Missed questions Flashcards
(371 cards)
1
Q
Smooth ER function
A
Steroid and lipid synthesis
2
Q
Mnemonic for G protein second messengers
A
Kiss and Kick till your Sick of SQS (super kinky sex)
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)
4
Q
Kick part of mnemonic
A
qiq
M1 = Gq (PLP C)
M2 = Gi (blocks cAMP)
M3 = Gq (PLP C)
5
Q
Sick part of mnemonic
A
siq
D1 = Gs (stims cAMP)
D2 = Gi (blocks cAMP)
H1 = Gq (PLP C)
6
Q
Super kinky sex part of mnemonic
A
sqs
H2 = Gs (stims cAMP)
V1 = Gq (PLP C)
V2 = Gs (stims cAMP)
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
8
Q
MAD 2’s
A
M2, alpha 2, D2 are Gi. cAMP and PKA
9
Q
Virus associated w/ nasopharyngeal carcinoma
A
EBV
10
Q
Erythema infectiousum cause
A
parvo b19. only ssDNA, non-enveloped
11
Q
Bence Jones Protein
A
Multiple Myeloma Ig light chains in urine
12
Q
Warfarin + _______ = less plasma warfarin
A
Phenytoin, rifampin, phenobarbital
13
Q
3rd pharyngeal pouch
A
Thymus and inferior parathyroid
14
Q
Red neurons
A
Irreversible injury 12-24 hrs post. No nissl substance
15
Q
Trigeminal nerve exits brainstem at…
A
Middle cerebellar peduncle
16
Q
Viral recombination
A
Gene exchange by crossing over of two dsdna molecules. Adenovirus
17
Q
Viral reassortment
A
Occurs with segmented viruses like flu. Exchange whole genome segments. H1n1
18
Q
Viral phenotypic mixing
A
Co infection by two strains. Progeny get packaged different
19
Q
Fragile x
A
Cgg repeat. Gene methylation defect. Try hunting for my fried eggs (eggs=x=cgg)
20
Q
Tamoxifen effect on endometrium
A
Stimulatory. Endometrial hyperplasia cancer
21
Q
Mousy odor genetic defect mental retardation
A
pku. AR. avoid aspartame
22
Q
Cryptococcus grows as a
A
Budding yeast
23
Q
Mechanism of uv damage
A
Thymine dimers repaired by uv endonuclease
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
25
Cck made in
Duodenum jejunum i cells
26
Multiple myeloma mnemonic
```
Crab
Hypercalcemia and constipation
Renal stuff
Anemia
Bone lesions back pain
```
Monocloma m protein
27
Horner syndrome
Ipsilateral ptosis miosis anhidrosis
28
Causes of secondary bacterial pna
Strep pna, mssa, h. Flu
29
Capsule mnemonic
```
Shine skis
Steep pna
Hib
Neisseria
E. Coli
Salmonella
Klebsiella
i
GBS
```
30
Pseudomonas
Elderly diabetic swimmer. Ear pain. Blue green oxidase positive lactose non fermenter
31
Small painless genital ulcers that heal then inguinal LAD
Lymphogranuloma venerum (chlamydia)
32
Coccidiodes
SW US. Dimorphic. Hyphae at 25, spherule with spores at37
33
Histoplasma capsulatum
Oral ulcers. Tuberculed Hyphae at 25, yeast IN MACROPHAGE (histiocyte) at 37.
Misissippi ohio river valley
Bird droppings
34
Blastomyces dermatidis
East of mississippi and central america. Dimorphic 25 hyphae with conidia. 37 budding yeast. Most rare and severe
35
Cryptococcus
All yeast all the time. Pigeon poop
36
Aspergillus
45 degree branching hyphae all the time. Bundle of spore berries at the end of hyphae
37
Candida
Pseudohyphae and budding yeast at 20. Germ tube at 37
38
Amphotericin mechanism
Binds ergosterols and creates pore. Some cross rxn with cholesterol. Rigors fever chills = shake and bake
39
Methimazole
Inhibits organification of iodine (binding to TPO). Use propylthiouracil in pregnancy. Causes agranulocytosis and aplastic anemia
40
Gp2b/3a inhibitor
Abciximab. Tirobifan. Stops platelet aggregation. Used for pci. Defective receptor =glanzmann thrombasthenia
41
Benztropine for Parkinsons mechanism
Loss of dopamine inhibits gabaergic neurons. Ach stimulates gabaergic neurons. Benztropine is a muscatinic antagonist
42
Isoniazid mechanism
Activated by mycobacterial catalase peroxidase KatG, inh disrupts mycolic acid synthesis by inhibiting incorporation of fatty acid into mycolic acid
43
Pde 3 inhibitors
Milrinone heart failure and cilostazol claudication
44
Mast cell stabalyzer
Cromolyn, nedocromil. Omalizumab
45
Ethambutol mechanism
Inhibits arabinosyl transferase required for arabinogalactan. That covalently linkzmycolic acid to cell wall
46
Fluconazole mechanism
Inhibits conversion of lanosterol to ergosterol. Inhibits 14a demethylase(P450 dependent enzyme)
47
Caspofungin Micafungin
Echinocandins. Inhibit synthesis of beta(1,3,D glucan) (only cell wall antimycotic)
48
Ipratroprium for asthma
Antimuscarinic. Blocks smooth muscle constriction in bronchi M3
49
Niacin deficiency mnemonic
3 Ds of pellagra: dementia, dermatitis (sun exposed areas), diarrhea. B3 synthesized from tryptophan
50
vitamin A overdose sx
increased ICP, dry Skin, HSM - vit A used to treat measles?
