Medical Terminology and Concepts, Exams of Nursing

Download Medical Terminology and Concepts and more Exams Nursing in PDF only on Docsity! ALL THE COMSAE COMPREHENSIVE QUESTIONS WITH COMPLETE SOLUTIONS 12mo development Correct Answers Cruises, fills/empties containers, sits up on own, holds up and drinks, imitates words, pincer grasp, stands a lone, turns pages, says 1-2 words, walks alone 15mo development Correct Answers Climbs furniture, Dances, jargon, rides toys, stacks 2 object tower, stands alone, scoops and recovers, throws ball, uses cup, uses spoon, says 4 words, walks well 18mo development Correct Answers says 8 or more words, feeds self, follows simple directions, imitates housework, knows 2 or more body parts, names pictures, rides toys, runs, uses spoon/fork, walks backward, walks up & down stairs 1mo development Correct Answers focus on face, lifts head, moro reflex, turns to sound, turns head to sound 1st line drug for osteoporosis, MOA, AE Correct Answers bisphosphonates, -dronates (ie alendronate), bind to hydroxyapetite in bone, act by binding to osteoclasts and osteoclast apoptosis, so the osteoclasts can't resorb bone (so bone calcium levels are maintained) can cause hypocalcemia (work to reduce hypercalcemia) 2 causes of SCID Correct Answers ADA deficiency (adenosine deaminase required for degradation of adenosim and deoxyadenosine - in ADA deficiency, high levels of dATP --> toxicity in lymphocytes --> SCID hypoplastic thymus 2 factors that influence starling curve Correct Answers x axis- preload (EDV) y axis- stroke volume or CO 2 most common causes of pancreatitis Correct Answers alcohol and gallstones. 24mo development Correct Answers 2-word sentences, follows 2-step verbal command, gets along well with fam members, acts worried if parent is sad, helps dress self, holds cup in one hand, jumps with both feet, kicks a ball, removes clothes, runs, walks up/down stairs, scribbles, throws overhand 2mo development Correct Answers Coos, fixe and follow, grasps, smiles responsively, lifts head, turns head to sound 3-yr developmental milestones Correct Answers 3-5 word sentences, balances on one foot, asks what? why? builds 10- block tower, copies circle and x, counts to 3, dresses self, knows name/age/gender, pedals tricyle, plays with other kids, recognizes 3 colors, toilet trained, walks upstairs alternating feet 3rd and 4th lumbricles Correct Answers Ulnar n Adenovirus (severe infection) Correct Answers cidofovir + probenecid ADH (desmopressin) Correct Answers pituitary (central, not nephrogenic) DI ADP receptor inhibitors Ticlopidine prasugrel, ticagrelor clopidogrel Correct Answers inhibit platelet aggregation by irreversibly blocking ADP receptors. Inhibit fibrinogen binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen. Used clinically for acute coronary syndrome; coronary stending. decreases incidence or reccurence of thrombotic stroke. toxicity includes: for ticlopidine neutropenia, fever and mouth ulcers. Adrenals Correct Answers T11 Adson's Test Correct Answers a test for thoracic outlet syndrome; with the patient in a sitting position, the hands resting on the thighs, the examiner palpates both radial pulses as the patient rapidly fills the lungs by deep inhalation and, holding the breath, hyperextends the neck and turns the head toward the affected side. If the radial pulse on that side is decidedly or completely obliterated, the result is positive. AE of giving calcitonin Correct Answers hypocalcemia (good for toning down calcium levels in hypercalcemia) AFP levels in down syndrome Correct Answers low Alcoholic cirrhosis Correct Answers final and irreversible form. micronodular, irregularly shrunken liver with "hobnail" appearance. Sclerosis around central vein (Zone III). has manifestations of chronic liver disease (e.g. jaundice, hypoalbuminemia. Alcoholic Hepatitis Correct Answers requires sustained, long term consumption. swollen and necrotic hepatocytes with neutrophilic infiltration. Mallory bodies (intracytoplasmic eosinophilic inclusions) are present. AST>ALT (ratio usually >1.5) ALL Correct Answers >20% blasts (+) for terminal deoxynucleotidyl transferase (TdT) (+)PAS alpha - glucosidase inhibitors (Acordbose and Miglitol) Correct Answers inhibit intestinal brush border alpha glucosidases. delayed sugar hydrolysis and glucose absorption leading to a decrease in post prandial hyperglycemia. Used as monotherapy in type 2 DM or combined with other agents. Can cause GI disturbances. Alternative tx for gonorrhea Correct Answers (when ceftriaxone isn't available) cefexime and azithromycin Alzheimer Disease Correct Answers decrease acetylcholine level from a deficiency of choline acetyltransferase most notably in the basal nucleus of meynert which participates in memory and cognition also decreased levels in the hippocampus Amantadine Correct Answers Anti-Parkinsons: Weak NMDA Antagonist, Increases DA release, Blocks DA reuptake AML Correct Answers >20% Blasts stain (+) myeloperoxidase DIC is a big Risk Factor Tx: Vit A Amylin Analogs (Pramlintide) Correct Answers decreases glucagon. used in type and 2 DM. side effects include hypoglycemia, nausea, diarrhea. Anastrozole, Letrozole, Exemestane Correct Answers Aromatase inhibitors used in postmenopausal women with breast cancer. Anion Gap Equation Correct Answers Na-Cl-bicarb normal is bw 8-16 Ankle ligament sprains Correct Answers 1. ATF 2. ATF and CF 3. ATF, CF, and PTF anterior innominate rotation means tight hip flexors or extensors? Correct Answers extensor- hamstrings Anthrax prophylaxis post-exposure Correct Answers ciprofloxacin or doxycycline + biothrax vaccine Atypical Antipsychotics- AE Correct Answers All-- prolonged QT interval, fewer EPS/anticholinergic effects -pines: Metabolic syndrome Clozapine- agranulocytosis Respiridone- Hyperprolactinemia Axis vs plane Correct Answers Axis is like the pole that the bone rotates across, plane is the field where the bone is moving in B1 Correct Answers thiamine: TPP B12 Correct Answers cobalamin B2 Correct Answers riboflavin: FAD, FMN B3 Correct Answers Niacin: NAD+ B5 Correct Answers pantothenic acid: CoA B6 Correct Answers pyridoxine: PLP B7 Correct Answers biotin B9 Correct Answers folate Bacillus anthracis Correct Answers ciprofloxacin + clindamycin + meropenem + raxibacumab Bacillus cereus Correct Answers Vancomycin or clindamycin Bacterial conjunctivitis Correct Answers fluoroquinolone drops Balantidium coli Correct Answers In trophozoites, the two nuclei are visible. The macronucleus is long and sausage- shaped, and the spherical micronucleus is nested next to it, often hidden by the macronucleus. Balantidium is the only ciliated protozoan known to infect humans. Balantidiasis is a zoonotic disease and is acquired by humans via the feco-oral route from the normal host, the pig, where it is asymptomatic. Contaminated water is the most common mechanism of transmission. In acute disease, explosive diarrhea may occur as often as every twenty minutes. Perforation of the colon may also occur in acute infections which can lead to life-threatening situations Balantidium coli Correct Answers protozoa found in pigs Balantidium coli Correct Answers protozoa found in pigs balantidium coli Correct Answers protozoa that causes GI infection, ingest cysts thru infected water or food produces hyalonuridase and creates ulcers in mucosal walls