QBank notes: 2/12/09 [48]

The penis, vagina, and anal canal drain to the medial side of the horizontal chain of superficial inguinal lymph nodes. Stomach cancers go to Virchow's nodes (left supraclavicular).

Pre-eclampsia = hypertension, proteinuria, edema; eclampsia: +seizures.

Since transplanted hearts are de-innervated, chest pain does not occur with progressive graft arteriosclerosis (intimal thickening without atheroma formation or significant inflammation). Immunosuppresants do not prevent graft arteriosclerosis.

Superior oblique. SO LID. Lateral rotation (abduction), intorsion, depression. Works with inferior rectus (which tends to extort and depress). Inferior oblique: adduction, extorsion, elevation. Works with superior rectus, which tends to intort and elevate.

In female patient with IUD, think Actinomyces israelii. Can cause lumpy jaw, female reproductive, or gastrointestinal mycetomas with sulfur granules.

South American immigrant with megaesophagus. Chagas disease, Trypanosoma cruzi. Presents with cardiac failure, megaesophagus, megacolon.

Haptoglobin binds free hemoglobin serum. Decreased haptoglobin, high bilirubin -- mostly indirect: intravascular hemolysis. Normal haptoglobin, high bilirubin -- mostly direct: obstructive jaundice. Normal haptoglobin, high bilirubin -- mostly indirect: Crigler-Najjar.

Catecholamine metabolites, important in pheochromocytoma (episodic or chronic hypertension, palpitations, sweating, headache, vomiting; 10% extra-adrenal, 10% bilateral, 10% malignant): VMA - vanillylmandelic acid; HVA - homovanillic acid. 5-HIAA - serotonin syndrome, i.e. carcinoid syndrome: diarrhea, flushing, wheezing (from bronchoconstriction).

Defecation: relaxation of internal anal sphincter, tensing of external anal sphincter, conscious urge to defecate. Pudendal nerve -- external sphincter; pelvic nerve -- internal sphincter.

Diabetes can overload loop of Henle with increased fluid and electrolytes, interfering with establishment of medullar osmotic gradient. This causes functional resistance to ADH.

Transudative edema -- liver cirrhosis. Exudative edema -- inflammation, lymphatic blockage.

AML. M1 = no differentiation, mostly myeloblasts. M2 = some differential, blasts and some promyelocytes. M3 = APL, lots of faggot cells (promyelocytes with Auer rods). M5 = promonocytes with nonspecific esterases. M7 = promegakaryocytes.

Left-sided neglect is a lesion of right parietal lobe. Also associated with extinguishing to double simultaneous stimuli of the stimuli on neglected side.