51
Standard error of mean
SEM = SD/ (n)^1/2 estimates how much variability between sample and true population mean
52
Ventromedial Hypothalamus
Stim the ven, get then (thin) with leptin
53
Ventrolateral hypothalamus
stim the lat, get fat
54
Anterior Hypothalamus
Anterior Cooling (AC)
55
Winters formula
For determining if resp compensation is appropriate. expected PCO2 = 1.5*HCO3 +8 +/-2
56
Anti-psuedomonal cephalosporins and cillins
cefipime (4th), ceftazidine (3rd), pip tazo, ticarcillin-clav
57
radiolucent kidney stones
uric acid
58
radioopaque kidney stones
calcium oxalate or phosphate
59
ACute promyelogenous leukemia mutation
t(15:17)
60
Tricyclic antidepressant mnemonic
3Cs. Convulsions cardiotoxicity. Coma. Treat od with bicarb
61
treatment of toxoplasmosis
pyrimethamine and sulfadiazine
62
Fertilization implantation HCG detection timeline
1 day post ovulation, 7 days post fertilization, as soon as implantation happens
63
Anaerobic infections above diaphragm - treat with
Clindamycin
64
Waterhouse-Friderrichsen syndrome
Neisseria and Adrenal Hemmorhage
65
Anaerobic infections above diaphragm - treat with
Clindamycin
66
Neutrophil chemotactic factor
il-8. clean up on isle eight
67
Antiphospholipid syndrome
Common in lupus but can occur alone. Hypercoagulable state, positive RPR anti-cardiolipin abs and abortions
68
Adenosine extracoronary effects
Dilation of coronary and cerebral vessels, bronchoconstriction
69
Dipyridamole mechamism
Pde5 inhibitor that increases intravascular adenosine
70
cGMP hormones/drugs
ANP, hydralazine, nitroprusside, nitrates, BNP, think vasodilators. Sildenafil
71
ADP receptor antagonists
clopidogrel and ticlodipine (oral ulcers and neutropenia)
72
follicular b-cell lymphoma translocation
BCL-2 t(14:18) an epidermal growth factor receptor
73
where do herpes viruses get their membrane?
host nuclear membrane
74
Multinucleate cell seen in TB
Macrophage (langhans) horseshoe nuclei. Th1 activated
75
Fungal complication of asthma
Allergic bronchopulmonary aspergillosis
76
Mechanism of presbyopia
Lens becomes less elastic. Same as skin aging.
77
Add ACE to Thiazide first dose effect
Hypotension (especially in already hyponatremic pts). But no reflex tachycardia
78
Class 3 antiarrythmics
AIDS amiodarone, ibutilide, dofetilide, sotalol. Phase 3 (blocks potassium efflux)
79
Equation for filtration fraction
FF=GFR/RPF
(RPF = (1- HCT) * RBF
80
Galactosemia mnemonic
FABGUT fructose is to Aldolase B as Galactose is to UridylTransferase
81
Cause of cataracts
galactose to galactitol via galactose reductase. galactokinase deficiency. Sorbitol (DM), trauma infection
82
tetrology of fallot mnemonic
PROVe. pulmonary stenosis. RVH. Overriding aorta. VSD.
83
Epinephrine low dose vs. high dose
Low dose beta high dose alpha
84
Paramyxoviruses
PaRaMyxovirus . Parainfluenza, measles mumps, rsv (ribavirin). rna ss - helical nonsegmented
85
Measles mnemonic
3c's. cough, coryza, conjunctivitis. Koplick spots
86
MEN1.
3 Ps. Parathyroid pancreas, pituitary. diamond with pit on top, panc on bottom
87
Middle aged woman with granulomatous destruction of bile ducts
Primary biliary cirrhosis. Anti-mitochondrial ab
88
Young man with ulcerative colitis. Onion skin bile duct fibrosis
Primary sclerosing cholangitis. P-anca
89
Serotonin releasing neurons in
Raphe nuclei
90
heteroplasmy definition
mitochondrial inheritance
91
Kartagener syndrome
recurrent respiratory infections, dextrocardia, situs inversus, bronchiectasis
A primary ciliary dyskinesia (AR)
dynein arms failure
92
IL-2 receptor deficiency
SCID
93
Enzyme that catalyzes NE to Epit
Phenyethanolamine -N methyltransferase (requires SAM) "From 4 to 6 I'm C'ing SAM"
94
Carotid artery from which aortic arch
C is third letter in alphabet. 3rd. Common carotid and proximal internal carotid
95
Maxillary artery embroyologic derivative
1st arch, is MAXimal
96
Aorta from which aortic arch
Aor ryhmes with four. FouRS right subclavian
97
Pulmonary arteries which aortic
| arch?
