Board Review Flashcards

Question

alpha-2 receptor

Answer 1

Gi --> decrease cAMP

Answer 2

Gs --> increase cAMP

Answer 3

Gs --> increased cAMP

Answer 4

Gs --> increased cAMP

Answer 5

- phospholipase C (PLC) --> IP3 and DAG - PKA --> increase Ca - receptors: alpha 1, V1

Answer 6

Gq; vascular bed and CNS

Answer 7

Gs; renal collecting ducts

Answer 8

- osmolality changes | - change in BP of blood volume

Answer 9

PDE3 inhibitor (prevents hydrolysis of cAMP)

Answer 10

recombinant BNP --> direct vasodilation

Answer 11

Inhibits Na/K ATPase --> increased intracellular Ca

Answer 12

- hypoK - alkalosis - hypoxemia - catecholamines

Answer 13

progressively prolonged conduction; AV node

Answer 14

abrupt failure to conduct; His conduction system

Answer 15

Paced; Sensed; Response

Answer 16

sinus arrest, bronchospasm, vasodilation

Answer 17

Quinidine, Procainamide, Lidocaine, Phenytoin, Flecainide

Answer 18

Verapamil, Diltiazem

Answer 19

Amiodarone

Answer 20

(1.34 x Hgb x SaO2) + (0.003 x PaO2)

Answer 21

- increased affinity for O2 | - decrease in CO2, temp, DPG

Answer 22

- decreased affinity for O2 | - increase in CO2, temp or DPG

Answer 23

HLA comparability; Tx = PLEX

Answer 24

IL_2 receptor Ab

Answer 25

T cell lysis

Answer 26

T cell inhibition; ex = cyclosporine, tacrolimus

Answer 27

R x C; time it takes for volume of respiratory system to decrease by 63%; normal 0.3 sec (children)

Answer 28

PaCO2 - PetCO2 / PaCO2

Answer 29

Ventilation increases steeply if PaO2 < 50 (not O2 content)

Answer 30

- H+ - carotid body - PaCO2 - brainstem/medulla - hypoxia --> augmented reponse

Answer 31

- FiO2 x (Patm - PH2O) - PaCO2/R - Patm = 760 - PH20 = 47 - R = 0.8

Answer 32

5-10 (increases with age)

Answer 33

- type I = fast twitch - type II A = good endurance - type II B = more susceptible to fatigue

Answer 34

- external --> inspiration | - internal --> expiration

Answer 35

Voriconazole

Answer 36

Expiratory Reserve Volume + Residual Volume

Answer 37

Spinal cord mediated

Answer 38

- Demographic: new onset, male, < 5 yo - Labs: hypocarbia, increased BUN - Treatment: bicarbonate

Answer 39

2 x NA + glucose/18 + BUN/2.8

Answer 40

- NAPQI | - combines with glutathione --> non-toxic conjugates

Answer 41

synthetic long-acting form of somatostatin

Answer 42

NH3 --> astrocyte --> glutamine

Answer 43

- heme in ferric state unable to bind O2 - Dx = co-oximetry (> 30% --> symptoms) - Tx = methylene blue

Answer 44

SLUDGE or DUMBELS

Answer 45

Binds acetylcholinesterase (AchE) --> increase Ach

Answer 46

- Pralidoxime = reactivates AchE | - Atropine = muscarinic receptor antagonist

Answer 47

- wrists/ankles --> trunk | - erythematous/macular --> petechial

Answer 48

thrombocytopenia, anemia, hypoNa

Answer 49

- SDH - tearing of bridging veins | - CVST - hyperosmolality

Answer 50

- decreased SBP - increased DBP - capacitance increased by air bubbles, compliant tubing

Answer 51

- increased SBP - decreased DBP - high spike - resonance in system

Answer 52

- main inhibitory NT in CNS | - Cl channel complex = binding site for BZD and barbituates

Answer 53

- thiazide like diuretic - inhibits Na reabsorption in the proximal convoluted tubule - produces diuresis even in GFR is low

Answer 54

- autoimmune reduction in number of Ach receptors on skeletal muscle - symptoms appear when < 30%

Answer 55

- associated with congenital deafness | - avoid volatile anesthetics, ketamine, succinylcholine

