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Flash RX 259 Flashcards

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1
Q

Stratified columnar epithelium

A
  • Conjunctivae of eye

- Male urethra (some parts)

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2
Q

Simple squamous epithelium

A
  • Alveoli
  • Loops of Henle
  • Blood vessels
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3
Q

Diabetic nephropathy

A
  • Non-specific linear deposition of albumin, IgG, or complement (no complexes)
  • Non-enzymatic glycosylation of EFFERNT arterioles leads to increased GFR, which in turns EXPANDS MESANGIUM
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4
Q

Renal amyloidosis (primary, AL)

A
  • Deposits of immunoglobulin light chains

- Biochemical property that causes them to form amyloid fibrils after being processed by macrophages

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5
Q

Renal amyloidosis (secondary, AA)

A
  • Amyloid due to the deposition of Beta-pleated sheets of

- Serum amyloid A protein (acute phase reactant)

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6
Q

vWF increased PTT and bleeding time b/c

A
  • Defect in platelet adhesion

- Decreased survival of factor VIII (not being stabilized)

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7
Q
  • Low molecular weight heparin
  • Inhibits factor Xa
  • Used in patients with A-fib (to prevent thrombus formation)
A

Enoxaparin

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8
Q

PAN (more common in men or women)

A

MEN

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9
Q

PAN

A
  • NEGATIVE for ANCA

- May have low titers of anti-NUCLEAR Abs or Rheumatoid factor

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10
Q

Frame-shift mutation (ex DMD)

A
  • Lead to garbled codons downstream

- Frequently stop codons arise

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11
Q

Quinidine (class Ia antiarrhythmic) ADR

A

-Cinchonism (tinnitus, HA, thrombocytopenia and Torsades des pointes)

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12
Q

Robertsonian translocations

A

-Down syndrome and recurrent fetal loss

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13
Q

PAN necrosis type

A
  • FIBRINOID necrosis
  • Due to inflammation of arterial wall→immune complex deposition→necrosis→loss of elasticity
  • Beads on a string
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14
Q

TB necrosis

A
  • Caseating

- Tubercle (granuloma) w/ central caseous necrosis and often Langhans’ giant cells

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15
Q

Most common benzodiazepine used in preventing and treating delirium tremens? What about in cases of liver dysfunction?

A
  • Chlordiazepoxide

- Liver dysfunction = lorazepam

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16
Q

Management of delirium tremens

A

-Benzo (Chlordiazepoxide)
-Monitor vitals
-IV hydration
-Thiamine/folic acid/multivitamins
-Labs
ALSO: TB TEST and Pneumococcal and Influenza vaccination

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17
Q

Lateral Rectus Action and Innervation

A
  • Abduct eye

- CN VI

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18
Q

Drugs that disrupt angiotensin-renin system (ACEI and ARBS) are contraindicated in:

A

Pregnancy→due to secondary fetal defects of heart and kidneys

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19
Q
  • HCTZ
  • Aplha-methyldopa (good for acute HTN→fast acting)
  • Labetalol (good for acute HTN→fast acting)
  • Nifedipine
A

Antihypertensive agents that are safe for pregnant hoes (Hypertensive Moms Love Nifedipine)

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20
Q

Antihypertensive agents that are safe for pregnant hoes (Hypertensive Moms Love Nifedipine)

A
  • HCTZ
  • Aplha-methyldopa (good for acute HTN→fast acting)
  • Labetalol (good for acute HTN→fast acting)
  • Nifedipine
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21
Q
  • Adult T-cell lymphoma
  • Cutaneous lesions
  • LAD
  • HSM
  • Endemic in Japan and Caribbean
A

Human T-lymphocyte leukemia virus

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22
Q
  • Symptomatic relief for heart failure
  • HYPERkalemia toxicity (hypokalemia and hypomagnesemia potentiates effect leading to toxicity but is not a toxicity)
  • Blurry and/or yellow vision
A

Digoxin

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23
Q

Do loops or thiazides have potential for hypercalcemia?

