MISSED Flashcards by Anisah Doe

Involves horseshoe kidney

Turners Syndrome

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bupivicane is

most arrhythmogenic

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presents with painful lytic bone lesions in addition to a rash, lymphadenopathy, hepatomegaly, hypernatremia

Langerhans cell histiocytosis

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spurling test mechanisms

extension and sidebend neck toward affection side with compression

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what can be transmitted via AC and has a charcoal buffer

Legionella

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claw hand

Klumpke Palsy - C8-T1

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Waiter’s tip, grasp reflex present

Erbs Palsy, C5-C6

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avoid contact sports in

EBV

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double uterus, cervix, vagina

Uterus didephys –> complete failure of mullerian ducts

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2 moderately separated endometrial cavities with indented fundal contour

Bicornate Uterus

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preferred initial dx test for postmenopausal bleeding in women with normal physical exam

endometrial biopsy

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with trich, how to DX?

wet mount

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if pt has hypokalemia, check

magnesium bc hypomagnesmia can cause hypokalemia

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lowering cutoff for test means

increased sensitivity and decreased specificity

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Urine 5IAA increased in

carcinoid syndrome

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abdominal pain, weight loss, gallstones, diabetes, diarrhea are present in

somatostatinoma

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dermatitis (necrolytic migratory erythema), diabetes, increased glucagon

Glucagonoma

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low potassium on ECG will show

U waves, flat T waves, depression of ST segment, prolonged QT interval

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I cells secrete

CCK

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patient who is anxious about upcoming surgery has liver issues

Lorazepam

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used to paralytic patients prior to procedures like intubation, depolarizes at nicotinic receptors

succinylcholine

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HIV/AIDS patient gets fever, chills, night sweats, abdominal pain, diarrhea, shows up as lowenstein Jensen agar

MAC infection

give clarithromycin and Ethambutol

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what cells associated with somatostanoma

pancreatic delta cells

delta cells secrete somatostatin

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what cells secrete glucagon

alpha

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sickle cell is on what chromosome

Produces clitoris and penis

Genital tubercle

produces labia majora, scrotum

labioscrotal swelling

produces labia minora, urethra

urogenital fold

produces bartholin gland, skene, cowper, prostate

urogenital sinus

tenderpoint for radial head/lat epicondyle

full extension and full supination

Chronic Obstructive Disease FEVs

decreased fev1, fev1/FRC, Increased tlc

mistaken pills for candy

iron tx usually deferoxamine

Sickle cell Amino Acid switch

glutamic acid to valine

In SIADH what lab value are you looking for?

Hyponatremia

besides clozapine, what else can cause agranulocytosis

Mirtazapine, carbamazepine

Delirium is due to

acetylcholine

benign polypoid epithelial tumor in lactiferous ducts

intraductal papilloma

clear cells with pleomorphic nuclei in epidermis

pagets

malignant from lobular tissue with stroma

phyllodes

enlarged ducts with microcalcifications, intact basement

invasive ductal carcinoma

fibrous popcorn like calcifications, increased in pregnancy/OCP and decreased in menopause

Fibroadenoma

mildly ill, mycoplasma pneumonia

Atypical pneumonias Tx: macrolides (azithro)

Typical bacterial pneumonia

strep pneumo

secretion of ammonia in

proximal tubule

DKA, diarrhea, lactic acidosis, renal failure

Met Acidosis

Excessive Diureses, vomiting

met alkalosis

hypoventilation

resp acidosis

hyperventilation

resp alkalosis

plantar fasciitis counterstrain

plantarflex ankle + flex knee tx the calf

rapidly progressive dementia + behavioral changes, involuntary movement and weakness in months

Cruzefeldt Jacob

enlarged kidney + liver, slow growth, increased levels of acid, fats, uric acid, low blood sugar

Von Gierke

amylo 1-6 glucosidase

Cori Disease

weak bones, damaged muscle and heart, cirrhosis or enlarged liver, amylo 1-6 glucosidase

cori disease

alpha 1,4 glucosidase, enlarged heart, liver, muscle weakness

pompe disease

in hypothyroidism levels of can be increased

Prolactin

hypocholesteromia is seen in what thyroid condition

Graves

give ___ for organophosphate poisoning

Atropine

Family Hx of kidney stones

cystine

MPO, IGE increased, foot/wrist droop

eosinophilic granulomatosis

false negative is a type 2 error. how to calculate?

