mixed deck 04/21 Flashcards Preview

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Flashcards in mixed deck 04/21 Deck (34):

overuse of diuretics can lead to contraction alkalosis

overuse of diuretics or any other causes of volume loss lead to compensatory increase in aldosterone production. aldosterone causes retention of sodium and water and a loss of potassium and hydrogen ions by the kidneys.
-this causes a contraction metabolic alkalosis
-typical lab findings will be a high pH, a high HCO3 and a high pCO2


panic attack episodes

-decreases the pc02 and causes a respiratory alkalosis
-acute condition so no metabolic compensatory


Petazocine and butorphanol are unique in that they are PARTIAL mu opiod receptor agonists. but

when used in combination with morphine or other opiods, they can competitively inhibit mu receptors and product antagonisist effects reducing opiod analgesic effects, this can lead patients to withdrawal symptoms


C. trachomatis is an intracellular pathogen that has a cell wall, but the cell wall is unique in that

it lacks peptidoglycan!!!

so b-lactam drugs are no use! and (cephalosporins, penicillins)

instead use macrolide like azithromycin or tetracylcines
note ureaplasma urealyticum also lacks a cell wall


Amphoterible B binds to ergosterol of fungal cell membranes to excert its antifungal effects, however it can bind what to some degree?

this is what causes the toxicity to human tissues

ex) nephrotoxicirt, hypoklemia, hypomagnesiemia, anemia, thrombophlebetis at site of injection, acute infusion related reactions like fever, chills, rigors and hypotension


azoles inhibit or induce CP450?

fluconazole, itraconazole


griseofulvin used for dermatophytes only binds to

microtubular proteins as the mechanism of action


inferior MI --> RCA , which perfuses the AV and SA node, this can lead to bradycardia.
to treat the bradycardia, use atropine an anticholinergic which will decrease the vagal tone. Watch out for sideeffectsL

CNS: sedation
EYE: mydriasis (dilated pupils), cycloplegia (paralysis of accommodation). Recall there are M3 for ciliary muscle and constrictor pupillage which do accomodation and constriction respectively.
-this can lead to a narrowing of the anterior chamber angle and diminished outflow aqueous humor --> angle-closure glaucoma
heart: tach
secretions: decrease
bladder: detruser relaxation, delays voiding
bronchi: bronchodilation


what anticholinergic which can cause CNS sedation can be used for motion sickness?



What anticholinergic which works on CNS sedation is used for Parkinsons disease?



what anticholinergic, specifically an antimuscarin can be used for bronchodilation?



H1 receptor antagonist diphenyhydramine can be used for allergic rhinitis, but dont forget it has

anticholinergic effects too of muscarinic receptors --> decreased secretions. Decreased sweat gland secretions can result in fever and compensatory cuteneous vasodilation
-inhibition of pupillary constrictor and ciliary muscles


Staph foreign body infections?

-release an extracellular polysacchidre matric that encases the bacteria!


Which organisms can make biofilms?

staph epidermidis
step mutans and step sanguinis (viridins)
pseudomonas aeruginosa
nontypable hemophilus influenza


examples of encapsulated bacteria?

streptococcus pneumoniae
haemophilus influenza type B
Neisseria meningitidis


antiphospholipid antibody syndrome immune hypercoagulability

-antiphospholipid antibodies (lupus anticoagulant/or anticardiolipid antibodies)
venous thromboembolism, arterial thromboembolism, or frequent fetal loss.
-prolongue aPTT


Paraneoplastic syndromes occur due to tumor cells producing substances that frequently induce an autoimmune reaction and cause damage and deferenation of healthy organs and tissues

-examples are lambert-eaton myasthenic syndrome
-paraneoplastic cerebellar degeneration


localized amyloidosis (confined to a single specific organs)

cardiac atria: atrial natriuretic peptide (senile)
thyroid gland: calcitonin (medullary carcinoma)
pancreatic islets: islet amyloid protein (amylin)
cerebrum/cerbral blood vessels: B-amyloid protein (alzheimers)
pituitary gland: prolactin

Immune globulin light chains cause multi-organ amyloid deposition in primary systemic amyloidosis



describes the retention of nuclei in the stratum corneum, which signals incomplete keratinization



describes excessive granulation in the startum granulosum of the epidermis and is seen in conditions such as lichen planus


the major histologic finding in patients with contact dermatitis

epidermal accumulation of edematous fluid in the intercellular spaces
-delayed hypersensitivity langerhand cells MHC II to CD4 T helped cells, to bring T cells in


eczematous dermatitis

erythematous, paulovesicular, weeping, encrusted lesions that may evolve into thickened, scaly plaques
-atopic dermatitis, drug related eczematous dermatitis, photo-eczematous dermatitis, primary irritant dermatitis


anaplastic tumor characteristics

-loss of polarity, complete disruption of normal architecture
-nucleo pleomorphism and cellular plemorphism (shapes and sizes)
-high N:C ration, that are often deep staining (hyper chromatic) with abundant, coarsely-clumped chromatin and large nucleoli
-mitotic figures
-giant multinucleated tumor cells


Bronchial epithelial cells can produce keratin pearls after a phenotypic switch from columnar epithelium to squamous epithelium.

this is metaplasia



bronchopneumnia - patchy inflammation of a number of lobules
interstitial: inflammatory infiltrate is confied to alveolar walls
lobar: inflammatory process involves an entire lung lobe


Lobar pneumonia typically follows 4 stages

congestion (first 24 hours)
-lobe is red, heavy, boggy
-histo vascular dilation, alveolar exudate contains mostly bacteria

red hepatization (2-3days)
-love is red, firm ( liver-like consistency)
-histo, alveolar excudate contains erythrocytes, neutrophils and fibrin

gray hepatization (4-6days)
-gray-brown firm lobe (pale and firm)
-histo: RBC disintegrate, alveolar exudate contains neutrophils and fibrin

lobe restoration of normal architecture
histo enzymatic digestion of exudate


internal juglar vein

drains the brain and superficialface and neck


external jugular vein

drains the scalp and portions of the lateral face


the subclvian vein is a continuation of the axillary vein

both drain blood from the upper extremity


SVC syndrom

-SVC is obstructed, which would have hface, neck, chest and both arms would be involved


the brachicephalic vein drains the ipsilateral external jugular vein and subclavian veins

-this would cause a one side SVC syndrome


the right brachiocephalic vein also drains the right lymphatic duct-drians the lymph from the right upper extremity, the right face and neck and the right hemithorax and the right upper quadrant of the abdomen

the left lymph is from left thoracic duct does the rest of the body


Gram-negative sepis is due to release of endotoxin LPS from bacterial cell walls. LPS is heat stable, and has three regions O antigen, core pollysacharide and lipid A

Lipid A is the toxic component
-it causes activation of macrophages leading to the widespread release of IL-1 and TNF alpha, which cause the signs and symptoms of septic shock, fever, hypotension, diarrhea, oliguria and vascular compromise and finally DIC


mulluscum contagiosum is caused by sexually transmitted poxvirus

DS and linear DNA
-characterized by white, umbilicated papules on the penis, vulva or groin