the kidney is located?------?retroperitoneal
the spleen is located?------?under ribs 9, 10 and 11
the urachus is a derivitive of the allantoic duct. normally the urachus obliterates and forms the?------?median umbilical ligament
medial umbilial ligament is the adult portion of the?------?umbilical artery
lumbrical muscles?------?extend the fingers at the IP joints
all of the mucles of the hand are innervated by the?------?ulnar nerve except the 1st and 2nd lumbricals innervated by the median nerve
radial nerve?------?posterior muscles of the arm and forearm, extensor digitorum, extensor digiti minimi which only extend at MCP joints
side effect of metformin, a biguanide oral hypogylcaemic?is?------?lactic acidosis esp those with renal insuffiency
clonidine?------?centrally acting antihypertensive used in refractory hypertension, migraine prophylaxis, withdrawal symptoms from drugs, alcohol, and symptoms of ADHD
Enalapril?------?ACE-i for hypertension and CCF
Furosimide?------?loop diuretic
glyburide, glipizide?------?sulfonylurea used as adjunct to diet to lower blood glucose levels by stimulating pancreatic beta cells that undergoes hepatic clearance thus safer in patients with renal insufficiency and heartfailure
which organisms cause reiter's syndrome and what HLA is it??------?shigella, salmonella, yersinia, campylobacter jejuni and chlamydia trachomatis.
HLA-B27
RhA associated with which infection and which HLA and which collagen?------?Epstein Barr
HLA-DR
type 2 collagen
Neisseria gonorrhoea infection causes?------?septic arthritis of one joint, usually the knee.
peripheral leukocytosis adn left shift common
disseminated infection with papules on trunk and extensor surfaces of distal extremities with migratory arthritis and tenosynovitis of multiple joints.
Klumpke paralysis?------?injury to C8-T1 and loss to the intrinsic hand muscles.? If T1 involved then horner syndrome results.
injury to axillary?nerve causes (fracture of surgical neck of humerus or dislocation of head)?------?weakness in abduction of arm
injury to median nerve?------?loss of flexion of digits 2, 3 and thenar muscles, lumbricals 1 and 2 and loss of opposition of thumb (ape hand)
injury to radial nerve (fracture of humerus)?------?inability to extend digits and wrist
injury to upper trunk (C5, 6)?------?Erb paralysis, waiters tip, injury to?axillary, suprascapular and musculocutaneous nerves. arm medially rotated and adducted, forearm extended and pronated
injury to lower trunk (C8, T1)?------?thorasic outlet syndrome, loss of all muscles of forearm and hand. combination claw hand and ape hand, may include horners.
Inferior mesenteric artery arrises from and supplies?------?th aorta at L3, where the 3rd part of the duodenum crosses the midline and supplies the distal 1/3 of the transverse colon to the upper part of anal canal
superior mesenteric artery arrises?------?L1, just below celiac artery and above the renal arteries
splitting?------?all good or all bad, in children and adults with borderline personality disorder or psychosis
displacement?------?feelings transfered to a more acceptable substitute
fixation?------?arrested stage of development
reaction formation?------?unconscious defense mechanism where person takes on the opposite?belief from true belief?
Rosiglitazone?------?Thiazolidinediones reduce insulin resistance by binding PPAR-gamma receptors.
Side effects: liver toxicity, CHF, peripheral oedema
Fibromyalgia?------?non inflammatory condition with widespread muscle pain, fatigue, headaches. painful trigger points.
tx: TCAs or muscle relaxants with strong Anti-ACh side effects such as dry mouth, tachycardia, urinary retention and decreased gastro motility.
