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541 Cards in this Set
- Front
- Back
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17 alpha hydroxylase deficiency
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decreased sex hormones
decreased cortisol increased mineral corticoids |
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21 hydroxylase deficiency
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decreased cortisol
decreased mineralcorticoids increased sex hormones |
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11-beta hydroxylase deficiency
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decreased cortisol
decreased aldosterone but HTN increased sex hormones |
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mannitol MOA
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osmotic diuretic that increased tubular fluid osmolarity to increase urine flow
works on proximal convoluted tubule |
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toxicity of mannitol (3)
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PE
dehydration CI in CHF |
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MOA of acetazolamide
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carbonic anhydrase inhibitor to cause self-limited NaHCO3 diuresis
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Uses of mannitol (3)
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used for shock, OD, and ICP
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uses of acetazolamide (4)
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glaucoma
urinary alkalinization metabolic alkalosis altitude sickness |
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MOA of furosemide
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inhibits cotransport of Na, K, 2Cl of thick ascending limb
abolishes the hypertonicity to prevent the concentration of urine |
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Uses of furosemide (3)
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edema
HTN hypercalcemia |
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toxicity of acetozalamide (4)
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hyperchoremic metabolic acidosis
neuropathy NH3 toxicity sulfa allergy |
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toxicity of furosemide (6)
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OH DANG
ototoxicity hypokalemia dehydration allergy (sulfa) Nephritis Gout |
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ethacrynic acid
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loop diuretic
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MOA of hydrochlorothyazide
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inhibits NaCl reabsorption in the early distal tubule reducing the diluting ability of the nephron
decreased Ca++ excretion |
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uses of hydrochlorothiazide (4)
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HTN
CHF idiopathic hypercalciuria nephrogenic diabetes insipidus |
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toxicity of hydrochlorothiazide (7)
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hypokalemic metabolic acidosis
hyponatremia hyperglycemia hyperlipidemia hyperuricemia hypercalcemia sulfa allergy |
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K+ sparing diuretics (3)
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Spironolactone
triamterene amiloride |
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spironolactone MOA
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competitive antagonist to aldosterone in the collecting tubule
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uses of spironolactone (3)
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hyperaldosteonism
K+ depletion CHF |
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toxicity of spironolatone (2)
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hyperkalemia
antiandrogen effects |
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what are the +ssRNA viruses?
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I went to a RETRO TOGA party where I drank FLAVored CORONA and ate HIPPY CALIfornia PICkles
Retro virus Toga virus flavivirus corona virus Hep E virus Calcivirus Picorniavirus |
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what are the naked viruses?
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most of the dsDNA viruses except pox and HBV and +ssRNA
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what are the beta-lactams? (7)
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inhibit peptidoglycan cross-linking
penicillin ampicillin ticarcillin piperacillin imipenem azotrenam cephalosporins |
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what antibiotics inhibit peptidoglycan synthesis? (2)
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bacitracin
vancomycin |
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what antibiotic disrupts cell membranes? (1)
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polymyxins
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what blocks bacterial nucleotide synthesis? (2)
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sulfonamides
trimethoprim (SMX-TMP) chemo effect |
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what blocks bacterial DNA topoisomerase? (1)
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flouroquinolones)
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what blocks bacteria mRNA synthesis? (1)
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rifampin
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what blocks bacterial protein synthesis at the 50s subunit? (5)
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chloramphenicol
macrolides clindamycin streptogramins linezolid |
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what blocks bacterial protein synthesis at the 30s subunit? (2)
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aminoglycosides
tetracyclines |
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how do cephalosporins work?
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beta lactams that are less susceptible to penicillinases
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what are 2 1st generation cephalosporins?
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cefazolin
cephalexin cover gram +s |
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what are 3 2nd generation cephalosporins?
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cefoxitin
cefaclor cefuroxime cover gram +s and some gram -s |
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what are 3 3rd generation cephalosporins?
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ceftriaxone
cefotaxime ceftazidime (covers vanco) great gram +s and gram-s |
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what is a 4th generation cephalosporin?
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cefepime
narrower spectrum but includes pseudomonas |
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what are 3 bacterial cAMP inducers?
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cholera
pertussis e.coli |
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what do parietal cells secrete and where are they found? (2)
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secrete HCl and IF
found in the body |
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what do chief cells secrete and where are they found?
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pepsinogen
found in the body |
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what do G cells secrete and where are they found?
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gastrin
found in the antrum |
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what do mucous cells secrete and where are they found?
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mucous
found in the antrum |
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what do I cells secrete and where are they found?
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CCK
found in the duodenum |
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what do S cells secrete and where are they found?
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secretin
found in the duodenum |
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what do K cells secrete and where are they found?
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GIP
found in the duodenum |
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what are the 3 receptors on a parietal cell?
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M3 (influenced by ACh)
CCKb (influenced by gastrin) H2 (influenced by histamine) |
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what are the 2 MC pathogens in lobar pneumonia?
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strep pneumonia
klebsiella |
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what are the 4 MC pathogens in bronchopneumonia?
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S auerus, H flu, klebsiella, strep pneumo
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what are the 4 MC pathogens in interstitial pneumonia?
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viruses
mycoplasma legionella chlamydia |
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what is the treatment for legionella?
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erythromycin
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what is the treatment for pseudomonas?
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aminoglycoside + anti-pseudomonal PCNs (piperacillin, ticarcillin)
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what is the treatment for chlamydia?
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macrolides or tetracycline
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what is the treatment for mycoplamsa?
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macrolides or tetraclcines
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what is the best way to treat a localized fungal infection?
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fluconazole or ketoconazole
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what is the best way to treat a systemic fungal infection?
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amphoterecin B
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what are 3 ways to diagnose cryptococcus?
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india ink (bright orange)
latex agglutination test mucicormine test |
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what is the treatment for PCP pneumonia? (3)
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TMP-SMX
pentamidine dapsone |
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what type of viral genetic exchange is the cause of worldwide pandemics?
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ressortment (when 2 viruses with segmented genomes exchange segments)
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what viruses are immunized against with a live vaccine? (5)
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small pox
yellow fever chicken pox sabins polio (oral) MMR |
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what viruses are immunized against with a killed vaccine? (4)
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rabies
influenza salk polio (injected) HAV |
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what type of vaccines are HPV and Hep B?
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a laboratory produced antigen
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what type of HPV causes warts?
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6 and 11
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what type of HPV causes cancer?
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16 and 18
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what are the DNA viruses? (7)
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hepadna
herpes adeno pox papilloma poyoma parvo |
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what is a transudate and what is it usually caused by? (3)
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a pleural effusion with decreased protein content due to CHF, nephrotic syndrome, or hepatic cirrhosis (aka a pressure problem)
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what is an exudate, what is it usually caused by, and what must be done about it? (4)
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a pleural effusion with increased protein content that will be cloudy, due to malignancy, pneumonia, collagen vascular disease (SLE, RA, scleroderma), or trauma
must be drained due to risk of infection |
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what is empyeme?
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an exudate with frank pus
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what is the MC lung cancer in non smokers?
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adenocarcinoma
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what are the 2 central lung cancers?
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small cell and squamous cell
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what is the paraneoplastic syndrome of squamous cell carcinoma?
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PTHrP
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what is the paraneoplastic syndrome of adenocarcinoma?
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hypertrophic oteoarthropy
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what is the paraneoplastic syndrome of small cell carcinoma?
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ectopic ADH or ACTH
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what lung cancers are best removed by surgery?
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the peripheral ones (adenocarcinoma and large cell)
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what is excess ACTH associated with?
