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70 Cards in this Set
- Front
- Back
What is the mneumonic for anticholinergic OD?
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"Dry as a bone, mad as a hatter, blind as a bat, hot as a hare"
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What does the opiate OD mneumonic MORPHINE statnd for?
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Miosis
Out of it Resp depression Pneumonia (aspiration) Hypotension Infrequency (urinary retention, constipation) Nausea Emesis |
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Antidote for cyanide poisoning?
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amyl-nitrate
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Antidote for benzos?
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Flumazenil
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Antidote for opiods?
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noloxone (narcan)
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What does SLUDGE stand for?
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Cholinergic OD
Salivation Lacrimation Urination Defacation GI upset Emesis |
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What is the mneumonic for aminoglycoside drugs?
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Stop going to a neophyte.
Streptomycin Gentamycin Tobramycin Amikacin Neomycin |
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What do quinolones inhibit?
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topoisomerase
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Chloramphenicol inhibits:
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peptidyl transferase
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Why is bacitracin only used topically?
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because it is very nephrotoxic
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What is a superior drug for UTIs and why?
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Nitrofurantoin becuase it accumulates well in urine
May turn urine brown. |
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DOC for osteomyelitis
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< 4mos old: nafcillin/oxacillin + ceftazidime OR cefepime
All others, nafcillin or oxacillin |
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DOC for any encephalitis
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acyclovir until CSF PCR results return. if HSV+ continue acyclovir, if not, discontinue and change to DOC for that agent
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DOC for Meningitis
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Neonate: ampicillin + cefotaxime
Child/adult: ceftriaxone + dexamethasone + vanco >50 yo, or alcoholic of any age, or immunocompromised, or pt has severe debilitation comorbid disease: ceftriaxone +dexamethasone + vanco + ampicillin |
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DOC for Meningitis prophylaxis of close contacts
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if H. influenzae: rifampin
if N. Meningitidis: rifampin or ceftriaxone or cipro |
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DOC for Otitis externa
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ofloxacin drops
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DOC for otitis media
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amoxicillin if < 2yrs old.
If > 2 yo, and afebrile without pain, then just analgesis are recommended |
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DOC for non-neonatal conjunctivitis
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viral (pink eye): nothing, or chilled artificial tears
bacterial: FQ drops |
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In hemophilia (A and B) and von Willebrands, which coag test will be prolonged?
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aPTT.
Difference between hemophilias and vWs: Hemophilias have a normal bleeding time, while vWs has a prolonged bleeding time. Why? Because bleeding time depends on platelet function which is diminished in vW but not in hemophilias. |
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What pathways does the PT test?
PTT? |
PT = extrinsic and common
PTT = intrinsic and common |
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Immune hemolytic anemia is _____ (IgG/Igm) at a temp of _____
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IgG, 37 degrees C
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What is the difference between direct and indirect Coombs test?
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Direct: RBC bound Abs (mix pts RBCs with anti-IgG Abs
Indirect: detects free Abs (mix pts serum with normal RBCs, which will get attacked by the free Abs) |
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What is difference b/t folate def anemia and B12 def anemia?
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No neuro Sx in Folate def, yes in B12 def
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What do Heinz bodies on blood smear indicate?
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G6PD def
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What do reticulocytes indicate on a blood smear?
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increased production and release of RBCs
recovery from hemorrhage |
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What is the difference between Hodgkins and NonHodgkins lymphoma?
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Hodgkins: continuous spread, Reed-Sternberg cells, no leukemic component
NonHodgkins: non continuous spread, leukemic component |
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What cancer is the "starry sky pattern" a/w?
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Burkitt Lymphoma
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Which is more serious, R->L shunts or L->R shunts?
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R->L shunts because deoxygenated blood is going into the systemic circulation
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What are the acyanotic shunts?
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VSD, ASD, PDA
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What are the four parts of Tetrology of Fallot?
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1) pulmonary artery stenosis
2) RVH 3) overriding aorta 4) VSD |
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If a virally infected cell has a down-regulation of MHC class I, what will most likely destroy it?
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NK cells.
natural killer cells, which are cells that are antigen nonspecific, play a major role in eradicating such cells. Natural killer cells are normally inhibited by the presence of cell surface MHC-I. Virally infected cells that have suffered a down-regulation of MHC-I expression are more likely to, instead, be destroyed by natural killer cells. |
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A 12-year old girl has an allergy to rose pollen. How do her mast cells work in this context?
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Pre-formed IgE binds to Fc receptors on mast cells, after which antigens associated with the rose pollen link with the mast cell-bound IgE antibodies; this linkage stimulates the mast cell to release histamine and, later, leukotrienes.
Explanation: When a patient has their first contact with a molecule the body will treat as an antigen, IgE antibodies are made to those antigens. Excess is made, so there are many IgE antibodies that are free “unbound.” Eventually, free IgE antibodies bind to high-affinity Fc receptors on the surface of mast cells and basophils. The antigen-binding portion of these antibodies are unbound and can bind to antigens (otherwise known as allergens when inciting an allergic response) when the patient comes in contact with the allergen again. The allergen, on this subsequent contact, now crosslinks the IgE antibodies together that are on the mast cell and basophil. The crosslinking triggers the release of intracytoplasmic granules which contain inflammatory mediators, most notably histamine. Leukotrienes are released later, which is why they are also known as slow reactive substances of anaphylaxis (SRS-A). |
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What is an anamnestic response?
