|
Term
| high fever, black emesis (d/t GI bleed), jaundice, INC LFT, Councilman bodies (necrotic eosinophilic globules-viral hep) |
|
Definition
Yellow fever - flavivirus and arbovirus, transmitted by Aedes mosquito (arthropod)
env, icosahedral, +ssRNA. reservoir: monkeys
Tx - self-limiting; live attenuated vaccine avail to travelers of S america & Africa |
|
|
Term
| autonomic insufficiency + Parkson-like Sx |
|
Definition
|
|
Term
| Lewy bodies, loss of dopaminergic neurons in substantia nigra & locus ceruleus, > 50, RESTING tremor ("pill-rolling" goes away when performs task, worsens w/ emotional stress), "masked face," bradykinesia, cogwheel rigidity (ratchet-like jerking when testing tone in UE while pt clenches opposite fist), micrographia (small handwriting) |
|
Definition
|
|
Term
| tremor INC w/ activity, improved w/ alcohol |
|
Definition
|
|
Term
| <30, copper metab prob, secondary to ceruplasmin deficiency, yellow rings in cornea (Kayser-fleischer rings), parkinson-like sx, renal/liver dz, psych issues |
|
Definition
|
|
Term
| auto-Ab stim of TSH-R -- thyroid stim Ig (TSI) bind to TSH-R --> thyroid prod |
|
Definition
Graves dz
females, mid age, HLA DR3 and B8, precip by stress, infection, excess iodine, childbirth.
opthalmopathy & exopthalmos (protruding eyes, eye mm weakness), pre-tibal myxedema (non-pitting edema), swelling/clubbing digits, diffuse goiter, thyroid scan - INC diffuse radioiode uptake
Tx - BB (DEC adrenergic effects & peripheral conversion), anti-thyroid (methimazole or PTU) - inhib thyroid hormone syn; if unresponsive to rxs --> ablation w/ thyroid hormone rep |
|
|
Term
| hyperthyroid sx, NO opthalmopathy, thyroid scan - DEC uptake iodine in thyroid |
|
Definition
| exogeneous admin thyroid hormone |
|
|
Term
| hyperthyroid sx, NO opthalmopathy, thyroid scan - INC uptake radioiodine in a specific area |
|
Definition
| thyroid adenoma - hot nodule (iodine upatke) |
|
|
Term
| wt gain, cold intolerance, fatigue, dry skin, constipation, hoarseness, bradycardia, INC TSH, low T3, T4 |
|
Definition
| Hashimoto's thyroiditis - lymphocytic infiltration of thyroid gland |
|
|
Term
| pruritic, annular circle, tan patch w/ no crusting/scaling on chest |
|
Definition
Tinea corporis... others: t pedis (feet), cruris (groin/jock itch), capitas (scalp), manuum (hand), faciale (face), barbae (beard) - monomorphic fungal infection cased by Microsporum, Trichophyton, Epidermophyton fungi. Very contagious.
Dx - + KOH stain
Tx - "-zazoles" |
|
|
Term
|
Definition
Tinea versicolor - caused by malassezia furfur yeast --> damage melanocytes. MC in hot, humid weather, after tanning
KOH stain - "spaghetti and meatballs"
Tx - tropical miconazole or selenium sulfide |
|
|
Term
|
Definition
interferon-alpha, anti-viral (lamivudine, adefovir)
HBIg & vaccine for post-exposure prophylaxis |
|
|
Term
| fever, NV, conj hyperbilirubinemia, elev aminotransferases, fecal-oral route, day-care setting |
|
Definition
Hep A - incubation 28 days ave (15-50). Others: Hep B 120 days (60-150), Hep C 45 days (14-180)
Dx - IgM anti-HAV
Tx - remove fr daycare, supportive |
|
|
Term
| sympathetic innerv middle GI/GU: jejunum, ileum, asc colon, prox 2/3 tranverse; adrenals, kidneys, upper ureters, gonads |
|
Definition
| T10-11 (jejunum - 2/3 prox transverse; adrenals - upper ureter) |
|
|
Term
| sympathetic innerv lower GI/GU: distal 1/3 transverse, desc, sigmoid colon, rectum, lower ureter, bladder |
|
Definition
|
|
Term
| PRL-secreting pituitary adenoma tx |
|
Definition
| 1st line - dopamine agonists (bromocriptine or cabergoline) - inhib PRL secretion, shrink tumor. if doesn't work - surg |
|
|
Term
|
Definition
MOA - inhib ergosterol syn
Use - systemic mycoses (blastomyces, coccidiodes, histoplasma), superficial fungal infections (ringworm), Candida albicans (oral thrush)
SE - gynecomastia, DEC libido, hair loss (M), amenorrhea (F)
Immunocompetent w/ oral thrush - Tx: nystatin mouthwash |
|
|
Term
| onychomycosis tx (infection of nails) |
|
Definition
terbinafine - inhib squalene epoxidase
Topical - tinea corporis, pedia, cruris |
|
|
Term
|
Definition
aromatase inhibitors
Use - postmenopausal w/ estrogen-R + breast CA |
|
|
Term
|
Definition
testosterone-R antag - bind/block testot-R
Use - prostate CA
SE - DEC libido, impotence |
|
|
Term
| hypocalcemia, INC phosphorous, lower limit of normal PTH, Chvostek's sign (facial nn tapping cause facial mm contraction), Trousseau's sign (BP cuff on arm causes carpopedal spasms), perioral parathesias, seizures, depression, anxiety |
|
Definition
Primary hypoparathyroidism - MCC surg
secondary hyperparathyroidism - usually d/t renal failure |
|
|
Term
| High PTH, low Ca, assoc w/ skeletal abnorm, mental retardation |
|
Definition
| pseudohypoparathyroidism - kidney unresponsive to PTH |
|
|
Term
|
Definition
|
|
Term
|
Definition
| L - liver, R - gallbladder |
|
|
Term
|
Definition
|
|
Term
| Chapman - 8-10th IC space |
|
Definition
|
|
Term
| Chapman - 1" superior, 1" lateral to umbilicus |
|
Definition
|
|
Term
|
Definition
INC concen req for Rx to prod half its maximal effect (EC50). Thus, addition of competitive antag DEC POTENCY of drug (shifts response curve to right)
ex. Naloxone - competitive antag at opiate-R.
Tx - opiate intoxication (pupil constriction, resp depression, coma) |
|
|
Term
|
Definition
irreversibly binds, DEC number receptors for other drug to bind -- DEC EFFICACY of Rx (shifts response curve down)
Less effect, no matter how much drug is given |
|
|
Term
| 1st line Tx for panic disorder |
|
Definition
SSRI (citalopram, escitalopram, fluoxetine, paroxetine, sertraline, zimelidine)
2nd line tx - TCA |
|
|
Term
|
Definition
| anxiolytic - general anxiety disorder |
|
|
Term
| profuse foul-smelling diarrhea after camping trip |
|
Definition
Giardiasis - lasts up to 4 wks
Dx - stool exam/immunoassay
Tx - metronidazole |
|
|
Term
| spore-forming bacillus that causes 2 forms of self-limited gastroenteritides (vomiting & diarrheal); fried rice |
|
Definition
|
|
Term
NV, abd cramps, diarrhea w/in 6 h ingestion & resolve over 24 hrs
sugar and cream, custard, potato salad |
|
Definition
| S aureus - common cause food poisoning |
|
|
Term
| childhood diarrheal illness |
|
Definition
rotavirus - small, encapsulated, short incubation, 4-7 days vomiting, watery diarrhea
usually asymptomatic in adults |
|
|
Term
| alpha-1 adrenoreceptor blockers |
|
Definition
"-sin"... prazosin, terazosin, doxazoxin
MOA - cause vasodilation, DEC arterial pressure
Use - males w/ HTN + BPH |
|
|
Term
| beta adrenoceptor blockers |
|
Definition
"-lol" propranolol
Use - HTN, angina, CHF
B-2 R blocker - contract bronchial smooth mm (INC airway resis). contraindicated in asthmatics |
|
|
Term
|
Definition
"-pril" (captopril, enalapril, lisinopril, fosinopril)
MOA - lower arteriolar resis by blocking Ang I --> II conversion, prevent breakdown bradykinin (SE: cough)
Use - HTN, prevent diabetic neprhopathy |
|
|
Term
| DEC sympathetic outflow fr vasomotor centers in brain |
|
Definition
centrally acting sympathoplegic rxs (methyldopa, clonidine)
MOA - DEC HR, CO
Use - intractable HTN, gestational HTN
Clonidine - anxiety disorders, ADHD |
|
|
Term
| depletion body Na & DEC blood vol |
|
Definition
thiazide diuretics
Use - HTN, edema, prevent Ca stone formation in kidneys (by INC Ca resorp at distal convoluted tubules) |
|
|
Term
| PGE2 agonist - used for cervical ripening, inducement of labor |
|
Definition
|
|
Term
| synthetic PGE1 that binds/stim PGE1-R, stim uterine contraction in postpartum hemorrhage or induced abortion |
|
Definition
|
|
Term
| cholinesterase inhibitor (indirect agonists bc do not directly bind to Ach-R, but prod INC stim of R) |
|
Definition
neostigmine, pyridostigmine, drophonium, physostigmine
Tx - myasthenia gravis, antitode to curare poisoning |
|
|
Term
| bind/block progesterone-R |
|
Definition
progesterone antag - Mifepristone (RU 486) - abortifacient
Progesterone - responsible for stim endometrial glandular secretions, spiral aa development, DEC myometrial excitability, uterine smooth mm relaxation, prod thick cervical mucus |
|
|
Term
|
Definition
| measure of how far above/below mean value in terms of std deviation |
|
|
Term
|
Definition
| used when population parameters are estimates rather than known values (common & effectively replace z scores) |
|
|
Term
| hereditary spherocytosis dx test |
|
Definition
osmotic fragility test. prone to excessive lysis in hypotonic soln
Hereditary spherocytosis - RBC membrane defect (DEC spectrin)
Small RBC, central pallor, macrophages destroy these cells (splenomegaly), hemolytic anemia, hyperbilirubinemia
Complication - cholelithiasis |
|
|
Term
| leukemia, aplastic anemia, multiple myeloma, other bone dz dx test |
|
Definition
|
|
Term
| sickle cell dz, thalassemia dx test |
|
Definition
| hemoglobin electrophoresis |
|
|
Term
| vitB12 deficiency dx test to see if pt has pernicious anemia |
|
Definition
|
|
Term
| low MCV, INC serum Fe, ferritin, normal TIBC, low MCHC, ringed sideroblasts |
|
Definition
|
|
Term
induced by infection, rxs, fava beans
Heinz bodies, bite cells |
|
Definition
| G6PD deficiency - result in hemolytic anemia |
|
|
Term
| crescent shaped RBC, acute pain episodes |
|
Definition
|
|
Term
| DEC reticulocytes & pancytopenia, smear has abnorm morphology (hypocellularity) |
|
Definition
|
|
Term
| bilat lower quadrant anopia |
|
Definition
| lesion of dorsal optic radiation tract on opp side of absent visual field |
|
|
Term
| right upper quadrant anopia |
|
Definition
| Meyer's loop lesion ("pie in the sky") |
|
|
Term
| Chapman - ant iliotibial band |
|
Definition
|
|
Term
| Chapman - 2" sup and 1" lat to umbilicus |
|
Definition
|
|
Term
| Chapman - over lesser trochanter |
|
Definition
|
|
Term
| Chapman - lat/post margin iliotibial band |
|
Definition
|
|
Term
| indep risk factors for pyelonephritis |
|
Definition
freq sex, new partner, UTI in prev 12 mon, hx of UTI, diabetes, incontinence
+ leukocyte esterase, nitrites, WBC casts
Tx - FQs |
|
|
Term
|
Definition
90% of head/neck CA are squamomus cell CA and occur in oral cavity
Mid-age men, chronically smoke, consume EtOH
MC on ventral surface tongue, floor of mouth, lower lip, soft palate, gingiva
early - hard, raised, pearly plaue or verrucous areas of mucosal thickening w/ irregular borders
as they grow --> protrude, become ulcerated w/ irregular rolled borders |
|
|
Term
|
Definition
| chronic hepatic congestion - R sided heart failure; subsequent pigmentation around central vv |
|
|
Term
| regenerative nodules of hepatocytes |
|
Definition
|
|
Term
|
Definition
| fatty liver, occurs after acute alcohol ingestion |
|
|
Term
| chronic inflammatory infiltration (liver) |
|
Definition
|
|
Term
| disorder of excretion of conjugated bilirubin. INC total & conjugated (direct) bilirubin, black liver, granular pigment in hepatocytes |
|
Definition
Dubin-Johnson syndrome
Rotor syndrome - similar, but without pigment |
|
|
Term
| autoimmune demyelination of peripheral nn. progressive asc neuropathy; back pain, chewing, speaking difficulties, lasts 4 wks, preceded by resp/GI infection |
|
Definition
Guillian-Barre
preceded by Campylobacter jejuni - comma shaped non-lactose-fermenting, oxidase-positive, gram neg bacillus
Spinal tap - INC CSF protein |
|
|
Term
| Gram neg, non-lactose fermenting, oxidase neg bacillus |
|
Definition
|
|
Term
| Gram neg, lactose fermenting bacillus |
|
Definition
| Klebsiella, Enterobacter, E coli |
|
|
Term
| Gram pos, coagulase-pos coccus |
|
Definition
|
|
Term
| Gram pos, coagulase-neg coccus |
|
Definition
| Staph epidermidis, saprophyticus |
|
|
Term
| Pellagra (diarrhea, dermatitis, dementia, death) |
|
Definition
caused by niacin (B3) defic
tryptophan is building block that makes niacin & serotonin
carcinoid syndrome cause exaggerated serotonin rel & tryptophan will be used up --> causing niacin deficiency |
|
|
Term
| vitamin that hydroxylates proline & lysin to make triple helical structure of collagen |
|
Definition
vit C (ascorbic acid)
4 types of collage:
Type 1 - skin/bones, 2 - connective tissue, 3 - aa/vv, 4 - basement membrane
Vit C defic = scurvy (swollen gums, bruising, anemia, poor wound healing) |
|
|
Term
|
Definition
Beriberi - malnourished alcoholics
Thiamine - frees energy fr glucose; thus Sx include lethargy & fatigue
Affects nervous & cardiac sys
Dry beriberi - inflamm of nn (polyneuritis) & mm wasting
Wet beriberi - high output cardiac failure (dilated cardiomyopathy) & myxedema |
|
|
Term
| bleeding into joints, soft tissue and mm, esp knees, elbows, ankles, shoulders, hips, prolonged aPTT |
|
Definition
| x-linked recess, defective prod coag factors VIII (hemophilia A) and IX (hemophilia B) |
|
|
Term
|
Definition
vit-K dep antithrombotic factor
protein C defic = hypercoagulability, thrombosis |
|
|
Term
|
Definition
von Willebrand dz, Glanzmann's thrombasthenia
bleeding abnorm, mostly at mucosal sites |
|
|
Term
|
Definition
inactivated by activated protein C
defective factor V (Factor V leiden mut) = resis to inactivation by protein C = hypercoagulability, thrombosis |
|
|
Term
| glycogen IIB IIIa receptors |
|
Definition
platelet aggregation
defect in IIB IIIa-R (Glanzmann's thromasthenia) = failure of platelet plugs = excess bleeding/bruising, esp at mumcosal sites |
|
|
Term
|
Definition
- afferent/efferent renal arterioles constrict = DEC GFR, RBF
- INC sympathetic nervous activity
activ renin-ang-ALD pathway (in response to low arterial pressure)
Note: at low levels, Ang II vasoconstricts efferent arteriole (DEC blood flow & INC GFR). Ang II acts on zona glomerulosa of adrenal cortex to stim ALD --> INC Na (and water) resorp in late nephron, INC blood vol |
|
|
Term
|
Definition
prod by kidney
local vasodilators |
|
|
Term
| Rx to loosen mucus in CF pt |
|
Definition
N-acetylcysteine
Also used as antidote for acetominophen overdose |
|
|
Term
| selective alpha-1 adrenergic agonist used as decongestant |
|
Definition
phenylephrine
MOA - vasoconstriction, DEC fluid secretions |
|
|
Term
| DEC swelling & inflamm of air spaces by inhib syn of cytokines & other pro-inflamm mediators |
|
Definition
beclomethasone
Use - control chronic asthma |
|
|
Term
| inhib lipoxygenase/LOX activity |
|
Definition
antileukotriene (zileuton - 5-LOX inhibitor)
Use - asthma |
|
|
Term
|
Definition
DEC smooth mm in bronchi & vessels tone
INC smooth mm tone in uterus (cause contractions) |
|
|
Term
|
Definition
similar to PGE1
Use - maintain PDA |
|
|
Term
|
Definition
DEC all smooth mm tone & platelet aggreg
Use - pulm HTN, prevent platelets fr clumping in dialysis machines |
|
|
Term
|
Definition
INC uterine & bronchial tone
Use - nonasthmatic pts w/ obstetric hemorrhage |
|
|
Term
|
Definition
INC smooth mm tone (vascular, uterine, bronchial)
INC platelet aggreg |
|
|
Term
|
Definition
inhib phospolipase A2 & COX
Phospholipase A2 - rel arachidonic acid fr phospholipids. Arachidonic acid prod PGs (by cycloxygenase) & leukotrienes (by lipoxygenase) |
|
|
Term
|
Definition
clopidogrel, ticlopidine, prasugrel
MOA - inhib ADP receptors, prevent platelet recruitment to vasc injury site
Use - prevent MI/stroke, use w/ aspirin |
|
|
Term
| Left sided heart failure (DEC LV contractility) |
|
Definition
pulm vasc congestion w/ pulm edema (hemosiderin-laden macrophages)
dyspnea on exertion, orthopnea, tachycardia |
|
|
Term
|
Definition
Cause - INC venous pressure & congestion in hepatic and GI venous circ
anasarca (gen edema), ascites
Note: MCC is L sided HF so pts present w/ mix sx |
|
|
Term
| cyclosporine, tacrolimus (FK-506) |
|
Definition
immunosuppressants to prevent organ rejection
MOA - suppress T cells by inhib calcineurin leading to inhib of IL-2 (stim T cell prolif) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Orlistat (anti-obestity rx)
less TG absorbed, along w/ fat sol vitamins
SE: steatorrhea |
|
|
Term
| lipoprotein lipase deficiency (normally degrades TGs in protein carriers ie chylomicrons & VLDL) |
|
Definition
| hyperTRIG... xanthomas (fatty plaques) on skin, atheromatous plaques assoc w/ CV dz |
|
|
Term
| hepatic triglyceride lipase |
|
Definition
| degrads TRIG in remaining IDL (intermediate density lipoprotein) to LDL |
|
|
Term
| lecithin-cholesterol acyltransferase |
|
Definition
| converts free cholesterol into cholesterol ester... when added to nascent HDL = mature HDL |
|
|
Term
| high Fe, ferritin, normal/DEC/INC TIBC |
|
Definition
sideroblastic anemia - ringed sideroblasts on smear
Tx - pyridoxine (B6) |
|
|
Term
| infant - petechiae, cerebral calcif, hearing loss, visual loss, seizures, large intranuclear inclusion ("owl's eye") |
|
Definition
|
|
Term
| infant - intracranial calcif, chorioretinitis, hydrocephalus |
|
Definition
| congenital toxoplasma gondii |
|
|
Term
| infant - Hutchinson's teeth, interstitial keratitis, rash |
|
Definition
|
|
Term
| infant - cataracts, hearing loss, cardiac defect |
|
Definition
|
|
Term
| infant - skin lesions, intranuc viral inclusions (Cowdry A inclusions) - small pink deposits surrounded by clear halo |
|
Definition
|
|
Term
| Rx SE: crystal deposit in renal tubules --> INC serum BUN & creatinine |
|
Definition
acyclovir - needle shaped crystals
ethylene glycol (antifreeze) - Ca oxalate |
|
|
Term
| Rxs that cause acute interstitial nephritis (allergic rxn) |
|
Definition
PCN, sulfonamides, NSAIDs, diuretics, rifampin, INH
fever, rash, azotemia, hematuria, eosinophils in urine |
|
|
Term
| used concurrently w/ NSAIDs to reduce incidence of ulcers |
|
Definition
misoprostol (PGE1 analog)
MOA - inhib gastric acid secretion, protect GI mucosa; also prod uterine contractions |
|
|
Term
|
Definition
antag serotonin 5-HT3-R
prevent NV |
|
|
Term
|
Definition
stim upper GI tract motility by sensitizing upper GI to respond to Ach
antag dopamine-R --> anti-emetic effects
Use - diabetic gastroparesis, GERD, prevent NV |
|
|
Term
|
Definition
inhib PG syn
Use - ulcerative colitis, RA |
|
|
Term
|
Definition
TNF alpha inhibitor
Use - Crohn's dz, psoriasis, RA, alkylosing spondylitis, UC |
|
|
Term
| "double-bubble" sign on radiography |
|
Definition
|
|
Term
| drains ovaries and testes |
|
Definition
para-aortic LN
Clinical - these LN routinely removed/examined in staging of OVCA and testicular CA |
|
|
Term
| drain ext genitalia, anal canal below dentate line, gluteal region, inferior abd wall, penis |
|
Definition
superficial inguinal LN - run parallel/distal to inguinal ligament
Clinical - vulvar CA, injury to foot, groin, ext genitalia |
|
|
Term
| drain inguinal LN, urethra, bladder fundus, upper vagina, cervix, prostate |
|
Definition
external iliac LN - lie along ext iliac BV
Clinical - cervical CA, prostate CA |
|
|
Term
|
Definition
| internal iliac LN - surrounds internal iliac aa & hypogastric aa |
|
|
Term
| serous/bloody nipple discharge - straw colored, peri/postmenopausal |
|
Definition
intraductal papilloma - benign, but multiple is premalignant
Tx - duct resection* |
|
|
Term
| MC non-invasive breast CA, confined to duct, precursor of invasive breast CA/intraductal CA |
|
Definition
ductal carcinoma in situ (DCIS)
Tx - lumpectomy vs mastectomy +/- radiation
Tamoxifen after surg of estrogen-R positive DCIS |
|
|
Term
| incidental finding on breast bx, asymptomatic, not precursor of intraductal invasive breast CA, INC risk invasive breast CA in either/both breasts |
|
Definition
lobular carcinoma in situ
Tx - monitor for invasive CA |
|
|
Term
| MC type invasive breast CA, lump, nipple retraction, microcalcif on mammography |
|
Definition
invasive ductal carcinoma
Tx - excision +/ chemo, radiation, tamoxifen |
|
|
Term
| pre-menopausal, lumpiness, premenstrual TENDERNESS and swelling |
|
Definition
Fibrocystic dz
Dx FNA prior to Tx
Tx - acetaminophen, NSAIDs |
|
|
Term
| absolute bioavailability eqn |
|
Definition
F = absolute bioavailability
AUC = area under the curve
PO = oral, IV
F = (AUC-PO/Dose-PO) / (AUC-IV/Dose-IV) |
|
|
Term
| DEC activity hepatic uridine-diphosphate-glucorunosyltransferase (UGT); lab - unconjugated hyperbilirubinemia, asymtompatic, benign |
|
Definition
Gilbert's syndrome - DEC bilirubin uptake by hepatocytes
Tx - none |
|
|
Term
| hepatic glucoronosyltransferase deficiency, rare & severe condition, lab - unconj hyperbilirubinemia |
|
Definition
Crigler-Naijar
Type 1 - most severe, death at young age
Type 2 - less severe, responds to phenobarbital (bilirubin DEC in Type II, but not Type I) |
|
|
Term
|
Definition
anti-cholinergic
Use - Parksinson's - DEC tremors/rigidity
NO effect on bradykinesia (caused by DEC dopamine)
SE - dry mouth, urinary retention, pupillary dilation |
|
|
Term
| Bromocriptine, pramipexole, ropinirole, apomorphine |
|
Definition
partial dopamine (D2)-R agonist
MOA - restore normal balance of dopamine/Ach
SE - NV
Normally dopamine blocks GABA-ergic activity on nigrostriatal pathway (dopamine inhib inhibitory neurons -- allow normal movement) |
|
|
Term
|
Definition
dopamine precursor-crosses BBB / inhib dopa decarboxylase (breaks down dopamine in periphery)
SE - hallucinations, dyskinesias
"on-off" phenomena:
"off" pts cannot initiate movement (akinesia) followed by "on" states - improved ability to move but assoc w/ dyskinesias (chorea, tics, tremors)
Txs - bradykinesia & rigidity, less effect on tremors |
|
|
Term
|
Definition
MOA - inhib MAO B (normally breaks down dopamine)
NOT at risk for tyramine induced HTN crises like those taking nonselective MAO inhibitors
Avoid SSRI bc can get serotonin syndrome (HA, tachycardia, tremors, high BP) |
|
|
Term
|
Definition
binds to insulin-R w/ tyrosine kinase activity
adipose/skeletal mm - glucose uptake via GLUT-4 --> aerobic metab, ATP generation
Anabolic effects - INC glycogen syn/storage, INC TRIG syn/storage, INC protein syn by INC aa transport
INHIBITS lipolysis, glycogenolysis (breakdown of glycogen into glucose), hepatic glucose release, hepatic gluconeogenesis (syn of glucose fr CHO, fat, protein)
INC activity Na, K, ATPase pump (brings 2 K into intracel in exchange for 3 Na to go extracell) = INC cell uptake K+
Clinical - monitor K level when giving IV insulin in DKA pt to prevent hypokalemia |
|
|
Term
Grey Turner's sign (ecchymoses in flank)
Cullen's sign (ecchymoses in periumbilical)
Fox sign (inguinal ecchymosis) |
|
Definition
| assoc w/ intra-abd hemorrhage and classic (but rare) to acute pancreatitis |
|
|
Term
| epigastric pain, NV, INC lipase, amylase, WBC count |
|
Definition
Acute pancreatitis - rel of activ pancreatic enzymes
Lipase - generates FFA that chelate Ca salts present in pancreas & result in Ca deposits in retroperitoneum & hypocalcemia
MCC acute - gallstones, EtOH (2nd MCC acute, MCC chronic); other - trauma (kids), ERCP, autoimmune, mumps, scorpion
Dx - CT scan (help r/o gallstone pancreatitis), if show necrosis/abscess --> add abx
Tx - analgesics, IV fluids, bowel rest (don't use morphone bc can INC pr in sphincter of Oddi)
INC risk - hyperlipidemia, hypercalcemia |
|
|
Term
| irreversible inflamm on pancreasis, fibrosis w/ calcif, normal-elev lipase/amylase, steatorrhea, fat-sol vit malabsorp |
|
Definition
|
|
Term
| adenocarcinoma assoc w/ smoking & EtOH; abd pain, migratory thrombophlebitis, jaundice, palpable gallbladder, painless jaundice esp when at head of pancreas |
|
Definition
|
|
Term
|
Definition
S pneumo
Consolidation d/t accum of fluid/exudate in air spaces
Dullness to percussion
Sudden onset, chills, high fever, blood sputum, pleuritic chest pain |
|
|
Term
|
Definition
S aureus, H flu, Klebsiella
Patchy infiltrate 1 or + lobes |
|
|
Term
| Interstitial (or atypical) pneumonia, "walking pneumonia) |
|
Definition
Mycoplasma pneumonia (MCC), chlamydophilia pneumonia, legionella penumonia, viruses (influenza, adenovirus, RSV)
Insidious onset (vs bacterial), young adults/kids
Low grade fever, dry cough, sore throat, pleuritic chest pain, malaise, myalgia, HA, pharyngitis
Prolonged period, CXR - diffuse, patchy inflamm of parenchyma in 1+ lobe
Tx - macrolide (azithromycin or doxycycliine) |
|
|
Term
| Pseudomonas aueroginosa pneumonia tx |
|
Definition
antipseudomonal PCN OR cephalosporin
+ aminoglycoside
+ FQ OR macrolide |
|
|
Term
| ABducts / ADducts fingers |
|
Definition
DAB - Dorsal (interossei) ABducts
PAD - Palmar (interossei) ADducts |
|
|
Term
| flex MCP jt, extend DIP & PIP |
|
Definition
|
|
Term
|
Definition
| ABductor pollicus brevis / ADductor pollicus |
|
|
Term
| hx gardening, painful, ulcerated nodule |
|
Definition
Sporotrichosis - caused by dimorphic fungus Sporothrix schenckii; resides in soil
Dx - culture fr skin/sputum, cigar shaped yeast
Tx - Itraconazole; if doesn't respond or is disseminated --> amphotericin B |
|
|
Term
MCC sporadic encephalitis temporal lobe (sudden hemorrhagic necrosis)
fever, HA, psych Sx, seizures, vomiting |
|
Definition
HSV-1 - dsDNA linear, env
use dynein via retrograde transport to trigeminal (access to brain) / dorsal root ganglia
Dx - MRI, CSF - INC lymphocytes, RBCs, protein, opening pressure, normal glucose
Tx - acyclovir, supportive care, manage ICP & seizures |
|
|
Term
| neonatal encephalitis & genital herpes |
|
Definition
|
|
Term
| antipsychotic that cause agranulocytosis (DEC WBC, eosinophils, basophils) |
|
Definition
Clozapine - atypical (2nd gen) anti-psychotic
Check CBC |
|
|
Term
| atypical (2nd gen) antipsychotics |
|
Definition
olanzapine, risperidone, ziprasidone, aripiprazole, clozapine (SE agranulocytosis)
SE - wt gain, T2DM, hyperPRL
MOA - antag dopamine-R w/ less potency that typical (1st gen), some antag at 5-HT-R (serotonin-R)
LESS EPS Sx: akathisia, acute dystonic rxn (mm contraction), tardive dyskinesia (involuntary/repetitive movements), parkinsonism |
|
|
Term
|
Definition
| SE wt gain, insulin resis, hyperLIPID |
|
|
Term
|
Definition
| SE sedation, lower seizure, esp head trauma pts |
|
|
Term
|
Definition
|
|
Term
|
Definition
| SE EPS sx & hyperPRL of all atypicals |
|
|
Term
| Romana's sign (unilat painless periorbital swelling & conjunctivitis) |
|
Definition
Chagas dz (American Trypanosomiasis) - caused by T cruzi protozoa; MC in Central/South America, transmit by feces of Reduviid (kissing) bug
Majority recover, 25% get meningoencephalitis (can lead to death), OR growth in:
1) heart (dilated cardiomyopathy)
2) colon (megacolon)
3) esophagus (dysphagia)
Dx - blood smear: S-shaped single cell w/ central nuc swimming around RBC
Tx - Nifurtimox |
|
|
Term
|
Definition
axon - endoneurium
grp of axons (fascicles) - perineurium
several fascicles (nerve) - epineirum = provides structure & nutrients (BV)
Clinical:
Guillian-Barre - endoneurium affected, axon de-myelinate
diabetic neuropathies - DEC blood flow in epineurium
trauma - pinched spinal nn, lacerating injuries - need to be re-attached at level of perineurium |
|
|
Term
| Dx test for demyelinating lesions (loss of oligodendrocytes) |
|
Definition
MRI
Dx - multiple sclerosis: fatigue, mm weakness, impotence, intermittent paresthesia |
|
|
Term
| Causes of Hypoaldosteronism (DEC K excretion in urine) |
|
Definition
Primary adrenal insufficiency (autoimmune destruc)
Rx - NSAIDs, K sparing diuretics, ACE inhibitors |
|
|
Term
| Causes of Hypokalemia (mm weakness, cardiac dysrhythmia - depressed T waves) |
|
Definition
| K losses fr diarrhea, diuretics, primary hyperaldosteronism (Conn's syndrome), conditions that INC K entry into cells ie Hyperinsulinemia (exogenous insulin or insulin-prod tumor), beta-adrenergic hyperactiity |
|
|
Term
| Causes of Hypermagnesia (neuromusc depression - absent DTR*, hypoTN, bradycardia - Mg acts as Ca channel blocker) |
|
Definition
| renal failure (renal excretion is body's only mechanism of Mg regulation), exogenous admin (given to pregos w/ pre-eclampsia for seizure prophylaxis) |
|
|
Term
| bilat loss pain/temp, flaccid paralysis over limited area (at level of lesion), vibration/touch/pressure intact |
|
Definition
Syringomyelia - central fluid filled cavitation (syrinx) of spinal cord --> damage ant white commissure (pain/temp) ant ventral horn (LMN - control mm)
Clinical - presents w/ Arnold-Chiari malformation (congenital downward displacement of cerebellar tonsils), AFTer spinal cord trauma (MVA) |
|
|
Term
| affects dorsal columns - touch, vibration, proprioception |
|
Definition
| tabes dorsalis - result of tertiary syphillis (neurosyphillis) |
|
|
Term
| UMN (corticospinal tract) & LMN (ventral horn) dz; NO sensory sx |
|
Definition
| amyotrophic lateral sclerosis (Lou-Gehrig's dz) |
|
|
Term
| progressive demyelinating dz of spinal cord/brain, hallmark is lesions separated in space (diff, assymetric locations) & time (diff sxs at diff times) |
|
Definition
|
|
Term
| viral dz of ventral horns, present w/ LMN sx (flaccid paralysis, areflexia, fasciculations, mm atrophy), NO sensory sxs |
|
Definition
|
|
Term
| oligomenorrhea/amenorrhea, hirsutism, acne, infertility, obesity |
|
Definition
PCOS - LH:FSH ratio at least 2:1
Pts should undergo OGTT - check for insulin resis hyperglycemia
Tx - OCPs +/- spironolactone (anti-androgen) if suboptimal response to OCPs after 6 mon of tx
Tx glucose intolerence w/ metformin or rosiglitazone |
|
|
Term
| causes of secondary amenorrhea (absence 6 mon w/ prev normal menses) |
|
Definition
Asherman's syndrome (repeated D&Cs), cervical stenosis
Premature ovarian failure (early menopause - INC FSH d/t DEC estrogen)
PCOS - INC LH/FSH ratio (2:1)
HyperPRL (pituitary adenoma, neuroleptic Rx, hypothyroidism - INC TRH --> stim PRL)
Pregnancy
Anorexia (BMI <18), extreme exercise - DEC pulsatile GnRH rel --> DEC rel LH & FSH; low FSH --> DEC ovarian stim, failure of follicle dev) = hypogonadotropic hypogonadism |
|
|
Term
| tearing chest pain --> bilat deficit pain/temp (spinothalamic tract) & motor control (corticospinal tract); touch, vibration, proprioception intact (dorsal column) |
|
Definition
| ant spinal aa syndrome - occlusion of aa d/t atherosclerosis or dissecting aortic aneurysm (tearing chest pain w/ radiation to back) |
|
|
Term
| impaired touch, proprioception, gait ataxia, arefleia, hypertrophic cardiomyopathy, foot deformities |
|
Definition
| Friedreich's ataxia - auto reces, GAA trinuc repeats --> disrupt mitochondria frataxin gene --> degen post columns, corticospinal, spinocerebellar tract |
|
|
Term
|
Definition
auto recess, atrophy of LMN ventral horn cells
mm atrophy, areflexia, resp failure, death ~ 1 yo |
|
|
Term
| defective type IV collagen, hematuria, proteinuria (INC risk ESRD), cochlear dysfxn (sensorineural hearing loss), ocular (anterior lenticonus - protrusion of lens into ant chamber) |
|
Definition
Alport syndrome - X-linked, auto recess
Dx - Bx, pedigree |
|
|
Term
|
Definition
| osteogenesis imperfecta, Ehlers-Danlos |
|
|
Term
|
Definition
|
|
Term
|
Definition
muscarinic antag - inhib Ach-R
MOA - INC HR, AV node conduction
Use - diarrhea, antitode for organophosphate poisoning, ophthalmologic eval (dilate pupil), bradycardia*
SE - hyperthermia, mydriasis (dilated pupil), dry skin, cutaneous vasodilation, confusion/hallucination = anticholinergic toxidrome; Antitode = physostigmine (AchE inhibitor - prevent breakdown of Ach) |
|
|
Term
| outpouching of hypopharynx, barium swallow shows diverticula |
|
Definition
|
|
Term
| pyogenic infections by encapsulated bacteria (recurrent), bruising, petechiae (d/t thrombocytopenia), eczema, low IgM Ab & platelet counts w/ high IgA & IgE |
|
Definition
Wiskott-Aldrich - x-linked, males, unable to mount IgM attack vs encapsulated bacteria (S pneumo, Salmonella typhi, Klebsiella, H flu, Neisseria meningitis)
Vaccinate WAS pts!