balantidium coli Correct Answers protozoa that causes GI infection, ingest cysts thru infected water or food produces hyalonuridase and creates ulcers in mucosal walls Ballottement test Correct Answers palpating surface of an organ at the surface of the body **i.e. during pregnancy, palpating the uterus Ballottement test Correct Answers palpating surface of an organ at the surface of the body **i.e. during pregnancy, palpating the uterus beta blockers for asthma Correct Answers none- even beta 1s can be nonselective at higher doses Beta Blockers- AE Correct Answers Exacerbation of COPD/asthma CV effects: bradycardia, AV block, HF Beta Blockers- Mechanism Correct Answers Decrease SA and AV nodal activity by decreasing cAMP/Ca2+ Decrease slope of phase 4 Beta Blockers- Use Correct Answers SVT, ventricular rate control for a-fib and a-flutter Biguanides - Metformin Correct Answers exact mechanism is unknown decrease gluconeogenesis, increased glycolysis, increased peripheral glucose uptake (insulin insensitivity) used clinically as first line therapy in type 2 DM. can be used in patients without islet function (oral). Can cause GI upset but its most serious side effect is lactic acidosis (thus contraindicated in renal failure). Bite Cells=? Correct Answers G6PD-->Ox damage-->Hgb Accumulation (Heinz)-->Bite cells Bladder Correct Answers Umbilicus Campylobacter jejuni Correct Answers azithromycin (alt: erythromycin) Candida spp. Correct Answers miconazole for skin/vagina; fluconazole for systemic infection cant treat kid w tetracycline so what do you give? Correct Answers amoxicillin capsaicin Correct Answers substance P Carbamazepine Correct Answers Binds inactivated Na Channels Tx Trigeminal neuralgia & general seizures SE: Diplopia, SIADH, leukopenia & Agranulocytosis P450 Inducer & DRESS syndrome Carcinoid Syndrome Correct Answers flushing wheezing, diahrrea and right sided valvular lesions especially tricuspid regurgitation. needs to have metastasized to the liver because if not and its in the GI tract it is subject to first pass effect so you will not see symptoms. Carrying angle of arm increases Correct Answers When wrist adducts and ulna abducts Cause of Fragile X mutation Correct Answers FMR1 gene mutation, CGG repeat causes of epiddymitis >35 yo Correct Answers ecoli, pseudomonas, proteus causes of epididymitis < 35 yo Correct Answers chlamydia, gonnohrea. cavernous hemangioma Correct Answers benign tumor of liver, A/W VHL cells w RBCs inside Correct Answers entaemoba histolytica Cerebellum Correct Answers Coracoid process Cherry red spot on macula, cerebral degeneraton in infant. Dx? Deficiency? Correct Answers Tay-Sachs with deficiency in hexosaminidase A Chlamydia trachomatis Correct Answers -doxycycline -azithromycin if non compliant, less than 8 y/o, or pregnant. -also need to treat gonorrhea (unless ruled out) Choriocarcinoma Correct Answers Ovarian Germ Cell tumor. Rare but malignant. can develop during or after malignancy of trophoblastic tissue chorionic villi are NOT present. Increased frequency of theca-lutein cysts. Along with moles, comprise spectrum of gestational trophoblastic neoplasia. Early Hematogenous spread to lungs. Tumor marker is hCG. Is a malignant proliferation of trophobolastic tissue with no villi. It can spread quickly cause it is genetically programmed to invade and find blood vessels. has a poor response to chemo. choriocarcinoma affecst what age group Correct Answers 15- 35 Chvostek's Sign Correct Answers on of the signs of tetany seen in hypocalcemia. it is elicited when the facial nerve is trapped at the angle of the mandible. over the masseter muscle. if the sign is positive, the facial muscle will contract momntarily (twitch) Cilostazol Correct Answers Cilostazol is approved for the treatment of intermittent claudication Cimetidine (-dines) - MOA Correct Answers H2 blockers Take H2 blockers before you dine; table for 2. Cimetidine- Use Correct Answers Peptic ulcer, gastritis, mild reflux Cimitidine- AE Correct Answers Inhibitor of cytochrome P450 Decrease renal excretion of creatinine Antiandrogenic, cross blood brain barrier Climacteric period Correct Answers Menopause Climacteric period Correct Answers Menopause Clomiphene Correct Answers SERM - Partial agonist at estrogen receptors in hypothalamus. prevents normal feedback inhibition and increased release of LH and FSH from pituitary, which stimulates ovulation. Used to treat infertility and polycystic ovarian syndrome. may cause hot flashes, ovarian Cyclophosphamide Correct Answers alkylates DNA Cyclophosphamide Correct Answers alkylates DNA Cyclophosphamide: MoA Correct Answers Alkylating Agent-- >G-T Pairing Desmin prevents Acrolein Accumulation Cytosolic steroid receptor Correct Answers VET CAP Vitamin D, Estrogen, Testosterone, Cortisol, Aldosterone, Progesterone Cytosolic steroid receptor Correct Answers VET CAP Vitamin D, Estrogen, Testosterone, Cortisol, Aldosterone, Progesterone Danazol Correct Answers a synthetic androgen that acts as partial agonist at androgen receptors used clinically in endometriosis and heretitary angioedema. toxicities include weight gain, edema, acne, hirsuitism, masculinization, decreased HDL levels, hepatotoxicity. DDP-4 inhibitors Linagliptin Saxagliptin Sitagliptin Correct Answers increase insulin and decrease glucagon release. Side effects include mild urinary or respiratory infections. Demeclocycline Correct Answers ADH antagonist (member of the tetracycline family) Used in SIADH. toxicity in nephrogenic DI, photosensitivity, abnormalities of bone and teeth Diarrhea prophylaxis during travel Correct Answers fluoroquinolone + loperamide with first loose stool diastolic murmur at left sternal border Correct Answers aortic regurgitation pulmonic regurgitation diastolic murmur at tricuspid area Correct Answers tricuspid stenosis ASD Difference between problem with median nerve (C6-C8, T1) and with Klumpke's palsy (C7, C8, T1) Correct Answers Both have extension of MCP, Flexion of PIP/DIP. Median nerve has thenar wasting and adducted thumb Digoxin Toxicity- Treatment Correct Answers Slowly normalize K+, cardiac pacer, anti-digoxin Fab fragments, Mg+ Digoxin- AE Correct Answers Hyperkalemia, blurry yellow vision, arrhythmias, AV block Digoxin- Clinical use Correct Answers Heart failure (increase contractility) atrial fibrillation (decrease conduction at AV node and depression of SA node) Digoxin- MOA Correct Answers Direct inhibition of Na/K ATPase --> indirect inhibition of Na/Ca exchange Increased Calcium concentration --> positive ionotropy. Stimulates vagus nerve --> decrease HR dimorphic- butterflies Correct Answers candida, histo, cocci, paracocci, blasto, sporothrix, butterflies huge pair of cocc catching stamp Diphyllobothrium latum Correct Answers praziquantel (alt: niclosamide) Disc herniation Correct Answers Affects the nerve of the lower spinal segment, unless above C7 (affects top segment) Disulfiram (antabuse) Correct Answers inhibits acetaldehyde dehydrogenase (acetaldehyde accumulates contributing to hangover symptoms) drug for UC/Crohns Correct Answers sulfasalazine Drug that is a PTH analog that builds bone? Correct Answers tereparatide Drugs for osteoporosis in postmenopausal women? Correct Answers raloxifine (SERM), denosumab- monoclonal antibody against RANK-L both inhibit osteoclast activity enterovirus 71 Correct Answers can