Question | Answer |
Risk factor: Diabetes. Services? | Eye, foot exams; urine tests |
Risk factor: Drug use. Services? | Hep immunizations; HIV, TB tests. |
Risk factor: Alcoholism. Services? | Pneumococcal, Influenza immunizations; TB test |
Risk factor: Overweight. Services? | Blood sugar tests for diabetes. |
Risk factor: Homeless, recent immigrant, inmate. Services? | TB test |
Risk factor: High-risk sexual behavior. Services? | HIV, hep B, syphilis, gonorrhea, chlamydia tests. |
Reportable diseases? | Hep, Hep, Hep, Hooray, the SSSMMART Chick is Gone! Hep A/B/C, HIV, Salmonella, Shigella, Syphilis, Measles, Mumps, AIDS, Rubella, TB, Chickenpox, Gonorrhea |
Leading causes of death in the US for infants | congenital anomalies, sort gestation/low birth weight, sudden infant death syndrome, maternal complications of pregnancy, respiratory distress syndrome |
Leading causes of death in the US for ages 1-14 | injuries, cancer, congenital anomalies, homicide, heart dz |
Leading causes of death in the US for ages 15-24 | injuries, homicide, suicide, cancer, heart disease. |
Leading causes of death in the US for ages 25-64 | cancer, heart dz, injuries, suicide, stroke. |
Leading causes of death in the US for ages 65+ | heart dz, cancer, stroke, COPD, PNA, influenza |
Stress affects | Induce production of free fatty acids, 17-OH corticosteroids, lipids, cholesterol, catecholamines; Affects water absorption, muscular tonicity, gastrocolic reflex, mucosal circulation. |
Differential diagnosis of sexual dysfunction | Drugs (antihypertensives, neuroleptics, SSRIs, ethanol), Diseases (depression, diabetes), Psychological (performance anxiety) |
5 heart block | Lyme dz, salmonella typhi (=typhoid), chagas dz (whipple's), legionella, diphtheria |
reiter's syndrome | chlamydia, shigella, yersinia, crohns, irrit.bowel dz |
low complement cryoglob. (bugs) | "I AM HE": influenza, adenovirus, mycoplasma, hep c, EBV . (=5 vasculitides assoc with Subacute Bacterial Endocarditis) |
drug induced SLE | "HIPPE": hydralazine, isoniazid, procainamide, penicillamine, phenytoin, ethosuximide |
drugs that blast BM | "ABCV": AZT, benzene, chloramphenicol, vinblastine |
comma shaped bugs | vibrio, campylobacter, listeria, H. pylori |
corynebacter | chinese letters |
giardia lamblia | crescent shaped protozoa |
TB Rx's | "RESPIre": Pyrazinamide, rifampin, ethambutol, isoniazid, streptomycin |
6 low complement associated nephrotic syndromes (vascultides) | Serum sickness, PSGN, SLE, SBE, Cryoglobulinemia, MPGN II (membranoproliferative GN) |
Induce P450 | "Really Quiet Bats Go Camping": Rifampin, Quinidine, Barbiturate, Alcohol (chronic), Tetracycline, Sulfa drugs, Griseofulvin, Carbamazepine |
Inhibit P450 | "I'd SMACK Q": INH, Dapsone, Spironolactones, Macrolides, Amiodarone, Cimetidine, Ketoconazole, Quinolones |
P450 dependant | "WEPTD": Warfarin, Estrogen, Phenytoin, Theophyline, Digoxin |
Neutrophil deficiency | CGD (chronic granulomatous dz)= NADPH-oxidase deficiency (X linked recesive) |
Side efects of Statins | Myositis, hepatitis, elevated liver enzymes |
Painful genital lesions | herpes, chancroid (hemophilus ducreyi), lymphogranuloma inguinale (venereum, chlamydia), granulom inuinale associated with Donovini |
4 hormones with disulfide bonds | "PIIG": prolactin, inhibin, insulin, growth hormone |
Hookworms | "NEATAS": necatur americanis, enterobius vermicularis, anklostoma duodenale, trichuris trichurium, ascaris lumbricoides, strongyloides |
x-linked enzyme deficiencies | G6PD (=MC), CGD (NADPH oxidase defic.), Pyruvate DH deficiency, Fabry's, Hunter's, Lesh-Nyhan. (are usualy AR) |