6 looks like lung
98
Carbohydrate calories
4kcal/gram
99
Fat calories
9kcal/gram
100
Ethanol calories
7kcal/g
101
Methotrexate side effects
Stomatitis, folate deficiency, hepatotoxicity. Myelosupressiin. Risk for b-cell lynphoma and pulmonary fibrosis. Contraindicated in pregnancy
102
Rifampin mnemonic
```
4Rs.
Rna polymerase inhibitor
Ramps up P450
Red body fluids
Rapid resistance if used alone
```
103
Ezetimibe mechanism
Inhibits intestinal cholesterol absorption
104
Cholestyramine mechanism and risk
Bind bile acid in GI tract. Increases hepatic bile acid secretion (using cholesterol for precursor)
105
gemfibrozil mechanism and risk
PPARalpha transcription products increases lipoprotein lipase decrease TG and VLDL. Increases cholesterol content in bile acid secretion and can predispose to gallstones
106
Finasteride mechanism and indication
5alpha reductase inhibitor. bph and alopecia
107
priopionic acid created from
Catabalism of branched chain AAs, odd-chain FA, methionine, threonine
108
Selective muscarinic antagonists
Scopolamine
109
noonselective muscarinic agonist
pilocarpine, methacholine
110
Other word for accuracy
validity
111
Other word for precision
reliability
112
urine that turns black when exposed to air
alkaptonuria, degradative pathway of tyrosine to fumarate, AR
113
main toxin in C. perfringens
lecithinase, also known as phospholipase C. Also known as alpha toxin
114
vitamin deficiency in Wernicke Korsakoff
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
115
beta 1 receptors found where?
Cardiac, Juxtaglomerular cells
116
Function of seminal vesicle
Secrete fructose protein and phospholipids
117
Bromocriptine
parkinsons drug BALSA
Bromocriptine - DA (D2)
Amantadine - increases DA synthesis, release, reuptake
Levodopa
Selegiline - MAO- inhibitor
Antimuscarinics - trihexyphenidyl and benztropine
118
Clomiphene
central SERM used to induce ovulation
119
Function of peptidyl transferase and drug
Covalent bond between AAs. 50s chloramphenicol
120
Neuroendocrine tumor markers
Chromagranin, synaptophysin, neuron specific enolase
121
MEN2a
2Ps Parathyroid and pheo. Square with medullary thyroid in middle
122
MEN2B
MEN2B 1 P. pheo. Triangle with neuroma on top, pheo other corners, medullary thyroid in middle. Marfanoid
123
Taut blister separating epidermis from dermis
```
bullous pemphigoid (Bullow the epidermis). IgG anti hemisesmosomes
Hemi stronger holds whole layer down instead of two cells together
```
124
Partial b-agonists
Pindolol acebutolol
125
Shiga and EHEC Toxin MOA
Inactivate 60s ribosome. Pulls Adenine off rRNA
126
Strep viridans classification and disease
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
127
PPV equation
PPV= TestP/(DiseaseP+False P) all positives
128
Selective IgA mnemonic
6As, Asymptomatic, Airway infection, Autoimmune disease, Atopy, Anaphylaxis to IgA containing products
129
Vasculitis associated with Smoking
Medium vessel vasculitis - Thromboangiitis obliterans (Beurger's disease). calf, foot and hand intermittent claudications
130
carboxylase require what cofactor
Biotin
131
Lesch-Nyhan genetics
hypoxanthine PRPP X-recessive
132
Leber hereditary optic neuropathy genetics
mitochondrial - red ragged
133
Huntingtons genetics
Autosomal Dominant
134
Hemophilia B genetics
X-linked recessive, Factor 9 defect
135
Classical galactosemia
Defect in galactose 1 uritdyl transferase (FABGUT)
136
Cold agglutinins
mycoplasma pna IgM that agglutinate RBC at cold temps, also EBV and hematologic malignancy
137
Muscarinic agonist used to treat post-op urinary retention
Bethanechol (similar in class to Methacholine)
138
menieres disease
episodic vertigo with tinnitis and hearing loss. increased volume of endolymph damages vestibula and cochlea
139
Von hippel lindau disease
AD capillary hemangioblastomas in retina or cerebellum, congenital cyts/neoplasms of kidney liver and pancrease, Renal cell carcinoma RCC three (chromosome)
140
Li Fraumini
p53 mutation AD, Sarcoma of breast, brain, adrenal cortex
141
dehydrogenase enzyme probably need these cofacters
Tender Loving Care for Nancy. Thiamine, Lipoate, Coenzyme A, FAD, NAD
142
Partial gene deletion syndromes
Cri du chat (5p), Prader willi/angelman (15q),
143
Interleukin mnemonic
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
144
IL-12
th0-->th1, stimulates NK cells (highest cytokine).
