DIT Flashcards
(363 cards)
1
Q
beta 2 Receptor actions
A
vasodilation (mild), bronchodilation, elevation of lipolysis and insulin, decrease in uterine tone
2
Q
adrenergic receptor types in skeletal muscle
A
alpha 1 and beta 2
3
Q
Zosin drugs–>what are they? what are they used for?
A
alpha 1 blockers; use for HTN and BPH (relax bladder neck muscles; especially Tamsulosin alpha 1A/D–>better for pts with BPH without HTN)
4
Q
pheochromocytoma treatment
A
alpha blocker first: phentolamine/phenoxybenzamine
beta blocker
5
Q
HTN and bradycardia patient–>how to treat
A
use acebutaolol or pindolol–>very weak beta 1/beta 2 agonists that are so weak they act as antagonists–>leads to less pronounced heart blocking effect
6
Q
Alpha 1 and beta 2 blockers?
A
carvedilol/ labetalol
7
Q
arotic dissection treatment
A
beta blocker–>lower blood pressure and rate of BP increase during systole
8
Q
what not to give pt with cocaine overdose?
A
beta blocker. Cocaine inhibits NE uptake… therefore blocking beta will result in alpha stimulation–>increase in HTN.
9
Q
beta blocker SE
A
bronchoconstriction; hypoglycemia, arrythmia, rebound HTN
10
Q
Timolol, nadolol
A
glaucoma
11
Q
partial beta agonists acting as antagonists?
A
Pindolol, acebutaolol
12
Q
Clonidine mech? use?
A
alpha 2 R blocker; used as sedative and malignant HTN
13
Q
beta blocker contraindications/use caution
A
asthmatics; DM; CHF/heart block patients/brady cardia
14
Q
Lithium Side effects (in adults)
A
- sedation/dizziness
- tremors (POSTURAL TREMOR!!!)
- sick sinus syndrome/heart block/bradycardia
- hypothyroidism/goiter
- polyuria (by blocking aquaporin)
15
Q
Mania dx criteria
A
Distractability Irresponsibility Grandiosity Flight of ideas Activity (goal directed)/agitation Sleep decrease Talkativity
More than 1 month
16
Q
Major Depression Dx criteria
A
more than 2 weeks must have loss of interest or depressive mood. plus 4 of the others.
Sleep changes Interest loss Guilt Energy loss Concentration loss Appetite loss Psychomotor sx Suicidal ideations
17
Q
Risk factors of Suicide
A
Sex (male) Age (teenagers; elderly) Depression Previous attempts Ethanol Rational thought loss Sickness Organized plan No Spouse/no support
18
Q
Acute pancreatitis causes
A
Gall stones Ethanol Trauma Scorpion sting Mumps Autoimmune Steroids Hyperlipidemia/hypercalcemia ERCP Drugs
19
Q
Hypercalcemia sx
A
Stones, groans, psychiatric overtones
20
Q
Hypocalcemia signs
A
trousseau’s sign; chvostek’s sign
21
Q
Audio hallucination most associated with?
Visual Hallucinations most associated with?
Tactile formication?
olfactory hallucinations?
A
- auditory: schizophrenia
- visual: medical illness (dementia/drugs/migraine)
- tactile: alcohol withdrawal; cocaine user
- olfactory: epilepsy/brain tumor
22
Q
gram positive cocci in pairs
A
strep pneumo
23
Q
What is Ferritin?
A
Ferritin is an acute phase reactant protein that stores iron (hides it away if there’s an infection)
24
Q
Calcium D synthesis/activation organs?
A
cholecalciferol (synthesized in skin/ingested in milk) or ergocalciferol from plants–>liver converts to 25 hydroxyD–>kidney converts to 1,25 hydroxyD
25
Conditions associated with elevated calcium/vitamin D
Sarcoidosis/ Hodgkins' lymphoma-- activation of macrophages and T cells and alpha 1 hydroxylase
26
synthesis of what depends on having a normal GI flora?
vitamin K
27
What are vit K dependent clotting factors?
C, S, prothrombin, II, VII, IX, X
28
Infant with hemorrhage? Why, how to prevent
no vitamin K due to sterile flora, give IM vit K at birth
29
Vitamin K deficiency causing medications?
Warfarin
antibiotics
phenytoin (and other anticonvulsants)
30
eskimo polar bear hunter who consumes liver and develops visual changes, vomiting, vertigo
Vitamin A
31
Vitamin A deficiency
```
Bitot spots on sclera
corneal degeneration (keratomalacia)
dry eyes (xerophthalmia)
night blindness
dry scaly skin
```
32
Vitamin A acute toxicity
Vomiting, Visual changes, Vertigo
33
Vitamin A chronic toxicity
increased intracranial pressure, papillary edema, hepatomegaly
joint pain, hair loss
34
fetal vitamin A teratogenic defects
clefting, dandywalker, cardiac abnl
35
What does vitamin E do primarily?
antioxidant protecting RBC
36
Vitamin E deficiency?
peripheral neuropathy, ataxia, muscle weakness, HEMOLYTIC ANEMIA!
