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Step 1 > Missed questions > Flashcards

Missed questions Flashcards

1
Q

Smooth ER function

A

Steroid and lipid synthesis

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2
Q

Mnemonic for G protein second messengers

A

Kiss and Kick till your Sick of SQS (super kinky sex)

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3
Q

Kiss part of mnemonic

A 
qiss.  
Alpha 1 = Gq (PLP C)
Alpha 2 = Gi (blocks cAMP)
Beta 1 = Gs (stim cAMP)
Beta 2 = Gs (stim cAMP)
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4
Q

Kick part of mnemonic

A

qiq
M1 = Gq (PLP C)
M2 = Gi (blocks cAMP)
M3 = Gq (PLP C)

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5
Q

Sick part of mnemonic

A

siq
D1 = Gs (stims cAMP)
D2 = Gi (blocks cAMP)
H1 = Gq (PLP C)

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6
Q

Super kinky sex part of mnemonic

A

sqs
H2 = Gs (stims cAMP)
V1 = Gq (PLP C)
V2 = Gs (stims cAMP)

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7
Q

Have 1 M&M

A

H1, alpha 1, V1 (the 1’s) M1 M3 (no M2 because that is a MAD 2)
PLP C –> Protein Kinase C and increase Ca

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8
Q

MAD 2’s

A

M2, alpha 2, D2 are Gi. cAMP and PKA

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9
Q

Virus associated w/ nasopharyngeal carcinoma

A

EBV

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10
Q

Erythema infectiousum cause

A

parvo b19. only ssDNA, non-enveloped

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11
Q

Bence Jones Protein

A

Multiple Myeloma Ig light chains in urine

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12
Q

Warfarin + _______ = less plasma warfarin

A

Phenytoin, rifampin, phenobarbital

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13
Q

3rd pharyngeal pouch

A

Thymus and inferior parathyroid

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14
Q

Red neurons

A

Irreversible injury 12-24 hrs post. No nissl substance

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15
Q

Trigeminal nerve exits brainstem at…

A

Middle cerebellar peduncle

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16
Q

Viral recombination

A

Gene exchange by crossing over of two dsdna molecules. Adenovirus

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17
Q

Viral reassortment

A

Occurs with segmented viruses like flu. Exchange whole genome segments. H1n1

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18
Q

Viral phenotypic mixing

A

Co infection by two strains. Progeny get packaged different

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19
Q

Fragile x

A

Cgg repeat. Gene methylation defect. Try hunting for my fried eggs (eggs=x=cgg)

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20
Q

Tamoxifen effect on endometrium

A

Stimulatory. Endometrial hyperplasia cancer

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21
Q

Mousy odor genetic defect mental retardation

A

pku. AR. avoid aspartame

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22
Q

Cryptococcus grows as a

A

Budding yeast

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23
Q

Mechanism of uv damage

A

Thymine dimers repaired by uv endonuclease

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24
Q

Atropine toxicity mnemonic

A 
Blind as a bat 
Hot as a hare
Red as a beet
Mad as a hatter
Dry as a bone
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25
Q

Cck made in

A

Duodenum jejunum i cells

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26
Q

Multiple myeloma mnemonic

A 
Crab
Hypercalcemia and constipation
Renal stuff
Anemia
Bone lesions back pain

Monocloma m protein

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27
Q

Horner syndrome

A

Ipsilateral ptosis miosis anhidrosis

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28
Q

Causes of secondary bacterial pna

A

Strep pna, mssa, h. Flu

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29
Q

Capsule mnemonic

A 
Shine skis 
Steep pna
Hib
Neisseria
E. Coli
Salmonella 
Klebsiella
i
GBS
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30
Q

Pseudomonas

A

Elderly diabetic swimmer. Ear pain. Blue green oxidase positive lactose non fermenter

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31
Q

Small painless genital ulcers that heal then inguinal LAD

A

Lymphogranuloma venerum (chlamydia)

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32
Q

Coccidiodes

A

SW US. Dimorphic. Hyphae at 25, spherule with spores at37

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33
Q

Histoplasma capsulatum

A

Oral ulcers. Tuberculed Hyphae at 25, yeast IN MACROPHAGE (histiocyte) at 37.

Misissippi ohio river valley
Bird droppings

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34
Q

Blastomyces dermatidis

A

East of mississippi and central america. Dimorphic 25 hyphae with conidia. 37 budding yeast. Most rare and severe

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35
Q

Cryptococcus

A

All yeast all the time. Pigeon poop

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36
Q

Aspergillus

A

45 degree branching hyphae all the time. Bundle of spore berries at the end of hyphae

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37
Q

Candida

A

Pseudohyphae and budding yeast at 20. Germ tube at 37

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38
Q

Amphotericin mechanism

A

Binds ergosterols and creates pore. Some cross rxn with cholesterol. Rigors fever chills = shake and bake

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39
Q

Methimazole

A

Inhibits organification of iodine (binding to TPO). Use propylthiouracil in pregnancy. Causes agranulocytosis and aplastic anemia

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40
Q

Gp2b/3a inhibitor

A

Abciximab. Tirobifan. Stops platelet aggregation. Used for pci. Defective receptor =glanzmann thrombasthenia

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41
Q

Benztropine for Parkinsons mechanism

A

Loss of dopamine inhibits gabaergic neurons. Ach stimulates gabaergic neurons. Benztropine is a muscatinic antagonist

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42
Q

Isoniazid mechanism

A

Activated by mycobacterial catalase peroxidase KatG, inh disrupts mycolic acid synthesis by inhibiting incorporation of fatty acid into mycolic acid

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43
Q

Pde 3 inhibitors

A

Milrinone heart failure and cilostazol claudication

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44
Q

Mast cell stabalyzer

A

Cromolyn, nedocromil. Omalizumab

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45
Q

Ethambutol mechanism

A

Inhibits arabinosyl transferase required for arabinogalactan. That covalently linkzmycolic acid to cell wall

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46
Q

Fluconazole mechanism

A

Inhibits conversion of lanosterol to ergosterol. Inhibits 14a demethylase(P450 dependent enzyme)

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47
Q

Caspofungin Micafungin

A

Echinocandins. Inhibit synthesis of beta(1,3,D glucan) (only cell wall antimycotic)

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48
Q

Ipratroprium for asthma

A

Antimuscarinic. Blocks smooth muscle constriction in bronchi M3

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49
Q

Niacin deficiency mnemonic

A

3 Ds of pellagra: dementia, dermatitis (sun exposed areas), diarrhea. B3 synthesized from tryptophan

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50
Q

vitamin A overdose sx

A

increased ICP, dry Skin, HSM - vit A used to treat measles?

