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Flashcards in April 6 Deck (37)
1

What does carotid sinus massage lead to?

Increased afferent firing from the carotid sinus--increasing vagal parasympathetic tone
--slowing conduction through the AV node and prolonging AV nodal refractory period--help to terminate reentrant tachycardias

2

What type of breathing is associated with advanced CHF?

Cheyne-Stokes breathing-- cyclic breathing with period of apnea followed by gradual increase in TV until next apnea episode

3

What is the MOA of trastuzumab?

Monoclonal antibody against HER-2 (c-erbB2)--a tyrosine kinase receptor

4

What 2 substances are responsible for taking naive CD4+ T-cells and differentiating them to Th1 cells?

IL-12
IFN-g

5

What substance is responsible for taking naive CD4+ T-cells and differentiating them to Th2 cells?

IL-4

6

What is the hormone that binds an intracellular receptor to maintain normal glucose levels during prolonged fasting?

Cortisol

7

What two antibodies can be present in pts with RA and which one is more specific?

Rheumatoid factor--autoantibodies targeting the Fc portion of human IgG

Anti-cyclic citrulinated peptide antibody--more specific

8

What are hamartomas and where are they most likely to occur?

Excessive growth of tissue type native to the organ of involvement

Most likely to occur in the lungs as well-defined coin lesion with popcorn calcifications
--composed of disorganized cartilage,fibrous and adipose tissue

9

What is the difference btw Schizophrenia and schizophreniform disorder?

Schizophreniform disorder has all the same characteristics as Schizophrenia but has only lasted 1-6 months

10

UV light is involved in the conversion of what to ultimately produce Vit D?

7-dehydrocholesterol ---> Vit D3 (cholecalciferol)

1st step in synthesis

11

Infants with hydrocephalus typically develop what?

Macrocephaly
Poor feeding
Muscle hypertonicity
Hyperreflexia

Last 2 are caused by UMN lesion caused by stretching of the periventricular pyramidal tracts

12

What step of the citric acid cycle produces GTP?

Succinyl-CoA----> Succinate by succinyl-CoA synthetase

13

Pt who is left dominant--what artery is going to feed the AV node?

Circumflex artery---feeding the posterior descending artery

Right dominant pt--MOST COMMON--supplied by RCA

14

What is typically indicative of irreversible cell injury?

Mitochondrial vacuolization

15

What type of collagen is deposited within the myocardium 2 wks into the healing process after MI--the final stages of healing from MI?

Type I collagen

Most abundant collagen in the body and primary collagen of mature scar

16

What fetal vessel has the highest O2 content?

Blood enters the fetus through the umbilical vein via the ductus venous into the IVC--highest O2

17

Pregnant women >20 wks can experience hypotension and syncope--this is caused by what?

When in the supine position the gravid uterus can compress the IVC causing decreased venous return and decreased CO

18

Imprinting involves imprinted/inactivation by ________.

Methylation

19

Horizontal transection of the rectus abdominis can result in injury to what structure?

Inferior epigastric artery --enters this muscle at the level of the arcuate line

20

What drug class can exacerbate hypoglycemia and can mask the adrenergic symptoms mediated by NE an EPI?

Non-selective B-blockers

21

What antipsychotic is the only one that has shown superior efficacy to treatment resistant schizophrenia?

Clozapine

22

What are the products of proinsulin and what happens to each?

Insulin and C-peptide

They are both packaged into secretory granules at the golgi and secreted together when appropriate

23

Positive skew =

Mode median mean to the right

Negative skew= mode median mean to the left

24

What is the S3 heart sound associated with?

Occurs in early diastole during rapid ventricular filling phase--increased LVESV seen with mitral regurgitation or HF

25

What is Jervell and Lange-Nielsen syndrome?

Autosomal recessive congenital long QT syndrome that involves sensorineural deafness

Romano-Ward syndrome--is AD--pure cardiac phenotype (no deafness)

26

What is seen with potter sequence (syndrome)?

POTTER
-Pulmonary hypoplasia
-Oligohydramnios--trigger
-Twisted face
-Twisted skin
-Extremity defects
-Renal failure (in utero)

Low set ears and flattened nose

Causes:
-ARPKD, obstructive uropathy, bilateral renal agenesis, chronic placental insufficiency

27

What do fibrates inhibit that cause a reduction in bile acid synthesis and favors the formation of cholesterol gallstones?

Cholesterol-7a-hydroxylase

--normally catalyzes the rate-limiting step in bile acid synthesis

28

Glucose-6-phosphate dehydrogenase is the rate-limiting enzyme in the _____________a major source of ______ and when deficient reduction of ______ and biosynthesis of ______, ______, ______ can not occur.

Pentose phosphate pathway
NADPH

Glutathione
Cholesterol
Fatty acids
Steroids

29

Cephalic and gastric phase of digestion ______ gastric acid secretion and intestinal phase _____ gastric acid secretion.

Stimulates
Reduces


Cephalic--triggered by smell, thought, taste of food
Gastric--mediated by presence of gastrin --triggered by food entering the stomach
Intestinal--triggered when protein containing food enters the duodenum

30

What is the most common complication that occurs after a VZV infection?

Postherpetic neuralgia--persistant local pain that can be present months after shingles rash occurs

31

Where are H1 histones located and what is there function?

Located outside of the histone core and help to package nucleosomes into more compact structures by binding and linking the DNA btw adjacent nucleosomes

32

Vit D supplementation is recommended babies with what 3 risk factors?

Breastfed
Lack of sunlight exposure
Dark pigmentation

Iron--recommended for preterm/low birthweight

33

Where is the putamen located?

Medial to the lnsula and lateral to the globus pallidus on coronal section

34

Atropine reverses the muscarinic effects seen with organophosphate poisoning, but what muscle be given in order to reverse the nicotinic effects such as muscle paralysis?

Pralidoxime

35

Gross hematuria in otherwise healthy patient with family hx of sickle cell suggests?

Renal papillary necrosis


Acute flank pain and passage of tissue fragments in the urine

SAAD papa with papillary necrosis
-Sickle cell disease or trait
-Acute pyelonephritis
-Analgesics
-DM

36

What lung cancer occurs most commonly in women who are non-smokers?

Adenocarcinoma --located at the periphery and consists of tumor cells of glandular or papillary structures

Squamous cell carcinoma and small cell carcinoma have strong association with smoking

37

What is the major virulence factor for S. pyogenes and what is its function?

Protein M--inhibits phagocytosis and the activation of complement