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Really Important High yield Flashcards

1
Q

liver angiosarcoma

A

CD31+, associated with arsenic and vinyl chloride exposure

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2
Q

Steps of collagen synthesis

A

HE Came To GO CROSS Dressing with cleavage
Hydroxylation - proline, and lysine requires vit C
Endoplasmic reticulum

C Vitamin

T triple helix
o

Glycosylation
Osteogenesis imperfecta

CROSS membrane, cross linked cl

Drehlers Danlos

cleavage - of N and C procollagen

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3
Q

AML

A

peroxidase positive. common in down syndrome DIC. age 65 M3. 3 is a multiple of 15

Auer Rods, Vitamin A. M3(15:17).

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4
Q

Drugs that affect thyroid

A

Both ways: Amiodarone, Iodine, Interferon

Hypo: Lithium, Sulfonamides, glucocorticoids

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5
Q

Case-control studies

A

Retrospective evaluating exposure association with outcome. Reports odds ratio

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6
Q

Cohort study

A

Retrospective or prospective. Selects an exposure and then evaluates Relative risk

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7
Q

Cross section study

A

Evaluates the prevalence of a disease and correlations using population data. Disease prevalence

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8
Q

Class 1 antiarrythmics

A

1A the Queen Proclaims Diso’s pyramid
quinidine, procainamide, disopyramide

1B Lettuce, Tomatoe, Mayo
Lidocaine, Tocainamide, MexileTine

1C Fries please?
Flecainamide, Propafenone

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9
Q

Coagulative necrosis

A

See this in infarcts in any tissue (except brain)
Due to loss of blood
Gross: tissue is firm
Micro: Cell outlines are preserved (cells look ghostly), and everything looks red

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10
Q

Liquefactive necrosis

A

See this in infections and, for some unknown reason, in brain infarcts
Due to lots of neutrophils around releasing their toxic contents, “liquefying” the tissue
Gross: tissue is liquidy and creamy yellow (pus)
Micro: lots of neutrophils and cell debris

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11
Q

Caseous necrosis

A

See this in tuberculosis
Due to the body trying to wall off and kill the bug with macrophages
Gross: White, soft, cheesy-looking (“caseous”) material
Micro: fragmented cells and debris surrounded by a collar of lymphocytes and macrophages (granuloma)

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12
Q

Fat necrosis

A

See this in acute pancreatitis
Damaged cells release lipases, which split the triglyceride esters within fat cells
Gross: chalky, white areas from the combination of the newly-formed free fatty acids with calcium (saponification)
Micro: shadowy outlines of dead fat cells (see image above); sometimes there is a bluish cast from the calcium deposits, which are basophilic

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13
Q

Fibrinoid necrosis

A

See this in immune reactions in vessels
Complexes of antigens and antibodies (immune complexes) combine with fibrin
Gross: changes too small to see grossly
Micro: vessel walls are thickened and pinkish-red (called “fibrinoid” because it looks like fibrin but has other stuff in there too

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14
Q

Gangrenous necrosis

A

See this when an entire limb loses blood supply and dies (usually the lower leg)
This isn’t really a different kind of necrosis, but people use the term clinically so it’s worth knowing about
Gross: skin looks black and dead; underlying tissue is in varying stages of decomposition
Micro: initially there is coagulative necrosis from the loss of blood supply (this stage is called “dry gangrene”); if bacterial infection is superimposed, there is liquefactive necrosis (this stage is called “wet gangrene”)

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15
Q

Standard contingency table

A

Disease on top. positives upper left

tests/exposure on left

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16
Q

Odds ration eqn

A

AD/BC (b for bottom) after death before christ

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17
Q

where is most water absorbed in kidney

A

Proximal tubule (60%) because most solutes are also reabsorbed here

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18
Q

equation for attributable risk percent in exposed

A

ARP = (RR exposed - RR unexposed)/RR exposed

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19
Q

Burkit lymphoma

A

Mickey ate one 4 then launched an encrypted nuke that destroyed burks planet leaving nothing but a starry sky.

c-myc t:8:14, nuclear transcription, starry sky appearance

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20
Q

MAC prophylaxis

A

z-pack

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21
Q

segmented viruses

A 
BOAR
bunyavirus - hanta calif enceph
orthomyxo - flu
arena - lassa, lcmv
rheo - rota colti
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22
Q

mnemonic rna viruses

A

CHRP CRFT BADPROF

Travel Viruses
Party Viruses

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23
Q

P450 inducer

A

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
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24
Q