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51
Q

Standard error of mean

A

SEM = SD/ (n)^1/2 estimates how much variability between sample and true population mean

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52
Q

Ventromedial Hypothalamus

A

Stim the ven, get then (thin) with leptin

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53
Q

Ventrolateral hypothalamus

A

stim the lat, get fat

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54
Q

Anterior Hypothalamus

A

Anterior Cooling (AC)

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55
Q

Winters formula

A

For determining if resp compensation is appropriate. expected PCO2 = 1.5*HCO3 +8 +/-2

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56
Q

Anti-psuedomonal cephalosporins and cillins

A

cefipime (4th), ceftazidine (3rd), pip tazo, ticarcillin-clav

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57
Q

radiolucent kidney stones

A

uric acid

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58
Q

radioopaque kidney stones

A

calcium oxalate or phosphate

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59
Q

ACute promyelogenous leukemia mutation

A

t(15:17)

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60
Q

Tricyclic antidepressant mnemonic

A

3Cs. Convulsions cardiotoxicity. Coma. Treat od with bicarb

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61
Q

treatment of toxoplasmosis

A

pyrimethamine and sulfadiazine

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62
Q

Fertilization implantation HCG detection timeline

A

1 day post ovulation, 7 days post fertilization, as soon as implantation happens

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63
Q

Anaerobic infections above diaphragm - treat with

A

Clindamycin

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64
Q

Waterhouse-Friderrichsen syndrome

A

Neisseria and Adrenal Hemmorhage

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65
Q

Anaerobic infections above diaphragm - treat with

A

Clindamycin

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66
Q

Neutrophil chemotactic factor

A

il-8. clean up on isle eight

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67
Q

Antiphospholipid syndrome

A

Common in lupus but can occur alone. Hypercoagulable state, positive RPR anti-cardiolipin abs and abortions

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68
Q

Adenosine extracoronary effects

A

Dilation of coronary and cerebral vessels, bronchoconstriction

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69
Q

Dipyridamole mechamism

A

Pde5 inhibitor that increases intravascular adenosine

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70
Q

cGMP hormones/drugs

A

ANP, hydralazine, nitroprusside, nitrates, BNP, think vasodilators. Sildenafil

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71
Q

ADP receptor antagonists

A

clopidogrel and ticlodipine (oral ulcers and neutropenia)

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72
Q

follicular b-cell lymphoma translocation

A

BCL-2 t(14:18) an epidermal growth factor receptor

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73
Q

where do herpes viruses get their membrane?

A

host nuclear membrane

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74
Q

Multinucleate cell seen in TB

A

Macrophage (langhans) horseshoe nuclei. Th1 activated

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75
Q

Fungal complication of asthma

A

Allergic bronchopulmonary aspergillosis

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76
Q

Mechanism of presbyopia

A

Lens becomes less elastic. Same as skin aging.

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77
Q

Add ACE to Thiazide first dose effect

A

Hypotension (especially in already hyponatremic pts). But no reflex tachycardia

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78
Q

Class 3 antiarrythmics

A

AIDS amiodarone, ibutilide, dofetilide, sotalol. Phase 3 (blocks potassium efflux)

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79
Q

Equation for filtration fraction

A

FF=GFR/RPF

(RPF = (1- HCT) * RBF

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80
Q

Galactosemia mnemonic

A

FABGUT fructose is to Aldolase B as Galactose is to UridylTransferase

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81
Q

Cause of cataracts

A

galactose to galactitol via galactose reductase. galactokinase deficiency. Sorbitol (DM), trauma infection

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82
Q

tetrology of fallot mnemonic

A

PROVe. pulmonary stenosis. RVH. Overriding aorta. VSD.

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83
Q

Epinephrine low dose vs. high dose

A

Low dose beta high dose alpha

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84
Q

Paramyxoviruses

A

PaRaMyxovirus . Parainfluenza, measles mumps, rsv (ribavirin). rna ss - helical nonsegmented

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85
Q

Measles mnemonic

A

3c’s. cough, coryza, conjunctivitis. Koplick spots

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86
Q

MEN1.

A

3 Ps. Parathyroid pancreas, pituitary. diamond with pit on top, panc on bottom

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87
Q

Middle aged woman with granulomatous destruction of bile ducts

A

Primary biliary cirrhosis. Anti-mitochondrial ab

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88
Q

Young man with ulcerative colitis. Onion skin bile duct fibrosis

A

Primary sclerosing cholangitis. P-anca

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89
Q

Serotonin releasing neurons in

A

Raphe nuclei

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90
Q

heteroplasmy definition

A

mitochondrial inheritance

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91
Q

Kartagener syndrome

A

recurrent respiratory infections, dextrocardia, situs inversus, bronchiectasis
A primary ciliary dyskinesia (AR)
dynein arms failure

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92
Q

IL-2 receptor deficiency

A

SCID

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93
Q

Enzyme that catalyzes NE to Epit

A

Phenyethanolamine -N methyltransferase (requires SAM) “From 4 to 6 I’m C’ing SAM”

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94
Q

Carotid artery from which aortic arch

A

C is third letter in alphabet. 3rd. Common carotid and proximal internal carotid

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95
Q

Maxillary artery embroyologic derivative

A

1st arch, is MAXimal

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96
Q

Aorta from which aortic arch

A

Aor ryhmes with four. FouRS right subclavian

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97
Q

Pulmonary arteries which aortic

arch?