cause hand foot mouth dz and severe neurological sx in children. responsible for small epidemics in 1970s Erectile penis or clit Correct Answers T11-L2 Ergonovine Correct Answers to facilitate delivery of the placenta and to prevent bleeding after childbirth by causing smooth muscle tissue in the blood vessel walls to narrow, thereby reducing blood flow; dx Prinzmental's angina Ergonovine Correct Answers to facilitate delivery of the placenta and to prevent bleeding after childbirth by causing smooth muscle tissue in the blood vessel walls to narrow, thereby reducing blood flow; dx Prinzmental's angina Ergotamine MoA Correct Answers 5-HT2b (Vasculature), 5- HT2d (Trigeminal) inhibition-->Vasoconstriction erythema infectiosum Correct Answers slapped cheek parvovirus B19 nonspecific fever/prodrome then slapp cheek rash 5 days later, then rash appears on arms and spreads to trunk/legs rash can worsen w fever and sun exposure TORCH infxn so baby in womb that is exposed can lead to hydrops fetalis Esophagus Correct Answers Sternum at 2nd ICS Esophagus Correct Answers T2 Esophagus Correct Answers T2-T8 Estrogens (Ethinyl Estradiol, DES, mestranol) Correct Answers Binds estrogen receptors. Used clinically in hypogonadism or ovarian failure, menstrual abnormalities, HRT in postmenopausal women; use in men with androgen-dependent prostate cancer. toxicity increases the risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of the vagina in females exposed to DES in utero, increase risk of thrombi. contraindications - ER - positive breast cancer, history of DVT's ethanol hypoglycemia Correct Answers ethanol metabolism increased NADH/NAD+ ratio in liver, causing diversion of pyruvate to lactate and OAA to malate, thereby inhibiting gluconeogenesis and stimulating fatty acid synthesis. Leads to hypoglycemia and hepatic fatty change (hepatocellular steatosis) seen in chronic alcoholics. Overproduction of lactate leads to acidosis. Depletion of OAA shuts down the TCA cycle, shunting acetyl CoA into keton production. Breakdown of excess malate increases NADPH and thus fatty acid synthesis. Ethanol Metabolism Correct Answers thanol is converted to acetaldehyse via the enzyme alcohol dehydrogenase and the cofactor NAD+ (to NADH). that happens in the cytosol. In the mitochondria Acetaldehyde is converted to acetate via Acetaldehyde dehydrogenase again with the help of NAD+. NAD+ is therefore the limiting reagent. Alcohol dehydrogenase operates via zero order kinetics. Ethosuxomide Correct Answers believed to block T - type calcium channels in thalamic neurons causing hyperpolarization and it is approved for the treatment of absence seizures. toxicity includes fatigue, GI distress, HEadache, Uriticaria and Stevens Johnson syndrome. Extension of shoulder Correct Answers Lat dorsi, teres major, post deltoid External rotation of shoulder Correct Answers Infraspinatus, teres minor Eye Correct Answers Lateral humerus facial canal vs. lower pons for LMN lesion of facial nerve? Correct Answers This is a mean question because either are good choices. I would choose facial canal if it were the only complaint involved and pons if patient had additional symptoms not explained by a LMN facial lesion Falciform Ligament Correct Answers connects the liver to the anterior abdominal wall. Contains the ligamentum teres hepatis. Flutamide Correct Answers a nonsteroidal competitive inhibitor of androgens at the testosterone receptor. used in prostate carcinoma. Fomepizole Correct Answers inhibits alcohol dehydrogenase and is an antidote for methanol or ethylene glycol poisening. FPR- direct or indirect? active or passive? Correct Answers indirect- place them in position of diagnosis passive Free nerve endings Correct Answers the most common type of nerve endings, they are of various types and respond to various stimuli, but are most commonly associated with temperature and pain Functions of Vitamin A (retinol) Correct Answers Antioxidant; constituent of visual pigments (retinal); essential for normal differentiation of epithelial cells into specialized tissue (pancreatic cells, mucus-secreting cells); prevents squamous metaplasia. used to treat measles and AML, subtype M3. used for wrinkles and acne. found in liver and leafy vegetables. Furosemide, bumetanide, torsemide (-ides) Correct Answers Loop diuretics Fusion Inhibitor: Rx Names Correct Answers Enfurvitide Gabapentin Correct Answers Binds Calcium channels Neuropathic pain Gallbladder Correct Answers Right 6th ICS Gallbladder Correct Answers Right T6 Gardnerella vaginalis Correct Answers metronidazole (alt: tinidazole) Gastro hepatic ligament Correct Answers connects liver to lesser curvature of the stomach. houses gastric arteries. seperates greater and lesser sacs on the right. may be cut during surgery to access lesser sac Gastrocolic ligament Correct Answers connects greater curvature and transverse colon. houses gastroepiploic arteries. is part of greater omentum. gastrosplenic ligament Correct Answers connects greater curvature and spleen. contains short gastrics and left gasroepiploics. Seperates greater an lesser sac on the left. Genital warts Correct Answers podophyllin resin or cryotherapy or trichloroacetic acid GFAP v Vimentin Correct Answers GFAP=Astrocytes Vimentin=Connective Tissue (Vimentin is connectin) GI ganglion Correct Answers Celiac: T5-9 Superior mesenteric: T10-11 Inferior mesenteric: T12-L2 GI malformation A/W down syndrome Correct Answers Hirschprungs- congenital aganglionic megacolon defective relaxation and peristalsis of rectum and distal sigmoid colon failure to pass meconium, empty rectal vault, megacolon Giardia lamblia Correct Answers tinidazole or nitazoxanide (alt: metronidazole) Glitazones/thiazolidinediones (pioglitazone, Rosiglitazone) Correct Answers increase insulin sensitivity in peripheral tissues. binds PPAR - gama - nuclear transcription regulator. genes activated by PPAR 0 gamma regulate fatty acid storage and glucose metabolism. activation of PPAR - gamma increases insulin sensitivity and levels of adiponectin. these drugs can be used as monotherapy in type 2 DM or combines with other agents. their toxicities include weight gain, edema. hepatotoxicity and heart failure. GLP - 1 analongs (Exenetide, Liraglutide) Correct Answers increases insulin and decreases glucagon release. used in type 2 DM and side effects include Nausea, vomiting and pancreatitis. Glucocorticoids Correct Answers Hydroxycortison, prednisone, triamcinolone, dexamethasone, beclomethasone. - decreases the production of leukotrines and prostaglandins by inhibiting phospholipase A2and expression of COX - 2. Used clinically in addisons disease, inflammation, immune suppression, asthma. toxicity includes iatrogenic cushings macrovesicular fatty change that may be reversible with cessation. Macrovesicular steatosis Hepatocytes filled with fat droplets. Hepatoduodenal ligament Correct Answers connects liver to duodenum and houses the portal triad. hepatic artery, portal vein and common bile duct. Pringle maneuver, ligament may be compressed bw thumb and index finger placed in omental foramen to control bleeding. Connects greater and lesser sacs. Herpes Encephalitis Correct Answers -acyclovir -if HSV (+): acyclovir -If not HSV (+): DOC for specific etiologic agent hip restricted in internal rotation dx? Correct Answers innom outflare Hit at occiput