JMC Human Medicine Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Femoral triangle borders

The femoral triangle is bounded by the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus medially, with a floor formed by iliopsoas and pectineus.

Median nerve forearm supply

The median nerve supplies all forearm flexors except flexor carpi ulnaris and the medial half of flexor digitorum profundus, which are supplied by the ulnar nerve.

Recurrent laryngeal nerve course

The right recurrent laryngeal nerve loops under the subclavian artery; the left loops under the aortic arch at the ligamentum arteriosum, making left-sided injury more common in thoracic disease.

Cardiac output formula

Cardiac output equals heart rate multiplied by stroke volume. Mean arterial pressure approximates diastolic pressure plus one-third of the pulse pressure, reflecting the cardiac cycle time weighting.

Renal clearance formula

Clearance equals urine concentration times urine flow divided by plasma concentration. Inulin clearance estimates glomerular filtration rate, while PAH clearance estimates effective renal plasma flow.

Alveolar gas equation

The alveolar oxygen partial pressure equals FiO2 times (atmospheric pressure minus 47) minus arterial CO2 divided by the respiratory quotient, usually taken as 0.8.

Starling filtration equation

Net filtration equals the filtration coefficient times capillary hydrostatic pressure minus interstitial hydrostatic pressure minus the reflection coefficient times the oncotic pressure difference.

Rate-limiting step of glycolysis

Phosphofructokinase-1 catalyzes the committed step of glycolysis. It is activated by AMP and fructose-2,6-bisphosphate and inhibited by ATP and citrate.

Pyruvate dehydrogenase cofactors

Pyruvate dehydrogenase requires thiamine pyrophosphate, lipoic acid, coenzyme A, FAD, and NAD. Deficiency, as in thiamine deficiency, impairs pyruvate entry into the citric acid cycle.

Lead poisoning enzyme targets

Lead inhibits aminolevulinic acid dehydratase and ferrochelatase in heme synthesis, causing microcytic anemia with basophilic stippling and elevated aminolevulinic acid.

Types of necrosis

Coagulative necrosis occurs in ischemic heart, kidney, and spleen. Liquefactive necrosis occurs in brain infarcts and abscesses, and caseous necrosis occurs in tuberculosis.

Two-hit hypothesis

Tumor suppressor genes such as TP53 and RB typically require inactivation of both alleles before function is lost, explaining the inherited predisposition in familial cancer syndromes.

Nephrotic versus nephritic syndrome

Nephrotic syndrome shows proteinuria above 3.5 g/day, hypoalbuminemia, edema, and hyperlipidemia. Nephritic syndrome shows hematuria, hypertension, and oliguria with active urine sediment.

First-order versus zero-order kinetics

First-order elimination removes a constant fraction of drug per unit time. Zero-order elimination removes a constant amount, as with phenytoin and ethanol at high concentrations.

Volume of distribution

Volume of distribution equals dose divided by plasma concentration. A large value indicates extensive tissue distribution, while a small value suggests confinement to the vascular space.

Competitive versus noncompetitive antagonism

Competitive antagonists shift the dose-response curve right without reducing maximal efficacy. Noncompetitive antagonists reduce maximal efficacy because they cannot be overcome by more agonist.

ACE inhibitor adverse effects

ACE inhibitors cause cough through bradykinin accumulation and are contraindicated in pregnancy and bilateral renal artery stenosis because they reduce glomerular perfusion.

Gram stain principle

Gram-positive bacteria have thick peptidoglycan that retains crystal violet after decolorization. Gram-negative bacteria have a thin wall and outer membrane and counterstain pink with safranin.

Mycobacterium tuberculosis staining

Mycobacterium tuberculosis is acid-fast because of mycolic acids in its cell wall. It is detected with Ziehl-Neelsen staining and cultured on Lowenstein-Jensen medium.

HIV entry mechanism

HIV gp120 binds CD4 and a coreceptor, CCR5 or CXCR4, allowing viral entry into T helper cells and macrophages. Reverse transcriptase converts viral RNA into DNA.

Incidence versus prevalence

Incidence counts new cases in a population at risk over time. Prevalence counts all existing cases and approximately equals incidence multiplied by mean disease duration.

Sensitivity and specificity

Sensitivity equals true positives divided by true positives plus false negatives. Specificity equals true negatives divided by true negatives plus false positives. Predictive values also depend on prevalence.

Number needed to treat

The number needed to treat is the reciprocal of the absolute risk reduction. A smaller value indicates a more effective intervention for preventing one additional adverse outcome.

Diabetic ketoacidosis management

Diabetic ketoacidosis shows hyperglycemia, ketonemia, and anion-gap metabolic acidosis. Treatment is isotonic saline, intravenous insulin, and potassium replacement once potassium is safe.

CURB-65 score

CURB-65 scores confusion, urea above 7 mmol/L, respiratory rate of 30 or more, low blood pressure, and age 65 or older to guide pneumonia site of care.

Anemia by MCV

Anemia is classified by mean corpuscular volume as microcytic, normocytic, or macrocytic. Iron deficiency and thalassemia are microcytic; vitamin B12 and folate deficiency are macrocytic.

ATLS primary survey order

The trauma primary survey proceeds through airway with cervical spine protection, breathing, circulation with hemorrhage control, disability, and exposure with environmental control.

Small bowel obstruction management

Small bowel obstruction presents with colicky pain, vomiting, distension, and absent flatus. Initial management is intravenous fluids, nasogastric decompression, and monitoring for strangulation.

Naegele rule

The estimated date of delivery equals the first day of the last menstrual period plus 280 days, or minus 3 months plus 7 days and 1 year.

Preeclampsia definition

Preeclampsia is blood pressure of 140/90 mmHg or higher after 20 weeks of gestation with proteinuria or end-organ dysfunction. Delivery is the definitive treatment.

Postpartum hemorrhage cause

Uterine atony is the most common cause of postpartum hemorrhage. Initial management is uterine massage, oxytocin, and intravenous fluids with blood product support as needed.

Kawasaki disease treatment

Kawasaki disease presents with fever for at least five days plus conjunctivitis, rash, mucosal changes, extremity changes, and cervical lymphadenopathy. Treatment is intravenous immunoglobulin and aspirin.