37
acanthocytosis is associated with what two things
dysbetalipidemia (apoE deficiency and accumulation of VLDL remnants) and vitamin E deficiency
38
Major functions of vitamin C?
1. collagen hydroxylation of pro and lys
2. antioxidant of vitamin E thus protects RBCs
3. Iron absorption
4. Dopamine to NE (dopamine hydroxylase)
39
methemoglobinemia; cause? treatment?
cause: nitrates/sulfates; treatment: methylene blue and vitamin C
40
Guy back from camping trip... cyanotic doesnt respond to 100% o2; what does he have? How to treat?
has cyanide poisoning from wells; treat with nitrates and sulfates
41
corkscrew hair
vitamin C deficinecy
42
perifollicular hemorrhage; ring sideroblast
vitamin C deficiency induced iron deficiency
43
cofactors for pyruvate DH and alpha-ketoglutarate DH
```
Thiamin
Lipoate
CoA
FAD
NAD
(Tender loving care for nobody)
```
44
Patient presents semi conscious. What do you give with GLucose?
Thiamine! or IV glucose will eat up all the thiamine and no ATP can be produced-->korsakoff/wernicke
45
Vitamin B2 deficiency sx
chelitis; corneal vascularization
46
casal necklace
Pellagra; niacin deficiency
47
Niacin SYnthesis
Tryptophan;
B2 (riboflavin)
B6 (pyridoxine)
48
Isoniazid decreases what vitamin?
B6 and thus B3
49
Niacin Deficiency causes
Hartnup disease (malabsorption of tryptophan)
malignant carcinoid syndrome
Isoniazid (INH): inhibits B6 and B2 thus B3 synthesis
50
prevention of niacin induced flushing with what
Asprin prophylaxis
51
What is B5? deficiency?
pentothenate AKA CoA
| dermatitis, enteritis, alopecia, ADRENAL INSUFFICIENCY
52
What is B6? what is it involved in?
It's pyrodoxine
porphyrin synthesis thus in RBC and hepatocytes (CYP)
transaminases (AST/ALT)
neurotransmitters
53
B6 deficiency sx?
neuropathy
convulsion (decrease in neurotransmitters)
chelitis/dermatitis/glossitis
54
Pt with TB what do you treat them with? what do you have to add?
```
Isoniazid, rifampin, ethambutol, and pyrazinamide
PLUS B6 (pyridoxine)
```
55
Toxoplasma treatment
Pyramethemine and Sulfadiazine
56
B7 What is it?? what kind of reactions does it do? what specific reactions are these?
biotin, carboxylation reactions
pyruvate to oxaloacetate
acetyl coA to malonyl coA
prioprionyl CoA to methylmalonyl CoA
57
Pernicious Anemia -->antibodies are against what?
| how to Dx?
gastric parietal cells and intrinsic factor
| Dx: Immunofluorescense OR Schilling Test
58
Schilling Test
Radiolabeled B12 oral and measure in urine. If low-->poorly absorbed
59
First dose hypotension
alpha 1 blocker
60
3 ways of increasing power of a study
increasing power means increasing the ability to reject H0 when there infact is a difference.
- increase sample size
- increase "expected effect size" by anticipating people droping out
- increase precision of measurement
61
hormones that increase gastric acid secretion
histamine, gastrin
62
hormones that inhibit gastric acid secretion
GIP, Somatostatin, Secretin, prostaglandin
63
Why does ACE I induce cough?
ACE I inhibit ACE thus inhibiting bradykinin breakdown...causing bronchoconstriction
64
1 standard deviation percent of population?
68
65
2 standard deviation inludes what percent of population?
95
66
3 standard deviation percent of population?
99.7
67
How does sample size affect confidence interval?
decrease
68
Z score is used to calculate what?
Z is multiplied by Standard Error and +/- to the mean to calculate the Confidence interval
69
CI=90%; Z score?
1.645
70
CI=99%; Z score?
2.58
71
CI=95%; Z score?
1.96
72
T test
continuous variable-->compares means of two groups
73
ANOVA
continuous variable-->compare means of 2+ groups
74
Chi squared test
categorical data
75
```
correlation coefficient (r)
What does 1 mean?
What does 0 mean?
What does -1 mean?
```
1=perfect positive correlation
0=no correlation
-1=perfect negative correlation
76
first born male vomiting at 2-6 weeks; non bilious
congenital pyloric stenosis
77
dressler syndrome
pericarditis 2-4 weeks post MI
| fever, pain, elevated ESR
78
xray finding during aortic dissection?
widening of mediastinum
79
which lipid lowering drugs bind c diff toxin?
cholestyramine
80
4 basic core ethical principles!!!
nonmaleficence
Beneficience
Autonomy
Justice
81
```
Antibiotics with:
Tendonitis?
Gray Baby Syndrome?
Cartillage damage?
Nephrotoxicity?
Ototoxicity when use with loop diuretics
c diff?