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presents as cushiness
associated with small cell carcinoma of the lungs |
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what is excess PTHrP associated with? (3)
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presents as hypercalcemia
associated with squamous cell lung carcinoma, renal cell carcinoma, and breast cancer |
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what is excess ADH associated with? (2)
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presents as SIADH
associated with any brain tumor and small cell carcinoma of the lung |
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what is excess erythropoitin associated with? (3)
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renal cell carcinoma
HCC hemangioblastoma |
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what is hyperuricemia/urate nephropathy associated with? (3)
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leukemia
lymphomas chemo |
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what exits the optic canal? (3)
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CN II
ophthalamic artery central retinal vein |
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what exits the superior orbital fissure? (6)
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CN 3, 4, 5, 6
ophthalamic vein sympathetic fibers |
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what exits the foramen rotundum?
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CNV2
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what exits the foramen oval?
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CNV3
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what exits the foramen spinosum?
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middle meningeal artery
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what exits the cribiform plate?
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CN I
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what exits the middle cranial fossa?
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CN 2 - 6
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what exits the posterior cranial fossa?
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CN 7 - 12
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what exits the internal auditory meatus? (2)
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CN 7 and 8
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what exits the jugular foramen? (4)
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CN 9, 10, 11 and the jugular vein
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what exits the hypoglossal canal?
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CN 12
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what exits the foramen magnum? (3)
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spinal roots of CN XI
brainstem vertebral arteries |
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where is BRCA1 located?
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17q
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where is BRCA2 located?
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13q
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where is APC located?
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5q
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where is Rb located?
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13q
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where is p53 located?
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17p
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where is the friedrichson ataxia gene located?
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9
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what is G6PD deficiency associated with?
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hemolytic anemia
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what is PDH deficiency associated with?
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wernicke korsakoff syndrome
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what type of thyroid cancer is the most common and has an excellent prognosis?
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papillary
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what type of thyroid cancer has ground glass nuclei (orphan anni), psammoma bodies, and nuclear grooves?
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papillary
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what type of thyroid cancer has increased risk with childhood irradiation?
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papillary
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what type of thyroid cancer has a good prognosis and uniform follicles?
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follicular carcinoma
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what type of thyroid cancer has parafollicular C cells that produces calcitonin and sheets of cells in the amyloid stroma?
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medullary carcinoma
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what type of thyroid cancer is typically in older patients, has a poor prognosis, and presents as a rapidly enlarging neck mass with dyspnea, cough, and hoarseness?
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undifferentiated/anaplastic
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what type of thyroid cancer is associated with hashimotos?
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lymphoma
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what is a common benign thyroid lesion consisting of a single large thyroid tissue which is often histologically similar to normal thyroid except patients are usually euthyroid?
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follicular adenoma
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what is a hiatal hernia?
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one in which the stomach herniates up through the esophageal hiatus of the diaphragm
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what is a paraesophageal hernia?
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GE junction is normal, the cardia moves into the thorax
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what is an indirect inguinal hernia?
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follows the path of decent of the testes, covered by all 3 layers of spermatic fascia
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why do indirect hernias occur?
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failure of the processes vaginalis to close
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what is the exact path of an indirect inguinal hernia? (3)
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deep inguinal ring (inferior to the epigastric artery) --> superficial inguinal ring --> scrotum
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if the hernia is medial to the inferior epigastric artery, what type is it?
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direct
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if the hernia is lateral to the inferior epigastric artery, what type is it?
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indirect
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what is a direct hernia?
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protrudes through the inguinal triangle and bulges directly through the abdominal wall
covered by external spermatic fascia and goes through the external inguinal ring only |
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which type of hernia is the leading cause of bowel incarceration?
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femoral
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what hernia is more common in women?
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femoral
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what is a femoral hernia?
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protrudes below the inguinal ligament through the femoral canal below and lateral to the pubic tubercle
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what is included in hesselbach's triangle?
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inferior epigastric artery, inguinal ligament, and lateral border of rectus abdominus
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what does LH do?
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produces testosterone in the leydig cells and ovulation
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what does FSH do?
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produces sperm in the sertoli cells and estrogen in the granulosa cell
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what is IFN-alpha used to treat? (3)
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Hep B, C, and kaposi sarcoma
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what is IFN-beta used to treat?
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MS
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what is IFN-gamma used to treat?
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NADPH oxidase deficiency
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what drugs will have a disulfiram reaction? (2)
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metronidazole
cephalosporins |
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what are 6 drugs that qualify as a sulfa drug?
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sulfasalazine
sulfonyureas thiazide diuretics acetazolamide furosemide celecoxib probenecid |
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what are 9 antibiotics that are CI in pregnancy?
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sulfonamides (kernicterus)
aminoglycosides (ototoxicity) flouroquinolones (cartilage) erythromycin (acute cholestatic hepatitis in mom) metronidazle (mutagenesis) tetracyclines (discolored teeth, inhibition of bone growth) ribavarin (teratogeneic) griseofulvin (teratogenic) chloramphenicol (grey baby) |
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what is IFN-gamma used to treat?
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NADPH oxidase deficiency
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what is a congenital prion?
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Gerst-mann straussler scheinkler
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what i a sporadic prion?
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crutzfeld-jakobs
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what drugs will have a disulfiram reaction? (2)
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metronidazole
cephalosporins |
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what is an acquired prion?
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kuru
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what are 6 drugs that qualify as a sulfa drug?
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sulfasalazine
sulfonyureas thiazide diuretics acetazolamide furosemide celecoxib probenecid |
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what is the progression of the rash in measles?
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oral (kopeck spots) --> head --> body
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what are 9 antibiotics that are CI in pregnancy?
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sulfonamides (kernicterus)
aminoglycosides (ototoxicity) flouroquinolones (cartilage) erythromycin (acute cholestatic hepatitis in mom) metronidazle (mutagenesis) tetracyclines (discolored teeth, inhibition of bone growth) ribavarin (teratogeneic) griseofulvin (teratogenic) chloramphenicol (grey baby) |
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who will a primary CNS lymphoma only be seen in?
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AIDS
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what is a congenital prion?
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Gerst-mann straussler scheinkler
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what does the serotype of flu depend on? (2)
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hemaglutinin (entry into the cell)
neuraminidase (exit from the cell) |
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what i a sporadic prion?
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crutzfeld-jakobs
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what is an acquired prion?
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kuru
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what is the progression of the rash in measles?
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oral (kopeck spots) --> head --> body
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who will a primary CNS lymphoma only be seen in?
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AIDS
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what does the serotype of flu depend on? (2)
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hemaglutinin (entry into the cell)
neuraminidase (exit from the cell) |
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what is the number 1 cause of gastroenteritis in kids?
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rotavirus
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what is the culture media for gonorrhea?
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thayer-martin/VPN
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what is the culture media for B pertussis?
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bordet-gengou
|
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what is the culture media for c. diphtheria?
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tellurite plate, loeffler's media
|
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what is the culture media for m. tuberculosis?
|
lowstein-jenson
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what is the culture media for m. pneumonia?
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eatons
|
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what is the culture media for fungi?
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saborurads
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what is the culture media for chlamydia?
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giemsa (will see IC inclusions)
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what is the culture media for cryptococcus?
|
india ink
|
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What is Lambert Eaton syndrome?
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autoantibodies against Ca++ channels that occurs in small cell carcinoma
presents with motor weakness |
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what are 6 complications of lung cancer?
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SPHERE
superior vena cava syndrome pancosts tumor horners syndomre endocrine (paraneoplastic) regurrent laryngeal symtpoms (horseness) effusions (pleural or pericardial) |
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what are the 4 MC sites for lung cancer to metastasize to?
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adrenals
brain bone liver |
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what is the special aspect of paramyxoviruses and what are 4 of them?
|
contain F (fusion) protein which results in multinucleate giant cells
includes parainfluenza, RSV, rubeola, and mumps |
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what DNA virus replicates in the cytoplasm?
|
poxvirus
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what RNA virus replicates in the nucleus? (2)
|
influenza and retro
|
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what are the only 2 ds DNA RNA viruses?