A

6 looks like lung

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98
Q

Carbohydrate calories

A

4kcal/gram

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99
Q

Fat calories

A

9kcal/gram

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100
Q

Ethanol calories

A

7kcal/g

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101
Q

Methotrexate side effects

A

Stomatitis, folate deficiency, hepatotoxicity. Myelosupressiin. Risk for b-cell lynphoma and pulmonary fibrosis. Contraindicated in pregnancy

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102
Q

Rifampin mnemonic

A 
4Rs. 
Rna polymerase inhibitor
Ramps up P450
Red body fluids
Rapid resistance if used alone
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103
Q

Ezetimibe mechanism

A

Inhibits intestinal cholesterol absorption

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104
Q

Cholestyramine mechanism and risk

A

Bind bile acid in GI tract. Increases hepatic bile acid secretion (using cholesterol for precursor)

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105
Q

gemfibrozil mechanism and risk

A

PPARalpha transcription products increases lipoprotein lipase decrease TG and VLDL. Increases cholesterol content in bile acid secretion and can predispose to gallstones

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106
Q

Finasteride mechanism and indication

A

5alpha reductase inhibitor. bph and alopecia

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107
Q

priopionic acid created from

A

Catabalism of branched chain AAs, odd-chain FA, methionine, threonine

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108
Q

Selective muscarinic antagonists

A

Scopolamine

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109
Q

noonselective muscarinic agonist

A

pilocarpine, methacholine

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110
Q

Other word for accuracy

A

validity

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111
Q

Other word for precision

A

reliability

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112
Q

urine that turns black when exposed to air

A

alkaptonuria, degradative pathway of tyrosine to fumarate, AR

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113
Q

main toxin in C. perfringens

A

lecithinase, also known as phospholipase C. Also known as alpha toxin

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114
Q

vitamin deficiency in Wernicke Korsakoff

A

WTK… not WTF. Thiamine (Pyruvate to Acetyl CoA via Pyruvate Dehydrogenase

Wernickes problems come in a CAN of beer
Confusion, Ataxia, Nystagmus

give thiamine with glucose. Glucose alone increases metabolic rate and worsens

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115
Q

beta 1 receptors found where?

A

Cardiac, Juxtaglomerular cells

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116
Q

Function of seminal vesicle

A

Secrete fructose protein and phospholipids

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117
Q

Bromocriptine

A

parkinsons drug BALSA
Bromocriptine - DA (D2)
Amantadine - increases DA synthesis, release, reuptake
Levodopa
Selegiline - MAO- inhibitor
Antimuscarinics - trihexyphenidyl and benztropine

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118
Q

Clomiphene

A

central SERM used to induce ovulation

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119
Q

Function of peptidyl transferase and drug

A

Covalent bond between AAs. 50s chloramphenicol

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120
Q

Neuroendocrine tumor markers

A

Chromagranin, synaptophysin, neuron specific enolase

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121
Q

MEN2a

A

2Ps Parathyroid and pheo. Square with medullary thyroid in middle

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122
Q

MEN2B

A

MEN2B 1 P. pheo. Triangle with neuroma on top, pheo other corners, medullary thyroid in middle. Marfanoid

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123
Q

Taut blister separating epidermis from dermis

A 
bullous pemphigoid (Bullow the epidermis). IgG anti hemisesmosomes
Hemi stronger holds whole layer down instead of two cells together
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124
Q

Partial b-agonists

A

Pindolol acebutolol

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125
Q

Shiga and EHEC Toxin MOA

A

Inactivate 60s ribosome. Pulls Adenine off rRNA

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126
Q

Strep viridans classification and disease

A

Alpha hemolytic optochin resistant (off the chin). Associated with dental caries and causes subacute endocarditis by adehering to damaged valve with dextrins that bind fibrin. Dextrin Damage-dental

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127
Q

PPV equation

A

PPV= TestP/(DiseaseP+False P) all positives

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128
Q

Selective IgA mnemonic

A

6As, Asymptomatic, Airway infection, Autoimmune disease, Atopy, Anaphylaxis to IgA containing products

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129
Q

Vasculitis associated with Smoking

A

Medium vessel vasculitis - Thromboangiitis obliterans (Beurger’s disease). calf, foot and hand intermittent claudications

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130
Q

carboxylase require what cofactor

A

Biotin

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131
Q

Lesch-Nyhan genetics

A

hypoxanthine PRPP X-recessive

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132
Q

Leber hereditary optic neuropathy genetics

A

mitochondrial - red ragged

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133
Q

Huntingtons genetics

A

Autosomal Dominant

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134
Q

Hemophilia B genetics

A

X-linked recessive, Factor 9 defect

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135
Q

Classical galactosemia

A

Defect in galactose 1 uritdyl transferase (FABGUT)

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136
Q

Cold agglutinins

A

mycoplasma pna IgM that agglutinate RBC at cold temps, also EBV and hematologic malignancy

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137
Q

Muscarinic agonist used to treat post-op urinary retention

A

Bethanechol (similar in class to Methacholine)

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138
Q

menieres disease

A

episodic vertigo with tinnitis and hearing loss. increased volume of endolymph damages vestibula and cochlea

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139
Q

Von hippel lindau disease

A

AD capillary hemangioblastomas in retina or cerebellum, congenital cyts/neoplasms of kidney liver and pancrease, Renal cell carcinoma RCC three (chromosome)

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140
Q

Li Fraumini

A

p53 mutation AD, Sarcoma of breast, brain, adrenal cortex

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141
Q

dehydrogenase enzyme probably need these cofacters

A

Tender Loving Care for Nancy. Thiamine, Lipoate, Coenzyme A, FAD, NAD

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142
Q

Partial gene deletion syndromes

A

Cri du chat (5p), Prader willi/angelman (15q),

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143
Q

Interleukin mnemonic

A

Hot T Bone STEAK. IL-1 fever, IL-2 T cell stimulator (also released by T-cells) a defect in SCID, IL-3 stimulates bone marrow, IL-4 stimulates IgE, IL-5 stims IgA, IL-6 stimulates aKute phase proteins

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144
Q

IL-12

A

th0–>th1, stimulates NK cells (highest cytokine).

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145
Q

Uric acid precipitates at what pH?

A

pKa=5.4 so in acidic environment

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146
Q

equation for half-life

A

t 1/2 = (.693xVd)/CL

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147
Q

Drug clearance is

A

rate of elimination/plasma concentration= Vd x elimination constant

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148
Q

neurophysin function

A

carrier protein for ADH and Oxytocin

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149
Q

digoxin side effects

A

Dig delirium. nausea, blurred vision, yellow green hallucinations. Hyperkalemia.

