Rx_Random Set #2

Question 1

Major nutritional deficiency/syndromes in CF?

Answer 1

• pancreatic insuffiency ==> deficiencies in fat-soluble vitamins (A, K, E, D)
• A ==> night blind/dry skin
• K ==> coag problems
• E ==> RBC dysfxn
• D ==> Rickett’s (children), osteomalacia (adults)

Question 2

LSD use presentation

Answer 2

• hallucinations, anxiety or depression, delusions
• nausea, weakness, paresthesias
• dilated pupils
• few observable behavioral changes

Question 3

Sx of phechomocytoma + associations

Answer 3

• sx = sweating, tachycardia, HTN
• associatiated w/heritable MEN syndrome
  
  • MEN-2A
  • MEN-2B

Question 4

MEN-1 Syndrome association

Answer 4

• “3 Ps”
• Pancreas
• Pituitary
• Parathyroid neoplasms

Question 5

MEN-2 syndrome associations

Answer 5

• MEN-2A = “2 Ps”
  
  • Pheochromocytoma
  • Parathyroid cancer
  • medullary thyroid cancer
• MEN-2B = “1 P”
  
  • Pheochromocytoma
  • medullary thyroid cancer
  • mucosal neoplasms

Question 6

Specificty definition/calculation

Answer 6

• specificty = how well test identifies those who are truly non-diseased
  
  • important in ruling out illness
• specificity = TN/(TN+FP)

Question 7

Sensitivity definition/calculation

Answer 7

• sensitivity = probablity of detecting disease when it is present
• sensitivity = TP/(TP + FN)

Question 8

Horner’s syndrome characteristics

Answer 8

• ptosis
• miosis
• anhidrosis

Question 9

Smoker/other lung cancer risk + shoulder pain + hoarseness + Horner’s syndrome ==> what tumor type & location

Answer 9

• squamous cell carcinoma (if smoker) @ apex of ipsilateral lung to neuro deficitis
• aka “Pancoast’s tumor” or “superior sulcus tumor”

Question 10

Recurrent viral infections indicate…

Answer 10

T-lymphocyte dysfxn

Question 11

Helper T cell cytokine deficiency ==> T lymphocyte dysfxn

Answer 11

IL-2

Question 12

Cause/characteristics of fifth disease

Answer 12

• fifth disease = “erythema infectiosum”
• caused by Parvovirus B19
• typically effects children 5-10yo
• ==> erythematous rash on both cheeks

Question 13

Common drug used in treatment of large B-lymphocyte lymphoma

Answer 13

Methotrexate

Question 14

Methotrexate MOA/use

Answer 14

• blocks dihydrofolate reductase ==> decreased deoxythymidine monophosphate & decreased DNA and protein synthesis in rapidly dividing cells
• used to treat B-lymphocyte lymphoma

Question 15

Acute poststreptococcal glomerulonephritis histologic appearance

Answer 15

• subepithelial deposition of antigen-antibody complexes ==>
• “lumpy-bumpy” pattern on light microscopy

Question 16

Dx + associated sx? Patient cannot dorsiflex wrist

Answer 16

• = “wrist drop” ==> indicates radial nerve injury
• “radial nerve innervates the BEST”
  
  • Brachioradialis
  • Extensor of wrist/fingers
  • Supinator
  • Triceps

Question 17

Histological appearance of osteoarthiritis @ joint space

Answer 17

• degeneration of articular cartilage
• disloged peices of cartilage and subchondral bone

Question 18

Lab values in metabolic alkalosis

Answer 18

• elevated pH
• elevated CO₂
• elevated HCO₃^-

Question 19

Diuretics that can cause metabolic alkalosis

Answer 19

• hydrochlorothiazide
• furosemide

Question 20

Common complications in Trisomy 18

Answer 20

• flexed fingers w/overriding digits
• prominent occiput
• congenital heart anomalies

Question 21

Fxn of C5 - C8

Answer 21

complement compoenents involved in membrane attack complex

Question 22

Deficiency of C5-C8 ==>

Answer 22

• increased susceptibility to gram-negative bacteria
• e.g. Neisseria meningitidis
  
  • pyrexia
  • petechial rash
  • blood culture findings

Question 23

Common muscle injury during vaginal delivery

Answer 23

perineal body & external anal sphincter ==> fecal incontinence

Question 24

characteristics of alpha1-antitrypsin deficiency

Answer 24

• AAT = enzyme normally produced @ liver that destroys elastase produced in lung parenychema
• misfolded protease inhibitor ==> overactivity of elastase ==>
• ephysema
• cirrhosis

Question 25

Histologic consequences of alpha-antitrypsin deficiency @ hepatocytes

Answer 25

PAS-positive globules

Question 26

Anti-phospholipid syndrome in SLE patients ==\>

Answer 26

* prolonged partial thromboplastin time (PTT) * not correctable w/ mixing 1:1 w/fresh-frozen plasma * "falsely-elevated" * actually predisposes to clot formation * DVTs * placental clots ==\> recurrent fetal loss

Question 27

Main types of renal stones + typical imaging

Answer 27

* calcium = radiopaque on xray * uric acid = radiolucent; seen on CT * struvite = xray * cystine =xray

Question 28

Syphilis presentation + tx

Answer 28

* presentation * painless chancre in vaginal area * positive venereal disease research laboratory test + positive FTA-Abs ==\> active infection * treatment * Penicilin G * administered IM

Question 29

Innervation/fxn/location of sweat glands

Answer 29

* eccrine * fxn = thermoregulation; watery solution produced * location = throughout skin, most @ palms/soles * innervation = sympathetic * apocrine * fxn = produces oily, viscid solution * location = axillae, groin * innervation = catecholamines

Question 30

Pharmacologic management of status epilepticus

Answer 30

* IV diazepam * IV phenytoin * IV phenobarbitol (if resistant status epilepticus)