studying random facts Flashcards

Question

chloramphenicol

Answer 1

inhibits peptidyl transferase 50s RMSF, meningitis (neisseria) Grey Baby (baby lack UDP gluc, this is necessary for this abx) aplastic anemia

Answer 2

binds 50s subunit methylation anaerobes\*\* above diaphragm (resistnace by B. Fragilis) Gardenella, Acne, PID Treat perfringins but cause C.Diff

Answer 3

Bind 50s subunit, bacteriostatic used in VRE, nosocomial infections weak MAO inhibitor (serotonin syndrome) optic neuritis, peripheral neuritis

Answer 4

all are bacterioSTATIC except aminoglycosides which are bacterioCIDAL

Answer 5

binds to transpeptidases "PCN binding proteins" mimic alanine (D-ala D-ala) residue and inactivate enzymes wall breakdown \> wall synthesis --\> autolysis

Answer 6

a gout drug that can be used to boost PCN via inhibiton of secretion of PCN in kidney

Answer 7

clavulonic acid, sulbactam, tazobactam (prevent degredation of beta lactam abx)

Answer 8

TEN is severe form of SJS that covers \>30% of total body surface area

Answer 9

classic presentation is fever, oliguria, increased BUN/Cr, Eosinophils in urine, white cells and WBC casts (sterile pyuria)

Answer 10

penetrate porin channel of gram - bacteria sensitive to Beta lactamase enzymes Amox: H. Infleunza, strep throat, otitis media, strep pneumo, H. Pylori, lymes (early) Amp: enterococcus, anaerobes, listeria, prophylaxis post splenectomy and dental proccedures commonly used with Beta lactamase inhibitors such as **clavulonic acid, sulbactam, tazobactam** **cause SJS, liver injury**

Answer 11

Piperacillin, Ticarcillin Greater porin channel penetration given with B-lactamase inhibitor Tic-Clav Pip-Tazo These are broad spectrum abx now

Answer 12

inhibit DNA gyrase (induce ds break, repair break), and Topoisomerase IV (get rid supercoils) Bacteriocidal resistance alter gyrase, topoisomerase Pyelonephritis, acute prostatitis, walking pneumonia, abd infections, bacteroides anthracis Cipro has most pseudamonas coverage (swimmer ear) GI upset, neuro side effect, PROLONG QT --\> Torsades Tendonitis, not use in children, not take with Ca,Mg **MSK side effects**

Answer 13

binds D-ala D-ala, prevent crosslinking (different from beta lactams that inhibit transpeptidases) bacteriocidal Resistance is D-ala D-lac TOO large to pass outer membrane so only Gram + nephrotoxicity, ototoxicity, Red Man Syndrome --\> histamine release (not hypersensitivity) just need to give slower

Answer 14

needs to be reduced by anaerobic bacteria when activated, **generate free radicals that lead to DNA breaks** **BELOW** the **diaphragm** infections Giardia, Entamebas, Trichamonas, Gardrenella, Aerobes (c. diff, bacteroides), H. Pylori **GET GAP** Disulfuram like rxn

Answer 15

use in UTI (concentrate in urine) safe pregnancy ppt hemolysis in pts with 6GPD

Answer 16

1. S. Aureus 2. Strep pyogenes

Answer 17

ingestion of tenia solium (pork tapeworm) eggs excreted in feces of HUMAN carriers clinically present with seizures see eosinophilia, cysts in brain tx albendazole

Answer 18

cell mediated immunity --\> T-cells | (Ab are useless)

Answer 19

Isoniazid (inhibits mycolic acid synthesis) Without their mycolic acids, mycobacteria lose their acid-fastness and become unable to synthesize new bacteria or multiply

Answer 20

caused by strep viridans (usually dental procdure) attacks previously damaged valves. The dextrans attach to fibrin There is fibrin and platelets at the site of endothelial trauma providing a site for bacterial adherence and colonization