Correct Answers Inferior strain Hit at occiput Correct Answers Inferior strain Hit in front or back of head Correct Answers SBS compression Hit in front or back of head Correct Answers SBS compression Hit on forehead at top of head Correct Answers Superior strain Hit on forehead at top of head Correct Answers Superior strain Hit on same side of head Correct Answers Lateral strain Hit on same side of head Correct Answers Lateral strain Hit under chin on same side Correct Answers Torsion Hit under chin on same side Correct Answers Torsion HIV Entry Inhibitor: Rx Names Correct Answers Maraviroc HIV Entry, Fusion, Integrase Inh Names Correct Answers Entry: Maraviroc Fusion: Enfurvitide Integrase: Raltegravir HLA-A3 Correct Answers associated with hemochromatosis HLA-B27 Correct Answers associated with psoriatic arthritis, ankylosing spondylitis, inflammatory bowel disease and reiters syndrome. HLA-B8 Correct Answers associated with Grave's Disease HLA-DR3 Correct Answers associated with DM type 1 Hoffman's sign Correct Answers a tingline sensation triggered by a mechanical stimulus in the distal part of an injured nerve. This sensation radiates peripherally, from the point where it is triggeres to the cutaneous distribution of the nerve. The tingling response can be compares with that produced by a weak electric current. Hormone Replacement Therapy Correct Answers used for relief or prevention of menopausal symptoms (e.g. hot flashes, vaginal atrophy) and osteoporosis (increased estrogen, decreased osteoclast activity) unopposed estrogen replacement therapy (ERT) increases the risk of endometrial cancer so progesterone is added. Possible increase in CV risk. hpL Correct Answers human placental lactogen - increases insulin resistance, stimulates proteolysis and lipolysis and inhibits gluconeogenesis --> hyperinsulin, hyperglycemia, hyperlipidemia hpL Correct Answers human placental lactogen - increases insulin resistance, stimulates proteolysis and lipolysis and inhibits gluconeogenesis --> hyperinsulin, hyperglycemia, hyperlipidemia Human or animal bite Correct Answers amoxicillin-clavulanic acid + tetanus prophylaxis +/- rabies prophylaxis - + acyclovir if from non-human primate HVLA contraindications Correct Answers Absolute: Osteoporosis, osteomyelitis, fractures in area of thrust (spondys), bone metastasis, severe RA, Down's syndrome (cervicals) Relative: Acute whiplash, pregnancy, post surgery, herniated disc, pts on anti-coags, vertebral artery ischemia (cervical) Influenza A (seasonal), Influenza B, adn avian flu (H5N1) Correct Answers zanamivir or oseltamivir inhaled anthrax Correct Answers shows up as mediastinal widening on CXR Inheritance of glycogen storage diseases Correct Answers All are AR Innervation: 1st and 2nd lumbricles Correct Answers Median n Innervation: Extensors of wrist and hand Correct Answers Radial nerve Innervation: Flexors of the wrist and hand besides flexor carpi ulnaris (ulnar nerve) Correct Answers Median nerve Innervation: Hypothenar eminence and interossi Correct Answers Ulnar n Innervation: Primary pronators of forearm Correct Answers Pronator teres and pronator quadratus: radial n Innervation: Primary supinators of forearm Correct Answers Biceps: musculocutaneous n Supinator: Radial n Innervation: Thenar eminence except abductor pollicus brevis (ulnar) Correct Answers Median n Inpatient UTI Correct Answers ciprofloxacin or levofloxacin Insulin Correct Answers binds insulin receptor (tyrosine Kinase Activity) in the liver it increases glucose stores as glycogen. in muscle it increases glycogen and protein synthesis. K+ uptake. In fat it aids in TG storage. used in the treatment of Type 2 DM, gestational diabetes, life threatening hyperkalemia and stress induced hyper glycemia. toxicities - hypoglycemia and very rarely hypersensitivity reactions insultation installers Correct Answers susceptible to asbestos Intermediate acting insulin Correct Answers NPH Internal rotation of shoulder Correct Answers Subscapularis, pect major, teres major, lat dorsi intracerebral hemorrhage adjacent to a lesion that contains a tangle of numerous tortuous vessels Correct Answers AVM arteriovenous malformation Isospora belli Correct Answers diarrhea, steatorrhea, malabsorption, non-bloody diarrhea Isospora belli Correct Answers diarrhea, steatorrhea, malabsorption, non-bloody diarrhea Isosporiasis Correct Answers The coccidian parasite Isospora belli infects the epithelial cells of the small intestine, and is the least common of the three intestinal coccidia that infect humans (Toxoplasma, Cryptosporidium, and Isospora). Infection causes acute, non-bloody diarrhea with crampy abdominal pain, which can last for weeks and result in malabsorption and weight loss. In immunodepressed patients, and in infants and children, the diarrhea can be severe. Eosinophilia may be present (differently from other protozoan infections. Jejunum absorbs? Correct Answers main site of lipid and folate absorption junctional rhythm Correct Answers pacemaker is the AV node. it usually presents without a P wave or with an inverted P wave. Retrograde P waves refers to the depolarization from the AV node back towards the SA node Kernig sign Correct Answers A sign indicating the presence of meningitis (inflammation of the meninges covering the brain and spinal cord). The test for Kernig sign is done by having the person lie flat on the back, flex the thigh so that it is at a right angle to the trunk, and completely extend the leg at the knee joint. If the leg cannot be completely extended due to pain, this is Kernig sign. kernig's sign Correct Answers can indicate either subarachnoid hemorrhage or meningitis Ketoconazole Correct Answers inhibits steroid synthesis (inhibits 17, 20 - desmolase) ketoconazole and spironolactone are used in the treatment of polycystic ovarian syndrome. decreases CYP 450 side effects of gynecomastia and amenorrhea Leser Trelat sign Correct Answers a sudden eruption of numerous suborrheic keratoses which are greasy stuck on papules that commonly occur in elderly patients. this is an indicator of gastrointestinal cancer as wells as lung, breast and genitourinary cancers. it is a sign of internal malignancy. leuprolide Correct Answers GnRH analog with agonist properties when used in a pulsatile fashion; antagonist properties when used in continuous fashion (down regulates GnRH receptor in pituitary which leads to a decrease in FSH/LH. used for infertility (pulsatile), prostate cancer (continuous - with flutamade), uterine fibroids (continuous), precocious puberty (continuous). toxicity - antiandrogen, nausea, vomiting. Levothyroxine, Triiodothyronine Correct Answers used in hypothyroidism, myxedema. A thyroxine replacement. toxicity includes tachycardia, heat intolerance, tremors and arrhythmias. Listeria monocytogenes Correct Answers ampcillin + gentamicin Lithium- AE Correct Answers LiTHIUM: Low Thyroid, Heart (Ebstein anomaly), Insipidus (nephrogenic), Unwanted Movements (tremor) Lithium- Clinical Use Correct Answers Mood stabilizer lithiums effects on urination Correct Answers inhibits vasopression/ADH --> increased urinary frequency Liver Correct Answers Right 5th and 6th ICS Liver Correct Answers Right T5-T6 Long acting benzos Correct Answers Clordiazepoxide, Clorazepate, Diazepam, Flurazepam Long acting benzos Correct Answers Clordiazepoxide, Clorazepate, Diazepam, Flurazepam