P450 inhibitor

A

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

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25
Q

Diabetic glomurolnephropathy

A

Nephrotic syndrome
LM - mesangial expansion, GBM, eosinophilic nodular glomerulosclerosis

Nonenzymatic glycosylation of GBM

Microalbuminuria first sign

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26
Q

Types of nephrotic

A

Mom Fights with Me and im SAD

Membranous - most common caucasian. Spike and Dome (subepi deposits, podocytes trying to put down BM)

Focal Segmental Glomerulosclerosis - African, hispanic.

Minimal Change - children, and hodgkin lymphoma

SLE - Membranous
Amyloid
DM

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27
Q

Focal segmental glomerulosclosis

A 
African, hispanic
HHH
Heavy 
Heroin
HIV
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28
Q

Nephritic

A

PIG ARM
Post strep
IgA nephrop (berger, henoch schonlein)
Goodpasture -

Alport - type IV collagen mutation
RPGN - Crescentic
MPGN

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29
Q

Membranous nephropathy

A 
Most common in caucasians 
ABCD
Autoimmune (SLE)
Hep B
Cancer
Drugs
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30
Q

Cardiac tissue that conducts the fastest

A

Park At Ventura Avenue or Pretty awesome ventricles await

Purkinje - fastest
Atria
Ventricles
AV- slowest

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31
Q

Wilms Tumor

A

kids 2-4

large palpable unilateral mass and or hematuria

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32
Q

homocystinuria

A

homos take too much meth. (increased methionine)

homos look down. (downward inward lens subluxation)

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33
Q

ASA toxicity

A

high dose– vertigo, tinnitus, hearing loss
stimulates respiratory drive –> hyperpnea
respiratory alkalosis. Salicylic acid accumulate in plasma (metabolic acidosis)

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34
Q

Anion gap metabolic acidosis causes

A 
MUDPILES
Methanol
Uremia
DKA
Propelen glycol
INH or Iron
Lactic acid
Ethylene glycol (oxalic acid) or oxalate crystals in urine(folded envelopes)
Salicylates (late)
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35
Q

Non-anion gap metabolic acidosis

A 
HARD-ASS
Hyperalimentation
Addison
Renal tubular acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline infustion
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36
Q

PT reference range

A

11-15seconds

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37
Q

PTT reference range

A

25-40seconds

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38
Q

bleeding time reference range

A

2-7 mins

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39
Q

sarcoidosis symptoms

A

hypercalcemia (macrophage 1alpha hydroxylase) and increased ACE. B/L hilar LAD, Th mediated. noncaseating granuloma

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40
Q

drugs that increase uric acid

A

HCTZ, cyclosporine, pyrazinamide, niacin

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41
Q

where do iron, folate, and b12 get reabsorbed

A

IFB, DJI backwards alfebetical.

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42
Q

Toxins that inactivate 60s subunit

A

Shigella and EHEC

43
Q

Toxins that bind EF2 and inhibit ADP ribosylation

A

Cornybacteria diptheriae, Psuedomona

44
Q

DKA electrolytes

A

hyperkalemia. (total K is down).

give sugar, fluids, insulin, potassium

45
Q

pathogenesis of Colorectal cancer *adenoma to carcinoma sequence)

A

normal colon, loses APC, KRAS mutation, Loss of p53, DCC

AK53

46
Q

serotonin syndrome

A 
SHIVERS
Shivering
Hyperreflexia
Increased temp
Vital sign instability - tachycardia
Encephalopathy
Restlessness
Sweating

neuromuscular excitation - hyperreflexia, clonus, myoclonus, rigidity

autonomic stim - hyperthermia, tachycardia, diaphoresis, tremor

AMS- agitation, confusion

47
Q

Thiazide diuretic action and side effect

A 
blocks Na/Cl reabsorbtion in DCT
hyperGLUC
hyperGlycemia
hyperLipidemia
hyperUricemia
hyperCalcemia (use for renal stones)
sulfa drug
48
Q

Why do we hyperventilate people with CHI/increased ICP

A

hyperventilation causes hypocapnea, which decreases cerebral blood flow, decreases ICP

