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Flashcards in 7/20 Deck (91)
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1

what can nitroprusside toxicity present as

cyanide poisoning

2

how can you treat cyanide poisoning

binding of cyanide ions:
tydroxycobalamin

induction of methemoglobinemia:
Sodium nitirite

Detoxifying sulfur donors:
sodium thiosulfate

3

what pts don't have an upper vagina with variable uterine development? normal ovaries and 2ndary sex characteristics

Mayer-Roitansky-Kuster-Hauser syndrome

AKA Mullerian aplasia

4

where does vasopressin work

medullary segment of the collecting duct, which is the deeper part (vs cortical segment)

5

what is the primary stimulator of respiration in healthy pts

PaCO2

6

what is the primary stimulator of respiration in COPD pts

response to PaCO2 is blunted, so hypoxemia becomes the important contributor to respiratory drive

PERIPHERAL CHEMORECEPTORS (AKA CAROTID BODIES) are primarily responsible for sensing arterial PaO2 and can be suppressed if you administer O₂ to a COPD pt

7

how do central chemoreceptors function

they're in the medulla, and
stimulated by decreased pH in the CSF

CO₂ readily diffuses through the BBB and forms H+ in the CSF, so
increased PaCO2 is the major stimulator of CENTRAL chemoreceptors

8

what heart abnormality is associated with Turner

Bicuspid aortic valve

9

what protein is released by eosinophils

Major Basic Protein

10

what is major basic protein's function

released by eosinophils to kill helminths

also contributes to epithelial damage sustained by pts with allergic asthma

11

what types of adenomatous polyps are found in colon

tubular, villous, and tubulovillous

according to histologic appearance

12

how does a villous adenoma in the colon present

larger, sessile, and more dysplastic (vs the other tubular adenomas)

they can cause bleeding, secretory diarrhea, and partial intestinal obstruction

can secrete large quantities of watery mucus!!! which leads to secretory diarrhea and electrolyte abnormalities

13

which type of colon adenoma poses the highest malignant potential

VILLOUOS > tubulovillous > tubular

VILLAINS ARE THE WORST

14

what is the buzzword for cauliflower-like colon projections

villous adenoma

they're large, sessile, and can have velvety or cauliflower-like projections

15

what does a colon tubular adenoma histology look like

dysplastic colonic mucosal cells that
form tube-shaped glands and
tend to be smaller and
pedunculated

16

what would you see in a hamartomatous polyp

disorganized mucosal glands, smooth muscle, and CT

may occur sporadically or with Peutz-Jeghers syndrome or Juvenile polyposis

these polyps can cause bleeding and intussusception, but
not secretory/mucos-y diarrhea

17

what would a hyperplastic polyp present like

well-differentiated mucosal cells that form glands and crypts

the crypts may be large or irregular but NOT dysplastic changes

almost always asymptomatic

18

what do signet ring cells look like

push nucleus to edge of cell with large central clearing

19

how do you use Hardy-Weinberg equation to calculate auto recessive questions

allele frequency = p + q = 1

phenotypic frequency = p^2 + 2pq + q^2 = 1

p^2 = frequency of NORMAL people (~1 in rare diseases)

2pq = CARRIER frequency (~2q in rare diseases)

q^2 = frequency of DISEASED people



when they give you disease prevalence (q^2), you can calculate the mutant allele frequency from the disease. (q).
take sqrt(disease prevalence) = q

carrier frequency:
this is probability of being a heterozygote
carrier = 2pq
for rare auto recessive disorders, p = 1, so
probability of being a carrier = 2q

so....
P(auto recessive disorder) =
1/4 [P(mom carrier) x P(dad carrier)]
which will come out to be:
1/4[(2q)x(2q)]

20

what is most likely to bleed in epistaxis

nasal septum, containing the
Kiesselbach plexus

anterior ethmoidal, sphenopalatine, and superior labial arteries anastomose this region

21

what is the MOA for bisphosphonates

similar to pyrophosphate- they attach to hydroxyappetite binding sites and inhibit bone respiration by MATURE osteoclasts

22

what is the MOA for SERMs

they slow the rate of bone loss by inhibiting differentiation and maturation of pre-osteoclasts

23

what is the MOA for interferons alpha and beta

produced in response to viral infections

they help suppress viral replication by halting protein synthesis and promoting apoptosis in infected cells, to limit the virus's ability to spread

24

what should you be suspicious of in a middle aged/older pt with iron-deficiency anemia but no "real" symptoms that jump out at you

occult blood loss from GI tract

this could even be if the pt denies bloody stools, menorrhagia, or any other sort of bleeding

25

what do pressure values look like when a pt has an inferior wall MI with complete occlusion of the proximal RCA?

this pt has a RV presents with hypotension, elevated JVP, and clear lungs

most often occurs in setting of LV inferior wall MI due to proximal RCA occlusion

present with:
high RA pressure (JVD, high CVP)
high Central venous pressure (RV dysfunction--> backup blood)
low PCWP (blood isn't making it to the LA)
low cardiac output (LV

26

what characteristics does a Barr body have

it's an inactivated X chromosome in females' genetics

it's compact heterochromatin

heterochromatin is densely packed, heavily methylated DNA in tight association with DE-acetylated histones and a low level of transcriptional activity.

27

what is reactive arthritis associated with

it's associated with HLA-B27 seronegative (Rh negative) arhtropathies

28

what lab value is always low in the congenital adrenal hyperplasias?

cortisol/glucocorticoids

that's why they don't make it in the "arrow" trick

29

what can sickle cell cause to femoral head most commonly

osteonecrosis (avascular necrosis)

2/2 impaired blood supply to that bone segment

30

what is contraindicated in hereditary angioedema

ACE inhibitors

this disease causes activation of bradykinin, C3a, and C5a (2/2 lack of C1 esterase inhibition)
so you have lots of vasodilation and vascular permeability