Long acting insulin Correct Answers Glargine and Detemir. Loop diuretics- AE Correct Answers OHH DAANG Ototoxicity, Hypokalemia, Hypomagnesemia, Dehydration, Allergy (sulfa), Alkalosis, Nephritis, Gout Loop diuretics- MOA Correct Answers Inhibit Na/K/2Cl in TAL Increase Ca excretion (Loops Lose Ca2+) Loop diuretics- Use Correct Answers Edema (HF, cirrhosis, nephrotic syndrome), HTN, hypercalcemia Loperamide Correct Answers Opioid with little to none BBB crossing-->Constipation loratidine vs ranitidine Correct Answers loratidine: 2nd gen H1 blocker, doesnt cross BBB --> less sedating ranitidine: H2 receptor antagonist (like cimetidine) Low leukocyte ALP Correct Answers CML Low leukocyte ALP Correct Answers CML Lower GI Correct Answers T12-L2 Lower lung Correct Answers T4 Lower ureters Correct Answers L1-L2 Lung dz Correct Answers Sternum at 4th ICS maculopapular rash with pruritic lesions and an altered mental status Correct Answers most likely Rickettsia rickettsiae maneuver that increases afterload Correct Answers handgrip maneuvers that decrease preload Correct Answers valsalva and standing maneuvers that increase pre load Correct Answers mueller maneuver squatting Marasmus Correct Answers energy malnutrition resulting in tissue and muscle wasting, loss of subcutaneous fat, and variable edema. marasmus results in Muscle Wasting contractility LES tone, and overall motility. Used to treat Diabetic gastroporesis SE - extrapyramidal symptoms like parkinsonism and dystonia. Metoclopramide Correct Answers anti-emetic Metoclopramide Correct Answers anti-emetic Metronidazole- AE Correct Answers Disulfiram-like reaction (flushing, tachycardia, hypotension) with alcohol. Headache, metallic taste Metronidazole- Clinical Use Correct Answers GET GAP Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (C. diff), H. Pylori (penicillin injury) (Anaerobic infection below the diaphragm) Metronidazole- MOA Correct Answers Forms toxic free radical metabolites in bacteria. Bacteriocidal Middle ear Correct Answers C1 laterally/ insertion of SCM Middle ear Correct Answers Superior clavicle Middle GI Correct Answers T9-T12 mifepristone (RU - 486) Correct Answers competitive inhibitor of progestins at progesterone receptors. used clinically to terminate pregnancy. is administered with misoprostol (PGE1) toxicity includes heavy bleeding, GI effects (nausa, vomiting, anorexia), and abdominal pain. Mild-moderate diarrhea Correct Answers fluids + lactose and caffeine free diet -may add anti-diarrheal agents if >4 loose stools/day mitral area diastolic murmur Correct Answers mitral stenosis Mitral Area systolic murmur Correct Answers mitral regurgitation Mitral Regurgitation Correct Answers Holosystolic, high pitched "blowing murmur" that is loudest at the apex and radiates toward the axilla. enhances by maneuvers that increase TPR like squatting and hand grip or LA return like expiration. MR is often due to ischemic heart dsease, MVP or LV dilation. Rheumatic fever and infective endocarditis can cause either MR or TR Mitral Stenosis Correct Answers follows opening snap which is due to abrupt halt in leaflet motion in diastole, after rapid opening due to fusion at leaflet tips. delayes rumbling late diastolic murmur. LA>>LV pressure during diastole. often occurs secondary to rheumatic fever. chronic MS can result in LA dilation. Enhanced by maneuvers that increase LA return (e.g. expiration) Mitral Valve Prolapse Correct Answers Late systolic crescendo murmur with midsystolic clid. Midsystolic click is due to sudden tensing of chordae tendineae. Most frequent valvular lesion. best heard over apex. loudest at S2. usually benign. can predispose to infective endocarditis. Can be caused by myxomatous degeneration (in developing countries), rheumatic fever, or chordae rupture. enhanced by maneuvers that decrease venous return (e.g. standing or valsalva) most common cause of cellultis Correct Answers staph aureus, strep pyogenes most common hepatitis A/W IVDA in the US Correct Answers hep c most common STD Correct Answers chlamydia sxs similar to STI plus discharge will have high neutrophil count Most susceptible renal sections to ATN Correct Answers PCT & TAL Mucinous Cystadenocarcinoma Correct Answers malignant. pseudomyxoma peritonei - intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor Mucinous Cystadenoma Correct Answers ovarian non germ cell tumor. mucous, from surface epithelium. multiocular cyst lined by mucous secreting epithelium. benign, intestine like tissue. MUDPILERS Correct Answers Methanol Nerve impingements Correct Answers C5: Numbness at lateral elbow and diminished biceps reflex C6: Numbness at lateral forearm, thumb, wrist extensors, and diminished brachioradialis C7: Numbness of middle finger, weakness of finger and elbow extensors, diminished triceps reflex Neuroblastoma Labs Correct Answers Enolase; Bombesin Homovanillic Acid (DA Metabolite) Vanyllylmandelic Acid (NE Metabolite) normal pressure in ascending aorta/ aortic arch? Correct Answers 130/90 mmHg normal pressure in pulmonary artery/pulmonary trunk? Correct Answers 25/10 mmHg pulmonary artery is where PCWP is measures and is usually <12 mmHg. PCWP in mmHg is a good approximation of left atrial pressure. In mitral stenosis, PCWP is greater than LV diastolic pressure. PCWP is measures with a pulmonary artery catheter (Swan - Ganz catheter). normal pressure in the left atrium? Correct Answers <12 mmHg normal pressure in the left ventricle? Correct Answers 130/0 mmHg normal pressure in the right atrium is? Correct Answers <5 mmHg normal pressure in the right ventricle? Correct Answers 25/5 mmHg Normal Splitting Correct Answers Inspiration leads to a drop in intrathoracic pressure which allows for an increase in venous return to the RV which increases RV stroke volume which increases RV ejection time and delays closure of the pulmonic valve. This decreases pulmonary impedance (increasing capacity of the pulmonary circulation) also occurs during inspiration, which contributes to delayes closure of pulmonic valve. Nuclear steroid receptor Correct Answers T3/T4 Nuclear steroid receptor Correct Answers T3/T4 Ophthalmia neonatorum prophylaxis Correct Answers tetracycline ointment or erythromycin ointment Orotic aciduria: Tx Correct Answers Uridine (UMP) (Pyrimidines) B12 will not help megaloblastic anemia Osteitis fibrosa cystica Correct Answers bone pain, subperiosteal bone resorption on the radial aspect of middle phalanges along with brown tumors of the long bones. Osteomyelitis (<4 months old) Correct Answers nafcillin or oxacillin + ceftazidime or cefepime Osteomyelitis (4 months - adult) Correct Answers nafcillin or oxacillin osteoporosis affects what parts of bone? Correct Answers (spongy and ) trabecular bone mass loss osteoporosis drugs Correct Answers Otitis externa Correct Answers acetic acid + propylene glycol + hydrocortisone drops or Cirpofloxacin + hydrocortisone drops Otitis media Correct Answers -amoxicillin if <2 y/o -analgesics if >2 with no pain or fever Outpatient UTI Correct Answers trimethoprim- sulfamthoxazole -nitrofurantoin if allergic ova in stool Correct Answers means one of the following: giardiasis amebiasis strongyloidosis taeniasis Ovaries Correct Answers Superior to pubic tubercle Pentoxifylline Correct Answers used for intermittent claudication and vascular dementia it changes