145
Uric acid precipitates at what pH?
pKa=5.4 so in acidic environment
146
equation for half-life
t 1/2 = (.693xVd)/CL
147
Drug clearance is
rate of elimination/plasma concentration= Vd x elimination constant
148
neurophysin function
carrier protein for ADH and Oxytocin
149
digoxin side effects
Dig delirium. nausea, blurred vision, yellow green hallucinations. Hyperkalemia.
Arrythmia
150
lepromin skin test and biopsy results in lepromatous vs tuberculoid leprosy
tuberculoid, skin test positive, biopsy negative
| lepromatous, skin test negative, biopsy positive
151
bronchiolitis obliterans pathology
chronic lung transplant rejection. Inflammation of small airways (bronchioles) leads to fibrosis and occlusion
152
mechanism of action anastrozole
aromatase inhibitor for ER+ breast cancer in post-menopausal women
153
PTH effect on phosphate
Phosphate Trashing Hormone. lower serum calcium by inhibiting Phosphate reabsorption in proximal tubule
154
Electrolytes that increase in Chronic Renal Failure
Phosphate, K, Cholesterol, TG
155
equation for NPV
NPV= TN/(TN + FN)
156
Spironolactone uses
1) CHF - reduces mortality, 2) diuretic 3) PCOS, 4) blocks testosterone production/androgen receptor complex. causes Non-anion gap met acidosis
157
dequervian thyroiditis: signs and symptoms
dequiver: shaking, deQuerVAIN is PAIN. painful. granullomatous inflammation
158
glucagonoma mnemonic
4D's. Dermatitis (necrolytic), diabetes (hyperglycemia), DVT, Depression. pancreatic alpha cells
159
beta blockers that are indicated and beta blockers that are contraindicated in diabetes
Contraindicated: Non-selective
Indicated: B1 specific (don't block metabolic sympathetic effects)
160
Pheo mnemonic/rule
```
rule of 10s
10% malignant
10% bilateral
10% extra adrenal
10% calcify
10% kids
```
5P's pressure, pain, perspiration, palpitations, pallor
161
Purely ketogenic AAs
Lysine and Leucine the onLy pureLy ketogenic
162
location of schwannomas
cerebellopontine angle. hearing loss and loss of corneal reflex. B/L with NF2
163
Trigeminal Nerve foramen mnemonic
Standing Room Only (sup orb fissure-V1, rotundumV2, ovaleV3)
164
Huntington mnemonic
Caudate loses Ach and GABA. increase in dopamine. Try hunting for my fried eggs. Hunting 4 food chromosome 4.
165
Thallesemia mnemonic
THAL. Target cells hemolytic anemia howell jolly bodies anisocytosis and low mcv
166
Pentazocine
Mu receptor partial agonist
167
CREST syndrome
Calcinosis, reynauds, esophageal dysmotility, telangiectasia. A limited scleroderma
168
Which toxins block ADP ribosylation of EF2
Cornebacterium Diptheria and pseudomonas
169
Bacteria toxins that mess with cAMP
CAMP. Cholera, anthrax, montezuma (m sideways, labile),bordatella pertussis
170
ARDS effect on lung compliance, wob, v/q matching, pcwp, capillary permeability
NL PCWP. All others worse
171
Niacin considerations
Gout hypertension diabetes
172
What affects Hb curve
c-BEAT. Co2 BPG, excercise, Altitude, temp
173
Sickle cell mutation
Glutamate to valine
174
only gram positive with endotoxin
Listeria
175
Listeria growth algorithm
GPR, Grows at 4C and catalase +, intracellular or extracellular
176
Stereotypical nonselective alpha blocker
Phentolamine
177
Only gram negative without an endotoxin
Bacteroides
178
mechanism of gallstones in Crohns
no bile acid resorption causes increase in Cholesterol:Bile Acid ratio of bile
179
Clostridium Toxin
A and B. inactivates Rho regulatory proteins. A is enterotoxin B is a cytoskeleton toxin (bind extracellular and are internalized)
180
GnRH agonist
leuprolide
181
polyarteritis nodosa
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
penicillamine
a chelator used to treat wilson's (copper), arsenic, gold, lead, cystinuria, causes membranous nephropathy (nephrotic), and myopathy
183
Alveolar Gas equation
Alveolar O2 = [FiO2 x (barometric P - water vapor pressure)] - PaCO2/.8
normally 150-(PaCO2)/.8
184
PAS stain mnemonic
PASs the sugar (stains glycogen)
185
carbolfuchsin stain
Ziehl-Neelson. AFB
186
vitamin a deficiency
dry scaly skin (necessary for differentiation of epithelial tissue into specialized cells), night blindness, immunosuppression. Vit A to treat measles?