Answer 21

**passive** immunization (diptheria **ANTITOXIN**)

Answer 22

this is indicative of cryptococcus think thick polysaccharide capsule on india ink and methanamine, muciarmine stain of tissue think BUDDING YEAST opporunistic infection can cause meningioencephalitis (soap bubble lesions in brain), pneumonia tx amphotericin B and flucytosine then maintenance with fluconazole

Answer 23

epithelial cells covered with gram-variable rods seen on wet mount indicative of gardrenella vaginosis (BV)

Answer 24

special capsule called Vi antigen that protects it from opsonization and phagocytosis remember that salmonella is most common cause of osteomyelitis in Sickle Cell pts

Answer 25

Considered replicative defective. Must have Hep B present in order to be infective The hep B surface antigen coats the Hep D antigen before it can infect hepatocytes

Answer 26

this shifts the curve to the right compete for same binding site but if increase dose enough, can overcome This decreases potency but does NOT change efficacy Diazepam + Flumazenil (competitive antagonist on GABA)

Answer 27

this shifts the efficacy DOWN but does NOT change the potency Essentially you are binding at an allosteric site and removing receptors from the system. This cannot be overcome by adding substrate concentration ex: NE + phenozybenzamine (noncompetative antagonist on alpha receptor)

Answer 28

this lowesrs the efficacy (potency is an independent variable. Here you are acting at the same site as the full agonist but with LOWER max effect Morphine + Buprinorphine (parial agonist at mu opioid receptor)

Answer 29

these are ipsilateral lesions that present as lack of coordination/dysmetria Think falling towards side of lesion

Answer 30

inhibit reuptake of both NE and 5HT

Answer 31

prone to UTIs from horshoe kidney

Answer 32

azithromycin clarithromycin doxycycline

Answer 33

Sepsis Pancreatitis Aspiration R Uremia Truama Amniotic Fluid Embolism Shock SPARTAS

Answer 34

same until week 35ish then L\>S 2:1 suggests lungs are mature

Answer 35

used to stimulate surfactant production in the lungs

Answer 36

1. broncopulmonary dysplasia 2. PDA 3. Retinopathy of prematurity (too much o2 causing detatchment of retina --\> blindness) via free radicals

Answer 37

L pulm artery goes SUPERIOR to L bronchus R pulm artery goes ANTERIOR to R bronchus

Answer 38

**perfusion -**-\> **O2** (normal healthy), **CO2, NO** (freely crosses membrane, limited by how quickly the blood is flowing by to take the gas away) **Diffusion** --\> **O2** (emphysema, fibrosis) **CO** (the problem is the gas crossing the membrane quickly enough, NOT the rate at which blood takes it away)

Answer 39

1. epoprostenol 2. bosentan 3. silfenafil This usually arises from an inactivating BMPR2 gene mutation that results in decreased NO and increased endothelin Results in smooth muscle proliferation

Answer 40

Pulmonary HTN normal pulm artery pressure is 10-14 pulm HTN is \>25 Results in arteriolosclerosis, medial hypertrophy, intimal fibrosis of pulm arteries

Answer 41

hypoxia = decreased O2 delivery to tissue 1. decrease CO 2. hypoxemia (decreased PaO2) 3. anemia 4. CO poisoning

Answer 42

low PaO2 (arterial) _Normal A-a gradient_ 1. High Altitiude 2. Hypoventilation _Increased A-a gradient_ 1. V/Q mismatch 2. Diffusion limitation (fibrosis) 3. Right to left shunt

Answer 43

Shunt --\> 100% O2 does NOT improve PaO2 (think airway obstruction, can get rid of CO2 as blood flows by but the blood is fully saturated with CO2) Dead space (PE), V/Q mismatch (pulm edema) --\> 100% O2 improves PaO2 (think PE, there is an area that cannot be perfused, but if give more O2, can fully oxygenate still)

