6.26.16 Flashcards
(189 cards)
1
Q
obstructive sleep apnea: pathophys
A
sleep –> upper airway –> recurrent obstruct –> reduce ventilation –> transient hypercapnia, hypoxemia:
- reflexive systemic & pulm vasoconstrict
- sym cardiac stim
2
Q
differentiate: class IA vs IB antiarr –> preferentially bind?
A
IC: open Na channel –> areas of normal automaticity
IB: inactivated Na channel –> areas of ischemia –> rapidly depolarize
3
Q
class IA antiarrh: MOA
A
1) block Na channel –> depress phase 0 depolarization
2) moderate block K channel –> prolong repolarization
==> increase AP duration
4
Q
injure cervical symp ganglia –> manifestation?
A
Horner synd
5
Q
heroin withdrawal: key ssx
A
- dilated pupil
- yawn
- lacrimation
6
Q
alcohol withdrawal w adv liver dz –> tx?
A
benzo without active metabolites –> lorazepam, oxazepam, temazepam
7
Q
absence + tonic clonic sz –> tx?
A
valproate
8
Q
what is: permissiveness
A
hormone allow another to exert its max effect
9
Q
Dx: “bunches of grapes”
Caused by?
A
complete mole
trophoblast prolif
10
Q
Dx: low LPL
A
familial chylomicronemia synd
11
Q
how is copper eliminated?
A
secrete into bile –> excreted in stool
12
Q
absence + tonic clonic sz –> tx –> ethosuximide?
A
no –> does not suppress tonic clonic sz
13
Q
what is: celecoxib
A
selective COX2 inh
14
Q
spasticity: clinical presentation
A
- muscle stiff
- painful muscle spasm
- scissoring gait
- lack of dexterity
15
Q
T/F: familial hyperchol –> premature coronary artery dz?
A
T
16
Q
dystrophin: fx
A
allow interaxn bw extracell CT & intracell contraction apparatus
17
Q
what hormone exerts permissiveness?
A
cortisol
18
Q
alcohol/benzo withdrawal: key ssx
A
sz
19
Q
nitrate: MOA
A
vasc smooth muscle relax –> systemic vasodilate –> decrease LVEDV, wall stress –> decrease preload –> decrease myocardial O2 demand –> relieve angina ssx
20
Q
what cytokines are produced in response to viral infect?
A
IFN a & B
21
Q
suspensory lig of ovary: contains?
A
ovarian A, V, N, lymphatics
22
Q
How do IFN a & B halt protein syn in virus infected cells?
A
signalling –> transcribe antiviral enzymes that can halt protein syn –> become active only in presence of dsRNA ==> inh protein syn only in virus infected cells
23
Q
radial N injury: cause
A
repetitive pressure/trauma at axilla
24
Q
huntingtin protein –> expand CAG trinucleotide repeats: effect?
A
gain of fx –> increase histone deacetylation –> repress transcription (silence) –> no neurotrophic factors –> neuron cell death
25
what is: lipid A
toxic component of LPS
26
difrerentiate: Duchenne vs Becker musc dystrophy --> type of mutation?
DMD: deletion --> frameshift
BMD: deletion --> no frameshift
27
2ndary bact pneumonia: 3 most common org
```
#1 strep pneumo
#2 staph aureus
#3 H flu
```
28
UV damaged DNA: repair mechanism?
nucleotide excision repair
29
renal A stenosis: who?
- elder (atherosclerosis)
| - F of childbearing age (fibromusc dysplasia)
30
alcohol withdrawal --> tx?
benzo
31
"-cept" suffix: what kind of drug?
receptor mole
32
complete mole: karyotype?
46 XX or XY (paternal DNA only)
33
patella fracture: ssx
- acute swollen knee
- focal patella tender
- can't extend knee against gravity
- palpable gap in extensor mechanism
34
complete mole: immunohist? why?
p57-
absence of maternal genome
35
ant cmpt of leg --> acute compartment synd --> will affect what struct?
- deep peroneal (fibular) N
| - ant tibial A & V
36
infraorbital N injury: ssx
paresthesia:
- upper cheek
- upper lip
- upper gingiva
37
T/F: familial dysbetalipoproteinemia --> premature coronary artery dz?
T
38
septic shock: ssx
- fever
- hypotension
- diarrhea
- oliguria
- vasc compromise
- DIC
39
CT: location of esophagus
- bw trachea & vertebral bodies
| - typically collapsed w no visible lumen
40
what type of dyslipidemia: tendon xanthoma
hyperchol
41
what can damage iliohypogastric N?
abd surg --> appendectomy
42
antipsychotics --> block CNS D2 receptor --> AE?
disrupt tuberoinfundibular pathway --> hyperprolactinemia --> galactorrhea, amenorrhea
43
what are the hydrophobic aa?