```
```
Tendonitis-Floroquinolones
Gray baby-Chloramphenocol
Cartilage-floroquinolones
Nephrotoxicity-Cephalosporins
Ototoxicity-aminoglycosides
C diff?clindamycine/ampicillin
```
82
three causes of megaloblastic anemia?
```
Folate B9 deficiency
B12 deficiency
orotic aciduria (due to UMP synthase deficiency)
```
83
Adenosine deaminase deficiency?
SCID
84
SCID features?
- severe recurrent infections-->candidiasis/ pneumocystis pneumonia
- diarrhea
- failure to thrive
- no thymic shadow on CXR
85
Post operative fever causes
Wind water wound walking wonder drugs
- Pneumonia-days after
- UTI-foley
- wound
- walking-DVT
- drugs
86
Floroquinolones mechanism?
inhibits topoisomerase
87
Mismatch repair?
base excision?
nucleotide exision?
non homologous end joining?
Mismatch repair-->recognizes base changes-->rids of the wrong ones and fill in the right ones
Nucleotide excision repair-->recognizes bulky defect. removes a chunk of DNA (thus need endonuclease, polymerase, and ligase)
Base excision-->base itself is damaged (modified)
glycosylase removes base, endonuclease activity, polymerase, and ligase
nonhomologous end joining--> double stranded break
88
What binds operator?
either repressor or inducer
89
which eukaryote RNA pol make which kind of RNA?
RNA pol I rRNA (Rampant)
RNA pol II mRNA (Massive)
RNA pol III tRNA (Tiny)
90
How does Tetracycline work?
inhibits tRNA binding to A site on 30S subunit; preventing elongation
91
How does Chloramphenicol work?
binds 50S subunit and inhibits aminopeptidyl transferase; therefore stopping elongation
92
How does Aminoglycoside work?
binds 30S subunit before anything else binds thus stopping initiation
93
How does macrolide work?
binding to 50S subunit preventing translocation from A to P thus stopping elongation
94
How does Linezolid work?
binds 50 S subunit preventing initiation
95
Williams syndrome. Mutation? Features/sx
Deletion of long arm on chr 7. Elvin facies, hypercalcemia /increased sensitivity to vit d! intellectual disability, well spoken and extremely friendly to strangers
96
Glycolysis rate limiting step
Phosphofructokinase 1
97
Gluconeogenesis rate limiting step
Fructose 1.6 bisphosphate
98
TCA cycle rate limiting st
Isocitrate dehydrogenase
99
Glycogenesis rate limiting step
Glycogen synthase
100
Glycogenolysis rate limiting step
Glycogen phosphorylase
101
Hmp shunt rate limiting step?
Glucose 6 phosphate dehydrogenase
102
De novo purine synthesis rate liming step
Prpp amidotransferase
103
De novo pyramiding synthesis rate limiting step
Carbamoyl phosphate synthase II (cyto)
104
Urea cycle rate limiting step
Carbamyol phosphate synthase I (mito)
105
Fatty acid oxidation rate limiting step
Carnitine acyl transferase I
106
Ketogenesis rate limiting step
HMG coa synthase
107
Cholesterol synthesis rate limiting step
HMG coa Reductase
108
three dz with marfanoid body habitus
marfan, MENIIB, homocysteine uria
109
prader-willi mutation?
paternal allele deletion (maternal allele is imprinted)
110
child with obesity, short, intellectual disability, tantrums/skin picking, hypogonadotropic hypogonadism, osteoporosis
almond eyes and down turned mouth
Prader-Willi
111
young child with ataxia, inappropriate laughing. dx?
Angelman syndrome (maternal deletion; paternal imprinted)
112
INdirect and direct ELISA
Direct=putting in antibody to look for antigen
| Indirect =putting in antigen to look for antibody
113
what will increase PFK1 activity? what will decrease it?
it will increase with increased AMP and fructo2,6 bisphosphate
It will decrease with ATP and citrate
114
what are the 4 enzymes of gluconeogenesis?
pyruvate carboxylase, PEP carboxykinase, fructose 1,6 bisphosphatase, glucose 6 phosphatase
115
what organs can do gluconeogenesis?
liver, kidney, intestinal epithelium
116
What are three processes involving both cytosol and mitochondria?
Heme synthesis
Urea cycle
Gluconeogenesis
117
what are the 4 fates of pyruvate?
CoA, Oxaloacetate, lactate, alanine
118
vomiting, rice water diarrhea, and garlic breath? dx
arsenic poisoning; inhibition of Lipoic acid thus pyruvate dehydrogenase is ineffective
119
pyruvate dehydrogenase deficiency congenital presentation?
neurologic defets, lactic acidosis, and high alanine
120
What is the Cori Cycle and what enzyme is important?
Cori cycle converts lactate to glucose in liver and glucose to lactate in RBC and muscle cells.