187
Hb right shift mnemonic
```
C-BEAT
CO2
BPG
Exercise
Altitude
Temperature
```
188
Peroxisome
Metabolizes very long chain fatty acids, branched FA, and AA
189
tRNA components
Tail is CCA Can Carry Amino Acids, Dihydrouracil,
190
drug of choice for trigeminal neuralgia
Carbamazepine. This works aMAZingly well
191
modafinil
like amphetamine used for narcolepsy
192
Most potent vasoconstrictor
Endothelin. Bosentan is an antagonist to treat PAH
193
narcolepsy pathology
decrease of orexin (hypocretin)
194
transamination reactions require what cofactor
B6. also heme synthesis succinyl co to AMINO Levulinic acid
195
COMT inhibitors
entecapone and tolcapone increase levodopa availability in brain
196
Dopamine agonists
bromocriptine, pergolide, pramipexole, ropinerole
197
First line for simple, complex, tonic clonic sz, trigeminal neuralgia, bipolar mood stabilizer
Carbamazepine, Na channel blocker, SJS, SIADH, agranulocytosis, aplastic anemia etch
198
Lipids (triglycerides, cholesterol, phospholipids) are absorbed in
Jejunum. For some reason the bile gets reabsorbed in the ileum along with B12
199
sarcoidosis symptoms
hypercalcemia and increased ACE. B/L hilar LAD, Th mediated. noncaseating granuloma
200
mobitz I vs mobitz II
mobitz I/wenkenbach "later later later drop thats what makes in wenkenbach". mobitz II unpreceded dropped p wave
201
tyrosine kinase oncogene in breast, ovarian, gastric carcinoma
HER2/neu (c-erb2)
Her2 neu breasts, ERB - estrogen receptor breast
treat with trastuzumab
202
Wilsons disease
```
Copper is Hella BAD.
decreased ceruloplasmin, cirrhosis, corneal deposits.
Hemolytic anemia
Basal ganglia degeneration
Asterixis
Dementia, dyskinesia, dysarthria
```
203
Thiamine needed for
Pirate AK transfer. pyruvate dehydrogenase, alpha KG dehydrogenase, transketolase (HMP)
204
MAO inhibitors
Selegiline (parkinsons, selective, increased DA)
MAO Takes Pride In Shanghai
( tranylcypromine, phenelzine, isocarboxazid, selegiline)
205
alpha 1 receptors when stimulated produce
increase vascular smooth muscle contraction, mydriasis, bladder and intestinal sphincter contraction
206
beta 2 receptors when stimulated produce
vasodilation, bronchodilation, insulin release, uterine relaxation, increase production of aqueous humor
207
Beta 1 receptors when stimulated produce
increased HR, contractility, renin release and lipolysis
208
Large vessel arteritis
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
Loop diuretics
Loops lose ca
210
Thiazides
HyperGLUC
211
Causes of acute pancreatitis
```
ETOH, gallstones, then I GET SMASHED
idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hypercalcemia/hyperTG
ERCP
Drugs
```
212
Berry aneurysm in who?
Ehlers danlos and PKD
213
theophylline
PDE inhibitor. analagous to B1 agonist like albuterol but also inhibits mast cell inlammatory meidator release. Acute intox = vomiting, seizures
214
thrombangiitis obliterans mnemonic
```
CRISP PIGS's beurger
C- chronic ulceration
Raynauds
Intermittent claudication
Segmented vasculitis
Phlebitis
Pain
Idiopathic
Gangrene
Smoking
```
215
mechanism of u opiod analgesics
increase K+ conductance on postsynaptic --> hyperpolarization
216
Neuroleptic Malignant Syndrome
rahm - rigitidy, autonomic instability, hyperthermia myoglobinuria,
217
vitamin deficiency in carcinoid syndrome
niacin. 3 D's of niacin. Diarhrea, dementia, dermatitis
218
electrolytes in sarcoidosis
hypercalcemia due to 1 alpha hydroxylase activation in macrophages
219
phrenic nerve roots
C3-5 keep the diaphragm alive
220
OCPs contraindicated in
smokers, hyperTrigs, hx of estrogen dependent tumor
221
Embryonic origin of pituitary and craniopharyngioma
Rathke pouch (from ectoderm that lines fetal oral cavity)
CRanio
Children/calcification
Rathke
222
Urea cycle mnemonic
Cars cannot accelerate as fast as usain bolt
223
Phenytoin uses, mechanism, SE
```
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
Closed vs open angle glaucoma
Open angle more insidious. Not related to mydriasis. Closed angle due to sudden increase in ocular pressure and mydriasis.
225
ending of TCAs
"tyline" "pramine" "xepine"
226
anditode for TCA toxicity
Sodium Bicarb. (TCAs have Na channel blockade)
227
MAO inhibitors and side effect
Selegiline, MAO Takes Pride In Shanghai
Trancypromine, Phenelzine, Isocarboxazide, Selegiline
Hypertensive Crisis Wine sausage and Cheese!
