test #9 3.23 Flashcards Preview

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Flashcards in test #9 3.23 Deck (153)
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1

which antidepressant is good for (1) depression w/ psychomotor retardation or hypersomnia (2) depression w/ smoking cessation desire (3) w/o sexual dysfxn

buproprion (NDRI and nAch-agonist). has stimulatory effects.

2

which antidepressant is good for patients w/ insomnia. side effect?

trazodone (highly sedating antidepressant, but can cause priapism & other sexual side effects. SARI -- 5-HT antagonist and reuptake inhibitor.

3

SSRI-induced sexual dysfxn in what %age? what 3 types?

50%. decreased libido, anorgasmia, and increased latency to ejaculation.

4

electrolyte abnormalities w/ hyperaldosteronism

hypokalemia, metabolic alkalosis. normal Na+ bc of aldosterone escape

5

describe aldosterone escape

hypernatremia is not seen w/ hyperaldosteronism. increased Na+ reabsorption --> intravascular hypervolemia --> promote ANP release --> diuresis --> compensatory Na+ loss.

6

presentation of primary mineralcorticoid excess

HTN, hypokalemia, suppressed renin, non-suppressible aldosterone

7

normal serum Na+, hypokalemia, metabolic acidosis suggests..

renal tubular acidosis

8

renal tubular acidosis types (1, 2, and 4)

1: distal: failure of H+ secretion by alpha-intercalated cells (hypokalemia) 2: proximal: failed HCO3- reabsorption in PCT 4: adrenal: aldosterone deficiency or resistance

9

renal tubular acidosis explanation

inability to acidify urine

10

how do CAG repeats in huntingtin gene lead to disease

code for abnormal huntingtin protein that decreases expression of OTHER genes by inhibiting transcription (hypermethylation of histone fragments). SILENCE of other neurotrophic genes

11

mutation of homeodomain gene would lead to..

alteration in body structure // spontaneous abortion

12

is macrocephaly a typical feature of common chromosomal syndromes

no

13

cleft palate, polydactylyl, rocker-bottom feet associated w/

trisomy 13 (patau syndrome)

14

down's syndrome have increased risk of..

AML-M7 and ALL in childhood. Alzheimer's in adulthood

15

common presentation of trisomy 21 (5)

mental retardation, facial dysmorphism, single palmar crease, endocardial cushion defects, duodenal atresia

16

case-control

select those w/ disease & w/o disease. then look back to look at exposure. calculate odds ratio

17

controls in a case-control experiment

individuals w/o disease (w/ and w/o exposure). goal: exposure frequency among non-disease general population

18

carcinoid heart disease (associated w/ carcinoid syndrome)

fibrous intimal thickening w/ endocardial plaques limited to the RIGHT heart (bc both 5-HT and bradykinin in blood are inactivated distally by pulmonary vascular endothelial monoamine oxidase). can result in pulmonic stenosis and restrictive cardiomyopathy.

19

carcinoid syndrome symptoms. results from?

skin flushing, abdominal cramping, nausea, vomiting, diarrhea. results from production of serotonin, kallikrein, bradykinin, histamine, prostaglandins and/or tachykinins produced by carcinoid tumor.

20

degree of endocardial fibrosis seen in carcinoid heart disease correlates w/..

plasma levels of serotonin and urinary excretion of 5-HIAA (5-hydroxyindoleacetic acid)

21

elevated plasma levels of homocysteine associated w/..

arterial and venous thrombosis. also atheroscerlosis

22

common way to injur PCL

MVA

23

lateral vs. medial meniscus

lateral -- rounder and covers a larger portion of the articular surface

24

lateral vs. medial articular surface of knee size

medial articular surface is larger, as it bears more body weight

25

conversion disorder

characterized by neurological symptoms (nonepileptic seizures, blindness, loss of sensation, weakness, paralysis) that are anatomically or physiologically inconsistent w/ neurologic disease but are NOT FEIGNED.

26

2 most important mechanisms involved in the development of complications w/ diabetes

(1) advanced glycosylation end products (2) polyol pathway impairment

27

describe how advanced glycosylation end products --> diabetic complications (microangiopathy, neuropathy, atheroscerlosis)

attach glucose to amino acids (reversible --> irreversible), accumulate & cross-link w/ collagen in blood vessel walls & interstitial tissue (MICROANGIOPATHY and NEUROPATHY). cross-linking also facilitates inflammatory cell invasion & deposition of LDL in vascular walls --> ATHEROSCLEROSIS

28

describe how polyol pathway impairment --> diabetic complications (cataracts & peripheral neuropathy)

in tissues that do not depend on insulin for glucose transport (lens, peripheral nerves, blood vessels, kidney). glucose --> sorbitol (via aldose reductase). sorbitol --> fructose. both sorbitol & fructose increase osmotic pressure in tissue --> osmotic cellular injury. increased water in lens fiber cells --> rupture of cells --> opacification of lens and CATARACT formation. osmotic injury of Schwann cells --> PERIPHERAL NEUROPATHY

29

which main tissues do not rely on insulin for glucose transport

lens, peripheral nerves, blood vessels, and kidney

30

why do patients w/ galactosemia get cataracts?

galactose --> galactitol (via aldose reductase) --> osmotic damage of lens cells