Gotta Know

Proximal Facial nerve lesion results in

Hyperacusis, lack of taste, and disturbances in salivation and lacrimation

Microcolon

results from intrauterine underutilization of the colon

Hypertrophic osteoarthropathy associated with

thoracic malignancies

epigastric bruit

can signify renal artery stenosis

autosomal polycystic kidney disease presents in

infancy

Gilbert's syndrome

Mild unconjugated hyperbilirubinemia (< 3.0mg/dl) in young adult patients

In nephrotic syndrome liver increases the synthesis of

lipids

Hot flashes are due to

ovarian burnout - decreased estrogen synthesis which leads to decreased regulation of GnRH, LH, and FSH and as a result stimulation of thermoregulatory centers in hypothalamus

Decreases FSH and LH and increased estrogen

McCune-Albright syndrome

Increased FSH, decreases LH, and decreased GnRH

GnRH analogue treatment

Increased LH, FSH, and GnRH

approaching menopause

Microsatellites

short repetitive sequences found throughout genome

Upper retina relays information to the

cuneus gyrus

Lower retina relays information to the

lingual gyrus

Macula is spared in lingual and cuneus gyri infarctions because

collateral blood supply is given by the middle cerebral artery

Superficial fibular (peroneal) nerve

fibularis longus
fibularis brevis - ankle eversion

Deep fibular (peroneal) nerve

tibialis anterior
extensor hallucis
extensor digitorum
fibularis tertius

Forament rotundum is traversed by

maxillary division of trigeminal nerve

Optic canal is traversed by

CN II and ophthalmic artery and central retinal vein

superior orbital fissure is traversed by

CN III, IV, VI, ophthalmic branch of trigeminal nerve, and veins, sympathetic fibers

foramen ovale is traversed by

mandibular branch of trigeminal nerve

foramen spinosum is traversed by

middle meningeal artery and vein

Internal auditory meatus is traversed by

CN VII and VIII

Jugular foramen is traversed by

CN IX, X, and XI and jugular vein

Hypoglossal canal

CN XII

Foramen magnum is traversed by

spinal cord, CN XI, and vertebral arteries

Prostate cancer commonly metastasizes to

axial skeleton (pelvis and vertebra)

Hashimoto's thyroiditis may lead to

Non-hodgkin's lymphoma

Duchenne muscular dystrophy is due to a

frameshift mutation

cystinuria can cause

staghorn caliculi

cyanide nitroprusside test

is to detect cystine as cyanide converts it into cysteine and nitroprusside reacts with cysteine to make the purple color

Aromatic amines cause what sort of cancer in bladder

transitional cell carcinoma

Unconjugated bilirubin aka

indirect bilirubin

Window period of Hep B

disappearance of HBsAg and appearance of anti-HBs; Anti-HBc IgM however is present in this period

Major source of blood supply to the nasal mucossa

sphenopalatine artery, which is the terminal branch of the maxillary artery

Kiesselbach's plexus

Anterior and posterior ethmoidal arteries, sphenoplatine artery, greater palatine artery, superior labial artery

Leydig cells tumors are mainly

benign

Reinke crystals (pale staining rod shaped inclusions) are pathognomic for?

Leydig cell tumors

Serology of mycoplasma pneumoniae

cold agglutinins

Diluting segment of nephron

thick ascending limb and early distal tubule

Oncogene associated with small cell carcinoma

L-myc

Small cell carcinoma resembles lymphoma so it must be differentiated using

LCA (lymphocyte common antigen) stain

PaO2

amount of oxygen dissolved in plasma

Breathing 100% oxygen increases PaO2 to

600 mm Hg

Blood O2 content

sum of dissolved O2 and Hb bound O2

Trousseau's sign

migratory thrombophlebitis commonly seen in lung, colon, and pancreas carcinoma

Renal involvement in bacterial endocarditis can cause

acute glomerulonephritis and infarction due to septic emboli

Halothane can cause

hepatic necrosis due to P450 mediated conversion into reactive metabolites

Absent fetal tissues is suggestive of a

complete mole (46 XX)

Gonococcal conjunctivitis occurs

2-7 days after birth

Chlamydial conjunctivitis occurs

5-14 days after birth

Hematological changes in Chlamydia infections

eosinophilia

Compensatory increase of RBC lifespan occurs in patients with

Iron and folate/Vit B12 deficiency and as a result HbA1C readings are falsely elevated

HbA1c reflects plasma glucose concentration over past

2-3 months

MEN1

Parathyroid
Pancreatic
Pituitary (gastrinoma and glucagonoma)

MEN2A

Medullary thyroid cancer
Pheochromacytoma
Parathyroid Cancer

MEN2B

Mucosal neuromas
Medullary thyroid carcinomas
Pheochromacytoma
Marfanoid habitus

Short gastric artery (no anastomosis) supplies the fundus of the stomach and is a branch of

splenic artery

Zileuton inhibits

5-lipoxygenase

General age of onset of Huntington's disease

20-40

Trinucleotide repeat seen in Huntington's

CAG in HTT gene on Chromosome 4

Zone 1 in liver

periportal zone. Area susceptible to direct toxic injury and also associated with lymphocyte infiltration in viral hepatitis.

Zone 2 in liver

intermediate zone

Zone 3 of liver

furthest away from portal tract (afferent vessels). Pericentral zone.

Most toxic part of LPS

Lipid A

TCA have strong ______ effects

antimuscarinic

Smudge cells

chronic lymphocytic leukemia

Pancoast tumor associated with

SVC syndrome
Horner syndrome
Ulnar nerve defects (pain)
Vertebral erosion

Most common Pancoast tumor

SCC

eculizumab

MOA: targets complement protein C5
Clinical use: paroxysmal nocturnal hemoglobinuria

Tree bark appearance of aorta

Caused by scarring and fibrosis of endarteritis from syphilis resulting in smooth muscle atrophy

Creatinine kinase percentages in myocardium

CK-MM is 75%
CK-MB is 25% (specific for myocardium)

Pemphigus vulgaris

Above the basal layer or disease that attacks desmoglein in desmosomes that holds epithelial cells together

Inhibin

Secreted by granulosa cells of growing follicles and by corpus luteum
Inhibits secretion of FSH and LH

Cal Exner bodies

Granulosa cell tumors

Tertiary prevention

Preventing relapse and reducing the impact of the disorder on the person's quality of life

Pox viruses are _______ shaped

brick

Gram-negative sepsis can cause

DIC

Nerve that supplies mucosa above the vocal cords

Internal branch of superior laryngeal nerve

Watershed zones of colon

splenic flexure
sigmoid colon

Hyperpyrexia, muscle rigidity, altered mental status, myoglobinuria, autonomic instability, elevated creatine kinase (< 1000 IU/L), and elevated AST, ALT, and LDH

Neuroleptic malignant syndrome

NMS caused by

Haloperidol, thiothixene, fluphenazine, chlopromazine

Reid index

the ratio of the thickness of the mucous gland layer in the bronchial wall submucosa to the thickness of the bronchial wall BETWEEN THE RESPIRATORY EPITHELIUM AND BRONCHIAL CARTILAGE.
progressive mucous gland enlargment is the major contributer to this th

Normal Reid Index

< 0.4

Drugs that cause acute interstitial nephritis

Antibiotics (penicillins, cephalosporins, and sulfa drugs)
Diuretics (thiazides and furosemide)
NSAIDs
Allopurinol
Cimetidine
PPIs

Carotid sinus baroreceptors override _________

aortic arch baroreceptors

Cholera toxin causes _____________ fluid loss

isosmotic

sausage finger

reactive arthritis and psoriatic arthritis

tubuloglomerular feedback relies on

Na-K-Cl cotransporter

Hirano bodies

intracytoplasmic proximal dentritic eosinophilic inclusions consisting of actin seen in Alzheimers p370

Window period for alteplase administration

4.5 hours

Primary oocytes are in

prophase of first meiotic division

BUN ________ in pre-renal azotemia

Increases

Why does BUN increase with prerenal azotemia?