Lactate dehydrogenase converts between pyruvate and lactate
121
what are the drug/things that inhibit electron transport chain complexes?
complex 1: Rotenone, Amytal, MPP
Complex 3: antimycin
Complex 4:: Cyanide, Azide, CO, and hydrogen sulfate
Complex 5: oligomycin
122
what is the point of the Alanine cycle?
carry nitrogen from muscle to liver in order to have it go through the urea cycle. The nitrogen is carried by both alanine and Glutamine
123
ALT catalyzes what reactino?
alpha ketoglutarate + alanine-->glutamate +pyruvate
124
What does AST catalyze?
glutamate + oxaloacetate-->alpha ketoglutarate +Aspartate
125
name 3 uncoupling agents
thermogenin, asprin, and 2,4 dinitrophenol
126
mutation in von gierke?
mutation in cori
mutation in pompe
mutation in mcardle
von gierke: glucose 6 phosphatase
cori: debranching enzyme (1.6 glucosidase)
pompe: lysosomal 1,4 glucosidase
mcardle: glycogen phosphorylase
127
deficiency in glycolytic enzymes and HMP shunt enzymes will cause hemolytic anemia. What are two classic conditions of these pathways? why does hemolytic anemia happen?
glycolysis: pyruvate kinase deficiency... It causes hemolytic anemia because RBCs depend on glycolysis for ATP production...thus no ATP will lead to dysfunctional Na/K ATPase ..thereby causing hemolytic anemia
HMP shunt: missing G6PD, therefore you can't reduce glutathione, and therefore you can't reduce the oxidative stress on red cells.
128
Classic galactosemia. What enzyme is deficient? what are sx?
Uridyltransferase deficiency. build up of galactitol, congenital cataracts, failure to thrive, jaundice, hepatomegaly, mental retardation
129
Galactokinase deficiency? symptoms?
infantile cataracts and galacitol buildup. failure to track objects/social smile
130
Essential fructosemia? sx? enzyme that's deficient?
cannot use fructose as energy and is in urine. otherwise benign.
fructokinase deficiency
131
Fructose intolerance. What is deficient?
ALdolase B
132
horseshoe kidney can't go up because what?
inferior mesenteric artery
133
ethanol speeds up which two reactions? why does the body do this with ethanol consumption? what's the clinical consequence?
pyruvate -->lactate, oxaloacetate-->malate
This is done to regenerate NAD from the NADH produced by alcohol DH and acetaledehyde DH
Therefore, gluconeogenesis is inhibited... and pt can be hypoglycemic
134
why do Kwashiorkor pts have fatty liver changes?
body cannot make APOB100 thus fatty acids accumulate
135
Kwashiorkor sx?
edema
anemia--> lack of protein thus can't keep up with cell division
fatty liver
skin depigmentation/skin lesions
FLAME-fatty liver, anemia, malnutrition, edema
136
refeeding syndrome. What do you need to watch in these patients?
Potassium, phosphate, magnesium.
| could lead to arrythmias and neurological abnormalities
137
Abetalipoproteinemia. What is missing? treatment?
missing ApoB48, ApoB100-->cholesterol/fats can't be packaged into chylomicrons-->steatorrhea/DEAK def/failure to thrive/nightblindness
Tx
vitamin E
138
weakness, hypotonia, hypoketootic hypoglycemia
carnitine deficiency
139
fatty acid synthesis rate liminting enzyme?
Acetyl Coa Carboxylase
140
fatty acid breakdown rate limiting enzyme?
carnitine acyltransferase 1; carnitine palmitoyl transferase 1
141
ketone body synthesis rate limiting enzyme?
HMG CoA synthase
142
cholesterole synthesis rate limiting enzyme
HMG Coa reductase
143
essential amino acids?
PVT TIM HLL
phe, valine, threonine, Tyrptophan, Isoleucine, met, Histidine,leucine, and lysine
144
Which amino acids are important during periods of growth?
Arg His
145
which AA are important for nuclear localization/histones
Arg Lys
146
arginine derivatives?
creatine, urea, nitric oxide (BH4)
147
tryptophan derivatives?
serotonin (B6 and BH4)-->melatonin
| niacin (B6)
148
histidine direvatives?
histamine (B6)
149
Glycine derivatives?
porphyrine (B6)-->heme
150
Glutamate derivatives?
GABA (B6), Glutathione
151
hypertension drugs in preg?
hypertensive moms love nifedipine
Hydralazine, methyldopa, labetalol, nifedipine
152
PKU causes..2
| treatment?
phe hydroxylase def; BH4 def
| avoid Phe and supplement Tyrosine
153
homocysteinuria enzyme deficient?
homoecysteine methyltransferase or B12 deficiency (can't generate methionine form homocystein)
cystathionine synthase or B6 deficiency
154
tall, kyphosis, osteoporosis
| mental retardation, atherosclerosis, downward subluxation of lense
homocysteine uria
155
Cysteinuria what is the defect?
PT reabsorption of Cysteine, Ornithine, Lysine, Arginine
156
maple syrup urine disease...what enzyme is missing? what's the cofactor?
```
alpha ketoaciddehydrogenase.
need thiamine (and all of these TLC For Nobody)
```
157
first pharyngeal arch muscles and nerves?
muscles of mastication, mylohyoid, tensor tympani, tensor veli palatini
mandibular and maxillary branches of V
158
mechanism of adenosine?
hyperpolarization via increasing outward K flow.
