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Really Important High yield Flashcards

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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
Diabetic glomurolnephropathy
Nephrotic syndrome LM - mesangial expansion, GBM, eosinophilic nodular glomerulosclerosis Nonenzymatic glycosylation of GBM Microalbuminuria first sign
26
Types of nephrotic
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
27
Focal segmental glomerulosclosis
``` African, hispanic HHH Heavy Heroin HIV ```
28
Nephritic
PIG ARM Post strep IgA nephrop (berger, henoch schonlein) Goodpasture - Alport - type IV collagen mutation RPGN - Crescentic MPGN
29
Membranous nephropathy
``` Most common in caucasians ABCD Autoimmune (SLE) Hep B Cancer Drugs ```
30
Cardiac tissue that conducts the fastest
Park At Ventura Avenue or Pretty awesome ventricles await Purkinje - fastest Atria Ventricles AV- slowest
31
Wilms Tumor
kids 2-4 | large palpable unilateral mass and or hematuria
32
homocystinuria
homos take too much meth. (increased methionine) | homos look down. (downward inward lens subluxation)
33
ASA toxicity
high dose-- vertigo, tinnitus, hearing loss stimulates respiratory drive --> hyperpnea respiratory alkalosis. Salicylic acid accumulate in plasma (metabolic acidosis)
34
Anion gap metabolic acidosis causes
``` MUDPILES Methanol Uremia DKA Propelen glycol INH or Iron Lactic acid Ethylene glycol (oxalic acid) or oxalate crystals in urine(folded envelopes) Salicylates (late) ```
35
Non-anion gap metabolic acidosis
``` HARD-ASS Hyperalimentation Addison Renal tubular acidosis Diarrhea Acetazolamide Spironolactone Saline infustion ```
36
PT reference range
11-15seconds
37
PTT reference range
25-40seconds
38
bleeding time reference range
2-7 mins
39
sarcoidosis symptoms
hypercalcemia (macrophage 1alpha hydroxylase) and increased ACE. B/L hilar LAD, Th mediated. noncaseating granuloma
40
drugs that increase uric acid
HCTZ, cyclosporine, pyrazinamide, niacin
41
where do iron, folate, and b12 get reabsorbed
IFB, DJI backwards alfebetical.
42
Toxins that inactivate 60s subunit
Shigella and EHEC
43
Toxins that bind EF2 and inhibit ADP ribosylation
Cornybacteria diptheriae, Psuedomona
44
DKA electrolytes
hyperkalemia. (total K is down). | give sugar, fluids, insulin, potassium
45
pathogenesis of Colorectal cancer *adenoma to carcinoma sequence)
normal colon, loses APC, KRAS mutation, Loss of p53, DCC | AK53
46
serotonin syndrome
``` 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
Thiazide diuretic action and side effect
``` blocks Na/Cl reabsorbtion in DCT hyperGLUC hyperGlycemia hyperLipidemia hyperUricemia hyperCalcemia (use for renal stones) sulfa drug ```
48
Why do we hyperventilate people with CHI/increased ICP
hyperventilation causes hypocapnea, which decreases cerebral blood flow, decreases ICP
49
Thrombangitis obliterans
``` CRISP PIGS's beurger C- chronic ulceration Raynauds Intermittent claudication Segmented vasculitis Phlebitis Pain Idiopathic Gangrene Smoking ```
50
Kawasaki disease
``` 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
Churg strauss
BEAN SAPP BE - Blood Eosinophilia A - asthma N - neuropathy S- sinus abnormality A - allergies P- perivascular eosinophilia P- P-anca
52
Microscopic Polyangiitis
like Wecners but no NP involvement and P-anca
53
Holosystolic murmurs
Mitral regurg- high pitched radiates to axilla Tricuspid regurge - tc area. Respiratory variation Vsd-harsh loud at tc are
54
Which ibd has granulomas
Crohns. Also cobblestones and rectal sparing
55
iBD with bloody diarrea
UC
56
Whipple disease
``` Foamy Whipped cream in a CAN foamy macrophages with PAS + (eosinophilic) Cardiac symptoms Arthralgias Neurologic symptoms ```
57
Octreotide
Somatostatin analog used in carcinoid syndrome. ``` VIPoma glucagonoma insulinoma Zollinger ellison Peptic ulcers ```
58
What cells secret pepsinogen and location
Chief cells (think chef, protein, pepsin). Body
59
What cells secrete gastrin, and location
G cells, antrum
60
What cells secrete acid and location
Parietal (pH) in antrum
61
What cells secrete Intrinsic factor?
do you know the IP of that cell? Intrinsic Parietal
62
What cells secrete somatostatin?