Low volume --> Increase in ADH --> increase urea absorption

Why does BUN decrease in late post-renal azotemia

Pressure defect has resolved but tubular damage remains.

Why does BUN increase in early post-renal azotemia

Back pressure favors reabsorption of urea into the circulation

FENa during long standing post renal azotemia

Increased

FENa during early post renal azotemia

Normal

Urine osmolality increased in

Pre-renal azotemia, Early post-renal azotemia,

Urine osmolality decreases in

Acute tubular necrosis and Late post-renal azotemia

Normal pressure hydrocephalus

urinary incontinence, ataxia, cognitive dysfunction (wet, wobbly, wacky)

AST & ALT in alcoholic hepatitis?

AST 2x higher than ALT

Lines of Zahn

Arterial thrombus

Secretin causes gastrin secretion to _____________ in patients with gastrinomas whereas it causes it to ____________ in normal patients

Increase; decrease

Sagittal sinus thrombosis associated with

hypercoagulable states (pregnancy)

Allantois

extends from urogenital sinus to umbilical cord

Bilateral ovary involvement signifies

metastasis

side effects of lithium

inhibition of 5'-deiodinase and decreased effect of TSH
diabetes insipidus due to decreased efficacy of ADH
Teratogenicity - Ebstein anomaly
Tremor, weight gain, cognitive impairment, and nausea
Hyperparathyroidism

Psammoma bodies

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

Side effects of intranasal fluticasone

mucosal thinning

E-cadherin mutation

Gastric adenocarcinoma and infiltrating lobular carcinoma of breast

Beta-1
Beta-2
D1
Glucagon
TSH
PTH

Gs

alpha-2
D2
M2

Gi

alpha-1
M1
M3
H1
V1
AT1

Gq

Tyrosine kinase

Insulin
EGF
VEGF
FGF
PDGF

Na+/K+ channel

NN
NM
5HT3

Intracellular receptors

Steroids, Vitamin D, and NO

JAK-STAT

Cytokines, GH, EPO

TTP typically presents with

neurologic symptoms

GGT

useful for detecting recent alcohol consumption

Gastrin has a __________ effect

trophic

Pertussis toxin can increase

insulin secretion from beta-islet cells

Pertactin

promotes binding to sulfated glycoprotein integrins on the membranes of ciliated respiratory cells; basis of the acellular pertussis vaccine

Trisomy 16

common cause of miscarriage and most common trisomy

Drugs that increase ROS

SMX-TMP, nitrofurantoin, fluoroquinolones, isoniazid, dapsone, primaquine, and quinine

Treatment for TCA overdose

bicarbonate infusion

High oxygen causes retinal vessels to

constrict and lead to retinopathy of prematurity

Side of retina that is poorly vascularized at term

temporal side

Type A chronic gastritis

Fundus of the stomach

Type B chronic gastritis

occurs at antrum; caused by h. pylori infection; increased risk of MALT lymphoma

left testicular vein drains into

left renal vein

Pharyngeal arch 1 gives rise to aortic arch that gives rise to

Maxillary artery

Pharyngeal arch 2 gives rise to aortic arch that gives rise to

Stapedial artery

Pharyngeal arch 3 gives rise to aortic arch that gives rise to

Internal carotid arteries

Pharyngeal arch 4 gives rise to aortic arch that gives rise to

Arch of aorta and subclavian arteries

Pharyngeal arch 6 gives rise to aortic arch that gives rise to

PDA and pulmonary arteries

cystic with mural nodule

pilocytic astrocytoma

Enzymes inhibited by lead

5'-nucleotidase
Aminolevulinate dehydratase
Ferrochelatase
*hyperuricemia

t(15;17)

acute promyelocytic leukemia

t(8;14)

Burkitt's lymphoma (c-myc activation)

Sympathetic fibers of the eye enter the orbit through the

superior orbital fissure

Parasympathetic fibers of the orbit

come with the oculomotor nerve and are situated in the periphery of the nerve

Aneurysmal compression of oculomotor nerve

results in dilated pupil and loss of accommodation early on

Ring sideroblasts are seen in

bone marrow

LEad inhibits

ferrochelatase and ALA dehydratase and 5'-nucleotidase

Superior rectal vein drains into

inferior mesenteric vein

Inferior rectal vein drains into

internal pudendal vein

Ankle jerk

S1

L2

hip flexion
sensory loss in upper anteromedial thigh

L3

hip flexion, hip adduction, knee extension
sensory loss in lower anteromedial thigh

L4

Hip adduction, knee extension, patellar reflex
Sensory loss in lower anterolateral thigh, knee, medial calf and foot

L5

Foot dorsiflexion and inversion, foot eversion, toe extension
Sensory loss in buttocks, posterolateral thigh, anterolateral leg, dorsal foot

S1

hip extension, knee flexion, foot plantarflexion, Achilles reflex
Sensory loss in buttocks, posterior thigh and calf, lateral foot

Urine exposure can cause infections of

CMV
Adenovirus
Escherichia col
Staphylococcus saprophyticus
Klebsiella pneumoniae

Increased AFP

neural tube defects
ventral wall defects
multiple gestation

Vitelline duct disappears

during 7th week

SSRI and SNRI require

several days to work

Immunohistochemistry of small cell lung cancer

chromogranin, synaptophysin, neural cell adhesion molecule (CD56)

Enhancer sequences

facilitate bending of DNA

location of enhancers and silencers

upstream, downstream, and in introns

Leber hereditary optic neuropathy

Mitochondrial disorder that leads to cell death in optic nerve neurons. Leads to permenent visual loss. 90% of cases are males.

MELAS

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes

Myoclonic epilepsy with ragged red fibers (MERRF)

myoclonic seizures and myopathy associated with exercise.. Skeletal muscle biopsy shows irregularly shaped muscle fibers

spinal trigeminal nucleus

a nucleus in the brainstem that receives pain and temperature information from the head and neck

c-jun & c-fos

nuclear transcription factors that directly bind DNA via a leucine zipper motif

Ras

a proto-oncogene involved in signal transduction

Retinoblastoma protein

Tumor suppressor gene that regulates the cell cycle by acting as a checkpoint from G1 to S phase

Retinoblastoma protein location

13q14

Hypophosphorylated Rb

active Rb

Medial lymphatic track of lower limb bypasses the

popliteal nodes but communicates with the superficial inguinal nodes

Lateral lymphatic tracts of lower limb communicates with

popliteal nodes and superficial inguinal nodes

Capsaicin MOA

depletes substance P

Clear cell carcinoma contains

abundant amounts glycogen and lipids which are loss during tissue preparation and give the tissue the characteristic clear cell appearance

tensor tympani

innervated by trigeminal nerve

stapedius muscle

innervated by Stapedius Nerve, which is a branch of CNVII. Paralysis of Stapedius Muscle will cause Hyperacusis. Ipsilateral Hyperacusis is usually seen in Bell's Palsy, which is a peripheral facial nerve palsy.

