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Flashcards in CBSSA_17 Deck (24)
1

Presentation of MLF

  • when looking to laterally, one eye demonstrates adduction deficit
  • side of the INO is named by the side of the adduction deficit, which is ipsilateral to the medial longitudinal fasciculus (MLF) lesion
    • e.g. Right MLF lesion ==> inability to adduct right eye when looking left

2

Structures?

  • coronal section of middle cranial fossa
  • artery = internal carotid w/in cavernous sinus
  • A = CN III
  • B = CN IV
  • C = CN VI
  • D = CN V
  • E = CN V 

3

Sertraline: MOA, uses

  • SSRI
  • uses: 
    • MDD
    • OCD
    • GAD
    • Panic disorder
    • PTSD

4

first sign of puberty in females

breast bud development

5

Erythromycin: MOA, SE

  • Macrolide = binds 50S subunit ==I protein synthesis
  • SE
    • (clarithro/eryhtro)  = QT prolongation
    • (clarithro/eryhtro)  = inhibit CYP450 (CYP3A4)

6

Gentamicin: MOA, SE

  • Aminoglycoside: binds 30S subunit ==I protein synthesis
  • SE
    • neurotox
    • nephrotox

7

Presentation of 11B-hydroxylase deficiency

  • MC
    • decreased aldosterone
    • increased 11-deoxycorticosterone = potent MC
  • decreased cortisol
  • increased sex hormones
  • labs = hypertension
  • sex hormones
    • XX: viriliaztion

8

Presentation of 21-hydroxylase deficiency

  • MC: decreased aldosterone
  • decreased cortisol
  • increased sex hormones
  • labs
    • hypotension
    • hyperkalemia
    • elevated renin activity
    • elevated 17-hydroxyprogesterone
  • ==> XX: viriliaztion

9

Type II familial hypercholesterolemia

  • in blood: elevated LDL, cholesterol
  • Pathophys
    • AD
    • Absent (homozygotes) or defective LDL receptors
    • heterozyg = cholesterol ~ 300
    • homozyg = cholesterol ~ 700+

10

Possible manifestations of hemochromatosis

  • hyperpigmentation
  • weakness & lethargy
  • elevated liver enzymes
  • elevated iron levels
  • DM
  • hypopituitarism ==> hypogonadism ==> impotence
  • arthralgia

11

Location of SA node

  • sinoatrial node is a group of cells positioned in the wall of the right atrium just lateral to the junction where the superior vena cava enters the right atrium

12

Possible CV complications of cocaine abuse

  • MI
  • aortic dissection (?)

13

Ibutilide: MOA, use, SE

  • MOA: exact mechanism of action is unknown; prolongs the action potential in cardiac tissue
  • Use: Acute termination of atrial fibrillation or flutter of recent onse
  • SE
    • Ventricular extrasystoles (5.1%), ventricular tachycardia (4.9%),  tachycardia/supraventricular tachycardia (2.7%)

14

?? ==> internal hemorrhoids

?? ==> external hemorrhoids

  • superior rectal vein dilation ==> internal
  • inferior rectal vein dilation ==> external

15

Alveolar cell types?

  • A = endothelial cells
  • B = erythrocytes
  • C = Type I pneumo
  • D = type II pneumo
  • E = macrophages

16

Anti-inflammatory/immunosuppressive actions of Prednisone

  • Inhibition of gene transcription for COX-2, cytokines, cell adhesion molecules, and inducible NO synthase
  • Blockage of Vitamin D3-mediated induction of osteocalcin gene in osteoblasts
  • Modification of collegenase gene transcription
  • Increase synthesis annexin-1, important in negative feedback on hypothalamus and anterior pituitary gland

17

hypervascular mass @ kidney ==> dx?

renal cell carcinoma

18

Tx of ascites

  • furosemide + sprinolactone

19

Peripheral blood smear in HELLP syndrome

  • schistocytes <== common in microangiopathic hemolytic anemia

20

Heinz bodies vs. Howell-Jolley bodies

  • Heinz = precipitated Hb
    • splenic macs remove heinz ==> bite cells
  • Howell-Jolly bodies = nuclear fragments in RBCs
    • present in patients without spleen
    • e.g. splenectomy to tx herid spherocytosis

21

Drug trial phases

Preclinical Testing of drug in non-human subjects, to gather efficacy,toxicity and pharmacokineticinformation unrestricted 

Phase I Testing of drug on healthy volunteers for dose-ranging often subtherapeutic, but with ascending doses 


Phase II Testing of drug on patients to assess efficacy and safety therapeutic dose


Phase III Testing of drug on patients to assess efficacy, effectiveness and safety therapeutic dose 


Phase IV Postmarketing surveillance – watching drug use in public therapeutic dose personal physician anyone seeking treatment from their physician watch drug's long-term effects

 

22

Sulfasalazine: MOA, use

Commonly used in RA & Crohn's disease and ulcerative colitis

it is thought to be an antinflammatory drug that provides topical relief inside the intestine. It does this via a number of mechanisms such as reducing the synthesis of inflammatory mediators known as eicosanoids and inflammatory cytokines.

23

CREST Syndrome

  • = systemic sclerosis
  • Calcinosis
  • Raynaud's
  • Esophageal dysmotility ==> fibrous replacement of m. ==> dilation and atony of esophagus and LES
  • Syndactyly
  • Telangiectasias

24

Rat poison toxicity + antidote

  • contains brodifacoum = 4-hydroxycoumarin derivative ==> coagulopathy and bleeding
  • tx = fresh frozen plasma + vitamin K

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