high risk lymphoma & leukemia |
|
|
Term
| pyogenic infection (staph & strep), silvery hair, light skin/eyes, photosensitivity, oculocutaneous albinism |
|
Definition
Chediak-Higashi - auto recess, mut LYST gene --> defective lysosomal emptying of phagocytic cells, lysosomes can't kill bacteria
Large lysosomes & melanosomes --> traps melanin pigment, prohibit disbursement
Peripheral neuropathy |
|
|
Term
| T lymphocytes do not prod sufficient interferon gamma -- low interferon-gamma, INC IgE, facial features course (prognathism - jaw juts fwd), multiple decidious sets of teeth, eczema |
|
Definition
Job's syndrome (hyperIgE syndrome) - missing signaling cytokine, interferon gamma; mut STAT3 gene --> miscommunication bet T lymphocytes & NTs --> recurrent staph & candida infections, abscess
Normally, IF-gamma alert NT to area & phagocytose bacterium |
|
|
Term
| lacks NADPH oxidase; defective NT enzymatic activity (normally NT ingest intracellular bacteria, tumor cells, viruses coated w/ opsonizing Abs & exposed to hypochloric acid --> death "respiratory burst") |
|
Definition
Chronic Granulomatous Dz - X-linked
Dx - nitroblue tetrazolium dye reduction test --> tests for fxn'l NADPH oxidase that makes O2 free radicals that kill bacteria; no blue = CGD
Opportunistic infections w/ S aureus, E coli, aspergillus |
|
|
Term
| no class switching to IgG, IgA or IgE |
|
Definition
Hyper IgM syndrome - prob w/ CD40 ligand & CD4 helper T cell stop plasma cell fr class switching
Severe pyogenic infections early in life bc B cell's inability to prod correct Ig |
|
|
Term
| controls body temp mood, hunger, thirst, sex drive, sleep, circadian rhythms |
|
Definition
hypothalmus - rel 8 hormones:
TRH, dopamine (PRL inhib hormone), GHRH, somatostatin, GRH, CRH, oxytocin, vasopressin --> sends to pituitary for rel of hormones |
|
|
Term
| lesion here causes expressive aphasia (slow labored speech, incomplete sentences) |
|
Definition
| Broca's area - post edge of frontal lobe's dominant hemisphere |
|
|
Term
| lesion here causes receptive aphasia (fluent, but incomprehensible... sentence don't make sense but complete) |
|
Definition
| Wernicke's area - temporal lobe in dominant hemisphere |
|
|
Term
| MC skin malignancy, little mets risk, palisading histo, no precursor lesion, skin CA on upper lip and hairline, men, INC w/ age, sun exposure, translucent/pearly papule w/ telangiectasia, rolled-up edges "rodent ulcer" |
|
Definition
Basal cell carcinoma
Dx - shave or punch bx
Tx - excision |
|
|
Term
| MCC skin CA death, looks like mole w/ ABCD (depth = mets risk) |
|
Definition
melanoma
Precursor - dysplastic nevus |
|
|
Term
| keratin pearls, ulcerated red, nodular mass on lower lip, actinic keratosis is precursor lesion, lil mets potential, variant is keratocanthoma |
|
Definition
|
|
Term
| papules w/ white striae, lace-like appearance |
|
Definition
|
|
Term
| Rx to prevent neonatal respiratory distress syndrome (NRDS) |
|
Definition
corticoteroids - INC prod type II pneumocytes --> prod surfactant, can turn into Type I cells
NRDS risk factors - prematurity, C-section, high insulin fr maternal diabetes
After delivery --> give infant artificial surfactant |
|
|
Term
| majority of surface area that line alveoli, thin, squamous cells that allow diffusion of gas (O2 and CO2) fr alveoli into/out pulm capillaries |
|
Definition
| Type I epithelial cells - cannot regenerate after damage, but Type II can turn into type I cells |
|
|
Term
| form lining pulm capillaries, gas diffuses across surface into/out alveoli |
|
Definition
|
|
Term
| synovial fluid - needle shaped crystals that are negatively birefringent** |
|
Definition
gouty arthritis
Cause - deposit of urate crystals in joint fr excess uric acid in blood (tumor lysis syndrome fr radiation tx)
Uric acid - final breakdown product of dietary & endogenous purines. Purines broken down by hypoxanthine/xanthine
Prophylaxis - allopurinol or rasburicase |
|
|
Term
|
Definition
1) underexcretion of uric acid fr kidney: chronic kidney dz, diuretics (INC urate reabsorp), aspirin & niacin (complete w/ uric acid for excretion)
2) INC dietery intake of purines - meat/EtOH (occurs at night couple hrs after meal)
3) deficiency HGPRT - Lesch-Nyhan syndrome: x linked reces, necessary for recycling of purines, presents at infancy, mental retard, aggression, choreoathetosis (dance-like, twisting), self-mutilation, seizures, urate nephropathy |
|
|
Term
physiologic barrier
anatomic barrier
restrictive/pathologic barrier |
|
Definition
physiologic - active ROM in healthhy joint
anatomic - passive ROM in health joint
restrictive - barrier b4 physiologic barrier that DEC active ROM |
|
|
Term
| 2 cm, non-tender, mobile, firm mass in breast |
|
Definition
fibroadenoma - MC breast tumor in women 15-35 yo; benign, firm, round, smooth, rubbery, MOBILE, most freq in upper outer quadrant breast
Dx - US: disting cystic or solid, confimred w/ fine needle or core needle bx |
|
|
Term
| white flaking in areas w/ sebaceous glands (scalp, axilla, body folds, ext ear canal) |
|
Definition
seborrheic dermatitis - dry scales w/ flaking (dandruff), poss pruritis
Tx - selenium sulfide shampoo (scalp) hydrocortisone other areas |
|
|
Term
| plaque that appears "stuck on," face and trunk |
|
Definition
|
|
Term
| study useful in distinguishing environmental from genetic factors, assuming all known confounding factors accounted for |
|
Definition
| adooption studies & twin concordance studies - takes twins/siblings who grew up in different areas |
|
|
Term
| bone pain, fatigue, anemia, hypercalcemia |
|
Definition
multiple myeloma - malig plasma cells
Dx - monoclonal light chain casts in urine
lytic bone dz = bone pain, hypercalcemia
MC renal dz in MM = myeloma cast nephropathy, excessive delivery of light chains (tamm-horsfall protein = uromodulin) that overwhelms ability of renal tubules for reabsorp
Tubular casts block distal nephron & asc loop of Henle --> interstitial nephritis (INC BUN, Cre) |
|
|
Term
| muddy brown granular casts (urine) |
|
Definition
acute tubular necrosis - sudden renal ischemia that damage renal tubular damage
Cause - renal hypoperfusion (ie hemorrhage, toxin exposure) |
|
|
Term
|
Definition
normal individuals after vigorous excercise, dehydration
casts formed by mucoproteins secreted by tubular epi cells |
|
|
Term
| calcium oxalate crystals (urine) |
|
Definition
precipitate in normal/acidic urine
Hypercalciuric pts, ethylene glycol ingestion (AMS, high sympathetic tone, cardiac arrhythmias) |
|
|
Term
|
Definition
Glomerulonephritides - bleeding in renal tubule fr glomerulus
PSGN, SLE, prior upper resp infection (Berger dz), hemoptysis (Wegener or Goodpasture) |
|
|
Term
| hypothyroidism, pernicious anemia, hypopigmentation (face, elbows, knees, body orifices) |
|
Definition
vitiligo - autoimmune, loss of melanocytes
assoc w/ Hashimoto's thyroiditis* (hypothyroid), pernicious anemia* |
|
|
Term
boys 10-14, affects long bones of LE, scapula, ribs, pelvis, localized persistant pain & swelling, noticed after minor trauma
Xray - destructive lesion w/ poorly defined margins "moth-eaten" and "onion peel" look (layers of reactive bone prod by periosteal rxn) |
|
Definition
Ewing's sarcoma - malig tumor of blue cells arising fr medullary canal of bone, t (11;22)
Bx - tumor of anaplastic small blue cells
Mets to lung, bone marrow, bone, spine
Tx - chemo |
|
|
Term
| similar to Ewing's sarcoma, but occurs in metaphysis of lone bones w/ pain, swelling & pathologic fracture |
|
Definition
Osteosarcoma - Codman's triangle (lifting periosteum by expanding tumor) or sunburst pattern
Hx - malig sarcomatous stroma, tumor osteoid & bone
More common in Paget's dz & familial retinoblastoma |
|
|
Term
malig tumor of cartilage, men, 30-60 yo, expansile glistening mass in medullary cavity
Histo - abundant matrix prod, irreg shaped lobules that can permeate bony trabeculae |
|
Definition
|
|
Term
benign tumor of osteoclasts, 20-40 yo, locally destructive, distal femur/prox tibia
Xray - "double bubble" or "soap bubble" |
|
Definition
giant cell tumor
histo - large multinuc giant osteoclastic cells & spindle-shaped mononuclear cells |
|
|
Term
| bengin bone tumor assoc w/ familial adenomatous polypopsis (FAP) - referred as Gardner's syndrome |
|
Definition
osteoma
Osteomata - skull, mandible, sinuses, auditory canal, long bones
Xray - radiolucent nidus surrounded by cortical thickening
Histo - nidus of osteoid & woven bone interconnected w/ trabeculae & surrounded by fibrous CT & sclerotic bone rxn |
|
|
Term
| Tx for oral candidiasis thrush and diaper rash |
|
Definition
| Nystatin - MOA similar to amphotericin B - bind ergosterol & form pores in fungal membrane; but too toxic for systemic use |
|
|
Term
| Tx topical dermatophytoses (finger/toe nail infections) |
|
Definition
|
|
Term
| fluconazole and ketoconazole |
|
Definition
| TOC for local mycosis infections |
|
|
Term
| MCC heel pain caused by overuse, sharp pain w/ first steps in am, or after prolonged periods of rest |
|
Definition
plantar fasciitis - inflamm where plantar fascia inserts onto calcaneal tuberosity
Tenderness at calcaneal tubercle and passive dorsiflex
Xray - bony heel spur
Tx - ice, rest, stretch, NSAIDs, orthoses, night splints |
|
|
Term
| heel pain w/ running & quick changes in direction, improvement w/ rest |
|
Definition
Achilles tendonitis
Tenderness at site of Achille's insertion on calcaneus |
|
|
Term
| entrapment neuropathy of common digital nn that travels et metatarsals; numbness/burning of toes, "walking on marble," Mulder click (metatarsals compressed together, elicit pain) |
|
Definition
Morton neuroma - fibrosis/degen of common digital nn that travels bet web spaces of toes (esp 3rd & 4th metatarsals) fr repetitive toe flex/extension
RUNNERS
Tx - NSAIDs, heat/ice, low-heeled cushioned shoes w/ wide box |
|
|
Term
| extreme pain, parasthesias, sensory loss, mm weakness; firm, wooden feeling of ant lower leg; ran marathon |
|
Definition
compartment syndrome
Dx - measure compartment pressure
Tx - immediate fasciotomy
Assoc w/ rhabdomyolysis (myoglobinuria, INC CK, hyperK, hyperP, hypovolemia, acidosis --> acute kidney injury, urine dip + blood) |
|
|
Term
| flattened intestinal villi (esp jejunum), lymphocytes in lamina propria on bx |
|
Definition
Celiac dz - malabsorp Fe, fol/B12, fat sol vit ADEK --> voluminous, foul smelling diarrhea
Dx - anti-gliadin, anti-tissue transglutaminase Abs
INC risk T cell lymphoma (malig CA of WBCs) |
|
|
Term
| male, rhinitis, "saddle shaped" nose, inflamm nasal mucosa & nasal polyps, c-ANCA Abs |
|
Definition
Wegener's Granulomatosis - autoimmune small vessel vasculitis, c-ANCA Abs attack BV of...
Nasopharynx --> nose bleeding, pain, ulcer, purulent discharge, nasal deformity
Lung --> nodules, infiltrates, cavities w/ hemoptysis
Kidney --> nephritic syndrome, RPGN (hematuria, proteinuria, edema, HTN)
Organs show granulomatous inflamm w/ giant WBCs |
|
|
Term
Drug-induced lupus: anti-histone autoAb
myalgia, arthralgia |
|
Definition
Hydralazine
Procainamide
INH
Penicillamine
Tetracycline
Pyrazinamide
Quinine
Carbamazepine
Phenytoin |
|
|
Term
| autoimmune condition where anti-mitochondrial abs target bile ducts (transport bile within liver); gen pruritis, jaundice, xanthomas, fatigue |
|
Definition
Primary biliary cirrhosis
+ anti-mitochondrial Abs
Severe - hepatic encephalopathy (coma) bc of ammonia build-up |
|
|
Term
|
Definition
Hyperkalemia - WRS widening --> cardiac arrhythmias (bradycardia, sinus arrest, v tach, v fib, asystole)
Note: KCl used in death penalty to stop heart
Tx - calcium gluconate - temp cardioprotective vs arrhythmias
Albuterol (B agonist), insulin - drive K intracellularly (acute tx)
**Hydration, Na polystyrene - definitive tx
Dialysis if above fails |
|
|
Term
| found in snails, fever, cough, abd pain, diarrhea, HSM, can result in transverse myelitis w/ flaccid paraplegia, cystitis & ureteritis w/ hematuria can progress to bladder CA |
|
Definition
| Schistosoma haematobium - Africa, Middle East |
|
|
Term
|
Definition
lung fluke, SE Asia & Japan, ingestion of undercooked/picked crab or crayfish
cough, hemoptysis, abnorm xray |
|
|
Term
|
Definition
| blood fluke, Far East, affects intestines, eggs dropit in brain --> cerebral granulomatous dz |
|
|
Term
|
Definition
| blood fluke, transverse myelitis w/ flaccid paraplegia or colonic polyposis w/ blood diarrhea |
|
|
Term
|
Definition
| sheep liver fluke, worldwide where sheep/cattle raised, consumption raw watercress |
|
|
Term
| asymptomatic, complications - painless rectal bright red bleeding, perforation, infection |
|
Definition
Diverticulosis - outpouching of colon wall by INC intracolonic pressure (secondary to low fiber) or weakness in wall
SIGMOID
Tx - INC diet fiber (if uncomplicated) |
|
|
Term
| wt loss, anemia, abd pain, melena, changes in bowel |
|
Definition
|
|
Term
| pain w/ defacation, blood on toiler paper |
|
Definition
|
|
Term
| prolonged PTT & bleeding time, excessive bleeding |
|
Definition
von Willebrand's dz
vWF - carrier of factor VIII --> DEC factor VIII --> prolong PTT
Tx - desmopressin (DDAVP) - INC vWF and factor VIII levels |
|
|
Term
| INC D-dimer, DEC fibrinogen, prolonged bleeding time, PT, PTT, DEC platelet count |
|
Definition
| disseminated intravascular coag (DIC) |
|
|
Term
| normal PT, PTT, DEC platelet count |
|
Definition
| HUS, idiopathic thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP) |
|
|
Term
| ventriculomegaly, upward corpus callosal bowing, classic triad: dementia, urinary incontinence, gait disturb ("wet, wobbly and wacky") |
|
Definition
| obstructive hydrocephalus |
|
|
Term
| ring-enhancing brain abscess, seizures, cranial nn defect, AMS, immunocompromised, transmit by cysts in meat or cat feces |
|
Definition
Toxoplasmosis
Dx - imaging, Ab serology, histology w/ sickle-shaped cells w/ large nuc
Tx - sulfadiazine + pyrimethamine
HIV CD4 <100, use TMP-SMX as prophylaxis |
|
|
Term
well-demarcated mass that compresses brain w/out invading it
MC primary brain tumor <40, benign, seizures, focal dysfxn, change in mental status |
|
Definition
Meningioma
histo - spindle cells w/ psammoma bodies |
|
|
Term
| Tx prostate CA, endometriosis, fibroids, central precocious puberty |
|
Definition
Leuprolide - GnRH agonist
MOA - suppress steroid rel by ovaries & testicles secondary by DEC LH & FSH (when given continuously) |
|
|
Term
|
Definition
monoclonal Ab that binds to HER-2-R - overexpressed on aggressive breast CA cells
proto-oncogene on chrom 17 that encodes HER-2 (tyrosine kinase) amplifies ability of CA cells to respond to CA promoting signaling; trastuzumab blocks this process |
|
|
Term
|
Definition
SERM - also Raloxifene
MOA - stim estrogen in uterus (lead to endometrial hyperplasia), but blocks estrogen in breast
Use - estrogen-R + breast CA, osteoporosis
Raloxifene - does not have endometrial agonist effect |
|
|
Term
| microcytic anemia, pica (appetite for dirt, clay, sand), koilonychia (spoon nails), esophageal webs (cause dysphagia) |
|
Definition
|
|
Term
| fatigue, irritability, wt loss, brittle hair, dry skin, arthralgia, bleeding, brusing in gums and into joints, poor wound healing |
|
Definition
|
|
Term
| neuropathy, Wernicke encephalopathy, Korsakoff syndrome, heart failure, anorexia, constipation |
|
Definition
| thiamine (B1) defic / beriberi |
|
|
Term
| fatigue, peripheral/CNS neurpathy |
|
Definition
|
|
Term
| hyperlycemia; insulin requires this to fxn properly |
|
Definition
|
|
Term
| Class 1a (Na channel-blocking) antiarrhythmic |
|
Definition
Procainamide, quinidine, disopyramide
MOA - inhib entry Na into cell, DEC phase 0 slope of action potential; also block K efflux during phase 3 --> INC refractory period
DEC myocardial excitability, DEC conduction velocity
Use - atrial & ventric arrhythmia |
|
|
Term
| inhib topoisomerase (DNA gyrase) |
|
Definition
| FQ (cipro-, levofloxacin) |
|
|
Term
| inhib 50S ribosomal subunit |
|
Definition
| chloramphenicol, azithromycin |
|
|
Term
| inhib transpeptidase & cross-linking of peptidoglycan of cell wall |
|
Definition
| cephalosporin, ie ceftriaxone - best alt to ciprofloxacin for typhoid (enteric) fever) |
|
|
Term
|
Definition
|
|
Term
|
Definition
ulnar nn/aa
entrapment - motor/sensory loss in all ulnar innervated hand intrinsics:
AD/ABduction digits, extending PIP little finger, opposing little finger
Severe - "claw hand" |
|
|
Term
|
Definition
aromatase inhibitors
Normally converts androgens to estrogens
Use - adv estrogen-R sensitive + breast CA, can use w/ tamoxifen or if it's ineffective |
|
|
Term
|
Definition
5-alpha reductase inhibitors
Normally 5-alpha converts testot to DHT in prostate, testes, hair follicles, adrenals
Use - BPH, male pattern baldness (finasteride) |
|
|
Term
|
Definition
androgen-R antag
Use - prostate CA |
|
|
Term
| 10 yo, fever, sore throat, jt pain, INC sed rate |
|
Definition
Acute rheumatic fever, recent hx Grp A strep pharyngitis.
2 major criteria: J<3NES (joints, carditis, nodules, erythema marginatum, Syndenham's chorea) AND 1+ minor criteria
Dx - throat culture, antistreptolysin O
Tx - PCN (ALL pts) to prevent recurrence |
|
|
Term
| granulosa cell tumor (type of sex cord-stromal tumor; MC malig tumor of this category) |
|
Definition
granulosa cell in ovary - convert androgen to estrogen
Tumor --> hyperestrogenism:
young - precocious puberty
adults - irreg menses or postmenopausal bleeding d/t endometrial hyperplasia
Hallmark - Call-Exner body** (follicles filled w/ eosinophilic fluid) or "coffee been" nuclei or rosette of cells |
|
|
Term
|
Definition
granulosa cell
fibroma (benign Meig's syndrome - ovarian fibroma, ascites, pleural effusion)
Sertoli-Leydig cell tumors - prod andreogens, virilization |
|
|
Term
| stomach CA that mets to ovary |
|
Definition
| Krukenberg tumor - mucin-secreting adenoma of ovary w/ signet ring cells |
|
|
Term
| ovarian fibroma, ascites, pleural effusion (typically on R) |
|
Definition
Meig's syndrome
Tx - resection
Histo - spindle-shaped fibroblasts (FIBROblasts = FIBROma) |
|
|
Term
| papillary projections and psammoma bodies |
|
Definition
serous cystadenocarcinoma - type of malig OVCA of surface epithelial origin, includes:
mucinous, endometrioid, transitional cell, clear cell, Brenner tumors
Risk factors - nulliparity, early menarche/late menopause, famHx
Suspect BRCA1/2 mut if 1+ family member had breast/OVCA
Psammoma bodies also seen in papillary thyroid CA |
|
|
Term
| tumor cell lined single papilla w/ central vessel (Schiller-Duval bodies* pathognomonic) |
|
Definition
yolk sac tumor (type of malig ovarian germ cell tumor), aka endodermal sinus tumor
acute abd signs if there's degen/rupture
F - ovary, M - testes
Malig germ cell tumor:
dysgerminoma (INC LDH)
yolk sac tumor (INC AFP)
immature teratoma |
|
|
Term
Germ cell tumors
MC ovarian malig Dx'd during childhood/adolescence |
|
Definition
"DEEPCT"
dysgerminoma, endodermal sinus (yolk sac), embryonal CA, polyembryoma, choriocarcinoma (INC HCG) |
|
|
Term
|
Definition
| dermoid cyst (mature teratoma) |
|
|
Term
| brain cyst, seizures - parasite |
|
Definition
| taenia solium (cystercosis) - Cestode (tapeworm) |
|
|
Term
|
Definition
| Echniococcus granulosus - tapeworm |
|
|
Term
|
Definition
| Diphyllobothrium latum - tapeworm |
|
|
Term
| biliary tract dz, cholangiocarcinoma - parasite |
|
Definition
| Chlonorchis sinensis - tremetode (fluke) |
|
|
Term
|
Definition
| Pragonimus westermani - fluke |
|
|
Term
|
Definition
| schistosoma masoni - fluke |
|
|
Term
| hematuria, bladder CA - parasite |
|
Definition
| schitosoma haematobium - fluke |
|
|
Term
| microcytic anemia - parasite |
|
Definition
| ancylostoma, necator - hookworm (type of nematode or roundworm) |
|
|
Term
| perianal pruritis - parasite |
|
Definition
| enterobus - pinworm (type of roundworm) |
|
|
Term
Volume of distribution
Vd = total amount in body / plasma Rx concenc |
|
Definition
Reflects extent Rx dristrib in extravasc tissue as opposed to plasma
If Rx distrib in tissue = HIGHER Vd
*Note Vd can exceed known vol of all body compartments combined if distrib primarily in tissue (ie chloroquine - malaria) --> HIGHLY lipophilic thus able to cross cell membranes
If Rx distrib mainly in blood = LOWER Vd |
|
|
Term
|
Definition
Rx tracted by liver & partially metab before sent to systemic circ --> result in lower levels delivered to systemic
Buccal/rectal route DEC first pass effect & bypasses portal circ |
|
|
Term
|
Definition
somatostatin analog - "off switch" for GI
Use - bleeding esophageal varices *DOC, gastrinoma or glucagonoma, acromegaly
MOA - inhib serotonin rel (Tx met carcinoid tumor) & almost all GI hormones (gastrinn, VIP, serotonin, insulin, glucagon, motilin), inhib GH
SE - N, abd pain, constipation OR diarrhea, abnorm glucose tolerance, flatulence |
|
|
Term
| adult - course facial features, large tongue (macroglossia), large hands/feet, INC shoe/glove size or ring tightening |
|
Definition
acromegaly
Tx - octreotide (somatostatin analog) |
|
|
Term
| Glucocorticoid (hydrocortisone) |
|
Definition
inhib enzyme phopholipase A2 (cleaves FA --> arachidonic acid --> PGs, leukotrienes = inflamm)
Use - dermatitis
SE - thin skin, iatrogenic Cushing's |
|
|
Term
|
Definition
biphosphanate
Use - osteoporosis
MOA - inhib osteoclasts (resorp)
SE - esophagitis, osteonecrosis of jaw* (rare) |
|
|
Term
|
Definition
dopamine-R agonist
Use - PRL secreting pituitary microadenoma (1st line)
SE - GI upset |
|
|
Term
block ALD-R (prevent reabsorp Na/Cl in distal tubule), competitively antag androgen-R (DHT-R)
Tx HTN & CHF, hirsutism (PCOS) |
|
Definition
Spironolactone - K sparing diuretic, prevent excretion K (can lead to hyperK+)
SE - gynecomastia, testicular atrophy, amenorrhea
Note - CHF d/t DEC CO & DEC renal perfusion which acitv RAAS sys & INC absorb Na, Cl, H2O in kidney --> peripheral/pulm edema |
|
|
Term
| inhib Na-Cl-K cotransporter in asc loop Henle & distal renal tubule |
|
Definition
Furosemide (loop diuretic) - INC excretion H2O, Na, Cl, Ca; INC excretion K & DEC excretion uric acid...
Imp SE - hypokalemia & gout
Use - CHF |
|
|
Term
| supplies ant wall LV, bundle of His, RBB |
|
Definition
|
|
Term
| supplies anterolat myocardium, apex, interventric septum |
|
Definition
| L ant descending coronary aa |
|
|
Term
| supplies postlat LV, anterolat papillary mm |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Flow of CSF in ventricles |
|
Definition
lateral ventricles --> foramen of Monro --> 3rd ventricle (no connection bet 2 lat ventricles, each lat ventricle has own foramen of Monro)
3rd ventricle --> aqueduct of Sylvius --> 4th ventricle --> exits via Magendie (middle), 2 foramina of Lushka draining into subarachnoid space via cisterna magna --> reabsorb by arachnoid villi in sup sag sinus & subarach space |
|
|
Term
| obstruction CSF outflow thru foramina of Lushka (2 lateral) & Magendie (middle) = dilated 4th, 3rd & lat ventricle |
|
Definition
| Dandy-walker malformation |
|
|
Term
| dilated 3rd & both lateral ventricles |
|
Definition
obstructed cerebral aqueduct (stenosis)
Arnold-Chiari malformation |
|
|
Term
| hematuria, abd pain, HTN, bilat palpable kidneys w/ multiple cysts |
|
Definition
ADPKD - abnorm on short arm chrom 16
Dx - US* imagine of choice, MRI, CT
Tx - annual US, control HTN
Complications - intracerebral berry aneurym*, heart valve abnorm, thoracic aortic aneurysm |
|
|
Term
| bright red rash on cheeks that faded followed by lace-like rash on trunk/extremities |
|
Definition
erythema infectiousum (Parvo B19)
Sickle cell pts more likely infected --> aplastic crises |
|
|
Term
| purple, pruritic, polygonal papules on ext, lace-like lesions on mucosa |
|
Definition
|
|
Term
| first fever --> rash starts on trunk, spread peripherally |
|
Definition
|
|
Term
| <2 yo, vomitting, diarrhea, bloody stool "currant-jelly", crying & curling into a ball |
|
Definition
intussusception - telescoping of distal bowel
Dx - barium or air enema |
|
|
Term
| "M-spike"** (large amount M protein) on serum protein electrophoresis, rouleaux formation (stacked coins), Bence-Jones proteinuria, **hypercalcemia, renal failure |
|
Definition
| Multiple myeloma - prolif of single clone plasma cells prod monoclonal Abs, "punched out" osteolytic lesions, Blacks > 45 yo, vertebral collapse (ht loss), leukopenia |
|
|
Term
|
Definition
ant displacement of vertebral body in relation to the one below
grade 1 0-25%
grade 2 26-50%
grade 3 51-75%
grade 4 76-100% |
|
|
Term
|
Definition
|
|
Term
|
Definition
defect in pars interarticularis
Xray - scotty dog "collar" |
|
|
Term
1. form BBB (w/ endothelial cells & BM)
2. support to neurons: nutrients (lactate), homeostasis (K metab), removal NT (glutamate), physical support
3. repair & scarring in form of reactive gliosis (fills physical space of damaged neurons that can't regrow after injury, ex resected tumor space) |
|
Definition
|
|
Term
major myelin producers of CNS, largest composition of white matter
each one capable of myelinating dozens of axons (which can regrow) |
|
Definition
|
|
Term
| phagocytes orig fr mesoderm, 1st line defense active immunity in CNS |
|
Definition
|
|
Term
| myelin coating for PNS neurons, do not exist in CNS, derived fr neural crest |
|
Definition
Schwann cells - can only myelinate ONE axon
Clinical - destroyed in Guillian-Barre syndrome |
|
|
Term
|
Definition
rate of elim proportional to drug concen (constant fraction/percent elim per unit time)
Rx DEC exponentially over time (ex. initial 1 mg/L, HL = 3 hr... after 3 hrs it becomes 0.5, next 3 hrs 0.25, etc)
Most Rxs follow this
Note: if Rx infused, takes 4-5 HL to reach steady state concen |
|
|
Term
|
Definition
rate of elimination constant regardless of present Rx plasma concen (ex. 0.25 mg/L elim after 3 hrs, 0.25 next 3 hrs, etc)
**phenytoin, ethanol, aspirin |
|
|
Term
| Gram neg, Giema-staining - cytoplasmic inclusion filled w/ dark circular bodies (reticulate bodies), yellow urethral discharge, dysuria |
|
Definition
Chlamydia trachomatis - serotypes D-K
Can be asymptomatic, urethritis/vaginitis (MC prepubescent), PID (postpubescent)
F - Can damage fallopian tubes --> infertility
M - epididymitis
M/F - Reiter's syndromem (can't pee, see, climb tree)
Neonatal pneumonia (staccato cough), conjunctivitis
Serotypes A-C Trachoma (blindness in Asia/Africa)
Serotypes L1-3 lymphogranuloma venerum (elephantiasis) |
|
|
Term
| Gram neg, NOT Giemsa-staining, glucose fermenting coccus, dysuria, intermenstrual bleeding, lower abd pain |
|
Definition
Gonorrhea
Can cause neonatal conjunctivitis, septic arthritis, Fitz-Hugh-Curtis syndrome, PID |
|
|
Term
white thick discharge, KOH - pseudohyphae, part of normal vag flora, overgrowth in diabetics or those on abx
Cause - esophageal thrush, diaper rash, endocarditis IVDU |
|
Definition
|
|
Term
foul smelling, green discharge, itching, burning, dyspareunia, dysuria, strawberry cervix
Dx - flagellated, pear shaped trophozoites w/ corkscrew motility |
|
Definition
Trichomoniasis
Tx - metronidazole |
|
|
Term
| flushing, wheezing, pruritis, diarrhea, heart valve damage, abd pain, 24-hr urine excretion INC 5-HIAA** |
|
Definition
Carcinoid syndrome - secretes serotonin (diarrhea, heart valve damage), histamine (flushing, wheezing, pruritis), kallikrein (flushing), mets causes abd pain
Dx - CT scan or somatostatin-R scintigraphy to localize tumor
Tx - resection, octreotide (*TOC if unresectable) |
|
|
Term
| neuroendocrine tumor that causes watery diarrhea, flushing, urinalysis shows dehydration |
|
Definition
| vasoactive intestinal peptide tumor |
|
|
Term
kid - hypokalemia, metabolic acidosis, chronic vomiting, normal-low BP, elev renin & ALD (explains hypokalemia)
inherited defect in thick ascending loop of Henle, juxtaglomerular cell hyperplasia |
|
Definition
Barrtter syndrome
Tx - K-sparing diuretic |
|
|
Term
| inhib Na-K-Cl transporter in thick asc loop of Henle |
|
Definition
loop diuretics - furosemide, bumetanide, torsemide
Use - edema d/t HF, nephrotic syndrome, cirrhosis, hyperCa, HTN; effective in pts w/ low GFR
SE - "OH DANG": Ototoxicity, HypoK+, Dehydration, sulfonamide-related Allergic rxn, interstitial Nephritis, Gout |
|
|
Term
| inhib Na-Cl transporter in distal convoluted tubule |
|
Definition
thiazide diuretics (-thiazide)
Use - HTN, edema cause by HF, nephrotic syndrome
SE - HyperGLUC: glycemia, lipidemia, uricemia, calcemia |
|
|
Term
| retention of H2O in tubular lumen by osmotic effect |
|
Definition
osmotic diuretic - mannitol
Freely filtered, prevent reabsorp of water --> diuresis
acts on entire nephron, except thick asc limb of loop of Henle
DEC intraocular/ICP, urinary excretion toxic substances
SE - dehydration, hyperNa, hypoTN, pulm edema, blurred vision |
|
|
Term
| inhib carbonic anhydrase - block reabsorp NaHCO3 in prox convoluted tubule |
|
Definition
CA inhibitor - acetazolamide, dichlorphenamide, methazolamide
Use - glaucoma (by DEC prod aqueous humor), edema, urinary alkalinization, met alkalosis, epilepsy, mtn sickness
SE - met acidosis, neuropathy, ammonia toxicity |
|
|
Term
enlarged clit/ambiguous genitalia, blind-ending vagina, palpable masses in inguinal canals or labial folds;
normal internal male genitalia but ext female genitalia at birth w/ secondary virilization at puberty, serum testot:DHT ratio >20, 46XY |
|
Definition
5-alpha-reductase deficiency - absent DHT necessary for normal male ext genitalia & 2ndary sex charac
Y chromosome - Wolffian ducts (testes, epididymis, seminal vesicle, vas def)
At puberty - LH surge cause INC testot --> virilization, 2ndary male charac
Tx - gender ID, hormonal, psych |
|
|
Term
masculinization at infancy, female pseudohermaphrodism, hypoTN, vol depletion, hypovolemic shock in newborn d/t salt wasting
17-hydroxyprogeseterone accum and converts to androstenedione (testot precursor) |
|
Definition
21-hydroxylase deficiency - needed for syn of CORT & ALD
MCC congenital adrenal hyperplasia
HyperK+, INC plasma renin |
|
|
Term
excess prod mineralocorticoids
infant - HTN, hypoK+ (d/t excess ALD)
M - normal M internal, female external; undescent testis
F - normal F internal, male external
both lack appropriate 2ndary charac |
|
Definition
17-hydroxylase defic (another type of congenital adrenal hyperplasia)
pregnenolone & proges CANNOT convert to CORT or androgens |
|
|
Term
HTN, masculinization
INC ALD precursor 11-deoxycorticosterone (mineralocorticoid), INC cortisol precursor 11-deoxycortisol, INC prod androgens |
|
Definition
11-hydroxylase defic (another type CAH)
necessar for syn ALD & CORT |
|
|
Term
| virilization of female fetuses (but normal internal genitalia - ovaries, uterus), primary amenorrhea, tall stature, polycystic ovaries, osteoporosis |
|
Definition
armoatase defic
need to convert testot --> estradiol |
|
|
Term
| defective hepatic uroporphyrinogen decarboxylase, 5 P's: Polyneuropathy, Psych abnorm, Painful abd, Pink urine, Pharmaceuticals (barbituates) |
|
Definition
Porphyria cutanea tarda (PCT) - MC porphyria
Tx - phlebotomy, avoid sunlight, EtOH, tobacco, Fe, estrogens
cutaneous/liver abnorm, chronic blistering, vesicles, bullae on sun exposed skin, males
exacerbated by Fe supp, EtOH, P450 inducers, smokers, exogenous extreogen |
|
|
Term
| seizure, new-onset porphyria (urine - aminulevulinic acid & porphobilinogen), no cutaneous manifestation |
|
Definition
| Acute intermittent porphyria d/t valproic acid** |
|
|
Term
| "ringed sideroblasts" in bone marrow (nuc RBC w/ ring of mitochondria along cell periphery) |
|
Definition
sideroblastic anemia (microcytic) - inability to incorporate heme into protoporphyrin & make Hgb
MCC in order: EtOH, B6 defic, lead poisoning |
|
|
Term
DEC factor III, lightheaded, fatigue
mucosal bleeding, excess bruising, epistaxis (nosebleed), menorrhagia |
|
Definition
von Willebrand dz - auto dom
vWF imp in hemostasis, bids factor VIII to prevent degradation by protein C
Tx - DDAVP (desmopressin - anti-diuretic), SE - hypoNa+ |
|
|
Term
| mtn climbing, anorexia, NV, fatigue, weakness, dizziness, lightheadedness |
|
Definition
acute mtn (altitude) sickness
Tx - acetazolamide (carbonic anhydrase inhibitor) - prevent HCO3 reabsorp at prox tubule, DEC H2O resabsorp, cause NaHCO3 diuresis
Accelerates body's normal response to resp alkalosis fr high altitude
SE - metabolic acidosis |
|
|
Term
| otherwise healthy pt has neutropenia & hypochromic anemia |
|
Definition
| Copper defic - needed for hematopoiesis |
|
|
Term
| selenium deficiency, can lead to cardiomyopathy, mmm weakness, |
|
Definition
Keshan dz
Note: selenium toxicity - hair loss, nn damage, garlic breath* |
|
|
Term
| hypothyroidism, goiter, stunted mental/physical growth (cretinism) |
|
Definition
|
|
Term
| anorexia, tremors, seizures, palpitations, AMS, depression, other electrolyte abnorm |
|
Definition
Mg defic
Note: hyperMg = weakness, AMS, resp depression, cardiac arrest |
|
|
Term
| flashes of light, floaters, sudden vision loss similar to shade being pulled down |
|
Definition
retinal detachment - eye trauma, DM (neovasc & scarring of choroid)
Fundoscopy - elev and folded retinal tissue |
|
|
Term
| blurry vision & ocular pain, sudden severe ocular pain, redness, halos, fixed dilated pupil, frontal HA, optic disk cupping |
|
Definition
closed-angle glaucoma - optic nn damage fr DEC angle bet iris & cornea
Note: open angle glaucoma - damage of trabecular meshwork, obstructed flow to canal of Schlemm, painless, but still shows optic disk cupping |
|
|
Term
blurred margins, enlarged blind spot, normal vision (unless very severe), HA, NV
fundoscopy - swelled optic disk, hemorrhages, cotton wool spots |
|
Definition
| papilledema - optic disk swelling 2ndary to INC ICP |
|
|
Term
gradual loss central vision
Fundoscopy - drusen (scattered yellow) deposits beneath retina |
|
Definition
| age related macular degen |
|
|
Term
| thrombocytopenia, leukopenia, sudden onset pleuritic chest pain, diffuse ST seg elev & PR depression, pericardial friction rub |
|
Definition
|
|
Term
| MCC of viral pericarditis |
|
Definition
Coxsackie B virus
pleuritic chest pain (relieved by leaning fwd), pericardial friction* (100% specific for pericarditis)
Normal platelet count, HIGH WBC count |
|
|
Term
| Premature - neonatal resp distress syndrome cyanosis, intercostal retraction, nasal flaring, grunting, tachypnea |
|
Definition
low lung compliance, low FRC, R-to-L shunting thru ductus arteriosus & foramen ovale
Tx - surfactant |
|
|
Term
| lateral deviated tongue w/ fasciculations, ipsi hypertrophy |
|
Definition
|
|
Term
|
Definition
eval sidebending lumbar spine
place hands on iliac crest & ask pt to bend one knee w/out lifting heel, allow compensatory wt shift & compare bilat
Normal - iliac creast on side of bent knee should drop >20 degrees |
|
|
Term
|
Definition
with lesion to oculomotor nn, light info still travels to bilat point --> tells both eyes to constrict pupil, but affect side cannot perform task while unaffected side can