Tetrodotoxin
(puffer fish)
Saxitoxin
(dinoflagellates in "red tide")

Toxins that block sodium channels and thereby limit transmission in all nerve fibers

Ciguatoxin (moray eel and exotic fish) and batrachotoxin (South American frogs)

Binds to Na+ channel and keep it open resulting in persistent depolarization

Niacin synthesis requires

riboflavin and pyridoxine

Normal A-a gradient

5-15 mmHg

SPINK1

(Serine peptidase inhibitor Kazal-type 1) trypsin inhibitor

Most common cause of hereditary pancreatitis

mutation producing abnormal trypsin that is not susceptible to inhibition

TTN gene

truncating mutations of it are the most common cause of familiar DCM

Hox signaling is affected by

retinoids and can result in branchial arch defects in a developing fetus

Ventromedial nucleus

mediates satiety; destruction causes hyperphagia

Lateral nucleus

mediates hunger; destruction leads to anorexia

Anterior nucleus

mediates heat dissipation; destruction causes hyperthermia

Posterior nucleus

mediates heat conservation, destruction causes hypothermia

Arcuate nucleus

secretion of dopamine (inhibiting prolactin), growth hormone-releasing hormone and gonadotropin-releasing hormone

Paraventricular nucleus

antidiuretic hormone, corticotropin-releasing hormone, oxytocin and thyrotropin-releasing hormone secretion

Supraoptic nucleus

secretion of antidiuretic hormone and oxytocin

Suprachiasmatic nucleus

circadian rhythm regulation and pineal gland function

External male genitalia require

DHT to develop properly (deficient in 5-alpha reductase deficiency)

PG12

potent inhibitor of platelet aggregation
prevents thrombus formation

sudan III stain

stains unabsorbed fat. for malabsorption Dx

Patients undergoing mechanical ventilation weaning have

weakened respiratory muscles and therefore tend to breathe at low tidal volumes to minimize the work of breathing. The hypoventilation triggers an increase in the respiratory rate.

RSBI

Rapid Shallow Breathing Index
Can be calculated by dividing respiratory rate by tidal volume. Low RSBI indicates efficient breathing and lower likelihood of recurrent respiratory failure once ventilatory support is discontinued. > 105 suggests unsuccessfu

Bile action on microbes

bacteriostatic

C5-C6

elbow flexion (biceps and brachioradialis reflexes)

C7-C8

triceps reflex

anserine bursitis

obesity and overuse

suprapatellar bursitis

prolonged repetitive quadriceps activity like running

Failure of neural tube to close results in a rise in

acetylcholinesterase and alphafetoprotein

Beta-glucuronidase

a bacterial enzyme that converts bilirubin into urobilinogen, some
of which is reabsorbed and excreted in urine (the renal fraction) and some of which is reexcreted
into bile (the hepatic fraction)

location of carotid body

just inferior to the hyoid bone

TPN can lead to

gallbladder hypomobility and gallstones

Thymidine kinase deficient varicella zoster infects

HIV infected individuals

Kozak sequence

plays a role in the initiation of translation (mRNA binding to ribosomes). A mutation three bases upstream of the start codon is assoicated with thalasemmia.

cGMP

activates protein kinase G and mediates smooth muscle relaxation, platelet activation, and sperm metabolism

cAMP is cleaved by

phosphodiesterase

Brodifacoum

Superwarfarin

Phrenic nerve roots

C3-C5

0.9% Saline
Lactated Ringer solutions

used for volume resuscitation in shock and hypovolemia

Insulin sensitivity is ___________ in patients with CKD

decreased

Insulin is broken down by

PCT cells

amatoxins (Amanita phalloides)

Potent inhibitor of RNA polymerase II

Ricin (Ricinus communis)

inhibits protein synthesis by cleaving rRNA component of the eukaryotic 60s subunit

Besides the thyroid gland, TSH receptors are also present on

fibroblasts and adipocytes (GRAVES ophthalmopathy)

BMPR2

primary pulmonary hypertension

Sclerostin

Made by osteocytes and suppresses bone formation by osteoblasts

romosozumab

monoclonal antibody for Sclerostin
Sclerostin usually inhibits Wnt receptor pathway
Wnt receptor pathway --> osteoblast proliferation

RANKL

Receptor activator of nuclear factor kappa-B ligand. Binds to RANK and promotes preosteoclast maturation to osteoclasts

GGT elevation

indicative of biliary disease. Used to confirm liver pathology when elevated alkaline phosphatase is seen

Roflumilast

phosphodiesterase-4 inhibitor used for COPD

Pirfenidone

inhibits TGF-beta

Nintedanib

Tyrosine kinase inhibitor that inhibits actions PDGF, FGF, and VEGF

Reslizumab

IL-5 antagonist

P bodies

particles in the cytoplasm that cut up old mRNA but may also store mRNA for later use; contain RNA exonucleases, mRNA decapping enzymes and constituents involved in mRNA quality control and microRNA-induced mRNA silencing.

HIV-2 is endemic to

West Africa

HIV-2 is resistant to

NNRTIs and fusion inhibitors

Urushiol

Allergenic substance found in poison ivy, poison oak, and poison sumac

Nondisjunction in Down syndrome occurs during

Maternal Meiosis I (On RFLP the child will have three different bands two of which are maternal homologous chromosomes. Meiosis two would have two extra sister chromatids)

furocoumarins

found in grapefruit and can inhibit CYP450 enzymes

Foods high in oxalate

dark roughage, spinach, rhubarb, asparagus, cabbage, tomatoes, beets, nuts, celery, parsley, runner beans, chocolate, cocoa, instant coffee, Ovaltine, tea, Worcestershire sauce

Osteoblastic metastases

prostate
small cell lung cancer
Hodgkin lymphoma

Osteolytic metastases

Multiple myeloma
Mon-small cell lung cancer
Non-Hodgkin lymphoma
Renal cell carcinoma
Melanoma

Mixed bone metastases

Gastrointestinal
Breast

Active Ras

bound to GTP

Wilson disease commonly effects the ________ in the CNS

Putamen

EBNA1 and LMP1

EBV proteins that are oncogenic

Nitrous oxide inhibits

methionine synthase

Nitroblue tetrazolium test and dihydrorhodamine flow cytometry

used to diagnose NADPH oxidase deficiency.

positive nitroblue tetrazolium test

lack of dark blue formazan

positive dihydrorhodamine flow cytrometry

lack of green fluorescence

Medicare covers

patients 65 and older who have worked and paid into the system, younger individuals with disabilities, end-stage renal disease, or amyotrophic lateral sclerosis.

Amiodarone can reduce

peripheral conversion of T4 to T3

trehalose dimycolate

cord factor, inhibits phagolysosome fusion

Beck triad

hypotension, distended neck veins, distant heart sounds

HPV has a predilection for...

stratified squamous epithelium

Calcium efflux prior to muscle relaxation

is accomplished by Ca2+-ATPase (SERCA) and the Na+/Ca2+ exchange mechanism.

