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DIT 2009 WK 2

Q&A from DIT emailed questions WK 2

Study that “looks back” comparing with vs w/o disease, answers: what happened Case-control
Study that measures Odds Ratio Case-control
Study that “looks forward” analyzes risk factor to see if it increases the chance of disease, answers: what will happen Cohort
Study that measures Relative Risk Cohort
Study that “looks at right now” assesses frequency of disease (and related risk factors) at given point of time, answers: what is happening Cross-sectional
Study that measures Disease prevalence Cross-sectional
Three days ago you hospitalized a 40-year-old male for myocardial infarction. He has been given all of the usual medications. Today you notice that his platelet count is 30,000. What do you suspect is the cause of his low platelets? Heparin-induced thrombocytopenia (HIT)
Treatment for Heparin-induced thrombocytopenia Lepirudin, Bivalirudin, Argatroban - all “hirudin” derivatives; directly inhibit thrombin active site
Etiologies of Cushing's Syndrome Increased cortisol due to: *Pituitary adenoma (Cushing’s disease): ACTH increased *Adrenal hyperplasia/neoplasia: ACTH decreased *Ectopic ACTH production (Small cell of lung): ACTH increased *Iatrogenic (chronic steroid use): ACTH decreased (MCC)
Findings in Cushing's Syndrome Hypertension, weight gain, moon facies, truncal obesity, buffalo hump, hyperglycemia (insulin resistance), skin changes (thinning, striae), osteoporosis, amenorrhea, and immune suppresion
Virus is responsible for croup in children Parainfluenza
Virus is responsible for the common cold (2) Rhinovirus and Coronavirus
Virus is responsible for fatal diarrhea in children Rotavirus
Virus is responsible for bronchiolitis in infants (especially if premature) RSV
How many half-lives does it take for a drug infused at a constant rate to reach 94% of steady state? 4 half-lives
What variables determine the half-life of a drug? t1/2 = (0.7 x Vd)/CL *Vd = volume of distribution: relates the amount of drug in the body to the plasma concentration *CL = clearance: relates the rate of elimination to the plasma concentration
What structures of the inner ear are responsible for the sensation of linear and angular acceleration? *Utricle and saccule contain Macule which detects linear acceleration *Semicircular canals contain Ampulle which detects angular acceleration
What is the basic equation for cardiac output? CO = Stroke Vol. X Heart Rate
What is the Fick principle? CO = _____rate of O2 consumption________ Arterial O2 content – Venous O2 content
What factors affect stroke volume? SV = CO/HR = End Diastolic Vol. – End Systolic Vol. Pulse pressure (systolic – diastolic) is proportional to SV
What are the two most common causes of chronic renal failure? MCC of CRF: Hypertension and diabetes
What is the most common cause of Erb-Duchenne palsy? Traction or tear of the upper trunk of the brachial plexus (C5 – C6 roots) -- MCC Blow to shoulder or trauma during delivery
What are the characteristic findings of Erb-Duchenne palsy? Limb hangs by side (paralysis of abductors, medially rotated (paralysis of lateral rotators), forearm is pronated (loss of biceps). “Waiter’s tip”
What are the signs and symptoms of poliomyelitis? Malaise, headache, fever, nausea, abdominal pain, sore throat. Signs of LMN lesions – muscle weakness and atrophy, fasciculations, fibrillation, and hyporeflexia
If you suspected polio in a pt of yours, where would you seek to obtain a viral sample from the pt? Stool or throat
CSF findings in poliomyelitis Lymphocytic pleocytosis with slight elevation of protein (with no change in CSF glucose)
What are the 3 different eukaryotic RNA polymerases? RNA polymerase I, II, & III
Type of RNA made by RNA polymerase I rRNA (greatest activity in nucleus)
Type of RNA made by RNA polymerase II mRNA (blocked by alpha-amanitin, found in death cap mushrooms)
Type of RNA made by RNA polymerase III tRNA (smallest, cloverleaf form, anticodon end is opposite 3’ aminoacyl end. Have CCA at 3’ end along w/ high % of chemically modified bases. Tetracyclines bind 30S subunit, preventing attachment of aminoacyl-tRNA)
How many umbilical vessels are there? 3: 2 arteries, 1 vein
Which umbilical vessel has the highest oxygen content? Vein: supplies oxygenated blood from placenta to fetus
What are Brunner’s glands? Glands that secrete alkaline mucus to neutralize acid contents entering the duodenum from the stomach
What are Peyer’s patches? Unencapsulated lymphoid tissue found in lamina propria and submucosa of small intestine
Where are Brunner's glands located? Located in the duodenal submucosa and are the only GI submucosal glands
Pathology in which there may be hypertrophy of Brunner's glands? Peptic ulcer disease
What is the rate-limiting enzyme for ketone synthesis HMG-CoA synthase
What is the rate-limiting enzyme for cholesterol synthesis HMG-CoA reductase
What is the classic triad of symptoms in multiple sclerosis? Charcot's triad (SIN): Scanning speech, Intention tremor, Nystagmus
With what disorders do pts with multiple sclerosis commonly present? Optic neuritis (sudden loss of vision), MLE syndrome (internuclear ophthalmoplegia), hemiparesis, hemisensory symptoms, or bladder/bowel incontinence
Which penicillin is often the DOC for Enterococcus sp Aminopenicillins (+clavulanic acid)
Which penicillin is effective against Pseudomonas sp Ticarcillin, carbenicillin, piperacillin
Which penicillin is good for otitis media b/c it covers Strep. pneumo and H. influenza Amoxicillin
Which penicillin is a/w interstitial nephritis methicillin, nafcillin, dicloxacillin
Which penicillin is a/w rash (especially in pt's w/ mononucleosis) aminopenicillins
Which are the aminopenicillins Ampicillin and Amoxicillin
Class of drugs used in the treatment of ADHD, narcolepsy, and obesity Indirect sympathomimetics - amphetamine
Definition of 1st-degree heart block PR interval being prolonged (>200 msec). Usually asymptomatic
Classic presentation of pt w/ gonococcal arthritis Septic, infectious arthritis presenting as a monoarticular, migratory arthritis with an asymmetrical pattern. The affected joint is swollen, red, and painful
What is malingering disorder? patient consciously fakes or claims to have a disorder in order to attain a specific gain, avoids treatment by medical personnel (Conscious motivation)
What is factitious disorder? patient consciously fakes or claims to have a disorder in order to attain a specific gain, avoids treatment by medical personnel (Conscious motivation)
Created by: snezya24



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