5/11 Flashcards by Karin Lavie

Fanconi is a defect in…

reabsorption in PCT of kidney

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Bartter syndrome

aut rec defect in thick ascending loop of Henle

similar to loop diuretics

hypokalemia, metabolic alkalosis

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Gitelman syndrome

aut rec defect of NaCl in DCT

hypokalemia, metabolic alkalosis

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Liddle syndrome

Aut dom gain of function mutation: increase Na reabsorption in collecting tubules

presents like hyperaldosteronism- met alkalosis, hypertension, hypokalemia

treat- amilioride

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sydrome of apparent mineralocorticoid excess

hereditary def of 11beta-hydroxysteroid dehydrogenase (cant convert cortisol to cortisone)

excess cortisol stimulates MR–> hypertension, hypokalemia

or eating too much licorice

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renal tubular acidosis (RTA) type 1

DISTAL: defect in alpha interacalated cells to secrete H+–> no new HCO3 generated

urine pH > 5.5, hypokalemia, risk for Ca stones

causes: amphotericin B, congenital anomalies, analgesic nephropathy

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RTA 2

PROXIMAL: defect in PCT HCO3 reabsorption

urine pH<5.5; hypokalemia; risk for rickets

causes: Fanconi, CA inhibitors

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RTA type 4

hypoaldosteronism–> HYPERKALEMIC –> less NH3 synthesis in PCT –> less NH4 excretion

urine pH<5.5

causes:
- less aldosterone made: diabetic hyporeninism, ACEI, ARBs, NSAIDs, heparin, cyclosporine, adrenal insuff
- aldosterone resistance (K sparing diuretics, TMP/SMX)

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uremia

increase in BUN

nausea, anorexia
pericarditis
asterixis
encephalopathy
platelet dysfunction

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which drugs can cause acute interstitial nephritis

diuretics
nsaids
penicillins, cephalopsporins
PPIs
rifampin

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renal papillary necrosis associations

sickle cell
acute pyelonephritis
analgesics (NSAIDs)
DM

SAAD

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what is the type of junction in endothelial BBB?

tight junctions

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cryptococcus neoformans enters via which route?

respiratory

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asbestos on imaging

pleural thickening with calcification

posterolateral midlung zone (6-9th rib)

pleural effusions can occur

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how does fragile x mutation inactivate the gene?

once you get over 200 CGG repeats, the gene FMR1 becomes hypermethylated, silencing the gene

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Ghon complex

lower lobe lung lesion + ipsilateral hilar adenopathy (calcified lymph node)

seen in primary TB- initial infection

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Bloom syndrome

aut rec BLM mutation- defective helicase

growth retardation, facial anomalies, photosensitivity, immunodeficiency

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JAK kinase is a receptor for

GH, prolactin

cytokines

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insulin activation pathway

1) tyrosine kinase receptor
2) phosphorylate IRS
3) IRS then stimulates two pathways:
- RAS/MAP kinase (cell growth, DNA synthesis)
- PI3K (protein phosphatase)- glycogen, lipid, protein synthesis

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where on the antibody is the site for complement attachment (C1)

the higher Fc region (above phagocytic attachment site)

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anesthesia’s effect on brain

decrease vascular resistance (increase cerebral blood flow)

can lead to increased intracranial pressure

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which anesthetics are preferred in asthmatics

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halothane and sevaflurane- bronchodilation

since other anesthetics suppress mucociliary clearance–> atelctasis

inhaled anesthetics on kidney

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decrease GFR
increase vascular resistance
decrease RPF

what is the intrapleural pressure at FRC?

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-5 cm H20

what disease is silicosis associated with and why?

TB silicosis impairs macrophages

tibial nerve injury

from injury to popliteal fossa problem with foot inversion, plantar flexion, and toe felxion problem with sensory stimulation of plantar side of foot

which muscle most affected in rotator cuff injury

supraspinatus impingement between acromion and humeral head

symptoms of radial injury in the supinator canal

weakness on finger/thumb extension (finger drop) cause: repetitive pronation/supination movements extensor muscles and cutaneous stimulation fine because that would need a more proximal injury

bacteria that produce dextrans from sucrose

strep viridans

Afferent and efferent limbs of the carotid sinus baroreceptor

afferent- Hering branch of CN IX to the medulla efferent- CN X

symptoms of Meckel's diverticulum

painless GI bleeding possible intrussception- colicky pain and currant jelly stools

which drugs can help post-op urinary retention

muscarinic agonist (eg. bethenacol) alpha one antagonist

ACE effect on bradykinin

ACE usually degrades bradykinin so ACEI leads to increased bradykinin

bicuspid aortic valve complication

aortic stenosis around age 50

where in the lungs does TB reactive

upper lobe bear apex

where in the nephon is water reabsorbed the most?

proximal tubule (regardless of hydration status)

patients with MS develop which type of incontinence?

first: urge incontinence- detrusor overactivity from lack of CNS inhibition later- bladder becomes dilated and atonic- leading to overflow incontinence

which agents help treat urge incontinence

muscarinic antagonist

how does kidney try to compensate metabolic acidosis?

- increase HCO3 reabs. - increase H+ secretion - excrete buffers (HPO4, NH3) to combine with H+ to form H2PO4 and NH4

Is PAH secreted or reabsorbed?

secreted, not reasborbed

3 phases of acute tubular necrosis

1. initiation- 36 hours- ischemic or toxic injury 2. maintenance- 1-2 weeks- tube damage- oliguria, metabolic acidosis, hyperkalemia; necrosis and casts; decrease GFR 3. recovery- re-epithelization of tubules- GFR recovers, casts clear

recurrent pneumonia, absent vas deferens, digital clubbing. Think...

cystic fibrosis

what are sources of NAD+?

niacin, tryptophan

in hardy-weinberg, for a really rare aut rec disorder, what is p in the probability of being a carrier (2pq)?

p=1

what can help prevent wrong-site surgery?

independent verification of site by 2 health care workers

wet vs dry age-related macular degeneration

dry: gradual vision loss from chronic oxidative damage leading to subretinal inflammation and bm thickening- drusen deposits progressive thickening--> hyoxia--> VEGF--> wet: acute vision loss with metamorphopsia (distortion of straight lines). greyish-green subretina.

valproate teratogen anomaly

neural tube defect (meningocele...)

what causes annular pancreas

abnormal migration of the ventral pancreatic bud

what can happen when baby goes down canal with genital warts?

HPV can infect other stratified squamous epithelium, like true vocal cords- weak cry, stridor, hoarse can acquire respiratory papillomatosis

what can precipitate thiamine def/wernicke encephalopathy

glucose infusion because thiamine is a cofactor for one of the enzymes in glucose metabolism

what should be a clue that the maculopapular rash on the immigrant is rubella and not measles?

postauricular/occipital LAD rubella rash also faster?

myotonic dystrophy

aut dom CTG trinucleotide repeat disease for myotonia-protein kinase gene mostly affects type 1 fibers symptoms: slow relaxation of muscle (hard to loosen grip after handshake), cataracts, balding, gonadal atrophy

hypertensive crisis pathology

onion-like concentric thickening- hyperplastic arteriolosclerosis

hypothyroid myopathy

muscle pain, cramps and weakness of proximal muscles delayed tendon reflexes other symptoms of hypothyroidism present ELEVATED CK

5/11 Flashcards

(54 cards)