Reason for silicosis increasing susceptibility to tuberculosis

crystalline silica particles interfere with phagolysosome fusion

Straighter bronchus

right bronchus

Muddy brown casts

acute tubular necrosis

waxy casts

chronic renal failure

fatty casts

Nephrotic syndrome

vasospastic angina can be triggered by

dihydroergotamine, cocaine, amphetamines, and triptans

Cutaneous neurofibromas are comprised of

Schwann cells

A band

where myosin filaments slightly overlap and not overlap the actin filaments in the sarcomere

M line

middle of sarcomere

I band

region where actin filaments do not overlap with myosin filaments

H band

region where myosin does not overlap with actin

Estrogen induces ____________ production in bone by stromal cells and osteoblasts

osteoprotegrin

Serotonergic neurons in the CNS are primarily found in

Raphe nuclei

Low transferrin, high serum ferritin, normal MCV

anemia of chronic disease

miRNA

a class of functional non-coding RNA that regulates the amount of protein produced by a eukaryotic gene. They are transcribed and undergo processing in to double-stranded precursors in the nucleus that become exported into the cytoplasm. A ribonuclease ca

Change in second messenger by alpha 1

increase IP3

Change in second messenger by alpha 2

decrease cAMP

Change in second messenger by Beta 1

increase cAMP

Change ine second messenger by Beta 2

Increase cAMP

Pericardial knock occurs

earlier than S3

Kussmaul sign

-? in JVP on inspiration instead of a normal decrease

Increased urinary citrate is associated with

decreased calcium oxalate stones becomes it prevents the formation of insoluble calcium-oxalate complexes

gamma gap

more than 4 g/dL (total protein - albumin)

Tamm-Horsfall protein

binds to Type 1 Fimbriae of E Coli
-anti-adherence factor serving to prevent E coli binding to urothelial receptors
and forms casts by aggregating with other stuff

Performing thoracocentesis below the ninth rib can increase the risk of penetrating

abdominal structures

Herring bodies

Accumulation of neurosecretory granules at dilated axon terminals

low molecular weight but hydrophilic

will distribute in interstitial fluid compartment as well as intravascular compartment (14-16L)

Calcidiol

precursor of calcitriol requires PTH for conversion

Lecithin levels rise after

33 weeks of gestation

FEV1/FVC ratio in COPD

< 0.7

organism responsible for COPD exacerbations

Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, rhinovirus, influenza, parainfluenza, pseudomonas aeruginosa

Aspirin can cause asthma attacks due to

leukotriene overproduction (pathway shunting)

Food rarely results in asthma attacks but if it does it is usually due to the presence of

sulfites

Teratogenic effects of phenytoin

neural tube defects, orofacial clefts, microcephaly, nail or digit hypoplasia

Teratogenic effects of lithium

ebstein anomaly, nephrogenic diabetes insipidus, hypothyroidism

Teratoogenic effects of valproate

neural tube defects due to interference with folate metabolism

Teratogenic effects of isotretinoin

microcephaly, thymic hypoplasia, small ears, hydrocephalus

Teratogenic effects of methotrexate

limb and craniofacial abnormalities, neural tube defects, abortion

Teratogenic effects of ACE inhibitors

renal dysgenesis, oligohydramnios

Teratogenic effects of warfarin

nasal hypoplasia, stippled epiphysis

ADH potentiates the release of

ACTH

Beta blocker overdose is treated with

glucagon

Angioedema

edema of deep dermis and subcutaneous tissue

Acanthosis

Increase in the thickness of stratum spinosum

Bicuspid aortic valve mutation

NOTCH1

TTN mutation

Dilated cardiomyopathy (Autosomal dominant)

Plakoglobin and desmoplakin mutations can lead to

arrhythmogenic right ventricular cardiomyopathy

Site of synthesis for erythropoietin

renal peritubular cells

Prior to administration of erythropoietin, patient should be tested for

iron levels to prevent iron deficiency

Cause of hypertelorism

frontonasal prominence hyperplasia

Vimentin

intermediate filament present in mesenchymal tissue. used to diagnose sarcomas

Composition of keratin

alanine, glycine and cysteine (disulfide bonds give the protein its rigidity)

Chromogranin A and synaptophysin

neuroendocrine tumors

Topical glucocorticoids adverse effects

dermal atrophy

sources of alkaline phosphatase

damaged biliary epithelial membrane/ bile canaliculi, small intestines from A blood group, bone, placenta later in pregnancy

Markers of osteoblast activity

alkaline phosphatase and N-terminal propeptide of type 1 procollagen

Most common cause of spinal epidural abscess

Staphylococcus aureus

Stop codons

UAA, UAG, UGA

Start codon

AUG (methionine)

pronator drift

Seen in pyramidal weakness/injury. Also characterized by weakness in lower extremity flexors and upper extremity extensors.

Features of UMN lesion

hyperreflexia, spastic paralysis, increased muscle tone, clasp-knife rigidity

Microscopic changes in ischemic stroke in 12-24 hours

Red neurons (eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance)

Microscopic changes in ischemic stroke in 24-72 hours

neutrophilic infiltration

Microscopic changes in ischemic stroke in 3-7 days

macrophage/microglia infiltration and phagocytosis begins

Microscopic changes in ischemic necrosis in 1-2 weeks

reactive gliosis and vascular proliferation around the necrotic area

Macroscopic changes in ischemic necrosis in 1-2 weeks

liquefactive necrosis

Microscopic changes in ischemic stroke after 2 weeks

glial scar formation

Macroscopic changes in ischemic stroke after 2 weeks

cystic area surrounded by dense glial fibers

Fibroblast growth factor 23

inhibits 1 alpha hydroxylase which produces Vitamin D

Time required for pancreatic pseudocyst formation

4-6 weeks

Microscopy of atheroembolus

needle shaped cholesterol clefts within the embolus

Congenital heart lesions that predispose to infective endocarditis

bicuspid aortic valve, ventricular septal defects, PDA, and unrepaired tetralogy of Fallot

Causes of hypokalemia

G-M CSF, diarrhea, heightened adrenergic activity (beta-2 receptor)

alcohol based disinfectants

kill vegetative bacteria, fungi, and enveloped viruses by dissolving their lipid bilayer. Not effective against spores and non-enveloped viruses.

chemotactic factors

IL-8, lipoxin A4, B4, leukotriene b4, eotaxin, MCP-1, RANTES, TNF, IL-F, C5a, 5-HETE
note chemoattractants act by binding to g-proteins or activating actin polymerization on the leading edges of the cell.

cremasteric reflex

L1-L2 (genitofemoral nerve)

Stages of salicylate poisoning

Respiratory alkalosis first followed by anion gap metabolic acidosis after 12 hours

Type 1 interferons are only activated in the presence of

double stranded RNA so that only virus infected cells are affected

Interferon gamma increased the expression of

class II MHC

Glucocorticoids decrease insulin

sensitivity

aldosterone escape

in the case of primary mineralocorticoid excess, K will be low and bicarb will be high...but Na will typically be normal because hypervolemia leads to ANP secretion which dumps Na specifically
so these pts willl have htn with volume expansion, normal Na,