the shape of RBCs Peroxisome Purpose Correct Answers Long FA chains Pharynx Correct Answers C2 spinous process Pharynx Correct Answers Rib 1 phenylalanine and tryptophan are potent stimulators of? Correct Answers also increased by stomach distention and alkanilization, amino acids, vagal stimulation and decreased by stomach pH<1.5. severely increased in ZE syndrome. and increased by chronic PPI use. Phenytoin Correct Answers Inactivates Na Channels SE: Folate deficiency-->Meg anemia, Ataxia, Gingival Hyperplasia, Hirsutism, SLE, DRESS, SJS/TEN Phenytoin, Carbamazapine and Valproic Acid Correct Answers inhibits neuronal high frequency firing by reducing the ability of sodium channels to recover from inactivation. physiological characteristics of cardiogenic shock Correct Answers increased central venous pressure increased pulmonary capillary wedge pressure increased stroke volume decreased cardiac output decreased venous oxygen saturation Pneumonia <1 months old Correct Answers ampicillin + gentamicin +/- cefotaxime (+ vancomycin if MRSA) Pneumonia >18 years old Correct Answers ceftriaxone or ceftaroline + azithromycin Pneumonia >3 months old - 18 years old Correct Answers ampicillin (if vacc. up to date) or cefotaxime (if vacc. not up to date) +/- azithromycin +/- vancomycin Pneumonia 1-3 months old Correct Answers -erythromycin or azithromycin -febrile: cefotaxime or ceftriaxone pol codes for? Correct Answers reverse transcriptase, aspartate protease, integrase. Polyarteritis Nodosa Correct Answers PAN: Pulmonary are not (affected) Polyostotic fibrous dysplasia Correct Answers bone is replaced by fibroblasts, collagen and irregular bony trabeculae. porphyromonas gingivalis Correct Answers is culprit in periodontal dz and is linked to rheumatic fever possible complication of pagets bone disease Correct Answers osteocarcoma Post-antibiotic diarrhea Correct Answers Metronidazole Pregnant patient with UTI Correct Answers nitrofurantoin Prevotella intermedia Correct Answers acute necrotizing ulcerative gingivitis periodontal infections Prevotella intermedia Correct Answers acute necrotizing ulcerative gingivitis periodontal infections primary disease prevention Correct Answers prevention of disease occurrence probenecid Correct Answers inhibits reabsoprtion of uric acid in PCT - also inhibits secretion of PCN - can ppt uric acid calculi proctalgia fugax Correct Answers levator ani syndrome Progestins Correct Answers bind progesterone receptors, reduce growth and increase in vascularization of endometrium. used clinically in oral contraceptives and in the treatment of endometrial cancer and abnormal uterine bleeding. Prophyromonas gingivalis Correct Answers gingivitis, periodontal disease Prophyromonas gingivalis Correct Answers gingivitis, periodontal disease Pyocyanin pigment Correct Answers blue pigment - Pseudomonas Quadrigeminal cistern Correct Answers Superior cistern or cistern of the great cerebral vein Rabies prophylaxis Correct Answers rabies immune globulin + rabies vaccine -contact with a bat, even without a bite, requires immunization Raloxifene Correct Answers SERM - Agonist on bone; reduces resorption of bonel used to treat osteoporosis. rapid acting insulin Correct Answers Lispro, Aspart, Glulisine the rapid acting insulins don't LAG Rapid Squatting Maneuver Correct Answers increases venous return, increases preload, increases afterload with prolonged squatting. Rectum Correct Answers Antero-medial thigh Resp Correct Answers T1-T7 Reyes Syndrome Correct Answers rare, often fatal childhood hepatoencephalopathy. findings include mitochondrial abnormalities, fatty liver (microvascular fatty change), hypoglycemia, vomiting, hepatomegaly, coma. Associated with viral infection (especially VZV and influenza B) that has been treated with aspirin. MechanismL aspiring metabolites decrease Beta oxidation by reversible inhibition of mitochondrial enzyme. Avoid Aspirin in children, except in those with Kawasaki's disease. Rib muscles for tx Correct Answers Rib 1: Ant and mid scalenes 2: Post scalene 3-5: Pect minor 6-9: Serratus anterior 10-12: Lat dorsi Ribs Correct Answers Atypical: 1, 2, 11, 12 Typical: 3-10 True: 1-7 False: 8-12 Pump: 1-5 Bucket: 6-10 Caliper: 11-12 Risk factors for Adenocarcinoma of the esophagus Correct Answers Barrets GERD Obesity Tobacco risk factors for SCC of the esophagus Correct Answers Alcohol (in US) Tobacco (in US) Consumption of N-Nitroso containing foods (in asia) Chewing beetle nuts (in asia) Ritodrine/Terbutaline Correct Answers Beta 2 agonist that relzxes the uterus to reduce premature uterine cotnractions; tocolytic "Ritodrine allows the fetus to return to dreams" Ritodrine/Terbutaline Correct Answers Beta 2 agonist that relzxes the uterus to reduce premature uterine cotnractions; tocolytic "Ritodrine allows the fetus to return to dreams" roseola Correct Answers 4 day high fever then rash on the trunk (spares face) affects babies up to 2 years HHV6- affects CD4 helper cells and kills them off Rovsings sign Correct Answers is a sign of appendicitis and refers to pain the the right lower quadrent of the abdomen when the lower left quadrant is palpates. Rubeola Virus Correct Answers causes measles 3C's cough coryza (cold like symptoms) conjunctivitis koplic spots 0 red oral lesions with white centers found in the buccal mucosa are characteristic of measles in the early stage. all of these symptoms are prodromic and will disappear before the measles rash begins. rash begins 2-5 days later and the child Sepsis in an adult Correct Answers any carbapenem or piperacillin-tazobactam + vancomycin Septic shock Correct Answers DOC for suspected organism + IV fluids + norepinephrine + blood glucose control with target of 140-180 +/- low dose steroids Serious Cystadenocarcinoma Correct Answers ovarian non germ cell tumors. is cystic and is from surface epithelium. malignant and frequently bilateral. psammoma bodies are seen on histology. risk factors include BRCA - 1 BRCA - 2 and HNPCC. significant genetic predisposition makes family history the most important risk factor. malignant clear invasion of cells in CT. larger tumor with complicated cysts with thick shaggy lining. usually post menopausal women 60-70 years of age. Serous Cystadenoma Correct Answers ovarian non germ cell tumor. is cystic and from surface epithelium. is from water and is benign. frequently bilateral, lined with fallopian tube - like epithelium. which have an increase in CA-125 which is the general ovarian cancer marker. good for monitoring progression, not for screening. single cyst with flat lining usually 30-40 years old, surface epithelium. present late, poor prognosis and extend to involve peritoneam. Severe diarrhea Correct Answers ciprofloxacin or levofloxacin + metronidazole + lactose and caffeine free diet -Children: trimethoprim-sulfamethoxazole Shigella species Correct Answers azithromycin or any fluoroquinolone (alt: ceftriaxone) Shistosoma spp. Correct Answers praziquantel Short acting benzos Correct Answers ATOM Alprazolam, Triazolam, Oxazepam, Midazolam Short acting benzos Correct Answers ATOM Alprazolam, Triazolam, Oxazepam, Midazolam Short Acting Benzos Correct Answers ATOM Alprazolam, Triazolam, Oxazepam, Midazolam short acting insulin Correct Answers Regular Sildenafil, Vardenafil Correct Answers inhibits PDE-5 causing an increase in cGMP, smooth muscle relaxation