228
pralidoxime indications
Phosphate poisoning organophosphate
229
friedrich ataxia memory aid and mnemonic
chromosome 9 with big heart(HOCUM) weak legs. FR-ATAXIN protein
Free Radicals
GAA
Gait Affected Autosomal Recessive
230
Tardive Dyskinesia Definition
involuntary, repetitive movements, (looks like a crazy person) an EPS (late sx)
231
Akathisia
Restlessness (4 day EPS sx)
232
Mesolimbic tract function
integrates sensory and motor systems dopaminergic
233
mesocortical tract function
communication and social dopamineregic pathway
234
nigrostriatal tract function
extra pyramidal control, dopaminergic pathway
235
Schizo positive sx
delusions, hallucinations,
236
Schizo negative sx
emotional blunting, social withdrawal, lack of motivationinexpressive face
237
Typical Antipsychotics
Halo-chlorp haloperidol, chlorpromazine
238
Atypical Antipsychotics
ROCA, risperidone, olanzapine, clozapine, aripriprazole
239
Mnemonic for depression
SIG E CAPS, Sleep, Interest, Guilt, Energy, Concentration, Anhedonia, Psychomotor, Suicide
240
4 domains of bipolar sx
1) Manic mood, 2) dysphoric mood 3)psychosis 4)cognitive sx (racing thoughts, distractibility, inattention)
241
Bipolar I disorder characterized by
mania only
242
Bipolar II disorder characterized by
Hypomania and major depression
243
Ketamine / Phencyclidine MOA
Glu-NMDA receptor antagonist
244
Cocaine neurotransmittors
Inhibits monoamine transporters, increase esp in DA
245
Treatment of Acute Benzo toxicity
Flumazenil (GABA receptor antagonist)
246
treatment for opioid withdrawal
methadone, clonidine, tincture of opium in newborns
247
drug for anti nicotine?
varencicline (chantix), buproprion
248
tabes dorsalis
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
5 nuclei of basal ganglia
Caudate, putamen, substantia nigra, subthalamic (hemiballismus), globus pallidus
250
Drugs in Stevens Johnsons and DRESS
Steven Johnson has an epileptic ALLergy to sulfa drugs and penicillin.
```
carbamazepine
lamotrigine
phenytoin
sulfa
phenobarbital
```
251
First line drugs for acute status and status prophylaxis
Benzos for acute (lorazepam), Phenytoin for prophylaxis. if still seizing give phenobarbital
252
Maintenance dose eqn
MD/tau=Cpss x Vd/F
MDs clear constant schedule over food
253
Clearance equation
CL = rate of elimination(kE)/Cp = kE x Vd
knockout cleared crazy smiles
Ke= CL x Css
254
Bug susceptibility in CGD
Aspergillus, Staph Aureus, Burkholderia Cepacia, Serratia, Nocardia
255
HACEK organisms
Haemophilus, Actinobacter, Cardiobacterium, Eikinella, Kingella
256
Enzymes requiring thiamine
PAT Pyruvate dehydrogenase, alpha KG dehydrogenase, transketolase (HMP to Glycolysis)
Ribulose 5P to Fructose 1,6 BP
Ribulose 5P to GA3P
257
Plummer-Vinson or Patterson Kelly syndrome
Esophageal webs from iron deficiency anemia
258
tuberous sclerosis
Autosomal dominant. Cutaneous angiofibromas, seizures, mental retardation, CNS hamartomas
259
location of cerebral aquaduct
between 3rd and 4th ventricle
260
location of foramen of monroe
between ventricles and 3rd ventricle
261
liquefactive necrosis
neurons. lysosomes released, causing necresis. microglia come to take care of the mess, then astrocytes form scar
also bacterial abscess
262
normal pressure hydrocephalus symptoms
wet, wacky, wobbly
| urinary incontinence, cognitive dysfunction, ataxia
263
vitamin E deficiency
hemolytic anemia, ancanthocytosis, muscle weakness, PCML, Spinocerebellar demyelination. like B12 but without MMA, megaloblasts
vitamin E is an antioxidant
264
Amphotericin Side effects
shake and bake (fevers and rigors), hyporkalemia and hypormagnesium due to nephrotoxicity
265
drug given with cyclophosphamide to prevent hemorrhagic cystitis
mesna (mercaptoethane sulfonate)
266
treatment of migraines
sumatriptan 5HT 1b, 1d agonist causes vasoconstricion
beta blockers, TCA and SNRIs, Valproate for prophylaxis
267
Henoch Schonlein
```
JARS
Joints
Abdominal Pain
Renal (Bergers)
Skin (palpable purpura)
```
268
direct hernias arise ____ to the epigastric arteriy
medial older men
269
indirect hernias arise ____ to the epigastric artery
lateral male infants
270
pramipexole
DA used in parkinsons
271
migratory superficial thrombophlebitis
troussea syndrome- paraneoplastic b/c adenocarcinomas make thromboplastin substance