FSH and LH increase the activity of

aromatase

color of brown adipose tissue is due to

increased number of mitochondria

Protons in the intermembrane space return to the matrix in mitochondria via the membrane protein

thermogenin

Vegetative bacteria are destroyed at temperatures of

more than 70 C (158 F)

Spore forming bacteria are resistant to temperatures as high as

120 C (248 F)

Partial pressure of oxygen in the alveoli

104 mmHg

Anti-Mullerian hormone is produced by

Sertoli cells

Distal gut atresia is due to

vascular occlusion in utero

Apple peel atresia

atresia of jejunum, ileum or colon due to vascular accident

Tocilizumab

IL-6 inhibitor used for giant cell arteritis

Cancers that can cause migratory thrombophlebitis

adenocarcinoma of pancreas, lung, and colon

Ischemic preconditioning

Myocardial cell adapts to brief episodes of ischemia by increasing "ischemic tolerance" to infarction

myocardial hibernation

prolonged reduction in systolic function due to coronary artery insufficiency, may resolve after CABG or other intervention

Meralgia Paresthetica

-compression of the
lateral femoral cutaneous nerve
-pain & tingling sensation but
no motor loss
-cause: obesity, postural changes, tight clothing, pregnancy

Common sites of non-occlusive colonic ischemia

watershed zones of colon: splenic flexure and rectosigmoid junction

Nerve to tensor tympani

maxillary division of trigeminal

Procainamide, hydralazine, and isoniazid area metabolized by

phase II acetylation in the liver

Desmopressin has minimal action on

V1 receptor hence it does not cause profound vascular smooth muscle contraction

GP160 is cleaved by

host protease rather than viral protease like gag and pol

Reticulocytes from sites of extramedullary hematopoiesis are

typically larger than those released from the bone marrow

Liver associated macrocytosis

increase in circulating phospholipids and cholesterol adsorb onto erythrocytes resulting in membrane expansion

Cremaster muscle originates from

internal oblique

MAC in HIV can be prevented by

weekly azithromycin

Splenic conditioning

macrophages in spleen remove excess membrane

Drugs that can cause fibrotic lung disease

cyclophosphamide, sulfasalazine, and methotrexate

Introns have ___________ at the 5' splice site

GU

Introns have ________ at the 3' splice site

AG

Crizotinib

Inhibitor of EML4-ALK fusion protein

sodium cyanide nitroprusside test

cystine kidney stones diagnosis

Cystine stones microscopic appearance

flat, yellow, hexagonal

Uric acid stones microscopic appearance

yellow or red-brown,
diamond or rhombus

Magnesium ammonium phosphate stoens microscopic appearance

rectangular prism (coffin lids)

Calcium phosphate stones microscopic appeance

elongated, wedge-shaped, and forms rosettes

Calcium oxalate stones microscopic appearance

octahedron (square with an x in the center)

Vasospasm after SAH can occur after

3-12 days

Glue sniffer's rash

dermatitis over nose and mouth

primary oocytes arrested in

prophase of meiosis I until puberty

axillary nerve supplies

deltoid and teres minor

Nerve roots of axillary nerve

C5-C6

platysma supplied by

facial nerve

Site of radiofrequency ablation for atrial flutter

Isthmus between tricuspid annulus and inferior vena cava

Microbe with intracellular polyphosphate granules

corynebacterium diphtheriae

subterminal spore position

Clostridium botulinum

Oculomotor nerve courses with

posterior communicating artery

long thoracic nerve roots

C5-C7

Action of ANP and BNP

Increases intracellular cGMP and causes afferent arteriole vasodilation and efferent arteriolar vasodilation in the kidney while simultaneously inhibiting sodium reabsorption in PCT and inhibiting renin secretion so that aldosterone will not be released

Angiotensin 2 increases

sodium reabsorption in the PCT and stimulates aldosterone secretion

Cytokeratin 20

marker for adenocarcinomas of intestinal origin

oxidative phosphorylation ceases at

108 F (42.2 C)

Temporal lobe encephalitis can lead to

personality changes (hypersexuality, aggression)

Phenytoin and carbamazepine can increase the catabolism of

Vitamin D

Simultaneous administration of of a diuretic and ACE inhibitor can result in

hypotension due to elevated renin levels which are being blocked

Vitamins that are low in breast milk

D and K

Drugs that decrease activity of P-gp

verapamil, diltiazem, and ketoconazole

Neoantigens are more common in

cancers with defects in mismatch repair proteins and high microsatellite instability

Microscopic changes in MI 0-4 hours

minimal change; myofibril relaxation may be seen

Microscopic changes in MI 4-12 hours

early coagulation necrosis, edema, hemorrhage, wavy fibers

Microscopic changes in MI 12-24 hours

coagulation necrosis and marginal contraction band necrosis

Microscopic changes in MI 1-5 days

coagulation necrosis and neutrophilic infiltrate

Microscopic changes in MI 5-10 days

macrophage phagocytosis of dead cells

Microscopic changes in MI 10-14 days

granulation tissue and neovascularization

Microscopic changes in MI 2 weeks to 2 months

collagen deposition/scar formation

Carbon tetrachloride

Liver centrilobular necrosis, fatty change due to free radical damage by CCl3 which is a metabolite formed by the P450 oxidase system in the liver

Nitrites cause formation of

methemoglobin

High doses of folate can antagonize

phenytoin

Granulomatous disease such as sarcoidosis as well as Hodgkin disease and some non-Hoodgkin lymphomas have

increased 1-alpha-hydroxylase activity due to the activated macrophages (PTH independent)

Myocardial glycogen may be depleted in

30 mins

histone acetylation

The attachment of acetyl groups to certain amino acids of histone proteins causing associated genes to be upregulated

DNA methylation

The addition of methyl groups (�CH3) to bases of DNA after DNA synthesis; may serve as a long-term control of gene expression by silencing genes.

Prenatal cocaine abuse can lead to

sponaneous abortion
fetal demise
placental abruption

CD4 count <200 requires prophylaxis against

Pneumocystis jiroveci with trimethoprim-sulfamethoxazole

CD4 count <100 requires prophylaxis against

Toxoplasma gondii with trimethoprim-sulfamethoxazole. Cryptococcus as well

CD4 count <50 requires prophylaxis against

MAC with azithromycin. CMV as well

Ortner syndrome

mitral stenosis can cause left atrial dilatation sufficient to impinge on left recurrent laryngeal nerve

Neutrophil count of joint fluid in gout

20,000-100,000

Shortest half life of all clotting factors

VII

Specific gravity of concentrated urine

>1.015

Calcific tendonitis commonly affects

rotator cuff

Common cause of epididymitis in men >35

Coliform bacteria in urethra

Common cause of epididymitis in men <35

Chlamydia, gonnorrhea

The sinoatrial node is

subepicardial

Location of AV node

in right atrium near the septal cusp of tricuspid valve

Obturator nerve roots

L2-L4

Regadenoson

coronary vasodilator that is used in cardiac stress testing to evaluate for coronary artery disease

Decerebrate posturing

extensor posturing arms are stiffly extended and held close to the body and the wrists are flexed outward indicates damage to midbrain or brain stem at or below the level of the red nucleus

Cause for decerebrate posturing

loss of descending excitation to the upper limb flexors via the rubrospinal tract

