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Final FA review > 4/20 CV/overall > Flashcards

4/20 CV/overall Flashcards

1
Q

intracerebral neoplasms

-what are 2 ways they can increase ICP?

A

1-obstruction of CSF flow.

2-disruption of BBB (inc vascular permeability => vasogenic edema).

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2
Q

construction worker w/muscle spasms (starting w/jaw)

-most likely problem?

A

tetanus

-rusty nail.

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3
Q

Causes of nephrogenic DI?

A
  • hereditary
  • hypercalcemia
  • lithium
  • demeclocycline (ADH antagonist)
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4
Q

Connection btwn a lung nodule & nephrogenic DI?

A

lung nodule may be squamous cell carcinoma and may produce PTHrP.
-Hypercalcemia can produce nephrogenic DI by down-regulating expression of aquaporins in collecting duct.

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5
Q

How does hypercalcemia cause nephrogenic DI?

A
  • down-regulating expression of aquaporins in collecting duct.
  • causes resistance to ADH action.
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6
Q

clopidogrel & P450 inhibitors

-whats the relationship?

A

clopidogrel is a prodrug that needs P450 system to activate it.
-P450 inhibitors will dec its activation then.

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7
Q

DNA coding strand

-definition:

A

The DNA strand which has the same base sequence as the RNA transcript produced (although with thymine replaced by uracil).

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8
Q

DNA coding strand

-definition:

A

The DNA strand which has the same base sequence as the RNA transcript produced (although with thymine replaced by uracil).

  • this is the strand which contains the codons.
  • its the anti-coding strand that gets transcribed.
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9
Q

Which DNA strand gets transcribed, the coding or non-coding strand?

A

The non-coding strand gets transcribed.

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10
Q

DNA coding strand

-aka?

A
  • sense.
  • non-template.

*the template is what mRNA made from and you know that one is not the coding strand.

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11
Q

Trabeculated part of ventricles

-derived from?

A

primitive ventricles.

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12
Q

Trabeculated part of ventricles

-derived from?

A

primitive ventricle.

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13
Q

Trabeculated part of atria

-derived from?

A

primitive atrium.

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14
Q

Trabeculated part of atria

-derived from?

A

primitive atria.

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15
Q

Smooth part of left atrium

-derived from?

A

pulmonary veins.

*makes sense bc pulm veins drain into left atrium & veins are smooth.

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16
Q

Smooth part of left atrium

-derived from?

A

primitive pulmonary vein.

*makes sense bc pulm veins drain into left atrium & veins are smooth.

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17
Q

Coronary sinus

-derived from?

A

left horn of sinus venosus

*makes sense bc it is a venous sinus that drains the left side (as opposed to the “right side” which was the systemic circ).

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18
Q

Coronary sinus

-derived from?

A

left horn of sinus venosus

*makes sense bc it is a venous sinus that drains the left side (as opposed to the “right side” which was the systemic circ = just think that heart is on your left side and it drains your heart).

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19
Q

Smooth part of both ventricles

-derived from?

A

bulbus cordis

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20
Q

Smooth part of right atrium

-derived from?

A

right horn of sinus venosus

*makes sense: sinus venosus = the sinus
of all the veins in the body do dump into
the right atrium.

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21
Q

SVC

-derived from?

A

right common cardinal vein and right anterior cardinal vein.

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22
Q

foramen secundum

  • forms in…
  • its remnant is called?
A
  • formed in septum primum.

- foramen ovale (what ever is not covered by the septum secundum).

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23
Q

endocardial cushions separate which compartments from each other?

A

atria from venticles.

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24
Q

heart valves derived from?

A

all valves derived from endocardial cushions.

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25
Q

umbilical vein

  • whats its remnant?
  • whats its remnant contained in? which ligament?
A
  • Ligamentum teres hepatis.
  • Contained in falciform ligament.

*umbilical vein kind of enters the liver a little bit - you know the umbilical artery has nothing to do w/the liver so if you have to choose btwn umb vein or art - must choose umb vein.

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26
Q

allantois

  • becomes which ligament?
  • mnemonic?
A
  • urachus
  • median umbilical ligament
  • bladder is exactly in the middle.
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27
Q

UmbiLical arteries

-whats its remnant?

A

MediaL umbilical ligaments.

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28
Q

Left-dominant circulation

-PDA arises from?

A

LCX

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29
Q

Fick equation:

A

= rate of O2 consumption / (A-V O2 content)

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30
Q

ASD murmur?

A
  • Presents with a pulmonary flow murmur (↑ flow through pulmonary valve) and a diastolic rumble (↑ flow across tricuspid).
  • The murmur later progresses to a louder diastolic murmur of pulmonic regurgitation from dilatation of the pulmonary artery.
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31
Q

All heart murmurs will inc w/inc blood in heart (inc preload).
-what are the 2 exceptions?

A

-MVP, HCM.