159
where are peyers patches found?
ILEUM
160
splenectomy findings 2 histo; 2 presentation
Howell jolly bodies, target cells, thrombosis, infection by encapsulated organisms
161
What are the encapsulated organisms?
```
Strep pneumo
Hemophilus
Neisseria
Salmonella
Klebsiella
Group B strep
```
162
hyperkalemia on EKG?
tall T waves
163
Theophylline antidote?
beta blockers
164
Langerhan cell histiocytosis. what markers are present?
CD1a; S100
165
which part of antibody is carboxy end, which one is amino?
carboxy=Fc region
| Amino =variable region
166
what structures hold together the antibody?
disulfid bonds
167
whats the normal Kappa to Lambda light chain ratio?
2:1
168
whats the normal Kappa to Lambda light chain ratio? what does it mean if this ratio is not 2:1
2:1 ; possibly multiple myeloma
169
IgG halflife?
21 days
170
whats colostrum?
early breast milk
171
whats colostrum?
early breast milk, have IgA
172
what is granzyme?
Serine protease
173
NK cells kill what kind of cells?
cells with low MHCI
174
What enhances NK cell activity?
IL2, IL12, IFNbeta, IFN alpha
175
CD16 are found where? what do they do
NK, macrophage, neutrophils
| ADCC
176
Th1 cells produce what cytokines?
IL2 and IFNY
177
Th1 cells are activated by what cytokines
IL12
178
Th2 cells produce what cytokines
IL2, IL4, IL5, IL10
179
Th2 cells are activated by what cytokines
IL4
180
what activates the classical complement pathway?
Ab crosslinking
181
What activates alternative complement pathway?
complement on its own C3b
182
what activates the classical complement pathway?
Ab crosslinking activating C1
183
what does C1 esterase inhibitor do?
it inhibits cleavage of C1 thus activation of the classical complement pathway
184
C1 esterase inhibitor deficiency causes what?
hereditary angioedema
185
C1 esterase inhibitor deficiency causes what? what is contraindicated in these patients?
hereditary angioedema
| DO NOT TAKE ACE I
186
C3 deficiency?
recurrent strep pneumo/haemophilus infection
| and increased risk for Glomerulonephritis (Type III hypersensitivity)
187
decay accelerating factor (DAF) deficiency?
paroxysmal nocturnal hemoglobinuria
188
what is the problem in paroxysmal nocturnal hemoglobinuria
```
missing GPI (CD59) which anchors DAF (CD55) to cell.
leading to overactive complement destruction of RBC
```
189
How do you dx nocturnal paroxysmal hemoglobinuria
Flowcytometry
| Ham's test
190
How to treat paroxysmal hemoglobinuria?
Transfusion, Warfarin, Eculizumab
191
What are three functions of the spleen?
store RBC
remove damaged RBC/encapsulated bacteria
sequester platelets
192
Name the encapsulated bacteria
```
Strep pneumo
Hemophilus influenza
E. coli
Salmonella
Klebsiella
group B Strep
```
193
macrophages if the joints are called what?
A cells
194
monocytes of kidney are called what
mesangial cells
195
Eosinophilia in renal biopsy
acute interstitial nephritis
196
what causes eosinophilia?
```
Drugs (NSAIDS, betalactams)
Neoplasms
Allergy/Atopic diseases
Acute interstitial nephritis
Addison's disease
Collagen disease
Parasites
```
197
what does Cromolyn do?
inhibit mast cell degranulation
198
what does IL3 do?
stimulates bone marrow
199
action of IFNalpha and beta?
antiviral. they promote viral mRNA degradation and inhibit cellular protein syntheis
200
what cytokines are produced by macrophages?
IL6, IL1, and TNFa
201
what cytokines are produced by macrophages?
IL6, IL1 (fever), and TNFa (shock, leukocyte recruitment)
202
what cytokines are produced by macrophages?
IL6, IL1 (fever), and TNFa (shock, leukocyte recruitment), IL8 (neutrophil chemotaxis)
203
neutrophil chemotaxis
IL8, C5a, LB4
204
IL12 function?
Th1 differentiation, activation of NK cells
205
Aldesleukin
| what is it? what's it used for?
Recomb IL2
| renal cell carcinoma, metastatic melanoma
206
which cytokine can act like GMCSF?
IL3
207
Oprelvekin. what is it? what's it used for?
IL11 derivative; treat thrombocytopenia
208
IFNa analogs can treat what disease?
```
Hairy cell leukemia
Hep C Hep B
melanoma
Kaposi carcinoma
Genital warts
```
209
IFNbeta is used to treat what?
multiple sclerosis
210
IFNy is used to treat what?