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Reo and rota
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what is the only ssDNA virus?
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Parvo
|
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what are 3 dermatophytes and which one is associated with pets?
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microsporum (pets)
trichophytan epidermophytan |
|
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what are 4 things that can cause granulomas?
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TB
mycoses chemical exposure sarcoidosis |
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what are 2 odd side effects of legionella?
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diarrhea
hyponatremia |
|
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what are branchial clefts derived from?
|
ectoderm
|
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what are branchial arches derived from?
|
mesoderm and neural crests
|
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what are branchial pouches derived from?
|
endoderm
|
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what is mesoderm? (2)
|
muscles and arteries
|
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what are neural crests? (2)
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bones and cartilage
|
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what does the 1st pharyngeal pouch form? (3)
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middle ear cavity
eustachian tube mastoid air cells |
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what does the 2nd pharyngeal pouch form? (1)
|
palatine tonsil
|
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what does the 3rd pharyngeal pouch (dorsal) form? (1)
|
inferior parathyroids
|
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what does the 3rd pharyngeal pouch (ventral) form? (1)
|
thymus
|
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what does the 4th pharyngeal pouch form? (2)
|
superior parathyroids
ultimobranchial body (parafollicular C cells) |
|
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what is an abnormality of the 1st pharyngeal arch?
|
treacher colling sndrome in which the 1st arch neural crest cells fail to migrate leading to mandibular hypoplasia and facial abnormalities
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what is the ultimobranchial body?
|
structure that neural crest cells migrate into to form the parafolliular C cells of the thyroid
|
|
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what is MEN2A and what it is a mutation of?
|
Germline mutation of RET (neural crest cells)
pheochromocytoma of the adrenal medulla parathyroid tumor medullar thyroid cancer of the parafollicular cells |
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Associated deficit with a lesion to the anterior spinal artery (3)
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contralateral hemiparesis of the lower extremities
decreased contralateral proprioception ipsilateral paralysis of the hypoglossal nerve |
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Associated deficit with a lesion to the PICA (13)
|
contralateral loss of pain and temperature
ipsilateral dysphagia, hoarseness, decreased gag reflex, vertigo, diplopia, nystagmus, vomiting, horners, facial pain and temperature, trigeminal nucleus, and ataxia |
|
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Associated deficit with a lesion to the AICA (6)
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ipsilateral facial paralysis, cochlear nucleus, nystagmus, facial pain and temp, dystaxia
|
|
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Associated deficit with a lesion to the posterior cerebral artery (2)
|
contralateral hemianopia with macular sparing
|
|
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Associated deficit with a lesion to the middle cerebral artery (3)
|
contralateral face and arm paralysis and sensory loss
aphasia left sided neglect |
|
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Associated deficit with a lesion to the anterior cerebral artery (2)
|
leg-fott motor area and sensory
|
|
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Associated deficit with a lesion to the anterior communicating artery
|
visual field defects
|
|
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Associated deficit with a lesion to the posterior communicating artery
|
CN III palsy - diplopia
|
|
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Associated deficit with a lesion to the lateral striate
|
pure motor hemiparesis
|
|
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Associated deficit with a lesion to the watershed zones (3)
|
due to severe hypotension
upper leg/arm weakness defects in higher order visual processing |
|
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Associated deficit with a lesion to the basilar artery
|
locked in syndrome
|
|
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Associated deficit with a lesion to the anterior circle of willis (3)
|
sensory and motor dysfunction, aphasia
|
|
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Associated deficit with a lesion to the posterior circle of willis (4)
|
cranial nerve defects, coma, cerebellar deficits, dominant hemisphere ataxia, nondominant neglect
|
|
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what occurs in brown-sequard syndrome? (4)
|
no sensation, LMN signs at the level of the lesion
contralateral below = loss of pain and temp (STT) ipsilateral below = loss of fine touch (dorsal column) and UMN signs (CST) |
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what is a key feature of friedreichs ataxia?
|
kyphoscoliosis
|
|
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what is argyll robinson pupil found in?
|
tabes dorsalis
|
|
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what is werdnig hoffman disease? (3)
|
similar to polio except it presents in infants
autosomal recessive degeneration of the anterior horns |
|
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what occurs in B12, vit E, and Friederichsons ataxia? (3)
|
demyelination of the dorsal columns, LCST, and spinocerebellar tracts
|
|
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what occurs during syringomylia?
|
bilateral loss of pain and temp due to damage of the anterior white commisure of the STT
|
|
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what is the lesion in tabes dorsal is?
|
degeneration of the dorsal roots and columns leading to impaired proprioception and locomotor ataxia
|
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what is lesioned in MS and what are 3 key symptoms?
|
random demyelination of the white matter of the cervical region
scanning speech intention tremor nystagmus |
|
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what is the normal direction for babinskis?
|
down (think UPN = UP)
|
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what is the function of the dorsal columns and where does it decussate?
|
contralateral fine touch and proprioception
decussates in the medulla |
|
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what is the function of the lateral CST?
|
contralateral voluntary movements
|
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what is the function of the STT and where does it decussate?
|
contralateral pain and temp
decussates in the anterior white commisure |
|
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what 4 areas of the brain are most susceptible to ischemia?
|
hippocampus
neocortex cerebellum watershed areas |
|
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what is a parenchymal hematoma?
|
usually in the basal ganglia and internal capsule
caused by local strokes all over the brain due to diabetes and tumors |
|
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what is a cushing's ulcer?
|
an acute stress ulcer due to increased ICP from trauma or illness; the ICP stimulate the vagus nerve which increases parietal secretions to cause an ulcer
|
|
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what is a charcot-bouchard aneurysm?
|
microaneyursm associated with chronic HTN
affects small vessels like the basal ganglia and thalamus |
|
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what is the MC site for a berry aneurysm?
|
bifurcation of the anterior communicating artery
|
|
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what is central pontine myelinolysis?
|
acute confusion, delirium, tremor, and hyperreflexia due to too rapid infusion of sodium
can progress to paralysis and loss of consciousness |
|
|
what is an essential tremor and how do you treat it?
|
a tremor that worsens when holding a posture
autosomal dominant patients may self-medicate with alcohol to decrease the tremor but the best treatment is beta-blockers |
|
|
what is the presentation of Huntington's (4) and what is its cause?
|
chorea
aggression depression dementia (so it can look like SA) due to caudate loss of ACh and GABA |
|
|
what lesions typically occurs in hemiballismus?
|
subthalamic nucleus lesion (eg lacunar stroke) with loss of inhibition of the thalamus through the globus pallid us (wild flailing of one arm and/or one leg)
|
|
|
what is a lewy body and what is it associated with?
|
increase in alpha-synuclein within the neurons in parkinsons
|
|
|
what is the TRAP of parkinsons?
|
T-tremor
R-rigidity A-akinesia P-postural instabilty |
|
|
what 4 things is CA 19-9 associated with?
|
pancreatic
colorectal esophageal HCC |
|
|
what 6 things is CEA associated with?
|
pancreatic
colorectal gastric lung breast medullar carcinoma |
|
|
what is the MOA of vanco and what are 3 other drugs that have a similar side effect?
|
inhibits cell wall synthesis by binding D-ala D-ala portion of cell wall precursors
causes flushing that is also seen with niacin, adenosine, and Ca++ blockers like verapamil |
|
|
what is the function of the VPM of the thalamus and where does it get its input?
|
facial sensation and taste
from trigeminal and gustatory pathway |
|
|
what is the function of the VPL of the thalamus and where does it get its input?
|
pain and temp
position and proprioception from the STT and dorsal column/medial lemniscus |
|
|
what is the function of the LGN of the thalamus and where does it get its input?
|
vision via CN II
|
|
|
what is the function of the MGN of the thalamus and where does it get its input?
|
hearing via the superior olive and inferior colliculus of the pons
|
|
|
what are 5 components of the limbic system?
