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High Yield Concepts Flashcards

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1
Q

Ph at what the nonprotonated form(A- or B) = the protonated form(AH or BH+)

A

PK

(Acid dissosiation constant)

  • Protonated form are impermeable to membranes
  • Non protonated forms are permeable to membranes
    • give acid to trap a base(give Nh3CL to eliminate amphetamines,phenobarbital,methrotrexate)
    • give base to trap an acid(give Bicarb to eliminate salicilates)
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2
Q

phase 1 drug metabolism

what does it yields?

afected by what?

A

Phase 1 (redox and hydrolisis )

  • yield more hydrosoluble methabolites
  • geriatric patins lose phase I first
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3
Q

maximal effect a drug can produce

A

Efficacy

retaled to Vmax

efficacy is decresed by non competitive inhibitors

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4
Q

amount of drug needed for a given effect

A

Potency

competitive inhibitor decrese potency

Km =1/potency=1/afinity

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5
Q

Drugs that cause “Miopization” , blurred vision, inability to see far objects

A

Muscarinic drugs toxicity

  • treat with atropine and pralidoxime(regenerates ECHE if given early)
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6
Q

reversal of neuromuscular junction blockade=

myastenia gravis crisis treatment=

atropine overdose=

A

Neostigmine

Pyridostigmine

Physiostigmine

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7
Q
A
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8
Q

what does epinephrine and isoproterenol does to MAP:

A

epinephrine(a1ß1):increases MAP –>reflex bradycardia.

isoproterenol(ß1ß2):decrese in MAP –>reflex tachi.

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9
Q

drug used in cardiogeny shock because it increases blood renal flow

A

Dopamine

D1 receptor

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10
Q

ß that decrease mortality in post MI patients.

A

Bisoprolol

Carvidelol

Metroprolol

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11
Q

what b blockers should be avoided in ashtma?

A

non selective b blokers(N-Z)

nadolol

pindolol

propanolol

timolol

carvidelol(has some b2 blockade activiry)

labetalol

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12
Q

halos around light with with painful sudden vision loss

A

Acude closed narrow glaucoma

fix mid dilated pupil

BE CAREFUL:Halos arround lights are also communly seen in cataracts.

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13
Q

most common ligament injured feet invertion

A

the anterior fibular ligament.

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14
Q

thoracic outlet syndrome

A

klumpke palsy

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15
Q

problems related with erythema nodosum

A
  • inflammatory bowel disease
  • sarcoidosis
  • sufa drugs
  • malignant neoplasm
  • tuberculosis
  • B-hemolitic streptococci
  • coccidioidomycosis
  • histoplasmosis
  • leprosy
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16
Q

collagen synthesis hidroxilation syntesis=

collagen synthesis glycosilation deffect=

A

scurby

osteogenesis imperfecta

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17
Q

agraphia

alogia

acalculia

A

Gerstmann´s syndrome

damage to the visual association cortex.

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18
Q

neurololgical claudication(pain with prolonged by walking ,standing and relieved by rest and forward flexion of the vertebral column) relieved by siting and have negative leg raises bilaterally

A

Lumbar spinal stenosis

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19
Q

only gram + who has endotoxin

A

Listeria

  • gastroenteritis in healthy patients
  • meningitis,spontaneous abortous in neonates
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20
Q

only bacterial capsule not composed of polysaccharide

A

bacillus anthracis composed of D-Glutamate

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21
Q

with what cytokines these shocks states are related?

septic shock

anaphilactic shock

A

CAUSED BY ENDOTOXIN (Lipid A) of gram - and Listeria

  • septic shock=nitric oxide hypotention(from macrophages)
  • anaphilactic shock= C3a a part of the complement(releases histamine from mast cell)hypotention and edema
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22
Q

toxin that prevents the release of inhibitory (glycine and GABA) neurotransmitters from renshaw cells in spinal cord.

A

tetanospasmin

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23
Q

what toxin cause scarlet fever?

