Flashcards in mixed deck 04/17 Deck (21):
male neonates XY with 5alpha reducaste deficiency
are born with feminized external genitalia, but male internal and are typically masculinze at puberty. a small phallus and hypospadias are commonly found
The earliest lesion of atherosclerosis?
intimal (fatty) streaks, the earliest lesion of atherosclerosis, are composed of intimal lipid filled foam cells, which are derived from macrophages and smooth muscle cells that have engulfed lipoproteins and predominantly LDL
is a reversible, competitive, nonspecific a-adrenergic antagonist used in the management of cathecolamine induced HTN crisis.
BUT high doses of NE can overcome its competitive antagonistic effects
phenoxybenzamine is irreversible competitive antagonist and would not be completely overcome by NE
most common cause of death in patients with DM?
coronary heart disease
Burkitt lymphoma t(8:14)
diffuse medium sized lymphocytes and high proliferation index represented by a high KI-67 fraction
-starry sky appearance is due to presence of benign macrophages
TCA overdose --> refractory hypotension and cardiac arrhthmias
inhibition of sodium channels in cardiac myocytes
(fast sodium channel conduction)
TCA inhibitor effects:
-central and peripheral muscarinic Ach receptors--> tach, delirium, dilated pupils, flushing, decreased diaphoresis, hyperthermia, intestinal ileus, urianry retension
-peripheral a-1-adrenergic receptors--> vasodilation --> orthostatic hypotension
-cardiac fast sodium channels--> conduction defects, arrhthmias, hypotension
-presynaptic NE and 5-HT reuptake --> seizures, tremors
-H1 receptors ---> sedation
Cutanous lymph drainage from the umbilicus to the feet including the external genitalia and anus (up to the dentate line) drain into?
what is the exclusion?
superficial inguinal lymph nodes
the posterior calf is the exclusion and drains to the popliteal lymph nodes
Sarcoidosis, chest xrays and staging
reveal bilateral hilary lymphadenopathy
bilateral hilar lymphadenopathy along with pulmonary infiltrates commonly in the upper lobes
Progression of the disease leads to disappearance of hilar lyphadenopathy
lung infiltrates only
tripsy your beagle stealing seretonin turkey at your table
-neuromuscular excitation: hyperreflexia, clonus, myoclonus, rigidity, tremor
-autonomic stimulation: hyperthermia, tachycardia, diaphoresis and vomiting/diarrhea
-altered mental status: agitation and confusion
How to treat serotonin syndrome
-supportive care including airway maintenance, hydration and temperature maintenance
-Cyproheptadine is a serotonin receptor antagonist which is a first generation histamine antagonist with non specific 5-HT1 and 5-HT2 receptor antagonistic properties
How to diminish cystplatins nephrotoxicity?
AMIFOSTINE is a thiol based cytoprotective free-radical scavenging agent
When using benzos watch out for other drugs with sedative effects. Name those drugs
-First generation H1-histamine receptor antagonists cause significant sedations.
diphenhydramine and chlorpheniramine
How do bronchial veins return blood to the heart?
- small portion via the azygous, accessory hemiazygous or intercostals veins.
-majority of blood supplied to bronchial arteries is returned to the left heart in deoxygenated form via the pulmonary veins
0this causes an admixture of blood and would should a decrease in oxygenation in the LA versus the capillaries of the respiratory system
-most common in younger children <2 : often without any structural cause (sometimes associated with viral infections).
-in patients older than 2, a lead point such as meckel diverticulum, foreign body, or intestinal tumor should be sought
colicky, intermittent abdominal pain, nausea, vomiting and currant jelly stools.
Cystinuria with cystine stones
-defect in renal PT
-decreased resorption of the amino acid cystine (2 cysteines)
-recurrent stone formation from a younger age
-urinalysis with show pathognomoic hexagonal cystine crystals
-the sodium cyanide-nitroprusside test detects cytine sulfhydryl groups and is diagnostic
volume of distribution of a drug
hypothetical volume of fluid into which the administered amount of drug would need to be uniformly distributed to produce the observed plasma concentration.
amount of drug given (mg)/plasma concentration of drug (mg/L)
Low volume of distribution 4-8L
high M.W. , high plasma protein binding, high charge and high hyrdophilicity tend to trap the drug in the plasma compartment resulting in a low Vd