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32
Q

Hand grip = inc. afterload.

-which murmurs will be increased and why?

A

-more systemic resistance, which means LV has to pump harder to overcome the pressure in the aorta.
1-more pressure build up in LV = inc P differential btwn LV & RV = inc. VSD murmur.
2-more pressure in aorta, so after LV systole, and during diastle, inc differential btw aorta & LV so aortic regurg will be louder.
3-more pressure build up in LV means the P differential btwn LV & LA is increased which means a louder mitral regurg murmur.

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33
Q

Hand grip = inc. afterload.

-which murmurs will be increased and why?

A

-more systemic resistance, which means LV has to pump harder to overcome the pressure in the aorta.
1-more pressure build up in LV = inc P differential btwn LV & RV = inc. VSD murmur.
2-more pressure in aorta, so after LV systole, and during diastle, inc differential btw aorta & LV so aortic regurg will be louder.
3-more pressure build up in LV means the P differential btwn LV & LA is increased which means a louder mitral regurg murmur. (same for MVP).

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34
Q

valsalva

-inc or dec preload?

A

dec. preload.

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35
Q

HCM

  • does inc. or dec. afterload reduce HCM murmur?
  • how?
A
  • inc afterload = dec. HCM murmur.
  • Reduces pressure differential btwn LV and aorta/systemic.
  • LV usually has higher pressures than aorta/systemic, so if you inc. systemic pressure, these will even out and you’ll reduce the murmur.

*inc. preload & inc. afterload both reduce HCM murmur.

36
Q

MVP

-what causes an earlier click/murmur?

A

decreased venous return.

37
Q

Mitral stenosis

-relationship btwn S2 & OS interval and the severity of the stenosis?

A
  • inverse relationship: the more stenosed the mitral valve the shorter the interval btwn S2 and opening snap.
  • S2 = when aortic/pulmonic close. Between S2 and S1 it diastole - when blood is flowing through mitral valve. So the more stenosed the valve, the inc. volume in the left atrium, and the faster it breaks through the stenosis so the decreased the interval is.
38
Q

Mitral stenosis

-relationship btwn S2 & OS interval and the severity of the stenosis?

A

-inverse relationship: the more stenosed the mitral valve the shorter the interval btwn S2 and opening snap.

  • S2 = when aortic/pulmonic close. Between S2 and S1 it diastole - when blood is flowing through mitral valve. So the more stenosed the valve, the inc. volume in the left atrium, and the faster it breaks through the stenosis so the decreased the interval is.
  • you normally shouldn’t hear any opening snap.
39
Q

Describe the S2 - opening snap interval in mitral stenosis.

A

The higher the early left atrial diastolic pressure, the earlier the opening snap will be.

  • The mitral valve opens the moment the pressure in the left atrium is higher than the pressure in the left ventricle.
  • So if the pressure in the left atrium is higher then the opening snap will occur sooner.

-the more severe the stenosis, the higher the steady state left atrium pressure in early diastole, and the shorter the S2-OS interval.

40
Q

JC virus

  • which virus family?
  • genome?
A

polyomaviridae

-naked dsDNA.

41
Q

PML

  • CSF analysis results?
  • does it enhance on MRI w/contrast?
A

Cerebrospinal fluid analysis is usually unremarkable, although the fact that PML does not enhance on MRI with contrast is a key feature.

42
Q

X-linked recessive

-2 features you’ll notice on a pedigree?

A

skipped generations & absence of male to male transmission.

43
Q

Glycogen breakdown

-where in the cell does it happen?

A

cytosol.

44
Q

Glycogen synthesis/breakdown

-where in the cell does it happen?

A

cytosol.

45
Q

Name 2 not-obvious Sxs of SLE:

A

Oral/nasopharyngeal ulcers, Neurologic disorders (e.g. seizures, psychosis).

46
Q

miglitol

-what is it?

A

like acarbose.

-α-glucosidase inhibitors

47
Q

Which cells make estriol?

A

placenta’s aromatase.

48
Q

normal PR interval:

A

200 msec

49
Q

1st degree AV block

  • Sxs:
  • Tx:
A
  • benign.

- no Sxs, no Tx.

50
Q

B-type (brain) natriuretic peptide

-who makes it?

A

ventricular myocytes.

51
Q

B-type (brain) natriuretic peptide

  • who makes it?
  • whats the recombinant form called?
A

ventricular myocytes.

-neseritide.

52
Q

pathological Q wave = sign of what?

A
  • q-wave is depol of IV septum.

- a pathological q-wave is sign of previous MI.

53
Q

why dont Ca channel blockers affect skeletal muscle?

A

these Ca channel blockers block the L-type Ca channel which is mechanically linked to ryanodine receptor in skeletal muscle only.
-skeletal muscle doesn’t rely on extracellular Ca - it relies on Ca from SR - so these Ca channel blockers dont affect it.