49
Q

Thrombangitis obliterans

A 
CRISP PIGS's beurger
C- chronic ulceration
Raynauds
Intermittent claudication
Segmented vasculitis
Phlebitis
Pain
Idiopathic 
Gangrene
Smoking
50
Q

Kawasaki disease

A 
Asian children CRASH and burn
C- conjunctival injection
R- Rash (polymorphic and desquamating)
A- adenopathy
S- Strawberry tongue (oral mucositis)
H - hand and foot edema

burn - fever

51
Q

Churg strauss

A

BEAN SAPP
BE - Blood Eosinophilia
A - asthma
N - neuropathy

S- sinus abnormality
A - allergies
P- perivascular eosinophilia
P- P-anca

52
Q

Microscopic Polyangiitis

A

like Wecners but no NP involvement and P-anca

53
Q

Holosystolic murmurs

A

Mitral regurg- high pitched radiates to axilla
Tricuspid regurge - tc area. Respiratory variation
Vsd-harsh loud at tc are

54
Q

Which ibd has granulomas

A

Crohns. Also cobblestones and rectal sparing

55
Q

iBD with bloody diarrea

A

UC

56
Q

Whipple disease

A 
Foamy Whipped cream in a CAN
foamy macrophages with PAS + (eosinophilic)
Cardiac symptoms
Arthralgias
Neurologic symptoms
57
Q

Octreotide

A

Somatostatin analog used in carcinoid syndrome.

VIPoma
glucagonoma
insulinoma
Zollinger ellison
Peptic ulcers
58
Q

What cells secret pepsinogen and location

A

Chief cells (think chef, protein, pepsin). Body

59
Q

What cells secrete gastrin, and location

A

G cells, antrum

60
Q

What cells secrete acid and location

A

Parietal (pH) in antrum

61
Q

What cells secrete Intrinsic factor?

A

do you know the IP of that cell? Intrinsic Parietal

62
Q

What cells secrete somatostatin?

A

pancreatic delta cells . blocks acid secretion, bicarb secretion, insulin secretion, glucagon secretion, pancreatic enzymes, GH release

63
Q

Main mediator of gastric pH

A

ECF cells, stimulated by gastrin, release histamine and stimulate parietal cells

64
Q

Loading dose equation

A

loading dose = Vd x Cp/ F

load with vics crap over food

65
Q

Maintenance dose eqn

A

MD/tau=Cpss x Vd/F

MDs clear constant schedule over food

66
Q

Clearance equation

A 
CL = rate of elimination/plasma drug concentration
CL = Vd x Ke(elimination constant)

(Ke)/Cp = kE x Vd
knockout cleared crazy smiles
Ke= CL x Css

CL= Uc x V(urine flow rate) / Pc
CL = UV/P uv shining over pee

GFR = Uinulin x V (urine flow rate)/Pinulin

67
Q

Renal clearance equation

A 
CL= Uc x Vol / Pc
CL = UV/P uv shining over pee
68
Q

Volume of distribution

A

Vd = amount of drug in body/plasma drug concentration

69
Q

Calculation of reabsorption/secretion,

A

Filtered load = GFR (CLinulin) x Px(plasma concentration of interest)
Excretion = V(urine flow) x Urine concentration

Reabsorption = filtered - excreted
Secreted = excreted - filtered
70
Q

halflife equation

A

t 1/2 = (.693xVd)/CL

71
Q

Multiple myeloma mnemonic

A 
Crab
Hypercalcemia and constipation
Renal stuff
Anemia
Bone lesions back pain

Monocloma m protein

72
Q

Horner syndrome

A

Ipsilateral ptosis miosis anhidrosis

73
Q

Niacin deficiency mnemonic

A

3 Ds of pellagra: dementia, dermatitis (sun exposed areas), diarrhea. B3 synthesized from tryptophan

74
Q

Class III antiarrythmic

A

AIDS amiodarone, ibutilide, dofetilide, sotalol. Phase 3 (blocks potassium efflux)

75
Q

Galactosemia mnemonic

A

FABGUT fructose is to Aldolase B as Galactose is to UridylTransferase

76
Q

Paramyxoviruses

A

PaRaMyxovirus . Parainfluenza, measles mumps, rsv (ribavirin). rna ss - helical nonsegmented

77
Q

measles mnemonic

A

3c’s. cough, coryza, conjunctivitis. Koplick spots

78
Q

vitamin deficiency in wernicke korsakoff

A

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

79
Q

beta 1 receptors found where?

