April 1 - Cardio, Psych, Derm Flashcards Preview

Designated study period: daily cards > April 1 - Cardio, Psych, Derm > Flashcards

Flashcards in April 1 - Cardio, Psych, Derm Deck (41):
1

Embryologic development of venous system

Three systems during development
1. Umbilical veins: connnect to placenta; degenerate
2. Vitelline veins: drain yolk sac; become portal system, including SMA, etc
3. Cardinal veins: become systemic circulation
In fetus, all drain to the sinus venosus (primitive part of heart)

2

Wolff-Parkinson-White syndrome: EKG findings, pathophys, complications

EKG: short PR interval (QRS comes right after P wave), delta wave (early activation of ventricle via bypass tract)

Pathophys: extra bypass tract that can conduct in both directions between atria and ventricles. Sets up for AV re-entrant tachycardia in which loop occurs through bypass tract and AV node

Complication: A fib can be life threatening because can conduct to ventricles through bypass tract. Need to avoid meds that slow AV node conduction as they increase flow through bypass tract

3

Myocardial ischemia: timing and effects

ATP decreases and results in loss of contractility within 60s of total myocardial ischemia.

Ischemis less thatn 30 mins reversible but with prolonged myocardial dysfunction for a few days after restarting blood flow

Ischemia longer than 30 mins results in large decrease in ATP with loss of cell homeostasis and irreversble injury

4

Risk factors for aortic dissection

HTN is single number one risk factor

5

NO synthase

Converts arginine + NADPH + O2 to NO

6

Brachiocephalic vein

External jugular drains scalp and lateral face to R subclavian vein. R subclavian vein drains arm and dumps to brachiocephalic.

IJV drains brain, neck, face and dump into brachiocephalic.

R lymphatic duct also drains to brachiocephalic

7

Other condition associated with congenital QT prolongation

Sensorineural deafness

8

Phenoxybenzamine

Irreversible alpha1 and alpha2 antagonist used to treat pheochromocytoma

9

Phentolamine

Reversible competitive alpha antagonist used to catecholamine induced HTN crisis

10

Fenoldopam

Peripheral D1 agonist that causes vasodilation, esp of renal artery, leading to diuresis and natriuresis.

11

Cilostazol

Decreases platelet activation and causes direct arterial vasodilation. Used in PAD

12

Segmented viruses

Orthomyxoviruses, reoviruses, bunyaviruses, arenaviruses

13

Burkitt lymphoma translocation

t(8;14) c myc and IgH

14

Calcineurin inhibitors; names, MOA, ADRs

Names: cyclosporine and tacrolimus

MOA: inhibit calcineurin, preventing activation of NFAT and production of I-2

Use: Autoimmune disease and transplants

ADRs: DDIs through CYP metabolism. Nephrotoxicity (constricts renal vessels) leading to HTN. Increased uric acid, hyperglycemia. Cyclosporine also causes gingival hyperplasia and hirsutism

15

Sirolumus: MOA, ADRs

Also called rapamycin

MOA: Inhibits mTOR, decreasing response to IL-2, decreasing B and T cell proliferation

ADRs: marrow suppression, hyperlipidemia, hyperglycemia

16

Methotrexate: MOA, ADRs

MOA: Inhibits dihydrofolate reductase. Prevents conversion of dUMP to dTMP, which requires THF.

ADRs: myelosuppression that is reversible with leucovorin/folinic acid. Stomatitis/mucositis. Abnormal LFTs

17

Cyclophosphamide: MOA, use, ADRs

MOA: alkylating agent that causes cross linking of DNA, inhibiting DNA replication

ADRs: myelosuppression, hemorrhagic cystitis (decreased with hydration and mesna), SIADH

Use: vasculitis, glomerulonephritis, chemo

18

Infliximab: MOA, use, ADRs

MOA: anti-TNF monoclonal
Use: RA and Crohns disease
ADR: can reactivate TB

19

Etanercept: MOA

Decoy receptor for TNF alpha

20

Linezolid: use and ADR

Antibiotic that treats resistant gram positive bugs. Has MAOI activity and can precipitate serotonin syndrome in someone on SSRI

21

Alcoholism pharmacotherapy

1. Disulfiram
2. Naltrexone: blocks rewarding/reinforcing effects of alcohol and decreases cravings, only one that can be initiated while still drinking
3. Acamprosate: modulates glutamate transmission at NMDA receptor

22

Fluphenazine

High potency first gen antipsychotic, similar to haloperidol

23

Thioridazine

Low potency first gen antipsychotic, similar to chlorpromazine

24

TCAD- how cause arrhythmias

Cause QT prolongation and QRS widening at high dose by blocking Na+ channels. Leads to arrhythmias

25

Transferance vs displacement

Transference: Shifting of emotions or desires associatied with person from PAST to person in PRESENT

Displacement: Expressing unacceptable feelings meant for someone else in present life to someone safer

26

Akathisia

Extrapyramidal side effect. Restlessness, inability to sit still, occurs days to weeks after starting antipsychotic.

27

Tourette disorder diag criteria and treatment

Both multiple motor and 1+ vocal tic (grunting, throat clearing, yelling, etc). Lasts over a year and onset before age 18

Treatment: antipsychotics, alpha agonists, behavioral therapy

28

Schizophreniform vs schizophrenia

Phreniform: 1-6mos
Phrenia: over 6 mos

29

Narcolepsy diag test

Low hypocretin-1 in CSF

30

Chronic lymphedema complication

Angiosarcoma 10 yrs later

31

Bullous pemphigoid vs pemphigus vulgaris

Bullous pemphigoid: ABs against hemidesmosomes
Pemphigus vulgaris: ABs against desmosomes

32

Intraductal papilloma

Most common cause of bloody nipple discharge. Papillary cells around fibrovascular core.

33

Fibrocystic change

Diffuse small cysts +/- metaplasia. Cyclic breast pain

34

Fibroadenoma

Small firm mobile mass. Proliferation of stroma and ducts. Stroma can compress ducts to slits.

35

Perineal body

Separates urogenital and anal triangles. Midline epidiotomy goes to it

36

Tuberous sclerosis

Auto dom. Renal angiomyolipomas, brain hamartomas, cardiac rhabdomyomas, ash leaf patches

37

Alkaptonuria

Tyrosine metabolism disorder (Can't convert tyrosine to fumarate). Deficient homogentisic acid dioxygenase. Black color to urine, black pigment on collagen, arthropathy in adulthood

38

Malformation

Intrinsic cell or tissue defect leads to chain of downstream effects.

39

Deformation

Caused by extrnisic mechanical forces

40

Disrupation

Breakdown of previously normal tissue

41

Theophylline intoxication

Seizures, tachyarrhthmia