Test 32 Flashcards by Sarah Carlson

0,8

right atrium

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4, 25

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9,25

Pulmonary artery

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2,12

left atrium

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9, 130

left ventricle

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70, 130

Aorta

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recurrent infections by neisseria species

deficiency of complement factors

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high fever
chills
altered mentaiton
petechial skin rash
septic shock

neisseria induced small vessel vasculitis

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tx for N. meningitidis

ceftriaxone at least 2 weeks

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1/ARR

NNT

Lower NNT > more beneficial treatment

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MOA of cocaine

inhibits presynaptic reuptake of NE, DA, 5HT

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agitation
tachycardia
HTN
light repsponsive mydriasis

increased SNS activity

Cocaine

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potent vasoconstrictor that can cause myocardial ischemia (due to increased SNS activity) and atrophy of nasal mucosa/septum (intranasal use)

cocaine

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blocks tyrosine hydoxylase>

decreased levels of catecholamines/SNS effects

metyrosine

conversion of tyrosine to DOPA

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blocks monoamine entry into presynaptic vesicles> sympatholytic effects

Reserpine

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COMT inhibitors that PROLONG the effects of levodopa tx in pts w/ parkinsons

entacapone

tocalpone

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sensation of excessive motion compared to physical reality

vertigo

dysfunction in vestibular system

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Neonate w/ swellin gof the hands (lymphedema) and cystic hygromas (cystic spaces separated by CT rich in lymphoid aggregates)

TUrners

**d/t abnormalities of lymph outflow

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cystic hygroma

tumors usually located on the neck that are present at birth

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roud face
microcephaly
ccat like cry

cri du caht

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neonate w/ 46 XY that appears to be a phenotypically normal female but has a blind ended vaginal pouch with NO uterus

Androgen insensitivity syndrome

defect in testosterone receptors
this pt would develop testes b/c testosterone

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Phosphodiesterase inhibitor used in pts w/ intermittent claudication

Cilostazol

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Inhibits platelet aggregation (increasing cAMP) and is a direct arterial vasodilator

Cilostazol

*good treatment for peripheral artery disease

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direct thrombin inhibitor largely used to tx heparin induced thrombocytopenia

agratroban

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competitive inhibitor of Vit K epoxide reductase used to tx/prevent thromboembolic events

warfarin

short t1/2 that activates antithrombin to cdecrase thrombin and factor XA

Heparin *prevents thromboembolic events

converts plasminogen to plasmin to aid in fibrinoilysis

tPA

block the platelet ADP receptor, allowing Gp+ IIb/IIIa to function apropriately

ticlodipine | clopidogrel

monoclonal ab that inhibits platelet aggregation by targeting IIb/IIIa receptor

abciximab

well known SE of hypolipidemic drugs

myopathy> elevated creatine kinase (sign of muscle damage) | hepatotoxicity

decrease incidence of second MI and mortality in pt's w/ previous MI

statins

tumbling MOTILE gram positive rods that produce narrow zone of b hemolysis grow well at refrigerated temps

listeria monocytogenes

what is needed to eliminate l. monocytogenes

intact cell mediated immunity

why is it bad if neonates get l. monocytogenes

up to 3 mos they're vulneragble b/c cell mediated immunity hasn't developed

varicella IgG Abs suggest

antecedent PRIMARY VZV infection (conver immunity against chicken box but not HZ which is why it can reactivate) IgM> IgG

why is skeletal muscle resistat to the effect of Ca channel blockers

does NOT require an influx of extracellular Ca for excitation contraction coupling

this muscle type depends on extracellular Ca entering the cell via VG L type Ca channels for excitation contraction coupling

cardiac adn smooth

target of verapamil and Ca channel blockers

VG Ca channels on cardiac and smooth muscle

how long does it take to lose cardiomyocyte contractitily after onset of total ischemia

60 seconds

restoration of blood flow that leads to reversible contractile dysfunction

myocardial stunning

30 minutes of total ischemia

irreversible injury

murmur of aortic stenosis

crescendo/decrescendo murmur starts afte hte first heart sound and ends

contraindications for OCPS

``` prior thromboembolitic event/stroke estrogen dep tumor women over 35 who smokes heavily hypertriglyceridemia liver disease pregnancy ```

arises from the lateral aspect of the mid pons

CN 5

dorsolateral aspect of cuadal pons at pontomedullary jxn

facial nerve

arises from preolivary sulcus at level of rostral medulla

CN 12

arises at level of superior oclliculus and red nculeus which are loated in the rostral mesencephalon (mid brain)

CN 8

arises from midbrain at level of inferior colliculus

trochlear

only nerve to decussate bbefore innervating its target

CN 4

only sensory pathway that doesn't relay to the thalamus

smell

spinothalamic | DCML

VPL

VPM

trigeminal (face sensation) | gustatory (taste)

LGN

Vision | light

MGN

Hearing | music

motor

MC cause of excessive daytime sleepiness in the US

Obstructive sleep apnea

daytime sleepiness morning HA depression

obstrutive sleep apnea

``` rathke's pouch (AP) lens and cornea inner ear organs olfactory epithelium nasal/oral epithelial linigns epidermis salivary/sweat/mammary glands ```

surface ectoderm

``` brain spinal cord Post pit pineal gland retina ```

neural tue

surface ctoderm neural tube neural crest

ectoderm

mesoderm

muscle bone CT serous linings of cavities

endoderm

``` GI tract liver pancrease lungs thymus PTH middle ear bladdder urethra ```

first line treatment for partial seizures and benign essential tremor

primidone active metabolites are phenobarbital and phenylehtylmalonamide SE: sedation

these cells move to an area of ischemic infarct 3-5 days after onset of ischemia and phagocytize gragments of neurons, myelin and necrotid depris

microglia phagocytosis of myelin breakdown products leads to a lot of lipids in cytoplasm

muffled heart sounds elevated JVD profound HYPOtension

pericardial tamponade

what cuases profoudn hypotension in pericardial tamponade

free wall rupture limits ventricular filling during diastole. As P increases venous return to heart is reduced> hypotension and pulseless electrical activity

MC cause of death in pts w/ TCA overdose

refractory hypotension and cardiac arrhytmias d/t inhibition of fast Na channels in cardiac myocytes> prolonged depolarization

block reuptake of NE/5HT and are used to treat depression

TCA

pramipexole | ropinirole

NONergot | Da agonist

ergot DA agonists

bromocriptine (used to tx galactorrhea) | pergolide

increass Da release and increases reuptake

Amantadine

impaired ubiquitin proteasome system contributes to these neurodegenerative disorders

parkinsons | alzheimers

ventricular enlargement d/t brain atrophy that is NOT accompanied by increase in CSF pressure

hydrocephalus ex vacuo