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Flashcards in 3/5 Deck (63):
1

P450 inducers?

Rifampin, Carbamazepine Barbiturates, Griseofulvin, chronic alcohol use

2

P450 inhibitors?

Cimetidine, isoniazid, macrolides, azole antifungals, grapefruit juice

3

What causes an early diastolic decrescendo murmur?

Aortic regurgitation

4

Why does administration of amyl nitrite reduce an aortic regurge murmur?

Causes vasodilation, reducing systemic resistance

5

What causes a systolic ejection murmur that increases with intensity when standing?

Hypertrophic cardiomyopathy (due to a decrease in LV outflow tract size)

6

What causes a systolic ejection murmur that decreases with intensity when standing?

Aortic stenosis

7

What type of inheritance is classical galactosemia? What is the defective gene?

AR, defective galactose-1-phosphate uridyltransferase

8

Common side effects of nitrates (nitroglycerine, isosorbide)?

Headaches and cutaneous flushing

9

Muscles that Munch (close the jaw)?

Masseter, teMporalis, Medial pterygoid

Lateral pterygoid opens jaw

10

Divisions of CN V exit the skull due to Standing Room Only, from which foramen?

Opthalmic: Superior orbital fissure
Maxillary: foramen Rotundum
Mandibular: foramen Ovale

11

What does heparin inhibit?

Factor Xa and thrombin (UFH)

12

What is lacking in Xeroderma Pigmentosum?

Repair enzyme UV-specific endonuclease

13

UV radiation causes formation of what type of bonds?

Covalent bonds between adjacent pyrimidine (thymine) NAs

14

What vitamin deficiency is associated with Isoniazid?

B6, pyridoxine
Supplementation recommended

15

What is ethosuximide's MOA in treating absence sz?

Blocks T-type Ca channels that rigger and sustain rhythmical burst discharges in thalamic neurons

16

Which 3 sz medications act by inhibiting neuronal high-freq firing by reducin the ability of Na channels to recover from inactivation?

Phenytoin
Carbamazepine
Valproic acid

17

What is the term for the high bone turnover rate seen in hyperPTH?

Osteitis fibrosa cystica

18

How do nitrites cause poisoning?

Oxidizing ferrous (2+) iron to ferric (3+) iron, forming methemoglobin. Shifts oxygen dissociation curve left. Partial pressure of O2 in blood is normal.

19

What sugar should be avoided in aldolase B def?

Fructose (which is also in sucrose)

20

How to characterize the glomerulus in PSGN?

Hypercellular

21

What are some lab findings in PSGN?

elevated titers of anti-streptococcal ab (anti-streptolysin O, andti-DNase B, anti-cationic proteinase)

Low C3 concentration

Serum cryoglobulins

22

Serum anti-glomerular basement membrane ab are found in what renal pathology?

Goodpastures RPGN, often with crescent formation on light microscopy

23

Serum anti-neutrophil cytoplasmic ab are found in what disease?

Granulomatosis with polyangiitis (Wegener's) RPGN, crescents

24

What to give for Jimson weed poisoning and atropine overdose?

Physostigmine

25

Atropine overdose sx mnemonic?

Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone

(Reverse cholinergic antagonists selective for muscarinic receptors)

26

What to give for beta blocker overdose?

Glucagon

27

What is the mechanism for glucagon rescue of beta blocker overdose?

GPCR that increases cAMP, increasing intracellular Ca release during muscle contraction

28

What infx in HIV pts is like TB, but has marked anemia, HSM, elevated alk phos and LDH, and also grows optimally at 41C?

MAC! Treat with macrolides (clarithro, azithro) +rifabutin or ethambutol

Prophylaxis with macro

29

What brain tumors show S-100 immunoreactivity?

Schwannomas and melanomas

30

What brain tumor is described as bizarre looking glial cells with multiple mitotic figures, pseudopalisading necrosis, and abundant neovascularization and hemorrhage?

Glioblastoma (WTF....)

31

What chronic diseases can lead to hyaline arteriolosclerosis?

NONmalignant HTN, DM

Underlying vessel wall is maintained, but intima is thickened and lumen is narrowed

32

What type of arteriolosclerosis is produced by malignant HTN?

