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USMLE-rx > Feb 19th Kaplan > Flashcards

Feb 19th Kaplan Flashcards

1
Q

What is ferritin?

A

Binds iron with in the cells

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2
Q

What is transferrin?

A

Transfers iron in the serum

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3
Q

Where is transferrin made and what causes it to increase in synthesis?

A

In the liver and its synthesis is increased when ferritin is low

Thus high ferritin leads to decrease in the production of transferrin

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4
Q

What is Total biding capacity and what does it show?

A

How much transferrin is in the serum to bind iron

- thus synonymous with transferrin levels

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5
Q

what is Percent transferrin saturation?

A

Amount of iron bound to transferrin

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6
Q

Where are common places for excess iron to accumulate?

A 
Pancreas 
Spleen 
Skin
Liver
Heart 
pituitary 
Joints
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7
Q

What tumor results in loss of vertical eye movements?

A

Pinealoma

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8
Q

What is central pontine myelinosis?

A

Demyelination primarily of the pons due to prolonged hyponatremia followed by rapid correction

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9
Q

Are steroids hormones produced on demand or stored in vesicles?

A

Produced on demand

- they are lipophilic thus can move quickly across membrane so no need to make them before

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10
Q

What sort of hormones are produced and stored in vesicles?

A

Protein hormones which are lipiphopic which means they need more time to get signal across cell membrane

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11
Q

Celiac has antibodies produced against which protein?

A

Gliadin

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12
Q

Which HLA typing is Celiac disease associated with?

A

HLA- DQ2 and DQ8

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13
Q

What are the common findings in celiac disease?

A
  1. IgA anti tissue transglutaminase
  2. Anti-endomysial
  3. Anti-deamindated gliadin peptides
  4. Reticulin IgA
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14
Q

Does a pt with celiac disease present with bone pain? why?

A

They can

- Auto-ab’s against osteoprotegerin which causes in activation of osteoclasts via RANK-ligand

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15
Q

What is another name for osteoprotegerin?

A

Osteoclastogenesis inhibitory factor

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16
Q

What is dermatitis herpetiformis?

A

Itchy red vesicular rash found predominantly on the extensors

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17
Q

What is the pathogenesis of dermatitis herpetiformis?

A

subepidermal deposition of IgA and Anti-transflutaminases

- May also find neutrophils

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18
Q

What is the mnemonic for sensitivity ruling out?

A

Dogs have SENSITIVE SNouts

  • SN- Sensitivity
  • Rules out
  • Like a D-dimer
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19
Q

What does the mnemonic SPPIN stand for?

A

Specificity rules IN

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20
Q

Who commonly presents with s. aureus scalded skin syndrome?

A

Infants–> especially around umbilicus
children
Adults with renal insufficiency

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21
Q

What is seen on physical exam in SSSS?

A

Positive Nikolsky sign of blisters
Sloughing of upper layers of epidermis
Erythema

22
Q

What is the cause and what is targeted in SSSS?

A

Exotoxin from S. Aureus

- Targets desmosomes at the layer between the granulosum and corneum.

23
Q

Where do SJS and TEN target on the skin layer?

A

Epidermal and dermal junction

24
Q

What does hypercapnia cause in terms of vessels?

A

Vasodilation

  • increase systemic and pulmonary resistance
  • thus increased afterload
25
Pt presents with increased anion gap metabolic acidosis? She is on metformin. What is the cause of the acidosis?
Lactic acid | - especially in renal insufficient patients
26
What is cyclobenzaprine?
Centrally acting Skeletal muscle relaxant | - spasmolytic
27
What are the AE's of Cyclobenzaprine?
Anticholinergic affects
28
What muscle controls contraction if the bladder?
Detrusor
29
What are oxybutin and tolterodine used for?
M3 antagonists which are used for urge incontinence | - leads to smooth muscle relaxation of bladder and ureters
30
What is Menetrier disease?
Gastric hyperplasia of mucosa--> leads to hypertrophied regae - increased proliferation of mucous producing cells
31
pt presents with Menetrier disease, what is lost in fecal matter?
protein - increased mucous cells causes parietal cell atrophy and decreased H+ which leads to decreased breakdown of proteins - malaborption downstream
32
What cytokine is overproduced in Menetriers disease
TGF-a
33
What is first line treatment for schizophrenia?
Atypical antipsychotics | - Risperidone
34
What else can be used to treat schizophrenia?
Antipsychotics (neuroleptics) - high potency - low potency
35
What is Torticollis?
involuntary twisting of the neck with neck pain and abnormal head posture
36
What drugs are commonly associated with Toricollis?
High potency antipsychotics - Haloperidol - Fluphenazine - Trifluoperazine
37
What is the mnemonics for high potency antipsychotics?
Try to fly high - Trifluoperazine - Haloperidol - Fluphenazine
38
What are some other common side affects of high potency antipsychotics?
More EPS symptoms and less non-neurological symptoms
39
How about low potency antipsychotics what are their sxs compared to high potency?
We need more of them to act - thus more non-neuro sxs - less EPS sxs
40
What is the mnemonic for low potency antipsychotics?
Cheating Thieves are low - Chlorpromazine - Thioridazine
41
What are EPS symptoms?
Extra-pyramidal sxs 1. acute dystonia 2. Akathisias 3. Parkinsonian syndromes 4. Tarditive dyskinesias (irreversible)
42
what can one give to treat the reversible EPS sxs?
Benztropine Diphenhydramine Benzos
43
What are the non-neuro sxs associated with taking typical antipsychotics?
Muscarinic Alpha1 Histamine
44
How many pts with mumps present with bilateral parotitis? Orchitis
90% and 40 respectively
45
Where are some common locations for tophus?
External ear Olecranon bursa Achilles
46
how do you treat acute gouty arthirtis?
NSAID's Indomethacin Steroids Colchicine
47
Increased AFP (amniotic and maternal) and Ache (amniotic) lead to what type of defect and when?
Day 27 - Meningocele or Meningomyelocele - NOT bifida
48
What is normal range of ejection fraction?
55-75%
49
What is the systemic response to hypoxia in terms of vessels?
vasodilation - allows for increase return of venous blood to heart - Constrictions small vessels and arterioles
50
Does gastrin weaken or strengthen the stomach lining?
Strengthen | - causes increase in cell division in the proliferation zone

USMLE-rx (9 decks)

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