A

Thiazides (good for osteoporosis patient)

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24
Q

Digoxin toxicity

A

N/V
Blurry yellow vision
Hyperkalemia
ECG abnormalities

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25
Treatment for Digoxin Toxicity
- Normalization of electrolytes - Administration of Lidocaine - Anti-digitalis Fab - Magnesium
26
Digoxin
- Symptomatic relief for heart failure - HYPERkalemia toxicity (hypokalemia and hypomagnesemia potentiates effect leading to toxicity but is not a toxicity) - Blurry and/or yellow vision
27
Goodpasture Triad
- Circulating anti-GMB - Nephritis - Diffuse pulmonary hemorrhage
28
- Crescent formation glomerulonephritis - PR3-ANCA / c-ANCA (anti-proteinase 3) - Upper and lower respiratory tracks also involved
Granulomatosis with Polyangiitis (Wegener)
29
- OVERLY ROUND RBC’s (missing central pallor and biconcave shape) - MCHC increased (results from decreased RBC volume and a stable Hb molar amount)→higher the MCHC the darker the RBC - MCV is decreased - Increased RBC fragility - Hemolytic anemia
Spherocytosis
30
White pupillary Reflex
Retinoblastoma (AD) RB on chromosome 13 -Presents with crossed eyes and lack or response to visual stimuli -Need that second mutation for neoplastic transformation
31
Significant proteinuria in nephrotic syndrome
-Decreased glomerular capillary oncotic pressure→leads to increase in GFR GFR= Kf (Pgc –Pbs)- (Oncotic GC- Oncotic BS) Bs=bowman space Gc=glomerular capillary Kf= filtration constant THINK ON THIS CARD YOU KNOW THIS…LOOK AT BRS if you still do not
32
- STAGHORN CALCULUS (STRUVITE-based stones usually) - Recurrent UTI - ALKALINATION of urine
Proteus and Klebsiella genera (urease-producing)
33
Positive direct Coombs test
-Suggest AUTOIMMUNE hemolytic anemia
34
Hospital acquired or drug resistant UTI (gram negative, anaerobic bacillus)
Pseudomonas aeruginosa
35
Spherocytosis
- OVERLY ROUND RBC’s (missing central pallor and biconcave shape) - MCHC increased (results from decreased RBC volume and a stable Hb molar amount)→higher the MCHC the darker the RBC - MCV is decreased - Increased RBC fragility - Hemolytic anemia
36
Retinoblastoma (AD)
RB on chromosome 13 - Presents with crossed eyes and lack or response to visual stimuli - Need that second mutation for neoplastic transformation - White pupillary reflex
37
How do you calculate urine flow rate?
- Use three parameters (GFR, plasma inulin, urinary inulin) - NOTE: GFR can be approximated by creatinine clearance Urine flow rate= GFR X [inulin] p / [inulin] u
38
Amygdalae mediates…
Fear, anxiety and aggression | Bilateral lesions→Kluver-Bucy Syndrome
39
- Amide-based local anesthetic - CARDIOTOCITY→hypotension and arrhythmia risk if given IV - EPIDURAL
Bupivacaine
40
- Ataxia of the limbs - You suck at finger-to-nose and heel-to-shin tests - Impaired rapid alternating movements
Damage to intermediate zone of cerebellar hemisphere
41
Bupivacaine
- Amide-based local anesthetic - CARDIOTOCITY→hypotension and arrhythmia risk if given IV - EPIDURAL
42
Second degree heart block Mobitz type II
-Normal PR intervals with several nonconducted/dropped beats
43
Fentanyl: Drug type and ADRs
- Opioid | - N/V, CONSTIPATION, RESPIRTATORY DEPRESSION, and coma
44
- Gaseous anesthetic - Hepatotoxic - Malignant hyperthermia w/depolarizing paralytic (succinylcholine) - Decrease in cardiac output and blood pressure
Halothane
45
Ibuprofen
- NSAID | - Gastric ulceration and renal failure (due to interaction with kidney autoregulation
46
Renal or hepatic impaired patient. Loading-dose is the SAME why? And lower maintenance dose why?
Loading dose dependent on VOLUME DISTRIBUTION, not excretion or metabolism Maintenance dose should be lowered to account for less effective clearance
47
How are Fluoroquinolones are excreted?
Renally
48
Tertiary syphilis and the heart
- Dilated aortic root and valve ring | - Linearly calcified, aneurysmal ACSENDING AORTA
49
Most common malignancy of small intestine
Carcinoid syndrome
50
Rheumatic fever can cause valvular