272
tumor associated with arsenic, vinylchloride and CD31+ cells
liver angiosarcoma
273
P450 inducer menomic
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
pramipexole
DA used in parkinsons
275
P450 inhibitor mnemonic
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
fidaxomicin
C. Diff. RNA pol inhibitor with minimal systemic absorption
277
P450 inducer menomic
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
P450 inhibitor mnemonic
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
P450 inhibitor mnemonic
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
fidaxomicin
C. Diff. RNA pol inhibitor with minimal systemic absorption
281
Immune response to Giardia
CD4 mediated IgA response
282
Acute Intermittent Porphyria
```
5 Ps.
Painful abdomen
Port wine urine
Polyneuropathy
Psychologic disturbances
P450 inducers
```
283
Tertiary (neuroactive) amine ACh-ase inhibitor
Physostigmine
284
enzyme that converts NE to epi
phenylethanolamine decarboxylase. Cortisol increases transcription
285
Bugs with IgA-ase toxin
Strep PNA, neisseria, hemophilus. Allows for adherence to mucosa. IgA binds piliae
286
acetaminophen metabolite
NAPQI
287
Renal papillary necrosis
```
SAAD Papa with papillary necrosis
Sickle cell
Acute pyelo
Analgesics (NSAIDS)
Diabetes
```
288
Goodpasture antibodies are against
Type IV collagen
289
Berksons bias
study population selected from hospitals is less healthy than the general population
290
Hawthorn effect in studies
observer effect. when subjects know they are being studied they change their behavior
291
fructose intolerance
Aldolase B defect. After fructose ingestion get hypoglycemia, jaundice, cirrhosis, vomiting
292
treatment of measles
vitamin A. resolves a virally induced hyporetinemia
293
mediator of gene expression in lac operon
inducer (lactose) binds repressor and inactivates it (prevents it from binding operator)
294
what recruits RNA pol in the lac operon
CAP. Catabolite Activating Protein (activated by cAMP) binds upstream of promoter
295
familial hypocalciuric hypercalcemia
problem with ca sensors in Parathyroid. and kidney. Benign
296
superior laryngeal nerve innervates what muscle
cricothyroid (4th arch derivative)
297
direct hernias caused by
weakness of transversalis fascia
298
vitamin C deficiency symptoms
bleeding gums, peticiae, impaired wound healing (collagen)
299
most common cancer in IBD and features
colorectal carcinoma. More likely to be:
Multifocal
Arise sporadically (not from polyps)
Develop early P53 and late late APC mutation
Higher grade
300
ovarian neoplasm that produces estrogen
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
seizure meds for multiple seizures. (absence and tonic clonic)
Valproic acid - 1st line tonic clonic, but treats everything else but status
Lamotrigine(SJS)
302
Pemphigous vulgaris
Vulgar language = mouth blisters,
vulgar people are younger and more superficial.
flaccid (more superficial)
IgG anti desmoglein (part of desmosome)
303
Gilbert syndrome
a decrease in UDP-glucuronyl tranferase, impaired bilirubin uptake. very common
304
primary HBV infection
JOINT pain!!! mailase, fever, rash, pruritis
305
kussmauls sign
increase in JVP on inspiration instead of decrease. due to tumor or constrictive pericarditis
306
waves of JVP
```
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
anticoagulant in pregnancy
heparin
308
cells with clear cytoplasm on renal biopsy
```
clear cell (renal cell) carcinoma. PCT
smoking, obesity, men 50-70
```
309
stages of syphilis
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
to prevent nephrotoxicity with cisplatin (testicular, bladder, ovary, lung cx) use
amifostine
311
part of male urethra most often damaged in pelvis fracture
membranous- anterior (bulbous) junction
312
chronic transplant rejection morphology
vascular wall thickening, interstitial fibrosis. low grade immune response
refractory to immunosuppressants
313
most common location of intussusception
ileocecal valve region
314
phenoxybenzamine
irreversible alpha blocker used to treat pheochromocytoma
| (noncompetitive)
315
phentolamine
nonselective alpha blocker (competitive)
316
mifepristone
progesterone antagonist for abortion. administered with PGE (misoprostol)
317
Misoprostol
PGE analog. Abortion and ulcers
318
hydroxyurea use
sickle cell. somehow upregulates HbF expression. Also in
319
necrotizing enterocolitis
preemie infants. enteric feeding causes bacterial overgrowth, gas, ischemic necrosis
320
chemo microtubule inhibitors
vincristine, vinblastine (neurotoxicity)
321
wegners mnemonic
WeCners - c-anca. draw a C. Nasopharynx, lungs, kidney
Epistaxis, URI, PNA, Glomerulonephritis (RPGN/crescenteric)
Granulomatosis with Polyangiitis
322
Lambert eaton myasthenic syndrome
Anti VSCC that participate in release ACh
323
histologic findings of rheumatic fever
aschoff giant cells. multinucleated macs, later replaced by fibrous tissue
324
WAGR complex
beckman wiedmann syndrome of Wilms Tumor, aniridia, GU malformation, mental Retardation
325
prostaglandins in pregnancy
PGE kEeps the PDA open
| uterine contraction stimulation (also abortifactant misoprostol)
326
gardos channel blockers
block K and H2O efflux from cells, preventing dehydration of RBCS for HbS
327
Cardiac output equations
O2 consumption/arteovenous difference.