Steroid side effects?------?Adrenal suppression, immunosuppression, increased Na+, decreased Ca+ and water retention
NSAID side effects?------?decreased renal blood flow, interstitial nephritis,?and ulcers
Opioid side effects?------?Respiratory depression, miosis, euphoria and constipation
Cefaclor, 2nd gen cephalosporin side effect?------?serum like sickness
Acarbose?------?antidiabetic, delays absorption of glucose
Diltiazem and side effects?------?Ca channel blocker, hypotension, bradycardia, dizziness, flushing
cyanosis, palpable spleen, raised leukocyte alk phos, raised haematocrit?------?polycythemia vera, a myeloprolif. disorder.? other disorders include?CML, myeloid metaplasia with myelofibrosis and essential thrombocythemia
causes of megalobastic anemia?------?vit b12 and folate deficiency
cold agglutinin autoimmune hemolytic anemia and cold hemolysis autoimmune hemo...?------?IgM mediated and IgG mediated
colonic polyps with sawtooth glandular epithelium, globlet cells and columnar epithelium.??------?hyperplastic polyps...no malignant potential
neoplastic colonic polyps?------?tubular adenomas, tubulovillous adenomas and villous adenomas.? will have dysplastic epithelium.
large polyps with no malignant potential and complex branching pattern??------?Peutz-Jeghers polyps
Painful cervical motion test, discharge, abdo pain, abnormal vaginal bleeding?------?PID, infection usually from N. gonorrhoeae or Chlamydia.
Tx: cefoxitin and doxycycline or clindamycin and gentamicin.
can case infertility, bacteremia, peritonitis, intestinal obstruction due to adhesions.
complication of mucinous tumors of ovary or appendix?------?pseudomyxoma peritonei
CSF in bacterial meningitis?------?raised pressure, raised leukocytes (PMNs in bacterial) and protein, low glucose.
CSF in viral meningitis...if herpes virus what part of brain is affected?------?Normal to raised pressure, raised lymphocytes, normal protein and glucose...lower part of cerebral cortex esp. temporal and frontal bases and causes hemorrhagic necrosis.
CSF in fungal/TB meningitis?------?raised pressure, raised lymphocytes and protein, low glucose
low pH, high PaCO2, with compensatory high Bicarb reabsorption from kidney?------?respiratory acidosis
low pH, low bicarb with compensatory reduction in PaCO2 (by hyperventilation)?------?metabolic acidosis
?
low pH, low bicarb and high paCO2?------?both resp and meta acidosis
high pH, high bicarb, compensatory increased PaCO2 (hypoventilation)?------?metabolic alkalosis
high pH with low PaCO2 with compensatory decreased bicarb reabsorption from kidneys?------?respiratory alkalosis
henderson hasselbalch equation?------?pH=pKa + log [HCO3-]/0.03 PCO2
respiratory are always opposite to pH and?------?metabolics are always the same as PH
propanolol, nonselective beta blocker used in tx and px of migraines contra in?------?CODP and asthma as it causes bronchoconstriction
Sumatriptan, TCA, NSAIDs?and Verapamil?------?used for migraines and will not cause bronchoconstriction
smoking increases risk of which types of cancer?------?lung, kidneys, bladder, uterine cervix and small association with colon cancer (decreased fiber is mainly associated with colon cancer)
alcohol associated with?------?esophageal squamous cell cancer, gastric adenocarcinoma
h. pylori assocated with which types of cancer?------?gastric adenocarcinoma, gastric lymphoma and chronic gastritis.
uncontrolled production of maturing granulocytes, predominately neutrophils, also eosinophils and basophils. this condition is associated with which abnormalitiy
abl-bcr and t(9:22)?------?CML,?caues dysregulated kinase activity
systemic complaints, symptoms of cancer and elevated WCC predominant neutrophils
follicular lymphomas?------?bcl-2 and t(14:18). bcl-2 blocks apoptosis
burkitts lymphoma?------?c-myc and t(8:14) translocation
iron deficiency anemia?------?decreased Hb, decreased MCV, decreased ferritin, increased transferritin
B-thalassemia, reduced B globin chain?------?increased iron and ferritin and decreased transferrin
chloramphenicol toxicity?------?aplastic anemia, inablity of bone marrow to produce erythrocytes so get decreased erythrocytes which are normo and normo
chronic autoimmune gastritis?------?autoab block binding btwn vit B12 and IF, impaired B12 absorption leads to megaloblastic anemia. B12 is cofactor for DNA syn. so get defective maturation of cells, large erythroid precursors (increased MCV) and large hypersegmented.?neutrophils
anemia of chronic disease?------?increased iron, ferritin
decreased transferrin
increased iron deposits in bone marrow
highest velocity and lowest velocity blood vessels?------?aorta
capillaries (largest cross sectional area)
only band that does not change length during muscle contraction?------?A band-length of the myosin thick filament
acute pyogenic meningitis?------?raised neutrophils
neisseria and strep pneumonia
acute lymphocytic meningitis?------?raised lymphocytes
herpes and mumps
?
chronic meningitis?------?raised lymphocytes, plasma, macrophages, fibroblasts
TB, brucellious, syphilis, chronic fungal infections
shift to the right, dissociation of o2?------?exercising muscle, everything increased except pH
BBRAS?------?Bacitracin,?B group (agalactiae), resistant,?A group (pyogens)?sensitive?