Answer 44

sarcoidosis

Answer 45

virulence factor for clostridium perfringes (alpha toxin)

Answer 46

Ciliary mucosal epithelium line from the traceha to the proximal portions of the respiratory bronchioles

Answer 47

polysaccharide capsule, which is composed of polyribosylribitol phosphate (PRP) The PRP capsule binds factor H, a circulating complement control protein that prevents complement depositon on host cells

Answer 48

used during anesthesia to determine the degree of paralysis induced by neuromuscular junction blocking agents -A peripheral nerve is stimulated 4 times in quick succession and the nerve impulse is recorded A **nondepolarizing agent** would result in decreased initial reading that **fades** away (vecuronium) A **depolarizing agent** (succinylcholine) shows initial decrease in all 4 phases, but then during a second trial would show fading.

Answer 49

partial agonist of a4b2 nicotinic ACh receptor in CNS because it is a partial agonist, it helps to decrease the symptoms of withdrawl by mildly stimulating the receptor

Answer 50

**zone 1:** does not occur in the lung under normal physiologic conditions, but would be found at the apex. alveolar pressure \> arterial pressure \> venous pressure. The arterial pressure is low becuse the heart must pump blood uphil to get here **zone 2:** here arterial \> alveolar \> venous. Blood flows through this section in pulsatile fashion **zone 3:** arterial \> venous \> alveolar so blood flows continuously through this section \*note, in a supine position, the blood flow is entirely in zone 3

Answer 51

1. lungs --\> secretes Cl (via ATP) so that it pulls water with it to hydrate the mucosal surface 2. In sweat glands --\> pulls NaCl out of sweat to make it hypotonic

Answer 52

AR, CFTR gene, chr 7, delta F508. Abnormal folding of protein CFTR secrete Cl in gi/lungs and reabsorb Cl in sweat glands Dx: Cl \>60, present hypokalemia, increase immunoreactive trypsinogen (newborn screen) get bronchiectasis, bronchitis, steatorea, meconium ileus, biliary cirrhosis, pancreatitis, absence vas deferens (problem with transport not spermatogenesis) tx: albuterol, dornase alfa, hypertonic saline, N-acetylcystine, pancreatic enzyms, abx

Answer 53

S wave in 1 Q wave in 3 Inverted T wave in 3 This is indicative of right heart strain --\> Pulmonary Embolism

Answer 54

Wiskott-Aldrich Syndrome X-linked disorder of WAS gene

Answer 55

platelts do not live as long as they should in the plasma **antibodies against the IIb/IIIa receptor** cleared by splenic macrophages --\> splenomegaly tx: ivig, steroids, splenectomy **ITP ab against TwoP~B**

Answer 56

disorder of small vessel thrombus formation consume platelts --\> thrombocytopenia decrease activity of vWF cleaving protein ADAMTS13 (which normally breaks down multimers of vWF) usually an acquired Ab to ADAMST13 DANGEROUS CONDITION

Answer 57

produce shistocytes seen in: HUS, TTP, DIC

Answer 58

renal dysfunction --\> bleeding poor aggregation and adhesion of platelets caused by uremic toxins in the plasma see prolonged BLEEDING TIME normal platelet count normal coag testing

Answer 59

persistent pattern of unstable relationships, mood lability, and impulsivity

Answer 60

think mistrust and suspicion

Answer 61

gap junctions

Answer 62

drug induced lupus procainamide, hydralizine, INH

Answer 63

nucleoside reverse transcriptase inhibitor used in HIV competitively binds to reverse transcriptase and is encorporated into the viral genome as a thymidine analog lack 3' OH group The 3' --\> 5' phosphodiester bond formation is inhibited

Answer 64

seen in Parvovirus B19, thymoma, lymphocytic leukemias (see normal granulopoiesis and thrombopoeiosis)

Answer 65

kidney laceration possible \*spleen above kidney **SKI** (spleen, kidney, intestine)

