Flashcards in Other Deck (36):
absence of ganglia that regulate peristalsis
(problem w/ neural crest cell migration)
Bacillus anthracis & cereus, clostridium perfringens, botulinum & tetani, & Coxiella burnetti
Drugs that INDUCE cytochrome P450
=> decrease effectiveness of the metabolized drug
1. Phenobarbitol/all barbiturates
5. Griseofulvin *also: chronic EtOH abuse
Drugs that INHIBIT cytochrome P450
=> decreased metabolism of cyp450 dependent drugs
3. Antibiotics: Isoniazid, Erythromycin
4. Antifungal/virals: Ketoconazole, Ritonavir
5. Grapefruit juice
HIV + patient, with diffuse neuro Sxs (headache, stiff neck, fever...).
What is the DDx (& assoc. treatment)?
#1. Toxoplasmosis (w/ ring-enhancing lesions on MRI)
Tx: pyrimethamine & sulfasiazine
#2. Primary CNS Lymphoma (B cell infiltrate & EBV DNA in CSF)
#3. Cryptococcus (diffuse)
Tx: Amphotericin B
Bacteria that causes infective endocarditis and is associated with colon cancer
Patient presents w/ mitral regurgitation and history of chorea in childhood.
Strep pyogenes => Rheumatic fever!
= molecular mimicry problem after resolved strep infection.
Acutely: fever, chorea
Chronic/long-term: mitral regurgitation OR mitral stenosis
Causes of Renal Papillary Necrosis
(Sx = gross hematuria, w/ a predisposing factor below)
1. Sickle cell disease OR trait
3. Severe obstructive pyelonephritis
4. Analgesic nephropathy (ie: NSAIDs)
Bacillary Angiomatosis vs. Kaposi's Sarcoma
Bacillary angiomatosis: benign, capillary skin papules.
- w/ AIDS, from bartonella.
Kaposi's Sarcoma: malignant, endothelial on skin OR mouth/GI/Resp.
- w/ HHV-8 & HIV
Sturge Weber disease
Congenital disease of capillaries.
- "port wine stain" on face
- ipsilateral leptomeningeal angiomatosis => intracerebral AVM
- seizures, early glaucoma
"Monday Disease" for Nitroglycerin exposure
develop tolerance during week of exposure (less vasodilation), but LOSE tolerance over weekend
=> tachycardia, dizziness, headache w/ re-exposure
Meds for lowering lipids
(class name, biggest effect, major SEs)
All decrease LDL.
#1. Statins: (--l HMG CoA reductase) decrease LDL *rhabdomyolysis
2. Niacin: increase HDL, *flushing, hyperglycemia/urate
3. Bile acid resins: block bile reabs. *gallstones
4. Ezetimibe: block cholesterol reabs.
5. Fibrates: upreg. LPL = decrease TGs! *myositis, LFTs up, gallstones
"3 Ds" --> Diarrhea, Dementia, Dermatitis
= Vit B3 def., common in EtOH abuse
* needed as coenzyme for NAD & NADPH
= paradoxical RISE in JVP during inspiration,
indicates Constrictive Pericarditis
(also likely to hear "pericardial knock" later than S3)
Signs and causes of Infectious Arthritis
S- Synovitis, T- tenosynovitis, D- Dermatitis
*often migratory, asymmetric Sxs!
Causes: S. aureus, Strep, Gonorrhea ("gonococcal arthritis")
Potential causes of avascular necrosis/osteonecrosis
2. high-dose corticosteroids
4. sickle cell disease
*usually @ femoral head.
Disease associated with Elevated ACE serum levels
(wide-spread, immune-mediated non-caseating granulomas)
Secondary causes of hypoxia => clubbing
1. Lung disease (esp. supurative): lung cancer, TB, CF, bronchiectasis, pulm. HTN, empyema, etc.
2. Heart disease: tetralogy of fallot/other congen. heart defects, bacterial endocarditis
3. Other: IBD (crohns/Ulc. colitis), hypERthyroidism, malabsorption
#1 most noxious toxin of Clostridium perfringens
Lecithinase, aka: "Alpha toxin" or Phospholipase C
-> splits phospholipid molecs
=> cell lysis & RBC hemolysis, edema, tissue necrosis
Metabolism mech for drugs associated with drug-induced lupus
(example drugs: hydralazine, procainamide)
N-Acetylation by the Liver (phase II)
*slow acetylators have greatest risk of developing drug-induced lupus.