Screen newborns | "Please Check B4 Going Home": PKU, CAH (Congenital Adrenal Hyperplasia), Biotidinase defic., Galactosemia, Hypothyroidism |
Actions of Steroids | "KIIISS": kils Th cels and eosinophils, inhibit macrophage migration, ingibits phospholipase A2, inhibits mast cel degranulation, stabilizes (tighten) endothelium, stimulate cell protein synthesis |
cause monocytosis | salmonella (typhoid), TB, EBV (MC), listeria, syphilis, CMV |
Ecoli is the most common cause of ? | "AAASUC": abdominal absces, ascending cholangitis, apendicitis, spontaneous bacterial peritonitis, UTI, cholecystitis |
one dose trx for chlamydia | azithromycin |
"Big Mama" Anaerobes | Strep Bovis, Clostridium melanogosepticus, Baceroides Fragilis |
"Big Mama" Trx for anaerobes | clindamycin, metronidazole, cefoxitin |
low volume state (serum) | low K/Na/Cl, hi pH/BP |
one dose Trx for gonorhea | "CCCCOG": ceftriaxone, cefixime, cefoxitin, ceprofloxacin, ofloxacin, gatifloxacin |
Psammoma bodies | "PSaMMoma" =calcified cancers: Papilary CA of thyroid, Serous cystadenoma of ovary, Meningioma, Mesothelioma |
Urease positive bacteria | "PPUNCH": proteus (struvite stones=90%, swarming motility), pseudomonas, ureaplasma urealyticum, nocardia spp., cryptococus neoformans, helicobacter pylori |
4 indications for PUD surgery | "IHOP": intractable pain, hemorage, obstruction (fr scarring), perforation |
cardiac fibrosis | adriamycin, phen-fen |
MCC of any ...penia | viral, drugs (ABCV-C: azt, vincblastine, chemo, benzene, chloramphenical) |
salmonela typhi triad | hi fever, intestinal fire, rose spots (rash) |
drugs that cause myositis | "RIPS": rifampin, inh, prednisone, statins |
7 encapsulated bacteria (gram negative) | "Some Strange Kilrs Have Prety Nice Capsules": salmonela, strep PNA, klebsiela, h. influenza, pseudomonas, neiseria, citrobacter |
jones criteria (rheumatic fever) | "PECCS": polyarthritis, erythema marginatum, carditis, chorea, Subcutaneous nodules |
eosinophilia | "CAPAN": neoplasms, alergies/asthma, adison's dz, colagen vasc. dz, parasites |
risk factor for primary liver ca (hepatoma) | "HAVE CASH BS": hep B/C, aflatoxin, vinyl chloride, EtOH, carbon tetrachloride, anyline dyes, smoking hemochromatosis, benzene, schistosomiasis mansoni |
9 live vacines | "MR OR Smal Blistery Yelow Vesicles": Measles, Mumps, Rubela, Oral Polio (Sabin), Rotavirus, Small Pox, BCG Yelow Fever, Varicella |
IgA Nephropathies | henoch-schonlein purpura, berger's, alport's |
autoimune hemolytic anemia | "PACS PAD": PTU, alpha-methyldopa, cephalosporins, sulfa, PNC, antimalarial , dapsone |
autoimune thrombocytopenia | ASA, heparin, quinidine |
drugs containing sulfa | sulfonamides, sulfonylurea, celbrex-celecoxib =COX2 specific (viox-rofecoxib=COX2 spec has NO sulfa) |
inhibit dihydrofolate reductase | pyremethamine/sulfadiazine, trimethoprim/sulfamethoxasole |
MI enzymes | TPI= appears in 2h, peaks in 2 d, gone in 7 d;
CKMB= appears in 6h, peaks in 12 h, gone in 24h;
LDH1=appears in 1d, peaks in 2 d, gone in 3d |
siver stains | "BC Lawyers Charge Hourly": bartonela henselae (Lymph nodes), candida (yeast), legionela, pneumocystis Carinii, H. pylori |
drugs that cause pulm fibrosis | "BBAT": bleomycin, busulfan, amiodarone, tocainide |
macrophage deficiency | chediak-higashi, NADPH-oxidase deficiency |
Side efect of loops and thiazides | "OHHHH": ototoxic, hyperglycemia, hyperuricemia, hypokalemia, hypovolemia |
the only 3 pansystolic M's | inc on expir, decr on inspir: MR, VSD; incr on inspir: TR |
