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152 Cards in this Set
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what is the most potent cerebral dilator?
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PCO2
it decreases cerebral vascular resistance causein increceased cerebral flow and increased intracranial pressure. Pt with COPD usually have low PO2 and high PCO2 so this will increase cerebral circulation! |
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what happens to cerebral circulation in pt with COPD
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PCO2
it decreases cerebral vascular resistance causein increceased cerebral flow and increased intracranial pressure. Pt with COPD usually have low PO2 and high PCO2 so this will increase cerebral circulation! |
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what heart problem to SLE pts get? what is chief complaint
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pericarditis
inceaased pain on inspiration radiates to neck and shoulder relieved by sitting up recall: SLE is women 20-40; MALAR face rash, photosensitivity, proteinuria |
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neonate has hydrocephalus, intracranial calcifications and chorioretinitis.... what disease and how did baby get it
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congenital toxoplasmosis
transplancetnal transmission PREGGERS should AVOID CAT LITTER |
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why should you aim for superior lateral quadrant of butt when giving a shot?
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bc. superior gluteal nerve (L4-S1) is in superior middle quadrant
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pt has decreased exercise tolerance, myoglobinuria, muscle pain. what enzyme is deficient?
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myophosphorylase deficiency causes failure of glycogenolysis. Lactic acid does NOT build up bc muscle isn't breaking down glycogen into glucose to burn
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HNPCC: what is defective mech.
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DNA mismatch repair is defective
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what are 2 categories of DA agonists? what disease are they used to treat
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used to treat Parkinsons by prolonging action of Levdopa
1. ergot derivatives (bromocriptine; pergolide) side effect is raynauds 2. nonergot derivitative (pramipexole and ropinerole) |
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what is bromocriptine and what does it treat?
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it is DA agonist, used to treat parkingsons (and maybe prolacintoma??)
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bilateral lesions in mamillary bodeis and in periaqueductal gray area... what should you IMMEDIATELY think of? how do you get it?
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werneckes encephalopathy
pts will also have HORIZONTAL nystagmus, ataxia, confulsion, pthalmoloplegia, you get it if pt is given glucose BEFORE thiamine... so always give thiamine first |
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verapamil is what kind of drug? what is mechanism?
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Ca channel blocker
class IV blocks SA and AV node; slows hase 0 depolarization (phase 0 occurs in diastole) |
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what mediates external male genitalia? pt with small phalus and hypospadias has what deficiency
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DHT mediates male ext. genitalia
pt has 5 alpha reductase deficicincy |
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gram +
lancet shaped diplococci in pairs? what is it sensitive to |
strep pneumo
sensitive to OPTICHIN |
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name two drugs that you can use to treat organophosphate poisoning
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atropine (muscrinic_____)
pralidoxime (muscarinic and nicotinic) prevents muscle paralysis |
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what is formula for renal blood flow?
what is formula for renal plasma flow |
RBF =
(renal plasma flow) / (1-hematocrit) Renal plasma flow = (urine PAH x Urine flow)/(Plasma PAH) |
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what is mc muscle damaged in rotator cuff injury
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supraspinatus
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long term use of systemic steroids causes what bone disease?
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osteoporosis because it inhibits vitamin D and causes increased PTH
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cystic hygromas should remind you of
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turners syndrome and kids
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urethritis
conjuctivitis arthritis in young men = what disease |
Reiters syndrome
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RA vs OA
which joints are affected? which has pain that improves with use? |
RA = pain that improves with use; NO DIP joints
OA = DIP joints |
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mc location for atherosclerotic plaque
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abdominal aorta
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right sided fibrous thickening; endocardial fibrosis with pulmonic stenosis and/or restrictive cadiomyopathy... what disease and what do you see in the urine?
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carcinoid syndrome;
severity correlates with plasma level of serotonin and uriniary excretion of serotonin metabolite 5-HIAA (5-hydroxyindoleacetic acid) |
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when is bHCG detected in relatin to ovuolation?
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8-11 days after ovulation (after blastocyst implants)
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hungington disease is what chromosome? what is mechanism? suggested tx?
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chromosome 4
increased CAG repeats; some histone fragment are hypermethylated so they are silenced ==> disruption of protein synthesis of neurotropic proteins tx is antimetabolite mithramycin (will decrease ethylatieon of histones and maybe useful in tx for Hungtington) |
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renal angiomyolipoma assoc with what disease
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b9 tumor (bilateral) associated with TUBEROUS SCLEROSIS (brain hamartomas and ash leaf skin patches; metnal retardation
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tx options for paranoid schizophrenia?
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typical: block dopamine D2 receptors
eg. haloperidol; -azines atypical: block dopamine and serotonin receptor eg. risperidone; clozapine is also good but it causes agranulocytosis |
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major worrisome side effect of clozapine? what is it used to treat?