OVRPS?------?Optocin, viridins resistant, pneumonia sensitive
NoStRES?------?Novobicin Staph aureus Resistant, Epidermidis Sensitive
Mycophenolate mofetil?------?converted to mycophenolic acid which inhibits de novo syn of guanine nucleotide and prolif dependent upon this purine synthesis
Tacrolimus?------?fungus derived macrolide that inhibts calcineurin mediated transcription of IL-2
Daclizumab and basiliximab?------?antibodies with high affinity for IL-2 receptor on activated T-cells
URTI with sore throat, low grade fever and adherent pseudomembrane on tonsil, pharynx and/or nose?------?corynebacterium diphtheriae which inactivates elongation factor 2 via ADP ribosylation which shuts down transcription (protein syn)
the floor of the orbit is the roof of the?------?maxillary sinus
function of the spleen?------?white-lymphocytes germinate in rxn to ag exposure
red-cords of billroth and sinuses filters the blood
Ito cells?------?hepatic adipose cells, storage for vit A, found in space of Disse the hepatic perisinusoidal space
Kupffer cells?------?final breakdown of RBC, found in liver sinusoids
Wernicke-Korsakoff syndrome?------?thiamine deficiency secondary to alcohol abuse
encephalopathy (reversible)-confusion, ataxia, vestibular dysfunction, sluggish pupillary light reflex, anisocoria and CN 3 dysfunction
chronic-amnesia, confabulation
lesions in mamillary bodies and dorsomedial nuclei of thalamus
the spleen is located?------?under ribs 9, 10 and 11
the urachus is a derivitive of the allantoic duct. normally the urachus obliterates and forms the?------?median umbilical ligament
medial umbilial ligament is the adult portion of the?------?umbilical artery
lumbrical muscles?------?extend the fingers at the IP joints
all of the mucles of the hand are innervated by the?------?ulnar nerve except the 1st and 2nd lumbricals innervated by the median nerve
radial nerve?------?posterior muscles of the arm and forearm, extensor digitorum, extensor digiti minimi which only extend at MCP joints
side effect of metformin, a biguanide oral hypogylcaemic?is?------?lactic acidosis esp those with renal insuffiency
clonidine?------?centrally acting antihypertensive used in refractory hypertension, migraine prophylaxis, withdrawal symptoms from drugs, alcohol, and symptoms of ADHD
Enalapril?------?ACE-i for hypertension and CCF
Furosimide?------?loop diuretic
glyburide, glipizide?------?sulfonylurea used as adjunct to diet to lower blood glucose levels by stimulating pancreatic beta cells that undergoes hepatic clearance thus safer in patients with renal insufficiency and heartfailure
which organisms cause reiter's syndrome and what HLA is it??------?shigella, salmonella, yersinia, campylobacter jejuni and chlamydia trachomatis.
HLA-B27
RhA associated with which infection and which HLA and which collagen?------?Epstein Barr
HLA-DR
type 2 collagen
Neisseria gonorrhoea infection causes?------?septic arthritis of one joint, usually the knee.
peripheral leukocytosis adn left shift common
disseminated infection with papules on trunk and extensor surfaces of distal extremities with migratory arthritis and tenosynovitis of multiple joints.