Hyperplastic arteriolosclerosis

Homogenous, onion-like, concentric thickening of arteriole walls

33

Heavy cigarette smokers can get calf, foot, or hand intermittent claudication, superficial nodular phlebitis, and cold sensitivity have what disease?

Thromboangiitis obliterans (Buerger's disease)

34

Significant risk factor for mesothelioma?

Asbestos (insulation, ship building, mining)

35

Toxic shock syndrome is mostly from what bug?

Staph aureus

36

Toxic shock syndrome activates what immune cells?

Macrophages and T cells

37

What are some histological markers of eczema?

Intraepidermal vesicles, superficial epidermal hyperkeratosis (scales), epidermal hyperplasia (acanthosis), chronic inflammatory infiltrate

38

What are the only 2 purely ketogenic AAs?

Lysine and Leucine

39

What is more distal, airway epithelial cilia, or goblet cells?

Cilia, present throughout the respiratory bronchioles. Goblet cells end in the bronchi.

40

Is excess neutrophil elastase activity in alveoli associated with panacinar or centriacinar emphysema?

Panacinar, more common in lower lung fields due to higher perfusion. Can be due to alpha1antitrypsin deficiency.

41

Is smoking associated with panacinar or centriacinar emphysema?

Centriacinar, with greater upper lobe distribution due to destructive proteases released by macrophages/neutrophils

42

Is alpha 1 antitrypsin deficiency associated with panacinar or centriacinar emphysema?

Panacinar

43

What molecules/hormones increase gastric acid secretion? (3 things)

Histamine, ACh, gastrin

44

What molecule inhibits gastric acid secretion?

PGE2

45

What syndrome causes excess gastrin secretion?

Zollinger-Ellison syndrome

46

vWF protects what clotting factor from degradation?

Factor VIII, so vWF deficiency can cause a prolonged bleeding time and PTT, with a normal platelet count.

47

In what disorder do you see an isolated PTT prolongation? What medication?

Hemophilia A (X linked disorder caused by factor VIII deficiency)

Heparin (antithrombin associated inhibition of factors II and X)

48

What do you see on PT, PTT, platelet count, and bleeding time with uremic platelet dysfunction?

Normal PT, PTT, platelet count

Increased bleeding time

49

Acute extrapyramidal symptoms are related to which neurotransmitter?

D2

50

Which Staph species is associated with foreign bodies?

Staph epidermidis (forms biofilm)

It is coagulase neg, part of normal skin flora

51

Which Staph species has protein A?

Staph Aureus (protein A binds to Fc region of Ig, inhibiting opsonization and phagocytosis)

52

What are the 3 phases in Paget disease of bone?

1. Osteolytic (osteoclast dominant from excessive RANK signaling and NK-kB activation)
2. Mixed (osteoclast/osteoblast) with abnormal new bone
3. Osteosclerotic (osteoblast dominant forming dense hypovascular mosaic pattern of lamellar bone with prominent cement lines)

53

Aqueous humor is produced by what cells?

Ciliary epithelial cells

54

What type of medications precipitate narrow angle glaucoma?

Anticholinergics, more acute presenting with h/a and eye pain

55

What drugs decreases secretion of aqueous humor? From where?

Timolol (nonselective beta blockers)
Acetalzolamide (carbonic anhydrase inhibitor)

Decrease secretion by ciliary epithelial cells

56

What drugs increase outflow of aqueous humor?

Prostaglandin F2a (latanoprost, unoprostone, travoprost)
Cholinomimetics (pilocarpine, carbachol)

57

What is the first line tx for Enterobiasis (dx by scotch tape test)

Albendazole

58

Virus that causes Mono?

EBV

59

Causes of mononucleosis-like sx?

CMV, toxo

60

Which cholesterol drugs increase risk for gallstones?

Fibrates and bile acid binding resins (cholestyramine, colestipol, colesevelam)

61

What does an intimal tear precede?

Aortic dissection

62

What does an intimal streak precede?

AAA

63

What to give for Succinylcholine slow metabolisers?

neostigmine