Answer 66

stimulates production of neutralizing antibodies against the binding component of the diptheria exotoxin (IgG against circulating proteins)

Answer 67

Na/K atpase and Ca pump results in higher Na in cell and higher Ca in cell --\> cellular swelling

Answer 68

polymyositis proximal muscle weakness also see anti-jo antibodies often underlying adenocarcinoma possible

Answer 69

polycythemia vera

Answer 70

hydroxyurea phlebotomy

Answer 71

obliteration of bone marrow with fibrosis increased fibroblast activity teardrop cells = dacrocyte MASSIVE SPLEEN start to see extramedullary hematopoeisis PDGF and TGF-B --\> activate fibroblasts

Answer 72

typically develos 2-4 weeks of age. Caused by birth trauma or malposition in utero resulting in SCM injury and fibrosis baby presents with only wanting to look to one side with pain upon moving head to other side

Answer 73

class 1a antiarrhythmic slow phase 0 prolong phase 3

Answer 74

broad spectrum antiviral nucleotide analog that does not depend on the presence of a virally encoded kinase

Answer 75

fenoldopam D1 agonist causes arterial vasodilation, increased renal perfusion and promotes naturesis

Answer 76

These do NOT **NEeD** phosphorylation to be active nevirapine (inducer) efavirenz delaviridine

Answer 77

procollagen peptidase deficiency | (hyperextensible skin)

Answer 78

inulin --\> GFR PAH --\> renal plasma flow

Answer 79

nearly 100% that enters the kidney leaves in the urine, therefore, we use this to measure Renal Plasma Flow.

Answer 80

RBF=RPF/(1-Hct) remember that plasma =1-hct

Answer 81

GFR=(Uinulin x V)/(Pinulin)

Answer 82

filtered + secreted - reabsorbed remember, for inulin, filtration = excreted (no reabsorption, no secretion)

Answer 83

neg gap --\> GI cause positive gap --\> Renal Tubular Acidosis (type 1)

Answer 84

**Type 1:** DISTAL, Bicarb \<10, bilateral kidney stones, HIGH urine pH. Think Sjorgen, RA, Amphotericin B **Type 2:** PROXIMAL, mild acidosis, fanconi **Type 4:** hyperkalemia, diabetics, renal failure, decreased aldosterone response/production. can be caused by TMP-SMX

Answer 85

glomerulonephritis, malignant HTN

Answer 86

acute pyelonephritis, transplant rejection, tubulointerstitial inflam (acute interstitial nephritis)

Answer 87

nephrotic syndrome

Answer 88

acute tubular necrosis

Answer 89

end stage renal disease/chronic renal failure (think Wax near end of alphabet, near end of kidney life)

Answer 90

modified smooth muscle of afferent arteriole

Answer 91

aminoglycosides (made even worse when combined with cephalosporins) and vancomycin

Answer 92

need to be cautious because they mask the effects of hypoglycemia --\> hypoglycemia unawareness

Answer 93

causes metabolic alkalosis due to loss of volume leading to activation of RAAS. The aldo then acts in the collecting duct to dump K and H and bring in Na and HCO3. This leads to a metabolic alkalosis

Answer 94

magnesium (alcohol causes increased excretion, also dietary intake is less)

Answer 95

proteus causes struvite stone (ammonium, mg, phosphate) radiopaque, coffin lid appearance (can also be saphrophiticus and klebsiella)

Answer 96

increased K increased phosphate (stop responding PTH) decreased Ca (stop activating vit D) metabolic acidosis (stop producing bicarb)

Answer 97

fanconi (F=first) = PCT barter (thick ascending loop) gitelman (DCT) little (collecting tubule)

Answer 98

1. ischemic --\> hypotension, shock, sepsis 2. nephrotoxic --\> rhabdo (myobogin), aminoglycosides, contrast dye, ethylene glycol