Chronic granulomatous disease
211
action of IFNalpha and beta?
antiviral. they promote viral mRNA degradation via RNase L and inhibit cellular protein syntheis (protein Kinase)
212
Cyclosporine mechanism? SE?
cyclosporin binds cyclophilin and inhibit clcineurine...thus decreasing IL2 production
Nephrotoxicity due to vasoconstriction of renal vessels
213
muromonab? mech?
inhibits CD3
214
mycophenylate mech?
inhibition of IMP dehydrogenase thus no guanine synthesis
215
Tacrolimus mech?SE?
binds FKBP and thus inhibiting IL2 synthesis. neurotoxicity
216
Daclizumab mech?
binds CD25 (IL2 receptor on activated T cells)
217
Thalidomide mech?
affects TNFalpha. used to treat erythema nodosum leprium.
teratogenic
218
what can you use to treat the diseases involved in PAIR?
TNFalpha inhibitors -->infliximab, adalizumab, etandercept
219
what can you use to treat the diseases involved in PAIR?
TNFalpha inhibitors -->infliximab, adalizumab, etandercept (decoy receptor)
220
rituximab?
CD20 inhibitor NHL
221
BTK gene is what? and what if it's defective?
a tyrosine kinase gene
Bruton's agammaglobulinemia; x-linked disease
onset about 6 months when maternal passive immunity has worn off
222
pt with no lymphnodes or tonsils? waht is this
Bruton's agammaglobulinemia
223
recurrent mild Sinus and GI infections? pt also has many allergies.
selective IgA deficency
224
selective IgA deficiency is at risk for what complication?
anaphylaxis with blood transfusions/ other things with IgA
225
recurrent mild Sinus and GI infections? pt also has many allergies.
selective IgA deficency
226
chronic mucocutaneous candidiasis cause?treatment?
T cell dysfunction; ketoconazole
227
which immunodeficiency causes dissemination of mycobacteria
IL12 def
228
IgM hyperglobulimemia, causes?
CD40, CD40L, or NEMO deficiency
229
SCID sx quad?
recurrent infections, diarrhea, and failure to thrive, no thymic shadow
230
no thymus ddx
SCID, di george
231
Wiskott aldrich syndrome triad?
Thrombocytopenic purpura
Ezcema on the trunk
Recurrent infection
232
trunkal eczema?
Wiskott aldrich
233
ataxia telangiectasia. muatation? triad? risk?
ATM gene leading to dsDNA breaks (dsDNA repair defect)
ataxia (poor smooth pursuit), angiomas, and IgA deficiency
risk of leukemia and lymphoma
AFP elevated
234
chedek hagashi. defective gene? sx?
```
LYST gene defect phagosomes can't fuse to lysosomes.
Will see giant neutrophilic granules
recurrent infections (skin and URT), partial albinism, neurological sx
```
235
Hyperimmunoglobulin E syndrome? aka? sx? mutation? and consequence?
Job syndrome
Eczema, recurrent Staph aureus abscesses, and coarse facial features
STAT3 mutation-->defecive neutrophil chemotaxis.
236
Hyperimmunoglobulin E syndrome? aka? sx? mutation? and consequence?
Job syndrome
Eczema, recurrent Staph aureus abscesses, and coarse facial features, 2 rows of teeth
STAT3 mutation-->defecive neutrophil chemotaxis.
237
2 rows of teeth? dx?
job syndrome. hyperimmunoglob E
238
reversible dementia. what is it? what are sx?
nl pressure hydrocphalus
| wacky, wobbly, wet
239
acidic drug overdose. what do you treat with to trap it in the urine?
bicarb...its something that takes up H
240
basic drug overdose. what do you treat with to trap it in urine?
ammonium chloride..it's something that gives off H
241
which drugs are classic acidic drugs?
Asprin, Phenobarbital, methorexate
242
which drug is a classic basic drug?
Amphetamines
243
0th order kinetics drugs
Phenytoin, Asprin, Ethanol
244
drugs that cause flushing?
Vancomycin, Adenosine, Niacin, Calcium channel blockers (nifedipine)
245
drugs that can cause vasospasms?
cocaine, amphetamines, ergotamines, tryptans
246
drugs that cause dilated cardiomyopathy?
doxorubicin, daunorubicin
247
how to treat torsades?
IV Mg
248
drugs that can cause thrombocytopenia?
HIT, cimetadine
249
drugs that cause agranulocytosis?
clozapine, carbamazepine, colchicine,
| PTU, methimazole, and Dapsone
250
aplastic anemia
chloramphenacol, Bezenes, NSAIDs, PTU, methimazole
251
afib patient with cough sx
amiodarone...possible pulmonary fibrosis?
252
pulmonary fibrosis SE drugs?
amiodarone, busulfan, bleomycin
253
liver necrosis drugs?
Halothane
Acetaminophen
Valproic acid
Amanita toxin
254
hepatitis
isonizid
255
Gynecomastia
```
Spironolactone
Estrogen
Digoxin
Cimetadine
chronic alcoholism/cirrhosis
Ketoconazole
Marijuana
```
256
tertiary adrenocortical insufficiency SE drugs?
withdrawal from corticosteroids
257
hot flashes SE drugs
Tamoxifen, clomifene
258
Hypothyroidism SE drugs
Amiodarone
Lithium
Sulfonamide
259
drugs inducing gout?
