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Flashcards in 4/3 - UW 43 Deck (55):
1

What process mediates the exopthalmos seen in Grave's disease?

Lymphocytic infiltrates in the extraocular tissue causes edema and activates retro-orbital fibroblasts to produce glycosaminoglycans, pushing out the eye.

2

Diffuse injury to the lung vascular endothelium and/or alveolar epithelium that is NOT from cardiogenic causes characterizes what syndrome?

Acute Respiratory Distress Syndrome

3

Nyctalopia (night blindness) and dry skin suggest deficiency of what vitamin?

Vit. A

4

A strict vegetarian diet predisposes to deficiency of what vitamin?

B12, cobalamin

5

Mucocutaneous bleeding (epistaxis, petechiae) suggests what?

Platelet defect

6

Deep tissue bleeding into joints, muscles, and subcutaneous tissue suggests what?

Coagulopathies

7

What vitamin is an essential component of NAD and NADP?

Niacin

8

What AA is a precursor to endogenous production of niacin?

Tryptophan

9

What is Arginine a precursor to?

NO, urea, ornithine, agmatine, creatine

10

What is Orotic acid a precursor for?

Pyrimidine

11

What is the precursor for Creatine?

Arginine

12

What is the precursor for Pyrimidine?

Orotic acid

13

What two variables should be checked in working up a metabolic alkalosis?

Volume Status
Urine Chloride

14

What are the most common causes of metabolic alkalosis?

1. Loss of HCl (low urine Cl, correct w saline)
2. Thiazide or Loop Diuretics (high urine Cl, correct w saline)
3. Mineralocorticoid excess (high aldosterone OR cortisol, high urine Cl, NOT corrected by saline)

15

Why does vomiting-induced metabolic alkalosis have low urine Cl?

Loss of HCl through vomiting. Low Cl decreases renal Cl excretion, which decreases HCO3 excretion, worsening the alkalosis

16

Calcification or aneurysm of what vessel would lead to a unilateral nasal hemianopia?

Internal carotid, which would impinge on uncrossed, lateral retinal fibers

17

Where would a lesion be to cause a "pie in the sky" lesion?

Contralateral temporal lobe (Meyer's loop)

18

Where would a lesion be to cause a "pie on the floor" lesion?

Contralateral parietal lobe (dorsal optic radiation)

19

What is the name of the process that marks a protein for degradation?

Ubiquitination

20

What are the 3 genes that help promote protein degradation, and mutations can lead to Parkinson?

Parkin
PINK1
DJ-1

21

Which one has more transcriptional activity, heterochromatin or euchromatin?

Euchromatin (loosely arranged chromatin), formation is promoted by histone acetylation

22

What is the transporter for glucose into pancreatic beta cells?

GLUT 2

23

What molecule affects the opening/closure of potassium channels in pancreatic beta cells?

ATP closes it (produced from glycolysis of glucose, pumped in by GLUT2)

24

What happens after ATP closes the potassium channels in pancreatic beta cells?

Cell membrane depolarizes, opening Ca channels. Ca influx leads to insulin release

25

What enzyme forms the covalent cross links between collagen fibrils?

Lysyl oxidase

26

What congenital syndrome is associated with cleft palate and polydactyly?

Patau syndrome (trisomy 13)

27

What congenital syndrome is associated with macroorchidism and a long face?

Fragile X syndrome

28

What 2 drugs can be used in lieu of exercise to test exercise-induced ischemia?

Adenosine and Dipyridamole (both selectively vasodilate coronary vessels)

29

What congenital syndrome is associated with endocardial cushion defects?

Down syndrome

30

What serious side effect can result from using Ticlodipine?

Neutropenia

31

What antiplatelet is associated with neutropenia?

Ticlodipine

32

What antiplatelet has the same MOA as clopidogrel?

Ticlodipine (ADP antagonist)

33

What 2 antiplatelets are ADP antagonists?

Clopidogrel and Ticlodipine

34

What DM medication acts by binding to PPAR-y?

Thiazolidinediones (TZDs), increasing insulin sensitivity

35

What is the worst side effect of amphotericin B?

Renal toxicity (renal vasoconstriction and lowered GFR, ATN) causing hypOkalemia and hypOmagnesemia

36

What two ions can be lost when using amphotericin B, and should be supplemented?

K and Mg

37

What are 2 main factors that increase risk of CV events due to oral contraceptives?

Age over 35
Smoking

38

Which Arnold-Chiari malformation is more severe?

Type II: symptomatic in the neonatal period, with abnormal cerebellum and medulla

39

What congenital disease causes low-lying cerebellar tonsils that extend below the foramen magnum, causing headaches and ataxia in adulthood?

Arnold-Chiari malformation TYPE I

40

What hepatic enzyme can metabolize pro-carcinogens into carcinogens?

Cytochrome P450 monooxygenase

41

Vasculitis with IgA and C3 deposition = ???

Henoch-Schonlein purpura

42

"Saddle nose" and oliguria = ???

Wegener's (c-ANCA_

43

Weak upper extremity pulses?

Takayasu arteritis

44

What are common clinical manifestations of Hemochromatosis?

Hepatomegaly, abd pain, skin hyperpigmentation, DM (pancreatic islet destruction), impotence, arthropathy, cardiac dysfunction (arrhythmias and cardiomegaly)

45

Why might you give "zosin" drugs? MOA?

Treatment of BPH and HTN (alpha1 blockers)

46

What is the first line treatment of essential HTN in the general population?

HCTZ

47

What is the difference between adult-type and infantile aortic coarctation?

Adult: stenosis is post-ductal

Infantile: stenosis is pre-ductal

48

What arteries are spared in Polyarteritis nodosa?

Pulmonary

49

What are some NNRTIs?

Nevirapine
Efavirenz
Delavirdine

50

What are the most concerning side effects in patients taking NNRTIs?

Acute onset flulike sx, abd pain, and jaundice may indicate HEPATIC FAILURE with ENCEPHALOPATHY

51

When are severe hepatotoxic reactions most likely to occur when using NNRTIs?

Within the first 6 weeks

52

Which HAART agent is most likely to cause severe hepatic disease?

NNRTIs

53

Which HAART agent is Ritonavir?

Protease Inhibitor

54

Which HAART agent is Enfuvirtide?

Fusion Inhibitor (binds to gp41)

55

What does the Wright-Giemsa stain?

rRNA