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Characterized by the development of hypoxemia and bilateral pulmonary infiltrates in the absence of heart
failure
-begins with initial injury of pul alveoli (smoke inhal) or pul endothelium (sepsis) which leads to the
recruitment of neutrophils- this worsens the situation and leads to intraalveolar accumulation and hyaline
membrane formation
-decreased lung compliance, increased work of breathing, worsened V/Q mismatch, and normal PCWP
20. Asthma Dec FEV1/ FVC
Exp wheeze
Caused by env and genetics
Chr Eosinophil Bronch: IL-5 by TH2 cells
MPB= bronch epith dmg- mc in exercise induced asthma
21. Asymptomatic heart -nonstenotic bicuspid aortic valve
defect in turner's -early systolic , high frequency click over right second IC space
synd
22. Avoid Nitrates in Nitrates decrease preload, which will increase the LV outflow tract... BUT since the ventricle is abnormally
Hypertrophic shaped, there is an outflow obstruction
Cardiomyopathy bc...
23. Beta Blocker S/E bronchospasm, bradycardia, fatigue, sexual dysfunction
24. Bicuspid Aortic Commonly presents in young, asymptomatic patient with soft systolic ejection at right 2nd ICS
Valve -can cause aortic regurg
25. Bone Marrow Stem CD34
Cells
26. Breast Milk -milk letdown is stim by oxytocin
-ideal infant nutrition when <6mo, exclusive breastfed infants require vit D supplementation
-contains: IgA, macrophages, lymphocytes
-reduces infant infections and is associated with the decreased risk of child dev asthma, allergies, DM, and
obesity
-breastfeeding decreases maternal risk of breast and ovarian cancer, and facilitates mother-child bonding
27. Caplan syndrome pneumoconiosis + cavitating rheumatoid nodules
28. Cardiac Changes w/ - decreased left ventricular chamber size
Normal Aging - shortened base- to- apex dimension
- ventricular septum becomes sigmoid and shape, with basilar portion bulging into LV outflow tract
- atrophy of myocardium causes increased interstitial connective tissue, often with concomitant extracellular
amyloid deposition
- lipofucin pigment accumulation within cardiomyocytes
29. Cause of LVHF Impaired diastolic return of Pul v. because high end diastolic pressure causes an increase in hydrostatic
shortness of breath pressure and transudate leaks out into the interstitium--> causes affected tissue to swell and increased
resistance of movement due to decreased lung compliance
= the neg pressure generated normally from inspiration isnt enough to distend the lungs, causing poor gas
exchange and sob
30. Causes of pelvic pain= E.C.T.O.P.I.C. Ectopic (mcc), Endometriosis
Cyst rupture (corpus leutium cyst rupture)
Torsion of ovary (compromise ovarian bl flow) or cyst
Ovulation (mittelschmerz)
PID, salpingitis, tubo-ovarian abscess
Incomplete abortion
Cystitis/pyelonephritis
31. Causes of Spontaneous Depol Hypokalemia, Hypermagnesemia, or prolonged QT interval
causing Tachyarrhythmias = all cause spontaneous depol of ventricles in phase 3 or 4 and it will cause an extra AP in
heart
32. CCB (diphenhydropine) S/E periph edema, dizziness/ lightheadedness
33. Chorioamnionitis -infection in fetal membranes
-danger of neonatal sepsis/ meningitis
34. Chronic Alcoholism --> Cerebellar - atrophy to the ant lobes and cerebellar vermis
Vermis effects - resulting in gait ataxia, truncal instability, intention tremor, and rhythmic "Parkinsonism" tremor
of the fingers and hands
35. Chronic diarrhea may cause a metabolic alkalosis because of volume contraction
36. Clozapine Treatment Guidelines - specific for treatment-resistant schizo and schizo assoc with suicidality
- A/E: agranulocytosis, seizures, myocarditis, and metab syndrome
37. Common S/E of ACE-Inhib cough, angioedema, inc K+
38. Common S/E of Thiazide Diuretics acute kidney injury, decreased Na+ and K+, hyperuricemia/ acute gout, elevated glu and
cholesterol levels
39. Compromised airways in -Residual volume increases because inspiratory volumes are always slightly greater than
Obstructive Airway Diseases expiratory volumes, leading to an increase in the AP diameter or the chest
-This explains the "barrel-chested" appearance of patients with emphysema
-Dynamic air trapping during exercise is a major limitation to rigorous activity in patients with
chronic obstructive pulmonary disease (COPD)