Answer 56

narrow peaked T-waves --> prolonged PR and widened QRS --> sine wave

Answer 57

Peri-engraftment period

Answer 58

lancet shaped gram postive diplococci

Answer 59

- female - abdominal radiation - elevated AST - HLA disparity

Answer 60

- elevated gastric pH - slower gastric emptying and intestinal motility - increased % body water - lower capacity for protein binding

Answer 61

- rerrihemate - tubular obstruction by myoglobin casts - alteration in GFR

Answer 62

- lateral mass lesion - temporal lobe herniates medially into tectorial notch - stretching of 3rd CN

Answer 63

downward displacement of thalamus and hypothalamus

Answer 64

actin inhibited from binding to myosin by troponin-tropomyosin complex

Answer 65

- foramen of Monro = lateral ventricle to 3rd ventricle - aqueduct of Sylvius = 3rd to 4th - foramen of Magendie and Luschka = outlets of 4th ventricle

Answer 66

- Shiga toxin = verotoxin - neurologic complications have greatest impact on mortality - non-diarrhea associated = poorer prognosis

Answer 67

125 mL O2/min/m2

Answer 68

long chain triglycerides absorbed by lacteals in small bowel

Answer 69

random cortisol < 18 and stimulation change < 9

Answer 70

random cortisol < 20-25 and stimulation change < 9

Answer 71

greatest in patients with high random (> 34) and poor stimulation change (< 9)

Answer 72

- direct stimulation of respiratory center --> respiratory alkalosis - compensatory metabolic acidosis from urinary exertion - interferes with Krebs cycle and oxidative phosphorylation

Answer 73

- alkalization --> shifts ASA from tissue to blood enhancing urine exertion - ASA = weak acid --> ionizes in alkaline urine (ion trapping)

Answer 74

- Q waves and ST elevation in leads I and aVL | - LVH in precordial leads

Answer 75

- inhibits hepatic production of vitamin K dependent factors (II, VII, IX, X) - short half life = factor VII and protein C - long half life = factors II, IX, X

Answer 76

reduce signal to noise ratio

Answer 77

elimination half-life = minutes regardless of liver/renal function or duration of infusion

Answer 78

- Pain control - NIPPV - Operative fixation = last resort

Answer 79

- mutation in NADPH oxidase complex - PNA and skin/soft tissue infections - Staph, Serratia, Burkholderia, Aspergillosis, Nocardia

Answer 80

- deficiency in ADA enzyme --> severe lymphopenia | - mutation in common gamma chain --> defective function of IL-2R

Answer 81

- mutation in Bruton tyrosine kinase | - Pseudomonas, HiB, S. pneumoniae, enterovirus

Answer 82

- 0.001 to 0.005 mg/kg every 2 min | - 0.1 mg/kg = full reversal

Answer 83

binds ATIII --> converts to rapid inhibitor of serine proteases (factors Xa and IIa)

Answer 84

- CO affinity for Hgb 204x greater than O2 | - Binding of CO to Hgb --> decrease in DPG --> left shift

Answer 85

- neurologic/cardiac symptoms - unconscious on scene - pregnant with COHb > 15% - COHb > 25%

Answer 86

- PAP > 25 - normal PCWP (< 15) - elated PVR (> 3 Wood units)

Answer 87

- Candida = cotton like lesions | - Aspergillus = yellowish macular infiltrates

Answer 88

- Clostridium tetani = gram positive, anerobic - Tetanospasm - blocks release of inhibitory NTs (glycine, GABA) - Tetanolysin - RBC hemolysis - Tx = TIG, Flagyl, debridement

Answer 89

- IgM = severe reactions to major blood group Ag | - IgG = less severe reaction to minor antigens

Answer 90

- symptoms = fatigue, disturbed color perception, HA, delirium - PVCs = earliest sign of toxicity - HyperK = best prognostic correlation - Tx = Dig-specific Ab fragments (Dfab)