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quick production of ABs to a exposure to an antigen. Occurs after vaccination
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What is immunologic paralysis?
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inability to have any immunologic response to an antigen, whether it is the first or subsequent exposure
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Which type of angina occurs at rest?
Tx? |
Prinzmetals
CCBs |
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How long after an MI does a gray and firm scar appear?
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8 weeks
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What is the most common cause of death immediately after an MI?
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arrythmia
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What are signs of Left HF?
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pulm congestion --> dyspnea, orthopnea
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Signs of Right HF?
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edema, ascites, liver congestion
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What bugs are a/w acute endocarditis?
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staph aureus, strep
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What bugs are a/w subacute endocarditis?
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strep viridans, gram neg bacilli
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What disease is Leibman-Sacks endocarditis a/w?
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SLE
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Which are the typical cervical vertebrae and what makes them typical?
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C3-C6.
Bifid spinous processes |
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Rotation and sidebending for the OA and AA are _____
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opposite
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Cervical nerve roots emerge _____ their corresponding segment
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above
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Difference b/t Bullous Pemphigoid and Pemphigus?
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BP: have bullae from anti-epidermal ABs
Pemphigus: anti-keratinocyte ABs, Nikolskys sign Both in elderly |
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Difference b/t Polyarteritis Nodosa and Microscopic Polyangitis?
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PN: larger vessels, NO glomerulonephritis
MP: capillaries, purpura, + glomerulonephritis |
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Difference b/t Progressive Systemic Sclerosis and CREST?
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PSS: systemic, anti-Scl-70 ABs
CREST: focal, anti-centromere ABs |
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What do you need to have to be able to call it SLE?
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lupus nephropathy
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What should you suspect with a female pt with jaundice and pruritis?
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primary biliary cirrhosis
Itchiness from accum of bile salts in blood |
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Difference b/t hyperacute and acute transplant rejection?
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hyperacute: minutes to hours, due to preformed ABs
acute: days to months, memory T cells recognize Ag |
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Why do we say Rheumatic fever is an autoimmune disease?
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molecular mimicry by the Strep pyogenes confuses ABs, they attach to our own heart tissue
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What do auto dominant and X linked dominant pedigrees have in common?
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NEVER SKIP GENERATIONS
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In _________ inheritance, a mother transmits to all of her children
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mitochondrial
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What type of cells are affected by cystic fibrosis?
Dx for CF? |
EPITHELIAL CELLS
bowel, pancreas, lung, skin Positive sweat test |
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What is the MOA of PCN?
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inhibit transpeptidases which catalyze the cross linking of the cell wall
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T/F. You can treat pseudomonas with one drug.
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False. Never treat pseudomonas with monotherapy.
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How are PCNs excreted? What implications does this have?
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Renally. Use caution in renal disease Pts.
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Bugs sensitive to 1st Gen Cephalosporins:
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PECK +Gram Pos
Proteus, E Colin, Klebsiella |
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Bugs sensitive to 2nd Gen Cephalosporins:
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HENPECK
H flu, enterobacter, neisseria, proteus, ecoli, klebsiella |
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Bugs sensitive to 3rd Gen Cephalosporins:
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HENPECK + Enterics
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Which are better against gram positives, 1st or 3rd Gen Cephs?
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1st
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Which are better against gram negatives, 1st or 3rd Gen Cephs?
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3rd
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What is the cause of the disulfram reaction?
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disulfram inhibits aldehyde dehydrogenase causing a buildup of acetyladehyde.
This causes flushing, tachycardia, hypotension, nausea and vomiting. |
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What is unique about ceftriaxone?
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it is excreted with the bile, so it is good for renal failure patients
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How do you remember the 3rd Gen Cephalosporins?
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Tough Assassins
cefTAzidime cefoTAxime cefTriAxone |
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Joint pain that is constant and not relieved by rest is characteristic of _______
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RA
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In this immunodeficiency disease, B cell levels are normal but they are not stimulated to form ABs. The disease involves both B and T cells.
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Wiskott-Aldrich
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What should patients be vaccinated against before a splenectomy and why?
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The spleen provides protection against encapsulated bacteria like strep pneumo, neissera meningitidis, and H influenza
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T/F. You should give an rH neg mother Rhogam even if she has not yet had an rH+ baby.
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True,
However, because she is Rh-, and despite the fact that this second child is not in danger of hemolytic anemia (erythroblastosis fetalis), and because the child she is now carrying might be RH+, she must receive RhoGAM at 28 weeks (and within 72 hours of birth if, after birth, the child is discovered to be Rh+)– so she will not develop anti-Rh antibodies during this current pregnancy or after delivery, so as to protect any fetuses in subsequent pregnancies |