Answer 99

acute tubular necrosis RPGN HUS acute interstitial nephritis **Would see:** FENa \>2% serum BUN/Cr \<15 (see a decrease in both of these)

Answer 100

anion gap 8-12 H: hyperalimentation A: addisons (adrenal insufficiency) R: renal tubular acidosis D: diarrhea A: acetazolamide S: spironolactone S: saline infusion

Answer 101

urine osmoles \> 500 urine sodium \< 20 (trying to conseve volume) FeNa \<1 serum BUN/CR \>20 (BUN is reabsorbed, creatinine is NOT..think of less fluid decreasing the GFR so it is moving slower and has more time to reabsorb the BUN as well as the Na)

Answer 102

subepithelial humps

Answer 103

SLE diffuse proliferative membranoproliferative

Answer 104

media**n** umbilical ligament (pee out of belly button) umbilical arteries --\> media**l** umbilical ligaments

Answer 105

blocks IL-2 production and its receptor IL-2 is necessary for differentiation and activation of ALL T-lymphocytes

Answer 106

acts to increase Na/H exchanger to pump more H into the lumen. This is then combined to eventually increase BICARB REABSORPTION NO net change in H+ Net Bicarb resorption

Answer 107

declining hepatic function leads to decreased GFR leads to progressive functional renal failure characterized by splanchnic vasodilation and vascoconstrction of the renal vascular beds RAAS activation pre-renal azotemia \*\*kidney looks normal\*\*

Answer 108

focal segmental glomerulosclerosis presents as nephrotic syndrome shows IgM in AFFECTED glomeruli

Answer 109

black homogentisic acid (due to defiency in homogentisic acid oxidase) these pts have problems with arthritis and their fingers are black-ish

Answer 110

Methylene Glycol Uremia DKA Propylene glycol INH, IRON Lactic Acidosis Ethylene Glycol Salicylates

Answer 111

T12-L3 Left is higher than right Retroperitoneal

Answer 112

dilate afferent and efferent and increase renal blood flow at higher levels, it would be alpha-1 agonist (vasoconstrict, give in shock)

Answer 113

sodium bicarb (used to alkalinize both the urine and plasma) see tinitis, n/v lethargy

Answer 114

200-375 glucose is seen in the urine \>375 glucose reabsorption is saturated and everything past this will be in urine

Answer 115

cephalosporin 1st gen

Answer 116

non-atherosclerotic, non-inflammatory disease of the blood vessels most commonly affects the renal and carotids main sx is HTN with bruit over renal artery

Answer 117

cannot bring in neutral AA (except for proline) in enterocytes and prox renal tubules. decreased tryprophan so no niacin so get pellagra

Answer 118

can cause nephrogenic DI also tooth discoloration, hepatotox, renal tox

Answer 119

allopurinol and hydration inhibits production of uric acid, prevents renal failure

Answer 120

due to loss of ability to excrete phosphate, leads to increase in PTH --\> increased bone reabsorption --\> increase fracture risk The increased phosphate also binds free calcium, which can lead ot hypocalcemia, which in turn leads to increased PTH production (secondary hyperparathyroidism) Decreased renal production of Vit D

Answer 121

side that cannot go medial is the side with the MLF lesion \*\*cannot move L eye medially, due to L MLF lesion\*\*

Answer 122

medially but cannot --\> INO (MLF lesion) laterally but cannot --\> CN 6 palsy (no lateral rectus)

Answer 123

TNF-alpha INF-y IL-1 IL-6

Answer 124

prerenal azotemia less blood flowing to kidney, allows more time for the BUN to be reabsorbed because the GFR is less. \*remember, BUN is reabsorbed, Cr is NOT\*

Answer 125

This implies intrinsic renal failure (acute tubular necrosis, PSGN, HUS) Get a decrease in GFR due to debris and necrotic tissue blocking the lumen The BUN reabsorption is impaired