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it is atypical antipsychotic used to treat paranoid schizophrenia;
side effect = AGRANULOCYTOSIS |
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Name 2 drugs to treat bipolar disorde
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lithium and valproate
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what is flumazenil used to treat?
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benzo intoxication
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what drug do you use to treat benzo intoxication
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flumazenil
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change in color perception, nausea, vominting, headache, confusion is overdose of WHAT drug? what is major serious side effect risk? how do you treat/
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digoxin toxicity!!!
most seirous side effect risk is ventricular tachyarrythmias; treat with management of hyperkalemia and anti-digoxin antibody fragmetns |
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blind as a bat, mad as a hatter, red as a peat, hot as a hare dry as a bone, bowel and bladder lose their tone, heart runs alone... is what drug poisoning? how can you reverse it?
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atropine poisinging (it is a reversible cholinergic ANTAgonst on muscarinic receptors)
can be reversied by cholinesterase inhibitors like physiostigmine |
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what can reverse atropine poisoning
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physiostigmine (cholinesterase inhibitor)
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what diuretic can cause gout
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hydrochlorothiazide
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what does allopurinol treat? what is mech?
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it treats gout
inhibits xanthing oxidase (involved in synthesis of uric acid) |
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which diuretic is used to treat HYPERCALCIURIA?
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so you have too much Ca in urine, you want drug to reabsorb Ca.... thiazides will hold onto CA in serum (Loops lose Ca)
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which drug causes excretion of Ca and can be used to treat hypercalcemia?
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loop diuretics (loops lose calcium)
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what part of nephron has highest capacity for NaCl reabsorption?
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ascending loop
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major loop side effect? major spironolactone side effect? major hydrocholorothiazide side effect?
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loop = ototoxicity (esp. when used with aminoglycosides)
sprinolactone = gynecomastia thiazides = causes gout |
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what drug to treat menieres disease?
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thiazides
menieres has tinnitus, vertigo, pressure in inner ear |
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pt with CHF - what kind of diuretic
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LOOP (also preffered in pulmonary edema)
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why are ARBs used instead of ACE I's in some pts?
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ARBs do not increase bradykinin levels and thereofre do NOT cause cough
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what is effect of ACE I's on K levels?
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All ACE I's cause
hypotension cough HYPERKALEMIA |
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incease cardiac output, reduce afterload, cause venodilatino, used to treat CHF, HTN, postMI
what drug category? |
ACE inhibitors -
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name a drug you would use in diabetic pt with CHF
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enalapril (it will tx CHF and SLOW renal disease in diabetes)
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side effect of cardiac glycosides
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can induce arrythmias
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what does digoxin do to:
CO SV vagal activity sympathetic tone |
inc. CO
inc SV inc. vagal activity DEC sympathetic tone |
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ventricular AP:
what is happening in phase 0 and phase 1 |
0 = voltage gated Na channels open
1 = Closure of Na channels; voltage gated K channels start to open |
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ventricular AP
phase 2, phase 3 and phase 4 |
2 = Ca influx thorugh voltage gated Ca channels balances K efflux; Ca influx triggers Ca release from sarcoplasmic reticulum and muscle contracts
3 = rapid repolarization; massive K efflux due to opening of SLOW K channels and closure of Ca channels 4 = resting potential; high K permeability through K channels |
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pacemaker AP
phase 0 phaase 1 phase 2 |
phase 0 = opening of voltage gated Ca channels (lack fast Na channels) these are used by AV node to prolong transmissino from atria to ventricle
1= doesnt exist 2 = plateau is gone |
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pacemaker AP
phase 3 phase 4 |
3 = inactivation fo Ca; activation of K (increased K efflux)
4. membrane spontaeneously depolarizes as Na conudctance increases; slope of phase 4 in SA node determines HR (Ach will dec. HR, NE will iinc HR, sympathetic stimulation will icnrease chance that If Na channels are open |
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what determies HR in AV node
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slope of phase 4;
phase 4 is spontaneous membrane depolarization due to incresed conudctance to Na due to If Na channels |
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class 1 antiarrythmetics do what
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block fast Na channels
slow rate of phase 0 depolarization 1A = quinidine (side effect is cinchonism and ventr arrythmias), procainamide (side effect of pro. is drug induced lupus) 1B = lidocaine - selectivity for damaged tissue; shortens duration of refractory period 1C = flecainide; propafenone |
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class II antiarrythmatics?
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B blockers (block AV node and prolong AV conudctance) decrease HR and contractility; tx for afib and atrial flutter; also prevent reflex tachycardia; side effect is bradycardia (can be treated with atropine or isoprotenerol)
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what class of antiarrythmtic will treat afib, aflutter, and prevent reflex tach?
