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Flashcards in 3/1 Deck (30):
1

Afferent renal arteriole is towards or away from the glomerulus?

Afferent is towards (pre) glomerulus

2

What type of cells compose the juxtaglomerular apparatus? Where do they reside?

JGA cells are modified smooth muscle cells of the afferent glomerular arterioles.
They synthesize renin.

3

Status epilepticus refers to what kind of seizure?

Tonic-clonic sz lasting more than 30min.
Without return to consciousness.
Recurrent or continuous.

4

First line drug for status epilepticus? Why?

IV benzodiazepine (Lorazepam is drug of choice)
Fast onset of action (within minutes)

5

What drug is given concurrently with lorazepam for status epilepticus? Why?

IV phenytoin
Prevents recurrence of szs
15 min onset

Inhibits neuronal high-freq firing by reducing Na channel deinactivation

6

Carcinoembryonic antigen (CEA) is a serum marker for what disease?

Colorectal cancer (CRC)

7

CA-125 is a serum marker for what disease?

Ovarian cancer. Poor screening tool, PPV only 3%

8

Acid phosphatase is a marker for what?

Prostate tumor, active osteoclast bone resorption

9

SLE patients who have paradoxically prolonged PTT have what syndrome? What are common symptoms?

Antiphospholipid antibody syndrome (APS).
At risk for venous and arterial thromboembolism
At risk for recurrently pregnancy loss

10

What is the most common cause of septic arthritis in sexually active young adults?

Neisseria gonorrhoeae
Intracellular organism!
Presents with asymmetrical large joint polyarthritis

11

What is the first step of the urea cycle? (Substrates, enzyme, and product)

Substrates: CO2, NH4, ATP
Enzyme: Carbamoyl phosphate synthetase
Product: Carbomyl phosphate

12

What is the AA primary structure change in HbS?

Valine (nonpolar, hydrophobic) in place of Glutamic acid (charged) in the 6th position in the beta subunit

13

Tyrosine kinase second messenger system activates what molecule?

Protein phosphatase
(Insulin action)

14

GPCR/adenylate cyclase second messenger system activates what molecule?

cAMP activates PKA

15

GPCR/IP3 second messenger system activates what molecule?

Phospholipase C, which degrates IP3 to diacylglycerol, which activates PKC (along with increased intracellular Ca from IP3)

16

JAK-_____, second messenger system

JAK-STAT

17

Benzodiazepine MoA?

Increases GABA receptor-chloride channel opening FREQUENCY, increased Cl influx, hyperpolarizes membrane

18

Benzo vs Barbs, which one increases Cl channel opening FREQ vs DURATION?

Benzo = higher FREQ
Barb = longer DURATION

19

Organism visualized by silver stain and cultured on buffered charcoal yeast extract? (BCYE)

Legionella pneumophila (aerosolization of contaminated water in commercial and hospital settings)

20

What are the two most common organisms to cause bacteriemia in sickle cell patients? (who become functionally asplenic)

Encapsulated organisms:
1. Stretococcus pneumoniae
2. Haemophilus influzenzae
(Asplenic patients receive penicillin prophylaxis and pneumococcal vax)

21

Sorbitol dehydrogenase converts sorbitol into what?

Fructose

22

CHF, give which beta blocker?

Carvedilol

23

What type of virus is CMV?

enveloped ds DNA

24

Interstitial PNA in a transplant patient showing intranuclear and cytoplasmic inclusion bodies = what organism?

CMV

25

What component of endotoxin (LPS) is responsible for its toxic properties?

Lipid A

26

Does myasthenia gravis muscle weakness increase or decrease with activity?

Increase

27

Does Eaton-Lambert muscle weakness increase or decrease with activity?

Decrease

28

Proximal muscle weakness = ?

polymyositis

29

What is the most common age affected by Henoch-Schonlein purpura (HSP)?

2-10 years old, preceded by viral or streptococcal URI
(HSP is the most common small vessel vasculitis in children)

30

What organ systems are most affected by Henoch-Schonlein purpura (HSP)?

GI tract (intermittent severe abd pain, upper and lower GI bleed, increased risk for intussesception)
Kidneys (identical effects as IgA nephropathy (Berger disease): mesangial proliferation and crescent formation)
Skin (palpable purpura on buttocks and LE)
Joints (self limited migratory arthralgias)