No pupillary constriction in either eye - optic nn (CN II) or retina injured
Pupillary dilation in both eyes (hydriasis) - damage to oculomotor nn, loss of constricting parasympathetics fr both Edinger-Westphal nuc |
|
|
Term
| weakness of forearm flexion (brachialis & biceps), supination (biceps), and loss sensation lat forearm |
|
Definition
musculocutaneous nn (C5-7) injury
"burners injury" or "stingers injury"
burning pain, numbness, tingling
Cause - depression of shoulder by forceful flexion of neck away fr involved side (football/rugby tackles) |
|
|
Term
| surgical neck of humerus fracture |
|
Definition
| axillary nn injury (C5-6) - deltoid (ABducts shoulder), sensory loss over shoulder |
|
|
Term
| hook of hamate fracture fr outstretched hand |
|
Definition
| ulnar nn injury (C8, T1); passes thru Guyon's canal - hypothenar, ADDuctor pollicus (adduct thumb), dorsal/palmer interossei, 2 medial lubricals 7 sensory to dorsal/palmar hand, 5th digit, medial half 4th |
|
|
Term
| midsystolic click, late systolic murmur, INC by valsalva, DEC by squatting |
|
Definition
|
|
Term
| apical holosystolic murmur radiates to axilla or back, inferiolat displaced PMI |
|
Definition
mitral regurg - asymptomatic
severe - exertional dyspnea & afib |
|
|
Term
| low pitched, apical diastolic rumble in L lateral decubitus position, INC w/ EXPiration |
|
Definition
mitral stenosis
Dx - ECG, CXR (L atrial hypertrophy)
Tx - diuretics, surg |
|
|
Term
|
Definition
PT/INR
PT - test sensitive to factors I, II (prothrombin), VII, X and factor V
measures activity of extrinsic & common coag pathways
INR - normal 2-3 |
|
|
Term
|
Definition
| erythrocyte sed red = nonspec for inflamm |
|
|
Term
|
Definition
measure intrinsic pathway
monitor tx w/ unfractionated heparin
Excess heparin - protamine sulfate
For LMWH (enoxaparin, dalteparin) - measure anti-factor Xa activity |
|
|
Term
negative birefringence (look like yellow needles on synovial fluid), sudden, nocturnal pain, men, affects metatarsophalangeal jt of great toe (podagra), ankles, knees; tender, swollen, warm joint
INC serum uric acid, INC ESR |
|
Definition
Gout - monosodium urate crystals, EtOH retains urate
Xray normal in initial attack
Chronic gout - tophi, erosions, overhanging cortical bone ("rat-bite erosions") |
|
|
Term
| jt pain, swelling, tenderness, warmth, jt aspiration shows calcium pyrophosphate crystals w/ weak positive bifringence that's blue and rhomboid shaped |
|
Definition
|
|
Term
| SE - dry cough (d/t bradykinin), acute renal failure, hyperK, angioedema |
|
Definition
ACE inhibitor
Use - chronic kidney dz, diabetes
If get SE, use ARB (-tan) |
|
|
Term
| kid, female, microcephaly, autism like behavior, handflapping, lose prior speech by 18 mon |
|
Definition
Rett syndrome - normal dev and sudden decline in motor/cognitive fxn
Hyperventilation/hypoventilation cycles, hand-flapping, scoliosis, bruxism (grinding teeth) |
|
|
Term
|
Definition
end-stage untreated hypothyroidism
d/t cessation of thyroid rep tx, precip by stroke, MI, infection, GI hemorrhage, trauma, excessive hydration, diuretic, sedative rx
S/S - social withdrawl, lethargy, drowsiness, confusion, hypothermia, AMS, hypoNa, hypercapnia
Tx - ventilatory support, T4 & steroid rep, water restriction (correct hypoNa)
Note: myxedema - non-pitting edema of face/hands d/t GAG) |
|
|
Term
| high TSH, low T3, T4, Ft4 |
|
Definition
Hypothyroidism
Etio: autoimmune (Hashimoto's) cretinism (d/t severe iodine defic in utero), subacute thyroiditis (self-limited after flu-like illness), Riedel's thyroiditis (thyroid tissue fibrosis), iatrogenic (thyroidectomy or radioiodine tx), Rx-induced (fr lithium or amiodarone) |
|
|
Term
| enlarged lymph nodes, hemorrhagic buboes (axilla, neck groin), bit by flea |
|
Definition
Yersinia pestis - gram neg, facultative-anaerobic enterobacteriaceae, non-lactose fermenting, non-motile, glucose-fermenting, oxidase-neg, catalase-pos, coagulase-pos, SW US deserts
Transmit by flea bite (dogs/rodents)
Bubonic plaque - high fevers, enlarged LN, hemorrhagic suppurative buboes, conjunctivitis
Tx - isolation, abx (aminoglycosides, FQs or tetracyclines) |
|
|
Term
| larger subcutaneous areas, more malig, spread quick, red borders surrounding black tissue |
|
Definition
Pseudomonas aeruginosa (water) - aerobic, Gram neg rod, non-lactose fermenting, oxidase pos
major source nosocomial sepsis and cellulitis (esp burn victims) |
|
|
Term
|
Definition
Heparin - activ antithrombin
DVT: Homan's sign (calf pain w/ passive dorsiflexion w/ knee extended) - can also be neg |
|
|
Term
|
Definition
direct thrombin inhibitor (lepirudin, bivalirudin, argatroban, dabigatran)
MOA - disrupt thrombin after it's alrdy bound to clot
Use - pts who cannot tolerate heparin or had heparin-induced thrombocytopenia (adverse rxn)* |
|
|
Term
|
Definition
anti-platelet (clopidogrel, ticlopidine, prasugrel)
Use - CAD, stroke |
|
|
Term
| antag GPIIb/IIIa receptor |
|
Definition
GPIIb/IIIa inhibitors (abciximab, eptifibatide, tirofiban)
MOA - prevent clot
Use - pts undergoing percutaneous coronary intervention (for MI) & high risk unstable angina |
|
|
Term
| conversion of plasminogen to plasmin |
|
Definition
fibrinolytic (clot buster) - tPA, streptokinase, urokinase
Use - dissolve alrdy formed clot in acute MI, ischemic stroke, massive PE
SE - bleeding
Do non-contrast CT to r/o hemorrhagic stroke (don't use in these pts) |
|
|
Term
|
Definition
weight-bearing & balance exercise
Ca + Vit D supp
Lifestyle changes (smoking cessation) |
|
|
Term
| excess CSF, communicating (non-obstructive) hydrocephalus - dilation of lateral, 3rd, 4th ventricles |
|
Definition
choroid plexus papilloma - benign tumor lining ventricles that prod CSF
Infant - bulging ant fontanel* classic d/t INC ICP |
|
|
Term
| dilated 4th, 3rd and lateral ventricles (non-communicating), enlarged cisterna magna, absent cerebellar vermis & enlarged brain's post fossa |
|
Definition
| Dandy Walker syndrome - congenital abnorm of cerebellum & 4th ventricle --> obstruction of CSF flow out of 4th ventricle into cisterna magna (non-communicating hydrocephalus) |
|
|
Term
| downward displacement cerebellum thru foramen magnum --> stenosis of aqueduct of Sylvius (block CSF flow fr 3rd to 4th) |
|
Definition
| Arnold Chiari malformation |
|
|
Term
| calfified brain tumor fr white matter of cerebral hemispheres, usually frontal lobes, "fried egg" appearance (central nuc and clear cytoplasm) |
|
Definition
|
|
Term
| infant - communicating hydrocephalus, esp chorioretinitis, mom exposed to cat litter |
|
Definition
|
|
Term
|
Definition
isotonic - constant mm tension, change in mm length
concentric - mm shortens
eccentric - mm lengthens
isometric - operater/pt have same force, neither shortening/lenghtening (ME)
isolytic - operator's force overcomes contraction of mm causing it to lengthen
isokinetic - mm shortens & lengthens at constant speed (professional swimming) |
|
|
Term
| Chapman - surgical neck of humerus |
|
Definition
|
|
Term
| Chapman - 1st rib and clavicles, lateral to where they cross 1st ribs |
|
Definition
|
|
Term
| echinocytes (burr cells or acanthocytes) - RBC w/ spoked projections on membrane |
|
Definition
| pyruvate kinase (PK) defic - last enzyme in glycosis, w/out this RBCs have lower energy stores |
|
|
Term
| + Coombs test, normocytic, normochromic anemia, anti-red cell Abs leading to extravasc hemolysis (in liver/spleen) |
|
Definition
| autoimmune hemolytic anemia |
|
|
Term
| red morning urine* classic, abnormal RBCs, granulocytes, platelets |
|
Definition
paroxysmal nocturnal hemoglobinuria - acquired clonal stem cell disorder, acidosis (during exercise/sleep) activates C' which explains red morning urine
Complications - freq thromboses, acute leukemia |
|
|
Term
|
Definition
african american males, Mediterranean
INC erythrocyte sensitivity to oxidative damage, triggered by:
antimalarials (primaquine)
anti-TB
sulfonamides
nitrofurantoin
viral/bacterial infections
fava beans (favism) |
|
|
Term
| GI - intraepithelial CD8+ T lymphocytic infiltration, crypt hyperplasia, villous atrophy, blunting of small intestinal villi |
|
Definition
|
|
Term
| causes of normal intestinal histology w/ diarrhea & wt loss |
|
Definition
| lactase defic, disaccharidase defic, abetalipoproteinemia |
|
|
Term
| transmural inflamm, collections of NT w/in crypts |
|
Definition
|
|
Term
| diffuse inflamm limited to mucosa & superficial submucosa w/ ulceration |
|
Definition
|
|
Term
| CNS tumors (hemangioblastomas), angiomatosis (1-3 red nodules w/ stringy BV along periphery of nodule) |
|
Definition
von Hippel-Lindau dz - auto dom, mut VHL gene on chrom 3
assoc w/ renal cell CA, epidermal cysts, pheochromocytomas |
|
|
Term
| port wine stain (trigem dermatome), leptominengial angiomatosis, mental retard, seizures, early onset glaucoma, phemochromocytoma |
|
Definition
|
|
Term
| newborn cyanosis (first few hrs), CXR "egg-on-a-string" |
|
Definition
transposition of great vessels (ASD, VSD, PDA must be present to live)
Tx - IV PGE1 (prevent closure), cardiac catheterization, balloon atrial septostomy, surgery |
|
|
Term
| newborn cyanosis - single BV arising fr R/L ventricles, VSD usually present, CXR - heart enlargement and fluid-filled lungs |
|
Definition
|
|
Term
| newborn cyanosis - boot shaped heart |
|
Definition
|
|
Term
| all 4 pulm vv drain into systemic vv or R atrium, CXR - "snowman" |
|
Definition
| total anomaous pulm venous return - ASD or foramen ovale imp for survival |
|
|
Term
| R atrium dilation, CXR - prominent R heart border |
|
Definition
| tricuspid atresia - lack of tricuspid valve (no connection bet R atrium & ventricle) |
|
|
Term
| test hypotheses which compare differences in proportions bet nominal grps (grp without a number, ie ethnic grps, gender, cured vs not cured) |
|
Definition
|
|
Term
| compare diff when there's one set of interval data (values, ie BP, temp, HR) and one or more sets nominal data (without number, ie ethnic grp, cured/not cured) |
|
Definition
|
|
Term
| find how well 2 sets of interval data (value, ie BP, HR) correlate |
|
Definition
| pearson product-moment correlation |
|
|
Term
| used for interval data, but one interval set has only 2 grps of nominal data |
|
Definition
|
|
Term
| dorsal column spinal cord |
|
Definition
IPSI pressure, vibration, touch, proprioception
most medial portion - legs
more lateral - arms
lesion result in DEC below injured level |
|
|
Term
| ant part medial aspect spinothalamic tract (ant parts) |
|
Definition
|
|
Term
| ant part lateral aspect spinothalamic tract |
|
Definition
|
|
Term
| prolonged diarrhea in immunocompromised |
|
Definition
cryptosporidiumm protozoa - acid-fast cysts on stool histology
Tx - nitazoxanide + HAART (HIV)
Prevention - water filtration |
|
|
Term
| bloody diarrhea, lactose neg, flagella, transmit by food, fecal-oral |
|
Definition
|
|
Term
| blood diarrhea, shiga exotoxin, lactose neg, no flagella, transmit by food, fecal-oral |
|
Definition
|
|
Term
| hemorrhagic diarrhea after eating undercooked red meat, unpasteurized milk |
|
Definition
| EHEC (O157:H7) - non-sorbitol fermenting |
|
|
Term
| obligate intracellular bacteria, transmit via resp/direct contact, thickened nn, loss of sensation, skin patches, leonine facies |
|
Definition
Mycobacterium leprae - acid-fast (also Nocardia)
Tuberculoid Hansen's dz - leprosy
1. Tuberculoid - good immunity, mild, one or multiple skin nodules, thickened peripheral nn, local loss sensation, not likely to transmit dz
2. Lepromatous - weak immunity, nodules, plaques bilat thruout body esp hands, fingers, forearms, face(leonine facies, resemble lion, loss of eyebrows, nasal collapse)
Tx - long-term dapsone (PO) or w/ rifampin or clofazimine
Dapsone SE - hemolysis, methemoglobinemia |
|
|
Term
| 4 P's: pruritic, purple, polygonal, papules, self-limiting, more common in older females or those w/Hep C |
|
Definition
Lichen planus
Tx - corticosteroids |
|
|
Term
| narrowing spinal canal that causes radiculopathy esp w/ extension |
|
Definition
spinal stenosis
Xray - stenosis fr degen changes |
|
|
Term
|
Definition
|
|
Term
| cause bronchodilation by inhib enzyme phosphodiesterase --> inhib degradation of cAMP to AMP |
|
Definition
Theophylline (along with caffeine & theobromine are methylxanthines) - narrow therapeutic index
cause cardio- & neuro-toxicities |
|
|
Term
| primary tumor in L atrium |
|
Definition
| myxomas - dyspnea, wt lsos, syncope, hemoptysis |
|
|
Term
| low grade fever, HSM, LAD (esp post cervical nodes), DEC energy/appetite, pharyngitis, + heterophile Ab test, infected B cells* |
|
Definition
|
|
Term
| Clonidine suppression test then measure serum catecholamines before/few hrs after |
|
Definition
Dx - pheochromocytoma
Clonidine - alpha-2-R agonist normally suppresses rel catecholamines fr adrenal glands but ineffective for pheochromocytoma
Confirm dx - CT/MRI
Tx - resection w/ alpha-blocking meds (phenoxybezamine - irreversible alpha blocker), BB only if adequate alpha blockade achieved bc unopposed alpha stim can lead to dangerous INC BP |
|
|
Term
| non-env RNA, fecal-oral, acute gastroenteritis, cruise, lasts few hrs to days, for contaminated seafood/water |
|
Definition
| Norovirus (Calicivirus family) |
|
|
Term
| infantile gastroenteritis |
|
Definition
|
|
Term
| gastroenteritis, cysts or trophozoites ingested fr fecally contaminated water, food, hands, sex, foul smelling diarrhea w/ blood & mucus, flatulence, abd pain |
|
Definition
|
|
Term
MCC diarrhea worldwide, starts 1 wk after ingestion of undercooked poultry, rural water, unpasteurized milk
Fever, severe lower abd pain, diarrhea w/ blood & pus, |
|
Definition
|
|
Term
| affects lungs (rhinitis, hemoptysis, cxr - interstitial lung dz, infiltrates, cavitary nodules) and kidneys (nephritic syndrome - hematuria, oliguria, none-mild proteinuria, edema, HTN) |
|
Definition
| Granulomatosis w/ polyangtis (aka Wegener's granulomatosis) |
|
|
Term
| npehritic syndrome, spares upper resp, serum anti-GBM Abs, CXR - normal or bilat perihilar patchy infiltrates |
|
Definition
| Goodpasture's syndrome - linear deposits (IF) |
|
|
Term
| MC nephrotic syndrome, IgG and C3 at BM, "spike and dome" |
|
Definition
| membranous glomerulonephritis |
|
|
Term
| low serum C3, IgG/C3 granular pattern (lumpy-bumpy) |
|
Definition
|
|
Term
|
Definition
| Staph aureus & strep pyogenes |
|
|
Term
| erythema multiforme - target lesions |
|
Definition
|
|
Term
| UTI in newly sexually active adolescent females, gram-pos, catalase-pos, coagulase-neg, novobiocin-resis coccus, |
|
Definition
Staph saprophyticus - 2nd MCC cystitis after E coli
Tx - quinolones |
|
|
Term
| Gram-pos, catalase-pos, coagulase-neg, novobiocin-sens, coccus, creates biofilms on prosthetic device & valves (bacterial endocarditis), catheters |
|
Definition
|
|
Term
| MCC UTI, Gram neg, traveler's diarrhea, neonate pneumonia |
|
Definition
E coli
Tx - 3rd gen cephalosporin, FQ |
|
|
Term
| Gram-neg, lactose and glucose fermenting, oxidase neg, catalase pos, rod, 3rd cause UTI, leading cause pneumonia in alcoholics/diabetics, thick red sputum |
|
Definition
Klebsiella
Tx - 3rd gen cephalosporin |
|
|
Term
| lesion above medullary pyramid |
|
Definition
lose motor contraol opposite side
ex. R internal capsule lesion - hemiparesis on L side |
|
|
Term
|
Definition
hrs to days - arrythmia (pulseless v tach, v fib --> asystole)
5-10 days - free wall rupture & tamponade, papillary mm & interventricular septum rupture
mon-yrs - aneurysm of ventric scar |
|
|
Term
|
Definition
0-4 h normal
4-12 h hypereosinophilia
12-24 h neutrophilic infiltration, beginning of coag necrosis
2-4 days eextensive NT infiltration, extensive coag necrosis
5 days granulation, macrophages
6-8 wks contracted scar |
|
|
Term
| tremor that worsens w/ movement (intention tremor) or when attempting to hold position for period of time (postural) |
|
Definition
Essential tremor - improves w/ EtOH
Tx - propranolol (nonselective BB) |
|
|
Term
|
Definition
Use - tremor & rigidity of Parkinson's
MOA - Ach-R blockade |
|
|
Term
|
Definition
| INC femoral venous pressure occurs bc of occlusion of pelvic vv & IVC by enlarged uterus. INC venous pressure --> INC hydrostatic pressure --> dependent edema |
|
|
Term
summer/fall, prodrome (fever, chills, NV, HA) followed by encephalitis (seizures, somnolence, obtundation, asymmetrical reflexes, + Babinski, coma)
Nonfatal encephalitis in kids, occurs usually summer/fall |
|
Definition
California enephalitis virus (La Cross virus - Bunyavirus family) - ssRNA, 3 segments, env, capsid
Spread by Aedes mosquitos |
|
|
Term
| Community acquired pneumonia tx |
|
Definition
macrolide (erythromycin)
MOA - motilin agonist (secreted by gastric, intestinal & colonic enterochrommaffin & Mo cells; controls motility during fasting state via MMCs; acts on G-protein R, INC motility stomach/intestings
SE - NVD |
|
|
Term
CNS & GI neutrotransmitter - cause signif intestinal secretion electrolytes (and water), relax intestinal smooth mm & sphincters, inhib gastric acid secretion, dilate peripheral BV
Dz - diarrhea, hypokalemia, low gastric acid, dehydration |
|
Definition
VIPoma
Dx - elev plasma VIP
Tx - fluid & K rep, somatostatin analogs (octreotide, lanreotide); adv - embolization, chemotherapy, radiotherapy, radiofreq ablation |
|
|
Term
|
Definition
degen myenteric plexus (lie bet longitudinal & circular layer esophagus) - can't rel NO = dilates LES
Dx - barium swallow |
|
|
Term
|
Definition
hormone prod by stomach, pituitary, hypothalamus
MOA - stim GH, induce gastric emptying & acid secretion, reg appetite & energy
Prader-Willi have INC ghrelin - fat |
|
|
Term
|
Definition
prod by gastric G cells in response to peptides and aa, stomach distention, vagal stim
Zollinger-Ellison syndrome (gastrinoma) - excess gastric acid, arise in DUODENUM (less likely in pancreas where it's more malig)
Dx - INC gastrin, give IV secretin (normal gastric cells inhib by secretin), tumor localted w/ US or radionuc octreotide scanning
Tx - acid suppression w/ PPI (omeprazole), surg exploration |
|
|
Term
|
Definition
Rifampin - hepatotoxicity* (follow LFTs), orange-red body fluids, MOA - inhib RNA poly (P450 inducer)
INH - peripheral neuropathy (give B6), MOA - inhib mycolic acid syn (P450 inhibitor)
Pyrazinamide - nongouty, arthralgia
Ethambutol - color-blindness, optic neuritis, MOA - obstruct cell wall
Streptomycin - ototoxicity & nephrotoxicity, bind 30S, inhib protein syn |
|
|
Term
|
Definition
Type 1 - bone, tendons, skin, fascia, dentin, cornea, ex Osteogenesis imperfecta - multiple fx after min trauma, blue sclerae, hearing loss, dental imperfection
Type II - cartilage, vitreous body, nuc pulposis, ex achondrogenesis - lethal neonatal disorder (large head, short neck, lung hypoplasia, short limb)
Type III - skin, BV, uterus, fetal, granulation tissue, ex Ehler-Danlos syndrome (EDS) - hyperelastic skin, hypermobile jt, easy bruising, transluscent skin, scoliosis, pes planus, assoc w/ berry aneurysm, MVP, organ rupture, also - Marfan syndrome
Type IV - basement membrane (kidney, lung alveoli, ears, eyes), epidermis basal lamina, ex Goodpasture's (RPGN, pulm dz), Alport's syndomre - hematuria, progressive GN, sensorineural hearing loss, cataracts
Type VII - fibrils at dermoepidermal jxn, ex. dystrophic epidermolysis bullosa (DEB) - blistered skin after minor trauma, mitten-like deformities (infancy) |
|
|
Term
|
Definition
can be d/t chronically elev PTH (secondary to chronic kidney dz)
Tx - low phosphate diet, admin of phosphate binders |
|
|
Term
| episodic digital ischemia -- blanching, cyanosis, rubor of digits |
|
Definition
Raynaud's pnenomenon
Tx - CCB - relax smooth mm, also used for angina, HTN< SVT, hypertrophic cardiomyopathy, migraine
dihydropyridines* (-pine, ex amlodipine)
(Note - non-dihydrophyridine - diltiazem & verapamil) |
|
|
Term
|
Definition
Use - peripheral artery dz, intermittent claudication
MOA - DEC blood viscosity |
|
|
Term
| alpha-galactosidase A defiency, accum ceramide trihexide (esp in cardio), renal failure MCC death |
|
Definition
Frabry dz - X linked recess, cardiac/renal dz, peripheral neuropathy (glove/stocking distrib), angiokeratoma (purple-red skin lesions), DEC vision
Note auto recess: Krabbe, Gaucher, Niemann-Pick, Tay-Sachs |
|
|
Term
| beta-glucocerebrosidase deficiency, accum glucocerebroside, "wrinkled tissue paper" macropahges |
|
Definition
|
|
Term
| galactocerebrosidase deficiency, accum galactocerebroside |
|
Definition
| Krabbe dz (globoid cell leukodystrophy) - auto recess, CNS probs, peripheral neuropathy, globoid cells |
|
|
Term
| hexosaminidase A deficiency |
|
Definition
| Tay-Sachs, accum GM2 gangliosides (esp in neurons), dev delay, progressive neurodegen, lysosomes "onion skinning" |
|
|
Term
|
Definition
Q fever: atypical pneumonia (sometimes hepatitis)
Gram neg intracellular, transmit via inhaled spores or aerosolized animal feces, urine (sheep/cattle), NEG Wil-Felix rxn |
|
|
Term
|
Definition
| intracellular organism, + Weil-Felix rxn, transmit by tick/flea, endemic typhus, flu-like sx, truncal rash spread to rest of body |
|
|
Term
|
Definition
All 3 RTA - hyperchlroemic metabolic acidosis w/ normal anion gap (normal <12)
Type 1 RTA - kidney can't secrete H+ into collecting tubule --> cause INC K excretion into urine --> acidosis; susceptible to Ca urinary stones bc alkaline urine promotes stone formation
Type II - prox tubule can't reabsorb HCO3; caused by multiple myeloma & amyloidosis - INC delivery HCO3 to distal nephron results in INC K secretion
Type IV - MC, ALD deficiency or antag of ALD - disrupt Na reabsorp & K/H secretion in collecting tubule, ex Addison dz - ALD deficiency; unique - hyperkalemia |
|
|
Term
| ACTH-secreting pituitary tumor --> cause adrenal hyperplasia --> INC CORT |
|
Definition
Cushing's dz
Dx - low dexamethasone supp test: 8AM cortisol level >1.8, high dex supp test - DEC CORT by at least 50%
Note: Cushing syndrome - adrenal tumor or ectopic ACTH-prod tumor and doesn't respond to dex supp test, Dx - 24 h urine - INC free CORT, Tx - tumor resection, glucocorticoid rep |
|
|
Term
| Chapman - bet transverse process T7 & T8 on R |
|
Definition
|
|
Term
| Chapman - bet spinous & transverse proess T11 & T12 |
|
Definition
|
|
Term
| Chapman - bet spinous & transverse process T12 & L1 |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Chapman - sup edge transverse process L2 |
|
Definition
|
|
Term
|
Definition
yellow CSF - caused by blood mixed w/ CSF (Hgb broken down into bilirubin = yellow)
Subarachnoid hemorrhage |
|
|
Term
|
Definition
Use - 2nd line Rx dementia, for pts who can't tolerate NV of other dementia Rxs
MOA - block NMDA-R, prevent glutamine-induced neurotoxicity
SE - hallucination |
|
|
Term
|
Definition
Use - 1st line narcolepsy: sleeping difficulty at night, excess daytime sleepiness, cataplexy (loss of mm tone w/ strong emotions)
MOA - block GABA |
|
|
Term
|
Definition
| Haloperidol or pimozide - dopamine (D2)-R blocker |
|
|
Term
Huntington's dz tx
Psych sx (personality changes, mood disorders, cognitive impairment), dementia, chorea
INC dopamine --> DEC GABA inhib in basal ganglia --> DEC Ach = chorea |
|
Definition
Haloperidol - block dopamine-R
VMAT (vesicular monoamine transporter)
Tetrabenazine & reserpine - prevent dopamine rel into synaptic cleft |
|
|
Term
|
Definition
hyptonic, short-term insomnia - sleep initiation, but does not help w/ sleep maintenance
MOA - bind GABA type-A-R
SE - parasomnias (binge eating, walking while aslp) |
|
|
Term
|
Definition
Ach-esterase inhibitor - 1st line Alzheimer's dementia
MOA - DEC Ach metab in synaptic cleft
SE - NV --> dehydration |
|
|
Term
| palpitation, HA, profuse swewaing |
|
Definition
pheochromocytoma
Tx - non-selective alpha block (phenoxybenzamie & phentolamine) |
|
|
Term
|
Definition
block muscarinic-R --> prevent rel IP3, inhib adenylyl cyclase --> anticholinergic effects (mydriasis-dilated pupil, cycloplegia-loss acccomodation, cutaneous vasodilation, bronchodilation, DE salivry, supp thermoreg sweating
Use - Parkinson's, motion sickness, opthalmologic disorders, asthma, COPD, poisoning by muscarinic agonists (organophosphates, mushroom, "nerve gases") |
|
|
Term
| Gram neg, "2 shaped" spirochete, cause flu-like sx + abd pain + photophobia |
|
Definition
Leptospira -- leptospirosis
More severe leptospirosis = Weil's dz (aseptic, ictohemorrhagic): jaundice, azotemia, hemorrhages, anemia, Dx - spinal tap |
|
|
Term
|
Definition
megaloblastic anemia, hypersegmented NT (also d/t folic acid defic)
Eventually have neuro sx, but not present initially
INC serum methymalonic acid (MMA), homocysteine levels, B12 normal/DEC (Note - folic acid has normal MMA, both have INC homocysteine) |
|
|
Term
| Congenital defects by mom using these Rxs |
|
Definition
lithium - Epstein's anomaly - downward displacement tricuspid valve, cyanosis, palpitation, exertional dyspnea, S3/S4 systolic murmur, ECK - R atrial hypertrophy, assoc w/ Wolff-Parksinson-White syndrome
Thalidomide - malformed arms/legs (phocomelia)
Lisinopril - fetal hypoTN, anuria, oligohydramnios, IGR (intrauterine growth restric)
Streptomycin - deafness
Doxycycline - stained teeth, abnorm bone growth |
|
|
Term
| Sleep walking (somnambulism) tx |
|
Definition
tricyclic antidepressant - imipramine, benzodiazepine - clonazepam
MOA - shorten sleep stages 3-4 (when sleep walking occurs)
Use - pts w/ freq episodes, prone to injury
Usually kids 4-10 (but can at any age) |
|
|
Term
|
Definition
Normal:
PR interval <200 msec
QRS complex <120 msec
QT interval - less than half distance bet QRS complex (<420 msec)
Delay in AV node 100 msec |
|
|
Term
|
Definition
1st degree (AV block) - PR interval >200 msec, QRS complex following P wave is diagnostic, asymptomatic, no Tx
Mobitz type 1 (Wenckebach) - PR-int lengthens bet each cardiac cycle until beat dropped, asymptomatic, no Tx
Mobitz type 2 - dropped beats at reg intervals (every other beat), consistent PR interval when QRS follows P wave (2:1, 3:1), can progress to 3rd degree AV block, Tx - pacemaker
3rd degree block (complete heart block), P waves "march along" w/ no meaningful relation to QRS complex, Tx - pacemaker
Note: If 3rd deg block caused by neg chronotropic Rx (BB, digoxin, CCB) - stop Rx, or by infection (Lyme dz - tx infection) |
|
|
Term
| Complication of rapid hyponatrmia correction |
|
Definition
central pontine myelinosis (CPM) - occurs if pt chronically exposed to hyponatremia - loss of osmolytes in brain in order to prevent cerebral edema
Correction can occurs faster than creation of osmolytes --> water pulled out of cells by osmosis --> shrink cells --> demyelination
Risk factors: Na <120, 2+ days, rapid correction (raise Na <10 in 1st 24 h and less than 21 in 1st 48)
Sx - dysarthria, dysphagia, paralysis, coma, seizure, "locked in" syndrome
Note: cerebral edema fr hyponatremia - physiologic adaptation of brain cells to lose osmolytes to limit water that enters it |
|
|
Term
|
Definition
Bipolar I - full blown mania (spending spree, indescretions) +/- depression
Bipolar II - MDD + hypomania
Rapid-cycling bipolar - 4+ episodes MDD, mania, hypomania, mixed w/in 12 mon
Cyclothymic - hypomania + mild depression alternating for at least 2 yrs
Pure mania: 1 wk w/ at least 3 of DIG FAST - distractability, insomnia, grandiosity, flight of ideas, activity INC, sleep deficit/sexual indiscretion, talkativeness |
|
|
Term
| severe vomiting - pyloric stenosis |
|
Definition
hypchloremia, hypokalemia metabolic alkalosis - both HCl and KCl lost fr gastric fluid
Body corrects alkalosis by uptaking H+ and releasing K (via H/K+ exchanger) further contrib to hypokelamia |
|
|
Term
| inactiv transcription WT1 or WT2 on chrom 11 |
|
Definition
| Wilm's tumor - age 2-5, asymptomatic abd mass, fever, hematuria, HTN, incidental finding, can show up as WAGR complex (Wilm's tumor, Aniridia, Genitourinary malformation, mental-motor Retardation) |
|
|
Term
| amplification of N-myc oncogene on chrom 2 |
|
Definition
| neuroblastoma - can present a/ abd mass, irreg shape, firm, crosses midline |
|
|
Term
| translocation of long arm chrom 21 to chrom 14 |
|
Definition
|
|
Term
| overexpression c-kit proto-oncogene on chrom 4 |
|
Definition
| gastrointestinal stromal tumor (GIST) - adult malignancy |
|
|
Term
| inactiv Rb tumor suppressor gene on chrom 13 |
|
Definition
| retinoblastoma - MC childhood intraocular malig, white papillary reflex (leukocoria "absent red reflex") |
|
|
Term
| dimorphic mycoses (cold=mold, heat=yeast), S and central America (esp Brazil), cause pneumonia, granulomatous dz that mimic TB, large circle w/ multiple budding yeast (pilot wheel) |
|
Definition
Paracoccidioides brasinliensis
Tx - Fluconazole, ketokonazole (local), amphotericin B (systemic) |
|
|
Term
|
Definition
tesicular torsion - absent cremasteric reflex
epididymitis - present cremasteric relfex, MCC <35 yo = Chlamydia (Tx - ceftriaxone/doxycycline or azithromycin), >35 yo = E coli |
|
|
Term
| skin "keratin pearls," scaling, indurated, ulcerated nodule on sun-exposed part )arms, back of hands, lower face) |
|
Definition
squamous cell carcinoma
Dx - sheets & islands of neplastic epidermal cells ("keratin pearls"), rarely mets, Tx - resection
Can arise fr actinic keratoses (premalig lesion) or Bowen's dz (squamous cell CA in situ) |
|
|
Term
| appears on sun exposed areas of upper face/head, pearly papule w/ telangiectasia, Bx - darkly staining basaloid cells w/ palisade nuclei at perphery of tumor cell |
|
Definition
|
|
Term
| benign prolif immature keratinocytes, hyperpigmented lesion, warty "stuck-on" look, histo - papillomatous epi prolif of basaloid cells containing horn cysts |
|
Definition
|
|
Term
| pre-malig (can progress to SCC), atypical epidermal keratinocytes, rough scaly papule, histo - hyperkeratosis, parakeratosis |
|
Definition
|
|
Term
|
Definition
Tetracycline - SE: photosensitivity, abnorm bone & teeth
Use - SIADH
MOA - ADH antag, block ADH V2-R in distal tubule --> DEC reabsorp of free water into blood, kidneys excrete more dilute urine (hypernatremia w/ very dilute urine) |
|
|
Term
|
Definition
Use - ashtma, Addison's dz (DEC GC prod bc damaged adrenals; adrenal crisis - hypoTN, hyperK, metabolic acidosis bc loss ALD)
MOA - inhib phopholipase A --> prod leukotrienes & PGs
SE - Cushing's syndrome |
|
|
Term
| Gram neg, facultative anaerobic, cause cellititis or osteomyelitis, bites fr cats/dogs, osteomyelitis: systemic (fever, chills, lethargy, irritability), localized (pain, edema, erythema, DEC ROM) |
|
Definition
Pasteurella multocida
Tx - amoxicillin & clavulanate |
|
|
Term
| bony enlargement DIP and PIP jt, brief am stiffness, xray - narrow jt space, osteophyte formation & bone cysts |
|
Definition
|
|
Term
| painless chancre, swollen inguinal LN, single, open lesion on penis |
|
Definition
Treponoma pallidum - syphillis
primary stage - painless chancre, enlarged LN
2ndary stage - maculopapular rash (soles/palms/trunk), contagious
Tertiary - yrs to decades later - granulomas ("gummas") thruout body, neuro & aortic sx
Tx - penicillin G - block cross-linking of peptidoglycans in cell wall |
|
|
Term
| block protein syn at 30S subunit ribosome |
|
Definition
| aminoglycoside, tetracycline |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| sulfonamides, trimethoprim |
|
|
Term
|
Definition
CHF, nephrotic syndrome, thromboembolism, cirrhosis
INC serum hydrostatic pressure (CHF), DEC serum oncotic presure (nephrotic syndrome, cirrhosis) |
|
|
Term
|
Definition
| cloudy, high protein, LDH |
|
|
Term
| Renal bx - crescents (parietal cells & leukocytes) within glomeruli, |
|
Definition
Rapidly progressive GN (RPGN) - progressive decline of renal fxn over days-mons
Type 1 - anti-GBM Abs (Goodpasture's), Tx - plasmapheresis, steroids
Type 2 - post-infectious glomerulonephritis, lupus nephritis, IgA nephropathy
Type III - Wegener dz or microscopic polyangiitis (pauci-immune)
Other Tx - steroids, cytotoxic agents |
|
|
Term
| mesangial & endothelial cell prolif, thickened capillary walls, splitting of GBM ("tram-track") |
|
Definition
| membranoproliferative glomerulonephritis (MPGN) |
|
|
Term
| sclerosis of some glomeruli, INC matrix, hyalinosis along capillary wall - HIV, heroin, sickle cell |
|
Definition
| Focal segmental glomerulosclerosis |
|
|
Term
| immune complex deposits subepi of BM, diffuse thickening of glomerular cap wall |
|
Definition
|
|
Term
Norepinephrine
(tyrosine --> L dopa --> dopamine --> norepi --> epi); degraded by monoamine oxidase (results in VMA which is secreted in urine, Dx renal NE-prod pheochromocytoma) |
|
Definition
NT & hormone
fight/flight, alertness, attention, learning
INC heart contractility (beta-1), BP (alpha-1), glucose rel (beta-3), smooth mm contraction (alpha-1) |
|
|
Term
|
Definition
glutamate --> GABA (catalyzed by glutamate decarboxylase, req B6, learning/memory)
tryptophan --> serotonin (prod by tryptophan hydroxylase, can metab to melatonin)
Tyrosine --> L dopa (thru tyrosine hydroxylase), Tx Parkinson's |
|
|
Term
| painless, gradual progressive visual field loss, optic nn changes ie atrophy & optic disk cupping, INC ICP |
|
Definition
open-angle glaucoma
Tx - timolol - nonselective beta antag
Note: close-angle glaucoma - painful, d/t obstruction of aqueous flow |
|
|
Term
|
Definition
ganglion-blocking drugs - hexamethonium, pentolinium, mecamylamine & trimethaphan
MOA - inhib postgang transmission, block all autonomic outflow, DEC secretion of all bodily fluids, orthostatic hypoTN, impotence, visual disturb |
|
|
Term
|
Definition
| phenothiazines (-zine, chlorpromazine, thioridazine, trifluoperazine), & butyrophenones (haloperidol, droperidol - antipsychotics) |
|
|
Term
|
Definition
anthracotic pigment - Coal Worker's pneumoconiosis (anthracosis in high pop cities, coal workers)
brown dumbbell-shaped rods in macrophages - asbestosis
hyphae & yeast - aspergillus, bastomyces, histoplasma, coccidiodes
Caseating granuloma - TB
Noncaseating granuloma - sarcoidosis (bilat hilar LAD) |
|
|
Term
|
Definition
| 2 NRTI (zidovudine* - bone marrow suppression, anemia) + NNRT (efavirenz) or protease inhib (-avir) |
|
|
Term
|
Definition
ADH antag (-vaptans)
Use - SIADH
MOA - block V2 ADH-R in collecting tubule, DEC ADH's effect |
|
|
Term
|
Definition
| loop diuretic - inhib Na/K/2Cl transporter in thick asc loop of Henle |
|
|
Term
|
Definition
thiazide diuretic
MOA - DEC reabsorp NaCl in distal convoluted tubule, inhib transporter |
|
|
Term
| necrotizing arteritis of medium vessels, affects skin, CV, renal/mesenteric, nervous sys; livedo reticularis, subcut nodules, digital gangrene, ulcer, HTN, abd pain w/ meals (mesenteric ischemia) |
|
Definition
Polyarteritis nodosa
Check hep B serology
Dx - Bx, mesenteric angiography |
|
|
Term
|
Definition
Inhib renal excretion of amoxicillin & other PCNs
INC uric acid excretion in gout pts |
|
|
Term