Decorticate posturing

arms flexed inward and bent in toward the body and the legs are extended

Drugs that prolong QT interval

Macrolides
fluoroquinolones
antiemetics (ondansetron)
azooles (fluconazole)
antipsychotics and tricyclic antidepressants (haloperidol and risperidone)

Cause of spontaneous gas gangrene

Clostridium septicum, which is a normal commensal of the GIT in humans, entering blood via a colonic malignancy

Spinal metastases cause pain that is worse at

night and does not improve with positional changes

Malignancies that metastisize to bone - "Laging Panalo Kung Taga Bulacan

breast, kidney, thyroid, and lung

Causes of false positives in screening for epithelial ovarian carcinoma using CA-125

Endometriosis and other conditions that disrupt the epithelial cell membrane

Secondary bacterial infections after influenza

are promoted by cleaved off sialic acid from the respiratory epithelium by neuraminidase of the influenza virus

Brown pigment stones are usually due to

biliary tract infections by microbes that produce beta-glucuronidases

Black pigment stones are usually due to

chronic hemolysis

All cranial nerves insulated by Schwann cells except for

optic nerve (oligodendrocytes)

Narrowing of aortomesenteric angle occus in conditions that cause

diminished mesenteric fat like decreased body weight, severe burns, prolonged bed rest, pronounced lordosis or after surgical correction of scoliosis

Superior mesenteric artery syndrome

Normally, the SMA and aorta form a 45 degree angle. If the angle diminishes to less than 20 degrees, the
transverse portion of the duodenum
can get trapped between SMA and aorta, and cause small bowel obstruction. Can obstruct left renal vein as well.
Nar

Creatinine clearance normal evne when kidney function is just

50% normal

Blood gas partition coefficient

Ratio of concentration in blood to the concentration of gas in contact with blood

Highly soluble inhlational anesthetics have a longer onset of action because

more amounts are required to saturate the blood and eventually saturate the brain

DRESS syndrome

Drug reaction with eosinophilia and systemic symptoms; associated with phenyotoin, carbamazepine, allopurinol, sulfonamides (sulfasalazine), minocycline, vancomycin.

DRESS syndrome symptoms

fever
generalized lymphadenopathy
facial edema
diffuse morbiliform skin rash that can progress to confluent erythema with follicular accentuation
hepatomegaly
jaundice
acute interstitial nephritis
cough
dyspnea

DRESS syndrome signs

eosinophilia
atypical lymphocytosis
elevated serum alanine transaminase

Cachectin

tumor necrosis factor

TGF-beta

Important fibroblasts growth factor involved in tissue regeneration and repair; also inhibits inflammation (with IL-10)

Tryptase

released along with histamine during mast cell degranulation; often used as a marker for mast cell activation in things like anaphylaxis

TRH effect on lactotrophs

stimulatory

Vitamins that are not present in breast milk

D and K

Accessory blood supply of liver

inferior phrenic, adrenal, intercostal arteries.

GLUT-4 translocation can be insulin independent during

muscle contraction

Glucocorticoids also decrease

peripheral conversion of T4 to T3

Wolff-Chaikoff effect

high levels of I- inhibit organification and, therefore, inhibit synthesis of thyroid hormone

Drugs to avoid in geriatric patients

First generation antihistamines
gastrointestinal antispasmodics
alpha-1 blockers
centrally acting alpha 2 agonists
many antiarrhythmics
tricyclic antidepressants
antipsychotics
barbiturates
benzodiazepines and other hypnotics
long acting sulfonylureas
sli

Temperature of autoclave

134 C (273.2)

Infarction of more than 50% of myocardium of a ventricle will lead to

ventricular dysfunction

Calcium levels >13 mg/dL

suggests and underlying malignancy

Difference between schizoaffective and bipolar disorder with psychotic features

In the bipolar disorder with psychotic features, psychotic features only emerge during mood imbalances. In schizoaffective disorder, psychotic features can occur outside the mood imbalances.

Difference between PTHrp and PTH

does not significantly increase 1,25-dihydroxyvitamin D production

Sodium nitroprusside generates NO in the

bloodstream making its action less selective for veins

ventral posterior lateral nucleus of thalamus

receives input from spinothalamic tract and dorsal columns

Nitrates predominately vasodilate

large veins

ventral posterior medial nucleus of thalamus

Receives input from the trigeminal pathway. Damage to this nucleus along with the ventral posterior lateral nucleus can lead to a complete contralateral sensory loss.

Microalbuminuria

30-300 mg/day

Beta-adrenergic hyperactivity can cause hypokalemia by

stimulation of sodium-potassium ATPase pump which causes transport of potassium intracellularly. Insulin release due to adrenergic activity can also promote intracellular potassium shifting.

Normal albumin/creatinine ratio

<30 micrograms

Migraine preventive drugs

Anticonvulsants
tricyclic antidepressants
beta blockers

stool osmotic gap

290 - 2(stool Na + stool K)

cognitive impairment becomes evident after ________ hours of wakefulness

17

Stool osmotic gap <50

secretory diarrhea

Aspiration while supine

involves posterior segments of upper poles and superior segments of the lower poles

stool osmotic gap > 100

osmotic diarrhea

Characteristic feature of asbestos ferruginous body

translucent fiber core

window period for alteplase use in stroke

4.5 hours

leucovorin

N5-formyl-THF

Emergency decompression is accomplished by

insertion of the needle (connected to a syringe) in the midclavicular line into the second intercostal space

leukocyte count in septic arthritis synovial fluid

>100000

Chest tube placement in pleural effusion, pneumothorax, and hemothorax

4th ICS midaxillary line

leukocyte count in gout and pseudogout synovial fluid

20000-100000

Thoracocentesis site

8th ICS posterior axillary line

Myeloblast presence in blood indicates

hematologic malignancy most of the time

Dextromethorphan

weak opioid receptor agonistand NMDA receptor antagonist; also inhibits serotonin and noradrenaline reuptake; used for cough suppression

Myelocyte presence in blood

Can sometimes be seen in normal individuals (leukemoid reaction and pregnancy)

fetal heart beat detectable at

week 6

Viruses that can cause myocarditis

adenoviru, HIV, HHV-6, parvovirus B-19,

Band forms presence in blood

normal

Cholesterol embolization syndrome

Trigger: Surgery, arteriogram, thrombolytic therapy
Present: Blue/black toes, renal insufficiency, abdominal pain/bleed, livedo reticularis, eosinophilia, eosinophiluria, Hollenhorst plaques on retina
Treatment: Supportive. DN anticoagulate

Gingivostomatitis from herpes can lead to

dehydration due to the pain caused by the vesicles

Nephrogenic diabetes insipidus due to lithium can be treated with

Potassium sparing diuretics that block ENaC (triamterene and eplerenone)

Infraorbital nerve

Branch of the fifth cranial nerve that affects the skin of the lower eyelid, side of the nose, upper lip, and mouth.

Drugs that cause a disulfiram like reaction

Metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st-generation sulfonylureas

Activins

stimulate FSH secretion

Testosterone acts on

The hypothalamus and anterior pituitary

Inhibit acts on

anterior pituitary only

Pentostatin

Inhibits adenosine deaminase-->decreased purine degradation
Tx for hairy cell leukemia
"Five hairs

Prosopagnosia

inability to recognize faces

High urine phosphate

Fanconi syndrome

Hypokalemia can cause

tremors

Fibromuscular dysplasia affects

Distal 2/3rds of renal artery

Atherosclerosis affects

Proximal 1/3 of renal artery

Synaptobrevin

v-SNARE

Asbestos involves the

lower lobes of the lung

Pneumoconioses typically affect the

upper lobe (except for asbestos)

iminodiacetic acid

IV injection leads to excretion into bile ducts

Vertebral venous plexus

...

