Flashcards in Medical 1.1 Deck (27)
Scleroderma (diffuse cutaneous version)- High specificity, but only 10-40% sensitive
Which auto-antibody?Associated with CNS lupus
Anti-ribosomal P protein
Partial opioid agonist
Monoclonal antibody against integrin molecules
These molecules are important to adhesion and migration of cells from the vasculature into inflamed tissue. Natalizumab blocks integrin association with vascular receptors, limiting adhesion and transmigration of leukocytes. Efficacy in specific disorders may be related to reduction in specific inflammatory cell populations in target tissues. In multiple sclerosis, efficacy may be related to blockade of T-lymphocyte migration into the central nervous system
Nonspecific potassium channel blocker, used in MS
Improves conduction in focally demyelinated axons by delaying repolarization and prolonging the duration of action potentials. Enhanced neuronal conduction is thought to strengthen skeletal muscle fiber twitch activity, thereby, improving peripheral motor neurologic function
Direct thrombin inhibitor
CADASIL: Clinical Features?
1) Migraine with Aura
2) Ischemic strokes/TIAs
3) Cognitive features
4) Neuropsyciatric symptoms
- Adrenal suppression
- No analgesic properties
Suppresses neural activity
Good for patients with elevated intracranial pressure, seizures, or CNS bleeding
Reduced secretion of cholesterol from liver, as well as absorption of cholesterol from intestines. This decreases the cholesterol content of bile and bile stones.
Valproic Acid: adverse effects?
Hyperammonemia is believed due to propionic acid, a metabolite of VPA, which inhibits mitochondrial carbamoyl phosphate synthetase, an enzyme necessary for ammonia elimination via the urea cycle. If the action of this enzyme is sufficiently impaired, ammonia levels will accumulate, frequently producing encephalopathy
Ketamine: adverse effects?
These reactions vary in their intensity and have been described as disorientation, dream-like experiences, or hallucinations that may be frightening. They occur in up to 20 percent of adults but can be prevented or treated by giving a small dose of midazolam
Anything that causes biliary obstruction and/or stasis
- Biliary calculi (28 to 70 percent)
- Benign stenosis (5 to 28 percent)
- Malignancy (10 to 57 percent)
Erythema Nodosum: associated conditions?
- Antecedent Streptococcal infection (most common cause worldwide)
- Sarcoidosis (will also see Hilar adenopathy)
- Fungal (Coccidioidomycosis, Histoplasmosis)
- Inflammatory Bowel Disease
- Bechet's disease
- Hilar adenopathy
- Acute polyarthritis
- Erythema Nodosum
Seen in patients with Sarcoidosis
Calcific Uremic Arteriolopathy
- Excruciatingly painful ischemic necrosis in high adiposity areas (abdomen, buttock, thigh)
- Violaceous, plaque-like subcutaneous nodules
Systemic medial calcification of arterioles, leading to ischemia and necrosis
Calciphylaxis: risk factors?
- Elevated plasma Ca x PO4 product
- Active Vitamin D administration
Cerebral T waves: etiology?
- Intracranial bleeding
Urine pH = 7.5
Proteus UTI (highly likely)
Proteus produces the enzyme Urease, which converts ammonia (NH4+) to ammonium (NH3), causing an alkaline urine
Implies presence of Proteus bacteria in the urinary tract
Proteus -> Urease, causing alkaline urine. The alkalinity promotes the precipitation of phosphate, carbonate and magnesium. This causes the formation of struvite stones, that often form large staghorn calculi.