Answer 91

- methanol - uremia - paraldehyde - isoniazid - lactate - ethanol - salicylates

Answer 92

``` 1 = apical, PA > Pa > Pv 2 = Pa > PA > Pv 3 = basilar, Pa > Pv > PA ```

Answer 93

- Zero order: concentration/2 x kel | - First order: 0.694/kel

Answer 94

amount of drug in body (mg) / peak serum concentration (mg/L) x body weight (kg)

Answer 95

- hypertension - hypervolemia - hemodilution - nimodipine

Answer 96

- released by JGA in response to low blood flow - Converts AG to AG1 --> AGII --> vasoconstriction and release of aldosterone - Aldosterone --> increased renal Na and water retention

Answer 97

- coefficient of determination | - % variability in x explained by y

Answer 98

- vomiting - hyperNH3 - increases LFTs/PT - cerebral edema

Answer 99

- noninflammatory vasculopathy - "hazy, cloudy puff of smoke" - T21, NF1, SCD, CCHD (TOF, CoA)

Answer 100

- gram negative coccobacillus | - resistance from 1) beta lactamase, 2) underexpression of porin, 3) over expression of efflux pumps

Answer 101

- increased cell membrane permeability by displacing Mg and Ca from LPS - anti-endotoxin - binds to lipid A portion of LPS - nephro and neurotoxicity

Answer 102

- SR underdeveloped - no T tubules - predominance of PS innervation - lower capacity to use fatty acids - decrease proportion of contractile elements

Answer 103

- phenobarbital - BZD - VPA - increases GABA concentration

Answer 104

- Phenytoin | - Carbamazepine

Answer 105

1) vomiting 2) recovery 3) recurrent GI symptoms, coma, acidosis, coagulopathy, shock 4) hepatic failure 5) GI healing with pyloric scarring

Answer 106

- whole bowel irrigation with polyethylene glycol | - deferoxamine = chelation; indicated if AG acidosis, Fe > 500 or significant pills on AXR

Answer 107

- arterial switch - Fontan - BT shunt

Answer 108

- cerebral vasoconstriction --> parasthesias, syncope - SVR/BP decrease, CO increase - cutaneous vasoconstriction - decreased coronary blood flow

Answer 109

- blocks catecholamine reuptake | - increased serotonin, glutamate and aspartate --> euphoria

Answer 110

- S. pneumoniae - H. influenzae - Neisseria (but milder disease)

Answer 111

- abnormal packaging of neutrophil lysosomes - staph aureus - albinism, photophobia and nystagmus

Answer 112

S. pneumoniae

Answer 113

- risk factors = HIV, steroids, organ transplant - CD4 response important for eradication - India ink stain - Tx = amphotericin and flucytosine

Answer 114

- most common viral infection after transplant - endoscopy = shallow erosions or ulcers - pathology = intranuclear inclusion bodies (owl's eyes) - Tx = ganciclovir

Answer 115

- 4 x wt x BSA = fluid over 24 hours - 1/2 over 8 hours; 1/2 over 16 hours - also add maintenance fluids - LR

Answer 116

- ataxia, nystagmus, tremors - hypoalbuminemia --> increased free phenytoin - large Vd and extensively bound to plasma protein

Answer 117

- prolonged PR, QRS and QT | - J wave = upward deflection after QRS

Answer 118

- recurrent pyogenic pneumonia - parasitic diarrhea - stomatitis

Answer 119

- bind to L-type Ca channels | - Verapamil = most cardioselective

Answer 120

hypoventilation --> increased CBF --> increased PBF

Answer 121

- dispersion of mean value calculated form experiment | - allows for 68% CI over the range of mean values

Answer 122

(mean MP - mean ICP) - elevation (in cm)/1.36

Answer 123

- begins at 7 weeks - conducting airways complete by 16 weeks - mature alveoli at 36 weeks - pre-acinar vessels follow development of airways - alveolar septa transition from 2 --> 1 capillary system

Answer 124

COWS = cold opposite, warm away (refers to fast nystagmus)

Answer 125

- decrease in T3 - increase in rT3 - normal thyrotropin - normal total T4

Answer 126

inhibits AchE --> muscarinic effects of PS nervous system (bronchorrhea, bronchospasm, bradycardia, miosis)