CD117

C-KIT
in GIST

cystic spaces with cellular debris

liquefactive necrosis

anti-saccharomyces cerevisiae (ASCA)

Crohn's disease

Increased FSH levels stimulate

aromatase synthesis

Sternocleidomastoid muscle wasting

myotonic dystrophy type 1 (Curschmann-Steinert disease)

Myotonic dystrophy symptoms

Skeletal muscle weakness and myotonia
Muscle pain
Arrhythmias
Cataracts
Testicular atrophy or features of ovarian insufficiency (i.e., infertility)
Hypogammaglobulinemia
Features of insulin resistance
Frontal balding
Cognitive impairment

Curschmann-Steinert disease

myotonic dystrophy of distal muscles

Myopathic fascies

Long, narrow face
Hollowed cheeks, and high arched palate
Ptosis
Sternocleidomastoid muscle wasting

Myotonic dystrophy type 2

mild myotonia affecting proximal muscles

length constant

is a measure of how far along an axon an electrical impulse can propagate. Without myelin the insulator, the length constant will decrease.

Metabisulfite

used to screen for sickle cell = causes cell to sickle even when the levels are less.

alpha globulin and beta globulin

Dipalmitoyl lecithin

dipalmitoylphosphatidylcholine

phosphatidylinositol 4,5-bisphosphate

PIP2 Gq receptor pathway

Phosphatidylserine

involved in intrinsic apoptosis when exposed on extracellular surfaces

Sphinogmyelin

composes myelin and also has roles in signal transduction, apoptosis. Lecithin: Sphingomyelin ratio >2 indicates mature fetal lungs.

ALL

0-14

AML

15-39; 40-59

CLL

60+

CML

40-59

Trypansoma cruzi

reduviid bug

Trypanosoma brucei

Tsetse fly

Flavivirus Group (West Nile Virus, Dengue)

Aedes mosquito

Microfilariae

black fly

Leishmania braziliensis

sand fly

Borrelia & Babesia

Ixodes tick

Rickebsia rickebsii & Francisella tularensis

Dermacentor tick

Rikebsia prowazekii

lice

Loa loa (African eye worm)

deer fly

Wuchereria bancrofti

mosquitoes

FEV1 after methacholine sensitivity

>20% reduction rules in asthma

Influenza exhibits tropism for

type II pneumocytes

Oteolysis due to bone mets is due to

PTH-rP

Leukocyte Larceny

O2 consumption by leukocytes and platelets in ABG samples

Axillary sheath

Deep fascia that encloses the brachial plexus (cords) and axillary vein and artery

placental growth hormone

hormone during pregnancy that reduces insulin sensitivity; similar to GH

Serotonin helps to initiate

sleep

ACh is higher during

REM Sleep

NE is lower during

REM Sleep

Dopamine produces

arousal and wakefulness

Chloroquine can reactivate

psoriasis

The Five R's of medication safety

Right drug
Right patient
Right dose
Right route
Right time
(Right to know information about the drug, Right to refuse the drug, Right documentation)

Hamman's sign

Cruching shound on auscultation
Emphysematous mediastinum
Seen with Boerhaave's syndrome, pneumomediastinum, etc.

battery action

touching to which the patient did not agree

negligent nondisclosure

when the physician discovers that the original diagnosis was wrong but does not disclose to the patient

therapeutic privilege

the withholding of relevant information from a patient when the physician believes disclosure would likely do harm

androgen binding protein

binds testosterone and accumulates it in the lumen of the seminiferous tubules and epididymis. produced by Sertoli cells.

Gubernaculum in females becomes

Superior portion persists as the proper ovarian ligament and the inferior portion becomes the round ligament

Clotting factor with longest half life

factor II. warfarin full effect is only reached when factor II is completely eliminated.

Acanthosis nigricans is associated with

Hyperinsulinemia and visceral malignancy (gastric adenocarcinoma)

Adenine residues are methylated after

DNA replication in order to differentiate between new and old strand

Serum osmolar gap

Serum osmolality - ((2*sodium) + (glucose/18) + (blood urea nitrogen/2.8)); >10 indicates the presence of an unmeasured solute

Euler-liljestrand reflex

alveolar hypoxia causes reflex vasospasm which resdistributes blood to areas that are properly ventilated;reduces perfusion in areas with insufficient gas exchange

Retinoids MOA

Increase keratinocyte turnover and reduce hyperkeratinization in the stratum corneum

Maturity Onset Diabetes of the Young (MODY)

type II is an autosomal dominant disorder involving mutations in the glucokinase gene
-patients have nonprogressive hyperglycemia that is usually asymptomatic at diagnosis and is usually managed with diet alone

CSF overproduction

choroid plexus adenoma

Cytotoxic edema

Cellular swelling caused by failure of Na+/K+ pump due to lack of ATP. Na+ accumulates INSIDE and K+ OUTSIDE. Water follows Na+ and causes edema.

Vasogenic edema

An accumulation of fluid in the cerebrum that is typically caused by an increase in capillary endothelial cell permeability with a disruption in the blood-brain barrier

Cantharidin

Vesicant used for the treatment of molluscum contagiosum.

Contraindications for cantharidin

diabietes mellitus, peripheral arterial disease, and other circulatory diseases

Alternative therapy for scabies

crotamiton, sulfur ointment, lindane, and oral ivermectin

Forchheimer sign

maculopapular enanthem on soft palate

Angioedema associated with increased bradykinin is not associated with

pruritus

Reactivation of a BCG vaccination scar with erythema and induration (early and very specific sign of __________________)

Kawasaki disease

Eczema herpeticum commonly associated with

atopic dermatitis

germinal matrix begins to involute around

32 weeks of gestation

Pneumocystis pneumonia is indolent in

AIDS

Pneumocystis pneumonia can lead to ARDS in

immunosuppressive therapy

Infection that can occur once CD4 counts fall below 180

cryptosporidium

Infection that can occur once CD4 counts fall below 100

Isosporidium/microsporidium

Infection that can occur once CD4 counts fall below 50

MAC and CMV

Preferred antidepressant after an MI

Sertraline

Citalopram can cause

QT prolongation

Glucocorticoids, especially at high doses can cause

psychosis, mania, or depression

Germ cell tumors in the anterior mediastinum are usually

primary than metastatic

Felty syndrome

Neutropenia
Splenomegaly
Rheumatoid arthritis (long-standing)
Usually diagnosed with high titers of rheumatoid factor and anticitrullinated peptide antibodies
(DR4+)

Drugs causing photosensitivity

Tetracyclines
chlorpromazine
prochlorperazine
furosemide
hydrochlorothiazide
amiodarone
promethazine
piroxicam

Treatment for Lambert-Eaton syndrome

Guanidine or 3,4-diaminopyridine to increase presynaptic acetylcholine levels

Patients with Lewy body dementia are susceptible to

neuroleptic malignant syndrome caused by first generation antipsychotics

Dejerine-Roussy syndrome

seen after a thalamic stroke and is characterized by severe paroxysmal burning pain and allodynia

