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Caleb's Step 1 > March 17 > Flashcards

March 17 Flashcards

(83 cards)

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1
Q

IL-4

A

B-cell switch to IgE

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2
Q

IL-5

A

B-cell switch to IgA

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3
Q

ADR of Lithium

A

Hypothyroid
DI
Tremor
Ebstein Anomaly (congential cardiac defect)

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4
Q

ADR of Digoxin

A

Neuro: color vision changes, weakness, confusion, fatigue

GI: nausea, vomiting, abd pain

Cardiac: arrhythmia! (any kind, esp ventricular)

precipitated by: hypokalemia, hypovolemia, renal failure

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5
Q

Burkitt Lymphoma

A

t(8:14)
8 = c-Myc - overexpression, oncogene promotes tumor growth

African type - jaw mass
sporadic - abdominal/pelvic mass

starry sky appearance on histology

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6
Q

Strep Viridans

A

synthesizes dextrans from sucrose

allows adhesion at Fibrin-Platelet aggregates

adheres to pre-existing valvular lesions –> endocarditis

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7
Q

Galactosemia

A

galactose-1-phosphate uridyl transferase deficiency is most common

inability to convert Galactose-1-phosphate –> glucose-1-phosphate

symp: jaundice, vomiting, hepatomegaly, E. coli sepsis, cataracts, hemolytic anemia

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8
Q

INH-induced Neuropathy

A

due to competition with and deficiency of Pyridoxine B6

defective synthesis of GABA and increased urinary loss of B6

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9
Q

Angiogenesis (2 substances)

A

VEGF (vascular endothelial growth factor)
FGF-2 (fibroblast growth factor-2)

IL-1 and IFN-gamma are pro-inflammatory cytokines that can increase VEGF to indirectly promote angiogenesis

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10
Q

Cord Factor in mycobacterium

A

Virulence factor!

mycobacteria without cord factor are not pathogenic

actions: inactivates neutrophils, damages mitochondria, induces release of TNF

causes TB to grow in ‘thick rope-like cords in a twisted serpentine pattern”

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11
Q

mRNA detection

A

Northern Blot

assess gene expression

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12
Q

Müllerian aplasia

A

aplasia = defective development or congenital absence

variable uterine development with a short vagina/no upper vagina

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13
Q

Cardiac Tamponade

A

pericardial effusion

Beck triad: hypotension, elevated JVP, muffled heart sounds

decreased systolic pulse pressure during inspiration due to increased venous return to RV which compresses LV

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14
Q

Chancroid

A

Haemophilus ducreyi

multiple deep painful ulcers with gray.yellow exudate at base

inguinal LAD

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15
Q

Cranial nerve effected by parotid gland tumor?

A

Facial Nerve CNVII courses through the parotid gland

can cause facial droop (CN VII = muscles of facial expression)

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16
Q

Influenced by disease PREVALENCE

A

positive and negative predictive value

NOT: sensitivity, specificity, nor likelihood ratio

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17
Q

Obturator Nerve

A

L2-L4
thigh adduction
injury @ pelvic surgery

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18
Q

Femoral Nerve

A

L2-L4
flexion of thigh, extension of leg
sensory over medial leg, knee
injury @ iliopsoas (hematoma or abscess)

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19
Q

Common Peroneal Nerve

A

L4-S2
foot eversion, doriflexion, toe extension
sensory over lateral lower leg and dorsum
injury @ fibular neck fracture

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20
Q

Tibial Nerve

A

L4-S3
foot inversion, plantar flexion, toe flexion
sensory of soles of feet
injury @ knee trauma

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21
Q

Superior Gluteal

A

L4-S1
stabilizes pelvis
injury @ upper medial gluteal (injection)

Trendelenburg gait - contralateral hip drops and patient leans towards side of lesion

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22
Q

Gallstones

Cholesterol?
Bile Acids?
Phosphatidylcholine?

A

cholesterol UP
bile acids DOWN
phosphatidylcholine DOWN

bile is supersaturated with cholesterol and precipitates out :(

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23
Q

Carotid Sinus Innervation

A

Afferent - glossopharyngeal nerve CN IX
Efferent - vagus nerve CN X

pressure @ carotid sinus –> increase in PNS and decrease in SNS –> bradycardia, hypotension and even syncope (carotid sinus hypersensitivity)

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24
Q

Pt with mono-like illness but negative heterophile antibody test?

