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374 Cards in this Set
- Front
- Back
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Neural crest |
Melanocytes, aorticopulmonary septim, ganglia(autonomic, dorsal root, enteric), iris stroma, chromaffin cells, cranial nerves, odontoblasts/ossicles, parafollicular(C) cells, sclerae |
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Neural tube |
CNS(neurons, oligodendrocytes, astrocytes, ependymal cells), pineal gland, posterior pituitary, retina |
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Teratogenic drugs |
ACEI/ARB(renal failure, oligohydramnios), aminoglycosides (ototoxicity), fluoroquinolones (cartilage damage), carbamazepine/valproic acid(neural tube defects), Lithium (Ebstein anomaly), statins, warfarin |
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Holoprosencephaly |
Fetal alcohol syndrome, sonic hedgehog gene mutations, patau syndrome |
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Embryonic genes |
HOX: skeletal layout, SHH: cranial-caudal axis, Wnt-7: Dorsal-ventral axis |
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Most common cause of neural tube defects |
Folate deficiency |
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Most common preventable cause of congenital malformations in the U.S |
Alcohol use in pregnancy |
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Nuclear localization signals |
4-8 amino acids, rich in proline, arginine, lysine(positive changed) |
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CDK and cyclin to enter S phase |
CDK4/ cyclin D; CDK2/ cyclin E |
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Golgi apparatus |
Add mannose-6- phosphate to lysosomal enzyme, defective-> I-cell disease |
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Proteolysis |
Proteasomal degradation, lysosomal degradation, Ca-dependent enzymes |
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Peroxisome |
Beta-oxidation (long-chain and branched FAs), synthesis of plasmalogen (in myelin), metabolizing ethanol |
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Cytokeratin |
Epithelial cells(desmo-hemidesmosomes), found in carcinoma |
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Desmin |
Muscle cells, found in rhabdomyosarcoma, leiomyosarcoma |
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Glial fibrillary acid proteins(GFAP) |
Astrocytes, Schwann cells, other neuroglias; found in Glioblastoma |
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Neurofilaments |
Axons within neurons; found in neuroblastoma |
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Nuclear lamins |
Nuclear envelope |
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Vimentin |
Connective tissue (support cellular membranes, fixed organelles), fibroblasts, leukocytes, endothelium; found in sarcomas |
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Drugs acting on microtubules |
Inhibits growing (vincristine, vinblastine); inhibits breakdown (paclitaxel, docetaxal); Benzimidazoles (Menbendazole,albendazole,thiabendazole); Griseofulvin; colchicine |
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Transport protein |
Dynein(-, alpha-tubulin); kinesin(+, beta-tubulin) |
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Cilia |
Respiratory tract (trachea, bronchioles), paranasal sinuses, fallopian tubes |
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Primary ciliary dyskinesia |
Immotile cilia due to dynein arm defect, infertility, bronchiectasis, chronic sinusitis, situs inversus(50%) |
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Kartagener syndrome |
Bronchiectasis, chronic sinusitis, situs inversus, infertility |
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Enzyme terminology |
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Digixin mechanism |
Block Na-K ATPase pump |
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LDL receptor defect |
Abnormal clathrin coated pit binding site |
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Arachidonic acid products |
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Nuclear damage |
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Apoptosis pathways |
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Coagulative necrosis |
Heart, liver, kidney; low oxygen content |
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Caseous necrosis |
TB, systemic fungal infections |
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Gangrenous necrosis |
Wet: bacterial infections, extremities; dry: ischemia, toes and feet |
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Markers for tissue injury |
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Red infarct |
Liver, lungs, intestine; reperfusion |
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Pale(white) infarcts |
Heart, kidney, spleen |
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Free radical degradation |
Catalase(H2O2-> O2 and H2O); superoxide dismutase(O2->H2O2); Glutathione peroxidase |
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Acute inflammation |
Inflammatory mediators (IL-1, IL-6, TNF-alpha); vascular permeability (histamine, serotonin, bradykinin); fibrosis(collagen, reqiures Vit.C); remodeling by metalloproteinases (zinc) |
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Neutrophilic chemotactic factors |
C5a, IL-8, LTB4, Kallikrein |
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Leukocyte adhesion deficiency |
