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Mesothelioma Psammoma bodies seen on histology. malignancy of the pleura associated asbestosis. pleural infusion, pleural thickening + calretinin
Paracoccidioidomycosis Budding yeast of Paracoccidioides with “captain’s wheel” latin america men > women presentation similar to blastomycosis
long thoracic nerve innervates serratus anterior muscle. - Injury to this nerve produces winged scapula, - prominent when a patient pushes their arm against a wall.
Axillary nerve innervates deltoid, teres, minor long head of the triceps brachii. Injury to the axillary nerve results in loss of abduction of the arm from 15-90 degrees.
Suprascapular nerve supraspinatus (suprascapular nerve)— abducts arm initially (before the action of the deltoid) external roatation of shoulder.
teres minor (axillary nerve) —adducts and externally rotates arm
Subscapularis (upper and lower subscapular nerves)—internally rotates and adducts arm
low anion gap metabolic acidosis Calculated serum anion gap = [Na+ – (CL- + HCO3-)] - seen in multiple myeloma (due to immunoglobin light chains ---> renal tubular injury ---> acidosis
high anion gap metabolic acidosis (remember the mnemonic MUDPILES M Methanol U Uremia D Diabetic ketoacidosis P Paraldehyde I Infection L Lactic acidosis E Ethylene glycol S Salicylates
idiopathic intracranial pressure psedutumor cerebri - Female TOAD - tetracyline - obesity - vitamin A excess - danazol
idiopathic intracranial pressure headache, tinnitus, diplopia (usually from CN VI palsy), no change in mental status. impaired optic nerve axoplasmic flow ---> papilledema.
Clostridium botulinum toxin Heat labile Toxin. inhibits ACh release at the neuromuscular junction, Diplopia, Dysarthria, Dysphagia, Dyspnea. descending flaccid paralysis).
acute hemolytic transfusion reaction (AHTR) In anesthetized patients, manifestations are hemodynamic instability (hypotension, tachycardia), red urine (hemoglobinuria) bleeding diathesis (uncontrollable bleeding from incision sites and mucous membranes) drop in hematocrit
acute hemolytic transfusion reaction (AHTR) Type II Hypersensitivity reaction ABO incompatibility ---> Hemolysis is intravascular in nature---> hemoglobinuria (intravascular hemolysis), Antibodies to blood group antigens other than ABO can also cause AHTR
acute hemolytic transfusion reaction (AHTR Host plasma antibodies against donor RBC antigens extravascular hemolysis ---> jaundice (extravascular) Flank pain or lower back pain, may lead to acute renal failure
Fomepizole blocks the activity of alcohol dehydrogenase,
Flumazenil a competitive antagonist of the GABA receptor and is used to reverse benzodiazepine overdose
Gaucher disease autosomal recessive glucocerebrosidase enzyme deficient lipids laden macrophages. foamy macrophages are often said to have a fried egg appearance/ crumpled tissue ---They are strongly PAS positive.
Gaucher disease Hepatosplenomegaly, pancytopenia, osteoporosis, avascular necrosis of femur, bone crises,
Rheumatoid arthritis Proximal interphalangeal and metacarpophalangeal joints. anti-CCP (anti-cyclic citrullinated peptides) is a specific blood test Rheumatoid factor (IgM antibodies against the Fc region of IgG antibodies).-> sensitive test
relative risk number of diseased who were exposed/total number of exposed]/[number of diseased not exposed/total number not exposed]
attributable risk of a disease refers to the fraction of disease events as a result of an exposure, relative to the total number of disease events.
vitamin A deficiency Bitot spots (keratin debris; foamy appearance on conjunctiva ); corneal degeneration (keratomalacia); immunosuppression.
Hypervitaminosis A Acute toxicity—nausea, vomiting, vertigo, and blurred vision
B1 cofactor for Be ATP -Branched-chain ketoacid dehydrogenase -α-ketoglutarate dehydrogenase (TCA cycle) ƒ -Transketolase (HMP shunt) - Pyruvate dehydrogenase (links glycolysis to TCA cycle)
pt on isoniazid can also get vit B3 deficiency (glossitis, pellagra) Vit B3 (niacin) derived from tryptophan. Synthesis requires vitamins B2 and B6
pellagra Diarrhea, Dementia (also hallucinations), Dermatitis (C3/C4 dermatome
Dermatitis, enteritis, alopecia, adrenal insuficiency pantothenic acid deficiency -Essential component of coenzyme A (CoA, a cofactor for acyl transfers) and fatty acid synthase.
biotin Pyruvate carboxylase: pyruvate (3C) oxaloacetate (4C) ƒ Acetyl-CoA carboxylase: acetyl-CoA (2C) malonyl-CoA (3C) ƒ Propionyl-CoA carboxylase: propionyl-CoA (3C) methylmalonyl-CoA (4C
cobalamin Cofactor for methionine synthase (transfers CH3 groups as methylcobalamin) methylmalonyl-CoA mutase. - absorbed in terminal ileum
cobalamin deficiency subacute combined degeneration degeneration of dorsal columns, lateral corticospinal tracts, spinocerebellar tracts) due to abnormal myelin.
Vitamin C dopamine β-hydroxylase, which converts dopamine to NE. facilitates iron absorption by reducing it to Fe2+ state
EXCESS vit C > iron toxicity in predisposed individuals (ie, can worsen hereditary hemochromatosis or transfusion-related iron overload ; thalassemia)
tocopherol, tocotrienol deficiency Hemolytic anemia, acanthocytosis, muscle weakness, demyelination of posterior columns ( position and vibration sensation) and spinocerebellar tract (ataxia).
BCR-ABL Chromosome 9 : ABL, Chromosome 22: BCR CML
white eye reflex congenital cataracts, retinoblastoma
non ionizing radiation - basal cell carcinoma - squamous cell - malignant melanoma UVB --> pyrimidine dimers
Burkitts lymphoma 8,22
medullary carcinoma of the thyroid calcitonin tumor marker ---> amyloid
colon cancer diffuse glomerulonephritis
Ovarian cancer CEA125
astroctytoma most common primary ***benign tumor**** in children
Beta thalassemia splicing defect, stop codon constant transfusion ---> iron overload
Alpha thalassemia gene deletion Hgb H (3 alpha deletions) Alpha thalassemia minor ( 2 alpha deletions) 4 gene deletion --> erythroblastosis fetalis
Created by: beccao