| osteomyelitis risk factors |
|
Definition
diabetes, open fractures, IVDA
S/S - edema, warmth, tenderness to palpation, late presentation, DEC ROM, INC ESR
MCC - S aureus - Gram pos coccus, catalase & coagulase pos
MCC in DM, foot wounds - Pseudomonas - gram neg bacilli
MCC in sickle cell pts - Salmonella - Gram neg bacillus, non-lactose fermenting |
|
|
Term
| Body dysmorphic disorder tx |
|
Definition
| cognitive behavior therapy (CBT) + SSRI |
|
|
Term
| malathion & parathion poisoning |
|
Definition
organophosphate poisoning
MOA - inhib AchE --> DUMBBELSS
Tx - atropine |
|
|
Term
| inhib fusion proteins in terminal membrane |
|
Definition
botulinum toxin
Normally - Ach rel occurs when voltage channels open, result in Ca influx --> fusion of vesicles containing Ach w/ surface membrane --> Ach rel into synaptic cleft |
|
|
Term
| inhib binding Ach to neuromusc end plate-R |
|
Definition
neuromusc blocker - tubocurarine & -ium (pancuronium, vecuronium, pipecuronium, atracurium)
Use - mm relaxant, adjunct w/ anesthesia, intubation |
|
|
Term
|
Definition
Cimetidine, ranitidine, famotidine, nizatidine
MOA - bind to gastric parietal cells --> inhib histamine induced rel of acid
Use - duodenal/gastric ulcer, GERD, prevent stress ulcers
SE - gynecomastia (also omeprazole), impotence |
|
|
Term
|
Definition
anti-flatulence
MOA - coat gas bubbles & cause them to collapse |
|
|
Term
|
Definition
antacid - also magnesium hydroxide (think motility), aluminum hydroxide
MOA - neutralize stomach acid by prod water fr HCl
Chronic consump + drink milk --> milk-alkali syndrome (hyperCa, met alkalosis, renal insufficiency) |
|
|
Term
|
Definition
differ immune-mediated hemolysis fr non-immune mediated
(+) Coombs = autoimmune hemolytic anemia (AHA) - idiopathic, 2ndary to dz
Smear - spherocytes, fragmented RBCs |
|
|
Term
|
Definition
-pam & -lam: diazepam, lorazepam, clonazepam, midazolam
Use - sedative, hypnotic, anxiolytic, anticonvulsant, mm relaxant
MOA - enhance GABA, depress CNS
Tx - Flumazenil - competitive benzo-R antag, binds GABA-R but doesn't activ them, DEC benzo POTENCY |
|
|
Term
| painful, slow-healing genital ulcer, gray-yellowish, hard (indurated) irreg borders, tender inguinal adenopathy |
|
Definition
Chancroid - Haemophilus ducreyi, chocolate agar, "school of fish"
Tx - azithromycin or ceftriaxone (low yield) |
|
|
Term
| fluid filled collection in popliteal fossa, can rupture causing pain, calf swelling, erythema; occurs in rhem arthritis, osteoarthritis, meniscal tear |
|
Definition
Baker cyst
Tx - aspirate cyst, conservative |
|
|
Term
|
Definition
innev latissimus dorsi - ADduction, int rot arm
Clinical - injured during mastectomy, also long thoracic nn (paralysis serratus ant --> winged scapula) |
|
|
Term
|
Definition
injured in femur, pelvic fractures, hip dislocation, trauma to butt/thigh
Motor innerv to hamstrings, all mm below knee; sensory to post/lat leg, sole of foot |
|
|
Term
|
Definition
| young males, inflamm arthritis affect spine, sacroiliac jt (back pain radiates to thigh), fusion "bamboo spine", assoc w/ HLA-B27, FamHx of ankylosing spondylitis, psoriasis, reactive arthritis, IBD |
|
|
Term
|
Definition
aka Reiter's syndrome - conjunctivitis, urethritis, arthritis (can't see, pee, climb tree)
Presents after chlamydia or enteric infxn |
|
|
Term
|
Definition
| migratory, leads to tenosynovitis (pain, swelling, difficulty moving jt), pustules over palms/soles |
|
|
Term
| De Quervain's tenosynovitis |
|
Definition
thicken tendons of ABductor pollicis longus & extensor pollicis brevis fr acute/repetitive trauma
Wrist pain on radial side
+ Finkelstein test - flexion of thumb across palm & ulnar deviation of wrist --> sharp pain
Day-care workers due to rep lifting of infants |
|
|
Term
congenital rx defect
1) cleft lip/palate
2) flipper-like hands
3) spinal defects
4) Epstein's anomaly
5) microcephaly, smooth filthrum, cardiac septal defect, small palpebral fissure, midfacial hypoplasia, micropthalmia |
|
Definition
1) diazepam
2) thalidomide
3) valproic acid
4) lithium
5) FAS |
|
|
Term
| Non-lactose fermenters = form white colonies on MacConkey's agar |
|
Definition
Salmonella, Shigella, Proteus, Pseudomonas
(vs E coli, Enterobacter, Klebsiella = pink colonies) |
|
|
Term
| Gram neg, lactose(-), flagellar motility, transmit by contaminated food or fecal-oral routes |
|
Definition
|
|
Term
| BLACK - fly, skin, and sight (blindness): subcutaneous nodules, hyperpig saggy skin, river blindness, transmit by blackflies (Africa, S & Central America) |
|
Definition
Onchocerca volvulus - nematode, live in skin/eyes
Tx - Ivermectin |
|
|
Term
| vit defic - blindness (affect retina), DEC immune response, growth retard, dry skin, hair, broken fingernails, repro (spontaneous abortion) |
|
Definition
|
|
Term
| older females, Hep C, 4 P's: pruritic, purple, polygonal, papules |
|
Definition
Lichen planus
Tx - Corticosteroids |
|
|
Term
| >65, low back pain radiates to butt/thighs, worse w/ standing & walking, improve w/ lumbar flexion & sitting (INC space in lumbar spinal canal) |
|
Definition
| spinal stenosis ("pseudoclaudication") |
|
|
Term
| back pain worse w/ flexion & sitting & relieved w/ standing |
|
Definition
| thoracic/lumbar disc herniation |
|
|
Term
| nucleus solitarius (solitary nucleus) |
|
Definition
| sensory fr CN VII, IX, X = taste |
|
|
Term
|
Definition
| motor neurons fr CN IX, XI = innerv upper esophagus, pharynx, larynx, uvula |
|
|
Term
|
Definition
| CN X autonomic nn for parasym innerv of viscera: GI tract, lungs, heart |
|
|
Term
|
Definition
| motor nucleus in midbrain - coordinate arm/shoulder movements |
|
|
Term
|
Definition
| located in medulla, connected to & aids in cerebellar motor learning |
|
|
Term
| hypertriglyceridemia, INC chylomicrons - altered ApoC2 or lipoprotein lipase defic |
|
Definition
| Type 1 Familial hyperlipidemia; kids - xanthomas, abd colic |
|
|
Term
|
Definition
| Type IIa (familial hypercholesterolemia), MC, tendon xanthomas, xanthelesma, corneal arcus |
|
|
Term
| INC LDL, VLDL - defective ApoB100 |
|
Definition
| Type IIb (familial hypercholesterolemia) |
|
|
Term
| INC TRIG (200-500) & IDL - defective ApoE2 |
|
Definition
| Type III (familial dysbetalipoproteinemia) |
|
|
Term
| INC VLDL leads to INC TRIG (high TRIG assoc w/ pancreatitis) |
|
Definition
| Type IV (familial triglyceridemia) |
|
|
Term
| INC VLDL, chylomicrons, TRIG - defective lipase or ApoC2 (like type I) |
|
Definition
| Type V (familial hyperlipoproteinemia) |
|
|
Term
| disc herniation C7-T1 (C8 nn root) |
|
Definition
| weakness handgrip, numbness, little finger & medial forearm |
|
|
Term
| disc herniation C6-7 (C7 nn root) |
|
Definition
| weakness/numbness middle finger, elbow extensor mm, DEC triceps reflex |
|
|
Term
|
Definition
| DEC biceps reflex, numbness lateral elbow |
|
|
Term
|
Definition
| weakness finger ABductors (also in C8 impingment) |
|
|
Term
|
Definition
| numbness lateral forearm, numbness thumb, wrist extensor weakness, DEC brachioradialis reflex |
|
|
Term
| test to assess if another MI occured |
|
Definition
| CK-MB - appears 4-6 h after Sx onset, peak at 24 h, normal in 3 days |
|
|
Term
|
Definition
INC viscosity (ex erythrocytosis - INC H&H fr EPO doping) --> INC peripheral vasc
Hct - INC coagulability & peripheral thrombi can occlude small arteries/arterioles |
|
|
Term
| difficulty breastfeeding after delivery (DEC PRL), amenorrhea wks-mon after delivery (d/t DEC LH, FSH), hypothyroidism sx (DEC TSH) |
|
Definition
| Sheehan syndrome - necrosis ant pituitary after delivery d/t massive hemorrhage during delivery, can lead to hypoTN & shock |
|
|
Term
| Glucose-6-phosphatase deficiency |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| post column & dorsal root damage secondary to tertiary syphillis, prorprioception impairment, loss DTR, unsteady gait, formication, Argyll Robertson pupils |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| ankylosing spondylitis, psoriasis, reactive arthritis, IBD |
|
|
Term
|
Definition
| postcoital spotting (after sex), vague abd pain, bleeding, watery discharge, spread to pelvic side walls, ureteral compression --> hydronephrosis |
|
|
Term
|
Definition
reflective of loss of red cell membrane surface area & cellular dehydration
Dx - hereditary spherocytosis - mut spectrin, ankyrin, paladin - defected membrane --> spherical, less deformable
Test - osmotic fragility test; can be acquired thru G6PD defic |
|
|
Term
| mid age F, fatigue, pruritiy, RUQ pain, jaundice, hepatomegaly, hypercholesterolemia (xanthomata & xanthelasmata), INC IgM, ESR, alk phosphatase, GGT, antimitochondrial Abs* (hallmark) |
|
Definition
| Primary biliary cirrhosis |
|
|
Term
|
Definition
cromolyn sodium
MOA - stabilizes mast cell membrane fr getting sensitized, inhib rel of inflamm compounds
Use - allergic rhinitis, conjunctivitis |
|
|
Term
| begins w/ "herald patch" - larger than patches that arise after, clear centrally, slight pruritis, trunk; precede general eruption by 1-2 wks, "christmas tree" look |
|
Definition
pityriasis rosea
Dx - KOH (to r/o tinea corporis)
Tx - none
Note - tinea corporus similar, but involves exposed skin area |
|
|
Term
| affects kids, hypopigmented patches esp after sun exposure |
|
Definition
Pityriasis alba
differ fr tinea versicolor by KOH prep |
|
|
Term
| necrotizing erythema, DM, wt loss, glossitis, stomatitis, cheilitis, DEC aa (by gluconeogenesis fr aa), INC glucagon |
|
Definition
Glucagonoma - arise in pancreatic alpha cells
Dx - US/CT
Tx - symptomatic - octreotide, surg vs chemo
Note: beta cells - insulin, delta - somatostatin |
|
|
Term
| common cold: nasal discharge, sneezing, congesetion |
|
Definition
| Rhinovirus (picornavirus family) - non-env, ss, linear, icosahedral, transmit via resp inhalation, occur fall (Aug-Oct) & spring (Mar-May) |
|
|
Term
| pneumonia in kids <.5, wheezing, labored breathing |
|
Definition
RSV - neg, ssRNA
Tx - Ribavarin (pneumonia) |
|
|
Term
| high fever, myalgia, not assoc w/ nasal discharge |
|
Definition
Influenza - genetic drift/shift, hemagglutin (viral entry), neuraminidase (release) virulence
Elderly, kdis, immunodeficient at risk for secondary pneumonial bacterial superinfection
Tx w/in 48 hrs - oseltamavir, zanamivir neuramindase-inhibitors |
|
|
Term
|
Definition
Coronavirus - env, +ssRNA, helical
Also responsible for SARS |
|
|
Term
| murmur that INC w/ valsalva & standing |
|
Definition
hypertrophic cardiomyopathy (hypertrophy of interventric septum) - systolic murmur at L sternal border that INC w/ valsalva/standing
Squatting DEC murmur
MVP |
|
|
Term
|
Definition
struvite (triple phosphate) - can grow large, block ureter; urine alkaline by urease bacteria (proteus), making phosphate stones more likely to develop
Tx - nephrolithotomy |
|
|
Term
| calcium oxalate or calcium pyrophosphate stone |
|
Definition
| MC kidney stone - assoc w/ primary hyperparathyroidism (due to hypercalciurea), renal tubular acidosis |
|
|
Term
|
Definition
| radioluscent (can't see on xray), byproduct fr breakdown of nucleic acids; pt has metabolic disorder, on chemo rxs, or obese |
|
|
Term
|
Definition
| pt has hereditary defect in metab of 4 aa: cystine, ornithine, lysine, arginine; fail to transport across prox convoluted tubule --> urine rich in cysteine, precipitate to stones |
|
|
Term
| autoimmune, excess colalgen depsoit thruout body, esp skin, GI tract, lungs, kidneys, sclerodactyly, ANA Abs (sensitive), anti-centromere ab (specific for CREST syndrome, a variant of scleroderma, better prog), anti-DNA topoisomerase I ab (anti-Scl ab - most specific) |
|
Definition
| Scleroderma - skin atrophy, hair loss, telangiectasia, tight facial features, absence wrinkles, sclerodactyly (taut, shiny skin), Raynauds |
|
|
Term
|
Definition
Colon CA: colonoscopy x 10 yrs, sigmoidoscopy x 5 yrs, or
fecal occult yrly start at 50 yo
mammogram x 2 yrs start at 50
cervical CA at 21
osteoporosis (DEXA scan) start at 65
pneumococcal vaccine |
|
|
Term
|
Definition
pepsin - protein (stomach)
enterokinase - intestinal brush border enzyme, activ proteolytic enzymes by pancreas & SI
Trypsin, elastase - secreted by pancreas, intestinal protein digestion |
|
|
Term
| rare myeloproliferative disorder, unexplained hyperprolif megakaryocytes in bone marrow causing thrombocytosis, 1/2 pts have JAK2 tyrosine kinase mut |
|
Definition
Essential thrombocytosis
Dx of exclusioon (r/o CML & polycythemia vera)
Tx - low-dose aspirin |
|
|
Term
|
Definition
DMARD
Use - RA, slow progression
SE - skin rash, stomatitis, cholestatic jaundice (lead to gen pruritis), nephrotoxicity, bone marrow suppression |
|
|
Term
| nephrogenic diabetes insipidus - DEC ability of collecting tubules to respond to vasopressin, hypernatremia, hyperosmolar serum, hypoosmolar urine |
|
Definition
| lithium, demecycline, methoxyflurane |
|
|
Term
| multiple spots on lips, oral mucosa, GI mucosa, <100 GI hamartomatous polyps in small bowel, prone to obstruction/intussusception |
|
Definition
| Peutz-Jegher's - risk of colorectal, testicular, uterine, cervical, ovarian & breast CA |
|
|
Term
| premature ovarian failure risk factors |
|
Definition
| Turner, Fragile X, chemo, pelvic radiation, chemotherapy, autoimmune |
|
|
Term
|
Definition
platinum-based alkylating agent
Use - solid tumors (breast, lungs, GI, head, neck, GU sys)
MOA - prevent DNA syn, excreted thru kidney
SE - nephrotoxicity, neurotoxicity (esp peripheral neuropathy & tinnitis/high freq hearing loss), myeolosuppression |
|
|
Term
|
Definition
Use - CML
MOA - interfere w/ DNA rep & transcription of RNA
SE - myelosuppression, pulm fibrosis, hemorrhagic cystitis |
|
|
Term
|
Definition
chemo agent (vinca alkaloid)
MOA - block formation of microtubules (tubulin)
SE - glove-and-stocking neuropathy, reversible |
|
|
Term
|
Definition
antineoplastic
MOA - inhib topoisomerase II (like anthracycline), damage DNA
SE - alopecia, GI distress, myelossupression |
|
|
Term
|
Definition
chemo agent
MOA - prevent disasssembly of microtubules (similar to arresting cell in mitosis)
Use - mets ovarian, breast, lung, GU, head & neck CA
SE - peripheral neuropathy |
|
|
Term
|
Definition
anti-thyroid peroxidase (anti-TPO) & anti-thyroglobulin abs - Hashimoto's thyroiditis
anti-TSH-R Ab - Grave's dz
anti-glutamic acid decarboxylase Ab - T1DM |
|
|
Term
| Primary resp mechanism (PRM) |
|
Definition
Inherent motion of brain/spinal cord
Fluctuation of CSF
Mobility of intracranial & intraspinal membrane
Articular mobility of cranial bones
Involuntary mobility of sacrum bet ilia |
|
|
Term
| hypertensive emergency tx |
|
Definition
sodium nitroprusside
MOA - rel NO fr endothelium --> relax arteriole & veins
SE - cerebral hypoperfusion, brain ischemia |
|
|
Term
| hyponatremia, hyperpigmentation, hyperkalemia + adrenal insufficiency sx |
|
Definition
| hyperpig fr hypothalamus secreting CRH in order to INC ACTH --> melanin |
|
|
Term
|
Definition
| PPI + amoxicillin + clarithromycin +/- bismuth subsalicylate (black stool) |
|
|
Term
|
Definition
bind ergosterol - amphotericin B, nystatin
inhib ergosterol syn - fluconazole, itraconazole, voriconazole |
|
|
Term
| inhib glucan syn in fungal cell wall |
|
Definition
|
|
Term
| inhib squalene epoxidase & synthesis of lanosterol precurosr (DEC lanosterol/ergosterol) in fungal cell membrane |
|
Definition
Terbinafine, naftifine
Use - superficial fungal infection d/t dermatophyte, ie onychomycosis (fungal nail), tinea capitis |
|
|
Term
| converts to fluorouracil in fungal cells --> inhib protein syn & cell growth |
|
Definition
|
|
Term
| fatigue, weakness, mucosal bleeding, IgM hypersecretion --> hyperviscosity syndrome, bone marrow bx - 10% lymphoid & plasmacytoid cells, no lytic lesions, not assoc w/ renal failure (vs MM), has rouleaux formation, IgM spike & Bence-Jones proteinuria |
|
Definition
| Waldenstrom's macroglobinemia - prolif showing plasmacytoid or plasma cell differentiation, viscosity --> HA, visual, deafness, vertigo, engored retinal vv, hemorrhage, papilledema, splneomegaly |
|
|
Term
|
Definition
| mm weakness, INC reflex, knife-clasp spasticity (passively flex/extend results in resistance), INC mm tone, spastic paralysis, + Babinski |
|
|
Term
| most sensitive stage of fetal development |
|
Definition
| weeks 3-8 "embryonic period" when embryo at highest risk of dev teratogenic dfect |
|
|
Term
| tx for toxicity of folic acid antag: methotrexate (chemo), trimethoprim (abx), pyrimethamine (antiprotozoal) |
|
Definition
| leucovorin - reverses neg effects of MTX bc of its inhib of dihydrofolate reducatase |
|
|
Term
|
Definition
| give to pts taking cyclophosphamide or ifosfamide to prevent hemorrhagic cystitis (breakdown product acrolein cause bladder toxicity bc mesna inactiv acrolein) |
|
|
Term
|
Definition
| propranolol - nonselective BB |
|
|
Term
|
Definition
Furosimide (sulfonamide) - loop diuretic
MOA - Na/K/2Cl transporter in loop of Henle
If have sulfa allergy --> use ethacrynic acid (same MOA) |
|
|
Term
| chronic renal failure complications |
|
Definition
| HTN, CAD, CHF, disturbed mineral metab & acid/base homeostasis, uremia --> pericarditis, encephalopathy, peripheral neuropathy |
|
|
Term
| large, encapsulated brownish helminthic eggs in stool, INC IgE & eosinophilia |
|
Definition
Ascaris lumbricoides (nematode - giant roundworm) - MC helminth in world (2nd MC in US after Enterobius)
Can cause: pneumonitis - when larvae reach lungs get dyspnea, wheezing, chest pain & GI blockage - NV, jaundice, abd pain, distention
Tx - bendazole or pyrantel pamoate
Life cycle - eggs ingested, rel larvae go into GI mucosa, travel thru blood to lungs, coughed up and swallowed |
|
|
Term
| eyes - affected by helminth |
|
Definition
Onchocerca volvulus - black flies, river blindness, hyperpig skin
Loa loa - flies, lives under skin & conjunctiva |
|
|
Term
| skin - affected by helminth |
|
Definition
| Ancylostoma duodenale, Strongyloides stercoralis, Loa Loa, Schistosoma |
|
|
Term
| urinary tract - affected by helminth |
|
Definition
| Schistosoma - penetrates thru skin, cause inflamm of spleen, liver, urinary tract & cause bladder squamous cell CA |
|
|
Term
| brain - affected by helminth |
|
Definition
| Taenia solium - cysticercosis, undercooked pork, brain mass lesions |
|
|
Term
| dysphagia + Fe defic anemia |
|
Definition
|
|
Term
| Rx SE - metallic taste, disulfiram-like rxn (make sure pt avoids EtOH), dark urine |
|
Definition
metronidazole
Use - trichomoniasis, pseudomembranonus oclitis, amebiasis, giardiasis, H pylori, Gadnerella vaginosis |
|
|
Term
| Tx aspergillus, bastomyces, coccidioides, cryptococcus, candida, histoplasma |
|
Definition
|
|
Term
| congenital infxn - hydrocephaly, chorioretinitis, intracranial calcif (esp basal ganglia), mom ate raw meat, exposed to cat feces |
|
Definition
Toxoplasmosis
Tx - pyramethamine & sulfadiazine |
|
|
Term
| INC ALD fr adrenals, suppressed renin, HTN, hyperNa, hypoK+ |
|
Definition
| Conn syndrome - HA, high BP |
|
|
Term
| benign, cystic childhood tumor in cerebellum*, hypothalanys, optic chiasm, INC ICP, GFAP + astrocytes w/ Rosenthal fibers (thick, elongated eosinophilic 'worm-like' fibers) |
|
Definition
|
|
Term
| benign, firm, resectable brain tumor arise fr arachnoid layer of meninges, MCC primary benign brain tumor, doesn't invade brain, Sx are result of mass effect; seizures, focal dysfxn, change in mental status |
|
Definition
meningioma
Histo - whorls, spindle cells, psamomma bodies (laminated calfic)
assoc w/ NF2 |
|
|
Term
| malig cerebellar tumor of early childhood that commpresses 4th ventricle cause hydrocephalus |
|
Definition
Medulloblastoma - radiosensitive
Histo - Homer-Wright rosettes (spoke-wheel halo of cells surrounding central ball-like structure filled w/ fibers) |
|
|
Term
| adult-age tumor, frontal lobes, slow growing, long-standing seizures |
|
Definition
Oligodendrogliomas
Histo - chicken wire blood vessels, "fried-egg" look w/ calcif (round cells w/ demarcated borders & dense nuc surrounded by clear cytoplasm) |
|
|
Term
| adult-age, resectable tumor, occur on acoustic nn, hearing loss, tinnitis |
|
Definition
Schwannomas
Histo - S-100 stain, palisading spindle cells, Verocay bodies, bilat acoustic neuromas found in NF2 |
|
|
Term
| mature cystic teratoma (dermoid cysts) |
|
Definition
MC benign ovarian tumor, 2-3 germ cell layers
Dx - US: calcif w/in smooth-walled, round cystic mass; can have struma ovarii* benign, made of thyroid tissue --> thyroid hormone --> hyperthyroidism |
|
|
Term
| ovarian tumor of epithelial origin |
|
Definition
Serous cystadenocarinoma - 50% ovarian CA, bilat, papillary projections, psammoma bodies
Mucinous cystadenocarcinoma - mucus-secreting, can cause pseudomyxoma peritonei (rupture/mets; mucin in peritoneum)
Clear cell tumor (rare endometroid) - resembles endometrium
All epi ovarian malig can have INC CA-125 |
|
|
Term
| benign ovarian tumor of epi origin |
|
Definition
Serous cystadenoma - cystic tumor lined by fallopian tube looking epi
Mucinous cystadenoma - multilocular cysts lined by columnar epi, secrete mucin
Brenner tumor - rare, resembles bladder transitional epi, surrounded by fibrous stroma |
|
|
Term
| malig ovarian tumor of sex cord-stromal origin |
|
Definition
Thecoma - lipid containing cells + fibroblasts, estrogen secreting
Fibroma - spindle-shaped fibroblasts, assoc w/ Meigs syndrome (triad of ovarian fibroma, ascites, hydrothorax)
Granulosa-theca cell tumor - estrogen-secreting --> endometrial hyperplasia, precocious puberty, Call-Exner bodies (small follicles w/ eosinophilic secretion)** hallmark
Sertoli-Leydig cell tumor - secrete testot, virilizing sx (hirsutism, deep voice) |
|
|
Term
| malignant tumor of GI origin |
|
Definition
| Kruckenberg tumor - mets tumor to ovary fr GI, breast, lung, signet ring cells** |
|
|
Term
| normal P waves followed by QRS complex, prolonged PR interval (>0.2 sec or 5 small boxes) = atrial depol to ventric depol |
|
Definition
First degree AV block - healthy pts, athletes
Asymptomatic, no Tx |
|
|
Term
|
Definition
Use - acute MI, acute ischemic stroke, PE
MOA - conversion of plasminogen to plasmin
Note: do non-contrast CT to r/o hemorrhagic stroke |
|
|
Term
| Direct thrombin inhib - lepirudin, bivalirudin, argatroban, dabigatran |
|
Definition
MOA - direct inhibition of thrombin (converts fibrinogen to fibrin - glue that holds clot together)
Use - disrupt thrombin after alrdy bound to clot |
|
|
Term
|
Definition
| MOA - inhib vit K epoxide reductase; vit K antag (clotting factors II, VII, IX, X, protein C & S) |
|
|
Term
|
Definition
| MOA - activ antithrombin III --> irreversibly inhib thrombin (factor IIa) & Xa --> prevent further clot, INC speed which antithrombin III degrades |
|
|
Term
| "eye worm," painfun subcutaneous nodules (skin) |
|
Definition
Loa loa - nematode in Africa, India, transmit by flies (deer, horse, mango)
Tx - diethylcarbamazine |
|
|
Term
|
Definition
Bendazoles (Mebendazole) - intestinal nematodes (Enterobius, Ascaris)
Diethycarbamazine - tissue-infecting nematodes (Loa loa)
Praziquantel - cestodes & trematodes |
|
|
Term
| lymphocytes of mantle zone of germinal follicles; 11:14 translocation, fever, nigh sweats, ALD, HSM, GI upset |
|
Definition
| mantle cell lymphoma - malig, overprod cyclin D |
|
|
Term
|
Definition
metolazone, chlorthalidone, indapamide, -thiazide
MOA - inhib Na-Cl transporter in distal convoluted tubule
Use - HTN< edema by HF & nephrotic syndrome
SE: hyperGLUC (glycemia, lipidemia, uricemia, calcemia) --> gout, high blood sugar |
|
|
Term
|
Definition
eplerenone, spironolactone, amiloride, triamterene
Use - HTN, hyperALD, hypoK, liver dz w/ edema, ascities, severe HF
SE - hyperK, hyperCl met acidosis, gynecomastia, kidney stones |
|
|
Term
|
Definition
Aliskiren
Use - essential HTN
MOA - inhib conversion of angiotensinogen to ang I |
|
|
Term
|
Definition
short-acting, IV selective dopamine-1 (D1) R agonist
use - postop HTN, hypertensive crisis |
|
|
Term
|
Definition
L main V1-6, I, aVL
LAD V1-2 = septal, V3-4 = ant, V1-4 = anteroseptal, V5-6 = apical
LCx I, aVL
RCA/PAD = II, III, aVF |
|
|
Term
| inhib transfer of RNA binding to bacterial ribosome |
|
Definition
doxycycline, other tetracyclines
prevent protein syn (30S subunit)
7 day course doxy - chlamydial urethritis |
|
|
Term
| inhib bacterial DNA gyrase |
|
Definition
FQ (cipro)
DNA gyraise - type of topoisomerase - enables separation of chromosomes during mitosis |
|
|
Term
| inhib bacterial folate syn & reduction |
|
Definition
TMP-SMX
Use - UTI, bacterial prostatitis, granuloma inguinale (donovanosis), TMP (folate syn) - SMX (reduction) |
|
|
Term
|
Definition
facial flushing, telangiectasia, papular lesion, rhinophyma* (soft tissue & sebaceous hyperplasia, large red nose)
Exacerbated by EtOH, spicy food, heat
Tx - metronidazole gel, oral tetracycline |
|
|
Term
|
Definition
| rosacea (inflamm pilo-sebaceous unit & BV of face) + comedomes |
|
|
Term
| Auerbach's (myenteric) plexus |
|
Definition
lies bet longitudinal & circular smooth mm = gastric motility
Assoc w/ achalasia |
|
|
Term
| submucosal (Meissner's) plexus |
|
Definition
| innerv intestinal glandular epi, endocrine cells, submucosal BV = GI secretions |
|
|
Term
| 30s, hot flashes, vag dryness, DEC estrogen, INC FSH/LH |
|
Definition
Premature ovarian failure (POF) - atresia of ovarian follicles of F during repro age
Risks - autoimmune dz, pelvic radiation, gonadal dysgenesis (Turner syndrome) |
|
|
Term
| Obligate anerobes - GI tract |
|
Definition
| Clostridium, bacteroides, peptostreptococcus, actinomyces |
|
|
Term
| <3 yo, seal bark, hoarseness, afebrile, inspiratory stridor, AP xray of neck - tapering of trachea ("steeple sign") |
|
Definition
parainfluenza virus - Croup, winter
Tx - humidified air, epinephrine, steroids, O2 |
|
|
Term
| "hot-potato" voice, inspiratory stridor, "thumb-print" sign on lat xray of neck |
|
Definition
| H influenza - epiglotittis |
|
|
Term
| MCC subacute bacterial endocarditis (SBE) |
|
Definition
Streptococcus sanguis - Gram +, alpha hemolytic, optochin-resis (takes months)
Note: acute bacterial endocarditis - S aureus (days/wks) |
|
|
Term
| alpha-hemolytic, optochin resis streptococcus |
|
Definition
| S pneumo - meningitis, otitis media, pneumonia, sinusitis |
|
|
Term
| beta-hemolytic, bacitracin-sensitive streptococcus |
|
Definition
| S pyogenes - pharyngitis, cellulitis, scarlet fever, toxic shock-like syndrome, rheumatic fever, glomerulonephritis |
|
|
Term
| beta-hemolytic, bacitracin-resis streptococcus |
|
Definition
| S agalactiae - pneumonia, meningitis, sepsis (babies) |
|
|
Term
| catalase-positive, coagulase positive staphylococcus |
|
Definition
| S aureus - acute bacterial endocarditis |
|
|
Term
| HA, palsies of cranial nn that pass thru cavernous sinus (III, IV, V1, V2, VI), present after manipulation of skin lesion (ie furuncle on face) |
|
Definition
| cavernous venous thrombosis |
|
|
Term
| Typical (1st gen) anti-psychotics |
|
Definition
Fluphenazine - hyperPRL (menses irreg, galactorrhea, sexual dysfxn)
... & Haloperidol - neuroleptic malignant syndrome
Thioridazine - retinal hyperpig
Chlorpromazine - Tx hiccups/singulutus
Typical SE - EPS (akathasia, acute dystonia, tardive dyskinesia, parkinsonism
antag D2 receptors |
|
|
Term
| Atypical (2nd gen) anti-psychotics |
|
Definition
Olanzapine - wt gain, hyperlipidemia, T2DM
Clozapine - agranulocytosis (monitor blood counts)
Quetiapine - cataracts, sedation
Ziprasidone - QT prolongation --> torsades de pointes; Tx - magnesium |
|
|
Term
|
Definition
| smoking (MC), radiation, aniline dyes, artificial sweeteners, cyclophosphamide, working w/ rubber, leather, textiles, paint products |
|
|
Term
|
Definition
non-nucleoside Rx
MOA - inhib viral DNA polymerase & syn
Use - CMV retinitis, esp if resis to ganciclovir and cidofovir
SE - renal toxicity (hypoK, hypoMg, albuminuria, renal failure) |
|
|
Term
|
Definition
nevirapine (non-nucleoside reverse transcriptase inhibitor - HIV)
atazanavir, ritonavir, lopinavir (HIV protease inhibitors) |
|
|
Term
|
Definition
| didanosine, stavudine (nucleoside reverse transcriptase inhibitors), also peirpheral neuropathy |
|
|
Term
|
Definition
| ribavirin (Tx RSV in infants, hep C) |
|
|
Term
|
Definition
| atazanavir, ritonavir, lopinavir (HIV protease inhibitors) - insulin resis --> DM |
|
|
Term
| red/purple plaques or nodules on skin or mucosal surface, HIV + |
|
Definition
|
|
Term
| white oral lesions that can't be rubbed off |
|
Definition
|
|
Term
| HIV+/diabetes/obese, oral plaque that can be rubbed off |
|
Definition
candidiasis
Dx - KOH wet prep - pseudohyphae/budding yeast
Tx - nystatin (or clotrimazole) swish or lozenges |
|
|
Term
|
Definition
CN III - eye movement (sup, medial, inf rectus, inf oblique); damage - ptosis, pupillary dilation, loss of accommodation, "down & out"
CN IV - trochlear - sup oblique; damage - vertical double vision, worse when looking medially & down (reading, walking down steps)
CN VI - lat rectus; damage - horizontal diplopia, medially devated eye |
|
|
Term
|
Definition
oxymetazoline, pseudoephedrine, phenylphrine - vasoconstriction
If used >3 days --> rebound congestion & rhinitis medicamentosa (Rx-induced rhinitis) |
|
|
Term
|
Definition
intranasal histamine-1 R antag
Use - 1st line tx for rhinitis
MOA - block H1-R, DEC sneezing, itching, rhinorrhea |
|
|
Term
|
Definition
| CN III palsy - "down & out" eye, ptosis, pupillary dilation |
|
|
Term
| berry aneurysm in ant communicating aa (males), jxn of internal carotid w/ post communicating aa (females) |
|
Definition
SAH - worst HA of life
Assoc w/ Marfan's, Ehler's Danlos, ADPKD, Osler-Weber-Rendu
Risk factors - HTN, age (50s), smoking, Black |
|
|
Term
| Post inf communicating aa occlusion (cerebellum) |
|
Definition
| Wallenberg syndrome - loss pain & temp (contralat), ipsi side of face, nystagmus, vertigo, ipsi dysphagia, ataxia, Horner syndrome |
|
|
Term
| ant cerebral aa occlusion |
|
Definition
asymptomatic d/t collateral circulation
Supplies leg/ft of motor/sensory cortex in medial aspect frontal lobes |
|
|
Term
| gram-neg dipplococci w/ many bacteria inside PMNs |
|
Definition
| gonococcal - Pili = virulence factor for asc infxn (urethritis, cerviciis, PID, epidydimitis, prostatitis, arthritis) |
|
|
Term
| protease virulence - cleaves IgA molecules (inactiv Abs) |
|
Definition
| Neisseria, S pneumo, H flu (3 MC to cause URI where IgA protease is useful) |
|
|
Term
| hyaluronidase virulence - eat thru connective tissue (hyaluronic acid) |
|
Definition
| Gram + rods: Grp A beta hemolytic strep, staph, C perfringens cause necrotizing fasciitis, cellulitis, gas gangrene (respectively) |
|
|
Term
|
Definition
CSF - oligoclonal bands on electrophoresis
MRI - brain lesions of periventricular white matter
optic neuritis & peripheral nn affected |
|
|
Term
|
Definition
C6 - thumb
C7 - middle finger
C8 - 5th digit
T4 - nipple
T7 - xiphoid
T10 - umbilicus
L1 - inguinal ligament
L4 - knee cap
S2-4 - penile, anus |
|
|
Term
| auto dom form of inherited CA of breast & colon, soft-tissue & bone sarcomas, brain tumors, leukemia, adrenocortical CA |
|
Definition
| Li-Fraumeni Syndrome - defect in p53 tumor suppressor gene, chrom 17 |
|
|
Term
| mut APC gene (chrom 5), auto dom |
|
Definition
FAP - 1000s large intestine adenomatous polyps, early onset colon CA, 20-30s, wt loss, rectal bleeding
Tx - prophylactic colectomy
2 variants:
Gardner's syndrome - FAP colon CA + skin, soft tissue/bone tumors (osteoma, thyroid CA, fibroma, sebaceous cyst)
Turcot's syndrome - FAP + brain tumor |
|
|
Term
| jaundice, palmar erythema, caput medusae, INC serum aminotransferases, PT, DEC albumin |
|
Definition
cirrhosis - micronodular cirrhosis - fibrous scar tissue & regen nodules, MCC EtOH
Note: macronodular cirrhosis - viral hepatitis |
|
|
Term
|
Definition
| inf frontal gyrus, stroke MCA, non-fluent expressive aphasia, intact comprehension, "Broke speech" |
|
|
Term
|
Definition
| sup temporal gyrus - fluent, receptive aphasia, no comprehension, nonsense speech |
|
|
Term
|
Definition
| connects Broca's & Wernicke's - speech/comprehension intact, can't repeat words = conduction aphasia |
|
|
Term
|
Definition
competitive blockade of muscarinic (Ach)-R
Use - COPD, control asthma exacerbation |
|
|
Term
|
Definition
Use - asthma
MOA - DEC IgE by binding to these Abs |
|
|
Term
|
Definition
undercooked pork meat (pork roundworm)
worms lay eggs in submucosa (thus no ova in stool), larvae travel in blood (eosinophilia), grow in mm --> myositis, myalgia, periorbital edema, urticaria
Sx - NV, abd pain,
Tx - "-bendazoles" |
|
|
Term
|
Definition
pinworm
intestinal nematode (MC helminth in US)
Anal pruritis ("scotch tape test")
Eggs survive outside body, transmit fecal/oral via surfaces, clothing, bedding |
|
|
Term
|
Definition
infects CNS (also eyes & heart)
Tx - praziquantel or -bendazoles |
|
|
Term
|
Definition
cestode, tapeworm
megaloblastic anemia (B12 defic)
Dx - proglottids or eggs in stool
Tx - praziquantel |
|
|
Term
|
Definition
intestinal nematode (MC helminth worldwide)
Pneumonitis, GI tract/biliary blockage
Dx - large, brown ova in stool
Tx - bendazole, pyrantel pamoate |
|
|
Term
|
Definition
free nn endings - pain/temp in skin/visceral organs
Meissner's corpuscles - light pressure, fine touch, hairless skin (fingers/lips), adapt quickly
Pacinian corpuscles - vibration/pressure, deep in skin, ligaments, jts
Merckel cells - shapes/textures, hair follicles, slow adapting
*Cell bodies of all lie in dorsal root/trigeminal ganglia |
|
|
Term
|
Definition
vicarious liability - being liable for someone else's action
conservatorship - person control finances of incompetent person
deterrence - punishment after crime is done
non-maleficence "do no harm" |
|
|
Term
|
Definition
intracellular R - steroid hormones
cAMP - FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, calcitonin, glucagon
cGMP - ANP, NO
IP3 - GnRH, GHRH, oxytocin, ADH (V1), TRH
Tyrosine kinase (transmembrane) - insulin, IGF-1, fibroblast growth factor (FGF), PDGF, PRL, GH |
|
|
Term
|
Definition
painless bleeding >20 wks gestation
Dx - transabd US |
|
|
Term
| ant knee pain, boys 10-15, repetitive running/jumping, swelling/painful of tibial tubercle (apophysitis) |
|
Definition
| Osgood-Schlatter dz - stress leads to inflamm & excess bone growth |
|
|
Term
Penile carcinoma in situ
Dx - Bx |
|
Definition
Bowen's dz - single, erythematous, skin-colored or pigmented lesion on penis shaft or scrotum, ncircumcised men, can progress to squamous cell CA
Erythroplasia of Queyrat - glans penis or prepuce
Bowenoid papulosis - multiple wart-like, resemble condyloma acuminatum (genital warts), younger, assoc w/ HPV 16, doesn't progress to invasive CA |
|
|
Term
| Tourette tx (motor + vocal tic, ex facial grimacing, head jerking, repeats words, mimics gesture) |
|
Definition
1st line tx - Fluphenazine, haloperidol (typical antipsychotic)
Assoc w/ ADHD, OCD< learning disorder, conduct disorder |