Thyroid replacement dose should be increased by __________ at the time of pregnancy detection

30%

Indications for statin therapy in primary prevention of ASCVD

LDL > 190 mg/dL
Age > 40 with diabetes mellitus
Estimated 10 year risk of ASCVD is more than 7.5-10%

Indications for statin therapy in secondary prevention of ASCVD

ACS
Stable Angina
CABG
Stroke, TIA, PAD

Aspirin is recommended in patients of high risk for ASCVD in the ages

50-70

Indication for statin therapy for primary therapy

LDL > 190 mg/dL
Age > 40 with diabetes mellitus
Estimated 10 year risk of ASCVD > 7.5%-10%

B-HCG increases until

the end of the first trimester

BZD withdrawal

agitations, tremors, perceptual changes, psychosis, elevated vital signs, delirium and seizures

OCPs increase the risk for

cervical cancer
hepatic adenoma

Treatment for severe bipolar disorder

Lithium or vaalproate combined with a second generation antipsychotic

Transient synovitis is associated with

viral illnesses

Amebiasis is not associated with

eosinophilia

Todd paralysis

self limited, focal weakness following a focal or generalized seizure. Presents in the postictal period with partial or complete hemiplegia

Skeletal muscle has higher levels of

AST

Adrenomedullin

vasodilator that inhibits insulin secretion

Laryngomalacia gets resolved by

18 months

Whipple disease can cause _________-losing enteropathy

protein

Risk factors for quadriceps tendon rupture

CKD, hyperparathyroidism, anabolic steroid abuse and fluoroquinolones

Hematological findings in primary adrenal insufficiency

eosinophilia because they are often inhibited by cortisol

Shy-Drager syndrome

parkinsonism, autonomic dysfunction, and other neurological signs

Riley-Day syndrome

presents at birth with feeding problems and low muscle tone, characterized by gross dysfunction of the autonomic nervous system (no tears and severe orthostatic hypotension); seen in Ashkenazi Jews

Treatment for akathisia

Propranolol

Light's criteria

Exudates have:
1. Pleural protein to serum protein ratio >0.5
2. Pleural LDH to serum LDH ratio > 0.6
3. Pleural LDH > 2/3 of upper normal limit

HSV infection may be associated with

dysuria and sterile pyuria

Weight loss inducing drugs

orlistat, locaserin, naltrexone/bupropion, phentermine/topiramate, liraglutide

Patients with a viral load of more than 1000 copies/mL of HIV should undergo

cesarean section

High myopia is characterized by more than

6 diopters of correction and may lead to retinal detachment

PaO2/FiO2 < 300

ARDS

halo sign on CT

Aspergillosis

Drugs that improve long term survival in patients with systolic dysfunction in African Americans

hydralazine and nitrates

Pseudothrombocytopenia

EDTA anticoagulant promotes clumping of platelets in vitro; misread as leukocytes and get spuriously low platelet count

Neuroimaging findings of patients with schizophrenia

dilated lateral ventricles along with cortical tissue volume loss, decreased volume of hippocampus and amygdala

Structural abnormalities in the orbitofronal cortex and basal ganglia is indicative of

OCD

Increased total brain volume is seen in

autism

Infections that cause an increase in LDH

PCP

Lamotrigine is effective in treating bipolar _________ episodes

depressive

Ulcers due to arterial insufficiency are found most often

at the tips of digits

Venou stasis ulcers are most often found at

pretibial area or above the medial malleolus

Triggers of psoriasis

GAS
Staph
HIV
Mechanical irritation
beta-blockers
lithium
chloroquine
interferon

Sweet syndrome

abrupt onset of painful edematous papules, plaques or nodules on the head neck and upper extremites. is is associated with hematologic malignancies in addition to upper respiratory and gastrointestinal infections and inflammatory.

Screening for bladder cancer is

not required because the disease is usually recognized in the early stages and screening does not increase the chances of survival. screening methods also have low sensitivity and specificity

Post fracture avascular necrosis is common in

scaphoid, femoral head, and metadiaphyseal junction of the fifth metatarsal

Platelet counts greater than ____________ provide adequate hemostats for most invasive procedures

50k

Congenital toxoplasmosis causes intracranial calcifications usually in the

basal ganglia

Congenital varicella can cause

limb abnormalities (club foot, hypo plastic limbs) and hydros fetalis

pregnant women with a history of genital HSV require prophylaxis starting at

36 weeks

Causes for decreased platelet production

EBV, HCV, HIV
Chemotherapy
Myelodysplasia
Alcohol Use
Falcon Syndrome
B12 or folate deficiency

Glutamate dehydrogenase antigen

protein present on all C difficile strains

Drugs that may cause a false positive for PCP

Dextromethorphan
Diphenhydramine
Doxylamine
Ketamine
Tramadol
Venlafaxine

Drugs that may cause a false positive for amphetamine

atenolol
propranolol
bupropion
nasal decongestants

Prolactin levels in prolactinomas

more than 200 ng/mL

acute fatty liver of pregnancy presents in

third trimester

Kleihauer-Betke test

Determined amount of fetal blood in maternal circulation if large fetomaternal transfusion is suspected. Blood is exposed to some acid that causes adult Hb to go away while fetal Hb remains.

Acid burns cause

coagulation necrosis due to protein denaturation

Alkali burns cause

liquefactive necrosis due to cell membrane dissolution

antipsychotic that can cause seizures

clozapine

External cephalic version is typically done after

37 weeks gestation

Internal cephalic version generally done for

second twin in twin gestation

Nonosmotic stimuli for ADH release

nausea
pain
physical or emotional stress
hypotension
hypovolemia
hypoxia
hypoglycemia

Thessaly test

___Instruct the patient to stand facing doctor while holding their hands/shoulders to stabilize them
___Patient balances on one leg and bends the weight bearing knee
5�
___Patient then rotates knee into
external rotation and internal rotation 3 times
___I

McMurray Test

compression of the meniscus of the knee combined with internal and external rotation while the patient is face-up to assess the integrity of the meniscus

Incubation period of varicella

1-3 weeks

Acetabulum and femoral head ossify after

4 months of age

Migraines in children are usually

bifrontal

Acute posthypoxic myoclonus

aka myoclonus status epilepticus; develops within 24 hours of the initial hypoxic insult while the patient is still unconscious; persistent episodes are a marker for poor prognosis

Chronic posthypoxic myoclonus

aka Lance-Adams syndrome; occurs days to weeks after the initial insult after the patient has regained consciousness. Usually focal in nature and exacerbated by action;

Drugs that commonly cause erectile dysfunction

beta blockers and thiazides and spironolactone and SSRIs

Magnesium sulfate is give prior to

32 weeks of gestation

Patients with PPROM are delivered at

34 weeks of gestation

Retinopathy of prematurity commonly occurs in children born

before 30 weeks of gestation

Treatment for borderline personality disorder

dialectical behavior therapy

Treatment for papulopustular rosacea

topical metronidazole
azelaic acid
ivermectin
and tetracyclines for very refractory cases.

Treatment for erythematotelangiectatic rosacea

topical brimonidinelaser/nintense pulsed light therapy

Treatment for phymatous rosacea

oral isotretinoin
laser therapy and surgery

Treatment for ocular rosacea