test #25 4.13 Flashcards Preview

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Flashcards in test #25 4.13 Deck (86)
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1

skin rash, photosensitivity, arthralgia, renal disease in young women. general pathogenesis of disease

SLE. generally: autoantibodies bind autoantigens, immune complex deposition in vessel walls --> complement activation --> tissue inflammation and injury.

acute: fibrinoid necrosis
chronic: fibrosis & narrow lumen

2

anti-Smith (anti-snRNPs) and anti-dsDNA

highly specific for SLE, but absence does not rule out!

60% have anti-dsDNA, 20-30% have anti-snRNP/smith. virtually all have anti-ANA, but not specific for lupus

3

transposition of the great vessels

failure of aorticopulmonary septum to spiral normally during fetal development. aorta to right ventricle. pulmonary artery to left ventricle.

incompatible w/ life unless PDA, septal defect, or patent foramen ovale to allow for mixing.

4

failure of proliferation

unilateral aplasia of fibula

5

failure of oblieration

branchial cleft cyst

6

failure of apoptosis

autoimmune disease due to persistence of autoreactive T/B cells

7

failure of migration

hirschsprung, Kallman's

8

failure of fusion

hypospadius

9

where can the saphenous vein be harvested?

just inferolateral to the pubic tubercle

10

when left anterior descending is occluded by plaque, which vein is often harvested?

left internal mammary artery (left internal thoracic artery).

11

when multiple coronary arteries are needed, which veins are used?

saphenous vein grafts. longest in body, located superficially. courses up from medial foot --> medial malleolus --> up medial aspect of leg and thigh. joins femoral vein in proximal anterior thigh 3-4cm infeolateral to pubic tubercle. in femoral triangle (inguinal ligament, sartorius, adductus longus)

12

most common type of hair less in males and females? genetics?

androgenetic alopecia (male pattern baldness). POLYGENIC inheritance w/ variable penetrance.

relationship between type of androgen receptor gene on X chromosome (X-linked recessive component)

NOT autosomal dominant as once thought

13

common polygenic medial conditions

androgenetic alopecia, epilepsy, ischemic heart disease, schizophrenia, glaucoma, hypertension, malignancy, DM type II

14

persistent vegetative state

severe brain damage that results in wakefulness without awareness. 50% of cases will regain consciousness in 6 months, but with severe subsequent disability

15

acute salicylate intoxication

2 different acid base abnormalities simultaneously.

(1) respiratory alkalosis: SOON AFTER INGESTION. directly stimulate medullary respiratory center --> hyperventillation, increased loss of CO2.

(2) few hours later, anion gap metabolic acidosis, due to accumulation of organic acids in blood. (high doses, salicylates increase lipolysis, uncouple oxidative phosphorylation, inhibit TCA --> accumulate ketoacid, alctate, pyruvate.

16

winter's formula

PaCO2 = (1.5 x HCO3- + 8) +/- 2
used to see if respiratory compensation for metabolic acidosis is appropriate or not.

(i.e. respiratory compensation or independent respiratory alkalosis)

17

adverse effect in drugs w/ selective vasodilation of arterioles (hydralazine and minoxidil)

reduced arterial pressure, stimulates baroreceptor-mediated activation of sympathetics --> increased heart rate, contractility, increased RENIN --> Na+ and fluid retention

when given, add diuretics and sympatholytics

18

persistent cough and angioedema with a anti-HTN drug?

ACE inhibitors

19

angioedema

rapid swelling of dermis, subcutaneous tissue, mucosa, and submucosa

20

how can c. botulinum be prevented?

thoroughly heating food prior to consumption (toxin is heat labile)

21

classic paralysis in c. botulinum

descending paralysis, first manifesting w/ cranial n. involvement (diplopia, dysphagia, difficulty speaking).

note, both nicotinic and muscarinics aren't getting Ach

22

hemicholinium

blocks choline entry into neuron

23

bromoacetylcholine

inhibits chAt (choline acetyltransferase) blocking synthesis of acetate + choline --> ACh

24

vesamicol

noncompetitively blocks vesicular Ach transporter.

25

transference

unconscious shifting of emotions or desires associated with one person to another. often arise from childhood parent child relationship

26

single most preventable cause of death and disease in US

smoking!

most effective preventative intervention

increased risk for macrovascular (MI, stroke), microvascular (retinopathy, nephropathy), complications of diabetes.

risk of MI-associated mortality decreases immediately upon smoking cessation

27

omeprazole

inhibit H+/K+ ATPase, decreasing concentration of HCl in stomach lumen

primary active transport

28

lidocaine

block voltage gated Na+ channels in sensory neurons, purkinje fibers, and ventricular cells

29

drug to reduce nicotine cravings while decreasing pleasurable effects of cigarettes?

varenicline PARTIAL AGONIST of a4b2 nAChR.

prevents nicotine binding & reduces symptoms of withdrawal by mildly stimulating receptor --> limited release of dopamine, less stimulation of reward parthways than nicotine would.

reduce cravings and rewarding effects of use

30

reinforcing effects of nicotine mediated by..

stimulate alpha-4-beta-2 nAChR in CNS