Power = 1 - B

risk of plaque rupture is due to

plaque stability

increase intraplaque metalloproteinse activity leads to

plaque rupture

least airway resistance is at

terminal bronchioles because they are arranged in parallel

pretibial myxedema is boggy thickening of lower legs in

Graves Disease

germinal centers on thyroid biopsy is seen in

Hashimotos

iron deficiency and microcytic anemia is due to

ancylostoma duodenule

decreased activity and negative symptoms are associated with ______ pathway

Mesocortical pathway

increased activity and positive symptoms are associated with ____ pathway

mesolimbic pathway

extrapyramidal symptoms are associated with what pathway?

nigrostriatal

AIDS dementia is associated with

multinucleated giant cells

frontal brain abscess due to

infection from frontal or ethmoid sinus

occurs secondary to a polymicrobial infection in uterus. 36 hours after abortion/postpartum. Foul smelling, fever, abdominal pain

acute endometritis

restriction in translation to the left implies that the OA is

sidebent LEFT (bc restriction in right sidebending) so ease is sidebent left

caused by failed obliteration of vitelline duct..

meckel diverticulum

true diverticulum involves all layers

meckel

more common in males - newborns or old men. Congenital failure of process vaginalis to close. Ipsilateral inguinal bulge, increases in size with coughing. "heaviness"

Indirect inguinal hernia

protrudes through inguinal ring --> scrotum

indirect inguinal hernia

older males, through inguinal triangle due to weak transversalis fascia

Direct hernia

___ diuretics can treat hypercalcemia

loop diuretics

Tx Loa Loa

diethylcarbamazine

1st line tx for HTN, may reduce risk of osteoporotic fractures used to manage nephorgenic DI

thiazide diuretics

mostly head of pancreas, jaundice, obstruction of common bile duct.

pancreatic adenocarcinoma

Nontender palpable gallbladder

courvoisier sign seen in pancreatic adenocarcinoma

papilledema + throbbing headaches, mostly women of childbearing age with obesity.

Idiopathic Intracranial HTN (IIH) tx: carbonic anhydrase inhibitor

CSF of Guillan Barre

Protein increased, normal leukocyte

small pounch formation in colon wall caused by increased pressure within in lumen. MC cause of painless rectal bleeding in older population, no visible findings on PE. Low fiber diet, constipation, obesity, lack of physical activity

Diverticulosis

with blastomyces you will see MC

skin involvement looks like SCC

Conn Syndrome

Primary Hyperaldosteronism HTN, hypokalemia, hypernatremia, met aklalsis tx: spironolactone

no uterus, fallopian tubes, no ovaries, could have testes

46 XY androgen insensitivity

fully developed vaginal canal, absent uterus, absent fallopian tubes, normal ovaries

46 XX mullerian agenesis

tinnitus, vertigo, N/V due to

aspirin tx: sodium bicarb

how to tx aspirin tox?

sodium bicarb

graves is a ___ hypersensitivity

type 2

inheritable disorder of copper uptake in GI leading to a deficiency in copper ---> sparse, kinky, fragile, silvery hair; skeletal abnormalities

Menkes Syndrome

supplies blood to stomach, part of duodenum, liver, gallbladder, spleen, pancreas

celiac trunk

OCD tx?

SSRIs/ CBT

35 year old woman presents to office with breast mass. Microcalicifications. Biopsy shows blue dome cysts

fibrocystic change

46 year old man presents with 1 cm cystic mass at upper pole of epididymys that transilluminates. Dilated tubular structures in efferent tubules of epidiymis

Spermatocyle

In refeeding syndrome, what drops?