Furosemide, thiazide
niacin
cyclosporin
pyrazinamide
260
Gingival hyperplasia SE drugs
phenytoin,
| Verapamil/nifedapine
261
osteoporosis SE drugs
corticosteroid, heparin
262
Photosensitivity SE drugs?
sulfonamides,
Amiodarone
tetracycline
263
Steven Johnson's drugs?
```
CLEPP and let Steven PAS
carbamazapine
lamotrigine
ethosuxomide
Phenytoin
Phenobarbital
---
Penicillin
Allopurinol
Sulfa drugs
```
264
SLE drug induced (what are the drugs?)
```
Sulfonamide
Hydralazine
Isoniazid
Phenytoin
Procainamide
```
265
Interstitial nephritis SE drugs?
Furosemide
NSAIDS
antibiotics
266
Drugs that cause Diabetes insipidus
Demeclocycline, Lithium
267
What drugs cause drug induced Fanconi's?
heavy metal exposure, Wilson's disease, expired tetracycline
268
Drugs causing parkinsonian symptoms?
Metoclopramine
Antipsychotics
Reserpine
269
Cinchonism is what? what drugs can cause it?
it's HA with dizziness, tinnitus
Quinidine, Quinine
270
drugs with seizures as side effects?
```
Tramadol
Imipenem
Isoniazid
metoclopramide
buproprion
benzodiazepine withdrwal
```
271
Drugs that can cause Tardive dyskinesia
antipsychotics
272
neurotoxicity PLUS neurotoxicity SE drugs
Cisplatin
Aminoglycoside
Polymyxin
273
nephrotoxic +ototoxic drugs?
Aminoglycoside
vancomycin
loop diuretics
Cisplatin
274
Anticholinergic SE drugs?
```
TCAs
H1 blockers
Atropine
Thioridazine
Chlorpromazine
```
275
How does strep viridans cause endocarditis?
It makes dextran from glucose and adheres to platelet and fibrin...which then sticks on heart valves
276
what are all the diseases strep pyogenes can cause?
superficial/pyrogenic: strep pharyngitis, impetigo, cellulitis, erysipelas
Immunogenic/organ specific: rheumatic fever, and poststrep glomerulonephritis
toxin mediated/systemic: Toxic shock-like syndrome, necrolyzing fascitis, scarlet fever
277
Aschoff bodies
Rheumatic fever
278
What are the bacteria that can do specialized transduction? what is one thing they have in common?
```
THESE ARE ALL TOXIN GENES TO BE GAINED!
ShigellA
Botulinum
Cholera tox
Diphtheria tox
Salmonella
Strep pyogenes
```
279
Group B strep causes what diseases in infants?
Meningitis, pneumonia, sepsis
280
subacute endocarditis...nothing is cultured...what is it?
HACEK
281
GI bleeding in the elderly. top two causes?
colon cancer, angiodysplasia
282
penicillin is mostly used for what gram bacteria?
G+
| and Neisseria
283
which penicillin type is oral and which is IV?
Penicillin V is oral; G is IV/IM
284
Ampicillin and Amoxicillin are the wide spectrum penicillins. What are they used for?
```
Hemophilus
E coli
Listeria
Proteus
Salmonella
Shigella
```
285
which penicillins are resistant to betalactamase?
Nafcillin
Oxacillin
Dicloxacillin
286
Mono patient develops a intense rash after abx therapy...what was the drug?
Ampicillin/amoxicillin
287
which drugs are usually coupled with betalactamase inhibitors?
amoxicillin/ampicillin, ticarcillin/piperacilin
288
pseudomonas treatment?
Ticarcillin/piperacilin
289
RBC cast
acute glomerulonephritis
290
Downey cells
EBV
291
Sixth disease?
Roseola HHV6
292
Reovirus...
What are the two in the family
What are the general viral family characteristics
Linear DS DNA virus
icosahedron, naked
Rotavirus, Coltavirus
293
when does rotavirus outbreaks occur?
winter
294
Colorado tick fever is caused by what?
Coltivirus. Wood tick
295
echoviruses outbreaks are when?
summer
296
Common Cold
Corona virus and Rhino virus
297
high fever, hemorrhagic disease (petechia, purpura, hematemesis) jaundice.. what do you think of?
Yellow fever. flavivirus
298
break bone disease with severe retrooral headache?
Dengue fever
299
how to test for dengue Hemorrhagic fever?
Tournaquette test-->pressure cuff to the point between SBP and DBP...positive if there's excess petechiae indicating vessel fragility
300
Name the flaviviruses
```
West Nile,
Dengue
Yellow fever
Hep C
St. Louis encephalitis
```
301
headache, malaise, anorexia, flaccid paralysis, alternating consciousness...what do you think of?
West Nile
302
how do you diagnose west nile?
antiWNV-IgM in CSF
303
encephalitis causing viruses... how are they spread?
theyre all arbovirus
304
congenital rubella heart defect?
open ductus arteriosus; pulmonic stenosis
305
SARS and MERS are what kind of viruses?
