Deck 4 Flashcards by Judy Garland

Lung histology showing lymphocytic infiltrates, broncial thickening, enlargement of mucous glands and patchy squamous metaplasia of bronchial mucosa. What caused it?

chronic bronchitis, from too much smoking

How well did you know this?

Not at all

Perfectly

Why does propofol have short action of duration?

It’s lipophilic and gets distributed to areas of high blood flow like brain, liver, kidneys. redistribution in other tissues accounts for short duration of action

How well did you know this?

Not at all

Perfectly

What connects lateral ventricles with 3rd ventricle?

IV foramen of Monroe

How well did you know this?

Not at all

Perfectly

What connects 3rd ventricle to 4th ventricle?

Cerebral aqueduct

How well did you know this?

Not at all

Perfectly

Where are foramina of lushka and magendie?

after 4th ventricle

How well did you know this?

Not at all

Perfectly

What is a drug cause of respiratory acidosis?

Heroin - hypoventillation

How well did you know this?

Not at all

Perfectly

What are the stop codons?

UAA UAG UGA –> stimulate releasing factor proteins to release polypeptide from ribosome and dissolution of ribosome-mRNA complex

How well did you know this?

Not at all

Perfectly

What are physiological changes in someone with Hypertrophic cardiomyopathy?

Reduced LV size
Enlarged Septum, asymmetric LV wall thickness
Enlarged L atrium
Normal/increased EF
Poorly developed coronary capillary network

How well did you know this?

Not at all

Perfectly

What are effects of PTH on bone, calicum, phosphate, and vit D?

Bone- increases resorption
increases calcium reabsrption from urine
Decreases phosphate reabsorption
Increases vit D, which increases GI absorption of Calcium and phosphate

How well did you know this?

Not at all

Perfectly

What drug do you use to Tx hypertensive emergency? MOA?

Fenoldopam, dopamine 1 receptor agonist
Vasodilates arteries, esp renal arteries**
Very good to give in ppl with AKI

How well did you know this?

Not at all

Perfectly

What does ingesting rat poison do? What is Tx?

Depletes vit K clotting factors, similar to wafarin toxicity. Risk of GI bleeds

Tx FFP

How well did you know this?

Not at all

Perfectly

What does bladder scan show in people with diabetic autonomic neuropathy?

Increased post-void residual volume, overflow incontinence

How well did you know this?

Not at all

Perfectly

Child with abdo pain, arthralgia, and purpuric rash. What is it?

HSP - IgA and C3 deposits, small vessel vasculitis, related to recent infection

How well did you know this?

Not at all

Perfectly

Child with hemolytic anemia, thrombocytopenia, and bloody diarrhea. What is it?

HUS - E Coli O:157

How well did you know this?

Not at all

Perfectly

What is the most common benign lung lesion?

Hamartoma “coin lesion” on x-ray

How well did you know this?

Not at all

Perfectly

What is seen in lung hamartomas on biopsy?

Hyaline cartilage**, fat, smooth muscle cells

How well did you know this?

Not at all

Perfectly

Which drugs increase systolic and diastolic BP and lower HR?

Alpha-1 adrenergic agonists (phenylephrine, methoxamine)

Vasoconstriction of blood vessels, stimulation of baroreceptors and increase in vagal tone as reflex

How well did you know this?

Not at all

Perfectly

What type of cancer does PCOS put you at risk for?

Endometrial carcinoma (lack of progesterone, which has growth inhibitory effects on endometrium)

How well did you know this?

Not at all

Perfectly

What medication inhibits testosterone synthesis?

Ketoconazole

How well did you know this?

Not at all

Perfectly

What medications inhibit peripheral conversion of testosterone to DHT?

5-alpha reductase (finasteride)

How well did you know this?

Not at all

Perfectly

What medications block androgen receptor binding?

Flutamide, cyproterone, spironolactone

How well did you know this?

Not at all

Perfectly

MOA flutamide?

Competitive testosterone receptor inhibitor

How well did you know this?

Not at all

Perfectly

What med is given along with flutamide?

GnRH agonists like leuprolide (have paradoxical effect on Leydig cells with long term use)

How well did you know this?

Not at all

Perfectly

What are syptoms of neonatal addiction to opoids?

Sweating, sneezing, pupillary dilation, tachypnea, jittery baby, irritability, tremors, irritability, poor feeding

How well did you know this?

Not at all

Perfectly

What do HPV 6, 11 cause?

genital warts

What do HPV 16, 18, 31 cause?

Anal, cervical, vaginal, vulvular carcinoma

What does HPV 1-4 cause?

Skin warts

Where does lateral vs medial foot drain in lymphatics?

Medial --> follow great saphenous vein and drains directly to inguinal nodes Lateral --> drains to popliteal AND inguinal nodes

Which HIV drug doesn't require intracellular activation by kinases?

