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77 Cards in this Set
- Front
- Back
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medial medullary syndrome
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ipsi--12 tongue flaccid paralysis
contra--spastic paresis |
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lateral medullary syndrome (PICA) WAllenberg
versus lateral infereior pontine syndome (AICA) versus pons syndrome versus caudate |
ipsis---5,9,10,11
contra---pain and temperature horner contralateral--- pain and temperature ipsilateral--- 5, 8 horner quadriplegia complete decerbrate pin point pupil transit hemiplegia frontal signs |
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pineal gland
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neuroectoderm
circadian rhythm, melatonin germinoma |
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Germinoma mc in pineal gland
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parinaud sydnome (obstruction of tectal area of mid brain)
=Dorsal midbrain syndrome uppergaze convergence |
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Germinoma
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identical to testicualr seminoma
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germinoma in pineal
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precocious puberty
(B-hCG) |
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germinoma in pineal
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obstructive hydrocephalus
(cerebral aqueduct) |
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superficial inguinal LN
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from umbilicus to feet
distal 1/3 vagina scrotum anus, penis, clitorus except post. calf---popliteal LN |
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obturator
hypogastric external iliac |
uterus, 2/3 proximal vagina
upper bladder (external iliac) |
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internal iliac
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lower bladder
prostate |
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Excess Vitamin C
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N/V/D fatigue and sleep problems
increase iron toxicity a those at risk (blood transfusion and hemochromatosis) |
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Hemochromatosis screeninig tests
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C282Y
cycteine replaced by tyrosine H63D hisitidine is replaced by aspartic acid HFE missence mutation at chromose 6 AR |
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HFE gene location
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basolateral surface of the epithelial cells of the intestinal cells crypts
usually complexes itself with B2-macroglobulin binds the transferrin receptor---Regulate endocytosis of transferrin/ iron complex entrance to the cells |
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Hemochromatosis
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prusian blue to differentiate iron from lipofuscin
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lipofuscin
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wear and tear process of peroxidation of lipids
Aging normal process in hepatocyete ddx from iron hemochromatosis by prussin blue test |
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Blood alcohol levels (BAC) %
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0.10% BAC and more--intoxication, impair decision making capacities, slurred speech
0.20% BAC and more--impair consciousness, blackout memory, marked motor impairment |
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AGING
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SYMMETRIC DECREMENTS IN SIZE AND FUNCTION
loss of nephron focal glomerulosclerosis, arteriolosclerosis, tubulointerstitial fibrosis |
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Campylobacter jujuni
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erythromycin
resistant to fluroquinolones |
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the stroke voulme can be mesaured in the pressure volume curve
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by the width of pressure loop
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lysozymes
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tears
saliva granules in neutrophiles hydrolyse the bonds of the peptidoglycan on the surface of cell mm of bacteria |
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TNF alpha
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macrophages, monocytes
RA, psoriatis Arthrists, TNF aplha inhibrtors Type 4 HSR |
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Il2
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made from Th1 cells
stimlate Th helper and cytotoxic and NK cells |
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Huntigton Disease
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hypermethylation of histone binding the Dna and prevent transcription of certain genes
INREASE Silensing of genes distrupt protein |
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Huntongton
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AD
HD gene on chromosome 4 tripple CAG NMDAR inhibition by glutamate |
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Huntingotn rx
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tetrabenazine
reserpine DEC dopaime packaging and release by Inhibtion of VMAT (vesicle monoamine transporter) |
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HD gene
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abnormal one due to the tripple repeats
inhibit other protein transcription |
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phencyclideine withdrawal
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its RE intoxication
agitaion, suciadal ideation vertical and horizontal nystagmus Ataxia Acute |
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acholo withdrawal
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tremor
agitation seizure (after 48 hours) tachycardia hypertension |
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smoking withdrawal
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anxiety
hedache irritablilty wt. gain |
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OPIATE WITHDRAWAL
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HEROIN
GIT (N/V/ABDOMINAL pain, diarrea) diaphoresis, fever mydriasais Piloerection |
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DKA low K inside cells
high k outside cells |
lack of insulin (which usually push K inside)
glycosuria (osmosis) more loss of K acidosis pull k to outisde cells |
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SVC syndrome
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1-lung CA
2-non hodjkins lymphoma 3-thrombsis from indewlling catheter |
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SVC syndrome
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Thin walled vein.
