Term
| What heart sounds increase intensity with inspiration? |
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Definition
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Term
| What heart sounds increase intensity with expiration? |
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Definition
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Term
| What heart sound is loudest at the apex and radiates towards the axilla, and is a holosystolic, high pitched, "blowing" murmer? |
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Definition
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Term
| What heart sound is loudest at the left sternal border, 5th intercostal space, and radiates to the right sternal border, and is enhanced by inspiration? |
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Definition
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Term
| What heart sound is a crescendo-decrescendo systolic ejection murmer following an ejection click? |
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Definition
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Term
| This heart sound is a holosystolic, harsh-sounding murmer, that is loudest at the tricuspid area... |
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Definition
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Term
| What heart sound is a late systolic crescendo murmer with a midsystolic click, that is loudest at S2, it's usually benign but can predispose to IE... |
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Definition
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Term
| This murmer is an immediate high pitched "blowing" diastolic murmer, can present with head bobbing and bounding pulses... |
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Definition
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Term
| This murmer follows an OS in diastole, and is a rumbling murmer that can result in LA dilation... |
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Definition
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Term
| What specific channels are responsible for automaticity? |
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Definition
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Term
| What should one treat atrial fibrillation with? |
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Definition
| Ca or beta blockers and then warfarin as prophylaxis for thromboembolism |
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Term
| What should one do to treat atrial flutter? |
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Definition
| class IA, IC or III anti-arrhythmics |
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Term
| Which Mobitz heart block is more likely to be pathologic? |
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Definition
| Mobitz type II (non-wenckebach), can progress to 3rd degree |
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Term
| In a third degree heart block, do the atria or the ventricles beat faster? |
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Definition
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Term
| What is a change in MAP detected by? |
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Definition
| the medullary vasomotor center (changes symp activity) and the kidneys (JGA leads to change in RAAS) |
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Term
| What hormone is responsible for the escape from aldosterone? |
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Definition
| ANP --> released from atria in response to increased pressure, constricts efferent arteriole and dilates afferent arteriole increasing diuresis |
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Term
| The aortic arch baroreceptors transmit via the ________ while the carotid sinus baroreceptors transmit via the __________ |
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Definition
| vagus nerve, glossopharyngeal nerve |
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Term
| What does the aortic arch respond to? The carotid sinus? |
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Definition
| increases in BP only; increases or decreases in BP |
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Term
| In what organ does hypoxia cause vasoconstriction? |
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Definition
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Term
| What is tricuspid atresia and what does it require for survival of the baby/ |
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Definition
| absence of a tricuspid (R-->L shunt), needs an ASD and VSD for survival |
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Term
| What are the causes of L to R shunt? |
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Definition
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Term
| What are the 4 characterstics of tetralogy of fallot? |
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Definition
| pulmonary stenosis, RVH, overriding aorta, and VSD |
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Term
| What do patients with tetralogy of fallot learn to do and why? |
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Definition
| squat to improve symptoms --> compresses femoral veins increasing venous return, decreasing R-->L shunt |
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Term
| What does d-transposition of the great vessels result from? |
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Definition
| failure of the aorticopulmonary septum to spiral |
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Term
| While infantile coarctation of the aorta is located ____________, adult is located ___________ |
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Definition
| proximal to the ductus arteriosus, distal to the ligamentum arteriosum |
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Term
| What can you give a patient with transposition of the great vessels to keep their PDA open (and therefore keep them alive)? |
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Definition
| prostaglandins (indomethacin would close the PDA) |
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Term
| What pathognomic feature is seen in arteriolosclerosis in malignant hypertension? |
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Definition
| hyperplastic "onion skinning" |
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Term
| What is CK-MB useful for in MI? |
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Definition
| diagnosing reinfarction on top of acute MI |
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Term
| What is more specific for MI than other protein markers? |
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Definition
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Term
| While transmural infarcts have ________ on ECG, subendocardial infarcts have _____________ |
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Definition
| st elevation, st depression |
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Term
| What leads will have Q waves in an inferior wall infarction? |
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Definition
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Term
| If a patient returns with chest pain 3-5 days after an MI and you hear a friction rub... |
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Definition
| the have postinfarction pericarditis - ok |
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Term
| What are the symptoms of hypoparathyroidism? |
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Definition
| hypocalcemia, tetany (Chvostek's sign and Trousseau's sign are both assoc) |
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Term
| What syndrome results in pseudohypoparathyroidism? |
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Definition
| Albright's - kidney doesn't respond to PTH, shortened 4th/5th digits, short stature, autosomal dominant |
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Term
What drugs can be used to shrink prolactinomas?
What visual defect can result from a pituitary adenoma? |
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Definition
bromocriptine and cabergoline
bitemporal hemianopsia - impingment on optic chiasm |
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Term
| When is increased GH seen normally? |
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Definition
| stress, exercise and hypoglycemia |
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Term
| How can one detect acromegaly for sure? |
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Definition
| failure to decrease serum GH after an oral glucose tolerance test |
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Term
| How can one test for diabetes insipidus? |
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Definition
| do a water deprivation test - urine osmolality should increase, if it doesn't --> DI |
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Term
| What drugs can be used to treat nephrogenic DI? |
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Definition
| hydrochlorothiazide, indomethacin, and amiloride |
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Term
| What is the effect of diabetes on potassium levels? |
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Definition
| causes hyperkalemia, but decreased intracellular potassium due to decreased insulin-induced shift |
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Term
| A patient shows up with recurrent diarrhea, cutaneous flushing, asthmatic wheezing, and R sided valvular disease. You take a urine sample and find increased 5-HIAA... what do they have? |
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Definition
| carcinoid syndrome - multiple carcinoid tumors that secrete serotonin |
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Term
| What are the tumors in carcinoid syndrome derived from? What is the treatment? |
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Definition
| neuroendocrine cells of the GI tract, octreotide |
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Term
A patient comes in with pain in their stomach with eating. They've been vomiting blood and having thick, black tarry stools. You do a CT and discover thickened rugae in the stomach. What is their condition associated with?
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Definition
| MEN 1 - Zollinger Ellison Syndrome is the dx |
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Term
| What does insulin result in at it's target organs? |
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Definition
| increases glucose uptake and productino of glycogen in the liver and muscle, production of fat in the lipose tissue, also increases protein production and K uptake in the muscle |
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Term
| What are the names of some sulfonylurea drugs? |
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Definition
| tolbutamide, chlorpropramide, glyburide, glipizide |
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Term
| What is the MOA of sulfonylurea drugs? |
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Definition
| close K channels in the beta cell membrane causing Ca influx, depolarizing the cell and triggering release of the patient's own insulin |
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Term
| What drug can be used in patients with no islet function (but it's not insulin)? |
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Definition
| Metformin - decreases gluconeogenesis and icnreases glycolysis, etc |
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Term
| What drugs increase insulin sensitivity in the peripheral tissue by binding the PPAR-gamma nuclear transcription regulator? |
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Definition
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Term
| What is the MOA of GLP-1 analogs? |
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Definition
| decrease glucagon release, increase insulin release |
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Term
| What does the falciform ligament connect? |
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Definition
| the liver to the anterior abdominal wall |
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Term
| What structures does the hepatoduodenal ligament contain? |
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Definition
| the hepatic artery, portal vein, and common bile duct |
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Term
| What does the gastrohepatic ligament contain? |
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Definition
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Term
| What ligament runs between the greater curvature and transverse colon? |
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Definition
| the gastrocolic ligament (has the gastroepiploic arteries) |
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Term
| What vessels does the gastrosplenic ligament contain? |
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Definition
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