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COCAINE intoxication - correct answers️️impaired judgement, pupil dilate, hallucination (coke bugs) sudden cardiac death; paranoid ideations, angina Tx: alpha blockers/ benzos caution B block bc can cause unopposed alpha Osteoporosis histo - correct answers️️trabecular and cortical bone lose mass and interconnection despite normal bone mineralization assoc w/ Colles fracture- distal radial fracture; fracture of femoral neck Gilbert Syndrome - correct answers️️mild dec UDP glucuronosyltransferase conjugation and impaired bilirubin uptake; asymptomatic or mild jaundice>> inc unconjugated bilirubin w/o hemolysis; w/ fasting and stress Crigler Najjar - correct answers️️ABSENT UDP glucuronsyltransferase; early in life; die few years find: jaundice, kernicterus (in brain) inc unconjugated bilirubin; tx: plasmapheresis and phototherapy; type II respond phenobarbital Dubin Johnson - correct answers️️Conjugated hyperbilirubinemia b/c defective liver excretion; grossly black liver Benign Rotor syndrome - correct answers️️milder in presentation w/o black liver impaired hepatic uptake and excretion wilson Disease - correct answers️️copper transporting ATPase; ATP7B on Chromosome 13 s/s: before 40 yo, liver dz, neurodisease, psych dz, Kayser Fleischer ring, hemolytic anemia, renal dz; find: dec serum ceruloplasmin, inc urine copper tx: chelation w/ penicillamine or Tridentine, oral zinc Hemochromatosis - correct answers️️recessive, HFE, chromosome 6; abnormal iron sensing, increase intestinal absorb find: inc ferritin, inc iron, dec TIBC, inc transferrin saturation identify w/ Prussian blue stain/ liver MRI Hemochromatosis finds - correct answers️️after age 40 >20 iron; triad: cirrhosis, DM, skin pigmentation; dilated cardiomyopathy, hypogonadism, arhtropathy; HCC is common cause death Treatment Hemochromatosis - correct answers️️repeat phlebotomy, chelation deferasirox, deferoxamine, oral deferiprone Wolff Parkinson White Syndrome - correct answers️️MC ventricular pre excitation syndrome abnml fast atria to ventricle (bundle of Kent); bypasses AV node>> ventricles begin partially depolarization earlier (NOTED BY DELTA WAVE ON EKG) widened QRS and shortened PR Conduction pathway heart - correct answers️️SA node> atira> AV node> bundle HIS, R and L bundle branches> purkinje fibers> ventricles L branch anterior/posterior fascicles Edema - correct answers️️inc capillary pressure dec plasma proteins (dec oncotic capillary pressure) inc capillary permeability increase interstitial fluid colloid oncotic pressure Celiac Disease - correct answers️️setting: 14 mo kid losing weight eating lots of foods; histology: crypt abnormalities (hyperplasia); villous atrophy, lymphocytic infiltration presents as malabsorbtion (diarrhea etc in kids) in adults= short stature, anemia delayed puberty Musculocutaneous nerve C5-C7 - correct answers️️upper trunk compression cause injury; loss forearm flexion/supination; loss sensation over lateral forearm Axillary nerve C5-C6 - correct answers️️flat deltoid; loss arm abduction, loss sensation over deltoid and lateral arm Radial C5-T1 - correct answers️️mid shaft fracture humerus, compression axilla find: dec grip, loss extension (wrist drop); loss sensation posterior arm, dorsal hand Median C5-T1 - correct answers️️supracondylar fracture humerus (proximal) CTS, wrist laceration (distal) ape hand pope's blessing loss wrist flexion, flex of lateral fingers, thumb opposition, lumbricals 2nd and 3rd digit; loss sensation over thenar eminence and dorsal and palmar aspects of lateral 3 1/2 fingers w/ proximal Ulnar C8-T1 - correct answers️️Fracture medial epicondyle humerus; fractured hook hamate (distal lesion) ulnar claw on extension; radial deception wrist upon flexion (proximal lesion) loss wrist flex, flex of medial fingers, abduction and adduction fingers; medial 2 lumbricals; loss sensation over 1 1/2 fingers including hypothenar eminence Recurrent branch median nerve - correct answers️️superficial laceration palm ape hand; loss thenar muscles