|
cingulate gyrus
hippocampus fornix mammilary bodies septal nucleus |
|
|
what is the difference between the lateral area of the hypothalamus and the ventromedial?
|
lateral = hunger
ventromedial = satiety |
|
|
where is NE synthesized?
|
locus coruleus
|
|
|
where is dopamine synthesized?
|
ventral tegmentum and SNc
|
|
|
where is 5-HT synthesized?
|
raphe nucleus
|
|
|
where is ACh synthesized?
|
basal nucleus of Meynert
|
|
|
where is GABA synthesized?
|
nucelus accumbens
|
|
|
what will decreased ACh do? (3)
|
alzheimers
huntingtons REM sleep |
|
|
what will decreased GABA do? (2)
|
anxiety
hungtingtons |
|
|
what are meissner's corpuscles and how fast do they adapt?
|
dynamic position sense and fine touch
adapt quickly |
|
|
what are 5 components of the limbic system?
|
cingulate gyrus
hippocampus fornix mammilary bodies septal nucleus |
|
|
what is the difference between the lateral area of the hypothalamus and the ventromedial?
|
lateral = hunger
ventromedial = satiety |
|
|
where is NE synthesized?
|
locus coruleus
|
|
|
where is dopamine synthesized?
|
ventral tegmentum and SNc
|
|
|
where is 5-HT synthesized?
|
raphe nucleus
|
|
|
where is ACh synthesized?
|
basal nucleus of Meynert
|
|
|
where is GABA synthesized?
|
nucelus accumbens
|
|
|
what will decreased ACh do? (3)
|
alzheimers
huntingtons REM sleep |
|
|
what will decreased GABA do? (2)
|
anxiety
hungtingtons |
|
|
what are meissner's corpuscles and how fast do they adapt?
|
dynamic position sense and fine touch
adapt quickly |
|
|
what are meckels discs and when do they adapt?
|
static position sense and fine touch
adapt slowly |
|
|
what are the 5 functions of astrocytes and how is it stained?
|
physical support
repair K+ metabolism removal of excess NT BBB stained with GFAP |
|
|
what is Nissl substance and where is it found?
|
RER in the neuron
found in the cell body and dendrites; not in the axon |
|
|
what are 4 things derived from the neuroectoderm?
|
CNS neurons
ependymal cells oligodendroglia astrocytes |
|
|
what are 2 things derived from neural crest?
|
schwann cells
PNS neurons |
|
|
what type of breast cancer is known for peau d'orange?
|
inflammatory
poor prognosis |
|
|
what are 3 way breast cancer metastasis can be seen?
|
through the thoracic fascia creating a fixation of the mass
via the skin causing dimpling and retraction via the lymphatics, obstructing drainage and peau d'orange |
|
|
what are 4 types of fibrocystic disease?
|
fibrosis = hyperplasia of the breast stroma
cystic = fluid filled, blue dome, ductal dilation sclerosing adenosis = increased glands, associated with calcification epithelial hyperplasia = increased risk of carcinoma with atypical cells |
|
|
what do psammoma bodies look like and where are they found?
|
whorled clusters of cells
papillary, serous (ovary), meningioma, and mesothelioma |
|
|
what is BH4? (4)
|
a cofactor in the synthesis of tyrosine, dopa, serotonin, and NO
|
|
|
what is mammilary duct ectasia?
|
special type of mastitis seen in multiparous women in their 5th decade presenting with pain, redness, induration around the areola with thick secretions, and skin fluctuations with nipple retractions --> rule out CA
|
|
|
what is a breast fibroadenoma?
|
the MC tumor in those <25 that will increase in size and tenderness with estrogen
usually bilateral, small, mobile, firm masses with sharp edges |
|
|
what is a phylloides tumor?
|
presents with spontaneous serous or bloody discharge that may increase the risk for carcinoma
|
|
|
what is the hormone responsible for the glandular proliferation and fat production of the breast?
|
estrogen
|
|
|
how will hyper-PTH present (4) vs hypo-PTH (5)?
|
hyper = weakness, constipation, kidney stones, cystic bone spaces filled with a brown fibrous tissues
hypo = tetany, muscle spasms, tingling, prolonged QT, psychiatric disturbances |
|
|
what is Chvostek's sign?
|
tapping of the facial nerve to elicit contraction of the facial muscles in hypo-PTH
|
|
|
what is Trousseau's sign?
|
occlusion of the brachial artery with the BP cuff leading to carpal spasm in hypo-PTH
|
|
|
how do you treat hypo-PTH?
|
calcium gluconate and calcitriol
|
|
|
how do you treat hyper-PTH?
|
dietary PO4 3- restriction and vit D supplementation
removal of 3 glands in tertiary |
|
|
what happens to proteins in minimal change disease?
|
loss of albumen --> compensation by the liver and increase in overall protein synthesis, including lipoproteins
|
|
|
what can decreased estriol indicate in pregnancy?
|
placental insufficiency because it is synthesized by the placenta and fetus
|
|
|
what innervates taste from the anterior 2/3 of the tongue?
|
CN VII
|
|
|
what does the facial N innervate? (5)
|
taste from anterior 2/3 of tongue
lacrimation salivation from submandibular and sublingual eyelid closing (orbicularis oculi) stapedius muscle in the ear |
|
|
what CN nuclei are located in the midbrain? (2)
|
3 and 4
|
|
|
what CN nuclei are located in the pons? (4)
|
5, 6, 7, and 8
|
|
|
what CN nuclei are located in the upper medulla? (4)
|
9, 10, 11, 12
|
|
|
what occurs in the lower medulla?
|
crossing point of fibers forming medial lemniscus and CST
|
|
|
which CN nuclei are medial? (3)
|
3, 6, 12
|
|
|
what is the afferent and efferent part of the corneal reflex?
|
afferent = V1
efferent = 7 |
|
|
what is the afferent and efferent part of the lacrimation reflex?
|
afferent = V1
efferent = 7 |
|
|
what is the afferent and efferent part of the jaw jerk reflex?
|
V3 for both
|
|
|
what is the afferent and efferent part of the pupillary light reflex?
|
afferent = 2
efferent = 3 |
|
|
what is the afferent and efferent part of the gag reflex?
|
afferent = 9
efferent = both 9 and 10 |
|
|
what is the nucleus solitarius?
|
carries visceral sensation and taste from CN 7, 9, and 10
|
|
|
what is the nucleus ambiguous?
|
efferent motor fibers of the vagus N
|
|
|
what is the dorsal motor nucleus?
|
of X
parasympathetic function in the GI tract, lungs, and other thoracic/abdominal innervations |
|
|
what occurs during near vision?
|
the cilliary muscle contracts
|
|
|
what occurs during far vision?
|
the colliery muscle relaxes (flattens)
|
|
|
what are 2 AIDS related eye issues?
|
macular degeneration
retinitis |
|
|
what is open angle glaucoma?
|
obstructed outflow from the canal of schlemm; silent
|
|
|
what is closed angle glaucoma?
|
obstruction of flow between the iris and lens so that the pressure builds up behind the iris
very painful rock hard eye epi is CI |
|
|
what are 2 visual changes that occur with papilledema?
|
blurred margins and a bigger blind spot
|
|
|
what is the function of the edinger westphal nucleus?
|
to control bilateral pupillary movement
|
|
|
what is a marcus gunn pupil?
|
afferent pupillary defect that usually occurs with retinal detachment
decreased bilateral pupillary constriction when the light is shown in the affected eye and dilation if light is shown in the unaffected eye |
|
|
what is wet macular degeneration?
|
rapid, due to neovascularization
|
|
|
what is dry macular degeneration?
|
slow, due to fat deposits
gradual decrease in vision |
|
|
what is the treatment for Guillian Barre? (2)
|
IVIG and plasmapheresis
|
|
|
what is charcot marie tooth disease?