A

ESCARLE FEVER(S.pyogenes type A)

  • erithrogenic toxin
  • pyrogenic toxin
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24
Q

caracteristics of MacConkey agar

A
  • bile salt and cristal viollet=>gran + inhibition
  • lactose
  • nuetral red

Lactose fermenters turn red:

  • FAST
    • Klebsiella
    • E.colli
    • enterobacter
  • SLOW:
    • citrobacter
    • serratia
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25
catalase positive bacteria
**PLACESS** * *Pseudomonas* * *Listeria* * *Aspergillus* * *Candida* * *E.coli* * *S.aireus* * *Serratia* *people with chronic granulomatous disease (NADPH oxidase deficiency)have current infections with these bugs*
26
obligated anaerobes
clostridium bacteroides actinomices
27
major virulence factor of S.pyogenes
**M PROTEIN** * (-) phagocytosis * (-) the activation of complement * enhance bacterial attachment antibodies against M protein cause rheumatic fever
28
toxins that produces scalded skin syndrome
* exfoliative toxin * epidermolitic toxin * enterotoxin
29
neutrophil chemotaxis
IL-8 C5a LB4
30
elevated ESR
* polymyalgia reuhmatica * temporal arteritis * disease activity in RA and SLE * infection * inflamation * malignacy
31
CD16= CD14= CD56= CD55 AND CD59=
CD16=Binds Fc of IgG in macrophages and NK CD14=macrophages it binds to LPS CD56=unique marque for BK CD55 AND CD59=DAF
32
likelyhood that alpha error(false positive) is present
*p* value
33
who do you increase statistical power
**_↑power and ↓ ß by:_** * ↑ sample size * ↑ expected effect size(how big the think you are looking for) * ↑precision of measurement
34
confidence interval between 2 variables includes 0
there is no significant difference and **H0 is not rejected**
35
if odds ratio includes 1?
**H0 is not rejected**
36
Aztreonam
for gram - rods when px its allergyc to amynoglycosides
37
MRSA and VRSA oral medication
Linezolid works on 50s fraction of the ribosome
38
sulfa drugs
**P**opular **FACTSSS** * Probenecid * furosemide * acetazolamide * celecoxib * thiazide * sulfonamide antibodies * sulfasalazina * sulfanylureas
39
serotoninergic syndrome
triptans linezolid ondansetron tramadol antidepresans
40
P 450 substrates * *A**lways, **A**lways, **A**lways, * *A**lways **T**hink **W**hen * *S**tarting **O**thers
* anti-epileptics * antidepressants * antipsychotics * anesthetics * theophylline * warfarin * statins * OCPs
41
P-450 inducers **G**uinness**,C**oronas**,** and **PBRs** induce **CHRONIC ALCOHOLISM**
**_They decrese p450 substrate concentration in plasma_** * **Griseofulvin** * **Carbamazepine** * **Phenytoin** * **Barbitures** * **Rifampin** * **chronic alcohol** * modafinil * st.jhons wort * nevirapine *
42
P-450 inhibitors **CRACK AMIGOS**
**They increse P-450 substrates(eg.warfarin) concentration in plasma** * **cipro** * **ritonavir** * **amiodarone** * **cimetidine** * **ketokonazol** * **alcute alcohol** * **macrolides** * **INH** * **Grape juice/gemfibrozil** * **omeprazol** * **sulfa**
43
trematodes realate to - squamos cell carcinoma of the bladder= - cholangiocarcinoma=
**-squamos cell carcinoma of the bladder=** * Schistosoma haematobium **-cholangiocarcinoma=** * clonorchis sinensis(from undercooked fish)
44
paracite causing B12 deficiency
**diphyllobotrium latum(cestode)** raw fresh water fish
45
paracite that causes hydatidi cyst
echinococus granulosus(cestodo) ingestion of eggs from dogs
46
cause of S3 sound
* Dilated Cardiomyopathy * CHF * Mitral regurgitation * Left to right shunt * normal in children and pregnancy
47
cause of s4 sound
ATRIAL KICK * hypertrophic cardiomyopathy * aortic stenosis * chronic HTN with LVH * after MI
48
drugs causing torsades