CO= HRx SVT
328
mechanism of thoracic aortic dissection
cystic medial (tunica media) degeneration. myxomatous change
fragmentation of elastic tissue
Marfans
329
krukenberg tumor
stomach cancer with bilateral metastases to ovaries.
| mucin secreting, signet ring cells
330
virchow node
left supraclavicular node. sentinel node in gastric adenocarcinoma
331
Sister mary joseph nodule
subcutaneous periumbilical metastasis of gastric adenocarcinoma
332
achondroplasia mutation
FGFR3 (autosomal dominant). fibroblast factor-angiogenesis
333
Familial hypercholesterolemia
IIa Autosomal dominant. Absent or defective LDL-receptor. tendon xanthomas, corneal arcus
heterozygote chol is 300, homo chol is 700+
334
hyperchylomicronemia
Autosomal recessive. LPL deficiency or altered apo CII
335
hypertriglyceridemia
AD, hepatic overproduction of VLDL. Causes acute pancreatitis
336
four stages of PNA
congestion (first 24 hrs)
red hepatiziation ( day 2-3)
grey hepatization (day 4-6)
resolution
337
neuroblastoma
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
toxic shock syndrome
staph aureusi. superantigen. cross links MHCII and TCR. Releases IL1, 2, IFN gamma, and TNF alpha. tampons and food poisoning
339
first line antihypertensive for isolated hypertension
thiazides and DHPRs
| Amlodipine=nifedipine>(diltiazem>verapamil non DHPRs)
340
FTA-ABS
Flourescent treponemal antibody . Syphilis
341
drugs that cause serotonin syndrome
Antidepressants, tramadol, antiemetics, Linezolid, triptans
342
Linezolid
for VRE and MRSA. 50S inhibitor
343
Type of crystal in psuedogout
calcium pyrophosphate. Psuedo-PyroPhosphate
Positive birefringent
Polygon
knee joint
344
Type of crystal in gout
uric acid. NN
Negative birefringent
Needle
metatarsal
345
Dubin Johnson and Rotors
Defective Removal of conjugated bIli
| Dubin- black liver. epinephrine metabolites in liver lysosomes
346
Gilberts and Crigjler Najer
Glucuronide conjugation defect of bilirubin metabolis,
347
wiscott aldrich syndrome
WATER. Wiscott Aldrich. TTP, eczema, recurrent infections. defective T-cells
348
difference between Thrombotic Thrombocytopenic Purpura and Immune Thrombocytopenic Purpura
TTP is associated with HUS in kids and drugs in adults
| ITP is autoimmune
349
Chedak Higashi syndrome
```
phagocyte immune deficiency
HIGASHI
Hair is silver
Immune deficiency
Granules - failure of phagolysosome fusion
Anemia, Pancytopenia
Seizures
Histiocytosis
Inclusions- giant, azure
```
350
Vitamin E deficiency similar to what?
Freidrichs ataxia
| Ataxia, dysarthria, PCML, spinocerebellar
351
vitamin E deficiency symptoms
like B12 deficiency without megaloblastic anemia. hemolytic anemia, muscle weakness,
352
ristocetin assay
no agglutination of platelts on addition. vWF and bernard souilier
353
glucagon is the antidote for
hypoglycemia and b-blocker toxicity. Gs coupled
354
secretin secreted by, does what
S-cells in duodenum increase pancreatic HCO3
Stimulate bile acid secretion
Stop gastic acid production
355
what do you give to stop uterine contractions?
uterus out of line? use terbutaline. B2 agonist
356
Treatment for chlamydia
Doxy azithromycin (plus ceftriaxone for gonnorhea) erythromycin eye drops in babies
357
Treatment for gonorrhea
Ceftriaxone
358
Treatment for neisseria mening
Ceftriaxone or penicillin G. Rifampin for prophylaxis
359
Major mutation in melanoma and treatment
BRAF. (Melanoma and no hodgkin lymphoma) serine kinase. Treat with vemurafinib
360
Main difference between raloxifene and tamoxifene.
Both antagonize at breast and agonist at bone. Tamoxifen agonist at uterus. Ralox antagonist
361
Causes of restrictive cardiomyopathy
```
Hem took Amy and Sarc to Rad House
Hemochromatosis (dilated too)
amyloidosis
Sarcoidosis (dilated too)
Radiation
```
362
Causes of dilated cardiomyopathy
```
ABCCCD
alcohol
Beriberi
Coxackie
Cocaine
Chagas
Doxirubicin
```
Hemochrom and sarcoid
363
Hexagonal urine crystals
Sixtinuria.
Cystinuria (defect in PCT amino acid transporter for COLA)
Cysteine, Ornithine, Lysiine, Arganine
364
beta lactams are analogs of what bacterial structure
D-Ala D-Ala in peptidogyclan
365
vancomycin mechanism
binds to D-Ala D-Ala. resistance when changed to D-ala D-lac
366
Drug that prolongs QT with low risk of torsades
Amiodarone
367
cardiac drugs that prolong QT
Class Ia, III, TCAs, antipsychotics, odansetron, macrolides, flouroquinolones
368
haptoglobin function
binds free heme in bloodstream. paradoxical decrease in serum concentration in the case of hemolytic anemia
369
Only two seizure drugs that block Ca2+
ethosuximide and GABApentin
370
angiogenesis growth factors
FGF and VEGF
371
drug induced lupus labs and drugs
ANA positive
Anti-Histone positive
Anti-dsDNA negative
Hydralazine
Procainamide
INH