|
hereditary motor and sensory neuropathy due to defective production of proteins needed for the peripheral nerves or myelin sheath
|
|
|
what is picks disease?
|
fronto-temporal dementia
contains tau proteins |
|
|
what are 3 treatments for tonic-clonic seizures?
|
phenytoin, carbamezapol, and valproic acid
|
|
|
what is the most malignant childhood tumor and what are 3 markers?
|
medulloblastoma
rosettes or perivascular pseudorosettes, small blue cells |
|
|
what is the marker for a pilocytic tumor?
|
rosenthal fibers (eosinophilic, corkscrew fibers)
|
|
|
what is the most lethal brain tumor and what is its marker?
|
glioblastoma multiforme
"pseudopallisading: pleomorphic cells that borders a central area of necrosis and hemorrhage |
|
|
what is used to detect HSV?
|
the tzanck test which takes a smear of an opened skin vesicle to detect multinucleate giant cells
|
|
|
what is couroisier's sign?
|
that a non-palpable gallbladder in someone with unexplained jaundice usually points to pancreatic carcinoma
|
|
|
what are the ABs in drug induced lupus?
|
anti-histone
|
|
|
What is the ideal pH?
|
7.4
|
|
|
What is the ideal pCO2?
|
40
|
|
|
what is the ideal HCO3-?
|
22-26
|
|
|
what is the ideal pO2?
|
80-100
|
|
|
how do you increase pCO2?
|
hypoventilate (stop breathing)
creates acidosis |
|
|
what is a respiratory acidosis?
|
acidotic becaise CO2 is increased
|
|
|
what is a metabolic acidosis?
|
acidotic because there is no bicarb to buffer it
|
|
|
what is a respiratory alkalosis?
|
alkalotic because there is decreased CO2 via hyperventilation
|
|
|
what is a metabolic alkalosis?
|
too much bicarb hanging around
|
|
|
what are the 2 main features of respiratory alkalosis?
|
increased pH
decreased pCO2 |
|
|
what are the 2 main features of respiratory acidosis?
|
decreased pH
increased pCO2 |
|
|
what are the 2 main features of metabolic acidosis?
|
decreased pH
decreased HCO3 |
|
|
what are the 2 main features of metabolic alkalosis?
|
increased pH
increased HCO3 |
|
|
how do you differentiate a pure respiratory abnormality from a compensatory one?
|
for every 10mmHg change in CO2, the pH should change 0.08 in the opposite direction; if not, it is not a pure respiratory abnormality, there is a compensatory abnormality at work
|
|
|
what does MUDPILES stand for?
|
methanol
uremia diabetic ketoacidosis paraldehyde INH lactic acidosis ETOH salicylates |
|
|
what are 5 causes of non-gapped metabolic acidosis?
|
HCO3 losses (diarrhea, small bowel surgery)
Renal tubular acidosis aldosterone deficiency acidifying salts (NH4Cl, arginine, HCl - usually given to reverse a respiratory alkalosis to stimulate breathing) medications |
|
|
what are 8 CYP inducers?
|
Queen Bard Steals Phen-phen and Refuses Greasy Carbs Chronically
Quinidine Barbituates St. Johns Wort Phentytoin Rifampin Griseofulvin Carbamezapines Chronic Alcohol use |
|
|
what are 8 CYP inhibitors?
|
Inhibit yourself from drinking beer from a KEG because it makes you Acutely SICk
HIV protease Inhibitors Ketoconazle Erythromycin Grapefruit juice Acute alcohol use Sulfonamides Isoniazid Cimetidine |
|
|
what is the spinal level of innervation for the head and neck?
|
T1-4
|
|
|
what is the spinal level of innervation for the heart?
|
T1-5
|
|
|
what is the spinal level of innervation for the respiratory system?
|
T2-7
|
|
|
what is the spinal level of innervation for the esophagus?
|
T2-8
|
|
|
what is the spinal level of innervation for the upper GI?
|
T5-9
|
|
|
what is the spinal level of innervation for the middle GI (distal duodenum to proximal 2/3 of the transverse colon)?
|
T10-11
|
|
|
what is the spinal level of innervation for the lower GI?
|
T12-L2
|
|
|
what is the spinal level of innervation for the appendix?
|
T12
|
|
|
what is the spinal level of innervation for the kidney/adrenals?
|
T10-11
|
|
|
what is the spinal level of innervation for the bladder?
|
T11-L2
|
|
|
what is the spinal level of innervation for the uterus?
|
T10-L2
|
|
|
what is the spinal level of innervation for the prostate?
|
T12-L2
|
|
|
What does IL-2 do?
|
activates CD8 cells
|
|
|
What does IL-1 do?
|
pyrogen secreted by the macrophages; stimulates WBCs, fibroblasts, and epithelial cells for growth and differentiation
|
|
|
What does IL-3 do?
|
supports growth and differentiation of bone marrow stem cells
|
|
|
What does IL-4 do?
|
stimulates Th2 cells
|
|
|
What does IL-8 do?
|
chemotaxis for neutrophils
|
|
|
What are 5 sarcoidosis symptoms?
|
GRAIN
gammaglobulinemia rheumatoid arthriris ACE elevation interstitial fibrosis noncaseating granulomas |
|
|
what is the antidote for beta-blockers?
|
glucagon
|
|
|
what is the antidote for digoxin? (3)
|
normalize the K+
lidocaine anti-dig FAb antibodies |
|
|
what is the antidote for iron?
|
deferoxamine
|
|
|
what is the antidote for lead? (4)
|
dimercaperiol
EDTA penicillamine succimer |
|
|
what is the antidote for mercury?
|
dimercaperol
|
|
|
what is the antidote for copper?
|
penicillamine
|
|
|
what is the antidote for cyanide? (3)
|
nitrate
hydroxycobalamin thiosulfate |
|
|
what is the antidote for methemaglobin?
|
methylene blue
vitamin C |
|
|
what is the antidote for TCAs?
|
NaHCO3
|
|
|
what is the antidote for heparin?
|
protamine
|
|
|
what is the antidote for warfarin?
|
vitamine K
fresh frozen plasma |
|
|
what is the antidote for theophylline?
|
beta blockers
|
|
|
what 2 drugs will cause torsades de pointes?
|
Class III (sotolol) and class IA antiarrhythmics
|
|
|
what is fanconis syndrome and what causes it?
|
passing large amounts of urine leading to dehydration, bone pain, and weakness
caused by expired tetracyclines |
|
|
what causes drug induced diabetes insipidus? (2)
|
lithium
demeclocine |
|
|
what does -afil mean?
|
erectile dysfunction drug
|
|
|
what does -azine mean?
|
phenothiazine drugs (neuroleptic, antiemetic)
|
|
|
what does -ipramine mean?
|
TCA
|
|
|
what does -navir mean?
|
protease inhibitors
|
|
|
what does -phylline mean?
|
methylxanthine (theophylline)
|
|
|
what does -triptyline mean?
|
TCA
|
|
|
what does -zolam mean?
|
benzo
|
|
|
how will osteopotrosis present?
|
erlenmyer flask bones that flare out
normal Ca++, PO43-, and alk phos decreased marrow space leading to anemia, thrombocytopenia, infection, and extra medullar hematopoesis |
|
|
how will pager's disease present?
|
increase in hat size, hearing loss due to narrowing of the auditory foramen
increase in alk phos may be caused by paramyxovirus |
|
|
what are 5 reparatory changes that will occur in pregnancy?
|
tidal volume increases
total lung capacity decreases expiratory reserve volume decreases minute ventilation increases PaCO2 decreases |
|
|
what are 4 GI changes that will occur in pregnancy?
|
prolonged gastric emptying time
decreased esophageal sphincter tone increased reflux decreased GI motility |
|
|
what are 4 renal changes that will occur in pregnancy?