A

CMV! especially in immunocompetent patients

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25
Atropine Overdose
give physostigmine crosses CNS to relieve all symptoms (dry as a bone, red as a beet, mad as a hatter, hot as a hare)
26
Terbinafine MOA
inhibits squalene epoxidase --> cannot produce Ergosterol
27
Timolol ophthalmic drops MOA
decreases aqueous humor production by ciliary epithelium acetazolamide does this too
28
Drugs that increase outflow of aqueous humor
muscarinic agonists: pilocarpine, carbachol - increase outflow at trabecular prostaglandin agonists = PGF2alpha - latanoprost, travoprost
29
Drugs that decrease aqueous humor production
timolol | acetazolamide
30
MOA IFN-alpha and IFN-beta
secreted in response to viral infection decrease/stop protein synthesis of infected and nearby cells (autocrine/paracrine)
31
Results of defective ApoE3 and ApoE4
decreased clearance of chylomicrons and VLDL --> elevated cholesterol and TGs eruptive palmar xanthomas (yellow nodules/papules) and premature atherosclerosis
32
Chronic Alcoholic Pancreatitis
abdominal pain, chronic diarrhea, weight loss due to exocrine insufficiency and malabsorption xray shows calcifications in the apigastric area
33
Dietary Energy
Protein - 4cal/1g Carbs - 4cal/1g Fats - 9cal/1g Ethanol - 7cal/1g
34
Anaplastic Features
``` loss of cell polarity pleomorphism - high variation in cell size and shape high N:C ratio lots of mitotic figures giant multinucleated cells ```
35
Effect of Nitrite Exposure
converts Fe2+ hemoglobin --> Fe3+ methemoglobin Methemoglobin cannot carry oxygen, causes dusky skin discoloration decreases oxygen carrying capacity, oxygen content, and bound fraction of oxygen partial pressure of oxygen (oxygen dissolved in the plasma, regardless of hemoglobin content/status) remains normal
36
Contra-indication for fibrate therapy?
gallstones! fibrates inhibit bile acid synthesis --> decreased cholesterol solubility --> increase precipitation of cholesterol and gall stone formation
37
Lesch-Nyhan
X-linked Recessive deficit in HGPRT (decreased purine salvage) see increased PRPP (phosphoribosyl pyrophosphate amidotransferase) due to increased de-novo purine synthesis symp: dystonia, developmental delay, self-mutilation, hyperuricemia, 'orange sand BM'
38
Uric acid precipitation
collecting ducts due to low urine pH uric acid precipitates in an acidic environment tx - urine alkalinization - acetazolamide
39
Hemolytic disease of the newborn
erythroblastosis fetalis destruction of fetal RBCs by maternal IgG due to Rh incompatibility ``` positive direct Coombs test (autoimmune hemolysis) anemia jaundice hydrops fetalis (massive edema) extramedullary hematopoiesis ```
40
COPD and Respiratory Drive
Chronic hypercapnia --> blunted PaCO2 response decreased PaO2 becomes the main respiratory drive; detected by the carotid and aortic bodies PaCO2 detected by central chemoreceptors in the medulla by decreased pH in the CSF
41
Superior Orbital Fissue
``` carries: Occulomotor Nerve (CN III) Trochlear Nerve (CN IV) Ophthalmic Nerve (CN V1) Abducens Nerve (CN VI) Superior ophthalmic vein ``` lesion here would cause loss of corneal blink reflex and inability to adduct eye
42
alpha unit of hCG is similar to
LH also FSH
43
Staph aureus food poisoning
due to ingestion of lots of preformed exotoxin from picnic/potluck mayo containing foods rapid onset (<6hrs) nausea, vom, abd cramps also poultry, egg, meat, tuna, and dairy foods
44
Hypophosphorylated Rb protein
prevention of G1/S cell cycle transition
45
Urodynamic changes in MS
bladder hypertonia and poor distensibility due to loss of inhibition urge incontinence and OAB aka spastic bladder
46
IgA nephropathy
painless hematuria 5-7 days post URI deposition of IgA complexes in the mesangium LM - mesangial hypercellularity IF - IgA in the mesangium Henoch-Schönlein purpura if extra-renal symptoms: abd pain, arthralgia, palpable purpura
47
Short acting insulins
Lispro Aspart Glulisine peak in 0.5-3hours given just pre-meal
48
MOA of hydroxyurea in HbS patients
increases hemoglobin F synthesis MOA unknown :D
49
First Generation H1 blockers
hydroxyzine, promethazine, chlorpheniramine, diphenhydramine sedative and contraindicated in older patients due to fall risk tx: allergy, motion sickness, sleep aid
50
Newer H1 blockers
Loratadine, cetirizine, fexofenadine non sedating and good for the treatment of allergy!
51