in the corpus cavernosum, increase in blood flow and penile erection. Used in the treatment of erectile dysfunction. toxicity includes headache, flushing, dyspepsia, impaired blue - green color vision. Risk of life threatening hypotension in patients taking nitrates. Sinuses Correct Answers C2 spinous process Sister Mary Joseph sign Correct Answers a palpable nodule bulging into the umbilicus due to abdominal or pelvic metastases of cancer. pancreatic cancer is the most common cause, but other primary sites may be to blame such as ovary or uterus. Sleep changes in depressed patients Correct Answers decreased slow-wave sleep, decreased REM latency, REM early in sleep cycle, increased total REM sleep, repeated nighttime awakenings, early-morning awakenings Sleep changes in depressed patients Correct Answers decreased slow-wave sleep, decreased REM latency, REM early in sleep cycle, increased total REM sleep, repeated nighttime awakenings, early-morning awakenings Small intestines Correct Answers T8-T10 Smallpox Correct Answers smallpox vaccine within 4 days of exposure + cidofovir + probenecid Somatostatin (octreotide) Correct Answers used for acromegaly, carcinoid, gastrinoma, glucagonoma, esophageal varices. Specific phobia Correct Answers severe, persistent (> 6 months) fear or anxiety due to presence or anticipation of a specific object or situation. Person recognizes fear is excessive. Can be treated with systematic desensitization. subsets: Social anxiety Disorder and Agoraphobia Social Anxiety Disorder ---> exaggerated fear of embarrassment in social situations (public speaking, using public restroom) tx: CTB, SSRI, venlafaxine **For only occasional anxiety-inducing situations (benzo or BB) Streptococcus pyogenes Correct Answers penicillin G or V Sulfanylureas: 1st gen - tolbutamide and chlorpropramide. 2nd generation - Glyberide, Glimepiride, Glipizide Correct Answers these drugs close K+ channel in beta cell membrane, so the cell depolarizes which leads to triggering of insulin release via a calcium influx. used clinically to stimulate the release of endogenous insuling in type 2 DM. Require some islet function function, so useless in type 1 DM. first generations cause disulfiram like effects. second generation can cause hypoglycemia. Sumatriptan Correct Answers 5-HT 1B/1D agonist --> vasoconstsriction, inhibition of trigeminal activation and vasoactive peptide release Sumatriptan Correct Answers 5-HT 1B/1D agonist --> vasoconstsriction, inhibition of trigeminal activation and vasoactive peptide release syngeneic graft Correct Answers from identical twin syngeneic graft Correct Answers from identical twin systolic ejection murmur at pulmonic area Correct Answers pulmonic stenosis flow murmur (e.g. asd, pda) systolic murmer at left sternal border Correct Answers hypertrophic cardiomyopathy Systolic murmur heard near aortic area Correct Answers aortic stenosis flow murmur aortic valve sclerosis T1 motor Correct Answers Interossi T1 sensation Correct Answers Medial elbow and medial arm T7 FRLSL with L 5th ICS ... what was associated? Chapman vs. Tender vs. Trigger Correct Answers Chapman's points represent the somatic manifestation of a visceral dysfunction Left 5th ICS Chapmans ---> stomach, hyperacidity Tamoxifen Correct Answers SERM antagonist on breast tissue used to treat and prevent recurrence of ER-Positive breast cancer. Tamsulosin Correct Answers alpha 1 antagonist used to treast BPH by inhibiting smooth muscle contraction. selective alpha 1 A,D receptors (found on prostate) vs vascular alpha 1B receptors Tartrate resistant acid phosphatase positive in Correct Answers Hairy Cell Leukemia Tartrate resistant acid phosphatase positive in Correct Answers Hairy Cell Leukemia Teratoma Correct Answers ovarian germ cell tumor. contains cells from 2 or 3 germ layers. Mature teratoma ("dermoid cyst") most common ovarian germ cell tumorl mostly benign. Immature teratoma is aggressively malignant. Struma ovarri - contains functional thyroid tissue. can present as hyperthyroidism. tissue IN the teratoma can have cancer. Terbutaline Correct Answers a beta 2 agonist that relaxes the uterus reduces premature uterine contractions. tertiary disease prevention Correct Answers aims to reduce the morbidity of an already acquired disease test for trichomonas Correct Answers nucleic acid amplification Testosterone, methyltestosterone Correct Answers agonist at androgen receptors. used to treat hypogonadism and promotes development of secondary sex characteristics; stimulation of anabolism to promote recovery after burn or injury. causes masculinization in females; reduces intratesticular testosterone in males by inhibiting release of LH ( via negative feetback), leading to gonadal atrophy. premature closure of epiphyseal plates which leads to an increase in LDL and decrease in HDL. Tetanus prophylaxis Correct Answers -Td + tetanus immune globulin if never vaccinated -Td if >5 years since vaccination -Nothing if <5 years since vaccination/booster treatment for legionares? Correct Answers respiratory floroquinolone Treatment for overactive bladder, AE of treatment Correct Answers anticholinergics (oxybutynin, fesoterodine, tolterodine), "mad as a hatter, dry as a bone, hot as a hare, red as a beet" treatment for tinea versicolor Correct Answers selenium sulfatide, topical miconazole Treatment of pericarditis? Correct Answers ibuprofen Treponema pallidum Correct Answers penicillin G Trichinella spiralis Correct Answers albendazole + prednisone Trichomonas vaginalis Correct Answers metronidazole (alt: tinidazole) trichophytum rubrum Correct Answers most common cause of athlete's foot, jock itch, ringworm Tricuspid regurgitation Correct Answers holosystolic, high pitched "blowing murmur" that is loudest at the tricuspid area and radiates to right sternal border. Enhanced by maneuvers that increase RA return (e.g. inspiration). TR can be caused by RV dilation. Rheumatic fever and infective endocarditis can cause either MR or TR Trousseau's Syndrome Correct Answers a migratory thrombophlebitis - presents with redness and tenderness on palpation of extremities. associated with a visceral malignancy mostly pancreatic adenocarcinoma or adenocarcinoma of the colon and lung etc. trousseaus sign Correct Answers occlusion of brachial arter with BP cuff which leads to carpal spasm. present in hypoparathyroidism Tx for Orotic aciduria Correct Answers Uridine - inhibits carbamoyl phosphate synthetase Tx for Orotic aciduria Correct Answers Uridine - inhibits carbamoyl phosphate synthetase tx for tinea Correct Answers azoles Tx for trigeminal neuralgia Correct Answers anticonvulsants, TCA Tx of S. pneumonia Correct Answers Penicillin Tx of S. pneumonia Correct Answers Penicillin Typical antipsychotics - AE Correct Answers EPS (ADAPT)- Acute dystonia, akathisia, parkinsonism, tardive dyskinesia Neuroleptic malignant syndrome (Malignant FEVER)- Myogllobinuria, fever, encephalopathy, vitals, increased enzymes, muscle rigidity Treatment: Dantrolene, D2 agonist (bromocriptine) Typical antipsychotics - Clinical Use Correct Answers Schizophrenia, pyschosis, bipolar, Huntington, OCD Typical antipsychotics (-azine)- MOA Correct Answers Block dopamine D2 receptor --> increase cAMP Unpasteurized goat cheese Correct Answers Brucella Unpasteurized goat cheese Correct Answers Brucella Upper GI Correct Answers