|
increased GFR
increased size of kidneys decreased BUN/Cr increased aldosterone (due to renin-agt) |
|
|
what are 5 hemodynamic changes that will occur in pregnancy?
|
increased RBC volume
decreased Hct increased plasma volume increased fibrinogen levels no change in bleeding time |
|
|
what are 6 endocrine changes that will occur in pregnancy?
|
increased estrogen
increased hCG increased thyroid binding globulin increased total bound T3/T4 decreased TSH free T4 = same |
|
|
what is used to monitor warfarin?
|
PT, the extrinsic pathways
|
|
|
what is used to monitor heparin?
|
PTT, the intrinsic pathway
|
|
|
what is the function of mesangial cells? (3)
|
contractile
phagocytic produce the ECM |
|
|
what is the enzyme deficient in homoystinuria?
|
cystathione synthetase deficiency
|
|
|
what is the function of human placental lactogen? (3)
|
increase maternal lipolysis and ketogenesis
decrease utilization of glucose (which may lead to glucose intolerance or gestational diabetes) |
|
|
what are the 4 MC locations for atherosclerosis?
|
abdominal aorta > coronary arteries > popliteal artery > carotids
|
|
|
what are 4 signs of a prolactinoma and how can it be treated?
|
amenorrhea
galactorrhea low libido infertility (decreased GnRH) dopamine agonists (bromocriptine, pergolide, or cabergoline) can shrink the prolactinoma |
|
|
what are 4 paraneoplastic syndromes of renal cell carcinoma?
|
EPO
ACTH PTHrP Prolactin |
|
|
what is the mutation in Von Hippel Lindau disease and what are 4 main organs affected?
|
mutated tumor suppressor VHL on chromosome 3
autosomal dominant skin, bilateral renal cell carcinoma, retina, adrenals |
|
|
what are 4 risk factors for transitional cell carcinoma?
|
Phenacetin (tylenol precursor)
smoking anyline dyes (especially naphthaline) cyclophosphamide |
|
|
what are 3 causes of stag horn calculi?
|
proteus
staph phosphate klebsiella |
|
|
what are 4 extra intestinal manifestations of Crohns?
|
uveitis
migratory polyarthritis erythema nodosum ankylosing spondylitis |
|
|
what are 2 extra intestinal manifestations of ulcerative colitis?
|
pyoderma gangrenosum
primary sclerosing cholangitis (still at risk even if colon is removed) |
|
|
which IBD is associated with a loss of austral folds?
|
ulcerative colitis
|
|
|
what is the treatment for crohns? (2)
|
corticosteroids
infliximab |
|
|
what is the treatment for ulcerative colitis? (3)
|
sulfasalazine
6-mercaptopurine infliximab |
|
|
which anti arrhythmic increases the action potential more than any other?
|
amiodarone
|
|
|
what are 3 side effects of lidocaine?
|
seizures, tremor, slurred speech
|
|
|
what is meckel's diverticulum the persistence of?
|
yolk stalk or vitelline duct
|
|
|
what is the MOA of metronidazole and what are 2 side effects?
|
forms free radicals in the bacterial cell to damage DNA
disulfiram reaction and metallic taste |
|
|
what enzyme is decreased in Gilberts?
|
UDP glucuronyl transferase
|
|
|
what is the MOA of bromocriptine, cebergoline, and pergolide?
|
dopamine agonists
|
|
|
what enzyme will be increased in leah nyhan?
|
phosphoribosyl pyrophosphate amino transferase
|
|
|
what are 3 key features of CML?
|
philadelphia chromosome
9:22 translocation can accelerate into AML or ALL |
|
|
what are 2 key features of CLL?
|
older adults
smudge cells (plasma cells) |
|
|
what are 4 key features of AML?
|
adults
auer rods responds to all-trans retinoic acid 15:17t |
|
|
what are 2 key features of ALL?
|
young kids
down syndrome |
|
|
what is wilms tumor and what is it associated with?
|
MC renal malignancy of childhood
deletion of tumor suppressor WT1 on 11p part of WAGR complex: wilms, aniridia, genitourinary malformations, retardation |
|
|
what is the presentation of PKU and what is the deficiency?
|
decreased phenylalanine hydroxylase or tetrahydrobiopterin cofactor
regular vomiting, skin rash, microcephaly, musty body odor tyrosine becomes essential |
|
|
what is a cystadenocarcinoma?
|
malignant and frequently bilateral ovarian tumor
cells secrete a mutinous material of epithelial origin |
|
|
what is the MOA of pacitaxel?
|
disrupts microtubule formation thereby disrupting the M phase
chemotherapeutic |
|
|
what is the gene associated with ALS?
|
SOD1 - superoxide dismutase
|
|
|
how is ALS treated?
|
riluzole (mostly decreased presynaptic glutamate release to lengthen survival)
|
|
|
what is the function of the reticular formation?
|
sleep-wake cycle
|
|
|
what is the function of the inter medial column?
|
white matter of sympathetics
|
|
|
what does the glomerulus secrete?
|
mineralcorticoids
|
|
|
what does the fasciculata secrete?
|
cortisol
|
|
|
what causes Ebsteins anomaly?
|
maternal lithium
|
|
|
what is unique about foscarnet?
|
it is a viral DNA protease inhibitor that binds to the pyrophosphate binding site of the polymerase of reverse transcriptase and is unique because it does not require activation by viral kinase
|
|
|
what is diphenoxylate?
|
an opiod anti-diarrheal similar to merperidine
acts at mu-opiod receptors |
|
|
what is the MOA of adenosine?
|
very short acting
primarily works on the AV node to slow conduction and decrease automaticity |
|
|
What is the MOA of theophylline?
|
structurally similar to caffeine
causes bronchodilation by inhibiting phosphodiesterase to decrease cAMP inhibits adenosine |
|
|
what is the MOA of ipatropium bromide?
|
competitive inhibitor of ACh which works to prevent bronchoconstriction
|
|
|
what is the deficiency and what are the signs in Von Gierkes?
|
Type I GSD
deficiency in glucose-6-phosphatase severe fasting hypoglycemia with increased glycogen in the liver and blood lactate |
|
|
what is the deficiency and what are the signs in Pompes?
|
Type II GSD
deficiency of lysosomal alpha-1-4-glucosidase cardiomegaly and early death |
|
|
what is the deficiency and what are the signs in Coris?
|
Type III GSD
deficiency of de-branching enzyme milder form of type I with normal blood lactate levels |
|
|
what is the deficiency and what are the signs in McArdles?
|
Type IV GSD
skeletal muscle glycogen phosphorylase painful muscle cramps, myoglobinuria with exercise |
|
|
what is the most specific test for SLE?
|
anti-dsDNA
|
|
|
what is the most sensitive test for SLE?
|
anti-nuclear
|
|
|
what 3 drugs are most likely to trigger drug-induced SLE?
|
hydralazine (anti-HTN)
INH procainamide |
|
|
what are 5 causes of microcytic anemia?
|
iron deficiency (including bleeding)
alpha-thalasemia beta-thalasemia sideroblastic anemia lead poisoning |
|
|
what is alpha-thalasemia and who is it seen in?
|
asians and africans
defect is in alpha-globin chain mutations number of deletions determines the severity of the disease |
|
|
what is beta-thalasemia and who is it seen in?
|
mediterrenean
defect is a point mutation in spincing sites and promotor sequences that can lead to beta-thalasemia minor or major |
|
|
what is beta-thalasemia minor?
|
heterozygote
beta-chain is underproduced, usually asymptomatic but can tell by seeing HbA2>3.5% on electrophoresis |
|
|
what is beta-thalasemia major?
|
homozygous
beta-chain is absent leading to severe anemia will see crew-cut skull and chipmunk faces |
|
|
what is sideroblastic anemia?