54
Q

Subarachnoid hemorrhage: prevents cerebral vasospasm w/which drug?

A

Nimodipine

55
Q

hydralazine

-how does it work?

A

inc. cGMP

- arteriolar vasodilation.

56
Q

hydralazine

-how does it work?

A

inc. cGMP
- arteriolar vasodilation.
* Frequently coadministered with a β-blocker to prevent reflex tachycardia.

57
Q

Poor wound healing & facial plethora

-Sxs of which disease?

A

Cushings.

58
Q

20 year old woman w/tumor at end of her femur epiphyses.

-whats the tumor?

A

giant cell tumor.

59
Q

What causes interstitial nephritis?

A
  • interstitial nephritis is an intrinsic cause of acute renal failure. Most often associated w/allergic rxns to drugs (as opposed to rhabdomyolysis for instance).
  • NSAIDs, diuretics, pencillin.
  • infections.
60
Q

renal papillary necrosis vs interstitial nephritis.

A

renal papillary necrosis = caused by ischemia, NOT by allergic reaction!
-interstitial nephritis is caused by allergic rxn to drugs and infections.

61
Q

What causes interstitial nephritis?

A
  • interstitial nephritis is an intrinsic cause of acute renal failure. Most often associated w/allergic rxns to drugs (as opposed to rhabdomyolysis for instance).
  • NSAIDs, diuretics, pencillin.
  • infections.
62
Q

Interstitial nephritis

-Sxs:

A

Associated with fever, rash, hematuria, and
costovertebral angle tenderness, but can be
asymptomatic.

63
Q

sideroblastic anemia

  • serum iron?
  • ferritin?
  • TIBC?
A
  • serum iron = inc.
  • ferritin = inc.
  • TIBC = dec.
64
Q

sideroblastic anemia

  • serum iron?
  • ferritin?
  • TIBC?
A
  • serum iron = inc.
  • ferritin = inc.
  • TIBC = normal/dec.
65
Q

brain tumor w/perivascular rosettes:

A

ependymoma.

66
Q

brain tumor w/perivascular rosettes:

A

ependymoma.

-cause hydrocephalus.

67
Q

Sirolimus (Rapamycin)

-mech:

A

-mTOR inhibitor = preventing IL-2 signal transduction.

68
Q

Link btwn volume depletion & dilated pupils.

A

volume depletion = high sympathetic tone = dilated pupils.

69
Q

Standard error of the mean

  • definition:
  • equation”
  • relationship to sample size:
A

-an estimation of how much variability exists between the
sample mean and the true population mean.
-SEM = σ/√n.
-inversely related to sample size.

70
Q

Diuretics & NSAIDs potential toxicity

A
  • diuretics => volume depletion.
  • kidneys release renin => AT2 to constrict efferent.
  • kidneys release prostaglandins to dilate afferent.
  • do both of these to maintain renal blood flow & GFR.
  • NSAIDs block prostaglandins dilation of afferent arteriole.
  • can go into acute renal failure.
71
Q

long thoracic nerve roots

A

C 5,6,7

72
Q

Acute transplant rejection

-whats the main cell involved?

A

CD8 T cell.

73
Q

Muscles that radial nerve innervates:

-mnemonic:

A

radial n. innervates the BEST.

  • brachioradialis
  • extensors
  • supinator
  • triceps.
74
Q

Where is the area postrema?

A

medulla.

75
Q

nondisjunction

-which step of mitosis is fucked up?

A

anaphase.

76
Q

NF1

-what type of gene? proto-onco? tumor suppressor?

A

Tumor suppressor.

77
Q

painless jaundice & palpable gallbladder

-Dx:

A

pancreatic cancer.

*choledocholithiasis presents w/pain and tenderness in the RUQ.

78
Q

painless jaundice & palpable gallbladder

-Dx:

A

pancreatic cancer.

*choledocholithiasis presents w/pain and tenderness in the RUQ.

79
Q

dont forget about the complement components that come in w/goodpastures.

A

these are what cause the breakdown of the basement membrane - Abs themselves dont do any damage!

80
Q

skin plaques and loss of eyebrows/eyelashes

-Dx?

A

lepromatous leprosy.

81
Q

child says “mama” and “dada”

-how old?

A

10 months.

82
Q

By age 2

-how many words does child say?

A

200

83
Q

By age 2

  • how many words does child say?
  • how many words per sentence?
A

200

-2 word sentences.

84
Q
  • xaban suffix

- which drugs?

A

factor Xa inhibitors.

-Xa-BAN - ban factor Xa.

85
Q
  • xaban suffix

- which drugs?

A

factor Xa inhibitors.

-Xa-BAN - ban factor Xa.

86
Q

Drugs that cause alopecia:

-mnemonic:

A

Propecia Every Day = PED
P = paclitaxel
E = Etoposide (& teniposide)
D = Doxorubicin (& daunorubicin)

Final FA review (52 decks)

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