Arrythmia

150
Q

lepromin skin test and biopsy results in lepromatous vs tuberculoid leprosy

A

tuberculoid, skin test positive, biopsy negative

lepromatous, skin test negative, biopsy positive

151
Q

bronchiolitis obliterans pathology

A

chronic lung transplant rejection. Inflammation of small airways (bronchioles) leads to fibrosis and occlusion

152
Q

mechanism of action anastrozole

A

aromatase inhibitor for ER+ breast cancer in post-menopausal women

153
Q

PTH effect on phosphate

A

Phosphate Trashing Hormone. lower serum calcium by inhibiting Phosphate reabsorption in proximal tubule

154
Q

Electrolytes that increase in Chronic Renal Failure

A

Phosphate, K, Cholesterol, TG

155
Q

equation for NPV

A

NPV= TN/(TN + FN)

156
Q

Spironolactone uses

A

1) CHF - reduces mortality, 2) diuretic 3) PCOS, 4) blocks testosterone production/androgen receptor complex. causes Non-anion gap met acidosis

157
Q

dequervian thyroiditis: signs and symptoms

A

dequiver: shaking, deQuerVAIN is PAIN. painful. granullomatous inflammation

158
Q

glucagonoma mnemonic

A

4D’s. Dermatitis (necrolytic), diabetes (hyperglycemia), DVT, Depression. pancreatic alpha cells

159
Q

beta blockers that are indicated and beta blockers that are contraindicated in diabetes

A

Contraindicated: Non-selective
Indicated: B1 specific (don’t block metabolic sympathetic effects)

160
Q

Pheo mnemonic/rule

A 
rule of 10s
10% malignant
10% bilateral
10% extra adrenal
10% calcify
10% kids

5P’s pressure, pain, perspiration, palpitations, pallor

161
Q

Purely ketogenic AAs

A

Lysine and Leucine the onLy pureLy ketogenic

162
Q

location of schwannomas

A

cerebellopontine angle. hearing loss and loss of corneal reflex. B/L with NF2

163
Q

Trigeminal Nerve foramen mnemonic

A

Standing Room Only (sup orb fissure-V1, rotundumV2, ovaleV3)

164
Q

Huntington mnemonic

A

Caudate loses Ach and GABA. increase in dopamine. Try hunting for my fried eggs. Hunting 4 food chromosome 4.

165
Q

Thallesemia mnemonic

A

THAL. Target cells hemolytic anemia howell jolly bodies anisocytosis and low mcv

166
Q

Pentazocine

A

Mu receptor partial agonist

167
Q

CREST syndrome

A

Calcinosis, reynauds, esophageal dysmotility, telangiectasia. A limited scleroderma

168
Q

Which toxins block ADP ribosylation of EF2

A

Cornebacterium Diptheria and pseudomonas

169
Q

Bacteria toxins that mess with cAMP

A

CAMP. Cholera, anthrax, montezuma (m sideways, labile),bordatella pertussis

170
Q

ARDS effect on lung compliance, wob, v/q matching, pcwp, capillary permeability

A

NL PCWP. All others worse

171
Q

Niacin considerations

A

Gout hypertension diabetes

172
Q

What affects Hb curve

A

c-BEAT. Co2 BPG, excercise, Altitude, temp

173
Q

Sickle cell mutation

A

Glutamate to valine

174
Q

only gram positive with endotoxin

A

Listeria

175
Q

Listeria growth algorithm

A

GPR, Grows at 4C and catalase +, intracellular or extracellular

176
Q

Stereotypical nonselective alpha blocker

A

Phentolamine

177
Q

Only gram negative without an endotoxin

A

Bacteroides

178
Q

mechanism of gallstones in Crohns

A

no bile acid resorption causes increase in Cholesterol:Bile Acid ratio of bile

179
Q

Clostridium Toxin

A

A and B. inactivates Rho regulatory proteins. A is enterotoxin B is a cytoskeleton toxin (bind extracellular and are internalized)

180
Q

GnRH agonist

A

leuprolide

181
Q

polyarteritis nodosa

A

POLY-ARTERITIS = string of pearls Medium vessel vasculitis, string of pearls (early and late lesions, early dilate), HBV, spares pulm arteries. fibrinoid necrosis. fever

182
Q

penicillamine

A

a chelator used to treat wilson’s (copper), arsenic, gold, lead, cystinuria, causes membranous nephropathy (nephrotic), and myopathy

183
Q

Alveolar Gas equation

A

Alveolar O2 = [FiO2 x (barometric P - water vapor pressure)] - PaCO2/.8

normally 150-(PaCO2)/.8

184
Q

PAS stain mnemonic

A

PASs the sugar (stains glycogen)

185
Q

carbolfuchsin stain

A

Ziehl-Neelson. AFB

186
Q

vitamin a deficiency

A

dry scaly skin (necessary for differentiation of epithelial tissue into specialized cells), night blindness, immunosuppression. Vit A to treat measles?

187
Q

Hb right shift mnemonic

A 
C-BEAT
CO2
BPG
Exercise
Altitude
Temperature
188
Q

Peroxisome

A

Metabolizes very long chain fatty acids, branched FA, and AA

189
Q

tRNA components

A

Tail is CCA Can Carry Amino Acids, Dihydrouracil,

190
Q

drug of choice for trigeminal neuralgia

A

Carbamazepine. This works aMAZingly well

191
Q

modafinil

A

like amphetamine used for narcolepsy

192
Q

Most potent vasoconstrictor

A

Endothelin. Bosentan is an antagonist to treat PAH

193
Q

narcolepsy pathology

A

decrease of orexin (hypocretin)

194
Q

transamination reactions require what cofactor

A

B6. also heme synthesis succinyl co to AMINO Levulinic acid

195
Q

COMT inhibitors

A

entecapone and tolcapone increase levodopa availability in brain

196
Q

Dopamine agonists

A

bromocriptine, pergolide, pramipexole, ropinerole

197
Q

First line for simple, complex, tonic clonic sz, trigeminal neuralgia, bipolar mood stabilizer

A

Carbamazepine, Na channel blocker, SJS, SIADH, agranulocytosis, aplastic anemia etch