|
defect in heme synthesis due to an x-linked defect in delta-aminolevulinic acid synthase or through alcohol or lead
treat with B6 will see ringed sideroblasts |
|
|
what is Kallman syndrome?
|
defect in the hypothalamus that leads to decreased synthesis of gonadotropin in the anterior pituitary
ABCD - Anosomia, Blindness of Color, Delayed puberty |
|
|
what will have a tram-track appearance on EM?
|
membranoproliferative glomerulonephritis
|
|
|
what will have a spike-and-dome appearance on EM?
|
membranous glomerulonephritis
|
|
|
what is Mobitz type II?
|
second degree heart block in which QRS are dropped randomly without a preceding increasing PR interval
|
|
|
where is the JGA found and what does it respond to?
|
distal convoluted tubule
secretes renin in response to low BP, low Na+, and increased beta-1 stimulation |
|
|
what is deficient in alkaptonuria?
|
homogentisic acid oxidase which metabolizes tyrosine to fumarate
|
|
|
what 4 things occur in Conn's syndrome?
|
HTN
hypokalemia metabolic alkalosis low plasma renin |
|
|
what will cause an increase in conjugated bilirubin?
|
Dubin Johnson syndrome
|
|
|
what is Alport syndrome?
|
congenital defect in type IV collagen synthesis leading to a split basement membrane
will also nerve problems, ocular disorders, and deafness (x-linked dominant) may present as HTN in a young child |
|
|
What are the symptoms of a niacin deficiency?
|
B3
Diarrhea dementia dermatitis |
|
|
what are the symptoms of a folic acid deficiency?
|
glossitis causing a painful tongue
colitis causing diarrhea or constipation anorexia |
|
|
what are the symptoms in organophosphate poisoning?
|
diarrhea
urination miosis bradycardia bronchospasm excitation of CNS and skeletal muscles Lacrimation Sweating Salivation |
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|
what are the symptoms of atropine poisoning?
|
Hot as a hare
dry as a bone red as a beet blind as a bat mad as a hatter |
|
|
what is the AB associated with hashimotos?
|
anti-microsomal ABs
|
|
|
what is the AB associated with primary biliary cirrhosis?
|
anti-mitochondrial
will see an increase in IgM and cholesterol |
|
|
what is the AB associated with autoimmune hepatitis?
|
anti-smooth muscle AB
|
|
|
what is the AB associated with scleroderma and how does this disease present?
|
anti-centromere for CREST (calcinosis, raynauds, esophageal dysmotility, sclerodactyly, and telagiectasias)
anti-scl70/DNA topoisomerase for diffuse scleroderma which is widespread and rapid with early visceral involvement |
|
|
what are 3 type II HSRs?
|
Graves
rheumatic fever ABO transfusion reactions |
|
|
How will kawasakis present?
|
fever
conjunctivitis strawberry tongue lymphadenitis desquamative skin rash may develop coronary aneurysm self-limiting |
|
|
what are curschmann's spirals?
|
shed epithelium from mucous plugs seen in asthma
|
|
|
what will be seen on the blood smears of Thomotic thrombocytopenic purport?
|
schistiocytes and increased LDH and indirect bilirubin
|
|
|
what is hydrazine and what are 2 side effects?
|
1st line HTN in pregnancy, vasodilates arterioles
can see compensatory tachycardia and lupus like syndrome |
|
|
what is isosorbide?
|
NO vasodilator
creates monday morning blues in industrial workers |
|
|
what are 4 complications of gallstones?
|
acute pancreatitis
fistula between the gallbladder and intestines leading to air in the biliary tree portal tract edema adenocarcinoma which will present with thickening of the gall bladder wall on CT, a protruding polyploid mass into the lumen, and enlarged lymph nodes |
|
|
what is the MOA of statins?
|
HMG-CoA reductase inhibtor
inhibits the cholesterol precursor melvalonate |
|
|
what is the MOA of niacin?
|
inhibits lipolysis in adipose tissue so it prevents the breakdown that results in fats going out into the body
reduces hepatic VLDL secretion into circulation |
|
|
what is the MOA of fibrates? (incl gemfibrozil)
|
up regulates LPL to increase TG clearance
|
|
|
what is takayasus?
|
pulseless disease
granulomatous thickening of the aortic arch and/or proximal great vessel FAN MY SKIN On Wednesday Fever Arthritis Night sweats MYalgias SKIN nodules Ocular disturbances Weak pulse in upper extremities |
|
|
what are the 3 MC causes of meningitis in newborns?
|
group B strep
E coli listeria |
|
|
what are the 3 MC causes of meningitis in 6 months - 6 years?
|
Strep pneumonia
N meningitis H flu enteroviruses |
|
|
what are the 3 MC causes of meningitis from 6-60years?
|
N meningitis
Enteroviruses Strep pneumonia HSV |
|
|
what are the 3 MC causes of meningitis over 60?
|
s pneumonia
Gram - rods listeria |
|
|
what is the MOA of cyclophosphamide?
|
covalent x-link DNA at guanine N-7
requires bioactivation by the liver |
|
|
what is the MOA of cyclosporine?
|
blocks the differentiation of T cells by inhibiting calcinerurein thus preventing IL-2 production
|
|
|
what is the treatment for SLE?
|
NSAIDs
corticosteroids |
|
|
what causes elephantiasis?
|
Wucheria
|
|
|
what causes river blindness?
|
onchocerca volvulus
|
|
|
what is amantadine?
|
an NMDA receptor antagonist that can be used to treat parkinsons or an antiviral for influenza A
|
|
|
what is bromocriptine?
|
a dopamine agonist for pituitary tumors
|
|
|
what is phenelzine?
|
MAO-I
|
|
|
what is segeline?
|
a selective MAO-B inhibitor
best used as a parkinsons add on |
|
|
what is trihexyphenedyl?
|
an anti-muscarinic anti-parkinsons drug
|
|
|
what is the rule of 3s?
|
T1-T3 = TP and SP are on the same level
T4-T6 = SP is 0.5 a segment below the corresponding TP (i.e. the SP of T5 os halfway between the TP of T5 and T6) T7-10 = SP is at the level of the TP below (i.e. SP of T8 is at the same level as the TP of T9) T11 = same as T4-6 T12 = same as T1-3 |
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|
What falls at the spine of the scapula?
|
T3
|
|
|
What falls at the inferior angle of the scapula?
|
T7
|
|
|
What falls at the level of the sternal notch?
|
T2
|
|
|
What falls at the sternal angle?
|
Attaches to the 2nd rib and level with T4
|
|
|
What dermatome is the nipple located in?
|
T4
|
|
|
What dermatome is the umbilicus located in?
|
T10
|
|
|
What is chlorazepoxide?
|
a benzo
can be used for cocaine OD |
|
|
what are the indications for dialysis for DIC?
|
AEIOU
Acidosis refractory to bicarb electrolyte abnormalities refractory to intervention (esp K+) intoxication with some drugs Overload (volume) refractory to diuretics Uremic symptoms (cardiac friction rub, altered mental status) |
|
|
what are 3 drugs that can be used to inhibit labor?
|
Ca++ channel blockers (nifedipime)
prostaglandin synthesis inhibitors (indomethicin, ketorolac, sulindac) Beta agonists (terbutaline) |
|
|
what should be used for non-MRSA staph?
|
nafcillin
|
|
|
what are the side effects of ACE-Is?
|
CAPTOPRIL
cough angioedema pregnancy problems (fetal renal) taste changes hypOtension proteinuria increased renin decreased agtII |
|
|
what is mansonella?
|
a nematode that can cause a milder form of filariasis
endemic to africa and the carribean |
|
|
what is the enzyme deficient in tay-sachs?
|
hexosaminidase A
|
|
|
What are the toxic effects of digoxin?
|
nausea, vomiting, diarrhea, blurry yellow vision
increased PR, decreased QT, scooping, T wave inversion, arrhythmia, and hyperkalemia |
|
|
what composes stag horn calculi?