Phosphate, potassium, magnesium

functional hypothalamic amenorrhea is also known as

exercise induced amenorrhea

invasion of vascular endothelial cells

think rickets

drains anterior thoracic wall and breast

Pectoral

receives from all other axillary nodes; located near clavicle; drains into subclavian vein/lymphatic duct

apical

drains upper limb

humeral (lateral)

drains posterior thoracic wall and scapular region

subscapular

Swelling of the upper limb + supraclavicular mass

think apical lymph nodes or subclavian vein compression

chronic leg length discrepancy >6 months

start with 1/8 inch every 2+ weeks

Acute leg length discrepancy

start with 1/16th inch and increase then

If the mother is Rh-negative

THEN worry only if baby is Rh+

If C3 translates easy to the left what is the dx?

rotated right sidebent left translation is opposite of sidebending

which viruses are airborne?

measles, TB, varicella MTV

In addison's disease.. findings?

Increased ACTH (hyperpigmentation) Hyperkalemia Hyponatremia Low cortisol

what stain for malaria and what will you see?

giemsa will see rings

Involves deep joint pain, instability, often with "clicking."

Labral impingement

repetitive overhead activity

labral impingement deep joint pain + obriens test

+ Neer, + Hawkins, or + Empty can show

supraspinatus tear

acute hyponatremia can lead to

cerebral edema

Exercise, especially aerobic, increases HDL levels and improves lipid profiles through

reverse cholesterol transport!!! HDL picks up cholesterol from peripheral tissues (like arterial walls) Carries it back to the liver for metabolism and excretion (via bile) This process is called reverse cholesterol transport HDL levels rise with aerobic exercise → helps clear atherogenic cholesterol

intermediate (or medial) hypothalamic area, particularly the paraventricular nucleus (PVN) and arcuate nucleus sense change in?

glucose

when to give rotavirus to baby

less than 8 months

MMR and varicella given at

12 months

Hep A vaccine given

12-23 months

If an elderly patient has new-onset gait instability + cognitive decline + urinary incontinence, think

NPH

Occur with axial compression/flexion

herniated disc

Young athlete + hyperextension sports + low back pain

think spondylolysis (pars defect).

with anterior innominate Muscle used for energy?

extensors (hamstrings)

with posterior innominate, muscle used for energy?

flexors (iliopsoas, rectus femoris)

psoas promotes

flexion

if psoas is hypertonic then

restriction in extension

motor aphasia is also

Brocas

sensory aphasia is also

wernickes

Fluent speech + poor comprehension + poor repetition

Wernickes (sensory)

Nonfluent speech + good comprehension + poor repetition

Brocas (motor)

Fluent speech + good comprehension + poor repetition

Conduction Aphasia (arcuate fasciulus)

patient can repeat back type of aphasia is

transcortical

Brocas brodman is

44 45

Wernickes Brodman is

neisseria meningitidis can also grown on

chocolate agar . pay attention to shape gram neg diplococci

wernickes located in

broadmann 22 and left superior temporal gyrus

brocas located in

broadmann 44 45 and left inferior frontal gyrus

chron's tx?

metronidazole

referred pain from chest, jaw, left arm

Thoracic sympathetic

A 12-year-old girl is found to have a right paravertebral rib hump at T7 during the forward bend test. Which physical exam finding is most likely associated with this presentation?

Restricted compression of the top of the right shoulder inferomedially toward T7

In iron deficiency, cells increase ____ to pull in more iron

transferrin receptor

what stores iron?

ferritin

is ferritin low or high in iron deficiency

low, bc not much to store

A 29-year-old professional cyclist is found to have elevated hematocrit, low LH, and gynecomastia during routine drug screening. What is the mechanism by which the likely drug he used exerts its primary effect?

✅ Activates a nuclear receptor Explanation: Anabolic steroids (synthetic androgens like testosterone) are lipophilic hormones They diffuse into the cell, bind to intracellular androgen receptors, then: Translocate to the nucleus Bind DNA and regulate gene transcription This results in: ↑ Muscle mass, ↑ erythropoiesis ↓ LH and FSH due to negative feedback Gynecomastia due to peripheral conversion to estrogen

A 78-year-old man presents with acute-onset right leg and foot weakness and diminished pinprick and vibratory sensation in the right lower extremity. Muscle strength is normal in all other extremities. Which artery is most likely occluded?