hedache, dizziness, inc. risk of anneurysm and rupture of arteries (Inc ICP) puffiness of face, hands, neck dialted collateral veins Medical emergency |
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post infectious GN
2-3 weeks |
anti streptolysin O not always elevated after impetigo
But always after pharyngitis Anti DNAse low C3 |
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SYnoharyngitis Disease
IgA nephropathy 2-3 days |
MC
young hermaturia |
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kerly B lines
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Acute HF
horizontal line perpendicular on the plural surface represent inter lobular septa edema |
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amenorrhea
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MVP, bradycarida, arrythmia
sick euthroid synd (low T3) metarsal stress fractures, osteoporoiss amneorrhea (loss of pulsatile GnrH from hypothalamus) launugo hair hypothermia pancytopenia electrolyte disturbances (hypochloremic metabolic alkalosis and hypokalemia) Nephrolithiasis |
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aspiration pneumonia
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Rt main bronchus and Rt lower lobe
shorter wider more vertical (strightal) than left |
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DM 1
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inappropriate apoptosis of B cells
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parafollicular cells
thyroid follicle |
ultimobranchial bodies fuse with the
evagination of pharyngeal epithelium |
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polymerase 1,2,3
Called Proof reading |
exonuclease activity 3'-5' remove mismatched repair
only polymerase 1 has 5'-3' activity remove RNA primer and put DNA |
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enterococus cloace
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UTI
vancomysin resistant |
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staph saprophyticus
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Sexually active women UTI
ins summer (seasonal more) |
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ureaplasma urealyticum
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UTI
but require speical media of cholestrol and uria to grow |
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Dobutamine
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HF (cardiogenic shock)
positive inotropic (inc contractility (vimp) --incr COP and decrease ventricular filling weak positive chronotropic (HR) BAD ONES are: increase O2 consumption (ISCHEMIA) increae conduction (Arrythmia) |
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nitroglycerin
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reduce O2 consuption
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HCV
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lack profreeding 3-5, so many mistakes---many variants
envelop glycoprotein has highly variable region subjected to high mutation |
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DNA primase
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is a form of RNA polymerase
in bacteria it binds helicase and synthesize short RNA prime which nucleotides will be added to DNA polymerase |
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glycosylase
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imp in base excision repair
remove nitrogen base from sugar base backbone |
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Diphenoxylate
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SE bloating, mild sedation
Euphoria and physical dependance. mix with atropine will cause decrease of the euphoria cause increase lomotil will cause nausea blurry vision and dry mouth |
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Mthotrexate
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ectopic pregnancy (less than 6 weeks)
on the actively dividing cells of trophoblasts accumulation of DHF polyglutamate inside the cells (toxic) poly glutamation is how the methrotrexate and folic acid and DHT unable to leave the cell |
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Burr cells
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microangiopathic HH
mechanical destruction (prosthesis) uremia pyruvate kinase def |
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systemic mastocytosis
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mast cells within the GI mucosa + pruritis, bronchospasm, hypotension, tachycardia, flushing, rash
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Thyrotoxicosis
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hypercalcemia
bec inc. osteoclstic bone resorption |
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HTCZ
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hyper calcemia
LOW PTH |
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familial hypocalcuric hyper calcemia
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response of PTH receptors to Ca is damaged
NL to High PTH High Ca in serium low in urine |
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Total flow (constant)
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flow x cross sectional area
Volume in= volume out A1xv1=A2xv2 |
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MVA
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aortic isthmus injury MC
just down where left subclavian a originates fro aorta |
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HTN, syphilis, vasculitis
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ascending aorta just where brachocephalic a originates
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allosteric binding at GABAa receptors
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Ion channel (inc Cl- influx)
BZ and dolpizem same location Barbituartes different alcohol different |
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very high dose of barbiturates
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will NOT need to bing GABAa
will direct gate the ion channel.. |
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BZ resistance
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decrease of GABAa recptors in the synaptic cleft
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valporic acid and vigabtrin
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alter mechanisim of GABAa
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GABA B
example Baclofen |
does NOT use ion channel
use G protein increase K efflux decrease Ca influx inhibit adenylate cyclase located in the brain |
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GABAc
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located in RETINA
ion channel Cl- influx |
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Global cerebral ischemia
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pyramidal cells of Hippocampus
neocortex purkinji cells of cerebellum |
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emphysema versus chronic bronchitis hypoxia
smoking |
irreversible dilate alveolar spaces so decrease the contact with the deoxygenated blood in alveolar capillaries
decrease the diameter of the conducting air spaces so less air is available for exchange smoking increase blood CO |
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increase Bleeding time in alcoholics
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direct effect of alcohol on Bm (thrombocytopenia)
increase hypersplenisim and splenic sequestration of pl |
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Liver Fibrinogen
Coagulation factor and acute face protein |
infection, acute inflammation ----increaee
liver failure ----decrease |
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Ceftaroline
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is the only Cephalosporin cover MRSA
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cephalosporine is LAME
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listeria, atypicsl (chlymida, mycoplasma), MRSA, enteroccoi
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vancomycin
Bacteicidal Not work on any gr -ve |
MRSA
enterococci Clostridum dificile (oral) |
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red man syndome
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Mast cells degranualtion NOT IgE
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Linezolid
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SE
thrombocytopenia, optic neuritis, incr. serotonine synd. MOA inhibit 23S subunit of 50 S (inhibti the intitation complex 70 S) Protein synthesis Used for MRSA (pneumonia) VRE |
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Daptomycin
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SE
not working in lung (pnumeonia) incativated by surfactant Not work against Gr-ve INCREASE CK (mypopathy) MOA creaste mm channels, so increase depolarization of cell mm, so inhibit DNA, RNA, protein syntheses) used for SKIN MRSA and VRE |
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Pityriasis (tinia) veriscolr
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degradation of lipids produce acids will damage mealnocytes
Failure to tan chest and back only cosmetic problems short cigar butts spagetti and meat balls Dimorphic |
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Dantrolene
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prevernt the rel
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