|
|
Term
| Trypanosomiasis (sleeping sickness) |
|
Definition
Trypanosoma, Tsetse fly, sub-Saharan Africa
Sx - enlarged post LN, urticaria, recurring fever, somnolence, irritability, coma, death
Dx - found in blood/tissue
Tx - suramin, melarsoprol |
|
|
Term
|
Definition
pneumatic dilation - TOC*
Other relief: botulin toxin (temp), myotomy (high risk), less effective - CCB, anticholinergics, opiods, nitrates |
|
|
Term
|
Definition
stim B-3-R - lipolysis (breakdown of fat), no GI sx, receptors on adipose/skeletal
inhib pancreatic lipase - orlistat, prevent preakdown of FA fr intestine, SE - steatorrhea |
|
|
Term
| stim opioid-R (morphine, heroin, hydromorphone, codeine) |
|
Definition
| DEC GI motility --> constipation |
|
|
Term
| activ cannabinoid-R (THC or marijuana, dronabinol) |
|
Definition
| INC hunger, wt gain - good for anorexia, CA, AIDS |
|
|
Term
|
Definition
transmit by mosquito (Anopheles) --> type I hypersensitivity --> elephantitis
Tx - diethylcarbamazine |
|
|
Term
|
Definition
| Rotor syndrome & Dubin-Johnson syndrome (conjugated hyperbilirubinemia) - urobilinogen formed fr breakdown of conjuated bilirubin); no jaundice or pruritis |
|
|
Term
|
Definition
usually asymptomatic
Lab - conjugated hyperbilirubinemia, INC total & direct bilirubin, normal urinary coproporphyrin, coproporphyrin I makes up >80% (Rotor is <70%)
Can't see gallbladder on oral cholecystography (can see in Rotor syndrome), black liver (no color change in Rotor), no Tx |
|
|
Term
| colonic adenomatous polyps (adenomas) |
|
Definition
tubular, tubulovillous - smaller, less malig risk
villous - larger, sessile, INC malig risk |
|
|
Term
|
Definition
schizophreniform - 1-6 mon, at least 2 of: delusions, hallucination, disorg speech, catatonic behavior & neg sx (flat affect, alogia, avolition)
Schizoid personality - introversion, detachment
Schizotypal personality - magical thoughts, illusions, superstition
Schizophrenia - sx > 6 mon |
|
|
Term
|
Definition
transmit thru IV drugs (dev countries), transfusions
can lead to cirrhosis, hepatocellular CA
ALT > AST, ELISA or PCR
Tx - interferon alpha & ribavirin |
|
|
Term
|
Definition
activ Cl ion channels --> hyperpol of nematode mm, paralysis & death
Note: Pyrantel - depol of nematode mm |
|
|
Term
|
Definition
inhib PG syn fr arachidonic acid --> vasoconstriction & INC parasite susceptibility to host immune defense
Use - extra-intestinal nematode: filariasis d/t Loa loa, Wuchereria, Brugia |
|
|
Term
|
Definition
| represents probability that type I error made |
|
|
Term
|
Definition
CA 19-9 - pancreatic (Dx/staging/Tx response)
CA 125 - OVCA
S-100 - melanoma skin CA
PSA - prostate CA
hCG - trophoblastic tumors, ie molar preg, OVCA, testicular (non-seminoma) |
|
|
Term
|
Definition
migratory superficial thrombophlebitis
assoc w/ pancreatic CA, lung CA
manifests as thrombosis of superficial vv |
|
|
Term
| hoarse cry, hypotonia, poor feeding, umbilical hernia, large fontanelle, macroglossia, dev delay |
|
Definition
iodine deficiency
Dx - DEC T3, T4, INC TSH
Tx - levothyroxine, dietary iodine supp |
|
|
Term
| short stature >2.5 std dev below mean height |
|
Definition
Congenital GH defic (sporadic/inherited)
High pitch voice, INC fat, micropenis, hypoglycemia (d/t unnopposed insulin)
Dx - GH stim testing, assess bone age (DEC), DEC IGF
Tx - GH rep |
|
|
Term
|
Definition
| calcium, struvite, cystine |
|
|
Term
| radioluscent kidney stones |
|
Definition
|
|
Term
|
Definition
defective absorp of neutral aa (tryptophan --> syn niacin) in renal prox tubules & GI tract
*Niacin (B3) defic --> pellagra-like sx: ataxia, dementia, diarrhea, red tongue, dermatitis (eczematous rash) |
|
|
Term
| vit defic in infants - hypotonia, lethargy, rash around ears |
|
Definition
biotin (B7) defic
Adults - neuropsych (depression, hallucinations, paresthesia, nausea, anorexia, rash on face/ext) |
|
|
Term
| vit defic - angular stomatitis, cheilosis, color changes in tongue |
|
Definition
|
|
Term
| BUN:Cre ratio >20:1, urine Na <20 mEq/L, FENa <1%, urine osmolality >500 mOsm/kg, hyaline casts |
|
Definition
prerenal acute renal failure
Etio: vol depletion, CHF, liver failure, sepsis, anti-HTN rxs, renal artery stenosis
Tx - stop offending agent, IV fluid, diuresis, monitor electrolytes |
|
|
Term
| granular casts (muddy brown casts), renal tubular casts |
|
Definition
|
|
Term
| nephritic glomerulonephropathy that presents DAYS after URI or GI infection, hematuria, low grade proteinuria, RBC casts |
|
Definition
|
|
Term
| non-anion, gap, hyperchloremic metabolic acidosis |
|
Definition
|
|
Term
theca-lutein cysts - cell hypertrophy, vasc, lipid accum
Sx - pelvic heaviness |
|
Definition
| stim by elev gonadotropin levels, seen in hydatidiform molar pregnancies (uterus larger than expected gestational age, hyperemesis gravidum), choriocarcinoma, exogenous use of gonadotropins (seen in intrauterine insemination or oocyte retrieval for in-vitro fertilization) |
|
|
Term
|
Definition
imipramine, clomipramie, amitriptyline
MOA - inhib serotonin, norepi transporters (reuptake at presynaptic neuron); inhib H1, serotonin, alpha-1, Ach-R
SE: AV conduction delays --> widening QRS complex
3 C's: coma, cardiotoxicity, convulsions; tachycardia, dry mucous membrane
Use - enuresis (bedwetting), depression |
|
|
Term
|
Definition
antidepressant (w/insomnia), anti-anxiety, anti-psychotic
MOA - inhib 5-HT2A (serotonin)-R in brain cortex
SE: priapism (prolonged, painful erection) |
|
|
Term
| alpha-1 antitrypsin defic |
|
Definition
auto recess, low level protease inhibitor
pulm emphysema - destruct of alveoli by uninhibited protease activity
Liver dz - accum of abnormally folded ATT protein in hepatocytes |
|
|
Term
|
Definition
| hyrdalazine (SE - drug-induced lupus, others: INH, phenytoin, procainamide, Dx - anti-histone Abs; reflex tachycardia) & methyldopa |
|
|
Term
| Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia |
|
Definition
CREST syndrome (limited form of scleroderma) - limited skin: face, neck & ext, better prog
Most specific test: anti-centromere Abs
Nnote: anti-SCL 70 Abs (anti-topoisomerase abs) - diffuse form scleroderma, involves all skin (including trunk), rapid onset, poor prog - affects cardiopulm & GI |
|
|
Term
| deletion of DPC tumor suppressor gene |
|
Definition
| pancreatic cancer ("deleted in pancreatic CA") |
|
|
Term
| deletion of p16 tumor suppressor gene |
|
Definition
|
|
Term
| autoimmune disorder, inflamm of muscles (myalgia) & skin (malar rash, Gottron's papules - pink over knuckles & interphalangeal jts, heliotrope rash - purple colored eye, aka "shawl & face"), positive ANA & anti-Jo1 Abs |
|
Definition
|
|
Term
| IgG abs attack hemidesomosomes of skin, create fluid-filled bullae bet epidermis & dermis, on arms, legs, abd |
|
Definition
|
|
Term
| deficiencies in B cells, T cells, IgA, ataxia, spider angioma |
|
Definition
|
|
Term
| zolpidem, zaleplon, zopiclone |
|
Definition
nonbenzo hypnotics
SE: "Z's" - parasonmnias, strange sleep behaviors (binge eating, walking, phone calls, don't remember) |
|
|
Term
|
Definition
glomerulosa (outer) - ALD, Conn's syndrome (HTN, hyperNa, hypoK, metabolic alkalosis, DEC renin-primary hyperALD, but INC in 2ndary hyperALD
fasciculata - CORT, Cushing's
reticularis - DHEA-S, testot, 5-DHT, virilization of females (hirsitism, etc), precious puberty, adv bone age
medulla - catecholamines (epi/norepi); paroxysmal HTN, tachycardia, diaphoresis, HA, tremor, INC urinary catecholamines |
|
|
Term
|
Definition
| multiple rib fractures break off & detach fr rest of thorax, rib cage collapse instead of expanding out |
|
|
Term
|
Definition
| tender at transverse processes of L4/5 and at iliac crests = lumbosacral SD |
|
|
Term
| sacrospinous ligament (accessory pelvic ligaments) |
|
Definition
| divides greater & lesser sciatic ligaments |
|
|
Term
| neuroleptic malignant syndrome (AMS, mm rigidity, fever d/t haloperidol or fluphenazine) Tx |
|
Definition
Dantrolene - mm relaxant
MOA - lock Ca ryanodine-R, interfere w/ Ca rel fr sarcoplasmic retic |
|
|
Term
|
Definition
ectopic ("stuck") endometrial glands in myometrium, >40, menorrhagia (MC) & dysmenorrhea, boggy, soft, enlarged uterus
Dx - transvag US/MRI
Tx - hysterectomy (if symptomatic) |
|
|
Term
| focal nodular hyperplasia |
|
Definition
| common benign, liver tumor, women of repro age, asymptomatic, RUQ pain, "central scar" on US/CT, do not grow rapid |
|
|
Term
|
Definition
| MC benign liver tumor, assoc w/ pregnancy, estrogen rep, oral contraception, US - hyperechoic mass |
|
|
Term
| Chapman - bet 5th & 6th ribs |
|
Definition
|
|
Term
| Chapman - bet 6th & 7th rib |
|
Definition
|
|
Term
| Chapman - 1" lat to umbillicus & 2" cephalad |
|
Definition
|
|
Term
|
Definition
T5-9 (foregut): celiac
T10-11 (midgut + appendix): sup mesenteric
T12-L2 (hindgut): inf mesenteric |
|
|
Term
| primary adrenal insufficiency (Addison's dz) |
|
Definition
| autoimmune lymphocytic destruction of adrenals, DEC CORT (GC), and ALD (MC), hyperpigmentation (POMC cleaves to form ACTH-INC & melanocyte stim hormone-MSH); dark skin not found in secondary adrenal insufficiency |
|
|
Term
| MEN type 1 (Wermer's syndrome) |
|
Definition
auto dom
3 P's: paratyroid, pancreatic islet cells, pituitary --> hyperparathyroidism, prolactinoma, acromegaly, gastrinoma (Zollinger-Ellison), insulinoma |
|
|
Term
| prevent disassembly of microtubules |
|
Definition
paclitaxel & docetaxel (taxanes)
MOA - arrest cell mitosis
Use - mets ovarian, breast, lung, GU, head & neck CA, Kaposi's sarcoma
SE - neutropenia, neuropathy |
|
|
Term
| ifosfamide, cyclophosphamide |
|
Definition
SE - hemorrhagic cystitis*
Give Mesna (mercaptoethanosulfate) to prevent complication, binds to acrolein which causes bladder SE |
|
|
Term
|
Definition
| psych disorder - infants, repeated regurg & rechewing of food x 1 mon, prev normal fxn |
|
|
Term
| non-obstructive gastric emptying disorder, caused by gastroesophageal dz, neuromusc, trauma, endocrinopathies (poorly controlled DM - autonomic neuropathy), NV, belching, bloating, discomfort after meals |
|
Definition
gastroparesis
Dx - nutritional supp, metoclopramide (prokinetic), control DM |
|
|
Term
| deficient insuliln secretion fr pancreatic beta cells assoc w/ amylin deposit & fibrosis |
|
Definition
|
|
Term
| stenosing flexor tenosynovitis (trigger finger) |
|
Definition
flexor tendon has swelling/nodule, prevents fr sliding normally thru "pulleys" at metacarpophalangeal jt
Sx - pain, snapping/clicking when ext/flexing finger
Cause - wear/tear of tendon, infection, rep trauma, DM, RA |
|
|
Term
|
Definition
lung:
small cell cA - ADH/ACTH --> Lambert Eaton syndrome
squamous cell CA - PTHrP --> hyperCa
carcinoid - serotonin --> flushing/diarrhea |
|
|
Term
|
Definition
Small cell* - small round blue cells
Squamous cell* - keratin pearls, intercellular bridges
Large cell - pleomorphic giant cells w/ leukocyt fragments
Mesothelioma - Psammoma bodies
Adenocarcinoma - Type II pneumocytes |
|
|
Term
| rolled ankle sprain - can't dorsiflex foot |
|
Definition
| Dx: post fibular head, ant talus (can't dorsiflex bc need to go post) |
|
|
Term
|
Definition
Type 1 - ant talofibular lig (ATFL)
Type 2 - ATFL + fibulocalcaneal ligament
Type 3 - above + post talofibular lig (injury in that order)
Type 1-3 - inversion & supination sprains |
|
|
Term
| toxic epidermal necrolysis |
|
Definition
| drug-induced, pruritis, blisters, involve mucosa, + Nikolsky sign |
|
|
Term
|
Definition
made in nucleus accumbens (pleasure/fear) fr glutamate by glutamate decarboxylase, req vit B6!
DEC GABA in anxiety & Huntington's, role in mm tone
GABA-R agonists - alcohol, benzos, barbituates
Note: DEC serotonin in anxiety |
|
|
Term
|
Definition
| reward-pleasure behavior, schizoprenia & psychosis (INC), Parkinson's (DEC), depression (DEC), ADHD (DEC), recreational & ADHD drugs (INC) |
|
|
Term
|
Definition
| CBT + venlafaxine, buspirone, SSRI |
|
|
Term
|
Definition
glipizide, glyburide
MOA - INC endogenous insulin secretion (not useful for T1DM)
SE - hypoglycemia & wt gain |
|
|
Term
|
Definition
pioglitazone, rosiglitazone
MOA - INC peripheral insulin sensitivity
SE - edema, wt gain, hepatotoxicity |
|
|
Term
| alpha-glucosidase inhibitors |
|
Definition
miglitol, acarbose
MOA - DEC intestinal absorp CHO
SE - flatulence, abd pain |
|
|
Term
|
Definition
MOA DEC hepatic glucose prod (sweating, seizure, LOC, visual disturb, confusion), INC peripheral sensitivity to insulin
SE - metallic taste, GI (indigestion, abd cramp, bloating, diarrhea, lactic acidosis* - esp in renal failure) |
|
|
Term
|
Definition
Clonorchis sinesis ("Chinese liver fluke) - Korea, China, Taiwan, Vietnam, undercooked freshwater fish - obstruct biliary duct --> cholangiocarcinoma*
Tx - praziquntel
Fasciola hepatica ("sheep liver fluke") - sheep/cattle, raw watercress
Tx - triclabendazole |
|
|
Term
|
Definition
| lung fluke, SE Asia & Japan, undercooked pickled crab/crayfish |
|
|
Term
|
Definition
| blood fluke, Far East, snails (host), penetrate skin |
|
|
Term
|
Definition
| Africa, Middle East, cystitis, urethritis, hematuria, bladder CA |
|
|
Term
| Lyme dz (by Borrelia burgdorferi secondary to Ixodes tick bite) Tx |
|
Definition
8+ yo doxycycline
<8 yo amoxicillin
Erythema migrans, Bell's palsy, meningitis, arthralgia, carditis |
|
|
Term
|
Definition
| sinus tracts discharge sulfur granules |
|
|
Term
| LMN lesion - sudden assymetrical mm weakness - flaccid paralysis, fasciculations, DEC/absent DTR |
|
Definition
poliomyelitis - CSF - INC leukocytes, protein
Prevention - vaccine |
|
|
Term
| unsteady gait, absent DTR knee/ankle, loss of proprioception, Argyll Robertson pupils |
|
Definition
|
|
Term
| IPSI hemiparesis, loss of proprioception & vibration, contral loss pain/temp, flaccid paralysis |
|
Definition
|
|
Term
| sup oblique mm (CN IV) - eye lesion |
|
Definition
| vertical diplopia while reading or walking down stairs |
|
|
Term
| heat rash, hot, humid climate, small papules/pustules similar to folliculitis, affects covered areas of skin, stinging sensation |
|
Definition
|
|
Term
|
Definition
Use - Dx/Tx paroxysmal SVT (ex atrial flutter)
MOA - slow conduction thru AV node, interupt AV reentry pathway by inducing hyperpol via INC K efflux
SE - flushing, hypoTN, chest pain, lightheadedness, diaphoresis, nausea, ventricular asystole, bronchospasm, sense of "impending doom," metallic taste |
|
|
Term
| Class I antiarrhythmic (Na channel blockers) |
|
Definition
Class Ia - quinidine, procainamide, disopyramide
MOA - moderate DEC phase 0 slope, lengthen AP, prolong repol
Class Ib - lidocaine, mexiletine, phenytoin - small DEC in phase 0, shorten AP & repol
Class Ic - flecainide, propafenone - marked DEC phase 0 slope, no effect on AP, lil effect on repol |
|
|
Term
| Class II antiarrhythmic (beta blockers) |
|
Definition
Propranolol, esmolol, metoprolol, atenolol, timolol
MOA - DEC sympathetic activity of heart, DEC slope phase 4
Use - SVT (by DEC conduction thru AV node) |
|
|
Term
| Class III antiarrhythmic (K channel blockers) |
|
Definition
Sotalol, ibutilide, bretylium, dofetilide, amiodarone, dronedarone
MOA - prolong repol (delay phase 3), INC AP duration & refractory pd
Use - re-entrant arrhythmias |
|
|
Term
| Class IV antiarrhythmics (Ca channel blockers) |
|
Definition
Verapamil, diltiazem
MOA - DEC conduction velocity by inhib Ca influx (esp AV node), shorten plateau (phase 2) of AP, DEC contractility
Use - HTN, angina
Contraindicated in heart failure |
|
|
Term
|
Definition
head of pancreas
adv - painful jaundice
early stage - painless jaundice* hallmark
Risk factors - smoking, FMhx, chronic pancreatitis, DM
+ Courvoisier's sign (non-tender, palpable GB) & + Trousseau's sign (migratory superficial thrombophlebitis) |
|
|
Term
|
Definition
dopamine-R agonist
Use - microadenoma, DEC PRL secretion & shrink adenoma b4 surg |
|
|
Term
|
Definition
Muscarinic-R antag
Use - Parkinson's - DEC tremor & rigidity
SE - sedation, mydriasis, urinary retention, dry mouth |
|
|
Term
| defect in bilirubin storage --> conjug hyperbilirubinemia, oral cholecystography shows normal gallbladder, INC urine coproporphyrin |
|
Definition
|
|
Term
|
Definition
Eosinophils - helminthic, tumors, asthma, allergies, collagen vasc dz
NT - initial response to acute infxn - bacteria, spirochetes, viruses, post op burns, DKA, neoplasms
Monocytes (precursor to macrophages) - chronic inflamm (TB, syphillis, autoimmune), malig (leukemias)
Macrophages - localized inflamm lesions
Basophils - allergic, contain heparin, histamine, leukotrienes; viral, asthma, chronic dermatitis, lymphomas |
|
|
Term
| miletone: roll fr prone to supine position, sit w/out support, transfer objects fr hand to hand, raking grasp, respond to name, babble, stranger anxiety |
|
Definition
|
|
Term
| renal artery stenosis, young females, new onset HTN, epigastric bruit |
|
Definition
Fibromuscular dysplasia
Dx - magnetic resonance angiogram - beaded appearance
INC renin |
|
|
Term
| superior facet of thoracic vertebrae orientation |
|
Definition
post, sup, lateral
Note: same in lumbar
Inf facet of thoracic - post, inf, medial |
|
|
Term
| Thyroid fxn in normal prego |
|
Definition
INC TIBG --> INC Total and bound T3 & T3
DEC TSH
Free thyroxine unchanged |
|
|
Term
|
Definition
strike tuning fork and place on mastoid, when can no longer hear --> move to auditory meatus
Norma - air conducted sound should be louder than bone conduction
Normal test = (+)
Abnormal test = (-) conductive hearing loss (bone > air conduction) |
|
|
Term
|
Definition
Follows Rinne test
Tuning fork placed at midline
Normal - pt will hear tuning fork equal loudness
Unilat conductive hearing loss --> hear tuning fork loudest in AFFECTED ear |
|
|
Term
| Sensorineural hearing loss |
|
Definition
Air > bone conduction w/ Rinne test
Weber test - sound localized toward GOOD ear |
|
|
Term
|
Definition
Use - MRSA
SE - hypoTN, flushing, erythematous rash (red man or red neck syndrome), bitter taste, ototoxicity, nephrotoxicitic |
|
|
Term
|
Definition
| Hepatic encephalopathy in kids after given aspirin, infiltration of hepatocytes w/ fat droplets |
|
|
Term
|
Definition
| giant gastric hypertrophy, INC risk gastric adenoCA |
|
|
Term
|
Definition
| CATCH-22: cardiac (TOF or truncus arteriosus), Abnormal facies (low set ears, short philtrum, micrognathia), THymic aplasia (T cell defic - infxns), Cleft palate, Hypoparathyroidism + HypoCa (tetany, convulsions), chrom 22 del |
|
|
Term
|
Definition
P malariae = chloroquine
P vivax/ovale = chloroquine + primaquine (tx dormant liver schizonts)
P falciparum = chloroquine or quinine + doxycycline or mefloquine (if resis) = medical emergency bc attack RBCs & block vasc |
|
|
Term
|
Definition
levoscoliosis - apex on L
dextroscloliosis - apex on R
mild <20 deg, moderate 20-45, severe >45
Mild/mod tx - OMT, bracing
Severe - surg |
|
|
Term
|
Definition
Phase I - addition of fxn'l grp in order to inactivate it & make more ready for excretion, ex reduction, oxidation, hydrolysis
Phase II - conjugation rxns, add polar substrate (acetate, glucoronic acid, sulfate) --> more easily elim by kidney |
|
|
Term
| Partial seizures - occur one part of brain |
|
Definition
Simple partial - abnorm memory, auditory, visual, tactile or psychic sensation, but intact consciousness
Complex partial - DEC consciousness, repetitive motor automatism
Both preceded by aura, can progress to secondarily generalized tonic-clonic seizure
Tx - any anticonvulsant, EXCEPT benzo or ethosuximide |
|
|
Term
| secondarily generalized tonic clonic seizure |
|
Definition
| begin as CPS or SPS, but progress to tonic-clonic seizure w/ stiffness + clonic jerks |
|
|
Term
|
Definition
drops to floor, no jerking, no loss of bowel
Tx - valproic acid, lamotrigine, topiramate |
|
|
Term
|
Definition
subtype of gen seizures, alternation bet stiffness & jerking of body
Tx - phenytoin or carbamazepine |
|
|
Term
| slow growing, well-circumscribed, mobile, painless, small subcutaneous mass |
|
Definition
Lipoma - MC soft tissue neoplasm, benign tumor of adipocytes
Histo - univacuolated adipocytes
Tx - resection |
|
|
Term
| multiple small painful nodules on forearm, prolif of capillary sized vessels mixed w/ mature adipose tissue |
|
Definition
|
|
Term
| dome-shaped lesion, painful swelling, numbness, enlargement of varicose vv, DEC ROM bc of tumor size, wt loss, fatigue |
|
Definition
liposarcoma - malig tumor of fat
histo - multivacuolated lipoblasts w/ scalloped nuclear membrane |
|
|
Term
| well-differentiated large cells that resemble striated mm cell |
|
Definition
| rhabdomyoma - benign, rare, neck mass, hoarseness, difficulty breathing/swallowing, cardiac, SOB |
|
|
Term
| small, round blue-cells that stain + for myoglobin |
|
Definition
| rhabdomyosarcoma - MC soft tissue malg sarcoma in kids, expanding mass, stan + for mm markers actin & desmin |
|
|
Term
|
Definition
CN III, IV, VI - can't adduct, abduct, intort, depress eye
CN V1, V2 - ophthalmic & maxillary sensation |
|
|
Term
|
Definition
HMG-CoA reductase inhibitor
MOA - DEC LDL (esp CAD - DEC oxidative stress, INC atherosclerotic plaques)
SE - myopathy (mm pain, INC CK), hepatic dysfxn |
|
|
Term
|
Definition
fibric acid derivative - bezafibrate, ciprofibrate, gemfibrozil
MOA - DEC TRIG, VLDL, LDL
SE - rash, GI sx; avoid in hepatic/renal/biliary tract dz |
|
|
Term
|
Definition
aka nicotinic acid (B3)
MOA - DEC VLDL, LDL, INC HDL*; inhib lipolysis in adipose
SE - cutaneous vasodilation, warm sensation, gout, acanthosis nigricans, Tx - aspirin/ibuprofen |
|
|
Term
| cholestyramine, colestipol, colesevelam |
|
Definition
bile acid-binding resin
Use - only for isolated INC LDL
MOA - bind bile acids, prevent reabsorption, INC conversion of cholesterol to bile acids in liver
SE - constipation, bloating |
|
|
Term
|
Definition
intestinal sterol absorption inhibitor
MOA - DEC LDL |
|
|
Term
|
Definition
| vascular dementia - banorm reflex, gait, carotid bruit, fundoscopic abnorm |
|
|
Term
| alpha-synuclein inclusions |
|
Definition
| aka Lewy bodies - Lewy body dementia - Parkinsonism, prob executing, paying attn, gradual memory loss, visual hallucination |
|
|
Term
|
Definition
alzheimers dementia
Pick's dz - frontotemporal dementia - aphasia, Parkinsonian features & personality changes |
|
|
Term
| (chronic) inhaled oral steroid use SE |
|
Definition
| oral candidiasis, cough, burning, unpleasant taste, nasal congestion, hoarseness, allergic rxn |
|
|
Term
| opiate withdrawal in newborn (morphine, codeine, heroin) |
|
Definition
high-pitched cry, convulsions, irritability, tachypnea, sweating, diarrhea, vomitting
Presents 48-72 h after birth |
|
|
Term
| onset of DM before 25 yo in non-obese pts w/ + famHx in auto dom inheritance pattern |
|
Definition
| maturity onset diabetes of the young (MODY) |
|
|
Term
| shoulder int rotation restriction |
|
Definition
| tight external rotator: infraspinatus (when arm at side) & teres minor (when shoulder at 90 degrees) |
|
|
Term
|
Definition
| int rot, flex, depress humeral head |
|
|
Term
|
Definition
|
|
Term
|
Definition
| SItS = supraspinatus, infraspinatus, teres inor, subscapularis |
|
|
Term
| liver cell damage causes: |
|
Definition
| testicular atrophy, gynecomastia, palmar erythema, spider nevi (bc estrogen not metab properly by liver) |
|
|
Term
|
Definition
| radial pulse felt later than contraction of heart --> assoc w/ aortic stenosis: mid-systolic crescendo-decrescendo murmur, radiation to carotid aa & apex, congenital, secondary to rheumatic heart dz of idiopathic calcif of valves, MCC elderly is degen calcif of aortic valve |
|
|
Term
|
Definition
|
|
Term
|
Definition
| MVP & hypertrophic cardiomyopathy |
|
|
Term
| INC murmur w/ inspiration |
|
Definition
| tricuspid stenosis/regurg |
|
|
Term
|
Definition
Use - CVA (stroke, CAD)
MOA - inhib adenosine diphohsphate-R (ADP-R), prevent aggregation of platelets
SE - neutropenia* (can cause infxn later on) |
|
|
Term
|
Definition
lat elbow, forearm pain
Pain exacerbated by wrist ext & supination vs resis |
|
|
Term
| electroconvulsive therapy |
|
Definition
Use - suicidality, psychotic depression, depression refractory to antidepressant meds
SE - anterograde/retrograde amnesia, postictal confusion, nausea, mm ache, HA |
|
|
Term
|
Definition
PAS - Whipple's dz (Tropheryma whippelii)
India ink - Cryptococcus neoformans
Giemsa - Plasmodium, Borrelia burgdorferi, Histoplasma, Chlamydiae
Ziehl-Neelsen - Mycobacteria tuberculosis & leprae
Note: Mycoplasma doens't stain bc has NO cell wall |
|
|
Term
|
Definition
Eaton's agar (sterols) - Mycoplasma
MacConkey's agar - lactose-fermenters: Enterobacter, Klebsiella (lowers pH = pink)
Sabouraud's agar - fungi
Bordet-Gengou agar - Bordetella pertussis
Thayer-Martin agar (VPN-abx) - Neisseria gonorrhoeae |
|
|
Term
|
Definition
Gram +
S pneumo, S pyogenes, Actinomyces |
|
|
Term
|
Definition
beta-lactam - inhib cell wall syn
wider spectrum than PCN
Enterococci, ie salmonella, E coli |
|
|
Term
| Clavulanic acid, sulbactam, tazobactam |
|
Definition
Beta-lactamase
Extended spectrum of beta-lactam Rxs |
|
|
Term
| Ceftriaxone, cefotaxime, ceftazidime |
|
Definition
3rd gen cephalosporin, beta-lactam
MOA - inhib cell wall syn
Comm acq pneumonia, meningitis, gram neg ie gonorrhea, pseudomonas |
|
|
Term
|
Definition
plumbers, roofers, ship-yard, demolition crew
Pleural plaques, gold-brown dumbbell-shaped rods in macrophages
MCC cancer - bronchogenic carcinoma (more common than mesothelioma; but if ques ask risk factor for mesothelioma - pick asbestos) |
|
|
Term
|
Definition
caused by injury to C8-T1 root:
Horner's syndrome (ptosis, miosis), ulnar nn distrib numbness, paralysis of intrinsic hand mm |
|
|
Term
|
Definition
appear in 1st 2 yrs of life: failure to thrive, enlarged spleen, microcytic anemia, misshapen bones
DEC beta chains, INC alpha chains (alpha > beta)
Extramedullary hematopoiesis, HSM,aplastic crisis w/ parvo B19
Tx - blood transfusion, iron chelation, splenectomy
INC Hemoglobin F and A2, and DEC Hgb A = both Beta-thal major & minor |
|
|
Term
|
Definition
| asymptomatic anemia (microcytic, hypochromic, normal ferritin), normal life |
|
|
Term
| DM, steatorrhea, pancreatic calcif on CT |
|
Definition
|
|
Term
| test for anti-p24 IgG abs |
|
Definition
|
|
Term
| test for anti-gp120, gp41, p24 IgG Abs |
|
Definition
| Western blot - HIV confirmatory |
|
|
Term
| protease inhibitor (-navir) SE |
|
Definition
| GI, metabolic syndromes (similar to Cushing), hyperglycemia, thrombocytopenia, nephrolithiasis, lactic acidosis |
|
|
Term
| nucleoside reverse transcriptase inhibitor (NRTI) SE |
|
Definition
| megaloblastic anemia (ZDV), pancreatitis* (Didanosine), bone marrow suppression (counter w/ EPO & GM-SCF), peripheral neuropathies, lactic acidosis |
|
|
Term
| non-nucleoside reverse transcriptase inhibitor (NNRTI) |
|
Definition
| rash, bone marrow suppression, peripheral neuropathies, hepatitis |
|
|
Term
|
Definition
| Enfuvirtide - local injection (erythema, nodules, cysts), GI, infxn, peripheral neuropathies |
|
|
Term
|
Definition
| upper resp infections & orthostatic hypoTN |
|
|
Term
| vitiligo - hypopigmentation |
|
Definition
assoc w/ autoimmune ie pernicious anemia, hypothyroidism, hyperthyroidism, Addison's dz, T1DM
Starts 1st/2nd decade |
|
|
Term
| fugue state (dissociative fugue) |
|
Definition
| pt suddenly travel, develop amnesia, assume new identity; follows stressor |
|
|
Term
|
Definition
caused by clindamycin or ampicillin
Tx - metronidazole |
|
|
Term
|
Definition
type 1 spinal muscular atrophy (SMA)
atrophy of LMN ant horn spinal cord --> baby dies by 18 mon fr pneumonia-induced resp failure
Sx - floppy baby syndrome, failure to thrive, weak sucking, areflexia |
|
|
Term
| blistering, mid age, affect mucous membranes, Bx - IgG bet epidermal cells |
|
Definition
| pemphigus vulgaris - + Nikolsky sign |
|
|
Term
| autoimmune blistering along abd, ext, groin, axilla, >65 yo, Bx - LINEAR pattern IgG and C3 along BM |
|
Definition
| bullous pemphigoid - (-) Nikolsky sign |
|
|
Term
|
Definition
|
|
Term
|
Definition
| assume sick role for primary gain (vs secondary gain in malingering); ex health care worker, knowledgeable about condition/txs |
|
|
Term
|
Definition
| fabricate Sxs for secondary gain (financial, gettoung out of prison, obtaining drugs) |
|
|
Term
| common reasons for anovulation (normal during perimernarche & perimenopause) |
|
Definition
PCOS, anorexia, stress, pituitary dysfxn, hypothalamic dysfxn
Confirm ovulation: measure cycle day 21 proges levels (elev = ovulating) |
|
|
Term
| painless thyroid enlargement |
|
Definition
Hashimoto's thyroiditis - autoimmune, anti-TPO Abs, weakness, fatigue, ahir loss, myxedema
High TSH, low T4/3
Tx - levothyroxine |
|
|
Term
|
Definition
medial zone - balance; injury - ataxia, ipsi falls (think center = balance)
lateral zone - voluntary limb movement - injury - error in force, speed, amplitude of movement (think outer = limb) |
|
|
Term
|
Definition
| control heating & sympathetics; lesion - hypothermia & hypoTN |
|
|
Term
|
Definition
epidemic typhus - flu-like sx, truncal rash spread to rest of body, transmit by human louse
All Rickettsia:
Sx - HA, fever, rash
Dx - Weil-Felix rxn
Tx - doxycycline |
|
|
Term
|
Definition
Rocky Mtn spotted fever
HA, fever, rash start on palms/soles spread to trunk
Transmit by dog/rodent ticks
Occur east of Rockies |
|
|
Term
| Diphyllobothrium latum (fish tapeworm) |
|
Definition
B12 defic
Tx - Praziquantel |
|
|
Term
epididymitis (fever/chills, erythematous/tender scrotum, freq/urgency, dysuria) tx
Note - leading cause >35: E coli |
|
Definition
>35 - ciprofloxacin - inhib DNA gyrase
<35 - ceftriaxone + doxycycline (bind 30S) or azithromycin (bind 50S) |
|
|
Term
| cingulate (subfalcine) herniation |
|
Definition
| cingulate gyrus herniate under falx cerebri --> compress ant cerebral aa d/t INC ICP (often fr subdural hematoma*) |
|
|
Term
|
Definition
cerebellar tonsils go thru foramen magnum --> compress brainstell --> Chiari malformation
Sx - neck pain, HA worse w/ cough, ataxia, diplopia |
|
|
Term
| transcalvarial (external) herniation |
|
Definition
| herniation of brain tissue thru fracture/surg incision |
|
|
Term
|
Definition
uncus (inner part of temporal lobe) push thru tentorium
Sx - ipsi dilated pupils, contra homonymous hemianopia, Durret hemorrhage (rupture of paramedian aa), ipsi paresis |
|
|
Term
| transtentorial (central) herniation |
|
Definition
brain thru tentorium cerebelli (dura mater that separates cerebellum fr occipital lobe
Cause tear in basilar aa --> coma, death |
|
|
Term
| squamous cell CA of esophagus risk factors (most mid esophagus) |
|
Definition
smoking, EtOH
Other - nitrosamines, achalasia, hot food/drinks
Dysphagia of solid then liquids (vs achalasia which is liquid then solid)
Barium swallow - "apple core" lesion |
|
|
Term
| adenocarcinoma of esophagus |
|
Definition
| Risk factor - Barrett's esophagus (GERD), lower third esophagus |
|
|
Term
|
Definition
low PCO2 (norm 40), normal HCO3 (23)
chronic resp alkalosis - low HCO3 d/t compensatory met acidosis
Cause - hyperventilation, psych, high altitude (stim hyperventilation) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
FLAT PiG:
FSH, LH, ACTH, TSH, PRL, GH |
|
|
Term
|
Definition
necrotizing migratory erythema* (macules/papules in inguinal, face, perineum, thighs, buttocks), DM, wt loss, glossitis, stomatitis, cheilitis
DEC amino acids (by gluconeogenesis fr aa), INC glucagon |
|
|
Term
| low pitched, apical diastolic rumble, L lateral decubitus position |
|
Definition
|
|
Term
| combination OCPs (estrogen/proges) |
|
Definition
neg fb of GnRH
Proges - prevent LH (surge causes ovulation) , thicken cervical mucus (inhib sperm entry)
Estrogen - prevent FSH (follicular dev) |
|
|
Term
|
Definition
BUN:Cre <20:1, urine Na >40, FENa >2%
MCC - Rx allergy (PCN, cephalosporin, NSAID, phenytoin, diuretic, sulfonamide)
Others - Sjogren's, SLE, sarcoidosis |
|
|
Term
| non-anion gap, hyperchloremic met acidosis |
|
Definition
| RTA (renal tubular acidosis) |
|
|
Term
| suspensory ligament of ovary |
|
Definition
| attach ovary to pelvic wall; contains ovarian a/v |
|
|
Term
|
Definition
| fibrous cord, runs thru uterus to deep inguinal canal, exits superficial inguinal ring & attach to labia majora; derivative of gubernaculum |
|
|
Term
|
Definition
Gram pos - teichoic acid, cell wall (spans fr capsule to inner cytoplasmic membrane)
Gram neg - outer membrane has LPS endotoxin & notablic periplasmic space bet inner & outer membrane (has beta-lactamase = Rx resis) |
|
|
Term
| MCC of normal anion gap metabolic acidosis (AG 8-12) |
|
Definition
|
|
Term
| metabolic alkalosis causes |
|
Definition
| vomitting, Conn's syndrome |
|
|
Term
|
Definition
|
|
Term
| sexual seduction, attention seeking |
|
Definition
| histrionic personality disorder |
|
|
Term
| impulsive, self-injury, substance abuse, overreaction, splitting is defense mechanism (all good/bad) |
|
Definition
| borderline personality disorder |
|
|
Term
|
Definition
inhib SYNTHESIS of peptidoglycan of cell wall by binding D-alanyl-D-alanine
vs PCN, cephalospoin, carbapenem, aztreoname - inhib CROSS-LINKING of peptidoglycan |
|
|
Term
| central obesity, moon facies, abd striae, impotence, abnorm menses, acne, glucose intolerance, mm wasting, hirsutism, HTN, psych |
|
Definition
|
|
Term
| absent cerebellar vermis, hydrocephalus, dilated 4th ventricle connecting to enlarged post fossa cyst that extends to cisterna magna |
|
Definition
| Dandy-Walker malformation |
|
|
Term
| Arnold-Chiari malformation |
|
Definition
| inferiorly displaced cerebellar tonsils thru forament magnum (can cause polyhydramnios bc affects control of swallowing)& myelomeningocele (spina bifida), hydrocephalus, small post fossa |
|
|
Term
|
Definition
| nosocomial sepsis/ecthyma gangrenosum (burns), pneumonia (CF), UTIs (catheters), osteomyelitis (DM & IVDU), external otitis (DM, swimmers) |
|
|
Term
| pseudomonas lethal factors |
|
Definition
blue-green pyocyanin pigment
endotoxin
exotoxin A (inactiv elong factor-2)
Tx - aminoglycoside + extended spec PCN |
|
|
Term
| Rx intoxication - expanded senses (radiant colors, visual hallucination, echoing sounds)-see music & hear colors, delusions, dilated pupils (mydriasis), fever, tachycardia, HTN, diaphoresis, paranoia, dry mouth, sleeplessness, flashbacks |
|
Definition
|
|
Term
| Rx intox - agitation, INC alertness, bruxism, euphoria, diaphoresis, mydriasis, confusion, anorexia, tachycardia, HTN, fever, dental erosion* |
|
Definition
amphetamine
Can lead to stroke/seizure |
|
|
Term
| Rx intox - pinpoint pupils (miosis)*, hypoxia, sedation, slurred speech, resp depression, euphoria, constipation |
|
Definition
|
|
Term
| Rx intox - impulsiveness, psychosis, violent behavior*, HTN, tachycardia, agitation, nystagumus* (horizontal, vertical, or rotary), rhabdomyolysis (complication) |
|
Definition