198
Q

Lipids (triglycerides, cholesterol, phospholipids) are absorbed in

A

Jejunum. For some reason the bile gets reabsorbed in the ileum along with B12

199
Q

sarcoidosis symptoms

A

hypercalcemia and increased ACE. B/L hilar LAD, Th mediated. noncaseating granuloma

200
Q

mobitz I vs mobitz II

A

mobitz I/wenkenbach “later later later drop thats what makes in wenkenbach”. mobitz II unpreceded dropped p wave

201
Q

tyrosine kinase oncogene in breast, ovarian, gastric carcinoma

A

HER2/neu (c-erb2)

Her2 neu breasts, ERB - estrogen receptor breast
treat with trastuzumab

202
Q

Wilsons disease

A 
Copper is Hella BAD.
decreased ceruloplasmin, cirrhosis, corneal deposits. 
Hemolytic anemia 
Basal ganglia degeneration
Asterixis
Dementia, dyskinesia, dysarthria
203
Q

Thiamine needed for

A

Pirate AK transfer. pyruvate dehydrogenase, alpha KG dehydrogenase, transketolase (HMP)

204
Q

MAO inhibitors

A

Selegiline (parkinsons, selective, increased DA)
MAO Takes Pride In Shanghai
( tranylcypromine, phenelzine, isocarboxazid, selegiline)

205
Q

alpha 1 receptors when stimulated produce

A

increase vascular smooth muscle contraction, mydriasis, bladder and intestinal sphincter contraction

206
Q

beta 2 receptors when stimulated produce

A

vasodilation, bronchodilation, insulin release, uterine relaxation, increase production of aqueous humor

207
Q

Beta 1 receptors when stimulated produce

A

increased HR, contractility, renin release and lipolysis

208
Q

Large vessel arteritis

A

Giant cell (temporal) and takayasu
old ladies, unilateral HA, polymyalgia rheumatica blindness, jaw claudication
carotid

I cant takayu pulse
japanese women
pulseless disease
fever night sweats
skin nodules
aortic arch
209
Q

Loop diuretics

A

Loops lose ca

210
Q

Thiazides

A

HyperGLUC

211
Q

Causes of acute pancreatitis

A 
ETOH, gallstones, then I GET SMASHED
idiopathic
Gallstones 
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hypercalcemia/hyperTG
ERCP
Drugs
212
Q

Berry aneurysm in who?

A

Ehlers danlos and PKD

213
Q

theophylline

A

PDE inhibitor. analagous to B1 agonist like albuterol but also inhibits mast cell inlammatory meidator release. Acute intox = vomiting, seizures

214
Q

thrombangiitis obliterans mnemonic

A 
CRISP PIGS's beurger
C- chronic ulceration
Raynauds
Intermittent claudication
Segmented vasculitis
Phlebitis
Pain
Idiopathic 
Gangrene
Smoking
215
Q

mechanism of u opiod analgesics

A

increase K+ conductance on postsynaptic –> hyperpolarization

216
Q

Neuroleptic Malignant Syndrome

A

rahm - rigitidy, autonomic instability, hyperthermia myoglobinuria,

217
Q

vitamin deficiency in carcinoid syndrome

A

niacin. 3 D’s of niacin. Diarhrea, dementia, dermatitis

218
Q

electrolytes in sarcoidosis

A

hypercalcemia due to 1 alpha hydroxylase activation in macrophages

219
Q

phrenic nerve roots

A

C3-5 keep the diaphragm alive

220
Q

OCPs contraindicated in

A

smokers, hyperTrigs, hx of estrogen dependent tumor

221
Q

Embryonic origin of pituitary and craniopharyngioma

A

Rathke pouch (from ectoderm that lines fetal oral cavity)
CRanio
Children/calcification
Rathke

222
Q

Urea cycle mnemonic

A

Cars cannot accelerate as fast as usain bolt

223
Q

Phenytoin uses, mechanism, SE

A 
First line prevention of tonic clonic and status.  Na blocker.
PHENYTOIN
P p450 inducer
H hirsuitism
E enlarged gums
N nystagmus
Y yellow browning of skin
T teratogen
O osteomalacia
I interference with folate
N neuropathies
S stevens johnsons
224
Q

Closed vs open angle glaucoma

A

Open angle more insidious. Not related to mydriasis. Closed angle due to sudden increase in ocular pressure and mydriasis.

225
Q

ending of TCAs

A

“tyline” “pramine” “xepine”

226
Q

anditode for TCA toxicity

A

Sodium Bicarb. (TCAs have Na channel blockade)

227
Q

MAO inhibitors and side effect

A

Selegiline, MAO Takes Pride In Shanghai

Trancypromine, Phenelzine, Isocarboxazide, Selegiline

Hypertensive Crisis Wine sausage and Cheese!

228
Q

pralidoxime indications

A

Phosphate poisoning organophosphate

229
Q

friedrich ataxia memory aid and mnemonic

A

chromosome 9 with big heart(HOCUM) weak legs. FR-ATAXIN protein
Free Radicals

GAA
Gait Affected Autosomal Recessive

230
Q

Tardive Dyskinesia Definition

A

involuntary, repetitive movements, (looks like a crazy person) an EPS (late sx)

231
Q

Akathisia

A

Restlessness (4 day EPS sx)

232
Q

Mesolimbic tract function

A

integrates sensory and motor systems dopaminergic

233
Q

mesocortical tract function

A

communication and social dopamineregic pathway

234
Q

nigrostriatal tract function

A

extra pyramidal control, dopaminergic pathway

235
Q

Schizo positive sx

A

delusions, hallucinations,

236
Q

Schizo negative sx

A

emotional blunting, social withdrawal, lack of motivationinexpressive face

237
Q

Typical Antipsychotics

A

Halo-chlorp haloperidol, chlorpromazine

238
Q

Atypical Antipsychotics

A

ROCA, risperidone, olanzapine, clozapine, aripriprazole

239
Q

Mnemonic for depression

A

SIG E CAPS, Sleep, Interest, Guilt, Energy, Concentration, Anhedonia, Psychomotor, Suicide

240
Q

4 domains of bipolar sx

A

1) Manic mood, 2) dysphoric mood 3)psychosis 4)cognitive sx (racing thoughts, distractibility, inattention)

241
Q

Bipolar I disorder characterized by

A

mania only

242
Q

Bipolar II disorder characterized by

A

Hypomania and major depression

243
Q

Ketamine / Phencyclidine MOA

A

Glu-NMDA receptor antagonist

244
Q

Cocaine neurotransmittors

A

Inhibits monoamine transporters, increase esp in DA

245
Q

Treatment of Acute Benzo toxicity

A

Flumazenil (GABA receptor antagonist)

246
Q

treatment for opioid withdrawal

A

methadone, clonidine, tincture of opium in newborns

247
Q

drug for anti nicotine?