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class II beta blockers
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systolic blowing murmur loudest at apex, radiates to axilla; holosystolic
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mitral regurg
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diastolc decrescendo high pitched blowing
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aortic regurg
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diastolic with opening sntap; what causes opening snap? what is mc cause of this conditin
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mitrasl stenosis
OS = sudden openeng of rigid valve; most commonly caused by rheumatic heart disease andinfective endocarditis |
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systolic; ejection click; crescendo decrescendo; radiates to carotids
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aortic stnosis
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loudest at S2
can predispose to infective endocarditis midsystolic click; |
mitral prolapse; assoc with Marfans
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machinery murmur
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PDA
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holosystolic loudest at tricuspid area
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VSD
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india ink will stain what?
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cryptococcus
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cryptococcus is stained with what?
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india ink
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what is cytochrome c
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mitochondrial enzyme that activates caspasases
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what is enzyme that activates caspasaese and where is it located
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cytochrome c
in the mitochondria |
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what is tx for opiod intoxication
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naloxone - it binds Mu receptors
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what is cilostazole
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PDE inhibitor; arteriole vasodilator and inhibits platelet aggregation
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formula for cardiac output and mean arterial pressur?
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CO = SV x HR
MAP = CO x TPR (also, CO = O2 consuption/ arteriovenule O2 difference |
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what is used to reverse effects of heparin
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protamine
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what is protamine used for
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reverse effects of heparine
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who makes PGI2 and wht does it oppose
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vascular endothelial cells secrete PGI2 and it prevents platelet aggregation and opposes TXA2
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what grows on cysteine tellurite agar?
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cornybacterium diptheriae
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what does cornybacterium dipthe. grow on (what kind of agar)?
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cysteine tellurite agar
*remember they grow corn in telluride colorado |
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what virus is segmented like influenza
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rotavirus
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what is used to treat rheumatoid arthritis
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methotrexate
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what is effect of propanolol on Thyroid hormone?
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for some reason, it decreaes peripheral converion of T4- to T3
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what cardio drug inhibits converion of T4 to T3 in peipheral tissues
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propanolol
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hyper igM syndrome is likely due to defect in what?
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CD40 ligand on B cells
can't isotype switch |
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what causes insulin resistance by phosphoyrlating serine and threonine residues?
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TNF alpha
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what is effect of TNF alpha on glucose levels
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causes insulin resistance by phosphoyrlating serine and threonine residues
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what is normal A-a gradient
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10 - 15
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what is diagnostic of paroxysmal nocturnl hemoglobinureia
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deficient CD55, CD59;
rbc's can't stop complement activation |
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deficient CD55 and CD59 is seen in what disease
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PNH
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short acting barbituate that increaes GABA ; rapid redistibution into adipose and skeletal muscle; because it is FAST acting it is used for induction
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thiopental
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thiopental is what kind of drug, used for what?
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short acting barbituate that increaes GABA ; rapid redistibution into adipose and skeletal muscle; because it is FAST acting it is used for induction
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black necrotic eschar in nose?
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mucormycosis in diabetic
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cell stains for chromogranin and synaptophysin, what kind of cancer?
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small cll lung cancer; ususallly centrally located; neuroendocrine origin
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cipro and other fluoroquinolones act by what mech?
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inhibit DNA gyrase
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what abx act by inhibiting DNA gyrase
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cipro and other fluoroquinolones
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streptomycin mech of action? what category of abx is it?
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it is aminoglycoside; binds 30 s subunit
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what is mech of rifampin?
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blocks DNA dependent RNA polymerase
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what drug blocks DNA dependent RNA polymerase
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rifampin
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antimitochondrial antibodies
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primary billary cirrhosis
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erythema infantosum?
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also called slapped cheek rash
parvo B19 ssDNA; also called 5th diseaes |
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mechanism of vincristine?
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it is vinca alkalyouids; stops microtubular formation; binds Beta tubulin and stops growth of cell in M phase
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what drug stops microtubule formation by binding B tubulin; stops growth in M phase?
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vincristine
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why does Hep D need Hep B
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to get ists coat
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ant DNA antibodies?
anti histone antibodies? anti Ro/SSA, anti La/SSB |
DNA = SLE
histone = drug induced lupus anti Ro = Sjogrren |
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antibodies seen in CREST
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anticentromere
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anticentromere antibodies seen in?
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CREST
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what bacteria needs factors 5 and 10 to grow?
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h. influemza
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what do hydralazine, procainamide and isoniazide have in common
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all cause drug induced lupus
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name 3 drugs that cause drug induced lupus?
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hydralazine; procainamide; isoniazide;
drug induced lupus has anti histone abs |
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Negative monospot mononucleosis cuased by
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CMV
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most common two viruses that cause viral meningitis
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enteroviruses:
coxsackie and echovirus |
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coxsackie and echovirus are mc common cause of what?