| phencyclidine hydrochloride (PCP) |
|
|
Term
|
Definition
| neuropsych SE ie paranoia, anxiety, hallucination |
|
|
Term
|
Definition
Vit A - resp, opthalmic
Vit D - rickets, osteomalacia
Vit E - peripheral neuropathy
Vit K - clotting defic (cofactor for II, VII, IX, X
Vit B12 - neuropathy, macrocytic anemia |
|
|
Term
|
Definition
Wt loss, epigastric pain
Risk factors: lower fiber diet, obesity, EBV, high Na intake, N-nitroso cmpds, smoked food, smoking, EtOH, blood type A, gastric surg, H pylori
Dx - endoscopy |
|
|
Term
|
Definition
prolong QRS, PR or QT interval, anticholinergic, CNS toxicity
Tx - ABC, NaHCO3 (arrhythmia), charcoal |
|
|
Term
|
Definition
| CNS depression bradycardia, heart block, color vision tend toward yellow-green |
|
|
Term
|
Definition
Torsades de pointes, cinchonism (tinnitis, flushed skin, CNS disturb)
Tx - IV magnesium |
|
|
Term
|
Definition
inhib acetylcholinesterase --> miosis, salivation, lacrimatino, diarrhea
Tx - atropine |
|
|
Term
|
Definition
CNS depression, resp/cardiac arrest, "almond-like odor in breath"*
Tx - amyl nitrate |
|
|
Term
| L5 findings for sacral torsions |
|
Definition
Forward torsion (STRA) - L5 Type 1 (STRA - Sidebend toward, Rotate away)
Backward torsion - L5 Type 2 |
|
|
Term
|
Definition
| medullary thyroid CA, pheochromocytoma, marfanoid body habitus, mucosal neuromas (ex tumor of tongue) |
|
|
Term
| chrom 5, long arm, APC gene defect |
|
Definition
| familial adenomatous polyposis - 1000s of colon polyps, teen yrs |
|
|
Term
|
Definition
| acute promyelocytic leukemia, Charcot-Parie-Tooth dz, Ehlers-Danlos, NF1, osteogenesis imperfecta, vitiligo |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| bladder CA, Huntington, Parksinson |
|
|
Term
| external rot of temporal bone |
|
Definition
| results in post displacement of mandibular fossa --> chin displaced toward side of temp ext rot |
|
|
Term
|
Definition
promote excretion of uric acid by competing w/ urate for transporter responsible for its reabsorption
*DEC reabsorp of uric acid
Use - gout |
|
|
Term
|
Definition
|
|
Term
|
Definition
| convert cholesterol to androgens |
|
|
Term
|
Definition
convert androgens to estradiol (via aromatase), also prod proges
In prego - estrogen prod by placenta |
|
|
Term
| nonselective activ of B1 & B2 |
|
Definition
|
|
Term
| nonselective agonist of alpha & beta receptors |
|
Definition
epinephrine
Tx - anaphylaxis |
|
|
Term
|
Definition
Use - endometriosis, PCOS
MOA - DEC ovarian syn of estradiol
SE - menopause Sx (hot flashes), hirsutism, acne, deep voice |
|
|
Term
|
Definition
selective estrogen-R modulator (SERM)
Use - breast CA
SE - endometrial hyperplasia (can lead to CA), hot flashes |
|
|
Term
| dysmenorrhea, dyspareunia, dyschezia (painful bowel) |
|
Definition
| endometriosis - starts b4 menses & ceases when stops* hallmark, smooth-walled cyst filled w/ old blood ("chocolate cysts") |
|
|
Term
|
Definition
phosphodiesterase (PDE-5) inhibitors
normally cGMP (smooth mm relax allow flow to corpus cavernosum) is degraded by PDE-5
*don't use w/ nitrates (DEC CO --> hypoTN) |
|
|
Term
|
Definition
aromatase inhibitors
Normally respons for conversion of androstenedione to estrogens by granulosa-theca cells, also converts testot to estrogen
Use - postmenopausal w/ estrogen-R positive breast CA |
|
|
Term
| Fitz-Hugh-Curtis syndrome |
|
Definition
complication of PID
inflamm liver capsule, violin string adhesions |
|
|
Term
|
Definition
pH <7, INC pCO2 >40, HCO3 >23
Main cause of INC pCO2 - hypoventilation: drugs, neuromusc (Guillian-Barre, myasthenia gravis, asthma, COPD) |
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Term
| normal anion-gap metabolic acidosis |
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Definition
low pH, pCO2, and HCO3
Cause - renal tubular acidosis, diarrhea |
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Term
| upper third esophagus, outpouching of mucosa, dysphagia, halitosis, regurg of undigested food, constant clearing of throat, neck mass, wt loss |
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Definition
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Term
| glossitis, iron defic anemia, dysphagia caused by esophageal webs |
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Definition
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Term
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Definition
Mantle-cell lymphoma - non-Hodgkin lymphoma, uncontrolled cell rep
malig cells similar to lymphocytes found in mantle zone of normal germinal follicles |
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Term
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Definition
Follicular lymphoma - non-Hodgkin lymphoma
dysreg bcl-2 & inhib of apoptosis of B cells
LN Bx - nodular pattern malig cells that resemble normal LN follicle |
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Term
| cutaneous T cell lymphoma |
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Definition
MC form - mycosis fungoides
hypopig skin (represent tumors)
Dx - Bx: infiltration of basal layer (upper derm) w/ malig lymphocytes |
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Term
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Definition
diaphyseal (middle) of long bones
t(11;22)
Xray - periostal "onion-skinning"
Histo - monotonous, round blue cells |
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Term
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Definition
Burkitt's lymphoma
C-myc activ, "starry sky" in macrophages, assoc w/ EBV, Africa variant - kid w/ jaw growth |
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Term
| nephrogenic diabetes insipidus (polyuria, polydipsia) |
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Definition
kidney doesn't respond to ADH
Cause - lithium, amphotericin B, demeclocycline (abx Tx for SIADH)
Tx - Na restriction, thiazide diuretic (HCTZ) +/- amiloride & indomethacin (INC ADH) |
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Term
| multiple dome shaped papules w/ central umbillication, contagious, spread via sex contact |
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Definition
molluscum contagiosum - poxvirus - large dsDNA linear
Tx - self limiting |
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Term
| congenital - chrioretinitis (present later in life w/ blurred vision, pain, photophobia, can lead to blindness), hydrocephaly, intracranial calcif, microcephaly, convulsions |
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Definition
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Term
| dermatomyositis - blacks, 40-50, +anti-Jo-1 Abs (spec) & +ANA (sens) |
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Definition
| polymyositis (prox mm weakness, INC CK), + derm: Gottron's papules (erythematous, scaly plaque on dorsum PIP/MCP), Shawl sign (erythema over shoulders, neck, upper chest, back |
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Term
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Definition
1-5 - pump handle - transverse axis
6-10 - bucket handle - Ant-post axis
11-12 - caliper/pincer - vertical axis |
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Term
| mixed morphology w/ Schiller Duval bodies (perivasc of epi cells), INC AFP, |
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Definition
endodermal sinus tumor: yolk sac tumors, malig germ cell tumors
MC testicular tumor in infancy/childhood |
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Term
| young men (15-35), painless enlarged testis, Hx of cryptorchidism |
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Definition
seminoma - malig germ cell tumor
radiosensitiev, curable
Histo - large cells in nobules w/ watery cytoplasm & "fried egg"* look (uniformly distrib nuclei) |
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Term
| testicular pain, INC hCG & AFP, undifferentiated glandular or papillary morphology (finger-like projections) |
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Definition
Embryonal carcinoma - malig germ cell tumor, 2nd MC testicular germ cell tumor (also occur in ovary)
Mets, poor prog |
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Term
| intracytoplasmic Reinke cyrastals, tumor prod androgens, precocious puberty in kids, gynecomastia in adults |
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Definition
Leydig cell (interstitial) tumor - benign, secrete hormone
Other non-germ cell tumor:
Sertoli cell tumors
Both can be found in ovary |
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Term
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Definition
bilat painless lens thickening opacification, DEC visual acuity, eventual loss of vision
Risk factors - age, smoking, DM, ethanol, HTN, obesity, UV exposure
Tx - surg |
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Term
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Definition
inhib ribonucleotide reductase - inhib DNA synthesis
Use - myeloprolif disorders (CML, PV, essential thrombocytosis), prevent sickle cell crisis --> elim of sickled cells leaves greater proportion of Hgb F cells |
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Term
| inhib dihydrofolate reductase |
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Definition
methotrexate
Use - ectopic pregnancy (target fast dividing cells) |
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Term
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Definition
mercaptopurine (6-MP), azathioprine
MOA - inhib purine synthesis
Use - ALL, AML, RA, prevent transplant rejection |
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Term
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Definition
cyclophosphamide
MOA - break DNA strand
SE - hemorrhagic cystitis, Tx - mesna to bind/inactiv acrolein (toxic byproduct) |
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Term
| bind excess iron for excretion |
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Definition
deferoxamine - iron-chelating (binding) agent
Use - iron toxicity or overload (2ndary to transfusion) |
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Term
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Definition
atypical pneumonia, HA, fever, nonprod cough, elderly, smokers, alcoholics
Also cause Pontiac fever (mild pneumonitis), transmit via aerosolized water
Dx - silver stain, charcoal yeast, urinary Ag
Tx - erythromycin |
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Term
| osteochondritis dissecans |
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Definition
| complication of avascular necrosis in physically active adolescants, crepitis, effusion, tenderness |
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Term
| 20-40 yo, F, morning stiffness >30 min, worse w/ rest, affect PIP, MCP, wrist, knees, symmetrical pattern |
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Definition
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Term
| insidious onset, pain, made worse by activity/weight bearing, relieved by rest, ESR NOT elev |
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Definition
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Term
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Definition
trematode fluke (INC eosinophil), transmit by undercooked shellfish (Japan), snails,
starts w/ GI infxn followed by acute lung illness --> chronic (bronchiectasis, secondary bacterial lung infxn) w/ prod cough, hemoptysis
Tx - praziquantel |
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Term
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Definition
| INC estrogen, LH, FSH, result in LH surge --> stim ovulation |
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Term
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Definition
| INC proges which peaks at 21 days, endometrium prolif & becomes secretory |
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Term
work up of congenital syphillis
late presentation - ulcer on palms/soles, rhinitis ("snuffles"), HSM, jaundice, Hutchinson's triad (interstitial keratitis, notched teeth, deafness) |
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Definition
1) rapid plasma reagin (RPR) - sensitive (do 1st)
2) FTA-ABS - specific
Tx - IM PCN G |
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Term
narcoplexy tx
Sx - excess daytime sleepiness, cataplexy (loss mm tone), sleep paralysis, hallucination before/after sleep |
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Definition
Methyphenidate
Other CNS stimulants - amphetamine, methamphetamine, modafinil, armodafinil
Use - relieve excess daytime sleepiness
MOA - inhib reuptake of norepi and dopamine into presynaptic nn terminal --> INC alertness/attn |
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Term
| inhib transport of monoamines (norepi, serotonin, dopamine) into vesicles |
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Definition
Reserpine (rarely used)
MOA - DEC sympathetic flow
Use - psychosis, HTN |
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Term
| MC malig primary brain tumor, 50-70 yo, wt loss, fatigue, "pseudopalisades" on histo |
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Definition
| Glioblastoma multiforme - crosses corpus caloosum |
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Term
| 2nd MC primary brain tumor |
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Definition
| meningioma - psammoma bodies, spindle-shaped cells in whorls |
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Term
| kids - tumor in post fossa, spreads thru CSF tracts, compress CSF tracts --> hydrocephalus, irritable, vomitting |
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Definition
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Term
| kid - tumor in brain ventricles, perivasc pseudorosettes, ependymal rosettes |
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Definition
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Term
| topical med - depletes neurons of substance P |
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Definition
capsaicin - extract fr hot chili peppers
MOA - activ nociceptors (pain sensing fibers), depletes substance P (peripheral chemomediator of pain) |
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Term
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Definition
| supratentorial brain herniates down & compresses CN III --> ipsi dilated pupil (can't constrict to light), contra homonymous hemianopsia (bc compress ipsi post cerebral aa) |
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Term
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Definition
hypovolemic - hx hemorrhage, overuse diuretics, diarrhea, vomitting
euvolemic - SIADH
hypervolemic - kidney, heart, liver failure |
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Term
| cause of dysphagia, loss of gag reflex, uvula deviation away fr side of lesion |
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Definition
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Term
| low glucose in pleural fluid |
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Definition
| rheum arthritis*, empyema, malignancy |
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Term
| pleural fluid - white milky appearance (chylothorax), TRIG >110 |
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Definition
| MCC lymphoma, trauma by thoracic surg |
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Term
| pleural fluid - blood effusion |
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Definition
| MCC pulm embolism, malignancy |
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Term
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Definition
| clear, watery nasal discharge (CSF rhinorrhea), periorbital ecchymosis (Raccoon eyes), ecchymosis over mastoid process (Batt'ls sign), hemotympanum (blood in tympanic membrane) |
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Term
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Definition
1st law - neutral mechanics: Rot & SB opp, Type I
2nd law - non-neutral mechanics: Rot & SB same, Type II
3rd law - motion in one direction DEC motion in all other directions |
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Term
| +c-ANCA, affect kidney (fr RPGN), upper/lower resp sx (look for ocular, ear, nose, throat involvement w/ pulm Sx - infiltrates, hemoptysis), saddle nose |
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Definition
Wegener's granulomatosis
Tx - cyclophosphamide & steroids |
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Term
| Abs to Type IV collagen in GBM, hemoptysis, GN/renal failure |
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Definition
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Term
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Definition
Hemolysis, Elev Liver enzymes, Low Platelets
Occurs 3rd trimester, variant of severe preeclampsia
MOA - fibrin/platelet deposits in capillaries --> occlusion & disrupt RBCs (endothelial cell & platelet dysfxn) cause microangiopathic hemolytic anemia, DEC platelet
Note: RBC hemolysis causes INC indirect bilirubin |
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Term
| most specific test for rheum arthritis |
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Definition
xray - show joint space narrowing, erosions (most specific blood test - anti-CCP)
RA - 20-40 yo, F, AM stiffness, better w/activity, PIP, MCP jt, wrist, knees, ular dev, swan-neck deformity, valgus of knees |
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Term
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Definition
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Term
| anti-smooth mm & anti-nuclear Abs |
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Definition
Type 1: autoimmune hepatitis - young-mid age F, follows viral illness (ex Hep A)
Sx - anorexia, nausea, abd pain, pruritis, arthralgia
Note: type II have +anti-LKM (liver kidney microsomal) Abs
INC AST, ALT > 1000
Tx - prednisone, azathioprine |
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Term
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Definition
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Term
| block re-uptake of catecholamines by adrenergic nn terminal |
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Definition
| cocaine - results INC norepi (stim alpha 1, 2, beta 1) & dopamine (nonselectively stim alpha, beta, dopa receptors) = INC vasoconstriction, INC HR, contractility, pupil dilation, HTN, anorexia, euphoria |
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Term
| part of brain involved in addiction (dopamine = NT of reward behavior) |
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Definition
| ventral tegmental area (midbrain) & nucleus accumbens (basal ganglia) |
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Term
| 2nd line Rx for dementia, for pts who can't tolerate NV |
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Definition
memantine - NMDA-R antag
SE - hallucinations |
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Term
| 1st line tx for narcoplexy |
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Definition
modafinil
MOA - block GABA --> get stimulant effect |
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Term
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Definition
| haloperidol (block dopa-R) or tetrabenazine & reserpine (prevent dopa relase into synatpic cleft) |
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Term
| tx for short-term relief of difficulty falling aslp |
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Definition
Zolpidem - non-benzo ("catch some Z's")
MOA - bind type-A GABA-R
Note: does NOT help w/ sleep maintenance |
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Term
| MCC of primary hyperparathyroidism (INC PTH, Ca, DEC phos) |
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Definition
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Term
| INC PTH, low/normal Ca, INC phos |
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Definition
| secondary hyperparathyroidism |
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Term
| pruiritic polygonal purple papules and plaques, papules have fine white streaks (Wickham's striae, "lace-like"), flexor surface of wrist, buccal mucosa, genitals |
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Definition
lichen planus
Tx - topical corticosteroids |
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Term
| thrombocytic thrombocytopenic purpura (TTP) |
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Definition
HUS + fever + neuro Sx
more in adults, d/t inhib of ADAMTS13 (protease that cleaves vWF) |
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Term
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Definition
| prolonged PT, PTT, activ of coag cascade |
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Term
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Definition
| INC bleeding time, normal/INC PTT |
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Term
| idiopathic thrombocytopenic purpura (ITP) |
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Definition
| affects kids after infection, chronic condition in adults |
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Term
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Definition
| triad: acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia, affects kids after ingestion of E coli O157:H7 (undercooked beef) |
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Term
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Definition
DEC O2 unloading, DEC O2 binding capacity, INC carboxyhemoglobin
Tx - O2 |
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Term
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Definition
>50 deg = resp compromise
>75 deg = cardio compromise |
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Term
| Rxs that cause SIADH (water retention, oliguria, natriuresis, hypoNA) - INC urine Na >400, low BUN & uric acid |
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Definition
vasopressin, chlorpropamide (sulfonylurea-DM, stim insulin rel), vincristine, cyclophosphamide
Others that cause SIADH - malignancies (small cell CA), infxn, CNS disorders |
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Term
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Definition
bacterial infxn of salivary gland - submandib or parotid glands
MC - S aureus
assoc w/ dehydration, Sjogren's
Tx - abx (nafcillin), hydration, warm compress, lemon drop/massage (stim salivation) |
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Term
| Warthin tumor (papillary cystadenoma lymphomatosum) |
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Definition
| benign neoplasm of salivary gland, 50-60s, smokers |
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Term
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Definition
| serious, invasion of tonsillar capsule, sore throat, odynophagia, "hot-potato" voice* |
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Term
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Definition
mu opiod-R agonist (pain med)
Do not use w/ MAO inhibitor or SSRI --> cause serotonin syndrome (delirium, HA, autonomic instability, mm rigidity, convulsion, coma) |
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Term
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Definition
| granylocytosis w/ granulocytic immaturity, anemia, thrombocytosis, splenomegaly, abd fullness* |
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Term
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Definition
| overprod blast cells in marrow, abnorm prod of other blood cells, anemia, thrombocytopenia, fatigue, weakness, dyspnea, easy bleeding/brusing |
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Term
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Definition
| B cells of germinal center, Reed-Sternberg cells, 15-34, 60+ grp, nontender LAD, supradiaphragmatic nodes (cervical/supracervical region) |
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Term
| testicular malig, 15-35, INC bHCG, histo - "fried egg" |
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Definition
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Term
| prepubescent male, high AFP, Schiller-Duvall bodies |
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Definition
| yolk sac (endodermal sinus) tumor |
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Term
| bind 30S ribosomal subunit |
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Definition
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Term
| bind 50S ribosomal subunit |
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Definition
| clindamycin, chloramphenicol, erythromycin, linezolid, lincomycin |
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Term
| bind D-alanyl-D-alanine portion of cell wall |
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Definition
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Term
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Definition
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Term
| inhib syn of peptidoglycan layer |
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Definition
| beta-lactam abx (PCN, cephalosporin, carbapenem, monobactam) |
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Term
| severe mm pain, influenza-like Sx, centrifugal rash |
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Definition
| Dengue fever (aka breakbone dz) - flavivirus, mosquitos, S & Central America, Africa, Asia |
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Term
| high fever, black emesis, jaundice, INC LFTs, Councilman bodies in liver or PCR |
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Definition
| Yellow fever - flavivirus, Aedes mosquito, S America, Africa |
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Term
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Definition
tolbutamide, chlorpropamide, glyburide, glipizide
MOA - stim insulin rel fr pancreatic beta cells
SE - hypoglycemia*, SIADH |
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Term
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Definition
DEC hepatic gluconeogenesis, INC insulin sensitivity
SE - lactic acidosis
Note: contraindicated in kidney failure!* |
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Term
| thiazolidinediones, rosiglitazone, pioglitazone |
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Definition
stim PPAR-gamma-R --> INC peripheral sensitivity to insulin
SE - wt gain, edema, hepatotoxicity, CHF |
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Term
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Definition
inhib alpha-glucosidase
MOA - inhib intestinal brush-border enzyme that breaks down complex sugar into glucose
SE - flatulence |
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Term
| malig cerebellar tumor of kids, compresses 4th ventricle (but doesn't arise in it), hydrocephalus, histo- small blue cells, Homer-Wright rosettes (halo of cells surrounding central ball-like filled w/ fibers) |
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Definition
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Term
|
Definition
depression
Tx - SSRI followed by SNRI (selective serotonin/norepi reuptake inhib) |
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Term
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Definition
INC dopa, DEC GABA & Ach (loss of Ach also seein in Alzheimer's), caudate nuc atrophy --> enlarged 3rd & 4th ventricles
Tx - reserpine & tetrabenzine (deplete dopa by DEC amine precursors), haloperidol (dopa-R antag) |
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Term
| gait ataxia, areflexia, hypertrophic cardiomyopathy, foot deformities |
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Definition
| Friedreich's ataxia - trinuc repeat, dirsup mitrochondria frataxin gene |
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Term
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Definition
| dopamine followed by serotonin |
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Term
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Definition
serotonin and norepi
Note: 1st line tx for depression - SSRI and SNRI |
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Term
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Definition
Ach
DEC in Alzheimer's, Huntington's, myasthenia gravic (thru nicotinic-R), promotes REM sleep, inhib effect on smooth mm (cardiac) via muscarinic-R & excitatory ones at NMJ via nicotinic-R --> activ skeletal m, GI contractility, constricts bronchioles |
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Term
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Definition
| dilated lat ventricles d/t cerebral white matter atrophy (ex Alzheimer's, aging) |
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Term
| MCC hypocalcemia (tetany, mm spasm, cramps, +Chvostek sign-facial spasm, +Trousseau's sign-carpopedal spasm) - means DEC ionized Ca (vs factitious hypoCa = DEC total Ca, not ionized |
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Definition
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Term
| acute intermittent porphyria |
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Definition
| build up of porphobilinogen & d-ALA, defective porphobilinogen deaminase |
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Term
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Definition
| build up uroporphyrin, defective uroporphyrinogen decarboxylase |
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Term
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Definition
| polyneuropathy, pyschiatric abnorm, painful abd, pink urine, pharmaceuticals (Rx-induced, barbituates contraindicated) |
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Term
|
Definition
| morphine, heroin, hydromorphone, codeine |
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Term
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Definition
rep ventric repol
hypokalemia (Conn syndrome - high ALD, Na, Low K) & antiarrythmic Rxs make it more pronounced
Congenital U waves marker for susceptibility to torsades de pointes |
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Term
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Definition
| QT prolongation --> risk of torsades de pointes (v tach) |
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Term
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Definition
weakness, tremors, mm cramps
arrhytmias, INC DTR |
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Term
|
Definition
| platinum-based agents (cisplatin, carboplatin, oxaliplatin) |
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Term
|
Definition
doxorubicin, daunorubicin
MOA - inhib topoisomerase II (prevent DNA repair), inserts itself bet DNA, block DNA synthesis, gen fre radicals (cell damage)
SE - Cardiotoxicity& |
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Term
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Definition
1st line - metronidazole
2nd line (if pt can't tolerate above) - ORAL vancomycin |
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Term
|
Definition
citalopram, fluoxetine, paroxetine, escitalopram, sertraline, fluvoxamine
MOA - inhib serotonin reuptake at presynaptic neurons (INC serotonin in synaptic cleft)
SE - DEC libido, sex dysfxn, serotonin syndrome (excess use or use w/ MAOI): hyperthermia, tachycardia, tremor, hallucination |
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Term
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Definition
selegiline
MAO - breaks down dopamine, serotonin & norepi
SE - serotonin syndrome if used w/ SSRI, hypertensive crisis if take w/ tyramine products (alcohol, cheese) |
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Term
|
Definition
amitriptyline
MOA - inhib serotonin & norepi transporters, inhib H1, 5-HT (serotonin), alpha-1, Ach receptors |
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Term
|
Definition
venlafaxine, desvenlafaxine, duloxetine
MOA - block serotonin & norepi transporters
Use - anxiety, diabetic neuropathy, fibromyalgia, msk pain |
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Term
|
Definition
antidepressant
MOA - antag serotonin, central alpha-2-R
Use - appetite stimulant, insomnia
SE - INC liver enzymes, neutropenia |
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Term
|
Definition
MOA - supress rel of FSH/LH, inhib ovarian estrogen prod
Use - endometriosis, fibrocystic breast dz
SE - INC androgens --> hirsutism, deep voice, wt gain, acne |
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Term
| large fixed, non-tender abd mass, HTN, INV HVA, VMA & dopamine |
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Definition
neuroblastoma - MC adrenal medulla tumor in kids
Dx - Bx: small clue cells w/ Homer-Wright rosettes (neuroblasts clustered around central space) |
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Term
| hyperthyroidism initial Dx test |
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Definition
TSH level will be DEC
(Note: INC T4 & T3)
Tx - methimazole or PTU (TOC)*, BB for tachycardia, palpitations, tremors |
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Term
| +anti-DNA topoisomerase I Ab or anti-SCL-70 Ab |
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Definition
|
|
Term
| sensory (afferent) pathway of cough reflex |
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Definition
| internal laryngeal nn (branch of sup laryngeal) - sensory innerv to larynx above vocal cords |
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Term
| motor (efferent) limb of cough reflex (glottis closure, bronchoconstriction, insp/expiratory phase of cough) |
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Definition
recurrent laryngeal nn (close to glottis to prevent further entry); often damaged during thyroid surg = hoarseness
Note: also makes up sensory limb of cough reflex below vocal cords |
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Term
| 1st line Tx for psoriasis |
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Definition
|
|
Term
|
Definition
supraspinatus - ABd
infraspinatus - ext rot
teres minor - ext rot
subscap - int rot |
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Term
|
Definition
Tests:
+Yergason's - forearm pronated & ext rot, flex vs resis
+Speed's - supinated forearm flexed to 90 deg vs resis while bicipital groove palpated |
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Term
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Definition