Tx for anaerobic pneumonia (due to aspiration)
Clindamycin!
52
Drugs related to Drug-Induced Lupus Erythematosus SLE-like syndrome
Drugs that are metabolized by N0acetylation in the liver Isoniazid Procainamide Hydralazine (also:Phenytoin, Sulfa drugs)
53
Hydralazine
increases cGMP in smooth muscle --> vasodilation arterioles>veins (reduces afterload) given with beta-blockers to prevent reflex tachy
54
MOA External beam radiotherapy
causes dsDNA breaks
55
Manifestation of Hyperestrinism in Liver Cirrhosis
gynecomastia testicular atrophy decreased body hair spider angiomata (estrogen is arteriolar dilator)
56
Osteodystrophy
long-term complication of chronic renal disease derangements in Ca and Phos --> increased PTH --> osteopenia and osteomalacia
57
Site of obstruction in fetal unilateral hydronephrosis
Ureteropelvic junction
58
Most common cause of viral meningitis?
Enteroviruses (coxackievirus A, poliovirus, echovirus) aka aseptic meningitis
59
Atrial Natriuretic Peptide
Kidney: dilates afferent arteriole --> increased GFR --> increased urinary output AND inhibits renin secretion Adrenal Gland: decreases aldosterone secretion Blood Vessels: relaxes smooth muscle --> vasodilates ANP broken down by neprilysin
60
Resistance in Parallel
1/Rtotal = 1/R1 + 1/R2 ..etc
61
Prophylaxis for HIV CD4 < 200
TMP-SMX or dapsone for PCP pneumonia and toxo ghondi
62
Prophylaxis for HIV CD4 < 50
Azithromycin + Rifambutin for MAC
63
Glossopharyngeal Nerve CN IX
Sensory: tympanic membrane, tonsils, and posterior 2/3 of tongue (taste and touch) and gag reflex Motor: stylopharyngeus carotid body and carotid sinus
64
Aortic Arch Derivatives ``` 1 2 3 4 6 ```
``` 1 = maxillary "maximal is first" 2 = stapedial (stapedial is second) 3 = Common Carotid (and prox internal carotid) 4 = aortic arch and prox R. subclavian 6 = pulmonary arteries and ductus arteriosus ```
65
How are viral proteins prepared for presentation on MHC-I
via ubiquitin ligase --> ubiquitin protease
66
Anterolateral humeral fracture (distal)
radial nerve injury
67
Anteromedial humeral fracture (distal)
median nerve injury | brachial artery injury
68
Fragile X syndrome
FMR1 gene on X chromosome long, narrow face prominent forehead and chin large testes hyperlaxity of joints of the hand ``` developmental delay (speech and motor) ADHD, anxiety, autism spectrum ```
69
Nerve injured during thyroidectomy
external branch of superior laryngeal - innervates cricothyroid muscle runs with superior thyroid artery and vein
70
Response to High Altitude
decreased PO2 --> decreased PaO2 increased ventilation --> decreased PaCO2 decreased PaCO2 --> respiratory alkalosis respiratory alk --> increased pH increased RR, increased EPO, increased 2,3 BPG, increased renal excretion of HCO3-
71
Class III Antiarrhythmics
Decreased function of voltage gated potassium channels in cardiac myocytes prolonged QT and prolonged action potential duration can degenerate into torsades de pointes or v. fib ex. Amiodarone, Ibutilide, Sotalol
72
Central Obesity and Pulmonary Function
Restrictive Lung Dz Decreased: FEV, FVC, ERV, TLC unchanged: RV
73
Fructose 2,6-bisphosphate
Activates PFK1 --> increased glycolysis inhibits gluconeogenesis
74
Aminoglycosides
Inhibit @ 30S --> bacteriCIDAL good for gram negative rods (esp Pesudomonas) ARDs: nephrotoxic, ototoxic, teratogen, tendon rupture (-mycin/micin) - gentamicin, neomycin, tobramycin
75
ADR of Tamoxifen
Endometrial hyperplasia and carcinoma Hot Flashes VTE (venous thromboembolism)
76
MOA Benzodiazepines
increase FREQUENCY of Cl- channel opening "I want benzos all the time"
77
MOA Barbiturates
increase DURATION of Cl- channel opening barbitDURates
78
Rivaroxaban
Factor Xa inhibitor rivaroXaban also apiXaban
79
Direct thrombin IIa inhibitors
Dabigatran, argatrobam, bivalirubin
80
Wright-Giemsa stain
used to visualize reticulocytes, picks up rRNA
81
Age-Related Macular Degeneration
gradual vision loss due to chronic oxidative damage grayish discoloration of the macula with areas of adjacent hemorrhage Tx: VEGF inhibitors (bevacizumab, ranibizumab)
82
Meconium ileus
Cystic Fibrosis obstructs at ileum
83
Acute vs Chronic Pericarditis
Acute friction rub Chronic friction rub 3rd heart sound pulsus paradoxus - drop in systolic >10 on inspiration kussmaul sign - increased JVP with inspiration increase venous return with inspiration

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