Foscarnet | Binds and inhibits DNA polymerase

What type of hypersensitivity reaction is PSGN?

type III (immune complexes of antigens and IgG)

What do you give men with prostate ca being treated for gynecomastia?

Tamoxifen (SERM)

MOA dexamethasone in lung maturation?

Increases DPPC (lecthin) and surfactant, decreases surface tension, increases type II pneumocyte production

What is PNH?

Complement mediated hemolysis, absence of CD55

What are symptoms of PNH?

``` Nocturnal hemoglobinuria Hemolytic anemia (elevated bili and LDH) thrombocytopenia pancytopenia Hemosiderosis (Iron deposition in kidney)*** -->CKD ```

Difference between schizophrenia, schizoaffective, and schizophreniform disorder?

Schizophrenia --> delusions and hallucinations > 6 months Schizophreniform --> delusions and hallucinations 1-6 months Schizoaffective --> delucions and hallucinations >2 weeks without any mania or depression + prominent mood disorder

Where does femoral herniation occur?

Medial to femoral artery and vein. Goes beneath the inguinal ligament

What are borders of Hesselbach triangle?

Inferior epigastric arteries, inguinal ligament, and rectus sheath

Where do direct hernias occur?

Medial to inferior epigastric arteries | In Hesselbach's triangle

Where do indirect hernias occur?

Lateral to inferior epigastric arteries | Through deep inguinal ring

What does hydatitiform mole show on immunochemistry staining?

p57-negative (absence of maternal genome) | p57-positive in partial moles (XXX or XXY, containing maternal and paternal DNA)

How do you calculate the Odds Ratio?

(a/b)/(c/d) | odds in exposed group/ odds in unexposed group

When do you use ANOVA?

When comparing multiple means in different groups

What is risk associated with familial chylomicronemia syndrome?

Acute pancreatitis & lipemia retinalis from hypertrycliceridiemia - This occurs due to complete lack of LPL and inability to clear chylomicrons

What condition is associated with xanthelasmas?

Familial hypercholesterolemia

What happens to vascular resistance and MAP during exercise?

Decrease in both systemic vascular resistance and MAP due to arteriolar vasodilation

What happens to systolic BP during exercise?

Increase

What should vastectomy patients be advised of after surgery?

Viable sperm for 3 months or 20 ejaculations after procedure

What is countertransferene (psych)

Unconcious beliefs and attitudes from past experiences that influence medical judgment

SE of amytriptyline?

Anticholinergic effects | Hypotension, urinary retention, constipation, confusion

What is the course of the median nerve?

At elbow - medial side of anticubital fossa, between humerus and ulna under pronator teres In forearm - between flexor digitorum superficialis and flexor digitorum profundus

What does obturator nerve supply?

Thigh adductors (adductor longus, brevis, and magnus) and medial sensation to thigh

What medication can precipitate opiod withdrawal in people who are opiod tolerant that have chronic pain?

Bupenorphrine - partial opiod agonist that binds with HIGH AFFINITY but has LOW POTENCY - someone who is addicted to opiods will definitely have withdrawal symptoms

What antiarrhythmics are used to treat ischemia-indcued ventricular arrhythmias?

Class IB- Lidocaine. They bind NOACTIVE Na+ channels

What does prolactinoma put you at risk of?

Osteoporosis | Prolactin inhibits GnRH and suppresses estrogen levels

What are causes of secondary hyperaldosteronism? (High ALD and renin)

JC cell tumor (renin secreting tumor), malignant HTN, RAS, diuretic use

What is Capitation?

Insurance plan where there is a fixed fee to cover all medical expenses

What is Cilostazol used for?

Peripheral artery disease. Inhibits platelet aggregation and vasodilates arteries. Phosphodiestrase inihbitor

What do opiods do to electrolytes?

Presynaptic neuron: inhibit Ca2+ influx | Postsynaptic neuron: inhibit K+ efflux

What are recommended meds for generalized seizures?

Valproic acid, levatiracetam, topiramate, lamotrigine

What are recommended meds for focal seizures?

Carbamazepine, gabapentin, phenytoin, pheobarbital

What med treats both absence and tonic clonic seizures?

valproic acid

What med should you give to prevent people at risk for colorectal carcinoma?

Aspirin (inhibits COX-2)

Where does RCC usually metastasize? What do you see on histology?

Lungs. Abundant clear cytoplasm

What peptidase inhibitor stops trypsin from being activated?

SPINK-1 Stops trypsin from digesting pancreas Hereditary pancreatitis if deficient

What area of throat gets infected with HPV and why?

True vocal cords- contains stratified squamous epithelium | HPV 6, 11

What is the region of highest osmoalrity in kidney?

Medulla

Where is action of ADH greatest?

Medullary portion of collecting duct (absorbs water and urea)