✅ Callosomarginal artery Explanation: Callosomarginal artery is a branch of the anterior cerebral artery (ACA)

A 66-year-old man with dyspnea, orthopnea, weight gain, edema, and a productive cough is diagnosed with congestive heart failure. Which pharmacologic target, when inhibited, has been shown to prolong survival in such patients?

✅ Mineralocorticoid Receptors Explanation: Aldosterone promotes Na⁺/water retention and myocardial fibrosis/remodeling Inhibition by spironolactone or eplerenone: Reduces preload and ventricular wall stress Decreases myocardial fibrosis Improves mortality and hospitalization rates in HFrEF (EF < 40%) Prevents hypokalemia

Microcytic anemia + hemolysis + increased indirect bilirubin + anisopoikilocytosis think

Beta thalaseemia

:A 5-year-old boy presents with recurrent epistaxis, joint swelling, and a family history of a maternal uncle dying from bleeding. What is the most likely inheritance pattern?

X-linked recessive Key associations: Think Hemophilia A or B Male patients affected Carrier mothers Maternal uncles often affected

Pancoast tumor can lead to horner's syndrome and compress the

stellate ganglion

capping, splicing, and polyadenylation occur in the

nucleus

First line tx for hyperkalemia with EKG changes

calcium gluconate

For catatonia, if not responsive to benzodiaezepines do

electroconvulsive therapy

angle of louis - 2nd rib point - sternal angle and

bifurcation of trachea

where is angle of louis

angle of mandible landmark

spine of scapula is at

What is the Leser-Trélat sign and its significance?

Sudden eruption of multiple seborrheic keratoses, often signaling an underlying GI malignancy like gastric adenocarcinoma (paraneoplastic).

what are a few risks of gastric adenocarcinoma

H pylori infection Nitrosamines (cig smokes, smoked foods) Highly salted (cured) foods chronic gastritis

A 15-year-old girl develops pruritus and a diffuse maculopapular rash after taking amoxicillin for a sore throat. She has fatigue, fever, nontender cervical lymphadenopathy, and splenomegaly. What is the most likely diagnosis, and why did the rash occur?

🟥 Back (A): Diagnosis: Infectious mononucleosis (caused by EBV) Cause of Rash: The rash is a classic reaction to amoxicillin in patients with mononucleosis—not a true allergy. Key Features: Fever Fatigue Posterior cervical lymphadenopathy Splenomegaly Maculopapular rash after amoxicillin Buzzwords: “Teen with sore throat and fatigue,” “Rash after amoxicillin,” “Atypical lymphocytosis” Test of choice: Heterophile antibody test (Monospot)

A patient presents with early morning headaches and seizures. Imaging shows a mass in the frontal lobe. Histology reveals compact, rounded cells with clear cytoplasm and delicate branching capillaries. What is the most likely diagnosis?

Oligodendroglioma Key Features: Frontal lobe tumor → often causes seizures, personality changes Histology: “Fried egg” cells = clear cytoplasm + dense nucleus “Chicken-wire” capillaries = delicate branching vessels Often shows calcifications Genetic hallmark: 1p/19q co-deletion (good prognosis) Slow-growing, better prognosis than glioblastoma

A life-threatening hypermetabolic crisis of skeletal muscle triggered by certain anesthetic agents in genetically susceptible individuals.

malignant hyperthermia 🚨 Triggers Volatile anesthetics (e.g. halothane, sevoflurane, desflurane) Succinylcholine (a depolarizing neuromuscular blocker) tx: dantrolene

Genetic mutation: RYR1 gene (ryanodine receptor on sarcoplasmic reticulum) Defective receptor causes uncontrolled calcium release from SR in skeletal muscle ↑ Intracellular Ca²⁺ → sustained contraction → ↑ ATP use, ↑ heat, rhabdomyolysis

malignant hyperthermia

patient has small lung mass and SIADH what med do u give

VAPTANs

MISSED Flashcards

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