Mitral>aortic>>tricuspid
51
Whorled pattern of cell growth surrounding laminated areas of dystrophic calcification
Psammoma bodies
52
Histology of Glioblastoma Multiforme
Pleomorphic tumor cells and central areas of necrosis and hemorrhage
53
- More in children - Usually Cerebellum - Foamy - High degree of vascularity
Hemangiomas
54
- S100 positive - Spindle cells - Usually localized to CNVIII
Schwannoma
55
Meningioma
Seizure Headache Visual field deficit
56
Fanconi anemia (FA) Inheritance
-AR
57
Fanconi anemia (AR)
- Bone marrow hypofunction→ Pancytopenia | - Bone problems at young age
58
Increased chromosomal breakage in response to DNA-damaging agents (esp. cyclophosphamide) due to a defect in HOMOLOGOUS recombination DNA REPAIR-Fanconi’s syndrome
-Even worse when being treated for arthritis too
59
Fanconi patients (AR) also at risk for…
``` Myelodysplastic syndromes (5% of cases) AML (acute myeloid leukemia) – 10% of cases ```
60
Knockout mutation of ATM gene (what does gene encode?)
- Ataxia-telangiectasia - Protein kinase that detects double-stranded DNA breaks - LOSS OF PURKINJE CELLS in the cerebellum and defective LYMPHOCYTE MATURATION and PROLIFERATION
61
- Ataxia-telangiectasia - Protein kinase that detects double-stranded DNA breaks - LOSS OF PURKINJE CELLS in the cerebellum and defective LYMPHOCYTE MATURATION and PROLIFERATION
Ataxia-telangiectasia
62
Ataxia-telangiectasia
- Ataxia - ELEVATED brown cutaneous lesions (secondary to chronic capillary dilation) - Extensor plantar responses - Distal sensory deficiencies
63
Ataxia-telangiectasia
- Ataxia-telangiectasia - Protein kinase that detects double-stranded DNA breaks - LOSS OF PURKINJE CELLS in the cerebellum and defective LYMPHOCYTE MATURATION and PROLIFERATION
64
Ataxia-telangiectasia symptoms
- Ataxia - ELEVATED brown cutaneous lesions (secondary to chronic capillary dilation) - Extensor plantar responses - Distal sensory deficiencies
65
ITP (idiopathic thrombocytopenia purpura)
- Commonly post viral exanthema or URI in a child | - Recover in 3-6 months usually
66
All the glory to...
GOD
67
Zeil-Neelsen stain
Acid Fast (ex: TB and leprosy)
68
Giemsa stains
- Borrelia - Plasmodium - Trypanosomes - Chlamydia
69
India Ink
Cryptococcus neoformans
70
Periodic acid-Schiff stain
-Carbohydrates (ex: glycogen)
71
Bouchard nodes
Proximal interphalangeal joints (PIP)→ bony enlargement | -OA and RA
72
Heberden Nodes
- Distal interphalangeal joints (DIP) → bony enlargement | - SPARED in RA and present in OA
73
- Calcium pyrophosphate crystals - Positive birefringent - Knee (men over 50)
Pseudogout
74
Subdural hematoma
- Bridging veins - Crescent-shaped - Can cross suture lines but not falx cerebri or tentorium cerebeli - Slow progression and speech motor involvement possible
75
- BICONVEX disc on CT - Can cross falx but and tentorium but NOT suture lines (opposite of subdural) - Middle meningeal artery
Epidural hematoma
76
When can pulsus paradoxus be seen?
- Cardiac tamponade - Asthma - Croup - Obstructive sleep apnea
77
All methotrexate uses:
- RA (due to reduction of adenosine-mediated inflammatory changes) - Breast, head and neck, lung and choriocarcinoma - ALL and non-Hodgkin’s Lymphoma - Ectopic pregnancy, psoriasis, IBD
78
Can tetracyclines be used in RA?
- Yes in early stage | - Inhibit activity of metalloproteinase involved in joint destruction
79
Cyclophosphamide (alkylating agent) uses:
- Non-Hodgkin, breast and ovarian carcinomas | - Immunosuppressant: SLE, MS, autoimmune hemolytic anemia
80
Probenecid (organic acid)
-Tx for chronic tophaceous gout or increasingly frequent gouty attacks
81
X-linked defect affecting the methylation and expression of the FMR1 gene
-Fragile X syndrome
82
Herpes Zoster (varicella-zoster)
- Nasty nose | - Especially if immunosuppressed
83
Is an inactive precursor that is activated by THYMIDINE KINASE when absorbed into infected cells→ forms GUANINE analog that results in chain termination
Acyclovir mechanism of action
84
Mantle Cell lymphoma Translocation
