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Flashcards in Mixed Block Notes 4 Deck (99):
1

Signs of Acute Tubular Necrossi

Oliguria, Muddy Brown Casts, Anion Gap Metabolic Acidosis

2

Signs of Aromatase Deficiency

Maternal virilization, High androgens, Low estrogen, Tall, Osteoporosis --> Girls have ambiguous genitalia, boys just tall and osteoporosis

3

Function of Red Nucleus

Motor control of Upper extremities

4

Skin biopsy in Dermatitis Herpetiformis shows

PMNs and fibrin at tips of dermal papilla = microabcesses; IgA deposits

5

Infant with malabsorption, failure to thrive, progressive ataxia, acanthocytes

Abetalipoproteinemia

6

Epinephrine stimulates B2 receptors in skeletal muscle to

Incr BF, Glycogenolysis, Lipolysis

7

Endocrine comorbidities with Down Syndrome

Hypothyroid, T1DM, Obesity

8

Rheumatology and Hematology comorbidities with Down Syndrome

Acute Leukemia, Atlantoaxial instability

9

are only found in Alzheimer's dementia

Neurofibrillary Tangles

10

Lewy bodies

Round, eosinophilic, intracytoplasmic inclusions that contain neurofilaments of a-synuclein

11

Negri Bodies

Round eosinophilic inclusions seen in the cytoplasm of pyramidal hippocampal neurons and cerebellar purkinje cells

12

When does the metonephros begin to produce urine

8-10 wks

13

Most common cause of fetal hydronephrosis

Inadequate recanalization of the ureteropelvic junctions

14

Tumor that causes necrolytic migratory erythema

Glucagonoma

15

Manifestations of Somatostatinoma

DM, Steatorrhea, Cholelithiasis, Hypochlohydria

16

Order of sound /pressure waves in inner ear

Round window --> Scala Vestibuli --> Scala Tympani --> Basilar Membrane dilation

17

Brown pigment stones typically arise secondary to

Infection of the biliary tract --> Releases B-Glucoronidase --> Hydrolysis of bilirubin glucoronides --> incr amount of unconjugated bilirubin in bile

18

7a-Hydroxylase function

Convert cholesterol to bile acids (sufficient activity reduces likelihood of cholesterol stone formation)

19

Important to metabolism/levels of digoxin

Renal clearance mostly, Plasma protein binding and body mass somewhat; Not liver enzymes

20

Most common known viral cause of acute hemorrhagic cystitis in children (and males in particular)

Adenovirus (serotypes 11 and 21 of B subgroup)

21

Pathogenesis of Centriacinar Emphysema

Smoke --> Macrophages --> PMNs --> Proteases active, Antiproteases inactivated

22

Club/Clara cell function

Nonciliated, secretory cells in terminal respiratory epithelium --> Secrete protein, surfactant and help detoxify

23

Is S3 or S4 always pathologic in young patients

S4 always in younger, Not always in older

24

V/Q and Acid/Base consequences of PE

Redistribution of blood to unaffected --> V/Q mismatch --> Hypoxemia stimulates hyperventilation --> Respiratory Alkalosis

25

3 NNRTI's

Nevirapine, Efavirenz, Delavirdine

26

MOA of Enfuvirtide

Prevent fusion by binding gp41

27

Most concerning AE of NNRTI's

Hepatic Failure with Encephalopathy

28

Holoprosencephaly is associated with

Trisomy 13 and 18, Fetal Alcohol Syndrome

29

Deformation vs Malformation

Deformation occurs due to extrinsic mechanical force; Malformation is a primary defect in cells or tissues that form an organ

30

"Disruption"

Secondary breakdown of a previously normal tissue or structure

31

Aldolase function

A/B/C metabolize F-1,6-BP to G3P and DHAP; Aldose B also metabolizes F-1-P to Glyceraldehyde and DHAP

32

Tx Aldolase B deficiency by

Eliminating dietary fructose (sucrose)

33

Sucrose

Fructose + Glucose

34

Lactose

Galactose + Glucose

35

Maltose

Glucose + Glucose

36

For patients with stiff lungs, work of breathing is minimized when

RR is high, TV is low

37

For patients with high airflow resistance, work of breathing is minimized when

RR is low, TV is high

38

LPS/LOS cause sepsis by induction of systemic inflammatory response characterized by

TNFa, IL-1b, IL-6, IL-8 (much of which is formed after interaction with TLR-4)

39

Osteoporosis is defined as

Bone density >2.5 SD below mean for peak young adult bone density

40

Risk factors for Osteoporotic Fractures

White/Hispanic/Asian, Hx, Decr activity, Low body weight, Excessive alcohol or tobacco, Premature menopause

41

How do GC's incr bone loss

(1) Decr GI absorption of Ca, (2) Inhibit collagen synthesis, (3) Decr GnRH, (4) Incr urinary Ca loss

42

Side effects of Statins

Myotoxicity, Hepatotoxicity (discontinue if LFT's >3x normal)

43

CYP Inducers

Chronic Alcohol, St Johns wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine

44

CYP substrates

Anti-epileptics, Theophylline, Warfarin, OCPs

45

CYP inhibitors

Acute Alcohol, Ritonavir, Amiodarone, Cimetidine, Ketoconazole, Sulfonamides, Isoniazid, Grapefruit, Quinidine, Macrolides (ex azithromycin)

46

Acanthosis

Incr thickness of stratum spinosum (psoriasis commonly associated with acanthosis)