A

varencicline (chantix), buproprion

248
Q

tabes dorsalis

A

from tertiary neurosyphilis
DORSALIS

Dorsal column degeneration and dorsal root

Orthopaedic pain (charcot’s joints)

Reflexes (deep tendon) are decreased

Shooting pain
Argyll-Robertson pupil (constricts to accomodation but not light)
Locomotor ataxia
Impaired proprioception
Syphilis
249
Q

5 nuclei of basal ganglia

A

Caudate, putamen, substantia nigra, subthalamic (hemiballismus), globus pallidus

250
Q

Drugs in Stevens Johnsons and DRESS

A

Steven Johnson has an epileptic ALLergy to sulfa drugs and penicillin.

carbamazepine
lamotrigine
phenytoin
sulfa 
phenobarbital
251
Q

First line drugs for acute status and status prophylaxis

A

Benzos for acute (lorazepam), Phenytoin for prophylaxis. if still seizing give phenobarbital

252
Q

Maintenance dose eqn

A

MD/tau=Cpss x Vd/F

MDs clear constant schedule over food

253
Q

Clearance equation

A

CL = rate of elimination(kE)/Cp = kE x Vd
knockout cleared crazy smiles
Ke= CL x Css

254
Q

Bug susceptibility in CGD

A

Aspergillus, Staph Aureus, Burkholderia Cepacia, Serratia, Nocardia

255
Q

HACEK organisms

A

Haemophilus, Actinobacter, Cardiobacterium, Eikinella, Kingella

256
Q

Enzymes requiring thiamine

A

PAT Pyruvate dehydrogenase, alpha KG dehydrogenase, transketolase (HMP to Glycolysis)

Ribulose 5P to Fructose 1,6 BP
Ribulose 5P to GA3P

257
Q

Plummer-Vinson or Patterson Kelly syndrome

A

Esophageal webs from iron deficiency anemia

258
Q

tuberous sclerosis

A

Autosomal dominant. Cutaneous angiofibromas, seizures, mental retardation, CNS hamartomas

259
Q

location of cerebral aquaduct

A

between 3rd and 4th ventricle

260
Q

location of foramen of monroe

A

between ventricles and 3rd ventricle

261
Q

liquefactive necrosis

A

neurons. lysosomes released, causing necresis. microglia come to take care of the mess, then astrocytes form scar

also bacterial abscess

262
Q

normal pressure hydrocephalus symptoms

A

wet, wacky, wobbly

urinary incontinence, cognitive dysfunction, ataxia

263
Q

vitamin E deficiency

A

hemolytic anemia, ancanthocytosis, muscle weakness, PCML, Spinocerebellar demyelination. like B12 but without MMA, megaloblasts

vitamin E is an antioxidant

264
Q

Amphotericin Side effects

A

shake and bake (fevers and rigors), hyporkalemia and hypormagnesium due to nephrotoxicity

265
Q

drug given with cyclophosphamide to prevent hemorrhagic cystitis

A

mesna (mercaptoethane sulfonate)

266
Q

treatment of migraines

A

sumatriptan 5HT 1b, 1d agonist causes vasoconstricion

beta blockers, TCA and SNRIs, Valproate for prophylaxis

267
Q

Henoch Schonlein

A 
JARS
Joints
Abdominal Pain
Renal (Bergers)
Skin (palpable purpura)
268
Q

direct hernias arise ____ to the epigastric arteriy

A

medial older men

269
Q

indirect hernias arise ____ to the epigastric artery

A

lateral male infants

270
Q

pramipexole

A

DA used in parkinsons

271
Q

migratory superficial thrombophlebitis

A

troussea syndrome- paraneoplastic b/c adenocarcinomas make thromboplastin substance

272
Q

tumor associated with arsenic, vinylchloride and CD31+ cells

A

liver angiosarcoma

273
Q

P450 inducer menomic

A

NEVIR drive your CARb up the RifAMP through the BARBwire fence into ST. JOHNS woods. You’ll be CHRONICALLY attacked by PHENding GRISzly Bears. MODAFINitley.

NEVIRapine
CARbamazepine
RifAMPin
PhenoBARBital
ST. JOHNS wort
CHRONIC alcoholics
GRISeofulvin
MODAFINil
274
Q

pramipexole

A

DA used in parkinsons

275
Q

P450 inhibitor mnemonic

A

VICK’s FACE All Over GQ stops ladies in their tracks

Valproic acid
Isoniazid
Cimetidine
Ketoconazole
Sulfonamides

Fluconazole
Acute Alcohol
Chloramphenicol
Erythromycin

Amiodarone
Omeprazole
Grapefruit juice
Quinidine

276
Q

fidaxomicin

A

C. Diff. RNA pol inhibitor with minimal systemic absorption

277
Q

P450 inducer menomic

A

NEVIR drive your CARb up the RifAMP through the BARBwire fence into ST. JOHNS woods. You’ll be CHRONICALLY attacked by PHENding GRISzly Bears. MODAFINitley.