t(11;14) | Overexpression of cyclin-D1
85
-Broad, darkly staining malignant lymphoid cells in the MANTLE region surrounding residual reactive germinal centers
Mantle Cell histology
86
PML/RAR-alpha hybrid protein
- T(15;17) | - APL
87
Treatment for acute pro-myelocytic leukemia | Forces differentiation of the leukemic cells into neutrophils, which have a short life span
All-trans retinoic acid
88
Brodetella pertussis culture media
Bordet-Gengou medium
89
Loffler’s Medium
Culture Corynebacterium diphtheriae
90
Thayer-Martin medium
Culture Neisseria
91
Pompe disease (Type II glycogen storage disease)
- Pompe trashes the pump (heart) - Lysosomal alpha-1,4-glucosidase is absent - Necessary for hydrolysis of outer branches of glycogen - Glycogen deposited in myocardium
92
ECG of infant shows short PR intervals and LARGE QRS complexes evidencing biventricular hypertrophy
- Pompe Disease - By six month of life child experiences developmental delay, feeding problems, and eventually heart failure - Cardiomegaly on CXR - Skeletal muscle and liver affected
93
Fabry disease
- Lysosomal storage disease | - Alpha-galactosidase A deficiency
94
Alpha-galactosidase A deficiency what disease and what accumulates
- Fabry disease | - Ceramide trihexoside → peripheral neuropathies of hands and feet, angiokeratomas, and cardiovascular and renal disease
95
Gaucher disease (Lysosomal storage disease)
- Beta-GLUCOCEREBROSIDASE deficiency - HSM - Aseptic necrosis of femur - Bone crises - GAUCHER CELLS
96
- Lysosomal storage disease | - Alpha-galactosidase A deficiency
Fabry disease
97
Pioglitazone (thiazolidinone)
- Sensitize skeletal muscle and liver to insulin→ increasing uptake of glucose - Binds and activates PPAR nuclear regulators→increase insulin receptors
98
- Long-acting synthetic insulin | - Continuous baseline level of insulin in blood
Glargine
99
- Sensitize skeletal muscle and liver to insulin→ increasing uptake of glucose - Binds and activates PPAR nuclear regulators→increase insulin receptors
Pioglitazone (thiazolidinone)
100
Acarbose
- Alpha-glucosidase inhibitor | - Acts on intestinal brush boarder to decrease absorption of starches and other polysaccharides
101
-Closes K+ channels expressed in the cell membrane of pancreatic acinar beta cells→cellular depolarization→calcium influx→triggers release of insulin
Glipizide (sulfonylurea)
102
Metformin
- Oral hypoglycemic agent - Inhibits HEPATIC gluconeogenesis - Decreased blood glucose levels - Increase skeletal muscle GLUT4 membrane translocation
103
Paget disease of bone
- Mosaic pattern (accelerated bone turnover/formation and resorption) - Pain, skeletal deformities and fractures - Associated with: secondary osteosarcoma and fibrosarcoma
104
- Alpha-glucosidase inhibitor | - Acts on intestinal brush boarder to decrease absorption of starches and other polysaccharides
Acarbose
105
Bronchiolitis from infection: RSV vs. Mycoplasma pneumonia
RSV 5 years of age
106
Treatment of prostate cancer with a drug that requires careful monitoring, as it will first INCREASE hormone production before therapeutically decreasing hormone production
Leuprolide (inhibits LH and FSH release)
107
CRH (Corticotropin-releasing hormone)
-Stimulates (+)→ POMC gene→Production of ACTH and MSH (melanocyte-stimulating hormone)
108
Leuprolide ADRs
- Impotence | - Hot flashes
109
Aminoglutethimide: Use and MOA
- Treat metastatic breast cancer - Inhibits synthesis of estrogens from cholesterol - Shrinks tumor in ESTROGEN-DEPENDENT breast cancer
110
5-FU ADRs
- Alopecia - PHOTOSENSITVITY - Myelosuppression - N/V - Diarrhea
111
- Treat metastatic breast cancer - Inhibits synthesis of estrogens from cholesterol - Shrinks tumor in ESTROGEN-DEPENDENT breast cancer
Aminoglutethimide: Use and MOA
112
What is responsible for feedback inhibition of GHRH?
Somatostatin
113
5-FU myelosuppression reversal
- THYMIDINE supplementation | - Bypass block to continue DNA synthesis
114
Aminoglutethimide: ADR
- Depression | - Maculopapular rash

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