| exercise, calcitonin (nasal rx for those who can't take oral, MOA - inhib Ca reabsorp, DEC osteoclastic activity), raloxifene, Ca, vit D, biphosphonates, PTH |
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Term
| fatigue, pruritis, F, jaundice, hypercholesterolemia, INC alk phosphatase, IgM, antimitochondrial abs* hallmark |
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Definition
| primary biliary cirrhosis |
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Term
| gout rx - inhib microtubule assembly, spindle formation, arrest cell division |
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Definition
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Term
|
Definition
febuxostat, allopurinol
normally converts hypoxanthine to xanthine which is metab to uric acid |
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Term
|
Definition
synthesized fr tryptophan in raphe nuc by tryptophan hydroxylase
Controls mood, sleep, temp, BP
DEC in depression & anxiety
GI motility (diarrhea), bronchoconstriction (wheezing), vasodilate (cerebral BV; Tx - cluster HA) |
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Term
|
Definition
made in nuc accumbens fr glutamate (req B6-pyridoxine)
DEC in anxiety, Huntington's
GABA-inducing rxs: alcohol, benzos, barbituates
Destruction of GABA in UMN = hypertonic mm |
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Term
| normal pressure hydrocephalus (NPH) |
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Definition
"wet, wobbly, and wacky" (incontinence, gait, dementia)
Impaired CSF absorp by arachnoid granulation --> INC pressure on periventricular white matter leads to Sx |
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Term
| strongloides stercoralis (threadworm) |
|
Definition
intestinal nematode, tropics, penetrates skin/mucosa, go to lung, cough and swallowed, invades intestine
Tx -bendazoles or ivermectin
*Serious dz in immunocompromised |
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Term
| undercooked pork helminth |
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Definition
| Trichinella spiralis, Taenia solium |
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Term
|
Definition
Paragonimus wetermani
Pneumonia w/ hemoptysis, secondary bacterial lung infxn
Tx - praziquantel |
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|
Term
| hip, shoulder, neck pain, assoc w/ temporal arteritis |
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Definition
|
|
Term
|
Definition
|
|
Term
| most of CNS cells arise fr |
|
Definition
| neuroectoderm: oligodendrocytes, astrocytes, ependymal cells |
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|
Term
| Schwann cels & PNS arise fr |
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Definition
|
|
Term
| Tx for MDD resis to monotherapy w/ antidepressants |
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Definition
|
|
Term
|
Definition
| loratadine, cetrizine - non-sedating (doesn't penetrate CNS) |
|
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Term
|
Definition
| diphenhydramine - sedating |
|
|
Term
| precocious puberty + cafe au lait spots |
|
Definition
|
|
Term
| INC hat size, hearing loss (bc of INC bone deposit narrows auditory foramen), INC alk phosphatase w/out INC Ca, phosphate or PTH |
|
Definition
| Paget's dz - osteoblastic/-clastic lesions |
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Term
|
Definition
| Gram + rod (bacilli), anaerobic spore-forming |
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Term
|
Definition
|
|
Term
|
Definition
| Enterobacter, Serratia, Salmonella, Shigella, Pseudomonas |
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|
Term
|
Definition
|
|
Term
| beingin, squamous cell papilloma, multiple wart-like on vagina, vulva or perianal, histo - koilocytes (expanded epi cells w/ perinuclear clearing) |
|
Definition
| Condylomata acuminata - HPV 6 & 11 |
|
|
Term
| intermittent fever, chills, hemolytic anemia (similar Sx to malaria), hemoglobinuria, thrombocytopenia, Smear - maltese cross** pathog or "diamond ring" |
|
Definition
Babesiosis - transmit by Ixodes (also cause Lyme dz), NE upper Midwest US
Tx - quinine + clindamycin |
|
|
Term
| dilated cardiomyopathy, megacolon, megaesophagus, transmit by Reduviid bug |
|
Definition
Chagas dz - T cruzi (protozoan)
Tx - nifurtimox |
|
|
Term
| mental retard, delayed devolpment, musty body oder |
|
Definition
PKU - DEC phenylalanine hydroxylase (convert phenylalanine to tyrosine)
Tx - restrict phenylalanine, INC tyrosine |
|
|
Term
| pruritic, macular target like lesions on palms/soles |
|
Definition
erythema multiforme minor - assoc w/ HSV
Note: erythema multiforme major - aka SJS - 2ndary to meds, cause mucous membrane ulceration + target lesions |
|
|
Term
|
Definition
| weakness in triceps (DEC reflex), tingling middle finger |
|
|
Term
|
Definition
| numbness lat foream & thumb, weakness wrist extensor & elbow flexor mm |
|
|
Term
|
Definition
| DEC biceps reflex, numbness lat elbow, shoulder ABduction |
|
|
Term
|
Definition
| numbness lil finger, forewarm, weak handgrip |
|
|
Term
| Imipenem, ertapenem, meropenem caution |
|
Definition
| INC valproic acid clearance (thus pt gets seizures), also causes seizures & other CNS (HA, irritability, ataxia, speech) indep of interaction w/ valproate |
|
|
Term
| arthrocentesis - weakly bifringent, blue rhomboid crystals, swollen knee, normal WBC & uric acid levels |
|
Definition
calcium pyrophosphate deposition dz (aka pseudogout)
Tx - NSAIDs
xray - chondrocalcinosis - calfic in hyaline/cartilage |
|
|
Term
|
Definition
Giemsa stain
lack muramic acid in cell walls so immune to B-lactams
Tx - doxycycline or macrolide (azithromycin) |
|
|
Term
|
Definition
"Bugs That Color Pink"
Berrelia, Trypanosomes, Chlamydia, Plasmodium |
|
|
Term
| Type IV collagen defect (makes up GBM), nephritis (hematuria), deafness, ocular lesions |
|
Definition
| Alport syndrome (eyes, ears, kidneys) |
|
|
Term
|
Definition
Ehlers Danlos
Osteogenesis imperfecta |
|
|
Term
|
Definition
| hylaine cartilage, jts, spine, veitreous humor of eye |
|
|
Term
|
Definition
skin, arterial walls, intestine
Ehlers-Danlos |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
HTN, rheumatic heart dz, CAD, hypertyroidism
Tx - cardioselective BB or CCB |
|
|
Term
| Zink's compensatory pattern |
|
Definition
OA - Rot L
Thoracic inlet - ease on R
Thoracoabd diaphragm (and lumbosacral fascia) - ease on L
Pelvic diaphragm (and lumbosacral fascia) - ease on R |
|
|
Term
| weakness on hip abd, "hip drop" on unaffected side when asked to stand on affected leg (+Trendelenburg sign) |
|
Definition
| injury to sup gluteal nn - gluteus medius, minimus & TFL |
|
|
Term
|
Definition
| inf gluteal nn - injury = extending/ext rot hip and thigh |
|
|
Term
|
Definition
| hip ADDuctors: gracilis, adductor longus/brevis/magnus (can't ride horse) |
|
|
Term
|
Definition
| ABductor magnus, biceps femoris, semitendinosus, semimembranosus (weak ADduction, hip ext, knee flexion |
|
|
Term
|
Definition
thigh flexors - iliacus, sartorius
leg extensors - rectus femoris, vastus medialis, vastus lateralis |
|
|
Term
|
Definition
within...
1 SD = 68% of pop
2 SD = 95%
3 SD = 99.7% |
|
|
Term
| hypothalamic medial preoptic nuc |
|
Definition
|
|
Term
|
Definition
| makes ADH, rel to post pituitary |
|
|
Term
| HIGH 17-hydroxyprogesterone |
|
Definition
lead to precocious puberty & virilization bc of excess androgens
Note: will have DEC CORT, d/t loss of neg fb, INC ACTH |
|
|
Term
|
Definition
1) medullary thyroid CA - malig of parafollicular C cells (normally secrete calcitonin)
pheochromocytoma
mucosal ganglioneuroma
*Marfenoid habitus |
|
|
Term
|
Definition
pancreas
parathyroid
pituitary |
|
|
Term
|
Definition
mdulluary thyroid CA
pheochromocytoma
parathyroid gland hyperplasia |
|
|
Term
| papillary thyroid adenoCA |
|
Definition
| MC thyroid CA, best prog, F, 20-30s, radiation exposure, histo - psammoma bodies, empty-appearing nuc (orphan Annie) |
|
|
Term
|
Definition
| present as thyroid nodule, does NOT enhance on radioiodine scan (cold nodule), histo - neoplastic follicles invading BV |
|
|
Term
|
Definition
| worst prog, elderly F, histo - squamoid, spindle, giant cell types w/ high mitosis |
|
|
Term
| follicular thyroid adenoma |
|
Definition
| MC benign tumor of tyroid, cold nodule, can progress to follicular thyroid CA |
|
|
Term
|
Definition
| where neurons receive info, where most receptors are found* |
|
|
Term
| aspergillus fumigatus (monomorphic mold w/ septate 45 deg branching hyphae w/ "fruiting bodies") |
|
Definition
Allergic bronchopulm aspergillosis (asthma)
Fungal ball (lung cavity, ex TB)
Inasive aspergillosis (immuncomp, CF) - Tx Voriconazole |
|
|
Term
| prolonged PTT & bleeding time |
|
Definition
von Willebrands dz
Tx - DDAVP (desmopressin) - INC circ vWF and factor VIII |
|
|
Term
|
Definition
| fetal vessels (normally insert at chorionic disk of placent w/in umbilical cord) are unprotected & insert bet 2 layers of placenta & cross over internal cervical os --> compression/rupture of fetal presenting part (rare) |
|
|
Term
| vit defic - alopecia, dermattiis, central/peripheral neuroptahy, depression, NV |
|
Definition
|
|
Term
| vit defic - neutropenia, osteoporiosis, hypochromic anemia |
|
Definition
|
|
Term
| vit defic - hypogonadism, alopecia, impaired immunity, anorexia, dermatitis, hypogeusia (DEC taste), night blindness, anemia, lethargy, impaired wound healing |
|
Definition
|
|
Term
| vit defic - ecchymosis, petechiae, bleding |
|
Definition
|
|
Term
|
Definition
hippocampus - memory formation
fornix - carries signal fr hyppocampus to hypothalamus
amygdala - emotional learning (fear)
mamillary bodies - memory formation
septal nuclei - connects areas, reward |
|
|
Term
|
Definition
| bilat temporal lobe lesion --> affect amygdala & limbic sys = social/emotional deficits: overeact to objects, loss of fear, hypersexuality, hyperorality |
|
|
Term
| need to be ctr of attn, sexually seductive/provocative, shallow expression of emotions, easily influenced, exagerate relationships |
|
Definition
| histrionic personality disorder |
|
|
Term
|
Definition
5-ASA / mesalamine or sulfasalazine
friable mucosa, erythema, crypt abscess, low grade fever, assoc w/ cholangiocarcinoma, sclerosing cholangitis, colon CA |
|
|
Term
| night terrors, nocturnal enuresis, somnambulism (sleep walking) |
|
Definition
| non-REM sleep (stages 3 & 4) |
|
|
Term
|
Definition
awake - beta
going to sleep - alpha
1 - theta (hypnagogic hallucination, twitching)
2 - sleep spindles, K complexes
3-4 - delta
REM - beta |
|
|
Term
|
Definition
spiral CT* TOC (aka CT angiogram or CT w/ PE protocol)
V/Q scan
Tx - heparin
EKG - S1Q3T3 (S wave lead 1, Q wave lead 3, reversed T wave lead 3), sinus tachycardia (MC) |
|
|
Term
| Deep vein thrombi setting of Virchow's triad |
|
Definition
venous stasis (immobilization)
vasc injury (surg)
hypercoagulability (malignancy INC procoagulable cytokines) |
|
|
Term
| EKG - ST seg diffusely elev, diffuse depressed PR seg |
|
Definition
|
|
Term
|
Definition
"PWHEAT"
Phenytoin
Phenylbutazone
Warfarin
Heparin
Ethanol
Asprin
Theophylline
Tolbutamide
*Note: any drug can have zero-order if given at high concenc |
|
|
Term
| inhib viral DNA polymerase when phosphorylated by viral thymidine kinase |
|
Definition
|
|
Term
| inhib of inosine monophosphate dehydrogenase |
|
Definition
ribavirin
Use - Chornic Hep C & RSV |
|
|
Term
| block viral uncoating to prevent penetration |
|
Definition
Amantidine
Use - influenza A, Parkinson's, Rx-induced EPS sxs |
|
|
Term
| inhib viral RNA & DNA polymerase |
|
Definition
Foscarnet
Use - acyclovir-resis HSV, CMV retinitis |
|
|
Term
| benign lesion, darkening plaque w/ wart-like, velvety texture, "stuck on" look, elderly, not assoc w/ sunlight |
|
Definition
|
|
Term
| ulcerated, nodular, crust, can result fr untreated actinic keratoses & sun exposure |
|
Definition
|
|
Term
| assoc w/ sun exposure, well demarcated, shiny papule w/ umbilicated ctr & telangiectasia |
|
Definition
|
|
Term
| masso cw/ sun exposure, has ABCDE charac (>6 mm) |
|
Definition
|
|
Term
| assoc w/ sunexposure, crusty lesion in sun-exposed area, may be pre-cancerous leading to SCC |
|
Definition
|
|
Term
| male smoker, >50, fever, wt loss, hematuria, flank pain, palpable mass, US* (TOC) - renal mass |
|
Definition
renal cell carcinoma
Assoc w/ paraneoplastic syndrome - polycythemia* (d/t DEC EPO), hypercalcemia* (d/t PTH-like secretion)
Risk factors: adult polycistic kidney dz, ESRD, heavy metal exposure, von Hippel Lindau syndrome (hemangioblastomas) |
|
|
Term
| somnambulism (sleep walking) tx |
|
Definition
TCA (imipramine) - inhib reuptake of serotonin & norepi
Benzo (clonazepam) - INC GABA efficiency by INC freq of opening Cl- channel |
|
|
Term
| prego - HTN, proteinuria, edema |
|
Definition
pre-eclampsia
Tx to prevent eclampsia = includes seiuzres |
|
|
Term
|
Definition
aka hiccups (spasmodic contractions of diaphragm)
Tx - myofascial diaphragm release |
|
|
Term
| Yersinia enterocolitica - glucose-fermenting, coagulase pos, oxidase neg |
|
Definition
| Gram neg - cause mesenteric adenitis (inflamed mesenteric LN w/ R abd pain - mimic appendicitis), invasive enterocolitis w/ fever & diarrhea (+/- blood, day care kids |
|
|
Term
| MAO inhibitors (inhib degradation of serotonin, dopamine, norepi) |
|
Definition
Tranylcypromie
Selegiline
Phenelzine
Isocarboxazid
SE - hypertensive crisis esp w/ tyramine food (wine, cheese)* or SSRI, analgesics, sympathomimetics |
|
|
Term
SSRI - inhib serotonin reuptake, INC serotonin
DOC* for depression |
|
Definition
fluoxetine, sertraline, fluvoxamine, citalopram, vilazodone
SE - serotonin syndrome (hyperthermia, mm rigidity, myoclonus, seizure, flushing, diarrhea) |
|
|
Term
SNRI - inhib reuptake of serotonin + norepi
2nd line tx for depression |
|
Definition
| venlafaxine, duloxetine, desvenlafaxine |
|
|
Term
| TCA (-triptyline, -pramine, doxepin) |
|
Definition
inhib reuptake serotonin + norepi
SE - cardiotoxicity |
|
|
Term
| rod shaped bacterium grows on TCBS/alkaline medium, comma-shaped, oxidase-pos, copious rice water diarrhea |
|
Definition
Vibrio
Tx - oral rehyration
has toxin that activ cAMP --> secreting electrolytes |
|
|
Term
| ototoxicic antibacterial rx |
|
Definition
aminoglycoside (gentamycin)
also nephrotoxic |
|
|
Term
stats
Power = 1 - beta (type II error) |
|
Definition
type II error = accept false null hypothesis
Power INC when: INC Type 1 error, INC diff bet actual mean & hypothesized mean of null, DEC sampling error, INC sample size
Note: Type 1 error - null hypothesis incorrectly rejected |
|
|
Term
| causes of metabolic alkalosis |
|
Definition
INC HCO3 & PCO2 (compensatory)
Loop diuretics, thiazides, vomiting, hyperALD (Conn's syndrome) |
|
|
Term
|
Definition
100% O2 (cheaper/safer than sumatriptan)
Verapamil - prophylaxis |
|
|
Term
| INC GGT + alk phosphatase |
|
Definition
|
|
Term
| normal GGT + INC alk phoshatase |
|
Definition
|
|
Term
|
Definition
PPI - inhib H/K/ATPase on gastric parietal cells
Also for ulcers, gastrinoma, prevent stress-related GI bleeding |
|
|
Term
|
Definition
Indomethacin (nonselective COX-1 & 2 NSAID)
Use - acute gouty arthritis, acute bursitis/tendonitis, osteoarthritis, rheum arthritis, ankylosing spondylitis, close PDA |
|
|
Term
|
Definition
hydromorphone, morphine, heroin, codeine, meperidine, tramadol
MOA - inhib GABAergic neurons
Use - arthritis, post op pain, pain of CA/terminal illness |
|
|
Term
| inhib phospholipase A2 and COX |
|
Definition
|
|
Term
|
Definition
glucosamine-chondroitin (makes up part of articular cartilage)
Use - osteoarthritis |
|
|
Term
|
Definition
antileukotriene - zileuton (5-LOX inhibitor)
Use - asthma
Normally leukotriene = pro-inflamm, bronchial constriction |
|
|
Term
| slow steo-wise decline in memory caused by cerebral atherosclerotic plaque |
|
Definition
multi-infarct dementia
Risk factors - hx stroke, atherosclerosis, smoking, HTN |
|
|
Term
|
Definition
frontotemporal dementia
personality changes, speech disturb, destruc of nn cells --> accum tau proteins (also seen in Alzheimer's) |
|
|
Term
|
Definition
Lewy bodies (intracytoplasmic inclusions in damaged cells of substantia nigra) - main component is alpha-synuclein*
Also in Parkinson's
>65 yo, initial - hallucinations
dementia, confusion, rigid mm, tremors, slow movement |
|
|
Term
| nephritic syndrome presents concurrently or w/in days of URI, assoc w/ HSP |
|
Definition
| Berger's dz (IgA nephropathy) |
|
|
Term
|
Definition
nonselective NSAID
Use - acute, opiod-level pain - post-op surg pain, given parenterally (don't give in GI ulers)
MOA - irrev inhib COX 1 & 2 |
|
|
Term
| looks like kid daydreaming, rapid eye blinking, lip smaking, head movements, consciousness impaired, "depersonalization" |
|
Definition
absence seizure
Tx - ethosuximide |
|
|
Term
| heavy bleeding, pelvic pressure, irreg shaped uterus |
|
Definition
Uterine leiomyoma
Tx - Leuprolide - GnRH agonist
Pulsatile - agonist - INC LH/FSH
Continuous - antag - block GnRH-R, DEC, FSH/LH
Other use - prostate CA, endometriosis |
|
|
Term
|
Definition
B-2 adrenergic agonist (lung/uterus)
Use - DEC uterine contractions in premature labor, COPD/asthma |
|
|
Term
|
Definition
MOA - DEC ovarian syn of estradiol
Use - Seldom used for fibroids, endometriosis bc of SE (hirsutism, breast atrophy, acne) |
|
|
Term
|
Definition
antidepressant
MOA - 5-HT & central alpha-2 adrenergic-R antag
Use - depression assoc w/ DEC appetite, insomnia
SE - INF LFT, neutropenia |
|
|
Term
|
Definition
antidepressant, sedating, priapism (prolonged painful erection)
MOA - inhib 5-HT2A (serotonin)-R |
|
|
Term
| impetigo (topical tx), nasal carriers of MRSA tx |
|
Definition
Mupirocin - topical, covers Group A strep, staph
MOA - inhib protein syn (also - retapamulin, fusidic acid) |
|
|
Term
|
Definition
ciprofloxacin, levofloxacin (FQs)
MOA - inhib DNA gyrase (topoisomerase) |
|
|
Term
|
Definition
amoxicillin-clavulanate or cefuroxime - adv impetigo
Nafcillin - Methicillin-sensitive staph |
|
|
Term
| INC membrane permeability abx |
|
Definition
| Daptomycin (IV) - serious MRSA infections |
|
|
Term
| pseudomembranous colitis tx |
|
Definition
|
|
Term
|
Definition
| POST-menopausal osteoporosis |
|
|
Term
| IgG abs vs demoglein (adhesion molecule), stats in oropharynx, spread to skin, Bx (IF) - IgG deposits bet epidermal cells, +Nikolsky's sign |
|
Definition
|
|
Term
| blisters (rarely affect mucosa), >65 yo or mid age, Abs vs BM, Bx - IgG & C3 linear pattern at derm jxn |
|
Definition
|
|
Term
| INC EPO, high vascilarity, clear, foamy cells, cerebellar or spinal cord location (adults), kids, von-Hippel Lindau dz |
|
Definition
|
|
Term
| pilocytic low-grade astrocytoma |
|
Definition
| kids (5-15), benign, tumor cerebellum, hypothalamus, optic chism, INC ICP, histo - GFAP+ astrocytes w/ Rosenthal fibers |
|
|
Term
| DM, cholelithiasis, steatorrhea, gastric hypochlorhydria, wt loss, hyperglycemia, INC somatostain levels |
|
Definition
| somatostainoma - malig neuroendocrine tumor of delta cells in pancreas --> inhib rel of insulin, glucagon, gastrin, GH, CCK (GB sxs), digestive enzymes |
|
|
Term
|
Definition
gram +, spore forming, obligate anaerobe, alpha toxin (gas gangrene - wounds, post-Gi surg), enterotoxin (food poisoning, diarrhea)
Tx - PCN G, clindamycin, surg debridement |
|
|
Term
|
Definition
Use - hepatic encephalopathy
MOA - acidifies gut and transform ammonia into ammonium (nonabsorbable) so it doesn't enter circ; DEC ammonia-producing gut flora
(acidification of colonic contents) |
|
|
Term
|
Definition
inhib aldehyde dehydrogenase (ethanol metab) --> accum acetaldehyde after ethanol ingesion = unpleasant rxn
Use - deterrent, alcoholism |
|
|
Term
| DEC tremors/rigidity of Parkinson's, anti-cholinergic SE (dry mouth, urinary retention, mydriasis) |
|
Definition
| benztropine - anti-cholinergic* |
|
|
Term
|
Definition
| persis hemorrhage into corpus luteum after ovulation, young pt a/ acute onset abd pain, neg prego test, no fever |
|
|
Term
|
Definition
|
|
Term
|
Definition
lead poisoning* and other heavy metals
thalassemia
alcohol abuse |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
DEC haptoglobin
INC indirect hyperbilirubinemia
neg Coombs test (r/o autoimmune hemolysis - Abs vs RBCs ie SLE, CLL, lymphomas) |
|
|
Term
| ANP/BNP (released in CHF) |
|
Definition
| DEC reabsorp of Na in distal tubules, collecting tubules, collecting ducts |
|
|
Term
|
Definition
| acts on prox tubules, thick asc loop of Henle, distal tubule to INC Na reabsorp, INC H+ secretion lead to "contraction alkalosis" |
|
|
Term
|
Definition
stim bone resorption
stim vit D activ
INC Ca reabsorp & phosphate excretion at prox tubule, thick asc loop of Henle, distal tubule |
|
|
Term
| inhib ALA dehydratase & ferrochelatase |
|
Definition
lead poisoning - fatigue, insomnia, malaise, abd pain, HA
Dx - blood lead level, smear - basophilic stippling, xray - line at epiphyses of long bones
Tx - EDTA, dimercaprol, succimer (kids) |
|
|
Term
|
Definition
caused by INH, hydralazine
peripheral neuropathy*, glossitis, weakness, irritablity
Smear - sideroblastic anemia |
|
|
Term
|
Definition
Biceps C5-6
Triceps C6-7
Patellar L3-4
Achilles S1-2 |
|
|
Term
| pleuritic chest pain, relieved by sitting fwd, friction rub, diffuse ST elev & PR depression |
|
Definition
Acute pericarditis
Etio - viral, bacteria, uremia, Dressler's syndrome (autoimmune rxn post-MI), post cardiac surg, SLE, amyloidosis, procainamide-induced* lupus pericarditis
Tx - address underlying cause (ex stop procainamide), NSAIDs (ibuprofen) |
|
|
Term
| INC ACE, hyperCa, bilat hilar LAD |
|
Definition
sarcoidosis
Tx for hypercalcemia - furosemide* (loop diuretic) - DEC Ca |
|
|
Term
|
Definition
| 1st line - supportive, cholinesterase inhib (donepezil, rivastigmine, galantamine - slow progression) |
|
|
Term
|
Definition
|
|
Term
| conversion by DOPA decarboxylase to dopamine |
|
Definition
| levodopa-carbidopa - Parkinson's |
|
|
Term
|
Definition
selegeline, rasagiline
Use - depression, dementia, early-onset Parkinson's |
|
|
Term
|
Definition
1) local anesthetics (-caines)
2) class 1 antiarrhythmics (quinidine, disopyramide, procainamide)
3) anticonvulsant (phenytoin, lamotrigine, carabamazepine) |
|
|
Term
|
Definition
INC BP, temp, HR, dipahoresis, HA, AMS
caused by selegiline (MAO-B) + serotonergic rxs (SSRI and antiemetic ondansetron) |
|
|
Term
|
Definition
| in pts taking non-selective MAOI (phenelzine, tranylcypromine) + tyramine foods |
|
|
Term
|
Definition
physician paid contracted rate for each member regardless of number of sevices provided
Ex. HMOs |
|
|
Term
|
Definition
| fee paid to doc according to service performed |
|
|
Term
|
Definition
| grp of employees collectively achieving agreements w/ employer (unionization) |
|
|
Term
|
Definition
| melena ("black and tarry stools"), Fe defic anemia |
|
|
Term
|
Definition
| hematochezia (bright red blood), narrow "pencil" stools |
|
|
Term
| LLQ pain, fever, leukocytosis |
|
Definition
|
|
Term
|
Definition
H flu - chocoalte agar
Vaccine - Ag fr bacteria's polysaccharide capsule + protein (dipheteria toxin)
Tx - Ceftriaxone, rifampin prophylaxis for fam members |
|
|
Term
|
Definition
Ceftriaxone, rifampin prophylaxis for fam members
Culture - chocolate agar |
|
|
Term
| obese F, HA, CN VI palsy (double vision on eye movement), papilledema, INC opening pressure on LP |
|
Definition
| idiopathic intracranial HTN |
|
|
Term
|
Definition
| physician acted negligently bc an accident occured |
|
|
Term
|
Definition
| patient, thru own negligence, contributed to injury |
|
|
Term
| Respondeat Superior / vicarious liability |
|
Definition
| employer responsible for employee's action performed during employment (ex doc working at hospital, nurse working at physician's office) |
|
|
Term
|
Definition
INC total body copper, DEC serum copper bc of DEC ceruloplasmin
Most specific test - liver Bx
TOC - penicillamine - promote excretion |
|
|
Term
|
Definition
|
|
Term
|
Definition
hypochromic anemia
sideroblastic anemia
anemia of chronic dz |
|
|
Term
| Causes of microcytic anemia |
|
Definition
Fe defic anemia
Anemia of chronic dz
Sideroblastic anemia
lead poisoning
thalassemia |
|
|
Term
| causes of normocytic anemia |
|
Definition
hemolysis:
sickle cell
autoimmune hemolytic anemia
hereditary spherocytosis
G6PD defic
anemia of chronic dz |
|
|
Term
|
Definition
megaloblastic - B12/fol defic, MTX use
nommegaloblastic - alcoholism, chronic liver dz, myelodysplastic syndrome, hypothyroidism |
|
|
Term
|
Definition
| inherited bone marrow failure, mut DNA repair gene, 6-9 yo, short, cafe au lait spots, anomalies (thumb, radius, GU) |
|
|
Term
|
Definition
bromocriptine
MOA - INC dopamine - reg inhib GABA-ergic effects, allow normal movement
Use - Parkinson's, prolactinoma |
|
|
Term
| CD19, CD20+ lymphocytes, t(14;18), progressive LAD of neck, enlarging abd mass, B sx (night sweats, fever, wt loss) |
|
Definition
| Diffuse large B cell lymphoma - MC non-Hodgkin lymphoma, males, 65 yo |
|
|
Term
| Reed-Sternberg cells (2+ prominent nucleoli surrounded by large clear cytoplasm), LN pain after drinking EtOH*, CD30+, CD15+, CD20- |
|
Definition
Nodular sclerosis Hodgkin lymphoma - MC Hodgkin lymphoma, bimodal peaks (15-35, 60+ yo), young F
Tx - ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) + radiation |
|
|
Term
| Other types Hodgkin lymphoma |
|
Definition
Mixed cellularity - assoc w/ EBV infxn
Lymphocyte rich - best prog
Lymphocyte depleted |
|
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Term
| Peripheral T cell lymphoma |
|
Definition
aggressive mature T cell lymphoma
Dx - CD4 and/or CD8 positivity |
|
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Term
| granulary casts, muddy brown casts or renal tubular casts, BUN:Cr ratio <20:1, urine Na >40, FENa >2%, urine osmolality <350 |
|
Definition
acute tubular necrosis - MCC acute renal failure
Etio - ischemia, nephrotoxicity (aminoglycosides*, NSAIDs, radiocontrast, cisplatin), myoglobinuria (rhabdomyolysis), Bence Jones protein (MM), hyperuricemia (cell lysis), hemoglobinuria, DEC RBF |
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Term
|
Definition
5-FU* - thymidylate synthetase inhibitor (normal - methylates dUMP to dTMP)
SE - myelosuppression (pancytopenia - anemia, thrombocytopenia) |
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Term
|
Definition
| acute, painless, monocular* loss of vision d/t embolis, pale retina w/ cherry-red macula (blood supply fr ciliary aa) |
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Term
|
Definition
| amaurosis fugax - brief ipsi vision loss, no cherry-red spot |
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Term
| ant choroidal aa occlusion (branch off internal carotid b4 join Circle of Willis) |
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Definition
| contralat hemiplegia, contra loss sensation, homonymous hemianopsia |
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Term
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Definition
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Term
|
Definition
UPEC - P pilus - attach urinary tract epi cells
EHEC/EIEC - shiga-like toxin
ETEC - heat labile toxin, activ cAMP
EPEC - injects proteins that interfere w/ villi actin rearrangement |
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Term
|
Definition
| motor - corneal & lacrimation reflex (senosry - CN V1), facial mm, eye lid closing, ear's stapedius, parasym for salivation (submandiublar, sublingal gland), taste fr ant 2/3 tongue |
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Term
|
Definition
selective NSAID
MOA - inhib COX-2 (prod PG & TxA2 fr arachidonic acid), less GI SE (COX-1 in GI)
Chronic use - MI, stroke, thrombosis |
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Term
|
Definition
1-44 unintentional injury
45-54 and 65+ CV dz
55-64 and 75-84 CA |
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Term
|
Definition
DEC resp rate, slurred speech, ataxia, coma, hypoTN, weakness
Antitode - flumazenil |
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Term
| JAK2 tyrosine kinase defect |
|
Definition
primary myelofibrosis - marrow fibrosis (overprod TGF-beta)
essential thrombocytosis |
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Term
|
Definition
| CML - t(9;22) Philadelphia chrom |
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Term
|
Definition
| medullary thyroid carcinoma |
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Term
| p53 defect (tumor suppressor) |
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Definition
| breast CA, soft tissue sarcoma, brain tumor, Wilms' tumor, pancreatic adenoCA, neuroblastoma |
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Term
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Definition
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Term
| Abs vs platelet factor 4 complexs --> activ neighboring platelets (eventually aggregate & removed fr circ) |
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Definition
heparin induced thrombocytopenia (HIT) - thrombocytopenia (DEC platelets) 5-10 days after heparin started
Note - Use LMWH to DEC risk of HIT |
|
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Term
| autoAbs vs vWF cleaving protease |
|
Definition
Thrombotic thrombocytopenic purpura (TTP) - can't cleave vWF --> accum large vWF cause overaggreg of platelets
Sx - fever, microangiopathic hemolytic anemia, thrombocytopenia (petechiae, prupura), renal fiaure, neuro (HA, stroke, AMS) |
|
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Term
| immune-mediated destruction of platelets |
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Definition
| Idiopathic thrombocytopenic purpura (ITP) - bleeding mucous membranes, ecchymoses, petechiae, assoc w/ SLE, CLL |
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Term
| DEC expression platelet glycoprotein Ib/IX |
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Definition
| Bernard Soulier syndrome - acts as receptor for vWF, bleeding tendency |
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Term
| defective platelet glycoprotein IIb/IIIa |
|
Definition
| Glanzmann thrombasthenia - defect platelet plug formation; bind fibrinogen to GPIIb/IIIa on 2 or more adj platelets |
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Term
|
Definition
nosocomial UTI, pneumonia, red pigment
Tx - aminoglycoside + piperacillin |
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Term
|
Definition
pneumonia (CF), sepsis (burn), UTIs (long-term catheters), osteomyelitis (diabetics), external otitis (DM)
Tx - aminoglycoside + extended-spec PCN |
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Term
|
Definition
INC urine pH (ammonia smell), kidney stones, UTIs, pyelonephritis
Tx - FQs |
|
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Term
| palpable purpura, abd pain, arthralgia |
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Definition
Henoch-Schonlein purpura - IgA mesangial deposits, affect skin, kidneys
Tx - self-limiting |
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Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
| Alport's syndrome (hearing loss) |
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Term
|
Definition
2 alpha + 2 beta = Hgb A (MC)
2 alpha + 2 delta = Hgb A2
2 alpha + 2 gamma = Hgb F
4 gamma = Hgb Bart (abort) |
|
|
Term
| widespread hemolysis (pallor, fatigue, jaundice, HSM), marrow expasion, "chipmunk facies", DEC life span, Mediterranean, African, S asian |
|
Definition
beta-thalassemia major (defect in alpha or beta chain, get delta or gamma instead)
Tx - transfusion, splenectomy |
|
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Term
| post-partum pituitary infarction or necrosis |
|
Definition
| Sheehan's syndrome - complication of severe post-portum hemorrhage: amenorrhea, can't breastfeed |
|
|
Term
| hematuria, abd pain, HTN, palpable kidneys |
|
Definition
ADPKD
Dx - US
Complications: intracerebral berry aneurysms, hepatic cysts, thoracic aortic aneurysms |
|
|
Term
| pruritis after shower*, splenomegaly, erthyrocytosis, hyperviscosity, vascular stasis, erthyromelalgia, hyperuricemia |
|
Definition
polycythemia vera (PV) - MC myeloproliferative dz, prolif of normal RBCs, granulocytes, platelets
Dx - erythrocytosis, leukocytosis, thrombocytosis
Hyperviscosity --> vertigo, tinnitis, HA, visual changes, TIA
Tx - phlebotomy, anticoag, allopurinol |
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Term
|
Definition
Acute promyelocytic leukemia (AML) - Auer rods, M3 subtype
Tx - all-trans-retinoic acid* |
|
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Term
|
Definition
| Von Hippel Lindau - hemangioblastomas, cysts, retinal angioma*, clear cell/renal cell CA, pheochromocytoma |
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Term
|
Definition
| NF2 (hearing loss, cataracts) |
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Term
|
Definition
Achondroplasia (FGR3 gene)
Huntington's - memory, involuntary movement |
|
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Term
|
Definition
| C5-6 injury (MC nn root injury during childbirth) |
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Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
| C5-8 (radial nn - fracture midshaft humerus, crutches) |
|
|
Term
| musculocutaneous nn palsy |
|
Definition
| C5-7 - hypertrophy of mm or entrapment of upper trunk |
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Term
|
Definition
| median nn (C6-T1) fracture supracondylar humerus |
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Term
|
Definition
| median nn (C6-T1), carpal tunnel, dislocated lunate |
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Term
|
Definition
| ulnar nn (C8-T1) fracture hook of hamate (fall on outstretched hand; trauma to heel of hand) |
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Term
|
Definition
| INC pulsatile rel of LH, overprod androgens by ovaries (virilization), hyperandrogenism, non-ovulatory bleeding, polycistic ovaries, LH:FSH ratio is 2:1 |
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Term
| DES in utero exposure (banned; used to prevent miscarriage & preterm labor) |
|
Definition
| INC risk vaginal clear cell adenocarcinoma*, transverse vaginal septum, T shaped uterine cavity, DEC fertility |
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Term
|
Definition
| Cryptococcus neoformans (also Sabouraud's agar, latex aglutination-soap bubble) - meningitis in AIDS, Tx -amphotericin B |
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Term
|
Definition
| fungi: pneumocystis, candida, legionella, H pylori, pseudomonas |
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Term
|
Definition
| Plasmodium, Histoplasma, Chlamydia |
|
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Term
|
Definition