7 palms and soles rashes | "TRACKSSS": TSS, RMSF (rocky mtn spotted fever), coxsackie A (hand/foot/mouth dz), kawasaki, scarlet fever, syphilis, sSSS(staph scald skin syndrome= exfolitin) |
every restrictive lung dz and low volume state | tachypnea, low pCO2, low pO2, hi pH |
2nd messengers: cAMP, cGMP | 2nd messengers: cAMP=symp., CRH. cGMP=parasymp. |
2nd messengers: IP3/DAG | NeuroTransmiter, GHRH, all hypothal. horm. xc CRH, smooth muscle by contraction |
2nd messengers: cAlcium/calmodulin | smooth musc. contr by distention |
2nd messengers: calcium | gastrin |
2nd messengers: tyrosine kinase | insulin, al GF's |
2nd messengers: NO | nitrates, viagra, ANP, LPS (endotoxin) |
T and B cel deficiency | WAS (wiskot Aldrich), SCID, CVID, HIV, HTLV1 |
WAS (wiskot Aldrich) | thrombocytopenia, IL4 infx, eczema, decr IgM (IgE?) |
SCID | framshift/nonsense mutation, adenosine deaminase defic; T>B; bact. and fungal infxns |
CVID | late onset, frameshift/misense mutation; tyrosine kinase defic |
HIV, HTLV1 | T>B, CD4 rich; brain testicles, cervix, blod vesels |
ETC poisons: | complex I=amytal, rotenone; complex II= malonate ; complex III=antimycin D; complex IV= CN-, CO, chloramphenical; complex V=oligomycin |
ETC chemical uncouplers | dnp, free fatty acids, aspirin (a physical uncoupler) |
4 sources of acid (Renal) | plasma, urea cycle, collecting ducts, gutaminase |
ETC poisons:complex I= | amytal, rotenone; |
ETC poisons:complex II= | malonate ; |
ETC poisons:complex III= | antimycin D; |
ETC poisons:complex IV= | CN-, CO, chloramphenical; |
ETC poisons:complex V= | oligomycin |
one dose trx hemophilus ducreyi | azithromycin 1 gr po, ceftriaxone 250 mg im, |
one dose trx candidiasis | ketoconazole 150 mg |
one dose trx vaginal candidiasis | 1 pill of diflucan |
one dose trx trichomonas | metronidazole 2 gr |
one dose trx gardnerella | metronidazole 2 gr |
to break down glycogen, 4 enz. | phosphorylase (Pi), debranching enz, alpha-1,6-glucosidase, phosphatase, alpha 1,4-glucosidase |
to make glycogen, 2 enz | glycogen synthase, branching enz (=glycogen alpha-1,4;alpha-1,6 glycosyl transferase) |
obstructive vs restrictive pulmonary dz | obstructive= hi pO2/N, or hi pCO2, low pH. (leads to resp. acidosis)
restrictive = low pO2, low pCO2, hi pH |
6 places of TCA where aa's feed in/out | pyruvate- gly, ala,ser; acetyl coA- Mr.PITT (phe, iso, thr,tyr) + lys, leu; alpha-KG - glu, gln; succinyl coA- phe, tryp, tyr; fumarate-pro; oxaloacetate- asp,asn |
4 steps of beta oxidation | 1. oxidation (7 NADH/21 ATP).
2. Hydration.
3. oxidatio(7 FADH/14 ATP).
4. thiolysis (8 AcCoA/ 96 ATP).
***total 131 ATP-2 to bring it in. |
4 H's produced by small cell CA | ACTH, ADH, PTH, TSH, (ANP) |
viruses directly cause CA | PAPILLOMA, EBV, HBV,HCV, HIV |
tPA 20mg iv push, 40mg drip. give inhibitors. | aminocaproic acid |
streptokinase 750K iv push, then 750K drip. give inhibitors. | aminocaproic acid |
warfarin. give inhibitors. | vitK |
heparin. give inhibitors. | protamin sulfate |
urokinase. | used only for feeding tubes, fistulas, etc. |
anticardiolipin | SLE |
anti-topoisomerase | PSS (Progressive Systemic Sclerosis) |
anti-TSH receptors | Graves |
anti-hair follicle | allopecia areata |
anti-myelin receptor | MS |
anti-melanocyte | viteligo |
anti-ACH | MG |
anti-ribonuclear protein | Mixed CT dz (MCTD) |
anti-parietal cell receptor | pernicious anemia (ab's to intrinsic factor) |
anti-epidermal anchoring protein receptors | pemphigus vulgaris (positive Nikolsky, ab's to intercellular jntn of epidermal cells) |
