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44 Cards in this Set
- Front
- Back
elevated acetylcholinesterase levels on 25 week amniocentesis?
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Neural Tube defect (4th week)
also alpha-fetoprtns are raised |
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light microscopy shows neurons w/shrunken nuclei, no detectable nissl substance, & intensely eosinophilic cytoplasms
these findings indicate? |
irreversible damage
this is a red neuron (12-24 hours) characterized by: -shrinkage of the cell body, -pyknosis of the nucleus, -loss of Nissl substance, and -eosinophilic cytoplasm |
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pt in status epilepticus, IV benzos started
what is started IV concurrently to prevent recurrence? |
phenytoin
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8 yo male w/hx recurrent pulm infections has unsteady gait, "eyes don't move steadily", has numerous superficial blanching nests of distended capillaries on sun-exposed areas, gene defect?
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Ataxia telangiectasia
ATM gene involved in DNA break repair, immunodeficiency relates to IgA classic triad: -cerebellar ataxia, telangiectasia, increased sinopulmonary infections |
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MC location of acoustic neuroma? Sx of unilateral CN V & VII involved?
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cerebellopontine angle
between cerebellum & lateral pons |
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where (physically identify) is post-chemo nausea mediated?
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chemoreceptor trigger zone
area postrema of the dorsal medulla, near the 4th ventricle |
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what nerve innervates salivary secretion from submandibular & sublingual gland?
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parasympathetics from superior salivatory nucleus
carried on CN VII via chorda tympani (taste) |
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what nerve innervates salivary secretion from parotid gland?
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CN IX
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what is the space constant? What changes it?
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measure of ability of impulse to travel down an axon, low space constant decreases length impulse will travel
decreased by demyelination |
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med recommended for motion sickness prevention? Main SE?
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Antimuscarinics & antihistamines-with antimuscarinic action are most effective
warn of dry mouth (& other such): ex - scopolamine, or meclizine & dimenhydrinate |
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how does NDMA relate to morphine tolerance?
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activation of NMDA receptors by glutamate is believed to enhance morphine tolerance by increasing phosphorylation of opioid receptrs, increasing nitric oxide levels
ketamine |
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what is serotonin precursor?
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tryptophan
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how do you tx serotonin syndrome?
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Cyproheptadine
anti-histamine w/antiserotonergic properties |
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motile gram positive rods w/beta hemolysis?
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Lysteria
cell mediated immunity is necessary to eliminate |
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hypertensive crisis following cheese or wine?
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MAO inhibitor (eg phenelzine)
prevent tyramine from being degraded by gut & it gets systemic |
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how do beta blockers effect glaucoma?
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decrease aqueous humor production by CILIARY EPITHELIUM
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lady on lithium for bipolar develops involuntary movements, ataxia, & tremor acutely worsening over past 2 days, fell down getting gup from a chair
started new BP med in last 2 months, has resting tremor & difficult balance, what was BP med? |
Hydrochlorothiazide
she has lithium toxicity - lithium is exclusively excreted by kidneys, thing altering kidney fxn can cause this |
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MC antibiotic for prophylaxis of n. meningitidis in close contacts?
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Rifampin
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44 yo man recently dx w/AIDS following PCP, c/o pain in arms & legs, PE - irregular unequal pupils that do not respond to light, do constrict
romberg sign positive, DTRs absent - what is causing neuro sx? |
Tabes dorsalis
found in neurosyphillis (AIDS or immigrants) - affects dorsal columsn & dorsal roots of spinal cords - loss of position, vibration, & pain sensation argyll-robertson pupil is characteristic |
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tell me about neurosyphillus signs?
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Argyll robinson pupil
TABES DORSALIS - dorsal columns & roots of spinal cord affected - loss of position, vibration, & pain sensation |
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pt w/NF1 (what is eponym for this?) found to have "rubbery cutaneous tumors on his neck", what cells comprise these? Orginiated from what embryologic tissue?
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Schwann cells, from neural crest
eponym is "von Recklinghausen's dz" |
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random ass associations of carpal tunnel syndrome?