Klumpke paralysis?------?injury to C8-T1 and loss to the intrinsic hand muscles.? If T1 involved then horner syndrome results.
injury to axillary?nerve causes (fracture of surgical neck of humerus or dislocation of head)?------?weakness in abduction of arm
injury to median nerve?------?loss of flexion of digits 2, 3 and thenar muscles, lumbricals 1 and 2 and loss of opposition of thumb (ape hand)
injury to radial nerve (fracture of humerus)?------?inability to extend digits and wrist
injury to upper trunk (C5, 6)?------?Erb paralysis, waiters tip, injury to?axillary, suprascapular and musculocutaneous nerves. arm medially rotated and adducted, forearm extended and pronated
injury to lower trunk (C8, T1)?------?thorasic outlet syndrome, loss of all muscles of forearm and hand. combination claw hand and ape hand, may include horners.
Inferior mesenteric artery arrises from and supplies?------?th aorta at L3, where the 3rd part of the duodenum crosses the midline and supplies the distal 1/3 of the transverse colon to the upper part of anal canal
superior mesenteric artery arrises?------?L1, just below celiac artery and above the renal arteries
splitting?------?all good or all bad, in children and adults with borderline personality disorder or psychosis
displacement?------?feelings transfered to a more acceptable substitute
fixation?------?arrested stage of development
reaction formation?------?unconscious defense mechanism where person takes on the opposite?belief from true belief?
Rosiglitazone?------?Thiazolidinediones reduce insulin resistance by binding PPAR-gamma receptors.
Side effects: liver toxicity, CHF, peripheral oedema
Fibromyalgia?------?non inflammatory condition with widespread muscle pain, fatigue, headaches. painful trigger points.
tx: TCAs or muscle relaxants with strong Anti-ACh side effects such as dry mouth, tachycardia, urinary retention and decreased gastro motility.
Steroid side effects?------?Adrenal suppression, immunosuppression, increased Na+, decreased Ca+ and water retention
NSAID side effects?------?decreased renal blood flow, interstitial nephritis,?and ulcers
Opioid side effects?------?Respiratory depression, miosis, euphoria and constipation
Cefaclor, 2nd gen cephalosporin side effect?------?serum like sickness
Acarbose?------?antidiabetic, delays absorption of glucose
Diltiazem and side effects?------?Ca channel blocker, hypotension, bradycardia, dizziness, flushing
cyanosis, palpable spleen, raised leukocyte alk phos, raised haematocrit?------?polycythemia vera, a myeloprolif. disorder.? other disorders include?CML, myeloid metaplasia with myelofibrosis and essential thrombocythemia
causes of megalobastic anemia?------?vit b12 and folate deficiency
cold agglutinin autoimmune hemolytic anemia and cold hemolysis autoimmune hemo...?------?IgM mediated and IgG mediated
colonic polyps with sawtooth glandular epithelium, globlet cells and columnar epithelium.??------?hyperplastic polyps...no malignant potential
neoplastic colonic polyps?------?tubular adenomas, tubulovillous adenomas and villous adenomas.? will have dysplastic epithelium.
large polyps with no malignant potential and complex branching pattern??------?Peutz-Jeghers polyps
Painful cervical motion test, discharge, abdo pain, abnormal vaginal bleeding?------?PID, infection usually from N. gonorrhoeae or Chlamydia.
Tx: cefoxitin and doxycycline or clindamycin and gentamicin.
can case infertility, bacteremia, peritonitis, intestinal obstruction due to adhesions.
complication of mucinous tumors of ovary or appendix?------?pseudomyxoma peritonei
CSF in bacterial meningitis?------?raised pressure, raised leukocytes (PMNs in bacterial) and protein, low glucose.
CSF in viral meningitis...if herpes virus what part of brain is affected?------?Normal to raised pressure, raised lymphocytes, normal protein and glucose...lower part of cerebral cortex esp. temporal and frontal bases and causes hemorrhagic necrosis.