|
ammonium magnesium phosphate
|
|
|
what is the trinucleotide repeat in Friedrichson's and what are 3 physical findings?
|
GAA
hammer toes pes cavus nystagmus |
|
|
what is the renal clearance equation?
|
Cx = UxV/Px
Ux = urine concentration V = urine flow rate Px = plasma concentration |
|
|
what is the profile for someone immunized against Hep B?
|
HBsAb
|
|
|
What is lispro?
|
a rapid acting insulin
|
|
|
what is aspart?
|
a rapid acting insulin
|
|
|
what is NPH?
|
an intermediate acting insulin
|
|
|
what is glargine?
|
a long acting insulin
|
|
|
what is delemir?
|
a long acting insulin
|
|
|
what are sulfonyureas?
|
type 2 diabetes meds that stimulate endogenous insulin release (so useless in type I DM)
|
|
|
what is tolbutamide?
|
a 1st generation sulfonyurea
|
|
|
what is chlorpropamide?
|
a 1st generation sulfonyurea
|
|
|
what is glyburide?
|
a 2nd generation sulfonyurea
|
|
|
what is glimeprde?
|
a 2nd generation sulfonyurea
|
|
|
what is glipizide?
|
a 2nd generation sulfonyurea
|
|
|
what is metformin?
|
a biguanide used in patients without islet function
|
|
|
what is ploglitazone?
|
a glitazone used to increase insulin sensitivity in type 2 DM
|
|
|
what is rosiglitazone?
|
a glitazone used to increase insulin sensitivity in type 2 DM
|
|
|
what is acabose?
|
alpha glucosidase inhibitor used to inhibit the intestinal brush border alpha glucosidase in type 2 DM
|
|
|
what is miglitol?
|
an alpha glucosidase inhibitor used to inhibit the intestinal brush border alpha glucosidase in type 2 DM
|
|
|
what is pramlintide?
|
a mimetic used to decrease glucagon in type 2 DM
|
|
|
what is eventide?
|
a GLP-1 analog used to increase insulin and decrease alpha glucosidase in type 2 DM
|
|
|
what drugs are used to treat type 1 DM?
|
metformin and insulin
|
|
|
what are the components of the primary respiratory mechanism? (5)
|
CNS
CSF dural membranes cranial bones sacrum |
|
|
What happens to the brain and spinal cord during inhalation?
|
they shorten and thicken
|
|
|
What is the normal cranial rhythmic pulse?
|
10-14 cycles per minute
|
|
|
Where are the dural attachments? (4)
|
foramen magnum
C2 C3 S2 |
|
|
Which way do the paired bones rotate during flexion of the midline bones? And what happens to the sacrum?
|
they externally rotate
the sacrum counter nutates |
|
|
What are the midline bones of the cranium? (4)
|
sphenoid
occiput ethmoid vomer |
|
|
What is a cranial torsion?
|
When the sphenoid and occiput rotate in opposite directions
named for the wing of the sphenoid that is most superior |
|
|
What is cranial side bending/rotation?
|
Occiput and sphenoid rotate in the same direction but come closer together on one side
Named for the side that the sphenoid bends toward, and the side that the sphenoid and occiput are inferior on |
|
|
What happens to the SBS during an extension lesion?
|
deviated caudad
|
|
|
What occurs during a vertical strain?
|
the sphenoid deviated cephalic (superior) or caudal in relation to the occiput
|
|
|
What occurs during lateral strain?
|
the sphenoid deviates laterally in relation the the occiput
parallelogram named for the direction the sphenoid goes in |
|
|
what is a compression strain usually due to and what happens to the CRI?
|
the CRI becomes severely decreased
usually due to trauma, especially the back of the head |
|
|
What can condylar compression lead to?
|
occipital compression
CN XII poor suckling in the newborn dysfunctions of 9 and 10 at the jugular foramen can also cause suckling problems |
|
|
What treatment can be used to enhance the CRI?
|
CV4 bulb decompression
This works by resisting the flexion phase and encouraging the extension phase until a still point is reached Can also help induce uterine contraction in post-date women |
|
|
Where is the index finger during the vault hold?
|
greater wing of the sphenoid
|
|
|
where is the middle finger during the vault hold?
|
temporal bone in front of the ear
|
|
|
where is the ring finger during the vault hold?
|
mastoid region of the temporal bone
|
|
|
where is the little finger during the vault hold?
|
squamous portion of the occiput
|
|
|
What is the V spread used for?
|
to separate restricted or impacted sutures
|
|
|
what is the treatment for ductal carcinoma in situ and what is its MOA?
|
transluzumab, an anti-Her2Neu monoclonal AB
|
|
|
what causes acute EPS and what is the treatment?
|
due to unopposed cholinergic activity in the CNS
treat with benzitopine |
|
|
what is an adverse effect of fibrates?
|
rhabdomyalasis
|
|
|
what is the MOA of rituximab?
|
monoclonal AB against CD-20 which is found in most B cell neoplasms
|
|
|
what is the MOA of infliximab?
|
monoclonal AB against TNF to neutralize it
|
|
|
what is the most important platelet factor to inhibit with aspirin?
|
TXA2 because it works to vasoconstrict
|
|
|
what is the triad in hemochromatosis?
|
cirrhosis
skin pigmentation diabetes |
|
|
what complement proteins are necessary for viral neutralization?
|
C1, C2, C3, C4
|
|
|
what complement proteins are necessary for anaphylaxis?
|
C3a, C5b
|
|
|
what complement protein is necessary for neutrophil chemotaxis?
|
C5a
|
|
|
what complement proteins are necessary to form the MAC?
|
C5b-9
|
|
|
what is given for ethylene glycol/methanol poisoning?
|
fomepizole
|
|
|
what is another name for MEN-1?
|
Werner's syndrome
|
|
|
what is another name for MEN-2a?
|
pheochromocytoma + parathyroid
sipple's syndrome |
|
|
What is water house friedrichson characterized by?
|
low aldosterone
high renin |
|
|
what is the adson's test used for?
|
used to test for thoracic outlet syndrome and klumpke's paralysis
patient's arm and shoulder are abducted and externally rotated; test is positive if there is a decrease in pulse when the patient turns their head toward the arm |
|
|
what is the thomas test?
|
used to detect a contracture of the iliopsoas muscle
patient lies supine with legs hanging off the table; as one knee is brought to the chest the other leg should remain down; if it doesn't it's positive |
|
|
what is the over test?
|
used to test for IT band syndrome
patient lies in lateral decubitus position with the leg to be tested on top the physician pulls the affected let into abduction and extension, if there is resistance as the physician lowers the leg, it is positive |
|
|
what are kulchitsky cells?
|
small, dark blue cells found in small cell carcinoma
|
|
|
where does cervical dysplasia usually begin?
|
the basal layer of the squamo-columnar junction and extends outward
|
|
|
what is menetrier disease?
|
gastric hypertrophy with protein loss, parietal cell atrophy, and increase in mucous cells
pre cancerous with corkscrew shape glands that look like brain |
|
|
What innervates the tensor tympani?
|
mandibular branch of CNV
|
|
|
what innervates the stapedius?
|
CN7
|
|
|
What is the actinomyces morphology and what is its treatment?
|
Gram+ anaerobe with yellow sulfur granules
treat with penicillin |
|
|
what are the 3 Cs of measles and 1 serious complication?
|
Cough, coryza, and conjunctivitis
subacute panencephalitis = rare but serious complication |
|
|
what is hypospadius due to?
|
failure of the urethral folds to close
|
|
|
what is epispadius due to?
|
faulty positioning of the genital tubercle; extrophy of the bladder
|
|
|
where is bicarb reabsorbed?
|
proximal tubule
|
|
|
where is H+ reabsorbed?
|
collecting duct
|