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fluid retention (renal failure, hypothyroidism, pregnancy)
diabetes mellitus, acromegaly, rheum arthritis and ofc chronic repetitive stress |
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lady on dialysis develops carpal tunnel syndrome?
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dialysis associated amyloidosis
w/long hx hemodialysis may develop beta-microglobulin deposition |
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PE maneuvers useful in carpal tunnel syndrome?
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Tinel's sign - sx reproduced by tapping on flexor surface of wrist
Phalen's sign - sx occur after flexion of wrist |
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lead poisoning - enzymes inhibited & substances built up, useful for testing?
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ALA dehydratase & ferrochelatase are enzymes in heme biosyntheitc pathway inactivated by lead
ALA and protoporphyrin IX accumulate production of heme is decreased --> microcytic anemia (2nd to lack of Hb) |
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defect in uroporhyrinogen I synthase?
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Acute intermittent porphyria
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defect in uroporhyrinogen decarboxylase?
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porphyria cutanea tarda
MC porphyria |
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vomiting, lethargy
diaper smells like "burned sugar"? How to manage? |
Maple Syrup Urine Dz (branched chains)
restrict diet, give thiamine supplementation |
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what is characterized by ANA? If this is drug induced, what 2 drugs are MC? What lab feature is absent in drug induced version?
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DILE (drug induced lupus erythematosus)
Procainamide & hydralizine highest risk unlike w/SLE anti-dsDNA antibodies rarely seen |
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cause of death in TCA overdose? Mediated how?
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refractory hypotension (inhibition of peripheral alpha-1 receptors) & CARDIAC arrythmias (inhibition of fast Na channels in cardiac myocytes)
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appetite suppressing drugs? Caused sudden death, what cardiac abnormality do you find?
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fenluramine or phentermine
find RV hypertrophy b/c they cause increased incidence of pulmonary HTN |
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how does silicosis predisopse to tuberculosis?
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impairs macrophage killing
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how does LV hypertrophy lead to pulmonary hypertension?
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reactive vasoconstriction secondary to pulmonary venous congestion
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congenital defects associated w/fetal alcohol syndrome?
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MCC mental retardation
assoc w/VSD, brain defects (micro/holoprosencephaly) & abnormal facies (short palpebral fissures, long smooth philtrum) |
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as dopamine dose increases, receptors are agonized in what order?
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D1 > B1 > A1
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during strenuous exercise what is the major limiting factor for coronary blood flow?
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duraiton of diastole
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seizures occuring in the morning, aggrevated by sleep deprivation
never lost conciuosness, sudden-onset arrhythmic jerking movements - type? Tx? |
Myoclonic seizures
1st line tx is Valproic acid |
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does carotid baroreceptor fireing increase or decrease w/carotid body massage?
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increase
low pressure environments result in decreased firing freq |
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23 yo male w/sudden heart palpitations
HR 160 BP 110/70 - what is it? Tx? |
PSVT, carotid body massage
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65 yo pt on multiple meds for HTN presents w/disturbed color vision, anorexia, nausea, vomiting, & diarrhea - what med toxicity? What is another common toxicity not listed here?
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Digoxin (changes in color vision)
could see arrhythmia |
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infant born to 25 yo IV drug users develops prominent oral thrush, interstitial pneumonia, & severe lymphopenia during 1st year life - what would have prevented this condition?
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baby has HIV
viral enzyme inhibitor would have helped |
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ornithine transport into mitochondria is essential for what function? If this process is deficient how should it be managed?
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urea formation
protein restriction (inside mitochondria ornithine --> citrulline via ornithine transcarbamoylase, carrying NH4+ out of mitochondria into cytosol) |
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which mycobacterial agent requires an acidic pH?
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Pyrazinamide, thus it is the best of the options for intracellular
the otehrs work better extracellularly |
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mucicarmine staining of lung tissue in immunocompromised pt w/cough & chest pain, turns red?
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Cryptococcus neoformans
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