- alanine
- valine
- leucine
- isoleucine
- phenylalanine
- tryptophan
- methionine
- proline
- glycine
44
colchicine: MOA
bind tubulin --> inh microtubule formation --> impair neutrophil mitosis, chemotaxis
45
complete mole --> treated --> must monitor what? why?
B-hCG
high risk for malig transformation --> invasive mole, choriocarcinoma
46
"-nib" suffix: what kind of drug?
kinase inh
47
norovirus gastroenteritis: ssx
- vomit
| - watery diarrhea
48
decreased V compliance --> leads to?
diastolic heart fail
49
Dx: unilat kidney atrophy
renal A stenosis
50
diastolic heart fail --> effect on: LVEF, LVEDV, LV filling pressure
- LVEF: normal
- LVEDV: normal
- LV filling pressure: increased
51
lactose intolerance: pathophys
lactase def
52
heroin is what type of subst?
opioid
53
Duchenne musc dystrophy: who?
2-5yo M
54
pernicious anemia: pathophys
autoimmune --> CD4+ T cells --> destroy parietal cell
55
IFN a & B: role in viral infect
suppress viral replication:
- halt protein syn
- promote apoptosis of infected cells
==> limit virus ability to spread
56
baclofen: MOA
GABA-A receptor agonist --> decrease excitability of spinal reflexes
57
radial N injury: motor findings
weak extensors:
- forearm
- hand
- finger
==> wrist drop, absent triceps reflex
58
direct frontal trauma to orbit --> fractures what?
orbital floor
59
name a microsomal monooxygenase
CYP450
60
cortisol --> permissiveness --> effect?
- increase glucose release by liver in response to glucagon
| - increase vasc & bronchial SM reactivity to catecholamines
61
dystrophin gene: location
X chrom p21
62
what mutation causes mast cell prolif?
KIT
63
norovirus outbreaks: where?
school, cruise ship, nursing homes
64
CYP450 --> role in carcinogen?
convert pro-carcinogen to active carcinogen
65
lipid A: pathophys
activate macrophage --> widespread IL-1, TNFa release --> septic shock
66
complete mole: US
diffuse echogenic material --> "snowstorm"
67
tuberoinfundibular pathway: fx
inh prolactin secretion
68
major basic protein: where? fx?
eosinophil granules --> help defend against parasite
69
X chrom p21 mutation --> dx?
DMD or BMD
70
complete mole: high B-hCG --> leads to?
- hyperemesis gravidarum
| - theca lutein cysts (d/t stim ovarian growth)
71
direct impact to ant aspect of knee --> leads to?
patella fracture
72
what induces CYP450?
- carbamazepine
- barbiturates
- phenytoin
- rifampin
- griseofulvin
- St John's wort
- modafinil
- cyclophosphamide
73
etanercept: use
mod-severe RA --> adjunct to methotrexate if methotrexate alone not work
74
dx: wrist drop, absent triceps reflex
radial N injury
75
differentiate: alcohol vs benzo withdrawal
alcohol: delirium
benzo: no delirium
76
what type of dyslipidemia: acute pancreatitis
familial chylomicronemia synd
77
radial N injury: sensory findings
sensory loss:
- post arm, forearm
- dorsolat hand
- dorsal thumb
78
Duchenne musc dystrophy: pathophys
dystrophin deletion
79
skeletal muscle contraction: Ca2+ fx?
SR --> release Ca2+ --> bind troponin C --> allow actin to bind myosin
80
what is: power
probability of seeing a difference when there is one
81
what is: B-endorphin
endogenous opioid peptide
82
how does sun exposure cause DNA damage?
UV --> create pyrimidine dimers
83
Dx: dilated pupils, piloerection, hyperactive bowel sounds, lacrimation, yawning
opioid withdrawal
84
nigrostriatal pathway: fx
regulates coordination of vol mvmt
85
ipsilat shoulder pain, upper limb paresthesia, areflexic arm weak --> what struct is injured?
brachial plexus
86
etanercept: MOA
decoy receptor for TNFa --> inh TNFa
87
acute pancreatitis: 2 most common causes
```
#1 gallstone
#2 alcohol abuse
```
88
where is: cerebellopontine angle
bw cerebellum & lateral pons
89
Dx: macrocytosis, AST:ALT >2
chronic alcohol use
90
what type of dyslipidemia: eruptive skin xanthoma
hyperTG
91
spasticity is a common problem in what dz?
mult sclerosis
92
what stimulates gastric acid secretion?