Answer 127

- ASA - Li - Theophylline - Depakote - Barbituates - Ethylene glycol - Methanol

Answer 128

= functionalization reactions (reduction/oxidation/hydrolysis)

Answer 129

= conjugation reactions

Answer 130

new cases in period / total population at risk (assess etiology)

Answer 131

total # of cases in a period /total population at risk

Answer 132

exhaled volume x fraction of exhaled CO2

Answer 133

- subdural/epidural empyema - brain abscess - orbital cellulitis - Pott's puffy tumor - CSF WBC usually < 200

Answer 134

- Aspergillus - TB - Measles - Varicella

Answer 135

cost vs. quality adjusted life-year

Answer 136

- folate antimetabolite | - CNS toxicity = AMS, hemiparesis, seizures

Answer 137

- vasoactive peptide - activated by factor XIIa - stimulates phospholipase A, ventilation, increased permeability

Answer 138

- activated by bradykinin | - hydrolyzes arachidonic acid and PAF from cell membrane

Answer 139

- primary source = activated platelets | - platelet aggregation, vasoconstriction, increased permeability

Answer 140

- g-protein | - increased permeability, vasoconstriction, neutrophil activation

Answer 141

- trigger = bird droppings | - antigen binds to lung IgG --> complement and macrophages activation

Answer 142

> 20 mL/kg or 2-4 mL/kg/hr blood loss

Answer 143

VC < 12-15 mL/kg | NIF < - 20

Answer 144

- TOF - 4 < 75%, 3 = 80%, 2 = 85%, 1 = 90%, 0 = 100% - Onset: small muscles --> large muscles --> special muscles - head lift > 5 second = most sensitive for assessing muscle strength

Answer 145

- WASp protein - thrombocytopenia - severe eczema

Answer 146

- released from endothelial cells in repose to thrombin | - vasoconstriction

Answer 147

- urine reducing substances, GALT enzyme - E. coli sepsis - cataracts

Answer 148

benefit only demonstrated with H. flu

Answer 149

- low iCa | - high total Ca

Answer 150

NBT, DHR, cytrochrome reduction

Answer 151

- Bactrim ppx | - IFN gamma

Answer 152

- internal burns = rare - massive catecholamine release --> HTN and tachycardia - Keraunoparalysis = transient, lower extremities, loss of sensation - Fixed/dilated pupils 2/2 ocular nerve damage

Answer 153

- gram positive bacillus | - toxin --> CNS and cardiac effects

Answer 154

- NH3 > 150, normal AG and glucose - arginine deficiency --> neurologic injury - Tx = Na phenyl acetate and Na benzoate (N2 scavengers)

Answer 155

- N/V, HA, blurred vision, metabolic acidosis - primary toxin = formic acid - Tx = bicarbonate, ethanol, HD

Answer 156

distal convoluted tubule

Answer 157

- increased glomerular permeability (injury to podocyte foot process) - complications = infection (pneumoccocal peritonitis), VTE - Tx = steroids

Answer 158

- Dx = glucose > 600, osm > 330, lack of significant ketosis - Tx = more fluids, less insulin - cerebral edema uncommon but risk of VTE

Answer 159

- RAAS antagonist --> reduced Na/H20 reabsorptoin | - vascular smooth muscle relaxation

Answer 160

- measure of variability - 68% of individuals w/in 1 SD - 95% w/in 2 SD

Answer 161

- Ach receptor agonist - metabolized by pseudocholinesterase - adverse events = arrhythmias, HTN, increased IOP/ICP, myoglobinuria, hyperK - activation of muscarinic receptors --> bradycardia

Answer 162

- flow = y axis - volume = x axis - restrictive = normal/increased flows with small TV - obstruction = scalloped, redid expiratory flow loop - normal = mid points have equal flow rate

Answer 163

- neurotoxin --> blockage of nicotinic receptors | - ptosis, salivation, vomiting, fasciculation's, weakness

Answer 164

- alpha-latrotoxin --> influx of Ca and massive release of Its --> autonomic stimulation - tachycardia, diaphoresis, HTN, muscle spasm, abdominal pain

Answer 165

local skin ulceration, DIC, renal failure

Answer 166