Some Risky Meds Can Prolong QT:Soltalol * Sotalol * Risperidona * Macrolides * Chroloquine * Protease inhibitors * Quinidine * Thiazides
49
5 deadly cause of chest pain
* Aortic dissection * unstable angina * myocardial infarction * tension pneumotorax * pulmonary embolus
50
causes of pulsus paradoxus
**_Droop pressure \>10mmhg during inspiration_** * asthma * caridac tamponade(electrical alternance in EKG) * obstructive sleep apnea * croup
51
kussmaul sign
decrease of capacitiy of the right ventricle **_increase JVP on inspioration instead of a normal decrease._** * constrictive pericarditis * restrictive cardiomyopathies * right atrial or ventricular tumors
52
live vaccines
**_Do not to give inmunocompromize patients and close contects_** * smallpox * chickenpox * yellow fiver * sabrin(polio) * MMR(can be give a patien with HIV buy not with AIDS) * intranasal influenza
53
egg vacciones
flu vaccine yellow vaccione MMR(does not induces allergy)
54
features of anaplastic cells
* high nucleous to cytoplasm ratio * prominent nucloli * nuclear chromatin clumping * many mitotic figures
55
epithelial tumor normally they spread through lympnoces, but someones do not, what epithelial tumor do not spread by lymph nodes?
carcinomas that spread hemotogenously(normally it would be by lymph node) * HCC * RCC * Follicular Thyroid * Choriocarcinoma
56
drug induce lupus
anti histone antibodies SHIP * sulfa drugs * hydralazine * INH * procainamida * phenytoin
57
essentia aminoacids
**PVT TIM H**a**LL** * Phenylalanine * Valine * tryptophan * Threonine * Isoleucine * Methionine * Histidine * Leucine * Lysine
58
golgi modified aminoacids= nuclear signaling aminoacids= collagen aminoacids=
golgi modified aminoacids= * seria * asparagina * threonina nuclear signaling aminoacids= * Lisina * arginina * prolina collagen aminoacids= * glycina * prolina * lysina
59
drugs with anticholinergic activity AVOID IN ELDERLY
1 generation antihistamines low potencia antipsychotics TCAs amantadine antimuscairinics
60
X linked diseases
61
autosomal recessive
* cystic fibrosis(chromosome 7)CFTR gene * BLOOD: * Sickle cell anemia * Thalassemias * METALS: * hemochromatosis * wilsons * ------ * albinism * ARPKD * glycogen storage disease * mucopolysaccharidoses(excep hunter syndrome) * sphingolipidoses(except fabry´s) * kartagener syndrome * phenylketonuria
62
Autosomic Dominant
* VHL(chromosome 3) * Huntington´s(chromosome 4)CAG trinucleotides * FAP(APC gen 5) * ADPKD(chromosome 16)PKD1 gene * NF-1(chromosome 17)NF1 gene * NF-2(chromosome 22)NF2 gene * familial hypercholesterolemia * Osler-Weber-Rendu(hereditary hemorrhagic telangiectasia) * Hereditary spherocytosis * Marfan * MEN * Tuberous Sclerosis
63
Nuclear signaling AA and Histones
Arginine Lysine
64
purine synthesis
Glysine Aspartate Glutamine
65
Nuclear signal
Lysina Arginine Proline
66
collagen synthesis AA
glycine Proline Lysine
67
Branched AA
Isoleucine Leucine Valine
68
Ketogenic AA
Tx for Pyruvate dehydrogenase defienciency Leucine Lysine
69
Essential AA
PVT TiM HaLL * phenylalanine * Valine * Threonine * Tryptophan * Methionine * Histidine * Leucine * Lysine
70
Acidic AA
Aspartate Glutamate
71
B1 (thiamine) is needed for?
alpha-ketoglutarate dehydrogenase Pyruvate dehydrogenase transketolase branched-chain ketoacid dehydrogenase
72
B6(piridoxyne) is needed for?
* Transamination(AST and ALT) * Neurotrasmiter synthesis: * 5HT * dopamine * norepinephrine * epinephrine * cystathionine syntethase(cofactor) * heme synthesis(ALA synthase cofactor) * Niacine * histamine *
73
Hydrophobic AA(in transmembrane proteins)
Valine,Isoleucine,alanine.methionine and phenylalanine
74

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