anti-epidermal BM protein | bullous pemphigoid,(IgG subepidermal blisters, oral etc.) |
anti-thyroglobulin | hashimoto's |
anti-microsomal | hashimoto's |
anti-smooth muscle | scleroderma |
anti-scl70 | scleroderma |
anti-rho (SS-A) | sjogren's |
anti-la | sjogren's |
anti-proteinase | wegener's |
clot in front of renal artery | renal artery stenosis |
clot off whole renal artery | renal failure |
clot in renal papilla | papillary necrosis |
clot off renal medulla | interstitial nephritis |
clot off pieces of nephron | focal segmental GN, HIV, drug use assoc. |
clot off lots of nephrons | RPGN |
MC nephrotic dz in adults | membranous GN |
MC renal dz in blacks/hispanics | focal segmental GN |
MC renal mass | a cyst |
MC malignant renal tumor in adults | adenocarcinoma |
MC malignant renal tumor in children | wilm's tumor |
MCC leading to RPGN | goodpasteurs |
alopecia areata | patch of hair |
alopecia totalis | entire head bald |
alopecia universalis | entire body hairless |
pulmonary infiltrate eosinophilia (PIE) syndrome | "NASSA": necator americanus, ascaris lumbricoides, schistosomiasis, strongyloides, ankylostoma duodenale |
2 enzymes used by B12 | homocystine methyl transferase, methyl malonyl mutase |
mitochondrial inheritance | NO male transmission, ALL |
increased susceptibility to pseudomonas and staph infxs | burn pts, CF pts, DM pts, neutropenic pts (cover 1x for S. aureus during 1st wk, cover 2x for pseudomonas after 2nd wk) |
cause of widened S2 | (incr pO2, incr vol in R ventricle).
1. blood transfusion.
2. giving O2.
3. R side failure.
4. pregnancy (incr vol).
5. iv fluids.
6. ASD.
7. deep breathing. |
8 cavities of blood loss | "PIMP TRAP":
pericardium,
intracranial,
mediastinum,
pleural cavity,
thighs,
retroperitoneum,
abdominal (=big),
pelvis (=deep) |
penicillin | gram positive, bone marrow suppression; simple anaerobes; #1 cause of anaphylax; interstitial nephritis; nonspecific rashes; as haptens->hemolytic anemia. |
negative-stranded RNA | prodromal period b4 sxs=1-3 wks b/c must switch to positive stranded before replication |
positive-stranded RNA | sxs within 1 wk or less (xc these negative stranded: hanta, ebola, yellow fever) |
5 cofactors for dehydrogenase complex | "Tender Loving Care For Nancy": TPP (thiamin-B1), lipoic acid (B4), CoA (pantothenic acid- B5), FAD (Riboflavin-B2), NAD (Niacin-B3). |
x-linked inheritance (all are x-recessive, xc one) | bruton's agammglobulinemia, CGD (NADPH defic.), duchenne, color blindness, G6PD, hemophilia, lesch-nyhan, vitamin resistant rickets (x-linked dominant) |
B-cell deficiency | bruton's agammaglobulinemia (tyrosine kinase deficiency), SCID (T-cell overlap), WAS (T-cell overlap), CVID (common variable immune defic., tyrosine kinase defic), leukemias, lymphomas, job-buckley syndrome (T-cell overlap) |
4 itchiest rash | "SLUD": scabies, lichen planus, urticaria, dermatitis herpetiformis |
I-myc | small cell lung CA, promyelocytic leukemia (Burkitt's lymphoma) |
c-myc | small cell lung CA, promyelocytic leukemia (Burkitt's lymphoma) |
N-myc | neuroblastoma, small cell lung CA |
c-abl | CML, ALL |
c-myb | colon CA, AML |
c-sis | osteosarcoma, glioma, fibrosarcoma |
c-erb B2 | epidermal growth factors receptors |
CSF-1 | breast |
erb-B2 | breast CA, ovarian, gastric |
ret | medullary CA of thyroid, MEN II/III, papillary CA |
Ki-ras | lung CA, colon CA |
bcl-2 | Burkitts, follicular lymphoma |
erb | retinoblastoma |
ranson's criteria of acute pancreatitis | at admission "GALAW": glu>200, age>55, LDH>350, AST>250, WBC>16,000.
