Post-111

Patient is taking combined OCPs, and is having side effects of breast tenderness?

-need to decrease the progesterone, it causes this side effect

Patient has achy low-grade lumbosacral pain, and there’s “narrow lucency down the middle of the L5 spinous process”?

-spina bifida occulta

What cranial bone is associated with otitis media?

-parietal bone

Patient has elbow pain and a tenderpoint at the lateral epicondyle. Does this correlate with the flexor or extensor tendons?

What tenderpoint location would correlate with the flexor tendons?

-extensor tendons

-medial epicondyle

UTIs, prostatitis, and endocarditis can be caused by what gram-positive cocci?

-enterococcus faecalis

anti-Scl-70 and anticentromere bodies?

-this can also involve blueing of the digits in response to stress or cold temps, known as __, which is caused by exaggerated __

-scleroderma

-Reynaud’s phenomenon; arterial vasoconstriction

Patient has a mutation in the alpha1-antitrypsin inhibitor. This normally functions as a __ to __.

But when you’re missing the inhibitor, then __

-protease/elastase; inhibit neutrophil elastase

-the neutrophil elastase goes unchecked and destroys alveolar tissue

Lead time bias?

Migration bias?

Reporting bias?

Selection bias?

-when screening detects a disease earlier than it would have been diagnosed, symptomatically

-when participants move away or drop out of the program

-when participants selectively suppress or reveal information

-when the study population doesn’t accurately represent the target population

Patient is currently taking an SSRI, and gets placed on dextromethorphan, why is this bad?

-dextromethorphan is a weak serotonin reuptake inhibitor, so this can cause slurring or words and even seizures

What structure runs parallel with the esophagus, and may be damaged from compromise of the esophagus, due to a Mallory Weiss tear?

-vagal trunks

Methylene tetrahydrofolate allows for the function of what enzyme? Which performs what conversion?

-thymidylate synthase; dUMP to dTMP

What artery is damage from avascular necrosis of the femur, in Legg-Calve-Perthes disease?

-medial circumflex femoral artery

If you have a patient that presents with Alzheimer’s-like symptoms, except there’s uncontrolled hypertension and stepwise deterioration of memory, then they have __, which is present with multiple __

-vascular dementia; cerebrocortical infarcts

Lymphadenitis is another way to refer to __

-buboes(Yersinia)

Patient has diabetes and “bronze skin” hyperpigmentation?

This means there’s a deficiency of? So there’s an abnormality of what process?

Hereditary Hemochromatosis

Hepcidin; intestinal iron uptake

Red, punctate, weakly bleeding spots on the pelvis peritoneum, in a woman with pain during/after sex?

These lesions are caused by?

-endometriosis

-locally produced estradiol

What is “wood alcohol”?

What are the 2 enzymes, in order, in the metabolism of any alcohol? And what is the end metabolite for methanol?

-term for methanol

-ADH, then ALDH; formic acid

Cocaine blocks?

-dopamine reuptake

What is an enlarged lymph node above the clavicle? And what is this an indicator for?

-Virchow’s node; gastric cancer

When are you osteopathically treating the OA, versus the sacrum?

-the OA is for the heart, lungs, and upper GI; the sacrum is for the lower GI and pelvis

Purulent blood-tinged sputum is a hallmark of __

-bronchitis

COPD Cole’s with a loss of what? This want causes what?

-radial traction/tethering force(what keeps the small airways open); the extended expiratory phase

Both testicular and ovarian tumors can metastasize to what lymph nodes?

-para-aortic/lumbar

What 2 brain regions are affected in rabies?

-hippocampus and cerebellum

Bleeding from the bladder is due to the __ artery

Bleeding from the prostate is due to the __ artery

Bleeding from the perineum/scrotum/penis is due to the __ artery

-superior vesical

-inferior vesical

-internal pudendal

In pregnancy, laying supine decreases __, which can cause difficulty breathing

-venous return

Atherogenesis is due to elevation of what?

-LDL(low density lipoproteins)

Beta-blockers run the risk of causing a __, so assume this if there’s no symptoms other than low HR and blood pressure with passing out

-sinus bradycardia

Pregnant patient has increase in blood pressure and seizures? Therefore the cause of the seizure is from __

-eclampsia; placental dysfunction

Rickettsia, the cause behind __, specifically targets and infects __ cells, which line small blood vessels

-Rocky Mountain Spotted Fever; endothelial

What 2 things are associated with a type 4 hypersensitivity?

-Th1 and IFN-gamma

Hirschsprung is associated with what oncogene mutation?

-RET

Patient undergoes a hysterectomy with a bilateral oophorectomy. Does she need a Pap smear?

-NO!

Being a major nosocomial infection, Enterococcus’s major risk factor is __

Hospitalization

Fibrosis, scarring, dilated ducts, and foamy macrophages?

What is the discharge made of?

-mammary duct ectasia

-yellow/green or white

Lipogranulomatous inflammation around a meibomian gland?

Painful or painless?

-chalazion

-painless

Describe a pyloric stenosis.

Bilious or non-bilious?

-picture

-non-bilious

Primary cause of bladder stones in men?

What is a common example of something that might cause this?

-incomplete bladder emptying or chronic urinary stasis

-prostatic hyperplasia

Where does the facial nerve exit the skull?

Damage of this nerve causes what?

-stylomastoid foramen

-Bell’s palsy

What drug is used for long-term care of panic disorder?

-SSRI/SNRI

Can gonorrhea cause a pharyngitis?

-YES!

A normal ankle-to-brachial index is? What does a lower value imply?

-1 to 1.4; peripheral artery disease

Cholecystokinin-stimulated hepatobiliary scintigraphy (HIDA scan) shows an abnormal ejection fraction of 0.35 (35%)?

-biliary dyskinesia

Meningococcal disease is meningitis caused by __, and the meningococcal vaccine is given as __

-Neisseria gonorrhea; prophylaxis

IV drug user with blue-red nodules that have spindle cells? Why is the IV drug user aspect important?

Due to HIV/AIDS, these patients are at increased risk of what other malignancy?

-Kaposi sarcoma; increased risk of HIV/AIDS

-Non-Hodgkin’s lymphoma

What are the viscerosomatic levels for the ovaries/testes?

-T10-11(kidneys, upper ureter, and GONADS)

Chromagranin and synaptophysin are tumors markers that indicate a tumor of __ origin

These tumors secrete what type of substances? Examples?

-neuroendocrine(carcinoid)

-vasoactive secretions; serotonin, histamine, bradykinin

-xanthine oxidase

Will PMS occur during menses? So if similar symptoms occur during menses, what is this?

-NO!; primary dysmenorrhea

If a patient has significantly increased levels of lead in their serum, they may have lead toxicity. This causes inhibition of what 2 enzymes? So what 2 substances are increased, from inhibition of these 2 enzymes?

-ALA dehydratase(increased delta-ALA) and ferrochelatase(protoporphyrin IX)

Describe bleeding time?

What’s a condition with an extended bleeding time?

How is this different than PT/PTT?

-time taken for platelet plug formation

-vWF disease

-PT/PTT is an issue of clotting factors, bleeding time is an issue of platelets

Patient with chronic hypertension has burning sensation in leg muscles and shortness of breath whenever he exercises, what causes this?

-decreased cardiac output and therefore delivery of O2 to tissues