76 yo man 30mins severe substernal chest pain while arguing with brother. 3 sublingal nitroglycerin no relieve. 5y h/o ischemic heart disease. P110, R20, BP120/80. Cardiac exam normal. EKG ST elevation at leads I, aVl, a
...
76 yo man 30mins severe substernal chest pain while arguing with brother. 3 sublingal nitroglycerin no relieve. 5y h/o ischemic heart disease. P110, R20, BP120/80. Cardiac exam normal. EKG ST elevation at leads I, aVl, and V4-V9. What happened during argument with brother?
Coronary vasospasm due to alpha 1 stimulation
40yo G0 women delivered newborn. CVS at 15 wks results male chromosome fetus. Physical exam show female external genitals and absent internal genitals. Mutation prevent response to what?
Testosterone
13yo girl grew 3in over summer. What accounts for increased Ca absorption?
Hormones derived from 7-dehyrocholesterol
56 yo man lethargy. No meds, no postural hypotention, no edema. Na: 125. Others normal. Dx?
Small Cell Carcinoma of lungs
15 yo girl received BMT 1 year ago due to AML. Now karyotype 46, XY. Dx?
Nonautologous donor
23yo women strenuous exercise. X-sectional area of pulmonary microcirculation?
increased, as a result of distention and recruitment of microvessels
33yo woman had weakness of right lower 2/3 of face. Where is brain lesion?
Primary motor cortex
30 yo man and 24 yo woman genetic counseling. Man's brother has type 1 oculocutaneous albinism (AR). Single gene disorder 1/40,000 in population. Pedigree shown. What are the odds?
q= sqr. rt of 1/40000 = 1/200
pq= 1/200 / 2= 1/100
1/100 that mom is a heterozygote
2/3 that dad is a carrier
AR disease= 1/4 of offspring affected
(1/100) (2/3) (1/4)= 1/600
Chemical disrupts tight junction between cells in the testes. Autoimmune response to products of germ cells entered circulation. What cells disrupted?
Sertoli cells
25 yo woman w/ AIDS in ICU treated for sepsis by Cryptococcus neoformans. Drug?
Amphotericin B
27yo man 4 days of cough producing blood-tinged sputum. BP160/100. Creatine: 4.8, erthyrocyte casts in urine. IgG deposites in IF microscopy. What glomerulus histologic abnormalities?
Crescent formation
48yo man. 3 yrs ago removed right kidney and adrenal gland of encapsulated renal cell carcinoma. 2 annual exams normal. No EtOH and no smoking. P75, BP130/88. Physical exam normal. Serum mild increased bilirubin, ALT, AST and ALP. CT abdomen shows widening hepatic venules. Radiographic fluorography pressure: R Atria: 5, Hepatic vein: 25, Hepatic wedge: 30. Dx?
Budd-Chiari Syndrome
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