at less than 48 hrs "CHOBBS": calcium<8mg/dl, hct drop of>10%, O2<60 (PaO2), base deficit>4, BUN>5, sequestration>6L |
hormones produced by placenta | "HI HOPE": hCG, inhibin, human placental lactogen (HPL), oxytocin, progesterone, estrogen |
pilocarpine | CF, glaucoma (painful, red, teary eye) |
causing dysgeusias (taste disorders) | metronidazole, clarithromycin, Zn deficiency |
Rashes associated with cancer: seborrheic keratosis (waxy warts) | colon ca or HIV if sudden increase in #. nL with aging. |
Rashes associated with cancer: dermatomyositis (violacious, heliotropic rash, malar area) | colon ca |
Rashes associated with cancer: akanthosis nigricans (dark lines in skin folds) | any visceral ca, end organ damage |
carcinoid syndrome (triad), measure what, | flushing, wheezing diarrhea (measure serotonin 5-HIAA; comes from pancreas, ileum) |
AVMs | "HEAL": heart (PDA),
elbow (fistula from dialysis in renal dz),
abd/brain (von hippel lindau, clot off with coils,
increased incidence of renal cell CA--chr3),
lungs (osler-weber-rendu syndrome). |
HDL carries | "CEAL": L-CAT, E, C-II, Apo-A |
VLDL carries | B-100, E, C-II, ApoA |
IDL carries | B-100, E, CII |
LDL carries | B-100 |
chylomicrons take TGs from GI to | liver (25%), endothelium (75%) |
erythema marginatum | little red spots with bright red margins, sandpapery, RF - Jones criteria ->strep pyogenes |
Measles | morbiliform rash, preceded by cough, conjuctivitis |
roseola | fever 2 days, sop, rash pops up= rash after fever (=HHV6) |
erythema nodosum | anterior aspect of leg, redness, teder nodules |
erythema multiforme | red macules, target lesions, allergy, viruses, severe = Toxic Epidermal Necrolsis (skin peels off); mild = stevens johnson syndrome; mild= virus (MCC), drugs (Sulfa) |
seborrheic dermatitis | scaly skin with oily shine on hairline |
seborrheic keratosis | stuck on "warts" |
psoriasis | HLA B27, extensor surfaces, silvery white plaques, scaly skin, pitted nails |
varicella zoster | stages- red macules, papules, vesicles, pustules, then scabs; different stages at same time (=HHV3) |
dermatitis herpetiformis | rash/blisters on ant. thigh, assoc. with diarrhea 2/2 celiac sprue flare up |
typhoid fever (salmonella) | rose spots assoc. with "intestinal fire" |
dermatomyositis | heliotropic rash |
erysipelas | reddened area on skin with raised borders; does not blanch |
tinea cruris | redness, itchy groin |
pityriasis rosea | herald patch; dr skin patches that follow skin lines, (HHV7) |
Tinea versicolor | hypopigmented macules on upper back in "V" pattern (upside-down Christmass tree); Trx=griseofulvin |
Scabies | linear excoriations on belt line and finger webs, etc. Trx: Lindane, or Permethrin. |
T-cell deficiency | DeGeorge's (hypokalemia, 3 & 4 pharyngeal pouch, deletion of chr22), HIV (also B-cell, but less so) |
Lipoprotein transports: chylomicron | takes TGs from GI to liver and endothelium |
Lipoprotein transports: VLDL | takes TGs from liver to adipose |
Lipoprotein transports: IDL | takes TGs from adipose to tissue |
Lipoprotein transports: LDL | only one to carry cholesterol |
Lipoprotein transports: excessive TGs | xanthelasma- eyelids/-brows |
Lipoprotein transports: excess cholesterol | xanthoma-elbows |
Lipoprotein transports: VLDL | is the only one made in the liver |
Lipoprotein transports: IDL and LDL | are break down products of VLDL |
hemophilus influenza | "pleomorphic" gram negative rod; "school of fish"; (Type A=80%, non-encapsulated, noninvasive, 2nd MCC of sinusitis/otitis/bronchitis). (Type B=20%, encapsulated-polyribosyl phosphate in capsule, IgA Protease, invasive dz, #1 cause of eiglotitis, stridor |
meningitis (wrong in AID): 0-2 months | GBS (agalactiae), Ecoli, listeria |
meningitis (wrong in AID): 2mo-10yrs | S. PNA, N. meningitides (adolescent yrs only) |
meningitis (wrong in AID): 10yrs-21yrs | N. meningitides |
meningitis (wrong in AID): >21yrs | S. PNA |
Strep pneumo vaccine | given at 2,4,6 months. covers 23 strains (98% of cases). indications include: anyone +65yo, splenectomized (sickle cell), end-organ damage (CF, RF, nephrotic syndrome) |
strep pyogenes | MCC of all throat infections. 2nd MCC of all skin infxns |
staphylococcus differentiation | S.aureus-gold pigment, S.epi-white pigment, S.saprophyticus-no pigment. |
rusty colored sputum | Strep pneumonia (pneumococcus) |