A

Cardiac, Juxtaglomerular cells

80
Q

Parkinsons drug mnemonic

A

parkinsons drug BALSA
Bromocriptine - DA (D2)
Amantadine - increases DA synthesis, release, reuptake
Levodopa
Selegiline - MAO- inhibitor
Antimuscarinics - trihexyphenidyl and benztropine

81
Q

MEN 2A

A

2Ps Parathyroid and pheo. Square with medullary thyroid in middle

82
Q

MEN 2B

A

MEN2B 1 P. pheo. Triangle with neuroma on top, pheo other corners, medullary thyroid in middle. Marfanoid

83
Q

Positive predicting value

A

PPV= TestP/(DiseaseP+False P) all positives

84
Q

dehydrogenase enzyme probably need these cofacters

A

Tender Loving Care for Nancy. Thiamine, Lipoate, Coenzyme A, FAD, NAD

85
Q

Interleukin mnemonic

A

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 (you’re sick)

IL-8 cleanup on IL 8
IL-10 - T cell
IL-12 - tho–>th1 and NK

86
Q

Digoxin side effects

A

Dig delirium. nausea, blurred vision, yellow green hallucinations. Hyperkalemia.

Arrythmia

87
Q

Equation for NPV

A

NPV= TN/(TN + FN)

88
Q

Thallesemia mnemonic

A

THAL. Target cells hemolytic anemia howell jolly bodies anisocytosis and low mcv

89
Q

Bacteria toxins that mess with cAMP

A

CAMP. Cholera, anthrax, montezuma (m sideways, labile),bordatella pertussis

90
Q

Hb curve is affected by

A

c-BEAT. Co2 BPG, excercise, Altitude, temp

91
Q

Alveolar gas equation

A

Alveolar O2 = [FiO2 x (barometric P - water vapor pressure)] - PaCO2/.8

normally 150-(PaCO2)/.8

92
Q

Wilsons disease

A 
Copper is Hella BAD.
decreased ceruloplasmin, cirrhosis, corneal deposits. 
Hemolytic anemia 
Basal ganglia degeneration
Asterixis
Dementia, dyskinesia, dysarthria
93
Q

Thiamine needed for

A

Pirate AK transfer. pyruvate dehydrogenase, alpha KG dehydrogenase, transketolase (HMP)

94
Q

alpha 1 receptors when stimulated produce

A

increase vascular smooth muscle contraction, mydriasis, bladder and intestinal sphincter contraction

95
Q

Beta 2 when stimulated produce

A

vasodilation, bronchodilation, insulin release, uterine relaxation, increase production of aqueous humor

96
Q

Beta 1 when stimulated produce

A

increased HR, contractility, renin release and lipolysis

97
Q

Causes o acute pancreatitis

A 
ETOH, gallstones, then I GET SMASHED
idiopathic
Gallstones 
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hypercalcemia/hyperTG
ERCP
Drugs
98
Q

Causes of dilate cardiomyopathy

A 
ABCCCD
alcohol
Beriberi
Coxackie
Cocaine
Chagas
Doxirubicin

Hemochrom and sarcoid

99
Q

Causes of restrictive cardiomyopathy

A 
Hem took Amy and Sarc to Rad House
Hemochromatosis (dilated too)
amyloidosis
Sarcoidosis (dilated too)
Radiation
100
Q

Murmurs that decrease when abrupt standing (stand up murmur down)

A

MVP and HOCM
decrease preload and afterload
low LV volume

101
Q

Murmurs that increase when sitting (sit down murmur up)

A

MVP and HOCM
increase preload and afterload
high LV volume

102
Q

Leg raise does what to cardiac parameters

A

increase preload

103
Q

Valsalva maneuver

A

decreases preload/afterload (high intrathoracic pressure) and stimulates baroreceptor/parasympathetic

104
Q

Inspiration effect on murmurs

A

Increases return to right heart, decreases return to left heart

Thus increases most right side murmurs
decreases most left side murmurs
watch out for s3 s4

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