Free water clearance is the amount of solute-free water that needs to be removed to make the urine osmolality the same as plasma osmolality. Negative free water clearance is the amount of solute-free water that needs to be added to make the urine osmolality the same as plasma osmolality.
Positive skew means the tail of the distribution is on the right. In other words, mean > median. The opposite applies for negative skew. For skewed distributions, median is the better representation of central tendency.
Beta blockers. A through M are beta1-selective, including atenolol, esmolol, and metoprolol. Exception: carvedilol, labetalol are nonselective. Acebutalol, carteolol, pindolol have intrinsic sympathomimetic activity.
Femoral nerve. Anterior compartment. Quadriceps femoris, sartorius "check bottom of foot for gum", pectineus. Obturator nerve. Medial compartment (gracilis, adductor longus, adductor brevis, anterior portion of adductor magnus). Adduct thigh, medially rotate thing. Tibial nerve. Posterior compartment of thigh (semimembranosus, semitendinosus, long head of biceps femoris, posterior portion of adductor magnus). Flex the knee, extend the thigh. Posterior compartment of leg (gastrocnemius, soleus, flexor digitorum longus, flexor hallucis longus, tibialis posterior). Plantarflexion, flex digits, inversion. Common peroneal nerve. Short head of biceps femoris. Flex knee. Superficial peroneal nerve. Lateral compartment of leg (peroneus longus, peroneus brevis). Eversion. Deep peroneal nerve. Anterior compartment of leg (tibialis anterior, extensor hallucis longus, extensor digitorum). Dorsiflexion, extend digits, inversion.
Muscle contraction velocity is determined by "myosin ATPase activity" -- however myosin ATPase activity does not affect maximum load that can be lifted. Conversely, increasing frequency of contraction, muscle hypertrophy, and increased motor unit recruitment will affect amount of weight that can be lifted but not the contraction velocity.
During pregnancy, increased estrogen stimulates more thyroid binding globulin (TBG). This can cause elevated serum thyroxine (T4). However, free serum thyroxine remains normal because of intact feedback mechanisms. During pregnancy, thyroid enlargement, tenderness, heat intolerance, and palpitations are normal. Do not interpret the woman as being in a hyperthyroid condition based on the symptoms and high total serum T4 levels; all these changes are normal.
Pemphigus vulgaris versus bullous pemphigoid. Pemphigus vulgaris: positive Nikolsky's sign (epidermis exfoliates on rubbing); lesions of oral mucosa; bad prognosis -- most die within a year without treatment. Bullous pemphigoid: negative Nikolsky's sign, no oral mucosal lesions, usually do quite well.
Mental retardation versus autism. Mental retardation: even decrease in all skills, still communicative with people, 1:1 male:female ratio, most common causes are fetal alcohol syndrome, fragile-X syndrome, and Down syndrome. Autism: uneven performance in skills, not communicative, 4:1 male:female ratio, association with chromosome 15. ADHD: 10:1 male to female ratio.
Prolactinomas suppress the HPTA axis.
N. gonorrhoeae arthritis: petechial rash, tenosynovitis, antigenic variation and phase variation of the pili allow reinfections. Especially susceptible to complement mediated killing. Treat with ceftriaxone.
Ascaris lumbricoides. Giant roundworm. Can cause small bowel obstruction. "Tinkly" sounds on auscultation; distended abdomen.
It seems infantile polycystic kidney disease is distinguished from adult polycystic kidney disease by mode of inheritance. The infantile disease is also known as ARPKD. The adult form is now known as ADPKD. ARPKD: presents in infancy with renal (and often hepatic) cysts, progressive renal failure, bilateral enlarged kidneys with smooth surfaces; spongelike appearance with multiple small cysts in cortex and medulla.
Strep pyogenes -- non immunogenic hyaluronic acid capsule.
Renal insufficiency can cause decreased calcium (decreased synthesis of 1,25(OH)2-D3) and increased phosphate (decreased excretion). Increased calcium and phosphate suggests Vit D intoxication. Decreased calcium and phosphate suggest Vit D deficiency (rickets in kids, osteomalacia in adults). Increase in calcium and alkaline phosphatase, and decrease in phosphate, suggest hyperparathyroidism.
Ketotifen: opthalmic selective, noncompetitive H1 antagonist. Limited systemic absorption. Stabilizes mast cells. Good for IgE-mediated conjunctivitis.
Intrinsic factor is degraded at alkaline pH. It allows B12 absorption. It exerts negative feedback on gastrin.
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