- decrease in maximum venous return - shift inflection point of curve - decrease slope of curve - increase RAP required to inhibit venous return

Answer 167

(Una x Pcr) / (Ucr x Pna)

Answer 168

competitive inhibitor of 11-hydroxylase

Answer 169

- tender hepatomegaly, hyperbilirubinemia, fluid retention - 30 days post-BMT - US - decreased hepatic vein flow, reversal of portal vein flow

Answer 170

- 4% shistocytes - thrombocytopenia - increased LDH - decreased Hgb and haptoglobin

Answer 171

- gangrenous cellulitis of neck/floor of mouth - polymicrobial - "woody" induration of submandibular area

Answer 172

inhibits inosine monophosphate dehydrogenase --> cytostatic effect on T/B cells

Answer 173

mTOR kinase inhibitor --> inhibits T cells

Answer 174

- increase in intracellular Ca - release of glutamate - vulnerable areas = CA1 region of hippocampus, cerebral cortical layers, basal ganglia, amygdala, cerebellar Purkinje cells

Answer 175

- glycolic acid --> calcium oxalate --> AKI and shock - metabolites inhibit mitochondrial e transport chain - metabolism --> increased AG acidosis and decrease in osmolar gap - Tx = ethanol/fomepizole, HD

Answer 176

- abnormal ryanodine receptor in skeletal muscle - trigger --> massive release of Ca - Tx = dantrolene, cooling

Answer 177

- hypertrophic = Beckwitih Wiedemann, Hunter, Pompe | - dilated = oxidative phosphylation defects, FA oxidation defects

Answer 178

antifibrinolytic - inhibits activation of plasminogen to plasmin

Answer 179

- expressed on APC (phagocytes, NK cells) - recognize DAMPs and PAMPs - remove inhibition on NF-kB ---> transcription of TNFa, IL-1, IL-2

Answer 180

- mutation in beta2-integrin CD18 - high WBC - imparted wound healing

Answer 181

- hepatic = rocuronium | - renal = pancuronium, vecuronium

Answer 182

< 8 breaths/min/mL/kg = predictive of extubation success in children

Answer 183

west zone 3

Answer 184

- hepatic metabolism - active metabolite = 10-11-epoxide - symptoms = AMS, ataxia, hallucinations, blurred vision, abdominal pain, shock - blood dyscrasia

Answer 185

- blocks muscarinic Ach receptors - acts on proximal airways - onset = 15-30 minutes

Answer 186

- rapid depolarization | - rapid influx of Na (m gate, h gate)

Answer 187

- early repolarization | - K efflux

Answer 188

- plateau | - C influx

Answer 189

- repolarization | - K efflux > Ca influx

Answer 190

- bicarb (60%), carbaminohemoglobin (30%), dissolved (10%) | - deoxygenation --> increased ability to carry CO2 (Haldane effect)

Answer 191

- autonomic ganglia | - skeletal muscle

Answer 192

- cardiac/visceral smooth muscle - secretory glands - sweat glands (innervated by SNS)

Answer 193

Decrease effectiveness in PCN at high concentration of organisms

Answer 194

- age < 1 or > 8 yo - CRP > 100 - WBC > 30 K - male

Answer 195

aortic DBP - RA pressure

Answer 196

ophthalmoplegia

Answer 197

True NA = measure Na + 1.6 x ((glucose - 100)/100)

Answer 198

- PDE5 inhibitor | - blocks degradation of cGMP

Answer 199

2Vrp/n (< 2000 = laminar, > 4000 = turbulent)

Answer 200

- phentolamine (alpha blockade) | - beta blockade AFTER

Answer 201

- bloody, "rice water" diarrhea | - stocking glove peripheral neuropathy

Answer 202

- dimercaprol (BAL) and EDTA (lead > 70) | - succorer (lead 45-69)

Answer 203

- dimercaprol (BAL) if clear history | - Do NOT give BAL if organic mercury --> increased CNS concentration

Answer 204

AchE inhibitor

Answer 205

- Phigh - set at/above plateau pressure - Thigh = 4-6 s - Plow - Tlow = 0.3-0.8 s - requires spontaneous ventilation

Answer 206

- superficial = 1st degree - superficial dermal = superficial 2nd degree (painful, dry edema, blanching, resemble sunburn) - deep derma = deep 2nd degree (waxy) - full thickness = 3rd degree (leathery, dry, painless)

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