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viral meningitis
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rapid correction of hyponatremia may have what effect in brain?
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cause osmotic demyelination of pons
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what would cause osmotic demyelination of pons?
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rapid correction of hyponatremia
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diffuse cortical atrophy, what dz? tx?
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alzheimers disease
tx is donepezil (chholinesterase inhibitor) vitamin E memanatine = NMDA receptar antagonist |
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donepezil and memanatine treat what ?
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alsheimers;
donepezil is cholinesterase inhibirtor memanatine is NMDA receptor antagonist |
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neonate with respiratory diffuculty has failure to carboyxlate glutamine... what is deficient?
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vitamin K
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vitamin K is associated with CARBOYXLATION of what?
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glutamine residues; vit K def in neonate would cause resp difficulty
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what is waterhouse friedrichson? who gets it
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kids get it; adrenal hemorrhage, usually casued my N meningitidis septicemia
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tuberoinfundibular pathway connects what
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connects hypothal and pituitary gland and causes Dopamine dependent PRL inhibition
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pt with low C1 esterase inhibitor serum level should NOT be given what?
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ACE inhibitor; nromally C1 esterase inhibitors inactivate kallikrein; kininogen via kallikrein becomes bradykinin
so patients with decreased C1 est. inhib have INC kallikrein and INC bradykinin so it will cuse cough |
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low C1 esterase inhibitor is diagnostic of what
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hereditary angioedema
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dont give ACE i's to pts that are deficeitn in what enzyem
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C1 esterase inhibitor
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pt with CHF or diabetes, what do you give as treatmetn?
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use ACE inhibitors NOT thiazides
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HbF is what chains
Hba2? |
HbF = alpha 2 gamma 2; replaced in first 6 months of life
HbA2 is alpha 2 delta 2 |
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morphine does what to potassium flow
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morphine binds to mu receptor and INCC K efflux; causes hyperpolarization of posty synaptic neurons
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what drug:
binds mu receptor causes inc. K efflux hence causes Hyperpolarizqtion of post synaptic neurons: |
morphine
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how does EBV enter cell
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CD21
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why is CD21 imporrttant
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its how EBV enters cell
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treatent for anaphylactic shock
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epinepherine
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what is etanercept, and what is major risk of its use
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itis TNF alpha inhibitor; but it can REACTIVATTE latent TB
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mamillary bodies with focal hemorrhage and necrosis....
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wernickes encephalopathy if you see increase in RBC transkelotae level aftr thiamine is given, it is diangostic for thiamine deficiency
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how can you diagnose thiamine def?
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give thiamine and if you see inc in rbc transkelotase level, it was deficient
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PRL, GH, cytokines use what signaling pathways
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tyrosine kinase asooc receptors and JAK/STAT sgnaling pathway
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what vasculidity is assoc with hep B
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PAN
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PAN is assoc with what virus
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hep B
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strawberry tongue
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kawasacki
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eczema
mental retard mousy odor |
PKU
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how are granulomas formed (what cells are stimulated and how
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Th cells make IFN y and this stimulates macrophge to form granulomas
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comedocarcinoma... another name for
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DCIS
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pigment deposits in connective tissue
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alkaptonuria
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gram neg. oxidase pos. non lactose fermenting produces pig.
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pseudomonas
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azole antifungal mech
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inhibit demethyation of lanosterol into ergosterol this suppress synthesis of fungal cell membrane
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inhibit demethyation of lanosterol into ergosterol this suppress synthesis of fungal cell membrane... what category of drugs
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azoles
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are azoles fungistatic or fungicidal
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fungiSTATIC
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what ANCA is assoc with PAN
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NONE! trick question
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dresslers synd?
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fibrinous pericardidiss several wks post MI
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2 mc causes of bacterial endocardiits
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1. acute is staph aureus
2. subacute is strep viridans s. epidermidids on prosthetic valve. |
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SLE causes what heart condition
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liebman sachs endocaritis (sle causes lse)
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this syndrome affects R heart not left heart, why
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carcinoid syndrome
bc 5HT is inactivated in lungs |
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wegeners
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C ANCA
tx is cyclophophamie which caues hhemorrhagic cystitis; so give mesna at same time to bind to metabolite acrolein in bladder |
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when do you give mesna
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with cyclophsophamide to prevent hemorrhagic cystitis by binding to metabolite acrolein in bladder
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what do you give with cyclophosphamide
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mesna; to avoid hemorrhagic cystitis
mesna binds to metabolite acrolein ain bladder |
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cANCA; treat with cyclophsophamide...what diseaes
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wegeners
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what is major side effect risk of cyclophosphamide
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hemorhhagic cystitis
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sawtooth ekg
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atrial flutter
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22q11
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tetralogy of fallot
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