Coronavirus
306
Name two retroviruses
HIV
| HTLV
307
viral cause of anterior horn symptoms?
polio
| west nile
308
influenza virus belongs to which class?
orthomyxo
309
ebola is what viral family?
filovirus; negative ssRNA
310
Patients who die of influenza related causes usually die of what?
secondary bacterial infections: staph and strep are common
311
live vaccines should not be given to who?
Immunocompromised and pregnant
312
VIral illnesses of winter months?
Influenza, rotavirus, RSV
313
Summer month viral illnesses?
enteroviruses (echovirus, poliovirus, coxackie)
| arboviruses (west nile)
314
RSV treatment in children? premies? in immunocompromized?
Children-->nothing
Palivizumab-->can be used for prophylaxis in premature infants
Ribavirin-->immunocompromised.
315
Ribavirin mech? use?
Guanosine analog;
| RSV, Hep c
316
Hep C treatment?
interferon alpha, ribivirin
317
which virus class can directly replicate?
positive sense RNA
318
Which virus class has RDRP?
negative sense RNA
319
giant cell pneumonia
measles
320
subacute sclerosing panencephalitis
measles
321
vit A treatment for what viral infection?
measles
322
what are the 4 classic complications of mumps?
parotitis
orchitis
pancreatitis
meningitis
323
DIC causes?
STOP Making Thrombi
Sepsis, Trauma, OB procedures, pancreatitis, malignancy, transfusions
324
what does Pol code for?
reverse transcriptase and integrase
325
What are the env proteins?
p120 which grabs on to TCR and either CCR5 or CXCR4
| p41 which allows entry into the cell
326
What is gag protein?
p24 which is a capsid protein
327
What is the dx criteria of AIDS?
CD4
328
Cotton wool spots on retina
CMV retinitis in AIDS pts
329
What is AIDS pt most at risk of when CD4
PCP
330
What is AIDS pt most at risk of when CD4
Toxoplasma, esophageal candidiasis
331
What is AIDS pt most at risk of when CD4
Histoplasma
332
What is AIDS pt most at risk of when CD4
MAC, TB
333
Cherry red spot on retina
Tay Sach'S
Neiman Pick
Central retinal occlusion
334
What hormone incrases prolactin secretion and what hormone decreases prolactin secretion
TRH increases
| Dopamin decreases, prolactin also decreases
335
Name 3 prion diseases?
Creuzfeld Jakob's
Gerstmann-Straussler-Scheinker
Kuru
336
superficial vacular proliferation in AIDS pt
Bacillary angiomatosis OR Kaposi Sarcoma.
Bacillary angiomatosis will have neutorphilic infiltrate
337
low grade fever, cough, hepatosplenomegaly, and tongue ulcer in AIDS pt
Histoplasmosis
338
chronic watery diarrhea in AIDS pt with acid fast cysts in stool
Cryptosporidium
339
AIDS pt with demetia
HIV itself
340
AIDS pt with encephalopathy
PML via JC polyoma virus
341
AIDS pt with meningitis
Cyrptococcus
342
reheated meat dishes-->food poisoning.
| What organism
C. perferingens
343
bloody diarrhea, live abscess, amoeba
entamoeba histolytica
344
Pneumonia in children 4week to 2 years. top 4 ddx?
RSV
mycoplasma
Chlamydia trachomatis/pneumonia
Strep pneumo
345
neonatal pneumonia ddx
Group B strep
| e. coli
346
Indinavir specific drug side effect?
nephrolithiasis...hematuria
347
HIV positive mother should receive what before delivery (if not already on HAART)?
Zidovudine
348
Which NRTI doesn't need phosphorylation. WHY
Tenofovir...because it's a nucleoTide analog
349
Give how many drugs for occupational exposure to HIV?
3 drugs for 4 weeks
350
Which NRTIs is strongly associated with bone marrow suppression? how to you mitigate the effects?
Zidovudine; give gCSF and erythropoeitin
351
Didanosine mech? side effect?
NRTI for HIV;
| SE: pancreatitis and peripheral neuropathy, steatosis
352
What's SE of Abacavir?
HIV NRTI;
| life threatening hypersensitivity in pts with certain HLA types
353
Unique SE of Efavirenz?
vivid dreams, false positive cannabinoid tests, teratogenic
354
List NRTIs
-Vudines
Didanosine
Abacavir
Tenofovir
355
List NNRTIs
Nevirapine
Efavirenz
Delavirdine
356
which drug inhibits gp41?
Efuvirtide
357
Which drug inhibits viral interaction with gp120?
Maraviroc
358
what do bisphosphonates do? SE?
inhibitis osteoclast;
| esophagitis, jaw necrosis
359
Denosumab. what is it for?
RANKL inhibitor for osteoporosis
360
osteoporosis first line therapy?
Bisphosponates
361
carbonic anhydrase II mutation?
Osteopetrosis
362
Bone in bone appearance
osteopetrosis
363
key features of mcune albright syndrome
precocious puberty
cafe aulait spots
dysplastic bones (increased collagen)