NEVIRapine
CARbamazepine
RifAMPin
PhenoBARBital
ST. JOHNS wort
CHRONIC alcoholics
GRISeofulvin
MODAFINil
278
Q

P450 inhibitor mnemonic

A

VICK’s FACE All Over GQ stops ladies in their tracks

Valproic acid
Isoniazid
Cimetidine
Ketoconazole
Sulfonamides

Fluconazole
Acute Alcohol
Chloramphenicol
Erythromycin

Amiodarone
Omeprazole
Grapefruit juice
Quinidine

279
Q

P450 inhibitor mnemonic

A

VICK’s FACE All Over GQ stops ladies in their tracks

Valproic acid
Isoniazid
Cimetidine
Ketoconazole
Sulfonamides

Fluconazole
Acute Alcohol
Chloramphenicol
Erythromycin

Amiodarone
Omeprazole
Grapefruit juice
Quinidine

280
Q

fidaxomicin

A

C. Diff. RNA pol inhibitor with minimal systemic absorption

281
Q

Immune response to Giardia

A

CD4 mediated IgA response

282
Q

Acute Intermittent Porphyria

A 
5 Ps.  
Painful abdomen
Port wine urine
Polyneuropathy
Psychologic disturbances
P450 inducers
283
Q

Tertiary (neuroactive) amine ACh-ase inhibitor

A

Physostigmine

284
Q

enzyme that converts NE to epi

A

phenylethanolamine decarboxylase. Cortisol increases transcription

285
Q

Bugs with IgA-ase toxin

A

Strep PNA, neisseria, hemophilus. Allows for adherence to mucosa. IgA binds piliae

286
Q

acetaminophen metabolite

A

NAPQI

287
Q

Renal papillary necrosis

A 
SAAD Papa with papillary necrosis
Sickle cell
Acute pyelo
Analgesics (NSAIDS)
Diabetes
288
Q

Goodpasture antibodies are against

A

Type IV collagen

289
Q

Berksons bias

A

study population selected from hospitals is less healthy than the general population

290
Q

Hawthorn effect in studies

A

observer effect. when subjects know they are being studied they change their behavior

291
Q

fructose intolerance

A

Aldolase B defect. After fructose ingestion get hypoglycemia, jaundice, cirrhosis, vomiting

292
Q

treatment of measles

A

vitamin A. resolves a virally induced hyporetinemia

293
Q

mediator of gene expression in lac operon

A

inducer (lactose) binds repressor and inactivates it (prevents it from binding operator)

294
Q

what recruits RNA pol in the lac operon

A

CAP. Catabolite Activating Protein (activated by cAMP) binds upstream of promoter

295
Q

familial hypocalciuric hypercalcemia

A

problem with ca sensors in Parathyroid. and kidney. Benign

296
Q

superior laryngeal nerve innervates what muscle

A

cricothyroid (4th arch derivative)

297
Q

direct hernias caused by

A

weakness of transversalis fascia

298
Q

vitamin C deficiency symptoms

A

bleeding gums, peticiae, impaired wound healing (collagen)

299
Q

most common cancer in IBD and features

A

colorectal carcinoma. More likely to be:
Multifocal
Arise sporadically (not from polyps)
Develop early P53 and late late APC mutation
Higher grade

300
Q

ovarian neoplasm that produces estrogen

A

Granulosa cell tumor. Call Exner bodies on Histology Endometrial proliferation predisposed to adenocarcinoma.

Teratomas are more common ovarian tumors but don’t produce estrogen. Mature contains thyroid tissue

301
Q

seizure meds for multiple seizures. (absence and tonic clonic)

A

Valproic acid - 1st line tonic clonic, but treats everything else but status

Lamotrigine(SJS)

302
Q

Pemphigous vulgaris

A

Vulgar language = mouth blisters,
vulgar people are younger and more superficial.
flaccid (more superficial)
IgG anti desmoglein (part of desmosome)

303
Q

Gilbert syndrome

A

a decrease in UDP-glucuronyl tranferase, impaired bilirubin uptake. very common

304
Q

primary HBV infection

A

JOINT pain!!! mailase, fever, rash, pruritis

305
Q

kussmauls sign

A

increase in JVP on inspiration instead of decrease. due to tumor or constrictive pericarditis

306
Q

waves of JVP

A 
a wave atrial contraction
c wave right ventricle Contraction
x descent - atrial relaxation
v wave - increase right atrial presssure due to Villing
y descent - RA emptYing into RV
307
Q

anticoagulant in pregnancy

A

heparin

308
Q

cells with clear cytoplasm on renal biopsy

A 
clear cell (renal cell) carcinoma.  PCT 
smoking, obesity, men 50-70
309
Q

stages of syphilis

A

1) Primary - painless ulcer on genital, resolves in a month
2) Secondary - bacteremic, 1-3 months, rash on palm and sole. Condyloma lata growths (wart like)
3) Latent - asymptomatic
4) Neuro - gummas, tabes dorsalis, meningoencephalitis

310
Q

to prevent nephrotoxicity with cisplatin (testicular, bladder, ovary, lung cx) use

A

amifostine

311
Q

part of male urethra most often damaged in pelvis fracture

A

membranous- anterior (bulbous) junction

312
Q

chronic transplant rejection morphology

A

vascular wall thickening, interstitial fibrosis. low grade immune response
refractory to immunosuppressants

313
Q

most common location of intussusception

A

ileocecal valve region

314
Q

phenoxybenzamine

A

irreversible alpha blocker used to treat pheochromocytoma

(noncompetitive)

315
Q

phentolamine

A

nonselective alpha blocker (competitive)

316
Q

mifepristone

A

progesterone antagonist for abortion. administered with PGE (misoprostol)

317
Q

Misoprostol

A

PGE analog. Abortion and ulcers

318
Q

hydroxyurea use

A

sickle cell. somehow upregulates HbF expression. Also in

319
Q

necrotizing enterocolitis

A

preemie infants. enteric feeding causes bacterial overgrowth, gas, ischemic necrosis

320
Q

chemo microtubule inhibitors

A

vincristine, vinblastine (neurotoxicity)

321
Q

wegners mnemonic

A

WeCners - c-anca. draw a C. Nasopharynx, lungs, kidney

Epistaxis, URI, PNA, Glomerulonephritis (RPGN/crescenteric)

Granulomatosis with Polyangiitis

322
Q

Lambert eaton myasthenic syndrome

A

Anti VSCC that participate in release ACh

323
Q

histologic findings of rheumatic fever

A

aschoff giant cells. multinucleated macs, later replaced by fibrous tissue

324
Q

WAGR complex

A

beckman wiedmann syndrome of Wilms Tumor, aniridia, GU malformation, mental Retardation

325
Q

prostaglandins in pregnancy

A

PGE kEeps the PDA open

uterine contraction stimulation (also abortifactant misoprostol)

326
Q

gardos channel blockers

A

block K and H2O efflux from cells, preventing dehydration of RBCS for HbS

327
Q

Cardiac output equations

A

O2 consumption/arteovenous difference.