| acid-fast, mycobacteria (tuberculosus, leprae) |
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|
Term
| Periodic acid-Schiff (PAS) stain |
|
Definition
| Whipple's dz (Tropheryma, whippelii) |
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Term
|
Definition
Use - testicular CA*, small cell/non-small cell lung CA, gastric CA, Hodgkin's and non-Hodgkin's lymphoma, Kaposi sarcoma
MOA - inhib DNA repair enzyme topoisomerase II
SE - alopecia, myelosuppresion, little cardiac effects* or neuropathy |
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Term
|
Definition
platinum-alkylating agent
MOA - bind DNA prevent synthesis
Use - solid tumors
SE - nephrotoxic, neurotoxic, less hair loss* |
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Term
|
Definition
C2 - back of skull
T4 - nipple
T10 - umbilicus
L1 - inguinal
S2-4 - perineum |
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|
Term
| priapism SE (prolonged painful erection) |
|
Definition
trazodone - anti-depressant, anti-anxiety, anti-psychotic
Use - depression w/ insomnia*
MOA - inhib 5-HT2A (serotonin)-R in brain cortex |
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|
Term
| MAOI's (phenelzine, tranycypromine, selegiline) KNOW THIS: |
|
Definition
1) Serotonin syndrome - if used w/ serotonergic Rxs
2) hypertensive crisis - if take w/ tyrosine foods (cheese/wine) |
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Term
|
Definition
Transformation - "competent" bacteria takes DNA fr environment thru its membrane
Conjugation - direct contact
Transduction - occurs w/ help of virus |
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Term
| filamentous, aerobic, partially acid fast, gram + |
|
Definition
Nocardia asteroides
Tx - sulfa rx
Cause - pulm infection (HIV), cellulitis & absces in cutaneous/subcutaneous tissue, brain abscess |
|
|
Term
| Gardner, linear nodules/pustules, cigar-shaped yeast, cutaneous transmission |
|
Definition
Sporothrix Schenckii
Rx - itraconazole, K iodide |
|
|
Term
| red lump in face w/ sinus tract draining w/ yellow granules following tooth extraction |
|
Definition
Acitnomyces israelii - Gram +, filamentous
Tx - PCN |
|
|
Term
| x-linked recess, 46 XY, normal F external genitalia, normal breast, scant axillary & public hair, blind ending vagina, no uterus, +testis in inguinal canals or abd caivity, INC testot |
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Definition
| androgen insensitivity syndrome - defective androgen-R |
|
|
Term
| nocturnal enuresis in kid |
|
Definition
| Tx - conditioning w/ bed pad & alarm |
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Term
| Q angle ('quadriceps angle') |
|
Definition
Q angle - long axis of femur to tibia
INC = genu valgum
DEC = genu varum |
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Term
|
Definition
| DEC Achilles reflex, sensory lat malleolus, toes 4 & 5, ankle plantar flexion (S1 nn root) |
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Term
|
Definition
| DEC patellar reflex, sensory medial malleolus, ankle dorsiflexion (L4 nn root) |
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Term
|
Definition
| DEC sensory dorsum foot & toes 1-3, DEC big toe extension |
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Term
|
Definition
tissue nematode, transmit by drinking water w/ fleas that ingested larvae, migrate thru subcut tissue --> emerge as ulcer in lower ext
Tx - Niridazole, worm extraction by twisting around stick
Prevention - water filtration |
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Term
|
Definition
MOA - lubricate stool (stool penetrable by water/lipids)
Use - fecal impaction in rectum |
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Term
|
Definition
Mg hydroxide, Mg citrate, polyethylene glycol
MOA - draw water into intestinal lumen
Use - acute/chronic constipation |
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Term
|
Definition
Senna, bisacodyl
MOA - enhance colonic electrolyte secretion & stim peristalsis
Use - acute constipation, doesn't respond to osmotic/builking laxative |
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Term
|
Definition
Psyllium (fiber), bran
MOA - long-term tx of constipation/diarrhea
MOA - adsorption of water to fecal material |
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|
Term
| Renal tubular acidosis = non-anion gap hyperchloremic met acidosis |
|
Definition
Type I - defect in distal tubule to secrete H+, urine pH >5.5, nephrolithiasis (Sjogren's, SLE, autoimmune), Tx - NaHCO3
Type II - lack of HCO3 reabsorp at prox tubule, Tx - Na restriction (kids - Fanconi's, MM, carbonic anhydrase inhibitor use)
Type IV - hypoALD (DM, interstitial nephritis), only RTA w/ hyperK+ - Tx - IV Ca (antag cardiac toxicity), loop/thiazide diuretic +/- NaHCO3 |
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Term
| RTA algorithm - KNOW THIS: |
|
Definition
1) determine RTA (hyperCl- acidosis, normal AG and GFR, no diarrhea = RTA)
2) check K+, higher than normal (3.5-4.5), auto RTA IV, if lower...
3) check urine pH, if lower than 5.5, auto RTA II, if higher...
4) check HCO3, if near normal = RTA I, if DEC = RTA II |
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Term
|
Definition
5th IC on R - liver
5th IC on L - stomach hyperacidity
6th IC on R - liver, gallbladder
6th IC on L - stomach peristalsis
7th IC on R - pancreas |
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Term
| proteinuria >3.5, hypoalbuminemia, hyperlipidemia, gen edema (anasarca, HIV, IVDU, sickle cell |
|
Definition
Focal segmental GN - MC nephrotic syndrome in that pt grp; have refractory HTN
Tx - prednisone, cyclophosphomide |
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Term
| nephrotic syndrome in adults, assoc w/ HBV, HCV, malaria, gold salts, penicillamine, SLE, malig, Bx - granular deposits of IgG & C3 at BM, "spike and dome" |
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Definition
Membranous GN
Tx - prednisone, cyclophosphamide |
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Term
| nephrotic syndrome in kids, causes - food allergies, meds, hematologic malig, fusion of epi foot processes |
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Definition
Minimal change dz
Tx - prednisone |
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Term
| uncommon nephrotic syndrome, LOW C3, "tram-track" d/t capillary BM thickening by interposition of mesangial cells, assoc w/ autoimmune dz & hepatitis |
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Definition
|
|
Term
| progressive dementia, personality changes, ataxia, seizure, MRI - intensity in putamen & caudate nuc |
|
Definition
Creutzfeldt-Jakob dz (CJD) - spongiform encephalopathy, prions, die in 6 mon, sporadic or transmissible
Other less common:
Kuru - transmit by cannibalism
Gertsmann-Straussler-Scheinker - genetic
Fatal familial insomnia - genetic |
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Term
|
Definition
1st line tx:
antipsychotic (olanzapine), mood stabilizer (lithium, carbamazepine), valproic acid; can add benzo |
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Term
| lesion above facial nuc (CN VII pathway) |
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Definition
| affect mm on opposite side of lower face |
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Term
|
Definition
purine antag
MOA - false metabolic, incorporate into DNA/RNA to inhib syn
Use - ALL & AML** (ALL assoc w/ Down's) |
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Term
| palpable purpura, polyarthralgia, pain pain; gross/microscopic hematuria, proteinuria |
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Definition
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|
Term
| competitive antag at progesterone-R, used as abortifacient |
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Definition
Mifepristone (RU 486)
MOA - also stim cervical softening, dilation
SE - heavy vag bleeding, cramps
Note: proges needed in early pregnancy to maintain it |
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Term
| prostaglandin-R agonist, abortifacient |
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Definition
Misoprostol - PGE1 analog, given days after Mifepristone to help expel contents
SE - abd pain, cramping, NVD |
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Term
|
Definition
|
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Term
| glycogen phosphorylase defic, mm cramps, breakdown (defect in glycogen) |
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Definition
| McArdle's dz - excess glyocgen in mm that can't break down --> painful mm cramps after exercise + myoglobinuria |
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Term
| alpha-1,6 glucosidase defic, hypoglycemia, normal blood lactate levels, hepatomegaly |
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Definition
| Cori's dz (type III glyocgen storage dz) - milder dz than Von Gierke's |
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Term
| glucose-6-phosphatase defic, hypoglycemia, INC lactate |
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Definition
Vongierke's dz (type I GSD) - liver can't rel glucose during fast state (hence INC lactate)
Tx - INC CHO in diet |
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Term
| alpha-1,4 glucosidase (acid maltase) defic, floppy, poor facial mm tone, delayed miletones, die at 8th month |
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Definition
Pompe's dz (Type II) - lysosomes can't degrade glycogen, affects legs, arms, diaphragm and heart
Note - "Pompe hurts the Pump (heart, liver, mm)" |
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Term
| RET proto-oncogene defect |
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Definition
| MEN IIA - medullary thyroid CA, pheochromocytoma, parathyroid hyperplasia (other - cutaneous lichen amyloidosis, Hirschspring dz) |
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Term
|
Definition
| MEN I - pancreas, parathyroid, pituitary |
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Term
|
Definition
| hereditary nonpolyposis colon CA (Lynch syndrome) - auto dom, DNA mismatch repair defect; assoc w/ other CA esp endometrial CA** |
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Term
|
Definition
| maturity- onset diabetes of the young (MODY_ - rare, non-obese DM b4 25 yo |
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Term
|
Definition
| Familial adenomatous polyposis (FA_ |
|
|
Term
| INC EPO, high vascularity, clear foamy cells, cerebellar/spinal cord location, adults |
|
Definition
Hemangioblastoma - hydrocephalus, ataxia, pain common
Can occur in kids (von Hippel Linday dz) |
|
|
Term
| brain: spoke-wheel arrangement of cells radiating around BV (perivasc pseudorosettes) and rod-shaped blepharoplasts |
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Definition
| ependymoma - solid tumors fr ependymal cells in 4th ventrcle, kids, hydrocephalus |
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|
Term
| brain: chicken wire BV and "fried egg" appearance w/ calcif |
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Definition
| oligodendrogliomas - adult, frontal lobe, slow growing, long-standing seizure |
|
|
Term
| brain: eosinophilic corkscrew fibers, GFAP-positive w/ Rosenthal fibers |
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Definition
| Pilocytic astrocytoma - cerebellum, INC ICP, focal lesions |
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|
Term
| brain: concentric whorls, interlacing spindle cells, laminated calcif (psammoma bodies) |
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Definition
| meningioma - benign, MC primary brain tumor, do not invade brain; seizures, focal lesion |
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Term
| numbness tingling 5th & part 4th finger, hypothenar atrophy, weak grip, +Tinel sign (percuss nn = tingling) |
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Definition
| Cubital tunnel syndrome - compression ulnar nn MC at medial elbow |
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|
Term
| numbness 1st, 2nd, 3rd, half 4th finger |
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Definition
|
|
Term
| pain at distal radius, +Finkelstein test (flex thumnb clench hand & ulnar deviate) |
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Definition
| De Quervain's tenosynovitis |
|
|
Term
| broad-based budding yeast |
|
Definition
| Blastomycosis - Mississippi & Ohio rivers, Central America |
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Term
|
Definition
MOA - bind fungal MT, inhib mitosis
Use - Tinea capitis - patchy hair loss, flaking scalp |
|
|
Term
| Itraconazole, fluconazole |
|
Definition
Use - dermatophyte infxns that doesn't respond to griseofulvin
MOA - inhib ergosterol syn |
|
|
Term
|
Definition
Use - dermpatophyte (ie tinea capitis)
MOA - inhib squalene epoxidase |
|
|
Term
|
Definition
Use - systemic infxn by Candida or Aspergillus
MOA - inhib glucan syn of fungal cell wall |
|
|
Term
|
Definition
Use - topical; Candida (oral swish), yeast infxns of skin/mucous membranes
MOA - bind ergosterol, INC membrane permeability so cytoplasm leaks |
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|
Term
|
Definition
bacterial capsule:
S pneumo, Neisseris, Klebsiella, H flu, Salmonella typhi, Crytococcus neoformans, Pseudomonas |
|
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Term
|
Definition
Rib 1 ant scalene
2 post scalene
3-5 pec minor
6-9 serratus anterior |
|
|
Term
| Postherpetic neuralgia tx |
|
Definition
TOC - TCA like amitriptyline, topical capsaicin
Cause - Herpes zoster complication |
|
|
Term
| oozing blood fr IV line, catheter, or wound site, INC PT, PTT, bleeding time,. D dimer and fibrin split products |
|
Definition
| caused by DIC - schistocytes bc of microthrombi (exhaust platelets) |
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|
Term
| lacks muramic acid, thus immune to beta-lactams |
|
Definition
| Chlamydia - Tx azithromycin (or doxycycline) |
|
|
Term
|
Definition
| golfer's elbow - repetitive flexion, pronation of wrist: pronator teres, flexor carpi radialis |
|
|
Term
|
Definition
| tennis elbow - repetitive extend, supination wrist/forearm: extensor carpi ulnaris |
|
|
Term
| Vit B12 vs fol defic test |
|
Definition
B12 defic - INC methylmalonic acid AND homocysteine
Fol defic - INC homocysteine ONLY |
|
|
Term
| spiking fevers, exposed to animals, drinks unpasteurized milk |
|
Definition
| Brucella - facultative-intracellular, Gram neg bacteria; normal smear |
|
|
Term
| Grame neg, "2 shaped" spirocete; flu-lie sx + abd pain + photophobia |
|
Definition
Leptospirosis
Severe - Weil's dz (aseptic, icterohemorrhagic) - jaundice, azotemia, hemorrhages, anemia, Dx - spinal tap |
|
|
Term
| Eval of solitary thyroid nodule |
|
Definition
Low TSH
Radioiodine scan:
1) hot - hyperfxning; rarely malig, follicular adenoma
2) warm - do FNA bx to r/o malig
3) cold - hypofxning; FNA bx to r/o malig; lymphoma (extranodal site), papiillary CA (psamomma bodies, orphan Annie nuclei-empty appearing), medullary CA (parafolic C cells, secrete calcitonin, nests of round cells stain for calcitonin) |
|
|
Term
| red lump on face w/ sinus tract draining yellow granules after tooth extraction |
|
Definition
Actinomyces israelii - Gram +, filamentous; can cause abscess elsewhere esp face, abd thorax, brain
Tx - PCN |
|
|
Term
|
Definition
Gram + filamentous, pulm infxn in immunocomp
Tx - sulfa rx |
|
|
Term
|
Definition
aerobic gram neg rod, pneumonia, UTIs, osteomyeltis, otitis, sepsis
Tx - aminoglycoside, piperacillin |
|
|
Term
|
Definition
|
|
Term
|
Definition
flexion SBS = sacrum counternutates (extend)
extension SBS = sacrum nutates (flex) |
|
|
Term
|
Definition
Taenia solium (pork tapeworm) T saginata (beef tapeworm) - infect eyes, heart, lung
Sx - Tx - praziquantel
Neurocysticercosis - seizure, intracranial HTN, psych, Brain MRI: single/multiple cysts, "swiss cheese look
Tx '-bendazole' |
|
|
Term
| isolated thrombocytopenia after this Rx use |
|
Definition
Heparin induced thrombocytopenia (HIT) - occurs after 2 wks of heparin use for DVT prophylaxis, anticoag, ACS/MI, PE
MOA - inactiv thrombin, prevent conversion of fibrinogen to fibrin |
|
|
Term
| eczema, immunodeficiency, thrombocytopenia (low platelets) |
|
Definition
|
|
Term
|
Definition
| hydralazine, procainamide, quinidine, INH |
|
|
Term
| adenomatous polyps + osteomas, lipomas, fibromas, cysts, dental abnorm |
|
Definition
|
|
Term
| A1AT allele inherited pattern |
|
Definition
|
|
Term
|
Definition
| targets proteinase-3, Wegener's |
|
|
Term
|
Definition
|
|
Term
|
Definition
| myocardium (MI), thyroid, esophagus, bronchi |
|
|
Term
|
Definition
|
|
Term
|
Definition
L - stomach peristalsis
R - gallbladder |
|
|
Term
| hemolytic uremic syndrome (acute renal failure, thrombocytopenia, microangiopathic anemia) + fever + neuro sxs |
|
Definition
| TTP - normal PT and PTT, DEC platelets (thrombocytopenia), petechiae, epistaxis, active bleeding |
|
|
Term
|
Definition
Class III K channel blocker
Use - V fib, pulseless ventric tachycardia
MOA - rich in iodine, similar to T4, inhib 5'-deiodinase enzyme
SE - Hypo/hyperthyroidism, pulm fibrosis, blue skin |
|
|
Term
|
Definition
| ptosis, pupillary dilation, loss of accomodation, "down & out" |
|
|
Term
|
Definition
sup oblique CN 4
lat rectus CN 6
all others CN 3 |
|
|
Term
| fecal-oral (contaminated water*), infects GI mucosa, harms spinal ant horns --> mm weakness, flaccid paralysis |
|
Definition
| Polio virus - Sx start as fever, HA, nausea then progress to LMN lesion Sx (mm weakness, atrophy, flaccid paralysis), Prevention - vaccine |
|
|
Term
|
Definition
Doxycycline - can't take w/ antacids, Ca, Mg, alumnimum, Fe, avoid sun; also Tx Rocky Mtn spotted fever
Amoxcillin
or Macrolide |
|
|
Term
|
Definition
<400 - derm (fungal, oral ulcers, shingles), start systemic infxns (wt loss, resp)
<200 - GI (cryptosporidium), lung (PCP), systemic coccidiomycosis
<100 - CNS toxoplasmosis, systemic histoplasmosis
<50 - Cryptococcus meningoencephalitis, CMV retinitis, HIV dementia, JC virus PML |
|
|
Term
|
Definition
opportunistic - PCP
fungus - Candida (then cryptococcus)
virus - CMV retinis (then HSV 1 & 2)
CNS - Toxoplasmosis (other - CMV retinitis, cryptococcus neoformans meningitis, JC virus PML, HIV viral encephalitis)
pneumonia - PCP
GI - cryptosporidium (watery diarrhea) |
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Term
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Definition
Nuc:
1) RNA strandls - 2 single, pos, linear
2) reverse transcriptase - intergrade into human DNA, code pol gene
3) p24 protein - capsid around RNA, code gag gene
Envelope:
4) pg41 - fusion/entry into host cell
5) gp120 - outermost protein of virus that attach to CD4 T cells
Note: number grows fr inside out
*Need CCR5 and CD4 proteins on macrophage to attach (homozug CCR5 mut immune to HIV) |
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Term
| 3 main malig assoc w/ HIV |
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Definition
1) Kaposi's sarcoma (HHV-8) - MC
2) HPV squamous cell cervical/rectal CA
3) EBV non-Hodgkin's lymphoma and Hairy leukoplakia |
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Term
| firm breast mass, spiky outgrowths on mammogrpahy, MC breast CA |
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Definition
| infiltrating ductal CA - most CA on outer quadrant of breast |
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Term
| unresponsive HTN, hypoK+, hyperNa, met alkalosis, low renin |
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Definition
Primary hyperALD
Tx - spironolactone |
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Term
| Chapman - lat/post margin IT band |
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Definition
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Term
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Definition
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Term
| Chapman - lesser trochanter |
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Definition
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Term
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Definition
| rabies, Yersinia pestis (plague), Pasteurella multocida (cellulitis) |
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Term
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Definition
| Yersinia pestis (plague), Rickettsia typhi (endemic typhus) |
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Term
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Definition
| Tichinella spiralis (myositis), Taenia solium (GI tapeworm, cysticercosis, neurocysticercosis) |
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Term
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Definition
| Histoplasmosis (bird droppings), salmonella (eggs), Chlamydophila psittaci (bird reservoir), avian influeza |
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Term
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Definition
| Ixodes tick - Transmit Borrelia burgdorferi (Lyme dz - 1) rash, 2) Bell's palsy, AV block, 3) arthritis, neuro) |
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Term
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Definition
Sx - GI (abd distension, diarrhea), migratory polyarthritis, neuro, derm, fever
Dx - upper endo, Bx - PAS+ macrophages, Gram +, acid-fast bacilli
Tx - nutritional supp, abx (PCN or ceftriaxone x 2 wks, TMP-SMX x 2 yrs) |
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Term
| CaSR gene mut, asymptomatic hyperCa, inappropriately normal PTH and low urine Ca |
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Definition
Familial hypocalciuric hypercalcemia (FHH)
Tx - none |
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Term
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Definition
d/t blunted end-organ response to PTH
ex. Albrecht's hereditary osteodystrophy - facial, skeletal abnorm (short 4th/5th digit), low Ca, high phosphate, high PTH |
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Term
| uterus bx - whorled bundles of smooth mm |
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Definition
uterine leimyoma (fibroids) - benign, pelvic pain, pressure, menorrhagia, estrogen senstive tumor, INC in size w/ estrogen (obesity), DEC in size w/ low estrogen (menopause* gets better)
Tx - 1st line - OCP |
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Term
| Mucor and rhizopus spp - nonseptate, monomorphic, empty-looking, wide-angle fungi |
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Definition
DEC mental status, CNS involvement w/ facial cellulitis, eschars, hemorhagic exudates, DKA, neutropenia (leukemia/lymphoma)
Tx - amphotericin B |
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Term
| Type II hypersensitivity examples |
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Definition
| Goodpasture's, pernicious anemia, Grave's dz, bullous pemphigoid, pemphigus vulgaris, myasthenia gravis |
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Term
| acute bacterial prostatitis |
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Definition
BPH, caused by E coli, Proteus
Tx - FQ (levofloxacin)
MOA - inhib bacterial DNA gyrase, well tolerated
SE - tendonitis, tendon rupture; adv age & concurrent corticosteroid INC this risk, occurs after 2+ wks of therapy |
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Term
| X-linked recessive lysosomal storage dz |
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Definition
Fabry's - alpha-galactosidase A defic, accum ceramide trihexoside, neuropathy, angiokeratoma, CV/renal dz
Hunter's - iduronate sulfatase defic, accum heparan sulfate, dermatan sulfate; mild Hurler's, NO corneal clouding |
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Term
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Definition
| Gaucher dz - MC lysosomal storage dz, glucocerebrosidase defic, accum glucocerebroside in liver, spleen, bone marrow (HSM, pancytopenia), histo - macrophages: crumpled tissue paper |
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Term
| galactocerebrosidase defic |
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Definition
| Krabbe's dz - galactocerebrosidase defic, accum galactocerebroside, optic atrophy, peripheral neuropathy, gobloid cells, dev delay |
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Term
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Definition
| Niemann-Pick dz - accum phingomyelin, cherry red macula, HSM, neurodegen, pulm infiltration, "foamy histiocytes"*, death by 3 yo |
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Term
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Definition
| Tay-Sachs dz - accum GM2 gangliosides, dev delay (severe MR), cherry red macula, "onion skin" lysosomes, death by 4 yo |
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Term
| Short PR interval, delta wave (slurred upstroke in QRS complex), wide QRS |
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Definition
| Wolf-Parkinson syndrome - pre-excitation ventricles d/t accessory pathway (bundle of Kent), asymptomatic or nonspec sx (chest pain) |
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Term
| synovitis, tenosynovitis, dermatitis |
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Definition
| Gonococcal arthritis (MCC of septic arthritis), synovial fluid >50,000 WBC, >90% NT, Gram neg diplococci (Neisseria) |
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Term
| spinal cord has 3 gray matter horns w/ 2nd-order neurons |
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Definition
post horn (pain/temp) - syringomyelia
intermediate/lateral horn (T1-L2, sympathetics)
Ant horn (w/ motor neurons) - AML, poliomyelitis, West Nile virus |
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Term
| flagellated, non-lactose fermenting, bloody diarrhea, common in kids, elderly |
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Definition
| Salmonella - H2S prod, oxidase-neg, raw poultry, uncooked eggs, unpasteurized milk, |
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Term
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Definition
Typhoid fever - fever, HA, diarrhea, rose spots
Tx - FQ, cephalosporin |
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Term
| Seizure etiologies by age grp |
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Definition
Kids - tuberous sclerosis*, febrile, trauma, congenital, metabolic
Adults - tumors*, trauma, strokes, febrile, Rxs, alcohol withdrawal
Elderly - stroke*, tumor, trauma, metabolic syndromes, febrile, degen (Alzheimer's) |
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Term
| high-pitched, blowing early diastolic murmur at L sternal border or 2nd IC space on R, PMI displaced lateral, wide pulse pressure (ex 140/65 mmHg) |
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Definition
aortic regurg
Cause - 2nd to rheumatic heart dz (MC), syphillis infxn, Marfan, infective endocarditis, idiopathic |
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Term
Weber: localizes to affected ear (hear better)
Rinne: bone > air conduction |
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Definition
Conductive hearing loss
Weber test - middle head
Rinne - mastoid to outside ear canal (should still be heard bc air conducts better than bone) |
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Term
Weber: localized to normal ear (which has normal CN VIII)
Rinne: normal (both air & bone conduction reduced) |
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Definition
| Sensorineural hearing loss |
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Term
| Behcet's syndrome - recurrent oral/genital ulcers, arthritis (knees, ankles), eye/CNS involvement (uteitis, retinitis, conjunctivitis) |
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Definition
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Term
| PAINFUL, diffusely enlarged thyroid gland & hyperthyroidism (INC T4, DEC TSH, no physical signs), recent viral infxn |
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Definition
| subacute granulomatous thyroiditis (de Quervain's thyroiditis) - inflamm process occurs after viral infxn |
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Term
| painLESS diffusely enlarged goiter, S/S of hyperthyroidism |
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Definition
| subacute lymphocytic thyroiditis |
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Term
| thyroid nodule - calcified psammoma bodies, Orphan Annie nucleus |
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Definition
| Papillary thyroid CA - MC |
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Term
| thyroid nodule - INC elev calcitonin |
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Definition
| Medullary thyroid CA - orig fr parafollicular cells (C cells) --> prod calcitonin |
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Term
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Definition
Ca oxalate - MC, radiopaque, acidic urine pH
uric acid - radioLUCENT
struvite - less common, Proteus, radiopaque
Cysteine - rare, radiopaque, hexagonal, hard to see on xray
Ca phosphate - not as common as Ca oxalate, radiopaque, alkalinic urine pH |
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Term
| diabetic - bony overgrowth of joint, jt deformity, swelling, crepitus, sensory neuropathy |
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Definition
| Neuroathic arthropathy (Charcot's jt) - non-inflamm jt dz cauzed by loss of deep sensation & proprioception d/t underlying neuropathy |
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Term
| renal - duplication of BM into 2 laers |
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Definition
| membranoproliferative GN (MPGN) - tram tracks, silver or PAS stain |
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Term
| renal - diffuse capillary & BM thickening |
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Definition
| membranonus glomerulonephropathy - MC nephrotic syndrome in adults, immune complex deposit on subepi side of BM |
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Term
| renal- segmental sclerosis and focal hyalinosis |
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Definition
| Focal segmental GN (FSGS) - assoc w/ HIV, heroin abuse, sickle cell |
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Term
| renal - nodular mesangial lesion (aka Kimmelstiel-Wilson nodules* pathognomotic) |
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Definition
| diabetic nephropathy - starts w/ thickening of GBM & loss of neg charged barrier --> progresses to mesnagial matrix expansion then sclerosis |
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Term
| renal - no signif pathology on light microscopy, except foot process effacement |
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Definition
Minimal change dz (MCD) - MC nephrotic syndrome in kids
Tx - corticosteroids |
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Term
| Blood types and gastric ulcers |
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Definition
Gastric ulcers - MC in Type A
Duodenal ulcers - MC in Type O |
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Term
| conjunctivitis, cough, coryza; Koplik spots (grey spots on buccal mucosa)* |
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Definition
Rubeola = measles = Paramyxovirus*
within 1 wk of Sxs, get maculopapular rash starts on face and spreads down |
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Term
| kid - suboccipital & postauricular LAD, maculopapular rash starts on face spreads down, arthralgia ("bone pain") |
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Definition
| Rubella = German measles = Togavirus |
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Term
| kid - fever 2-5 days, followed by maculopapular rash starts on trunk spreads to neck/extremities |
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Definition
HHV-6 = Roseola infantum = Exanthem subitum = 6th dz
Tx - Self- limiting |
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Term
| Risk factors for Crohn's and UC |
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Definition
| smoking (except in UC, this DEC UC risk), famHx, 15-35 yo, white skin |
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Term
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Definition
| kidney stones (d/t fat malabsorp - fat binds to Ca leaving oxalate free to make kidney stones), gallstones (fr depletion of bile salt secondary to terminal ileal dz INC cholesterol gallstones), anal fissures, fistulas, abscesses, SBO, colon CA (less common than UC) |
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Term
gastric adenocarcinoma risk factors
Sx - hematemesis, epigastric pain, bloating |
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Definition
| Asians, ingestion of smoked food, nitrosamines, H pylori infxn, gastric ulcers, smoking, high salt intake*, type A blood, pernicious anemia, low fiber diet |
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Term
| gastric - signet ring cells (filled w/ mucin which forces nucleus to side of cell) |
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Definition
| gastric adenocarcinoma (diffuse type) |
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Term
| gastric - atrophied parietal cells |
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Definition
| Menetriere's dz - achlorhydria |
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Term
| mucus & goblet cells in columnar epithelium |
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Definition
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Term
| hypoNa, lower serum osmolality, low urine level |
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Definition
| SIADH - excess ADH in euvolenmic state, DEC BUN & uric acid |
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Term
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Definition
2 parallel vertical axes (sphenoid/occiput move same direction) = lateral strain
1 AP axix (sphenoid/occiput move same direction), 2 parallel vertical axes (sphenoid/occiput move opposite) = Side bending-rotation
1 AP axis (sphenoid/occiput move opp) = Torsion
2 parallel transverse axis (sphenoid/occip move same) = Vertical strain |
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Term
| Determine if metabolic acidosis is compensated for using Winter's formula |
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Definition
Winter's:
Expected pCO2 = 1.5 (HCO3) + 8 (+/- 2) |
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