47

Spongiosis

Intercellular epidermal edema --> incr space b/t cells (eg eczematous dermatitis)

48

Dyskeratosis

Premature keratinization of individual keratinocytes (eg SCC)

49

First line for isolated systolic HTN in non diabetics

Thiazides and DHP CCBs

50

HTN drug that can lead to flushing and peripheral edema

Amlodipine

51

First line for essential HTN in general public

HCTZ

52

Most frequent AE's w/ Verapamil

Constipation, Gingival hyperplasia

53

Drugs that cause Gingival Hyperplasia

Phenytoin, CCBs, Cyclosporine

54

MOA of Clomiphene

SERM that prevents negative feedback inhibition on hypothalamus (used in PCOS)

55

Diseases that cause myocardial fibrosis

Dermatomyositis, Muscular Dystrophy, Sarcoidosis, Scleroderma

56

Why doesnt Anti-HepC IgG confer immunity?

RNA polymerase errors --> Varied antigenic structure

57

AE's of Amphotericin B

Infusion reaction, Thrombophlebitis, Nephrotoxicity, HypoMg/HypoK, Anemia (suppressed EPO)

58

BH4 is a cofactor for synthesis of

Tyrosine, DOPA, Serotonin, Prolactin, NO

59

Cardiac morphology changes with aging

(1) Decr LV chamber size; (2) Sigmoid IV septum; (3) Incr interstitial CT; (4) Lipofuscin accumulation

60

Murmur of VSD

Loud holosystolic murmur over left sternal border 3-4 intercostal space (smaller = louder)

61

Phenylethanolamine N-methyltransferase

NE to Epi

62

Systemic sclerosis is thought to be due to activation of what cell type

CD4

63

A strict vegetarian diet can cause a deficiency of

B12

64

Free wall rupture occurs how long after MI

3-7 days

65

Triad of muffled heart sounds, elevated JVP, profound hypotension indicate

Pericardial Tamponade

66

How does GI bleed precipitate Hepatic Encephalopathy

Incr nitrogen delivery to gut in form of hemoglobin --> converted to ammonia and enters bloods stream

67

Molecules that act thru nuclear receptors

TH, Retinoids, PPAR, Fatty Acids

68

Spirochetes are universally sensitive to

Penicillin (gram nevative peptidoglycan cell wall)

69

Xeroderma Pigmentosa is defect in

DNA excision repair

70

DNA mismatch repair defect

Lynch syndrome

71

Why doesn't Ceftriaxone work on Chlamydia

Cell wall lacks peptidoglycan (Ureaplasma lacks cell wall alltogether)

72

Phentolamine MOA

Alpha 1 and 2 blocker (no BB effects)

73

Dose-dependent effects of Epinephrine

Increases systolic, Increases HR, and either increases or decreases diastolic dependending on dose (a1 at high, or B2 at low)

74

Kappa opioid receptors mediate

Miosis

75

Hexamethonium MOA

Potent nicotinic receptor antagonist

76

Defect in keratins 5 and 14

Epidermolysis Bullosa Simplex

77

Characteristic Triad of Ataxia Telangiectasia

Those + Incr risk of sinopulmonary infections (IgA deficiency)

78

ATM gene is responsible for

DNA break repair (hypersensitive to x ray radiation)

79

Why does lead cause hypochromic anemia

Inhibits mitochondrial iron transport

80

Bare Lymphocyte Syndrome

Absent MHC II --> T and B cell deficiency

81

Features of Lesch-Nyhan

Hyperuricemia, Gout, Pissed off, Retardation, dysTonia

82

AICA block

Facial droop means AICA's pooped

83

Process of Base Excision Repair

Abnormal Base --> Glycosylase removes --> Endonuclease and Lyase cleave 5 and 3' --> DNA polymerase and ligase

84

Pyrophosphate analog that doesn't require phosphorylation

Foscarnet

85

Properties of Type 1 muscle fibers

Slow = Aerobic, High myoglobin and mitochondria

86

Side chain cleavage enzyme in adrenals

Cholesterol --> Pregnenalone

87

Pulmonary Stretch Receptors

C fibers in lungs and airways that regulate degree of distension (Hering-Breuer reflex)

88

Infant with Air in bowel wall, Abdominal distension, and Bloody stools

Necrotizing Enterocolitis

89

N-acetylmuramic acid and N-acetylglucosamine

Saccharides that combine with AA chain to form peptidoglycan cell wall

90

Tay Sachs findings

Cherry Red Macula, Neurodegeneration, Developmental delay, Onion Skin Lysosomes, No HSM (vs Niemann-Pick)

91

Niemann-Pick findings

Cherry Red Macula, Neurodegeneration, Foam Cells, HSM

92

Important genes altered by PPARg

Adiponectin, FA transport, Insulin receptor, Glut-4

93

DOC for Complex Partial Seizures

Carbamazepine

94

PTH effects on bone cells

Incr RANKL and M-CSF production by osteoblasts; Decr OPG

95

MOA of Pergolide

D2 agonist

96

Isoniazid vitamin deficiency

B6 --> Peripheral neuropathy (GABA def)

97

4 phases of lobar pneumonia

Congestions (first 24hr) --> Red Hepatization (2-3d) --> Gray Hepatization (4-6d) --> Resolution

98

Microscopic appearance in Congestion --> Red --> Gray Hepatization

Vascular Dilatation, Mostly bacteria --> RBCs, PMNs, Fibrin --> Disintegrated RBCs, PMNs and Fibrin

99

MTB virulence factor allowing for intracellular proliferation

Sulfatide