CO= HRx SVT

328
Q

mechanism of thoracic aortic dissection

A

cystic medial (tunica media) degeneration. myxomatous change
fragmentation of elastic tissue
Marfans

329
Q

krukenberg tumor

A

stomach cancer with bilateral metastases to ovaries.

mucin secreting, signet ring cells

330
Q

virchow node

A

left supraclavicular node. sentinel node in gastric adenocarcinoma

331
Q

Sister mary joseph nodule

A

subcutaneous periumbilical metastasis of gastric adenocarcinoma

332
Q

achondroplasia mutation

A

FGFR3 (autosomal dominant). fibroblast factor-angiogenesis

333
Q

Familial hypercholesterolemia

A

IIa Autosomal dominant. Absent or defective LDL-receptor. tendon xanthomas, corneal arcus
heterozygote chol is 300, homo chol is 700+

334
Q

hyperchylomicronemia

A

Autosomal recessive. LPL deficiency or altered apo CII

335
Q

hypertriglyceridemia

A

AD, hepatic overproduction of VLDL. Causes acute pancreatitis

336
Q

four stages of PNA

A

congestion (first 24 hrs)
red hepatiziation ( day 2-3)
grey hepatization (day 4-6)
resolution

337
Q

neuroblastoma

A

adrenal medullary tumor in children under 4. Homer wright rosettes
can cross midline. Abdominal pain and dancing eyes
NElson MANDELa - VMA and HVA positive

338
Q

toxic shock syndrome

A

staph aureusi. superantigen. cross links MHCII and TCR. Releases IL1, 2, IFN gamma, and TNF alpha. tampons and food poisoning

339
Q

first line antihypertensive for isolated hypertension

A

thiazides and DHPRs

Amlodipine=nifedipine>(diltiazem>verapamil non DHPRs)

340
Q

FTA-ABS

A

Flourescent treponemal antibody . Syphilis

341
Q

drugs that cause serotonin syndrome

A

Antidepressants, tramadol, antiemetics, Linezolid, triptans

342
Q

Linezolid

A

for VRE and MRSA. 50S inhibitor

343
Q

Type of crystal in psuedogout

A

calcium pyrophosphate. Psuedo-PyroPhosphate
Positive birefringent
Polygon
knee joint

344
Q

Type of crystal in gout

A

uric acid. NN
Negative birefringent
Needle
metatarsal

345
Q

Dubin Johnson and Rotors

A

Defective Removal of conjugated bIli

Dubin- black liver. epinephrine metabolites in liver lysosomes

346
Q

Gilberts and Crigjler Najer

A

Glucuronide conjugation defect of bilirubin metabolis,

347
Q

wiscott aldrich syndrome

A

WATER. Wiscott Aldrich. TTP, eczema, recurrent infections. defective T-cells

348
Q

difference between Thrombotic Thrombocytopenic Purpura and Immune Thrombocytopenic Purpura

A

TTP is associated with HUS in kids and drugs in adults

ITP is autoimmune

349
Q

Chedak Higashi syndrome

A 
phagocyte immune deficiency
HIGASHI
Hair is silver
Immune deficiency
Granules - failure of phagolysosome fusion
Anemia, Pancytopenia
Seizures
Histiocytosis
Inclusions- giant, azure
350
Q

Vitamin E deficiency similar to what?

A

Freidrichs ataxia

Ataxia, dysarthria, PCML, spinocerebellar

351
Q

vitamin E deficiency symptoms

A

like B12 deficiency without megaloblastic anemia. hemolytic anemia, muscle weakness,

352
Q

ristocetin assay

A

no agglutination of platelts on addition. vWF and bernard souilier

353
Q

glucagon is the antidote for

A

hypoglycemia and b-blocker toxicity. Gs coupled

354
Q

secretin secreted by, does what

A

S-cells in duodenum increase pancreatic HCO3
Stimulate bile acid secretion
Stop gastic acid production

355
Q

what do you give to stop uterine contractions?

A

uterus out of line? use terbutaline. B2 agonist

356
Q

Treatment for chlamydia

A

Doxy azithromycin (plus ceftriaxone for gonnorhea) erythromycin eye drops in babies

357
Q

Treatment for gonorrhea

A

Ceftriaxone

358
Q

Treatment for neisseria mening

A

Ceftriaxone or penicillin G. Rifampin for prophylaxis

359
Q

Major mutation in melanoma and treatment

A

BRAF. (Melanoma and no hodgkin lymphoma) serine kinase. Treat with vemurafinib

360
Q

Main difference between raloxifene and tamoxifene.

A

Both antagonize at breast and agonist at bone. Tamoxifen agonist at uterus. Ralox antagonist

361
Q

Causes of restrictive cardiomyopathy

A 
Hem took Amy and Sarc to Rad House
Hemochromatosis (dilated too)
amyloidosis
Sarcoidosis (dilated too)
Radiation
362
Q

Causes of dilated cardiomyopathy

A 
ABCCCD
alcohol
Beriberi
Coxackie
Cocaine
Chagas
Doxirubicin

Hemochrom and sarcoid

363
Q

Hexagonal urine crystals

A

Sixtinuria.

Cystinuria (defect in PCT amino acid transporter for COLA)
Cysteine, Ornithine, Lysiine, Arganine

364
Q

beta lactams are analogs of what bacterial structure

A

D-Ala D-Ala in peptidogyclan

365
Q

vancomycin mechanism

A

binds to D-Ala D-Ala. resistance when changed to D-ala D-lac

366
Q

Drug that prolongs QT with low risk of torsades

A

Amiodarone

367
Q

cardiac drugs that prolong QT

A

Class Ia, III, TCAs, antipsychotics, odansetron, macrolides, flouroquinolones

368
Q

haptoglobin function

A

binds free heme in bloodstream. paradoxical decrease in serum concentration in the case of hemolytic anemia

369
Q

Only two seizure drugs that block Ca2+

A

ethosuximide and GABApentin

370
Q

angiogenesis growth factors

A

FGF and VEGF

371
Q

drug induced lupus labs and drugs

A

ANA positive
Anti-Histone positive
Anti-dsDNA negative

Hydralazine
Procainamide
INH

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