- histamine
- ACh
- gastrin
93
acoustic neuroma: common location
cerebellopontine angle
94
auer rod found in what cell?
myeloblast
95
radical mastectomy w axillary lymph node dissection: comp
chronic lymphedema --> angiosarcoma
96
what is: systemic mastocytosis
abnormal prolif of mast cells --> increase hist release
97
acoustic neuroma: ssx
- sensorineural hearing loss
| - tinnitis
98
chlordiazepoxide: drug class?
benzo
99
Duchenne musc dystrophy: how does it manifest?
- proximal muscle weak
| - distal muscle enlarge
100
acute compartment synd: most common location
ant cmpt of leg
101
acute compartment synd: ssx
- severe pain
- myonecrosis
- N injury
102
protein --> mult a-helical regions --> composed of valine, alanine, isoleucine --> what is the fx of this region?
anchor to cell membrane
103
complete mole: trophoblast secretes?
B-hCG
104
contact dermatitis: what happens with chronic exposure?
lesions become less edematous --> stratum spinosum & corneum thicken
105
status epilepticus: initial tx
IV lorazepam + phenytoin
106
differentiate: opioid vs alcohol/benzo withdrawal: how serious?
- opioid: non-life threatening
| - alcohol/benzo: sz
107
iliohypogastric N: fx
sensory:
- suprapubic
- gluteal
motor:
- ant-lat abd wall muscles
108
orbital floor fracture --> why is vertical gaze impaired?
inf rectus M become entrapped
109
compound nevus: lesion
slight raised papule --> uniform pigment, symm sharp border
110
can HTN lead to hypertrophic cardiomyopathy?
no
111
familial chylomicronemia synd: onset?
childhood
112
Dx: Gower sign & calf enlargement
DMD
113
what is the major blood supply to the ovary?
ovarian A
114
carbamazepine: MOA
reduce Na channel ability to recover from inactivation --> inh neuronal high-freq firing
115
phenytoin: MOA
Na channel --> decrease ability to recover from inactivation --> inh neuron high freq firing
116
MI --> ventricular arrhythmia --> tx?
amiodarone
117
high levels of what decrease risk for gallstone?
bile salt & phosphatidylcholine --> increase chol solubility
118
carbamazepine: need to monitor what? why?
BM suppress --> monitor CBC
119
what inflamm dz can cause 2ndary (acquired) lactose intolerance?
celiac dz
120
what infection can cause 2ndary (acquired) lactose intolerance?
giardia
121
obstructive hydrocephalus: ssx
- papilledema
- HA
- vomit
122
what type of dyslipidemia: xanthelasma
hyperchol
123
what does proopiomelanocortin (POMC) produce?
- B-endorphins
- ACTH
- MSH
124
tachycardia, HTN, hyperthermia, diaphoresis, mydriasis --> intoxicated w what subst?
stimulant
125
familial chylomicronemia synd: clinical manifestation
- recurrent acute pancreatitis
- hyperTG
- lipemia retinalis
126
what is: infliximab
monoclonal Ab --> irrev bind & inh TNF-a
127
what is: Gower sign
use hands to get up --> compensate for proximal muscle weak
128
defect in nucleotide excision repair --> leads to?
xeroderma pigmentosum
129
nucleotide excision repair: MOA
1) endonuclease complex --> recog deformed helix --> single strand cleavage on both sides
2) damaged segment discarded
3) DNApol --> synthesize new segment
4) DNA ligase --> ligate gap
130
dorsal midbrain (Parinaud) synd: charact
- limited upward gaze
- bilat eyelid retraction
- light-near dissoc (pupil react to accommodation but not to light)
131
what is: Stewart-Treves synd
chronic lymphedema --> predispose to angiosarcoma
132
nicotine withdrawal: key ssx
increased appetite
133
when is LPS released?
bacterial cell:
- divide
- lyse
LPS is NOT actively secreted!
134
contact dermatitis: histology
spongiosis --> accumulation of edema fluid in intercell spaces of epidermis
135
systemic mastocytosis: ssx
- hypotension
- flushing
- pruritis
- gastric hypersecrete
136
germinoma: clinical presentation
- obstructive hydrocephalus
- dorsal midbrain (Parinaud) synd
- endocrinopathy (if in suprasellar region --> pit/hypo dysfx)
137
stimulant (cocaine, amphetamine) withdrawal: key ssx
- intense psychomotor retardation
| - severe depression ("crash")
138
what is the precursor to nitric oxide?
arginine
139
contact dermatitis: gross findings
erythematous, papulovesicular, weeping lesions
140
complete mole: composed of?