pancreatic delta cells . blocks acid secretion, bicarb secretion, insulin secretion, glucagon secretion, pancreatic enzymes, GH release
63
Main mediator of gastric pH
ECF cells, stimulated by gastrin, release histamine and stimulate parietal cells
64
Loading dose equation
loading dose = Vd x Cp/ F | load with vics crap over food
65
Maintenance dose eqn
MD/tau=Cpss x Vd/F MDs clear constant schedule over food
66
Clearance equation
``` 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
Renal clearance equation
``` CL= Uc x Vol / Pc CL = UV/P uv shining over pee ```
68
Volume of distribution
Vd = amount of drug in body/plasma drug concentration
69
Calculation of reabsorption/secretion,
Filtered load = GFR (CLinulin) x Px(plasma concentration of interest) Excretion = V(urine flow) x Urine concentration ``` Reabsorption = filtered - excreted Secreted = excreted - filtered ```
70
halflife equation
t 1/2 = (.693xVd)/CL
71
Multiple myeloma mnemonic
``` Crab Hypercalcemia and constipation Renal stuff Anemia Bone lesions back pain ``` Monocloma m protein
72
Horner syndrome
Ipsilateral ptosis miosis anhidrosis
73
Niacin deficiency mnemonic
3 Ds of pellagra: dementia, dermatitis (sun exposed areas), diarrhea. B3 synthesized from tryptophan
74
Class III antiarrythmic
AIDS amiodarone, ibutilide, dofetilide, sotalol. Phase 3 (blocks potassium efflux)
75
Galactosemia mnemonic
FABGUT fructose is to Aldolase B as Galactose is to UridylTransferase
76
Paramyxoviruses
PaRaMyxovirus . Parainfluenza, measles mumps, rsv (ribavirin). rna ss - helical nonsegmented
77
measles mnemonic
3c's. cough, coryza, conjunctivitis. Koplick spots
78
vitamin deficiency in wernicke korsakoff
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
beta 1 receptors found where?
Cardiac, Juxtaglomerular cells
80
Parkinsons drug mnemonic
parkinsons drug BALSA Bromocriptine - DA (D2) Amantadine - increases DA synthesis, release, reuptake Levodopa Selegiline - MAO- inhibitor Antimuscarinics - trihexyphenidyl and benztropine
81
MEN 2A
2Ps Parathyroid and pheo. Square with medullary thyroid in middle
82
MEN 2B
MEN2B 1 P. pheo. Triangle with neuroma on top, pheo other corners, medullary thyroid in middle. Marfanoid
83
Positive predicting value
PPV= TestP/(DiseaseP+False P) all positives
84
dehydrogenase enzyme probably need these cofacters
Tender Loving Care for Nancy. Thiamine, Lipoate, Coenzyme A, FAD, NAD
85
Interleukin mnemonic
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
Digoxin side effects
Dig delirium. nausea, blurred vision, yellow green hallucinations. Hyperkalemia. Arrythmia
87
Equation for NPV
NPV= TN/(TN + FN)
88
Thallesemia mnemonic
THAL. Target cells hemolytic anemia howell jolly bodies anisocytosis and low mcv
89
Bacteria toxins that mess with cAMP
CAMP. Cholera, anthrax, montezuma (m sideways, labile),bordatella pertussis
90
Hb curve is affected by
c-BEAT. Co2 BPG, excercise, Altitude, temp
91
Alveolar gas equation
Alveolar O2 = [FiO2 x (barometric P - water vapor pressure)] - PaCO2/.8 normally 150-(PaCO2)/.8
92
Wilsons disease
``` Copper is Hella BAD. decreased ceruloplasmin, cirrhosis, corneal deposits. Hemolytic anemia Basal ganglia degeneration Asterixis Dementia, dyskinesia, dysarthria ```
93
Thiamine needed for
Pirate AK transfer. pyruvate dehydrogenase, alpha KG dehydrogenase, transketolase (HMP)
94
alpha 1 receptors when stimulated produce
increase vascular smooth muscle contraction, mydriasis, bladder and intestinal sphincter contraction
95
Beta 2 when stimulated produce
vasodilation, bronchodilation, insulin release, uterine relaxation, increase production of aqueous humor
96
Beta 1 when stimulated produce
increased HR, contractility, renin release and lipolysis
97
Causes o acute pancreatitis
``` ETOH, gallstones, then I GET SMASHED idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion sting Hypercalcemia/hyperTG ERCP Drugs ```
98
Causes of dilate cardiomyopathy
``` ABCCCD alcohol Beriberi Coxackie Cocaine Chagas Doxirubicin ``` Hemochrom and sarcoid
99
Causes of restrictive cardiomyopathy
``` Hem took Amy and Sarc to Rad House Hemochromatosis (dilated too) amyloidosis Sarcoidosis (dilated too) Radiation ```
100
Murmurs that decrease when abrupt standing (stand up murmur down)
MVP and HOCM decrease preload and afterload low LV volume
101
Murmurs that increase when sitting (sit down murmur up)
MVP and HOCM increase preload and afterload high LV volume
102
Leg raise does what to cardiac parameters
increase preload
103
Valsalva maneuver
decreases preload/afterload (high intrathoracic pressure) and stimulates baroreceptor/parasympathetic
104
Inspiration effect on murmurs
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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