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1

What type of inheritance is PKU?

AR

2

What are the first line treatments for afib with SVT?

CCB and beta blockers

3

In what subset of patients with afib might you give digoxin?

Those with underlying systolic dysfunction

4

What are some sx of digitalis toxicity?

Head: Fatigue, headache, dizziness, confusion, delirium
Vision: Blurry, color (yellow/green)
GI: N/v, diarrhea, abd pain

Increase in K is correlated to dig level

5

Tx of digitalis toxicity?

1. Oral activated charcoal
2. Insulin, Kayexalate, hemodialysis to manage hyperK (NOT calcium gluconate)
3. Antibody to dig

6

How does HIT cause paradoxical thrombosis?

Ab to heparin and Platelet factor IV

7

What drugs are given for HIT?

Direct thrombin inhibitors (hirudin, lepirudin, argatroban), which do not require antithrombin-III

8

What drug blocks glutamate residun carboxylation of clotting factors?

Warfarin inhibits vit K dependent y-carboxylation of glutamic acid residues of factors 2, 7, 9, 10

9

Where are Pancoast tumors and what syndrome do they cause?

They are apical lung tumors that cause Horner syndrome in 50% of patients

10

What is the triad of Horner syndrome?

Ipsilateral miosis, ptosis, anhidrosis

11

What condition presents with spongiotic dermatitis (with epidermal spongiosis)?

Eczematous dermatitis

12

Acanthosis is associated with what condition?

Psoriasis

13

What is acantholysis?

Loss of cohesion between keratinocytes in the epidermis or adnexal structures. Associated with spongiotic dermatitis, as in eczematous dermatitis

14

What brain areas are most vulnerable to ischemia from cardiac arrest?

Pyramidal cells of hippocampus (#1)/neocortex

Purkinje cells of the cerebellum

15

What is thyroid peroxidase responsible for?

Thyroglobulin iodination

16

What kind of skin presentation is seen with Bartonella in immunocompromised patients?

Bacillary angiomatosis: red/purple papules that resemble Kaposi sarcoma lesions

17

Tell me about Rickettsia rickettsia.

Rocky Mountain spotted fever.
Tick-borne.
Dogs and exposure to wooded areas or grassy fields.
Prompt doxycycline treatment

18

What organism characterizes swimming pools and cervical LAD?

Mycobacterium scrofulaceum

19

What do you get from animal urine?

Leptospirosis, causing conjunctival suffusion

20

What is the most common cause of inhaled anesthetic hepatotoxicity?

Halothane, can cause liver to be shrunken

21

Reduced serum albumin levels indicate what time course of liver disease?

Chronic, NOT in acute liver injury, because albumin has half life of 20 days

22

What is the half life of albumin?

20 days

23

What lab findings will be seen in patients with inhaled-anesthetic induced hepatotoxicity?

Elevated AST/ALT
Prolonged PT (deficiency of factor VII, which has the shortest half life)

24

Ammonia toxicity in the brain can result from depletion of what molecules?

Glutamate or alpha-ketoglutarate

25

PRPP is an enzyme for the production of what?

De novo synthesis of purines and pyrimidines

26

What cells mediate the inflammatory reaction in gouty arthritis?

Neutrophils...duh

27

If a patient with gouty arthritis can't take NSAIDs, what should you give them?

Colchicine, which impairs neutrophil migration and phagocytosis

28

What is Tardive dyskinesia?

Involuntary perioral movements and choreoathetoid movements.

From antipsychotics.

29

What is the antipsychotic most likely to cause EPS (like Tardive diskinesia)?

Risperidone

30

What is the antipsychotic least likely to cause EPS?

Clozapine (but it is associated with agranulocytosis)