Answer 126

**pyrimadal** --\> corticospinal tract, see WEAKNESS **extrapyrimidal** --\> basal ganglia nuclei. MOVEMENT DISORDERS

Answer 127

**ADAPT** (much more common with high potency --\> haloperidol) **AD:** Acute Dystonia --\> hours to days, muscle spasm, stiffness **A**kathisia --\> days/months (restlessness, urge to move) **P**arkinsonism (bradykinesia) **T**ardive Dyskinesia --\> months/years (irreversible, chorea, snake-like movements)

Answer 128

lewy body = alpha-synuclein cortex --\> Lewy Body Dementia Basal ganglia --\> Parkinson

Answer 129

can produce EPO --\> polycythemia vera Associated with Von-Hippel-Lindau Syndrome (chr 3, renal cell carcinoma)

Answer 130

cause perinaud syndrome and hydrocephalus (cannot look up via compression of tectum and compress cerebral aqueduct)

Answer 131

Meningioma Common primary benign brain tumor. Occurs near surface of the brain "extra-axial" +Psammoma bodies

Answer 132

anterior and cephalad deviation of the infundibular septum during embyologic development resulting in a malgaligned VSD with an overriding aorta

Answer 133

normal, this is considered a noncardiogenic pulmonary edema that can be caused by SPARTA An elevated PCWP would be more indicative of cardiogenic pulm edema

Answer 134

leukocyte adhesion deficiency (recurrent skin and mucosal bacterial infections with NO pus, umbilical cord stay attached for \>21 days)

Answer 135

alveolar macrophages

Answer 136

exotoxin mediated skin damage \*Think exo for exfoliate (+ nikolski sign)\*

Answer 137

NORMAL as this is a meausre of the oxygen dissolved in plasma and unrelated to hemoglobin fxn

Answer 138

High dose glucocorticoids such as prednisone help to decrease the severity of inflammation and decrease extraocular volume \*Note the normal antithyroid drugs do NOT improve opthalmopathy

Answer 139

If they came in with something like sore throat you would be concerned about **agranulocytosis** caused by these drugs

Answer 140

HBeAg and viral load can be detectable

Answer 141

**S**ubmucosa --\> Mei**ss**ner = submucosal nerve plexus (control secretions) **M**uscularis externa --\> Auerbach = **M**yenteric plexus (control GI motility)

Answer 142

Alk phos \> AST/ALT --\> chestatic pattern (bile duct problem) AST/ALT \> Alk Phos --\> hepatocellular pattern (hepatocyte problem)

Answer 143

Isosorbide Dinitrite Diuretics (decrease preload) Vasodilators in general (CCB, NO, ACE-I) all lead to decreased afterload

Answer 144

weber localizes to affected ear with conductive hearing loss **WAC** weber localizes to unaffected sensorineural side **WUS**

Answer 145

Dopamine Agonist (pramipexole)

Answer 146

stimulate cytotoxic CD8 T cells to destroy infected hepatocytes

Answer 147

inducer (st john's island induce bliss)

Answer 148

carrier mediated secretion (remember, it is filtered and then secreted) The secreted part of this is the RLS in how much PAH can be secreted into urine

Answer 149

teriperatide (remember that bisphosphonates decrease osteoclast activity by binding hydroxyapetite)

Answer 150

widespread kidney damage due to granulomatous tissue containing foamy macrophages. A result of having chronic pyelonephritis

Answer 151

G-CSF (use to recover bone marrow) increase entire myeloid lineage

Answer 152

ITP (anti GP IIb/IIIa antibodies --\> splenic consumption of platelet-antibody complex. Commonly due to viral illness)

Answer 153

inhibits fatty acid oxidation required for synthesis

Answer 154

bone marrow suppression renal tox use in CMV (guanosine analog)

Answer 155

nephrotoxicity electrolyte abnormalities that can lead to seizures

studying random facts Flashcards

(186 cards)