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Set 1 Flashcards

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1
Q

What is the difference between standard deviation and standard error?

A

Standard Deviation looks at the spread of individualism with in a normal distribution sample.
Standard Error looks at the variability due to sampling, and helps estimate the true mean of the underlying population.

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2
Q

How do Fibrates work? Name one?

A

Fibrates block Cholesterol 7-alpha-hydroxylase, which catalyze the rate-limiting step in the synthesis of bile acids.
Reduced bile acid production on results in decreased cholesterol solubility in bile and favors the rotation of cholesterol stones.

Gemfibrozil or Fenofibrate

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3
Q

Pt. W/ recurrent abdominal pain, + “ultrasonic Murphy sign”, and multiple cholesterol gallstones

A

Cholelithiasis

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4
Q

Risk factors for gallstones?

A
  • Obesity or Rapid Weight loss
  • Female
  • Glucose intolerance
  • Hypomotility of the gallbladder (pregnancy or prolonged fasting)
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5
Q

How do aromatase inhibitors work? Name one?

A

Aromatherapy catalyze the conversion of androgens to estrogen; inhibiting this would cause decreased gallstone formation.
Estrogenic medications cause an increase in the amount of cholesterol secreted in bile and contribute to formation of gallstones.
Anastrozole is anaromatase inhibitor,

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6
Q

How do estrogens increase cholesterol biosynthesis?

A

Estrogen uptrgulate hepatic HMG-CoA reductive activity.

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7
Q

Beta-glucuronidase

A

Deconjugates bilirubin, and the resulting free bilirubin precipitates with calcium in the bile to form pigmented gallstones.

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8
Q

Thiolase

A

1st step in cholesterol synthesis, condenses 2 molecules of acetyl-coA to form acetoacetyl-CoA

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9
Q

What is the difference between an erosion and an ulcer?

A

Erosions are mucosal defects that do not fully extend through the muscularis mucosa.
Ulcers can extend into the submuscosal areas and the muscularis propria.

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10
Q

Multifactorial Disease

A

The complex interaction of numerous genetic and environmental factors to determine phenotypic expression.

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11
Q

Progressive Joint pain and swelling involving the proximal interphalnageal joints, metacarpophylangeal joints and wrists bilarterally.
Morning stiffness lasting longer than 30 minutes
Six present for >6 weeks

A

Rheumatoid Arthritis

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12
Q

Serum antibodies found in RA?

A

Anti-cyclic citrullinated peptide (anti-CCP) antibodies

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13
Q

What species of bacteria can survive boiling?

A

Spore forming bacteria - Clostridium and Bacillus species

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14
Q

How do you kill spore-forming species?

A

Autoclave

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15
Q

What is a cryptogenic stroke?

A

When an embolism travels through a Right-to-left cardiac shunt.

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16
Q

Elevated Right Heart Pressure

A

Eisenmenger syndrome

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17
Q

Fixed S2 splitting

A

ASD

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18
Q

Incomplete development of the aroticopulmonary septum

A

Truncus arteriosus

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19
Q

Holosystolic murmur at the lower left sternal border

A

Ventral septal defect

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20
Q

A small VSD will cause a smaller or greater sound?

A

Greater

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21
Q

Continuous “machine-like” murmur

A

Patent ductus arteriosus

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22
Q

What do you use to close a PDA?

A

Indomethacin

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23
Q

What do you do to keep a PDA open?