*anti-histone Ab = most specific for drug-induced Lupus
Triad of Sxs/complications in Congenital Rubella infection
1. "white pupils" (= congenital cataracts)
2. Sensorineural hearing loss
3. PDA/congen. heart defects
*prevent by vaccinating NON-pregnant women of child-bearing age!
(w/ live attenuated vaccine)
toxins of Pseudomonas aeruginosa
* gram + rod => "ecthyma gangrenosum" (purple cut. lesions, esp. if lacking humeral immunity)
1. Exotoxin A --l protein synthesis
2. Elastase --> blood vessel destruction
3. Phospholipase C --> degrades cell membranes
4. pyocyanin: makes ROS
Odds Ratio vs. Relative Risk calculations
Odds ratio: (#Tx & disease/#Tx & no disease)/(#disease and NO Tx/#no Tx & no disease) = "(AxD/BxC)
aka: (%Tx w/ outcome)/(%not Tx w/ outcome)
Relative risk: (#Tx & outcome/all Tx)/(#noTx & outcome/all NOT Tx)
Mycobacterium (not TB),
causes disease in healthy OR immunosuppressed pts.
Sxs: hepatosplenomegaly & elevated AlkPhos, fever, weight loss, diarrhea... *clear chest Xray (vs. granulomas if TB)
**grows best at 41C! Prophylactic Tx w/ azithromycin (esp. if CD4 <50)
Amino acids with 3 titratable protons
(=> 3 points distinct points on titration)
(7) Histidine, Lysine, Arginine,
Aspartic acid, Glutamic acid,
Fetal development timeline & landmarks
(week 1, 2, ...)
wk 1: hCG secretion begins (can confirm on urine test)
wk 2: BiLaminar disc (epiblast/hypoblast)
wk 3: TriLaminar/gastrulation (endo/meso/ectoderm)
wk 4: 4 limb buds, heart beats
wk 8: fetal mvmt, wk 10: genitalia formed (complete @ wk 12)
Fetal "triple test" components and significance
1. AFP: increases w/ # wks => likely dating error if abnormal
2. hCG: high => twins, hydatidiform mole, or choriocarcinoma
3. Estriol: low = placental insufficiency
Major Tissues that originate from surface ectoderm (5)
2. Ant. Pituitary (Adenohypophysis)
3. Parotid, sweat, & mammary glands
4. sensory organs of ear
5. epithelial lining of mouth
Major tissues that originate from the Neuroectoderm (3)
1. Brain/CNS (includes spinal cord)
2. Retina & optic nerve
3. pineal gland
Major tissues originating from Neural Crest (6)
3. Chromaffin cells of adrenal medulla
4. Parafollicular ("C") cells of thyroid
5. skull bones, 6. Aorticopulmonary septum
Major tissues that originate from the Mesoderm (6)
1. Muscle *includes heart!
3. CT & dermis
4. serous lining of body cavities (peritoneum, spleen)
5. Blood & lymphatics
Major tissues derived from Endoderm (~2)
1. gut epithelium
2. "Lumenal epithelium" => Lungs, Liver, gallbladder, pancreas, paraT, thymus...
Deformation vs. Malformation
Deformation = EXtrinsic disruption of dvpt, AFTER embryonic period
Malformation = INtrinsic disruption, DURING embryonic period
"Fetal Hydantoin Syndrome"
= results of phenytoin (teratogen).
=> microcephaly & dysmorphic craniofacial features, hypoplastic fingernails & distal phalanges, AND cardiac defects, mental retardation
(*similar to carbemazepine effects)
Effects on Fetus of Nicotine vs. Cocaine vs. EtOH
...vs. Diabetes vs. Vitamin A excess
Nicotine: IUGR (small), placenta problems, ADHD, preterm labor
Cocaine: fetal addiction, placental abruption
EtOH: major birth defects & mental retardation (FAS)
*Diabetes: caudal regression, heart & neural tube defects
* VitA: cleft palate & heart defects