CSF in fungal/TB meningitis?------?raised pressure, raised lymphocytes and protein, low glucose
low pH, high PaCO2, with compensatory high Bicarb reabsorption from kidney?------?respiratory acidosis
low pH, low bicarb with compensatory reduction in PaCO2 (by hyperventilation)?------?metabolic acidosis
?
low pH, low bicarb and high paCO2?------?both resp and meta acidosis
high pH, high bicarb, compensatory increased PaCO2 (hypoventilation)?------?metabolic alkalosis
high pH with low PaCO2 with compensatory decreased bicarb reabsorption from kidneys?------?respiratory alkalosis
henderson hasselbalch equation?------?pH=pKa + log [HCO3-]/0.03 PCO2
respiratory are always opposite to pH and?------?metabolics are always the same as PH
propanolol, nonselective beta blocker used in tx and px of migraines contra in?------?CODP and asthma as it causes bronchoconstriction
Sumatriptan, TCA, NSAIDs?and Verapamil?------?used for migraines and will not cause bronchoconstriction
smoking increases risk of which types of cancer?------?lung, kidneys, bladder, uterine cervix and small association with colon cancer (decreased fiber is mainly associated with colon cancer)
alcohol associated with?------?esophageal squamous cell cancer, gastric adenocarcinoma
h. pylori assocated with which types of cancer?------?gastric adenocarcinoma, gastric lymphoma and chronic gastritis.
uncontrolled production of maturing granulocytes, predominately neutrophils, also eosinophils and basophils. this condition is associated with which abnormalitiy
abl-bcr and t(9:22)?------?CML,?caues dysregulated kinase activity
systemic complaints, symptoms of cancer and elevated WCC predominant neutrophils
follicular lymphomas?------?bcl-2 and t(14:18). bcl-2 blocks apoptosis
burkitts lymphoma?------?c-myc and t(8:14) translocation
iron deficiency anemia?------?decreased Hb, decreased MCV, decreased ferritin, increased transferritin
B-thalassemia, reduced B globin chain?------?increased iron and ferritin and decreased transferrin
chloramphenicol toxicity?------?aplastic anemia, inablity of bone marrow to produce erythrocytes so get decreased erythrocytes which are normo and normo
chronic autoimmune gastritis?------?autoab block binding btwn vit B12 and IF, impaired B12 absorption leads to megaloblastic anemia. B12 is cofactor for DNA syn. so get defective maturation of cells, large erythroid precursors (increased MCV) and large hypersegmented.?neutrophils
anemia of chronic disease?------?increased iron, ferritin
decreased transferrin
increased iron deposits in bone marrow
highest velocity and lowest velocity blood vessels?------?aorta
capillaries (largest cross sectional area)
only band that does not change length during muscle contraction?------?A band-length of the myosin thick filament
acute pyogenic meningitis?------?raised neutrophils
neisseria and strep pneumonia
acute lymphocytic meningitis?------?raised lymphocytes
herpes and mumps
?
chronic meningitis?------?raised lymphocytes, plasma, macrophages, fibroblasts
TB, brucellious, syphilis, chronic fungal infections
shift to the right, dissociation of o2?------?exercising muscle, everything increased except pH
BBRAS?------?Bacitracin,?B group (agalactiae), resistant,?A group (pyogens)?sensitive?
OVRPS?------?Optocin, viridins resistant, pneumonia sensitive
NoStRES?------?Novobicin Staph aureus Resistant, Epidermidis Sensitive
Mycophenolate mofetil?------?converted to mycophenolic acid which inhibits de novo syn of guanine nucleotide and prolif dependent upon this purine synthesis
Tacrolimus?------?fungus derived macrolide that inhibts calcineurin mediated transcription of IL-2
Daclizumab and basiliximab?------?antibodies with high affinity for IL-2 receptor on activated T-cells
URTI with sore throat, low grade fever and adherent pseudomembrane on tonsil, pharynx and/or nose?------?corynebacterium diphtheriae which inactivates elongation factor 2 via ADP ribosylation which shuts down transcription (protein syn)
the floor of the orbit is the roof of the?------?maxillary sinus
function of the spleen?------?white-lymphocytes germinate in rxn to ag exposure
red-cords of billroth and sinuses filters the blood
Ito cells?------?hepatic adipose cells, storage for vit A, found in space of Disse the hepatic perisinusoidal space
Kupffer cells?------?final breakdown of RBC, found in liver sinusoids
Wernicke-Korsakoff syndrome?------?thiamine deficiency secondary to alcohol abuse
encephalopathy (reversible)-confusion, ataxia, vestibular dysfunction, sluggish pupillary light reflex, anisocoria and CN 3 dysfunction
chronic-amnesia, confabulation
lesions in mamillary bodies and dorsomedial nuclei of thalamus
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