MF1
What pathology is associated with an ejection systolic murmur which radiates to the carotids & apex?
Aortic stenosis
How do the actions of ADH & Aldosterone differ?
Aldosterone ⇒ ↑Na+/Cl- reabsorption in collecting duct (H2O follows); increased ENaC and Na/K+ antiporter activity, ↑K+ secretion
ADH ⇒ aquaporins in collecting duct + ↑Na+K+Cl- activity (↑ H2O reabsorption); made in hypothalamus; released in PP; released when we have high osmolarity (osmoreceptors)
Irreversible inhibitor of H+/K+/ATPase transporter (proton pump)
The tendons of which 3 muscles make up the pes anserine?
Sartorius, gracilis, semitendinosus
Strengths, School, Home, Activities, Drugs, Emotions/Eating, Sexuality, and Safety.
What are typical asthma spirometry results?
FEV1 = <80%
FEV1/FVC ratio = <70%
Bronchodilator response (change in FEV1), >12%
How do we differentiate between Nephritic and Nephrotic syndrome? Must include broad mechanism & at least one clinical manifestation difference.
Nephritic Syndrome ⇒ glomeruli are damaged by inflammation (glomerulonephritis) and allow RBCs to leak through; characterized by hematuria (RBC casts), high BP (HTN), sometimes reduced urine output (oliguria), sterile pyuria (no infection) increased BUN & Cr; can also include mild edema/proteinuria
Nephrotic Syndrome ⇒ glomeruli do not properly filter protein (albumin), typically caused by glomerulosclerosis (scarring/hardening of blood vessels); heavy proteinuria (>3.5g/day), hypoalbuminemia, edema, lipiduria
a) levothyroxine (synthroid)
b) methimazole
Beta amyloid, tau
Name (at least 4) of the APGAR Criteria
Appearance (pink colour)
Pulse (>100 bpm)
Grimace (cry response to stimuli)
Activity (muscle tone; flexion)
Respiratory (strong cry)
What is it called when V/Q = 0 and when V/Q = ∞? What do these mean?
V/Q = 0 = Shunting = wasted perfusion (ex: passage of blood from the right side of the heart to the left without participating in sufficient or any gas exchange with ventilated alveoli)
V/Q = ∞ = Anatomical dead space = wasted ventilation (the volume of the conducting airways--nose, pharynx, larynx, trachea, bronchi, and bronchioles--that does not participate in gas exchange because it does not reach alveoli with a blood supply)
Both can be anatomical or pathological
What are two differences between PT/INR & APTT?
PT/INR = Prothrombin Time/International Normalized Ratio = extrinsic pathway; warfarin monitoring, vitamin K deficiency, liver function; normal INR is 0.8-1.2
APTT = activated partial thromboplastin time = intrinsic pathway; heparin monitoring, hemophilia/clotting disorders (ex: wVD); normal APTT 22 - 40 seconds
What is meconium ileus, and what is it most commonly secondary to?
a) Neonatal bowel obstruction -- meconium becomes excessively thick and sticky, blocking the small intestine
b) Cystic fibrosis
At what point(s) does the DCML spinal tract decussate & synapse?
Decussate = medulla
Synapse = medulla, thalamus
Which congenital disease is one of the leading causes of pediatric short bowel syndrome and is characterized by the absence of ganglion cells at Meissner's & Auerbach's plexi of the distal colon?
Hirschsprungs
How do you differentiate between the two types of 2nd degree heart block (Mobitz I & Mobitz II)?
Mobitz I (Wenkebach) = Progressive prolonging of PR interval, until one impulse fails to conduct (absent QRS complex)
Mobitz II = Sudden failure in impulse conduction from atria to ventricles without progressive increase in PR intervals (intermittent absent QRS complexes)
What are at least 3 serious primary conditions associated with schistocytes on a peripheral blood smear due to microangiopathic hemolytic anemia?
List of possible answers:
Thrombotic Thrombocytopenic Purpura (TTP), Hemolytic Uremic Syndrome (HUS), Disseminated Intravascular Coagulation (DIC), HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets), Thrombotic microangiopathy (TMA), etc.
Diabetic Ketoacidosis (DKA) = Low insulin & high glucose → need energy → Lipolysis into free fatty acids → liver turns FFAs into ketone bodies → ketones decrease blood pH → high anion gap metabolic acidosis
Hyperosmolar Hyperglycemic State (HHS) = ⬆ blood glucose → ⬆ osmolarity → severe dehydration → dry mouth, extreme thirst, warm dry skin, sleepiness, confusion, depressed reflexes, tremors → in severe/untreated cases coma and death
What pathology is the "Waiter's Tip" posture most associated with, and what spinal nerve roots are implicated?
Erb-Duchenne palsy; C5, C6, +/- C7
What epigenetic process involves the silencing of one parent's gene during the formation of an egg or sperm cell, and is implicated in both Prader Willi & Angelman's syndromes?
Genomic Imprinting
What are the 4 heart defects associated with "tetralogy of Fallot"?
1. Ventricular Septal Defect (VSD) 2. Pulmonary Stenosis 3. Overriding aorta 4. Right ventricular hypertrophy
What is the order of urine flow through the kidney from afferent arteriole to ureter?
Afferent arteriole --> renal corpuscle (Glomerular Capsule + Bowman’s space) --> PCT --> Loop of Henle (descending) --> Loop of Henle (ascending) --> DCT --> Collecting duct -->Minor calyx --> Major calyx --> Renal pelvis --> Ureter
What are the four T’s of Post-Partum Hemorrhage? (will also take the 4 main factors that affect amount of post-partum bleeding, doesn't have to be "4 T's mnemonic)
Trauma = Uterine/vaginal trauma bleeding independently of placental separation
Thrombin = Coagulation cascade: coagulopathies; massive bleeding can consume available coagulation factors even without coagulopathy
Tone = Insufficient uterine tonal contractions, worsened by overdistension of uterus (multiple pregnancy, polyhydramnios, macrosomia) due to stretched myometrium (strength-length muscle relationship), myometrial exhaustion from prolonged or rapid labour, or placental/uterine abnormalities (placenta previa - malpositioned placenta, fibroids, infection)
Tissue = Incomplete placental separation, e.g. with areas of retained placenta preventing full myometrial contraction, overly adherent placenta that invades too deeply into the decidua/myometrium (placenta accreta)
What are the names & innervation of all 6 extraoccular eye muscles?
CN III = Superior Rectus, Medial Rectus, Inferior Rectus, Inferior Oblique
CN IV = Superior Oblique
CN VI = Lateral Rectus
In neonates with hyperbilirubinemia (neonatal jaundice), first line treatment is non-UV phototherapy. How does this treatment function?
Isomerises unconjugated (indirect) bilirubin, which makes it soluble so that it can be excreted.
It does NOT conjugate it and turn it into direct bilirubin!
(acceptable answer = modifies/alters indirect bilirubin to make it soluble)