A

Prostaglandin E

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24
Q

HBeAg

A

An indication of HBV infectivity

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25
A person vaccinated against HBV has this serology
(+) anti-HBsAb, (-) anti-HBcAg, anti-HBeAg, or any viral antigens
26
Class IA antiarrhythmics
Quinidine, procainamide, and disopyramide. | Na channel blocking agents that depress phase 0 depolarization.
27
Side effects of Class Ia Antiarrhythmics
- Cinchonism (Headache, tinnitus) ->Quinidine - Reversible SLE-like syndrome -> Procainamide - Heart Failure -> Dispyramide - Thrombocytopenia and TdP -> all
28
MOA of class Is antiarrhythmics
- increased AP - increased effective refractory period - increased QT prolongation
29
Class IB antiarrhthymics
Lidocaine, Mexiletine | - prevent Post MI arrhythmia (acute ventricular arrhythmia & digitalis-induced arrhythmia)
30
SE for class Is antiarrhythmics
CNS stimulation/depression, cardiovascular depression
31
MOA for Class Ib antiarrhythmics
- decreased AP duration | - preferentially affect ischemic or depolarizer purkinje and ventricular tissue.
32
Class Ic drugs
Flecainide, Propafenone | - SVT's including: a-fib (last resort refractory VT)
33
SE of Class Ic antiarrhythmics
- Proarrhythmic, especially post-MI
34
MOA of class Ic antiarrhythmics
Significantly prolongs refractory period in AV node | Minimal effect on AP duration,
35
Class II antiarrhythmics
Beta-blockers | - Used for SVT, slowing ventricular rate during a-fib and a-flutter
36
SE of Class II antiarrhythmics
- Impotence, exacerbation of COPD and asthma, cardiovascular effects (bradycardia, AV block, CHF) - Sedation, sleep alteration
37
SE of metoprolol only
Dyslipidemia
38
SE of propranolol only
Exacerbation vasospasm in prinzmetal angina.
39
Class III antiarrhythmics
Potassium channel blockers Amiodarone, Ibutilide, Dofetilide, Sotalol - Used in A-fib, a-flutter, ventricular tachycardia
40
SE of sotalol
TdP | Excessive Beta-blockade
41
SE of Ibutilide
TdP
42
SE of Amiodarone
Pulmonary fibrosis, hepatotoxicity, hypothyroidism/hyperthyroidism, corneal deposits, skin deposits resulting in photodermatitis, neurological effects, constipation, cardiovascular effects Always Check PFTs, LFTs, and TFTs when using amiodarone
43
MOA of class III antiarrhythmics
- Increased AP duration - Increased ERP - increased QT prolongation
44
Class IV antiarrhythmics
Ca-channel blockers Verapamil, Diltiazem - Prevention of nodal arrhythmia, rate control in a-fib
45
SE of Class IV antiarrhythmics
Constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression).
46
MOA of class IV antiarrhythmics
- decrease conduction velocity - increase ERP - increased PR interval
47
MOA of Adenosine
Increase potassium effluent from cell, causing hyperpolarization of the cell and decreased Ca conductance. - used in abolishing supraventricular tachycardia - Short acting
48
SI of adenosine
Flushing, hypotension, chest pain | - effects blocked by caffeine and theophylline use.
49
What do you use in TdP or digit in toxicity
Mg
50
What is the inheritance of Sickle Cell Anemia?
Autosomal recessive
51
What is the mutation in Sickle Cell Anemia?
Glutamic acid -> Valine | - polar -> non-polar => allows for hydrophobic accumulation
52
The drug do you give sickle cell patients
Hydroxyurea - increases production of HbF
53
They subunits are in HgF
Gamma -2 & alpha -2
54
prevalence effects which statistical modalities
PPV and NPV
55
Lesser Omentum
Double layer of peritoneum that extends from the liver to the lesser curvature of the stomach and the beginning of the duodenum.
56
The two ligaments of the lesser omentum
Hepatogastric ligament -connecting the lesser curvature of the stomach, Hepatoduodenal legament- connecting to the duodenum
57
Falciform ligament
Attaches the liver to the anterior body wall
58
Greater Omentum
Large Fold of visceral peritoneum that extends from the greater curvature of the stomach, travels inferiority over the small intestine, and then reflects on itself and ascends to encompass the transverse colon before reaching the posterior abdominal wall.
59
Splenorenal ligament
Lies between the left kidney and the spleen. Contains the splenic vessels and the tail of the pancreas.
60
T(9;22)
Philadelphia chromosome -> CML
61
T(8;14)
C-myc activation -> Burkett Lymphoma
62
t(11;14)
Cyclin-D1-activation -> Mantle Cell Lymphoma
63
T(14;18)
Bcl-2 activation - > Follicular Lymphoma
64
T(15;17)
M3 type AML
65
What M3 AML respond best to
All-trans retinoic acid
66
Sx of CML
- Fatigue, weight loss, excessive sweating - Splenomegaly, Leukocytois w/left shift - Myelocytes, metamelanocytes, band forms
67
Mutation of CML
BCR-abl fusion protein - t(9;22)
68
Essential Thrombocytopenia
Hemorrhagic and Thrombotic symptoms - easy bruising, microangiopathic occlusion - Thrombocytosis - Megakaryocytic hyperplasia
69
Mutation in Essential Thrombocytopenia
JAK2
70
Mutation in Polycythemia Vera
JAK 2
71
Mutation in Primary Myelofibrosis
JAK 2
72
Polycythemia Vera
- Pruritis, erytheromylegia, splenomegaly, thrombotic complications, erythrocytosis and thrombocytosis
73
Primary myelofibrosis
Sever fatigue, splenomegaly, hepatomegaly, anemia + bone marrow fibrosis
74
Blood work for Polycythemia Vera
RBC - increased WBC - increased Platelets - increased
75
Blood Work with Essential Throbocytosis
Platelets - increased | RBC/WBC - normal
76
Myelofibrosis Blood Work
RBC - decreased | WBC/platelets - variable
77
CML Blood Work
RBC - decreased WBC - increased Platelets - increased
78
Treatment of primary myelofibrosis
Ruxolitinib
79
Starry sky histology
Burkett Lymphoma - Associated with Ebstein Barr Virus
80
Facial Pain, Headache, and black nectrotic eschar in the nasal cavity in a patient with diabetic ketoacidosis
Murcormycosis
81
Ischemia of the inferior surface of the heart
Right coronary artery occlusion
82
Ischemia of the anterior 2/3s of the interventricular septum, anterior wall of the left ventricle, and part of the anterior papillary muscle.
Occlusion of the LAD
83
Ischemia of the LAteral and posterior superior walls of the left ventricle
Left cricumflex artery occlusion
84
Ischemia of the right ventricle
Occlusion of the right rational branch of the right coronary artery.
85
SE of Thiazide Diuretics
- Volume Depletion - Hypokalemia and metabolic alkalosis - Hyponatremia and Hypercalcemia
86
SE of Loop Diuretics
Volume Depletion Hypokalemia and metabolic alkalosis Hypokalemia
87
First line for Panic Disorder, acutely
Benzodiazepine
88
First-line pharmacology for panic disorder, chronically
SSRI and CBT
89
Pathology of PE causing hypoxemia
Ventilation/perfusion mismatch
90
Abnormal interaction between the uterine bud and metanephric mesenchyme, resulting in a nonfunctional kidney consisting of cysts and connective tissue. Most likely unilateral.
Multicystic dysplastic kidney

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