T5-T9 Upper lung and myocardium Correct Answers T3 Upper ureters Correct Answers T10-L1 Urinary bladder and urethra Correct Answers T11-L2 Uterus Correct Answers Pubic symphysis Uterus and cervix Correct Answers T10-L2 vaginosis and pH Correct Answers pH of greater than 4.5 is likely bacterial Valproate Correct Answers Inactivates Na Channels; Increases GABA; Vitamin B12 (cobalamin) deficiency Correct Answers macrocytic, megaloblastic anemia, hypersegmented PMN's, neurologic symptoms (parasthesias, subacute combined degeneration) due to abnormal myelin. Prolonged deficiency leads to irreversible nervous system damage. Vitamin B12 (cobalamin) functions Correct Answers cofactor for homocystein methyltransferase (transfers CH3 groups as methylcobalamin) and methylmalonyl CoA mutase. Vitamin B2 (riboflavin) deficiency Correct Answers cheilosis (inflammation of lips, scaling and fissures at the corners of the mouth), corneal vascularization. Vitamin B2 (riboflavin) function Correct Answers cofactor in oxydation and reduction (e.g. FADH2) FAD and FMN are derived from riboflavin (B2 = 2ATP) Vitamin B3 (niacin) deficiency Correct Answers glossitis. severe deficiency leads to pellagra which can be caused by hartnup disease (deficiency in tryptophan absorption), malignant carcinoid syndrome (increased tryptophan metabolism) and INH (decreased vitamin B6). symptoms of pellagro are diarrhea, dementia, dermititis and death. Vitamin B3 (niacin) excess Correct Answers facial flushing (due to pharmacologic doses for treatment of hyperlipidemia) Vitamin B3 (niacin) function Correct Answers constituent of NAD+, NADP+ (used in redox reactions) derived from tryptophan. synthesis requires B6. NAD is derived from Niacin (B3 = 3ATP) Vitamin B5 (pantothenate) deficiency Correct Answers dermatitis, enteritis, alopecia, adrenal insufficiency. Vitamin B5 (pantothenate) function Correct Answers essential component of CoA (a cofactor for acyl B5 is "pento" thenate. transfers) and fatty acid synthase. Vitamin B6 (pyridoxine) Deficiency Correct Answers convulsions, hyperirritability, peripheral neuropathy (deficiency inducible by INH and oral contraceptives), sideroblastic anemias due to impaired hemoglobin synthesis and iron excess. Vitamin B6 (pyridoxine) function Correct Answers converted to pyridoxal phosphate, a cofactor used in transamination (e.g. ALT and AST), decarboxylation reactions, glycogen phosphorylase. synthesis of cystathionine, heme, niacin, histamine, and neurotransmitters including serotonin, epinephrine, norepinephrine and GABA. Vitamin B7 (biotin) deficiency Correct Answers relatively rare. dermatitis, alopecia, enteritis. caused by antibiotic use or excessive ingestion of raw eggs. Vitamin B7 (biotin) function Correct Answers cofactor for carboxylation enzymes which add a 1-carbon group)\1) pyruvate carboxylasel pyruvate (3C) --> oxaloacetate (4C) 2) Acetyl - CoA carboxylase: acetyl - CoA (2C) __> malonyl - CoA (3C) 3) propionyl - CoA carboxylase; Propionyl - CoA (3C) --> methylmalonyl - CoA (4C) Vitamin B9 (folic acid) deficiency Correct Answers macrocytic, megaloblastic anemial no neurologic symptoms (as opposed to vitramin B12 deficiency) most common vitamin deficiency in the US. seen in alcoholism and pregnancy. deficiency can be caused by several drugs like phenytoin, sulfonamides, MTH, valproic acid. supplemental folic acid in early pregnancy reduces neural tube defects. Vitamin B9 (folic acid) function) Correct Answers converted to tetrahydrofolate (THF), a coenzyme for 1 carbon transfer/methylation reactions. important for the synthesis of itrogenous bases in DNA and RNA. Found in leafy green vegetables, smal reserve pool primarily in the liver. vitamin C Correct Answers ascorbic acid Vitamin C (ascorbic acid) deficiency Correct Answers causes scurvy due to a collagen synthesis defect - swollen gums, bruising, hemarthrosis, anemia, poor wound healing, weakened immune response. Vitamin C (ascorbic acid) function Correct Answers is an antioxidant. also facilitates iron absorption by keeping iron in Fe2+ reduced state. It is also necessary for hydroxilation of proline and lysine in colagen synthesis. Is also necesary for dopamine beta hydroxylase which converts dopamine. found in fruits in vegetables. Warfarin- Pregnancy Correct Answers CI in pregnant women-- crosses placenta water solble vitamins Correct Answers all wash out easily from body except B12 and folate which are stored in the liver. B complex deficiencies often result in dermatitis, glossitis and diarrhea Wernicke Korsakoff Correct Answers confusion, opthalmoplegia, ataxia (classic triad)+ confabulation, personality change, memory loss (permanent) damage to medial dorsal nucleus of thalamus, mamillary bodies. Wet beriberi Correct Answers high output cardiac failure (dilated cardiomyopathy) edema. what are some indirect indicators of chronic alcohol consumption? Correct Answers Macrocytosis AST:ALT Ratio >2 Increase GGT (gamma glutamyl transferase) What are the causes of high anion gap metabolic acidosis? Correct Answers MUDPILES- methanol, uremia, diabetic ketoacidosis, propylene glycol, iron, lactic acidosis, ethylene glycol, salicylates What are the symptoms of neuroleptic malignant syndrome? Correct Answers lead-pipe rigidity, fever, altered mental status, elevated CK, leukocytosis, if severe may see rhabdomyolysis what blocks NE reuptake? Correct Answers TCA or SNRIs What causes toxic shock syndrome? Correct Answers super antigen of staph aureus What composes the lower GI Correct Answers Distal 1/3 transverse colon, descending colon, sigmoid colon, rectum What composes the middle GI? Correct Answers Portions of pancreas and duodenum, jejunum, ileum, ascending colon, prox 2/3 of transverse colon What composes the upper GI? Correct Answers Stomach, liver, gallbladder, spleen, part of pancreas and duodenum what does Hct tell you? Correct Answers ratio of volume of RBCs compared to total blood volume What heavy metal can cause memory loss? Correct Answers arsenic What is rosacea? Triggers? Correct Answers sebaceous gland hyperplasia (can often look like malar rash and enlarged nose); spicy foods, alcohol, and heat can trigger flushing what kind of teratogenic effects are seen w ACE/ARBs Correct Answers fetal renal agenesis What ligaments are affected in spinal stenosis? Correct Answers posterior longitudinal ligament, ligamentum flavum What neurotransmitter is elevated in PTSD? Correct Answers norepiphrine What type of breathing will you see in DKA? Correct Answers Kussmaul breathing (hyperpnoea means increased depth and rate of breathing) What type of stone causes staghorn caliculi? Correct Answers magnesium ammonium phosphate- struvite crystals (common to see paired with proteus alkalizination of urine) What's defective in Marfan syndrome? Diagnosis? Correct Answers mutated fibrillin-1 gene (inherited in autosomal dominant pattern), diagnose via echo to see increased diameter of aortic root Where is Colle's fracture? Correct Answers distal radius which Heps are there currently vaccines for? Correct Answers A and B (and so by virtue, also D) Which Stigmine rescue for anti-cholinergic poisoning? Correct Answers Physostigmine which type of pneumothorax causes tracheal deviation to the contra side? Correct Answers tension why does Hep D need Hep B? Correct Answers Hep D utilizes the HBV surface antigen as its envelope?