-Air trapping results in an elevated FRC at which tidal breaths occur--> airways are more
patent, which reduces airflow resistance particularly during expiration; this decreases the work
of breathing
40. Concentric LVH = pressure overload
-chr htn
-aortic stenosis
41. Congenital Cardiac Anomaly assoc COARCATION OF THE AORTA! (also assoc with Berry aneurysms)
with Ruptured Cerebral = ruptures d/t HTN of branches of aortic arch proximal to the coarct--> subarachnoid
Aneurysms... hemorrhage
42. Congenital Deficiency of -prevents conversion of propionyl CoA to methylmalonyl CoA
Propionyl CoA Carboxylase -propionyl CoA derived from= val, ile, met, thr, odd # FA, cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy, dehydration, anion gap
acidosis
43. Congenital Pyloric Stenosis -thickening of stomach wall, hypertrophy of smooth muscle pyloric stenosis
-palpable olive mass- epigastric region
-nonbilious projectile vomiting at 2-6 weeks of age
-assoc w/ Macrolides
-hypokalemia, hypochloremic, metab alkalosis
44. CO Poisoning Normal PO2 (dissolved O2)
Decreased %sat of Hb
Decreased total O2 content
= makes Fe2+ into Fe3+(ferric), leading to the formation of methemoglobin which cannot bind to O2- this
causes a left shift on the saturation curve- methemoglobin will present with cyanosis
under-tx'd MG pt presents with exaggerated MG sx, and when infused with edrophonium the sx subside it
indicates that the MG treatment (AChE inhib) need to increase in dose
217. Testis descent - transabdominal phase: descend to lower abd/ pelvic brim= Mllerian inhibitory substance (MIS) is responsible
for this phase
- inguinoscrotal phase: androgen- and hCG-dependent
218. Thyroid storm causes:
-inadequately treated patients with Graves disease undergo surgery
-infection, trauma
-iodine, pregnancy
sx:tachyarrhythmias, hyperpyrexia, coma, shock (volume depletion from vomiting)
Tx:
(1) Inhibit hormone synthesis: Propylthiouracil or Iodide
(2) Sympathetic blockade with -blockers
(3) Hydrocortisone
(4) Cooling blanket
219. Thyrotoxicosis -weight loss
-heat intolerance
-anxiety
-diarrhea
-oligomenorrhea and lid stare
-atrial fibrillation, sinus tachycardia, systolic HTN, high output failure
- brisk reflexes, osteoporosis
-glucose, calcium, lymphocytes; cholesterol
220. Toxic -one/more nodules in multinodular goiter become TSH-independent
multinodular -no exophthalmos/pretibial myxedema
goiter
221. True -46,XX karyotype, most common, followed by 46,XX/46,XY mosaicism
hermaphroditism -No sertoli cells or lack of mullerian inhibitory factor
-Presence of both ovarian and testicular tissues
-Ovulation and spermatogenesis may both occur
222. Tuberous -tuberin and harmartin mutations
Sclerosis - facial angiofibroma
- seizures
- intellectual disability
- heart defects= cardiac rhabdoyomas in ventricular walls and AV valves, cutaneous angiofibromas (adenoma
sebaceum)
assoc neoplasms:
giant cell astrocytoma -- CNS hamartoma
renal angiomyolipoma-- renal cysts
cardiac rhabdomyoma
223. Turner -45,XO karyotype with absent Barr body
syndrome -Meiotic nondisjunction
-Streaked ovaries, amenorrhea, short stature, webbed neck/ cystic hygroma (lynch defects), (preductal) aortic
coarctation, shield chest, bicuspid aortic valve, horseshoe kidney, cubitus valgus, menopause before menarche
- decreased estrogen leads to increased LH, FSH
224. Upper - Musculocutaneous and Suprascapular N.
Brachial - dystocia mc in neonates; severe trauma mc in adults
Plexus Injury - should adduction, elbow extension, and forearm pronation
225. Ureteric Bud -caudal end of mesonephric duct
-gives rise of ureter, pelvises, calyces, and collecting ducts
-canalized by 10th week
226. Ventricular -MC occurs in membranous septum
Septal Defect -Acyanotic at birth bc of L to R shunt
227. Vomiting powerfully stimulates metabolic alkalosis through direct loss of H, loss of Cl , and volume depletion
228. Warburg malignant cells undergo high rates of glycolysis to produce macromolecules necessary to sustain rapid cellular
Effect growth
229. Wernicke's -word salad: well-articulated, nonsensical speech paired with lack of lang comprehension
Aphasia -aud association cortex: post part of sup temporal gyrus
- supplied by MCA
230. Whipple triad (1) Symptoms occur: adrenergic and neurological sx
(2) Hypoglycemia
(3) Symptoms are relieved by glucose
231. Zero Order EtOH
Drugs Salicylates
Phenytoin
Lithium