edematous hydropic villi --> "bunches of grapes"
141
radial N: fx
motor: extensors --> forearm, hand, finger
sensory:
- post arm, forearm
- dorsolat hand
- dorsal thumb
142
Dx: benign prolif of melanocytes --> dermis & epidermis
compound nevus
143
giardia --> can lead to?
lactose intolerance
144
acid a-glucosidase: fx
brkdown glycogen in lysosome
145
lots of auer rods can be found in what dz?
acute promyelocytic leukemia
146
IV lorazepam + phenytoin for initial tx of status epilepticus --> role of each?
lorazepam: stop sz
phenytoin: prevent sz recurrence
147
signs of radial N injury but triceps brachii is spared --> dx?
distal radial N injury
148
what nerve is found at the orbital floor?
infraorbital N
149
what is: status epilepticus
- 1 sz --> >5min
| - mult sz --> incomplete recovery of consciousness bw episodes
150
Pompe dz: ssx
early infancy:
- cardiomegaly
- macroglossia
- profound musc hypotonia
151
alcohol abuse: liver lab finding?
>2 AST: ALT
152
what is: spasticity
- increase resistance to passive muscle mvmt
| - velocity-dep increase in tonic stretch reflex
153
2ndary (acquired) lactose intolerance: pathophys
inflamm, infect --> damage microvilli --> damage cells slough off --> immature cells replace --> low lactase
154
brain, spinal cord dz --> spasticity --> tx?
- baclofen
| - tizanidine
155
gamma-glutamyl transpeptidase (GGTP): use
GGTP predominantly present in hepatocytes & biliary epithelia --> determine whether elevated alk phos is of hepatic of bony origin
156
acid a-glucosidase def --> leads to?
Pompe dz
157
power: calc
1-B
B = type II error rate
158
what is: auer rod
deformed azurophilic granules in myeloblast cyto --> stain positively for myeloperoxidase
159
improperly fitted crutches --> lead to?
"crutch palsy" (proximal radial N injury)
160
what is: eczematous dermatitis
grp of conditions charact by erythematous, papulovesicular, weeping lesions
161
hypertrophic cardiomyopathy: pathophys
AD --> cardiac sarcomere --> severe myocardial hypertrophy
162
Duchenne musc dystrophy: mode of inheritance
XR
163
trigeminal neuralgia --> tx?
carbamazepine
164
nitric oxide synthase: rxn
arginine --> nitric oxide
165
what inh CYP450?
- amiodarone
- cimetidine
- fluoroquinolone
- clarithromycin
- azole antifungal
- grapefruit juice
- isoniazid
- ritonavir (protease inh)
166
cryptococcus neoformans: most common manifestation
meningoencephalitis
167
what is another name for the suspensory lig of ovary?
infundibulopelvic lig
168
elder --> insomnia --> tx?
ramelteon
169
acoustic neuroma: derived from?
vestibulocochlear N --> vestibular portion --> Schwann cell
170
what is: suspensory lig of ovary
fold of peritoneum that attach ovary to pelvic sidewall
171
what part of brain is responsible for inh prolactin secretion?
tuberoinfundibular pathway
172
what is the major form of copper in the human body?
ceruloplasmin
173
alcohol withdrawal: ssx
- insomnia
- tremulous
- anxiety
- autonomic hyperactivity
174
dx: suprapubic region --> decrease sensation, burning pain
iliohypogastric N injury
175
obstructive sleep apnea: comp
- systemic HTN
| - pulm HTN --> RH fail
176
Pompe dz: muscle bx
lysosomes --> abnormal glycogen accumulation
177
to avoid excessive bleed during oophorectomy, the surgeon should ligate what struct?
suspensory lig of ovary
178
what is the most common pineal gland tumor?
germinoma
179
T/F: familial chylomicronemia synd --> premature coronary artery dz?
F
180
familial chylomicronemia synd: enzyme
lipoprotein lipase
181
mesolimbic & mesocortical pathway: fx
regulate cognition, beh
182
what are the major dopaminergic pathways in the brain?
- mesolimbic & mesocortical
- nigrostriatal
- tuberoinfundibular
183
angiosarcoma: RF
chronic lymphedema
184
complete mole: classic clinical findings
- 1st trimester --> vaginal bleed
- enlarged uterus inconsistent w dates
- extremely high B-hCG
185
viral gastroenteritis: #1 cause?
norovirus
186
acute compartment synd: cause
increased pressure in fascial compartment of limb --> impair perfusion
187
E.coli --> septic shock --> what bacterial factor caused it?
lipid A
188
Pancoast tumor: can involve what struct?
- brachial plexus
| - cervical sym ganglia
189
Pompe dz: enzyme?
acid a-glucosidase