Abnormal LFA-1(integrin), delayed separation of umbilicus, recurrent bacterial infections |
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Neutrophil extravasation |
Rolling(selectins), tight binding (integrins), diapedesis(PECAM-1), migration (C5a, IL-8, LTB4, Kallikrein) |
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Fibrinogen, CRP producton |
Hepatocytes |
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Type1 collagen (strong) |
Bone, skin, dentin, scar tissue |
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Type 2 collagen (slippery) |
Cartilage, vitreous body, nucleus pulposus |
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Type 3 collagen(stretchy) |
Granulation tissue, blood vessels, skin, uterus, fetal tissue, reticular fibers |
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Type 4 collagen |
Basement membrane |
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Osteogenesis imperfecta |
Type1: AD, normal but deficient type1 collagen, blue sclerae, multiple fractures, hearing loss, dental abnormalities; type2: AR, perinatal lethal |
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Ehlers-Danlos syndrome |
Classical: affects type5 collagen-> type1, hyperextensible skin, joint hypermobility; Vascular: type3, aterial rupture, hemorrhage, easy bruising, intracranial aneurysms |
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Alport syndrome |
Type 4 collagen defects; nephritis and kidney failure, hearing loss, eye problems(cataracts, lenticonus) |
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Marfan syndrome |
Defects in fibrillin-> affects elastin, hyperelastic joints, heart(valves, aorta), very tall, long arms and legs, arachnodactyly, pectus carinatum |
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Alpha1- antitrypsin deficiency |
Increased elastase activity, destruction of elastin in alveoli, panacinar emphysema, hepatitis, cirrhosis, HCC |
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Wound healing |
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Vit.C in collagen synthesis |
Hydroxylation of lysine and proline |
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Causes of atrophy |
Disuse, decreased hormonal signal, loss of innervation, inadequate supply of oxygen/nutrients, increased pressure |
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Rapid-fire facts! |
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Amino acids modified in the Golgi apparatus |
Serine, threonine, asparagine |
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Marker for astrocytes |
Glial fibrillary acidic protein(GFAP) |
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Glial cell notes |
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Substance that can cross BBB |
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Drug most commonly used to reduce intracranial pressure |
Mannitol |
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Dopamine |
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Dopamine pathways-1 |
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Dopamine pathways-2 |
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Norepinephrine |
Decreased: depression, increased: anxiety, mania |
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Sorotonin |
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Acetylcholine |
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GABA |
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Main inhibitory neurotransmitter of the spinal cord |
Glycine |
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Main excitatory neurotransmitter of the CNS |
Glutamate |
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RAS |
Lesion leads to coma |
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Brain development |
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Alpha fetal protein |
Increased: neural tube defect, anterior abdominal wall defect; decreased: Down syndrome |
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Chiari malformations |
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Dandy-walker syndrome |
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Pharyngeal clefts |
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Thyroglossal duct cyst Vs. pharyngeal cleft cyst |
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Pharyngeal pouch-1 |
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Pharyngeal pouch-2 |
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DiGeorge syndrome |
Thymic aplasia-> T-cell deficiency |
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Pharyngeal arch-1 |
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Pharyngeal arch-2 |
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Frontal cortex lesion |
Disinhibition, poor judgement, primitive reflex |
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Carotid sheath |
Carotid artery, jugular vein, vagus nerve |
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Circle of Wills |
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Conduction aphasia |
Poor repetition, arcuate fasciculus lesion |
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Dysprosody |
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Parietal cortex lesions |
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Risks for aneurysms |
ADPKD, Ehlers-Danlos syndrome, HTN, smoking, advanced age, Race(black) |
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Most common cause of SAH |
Trauma; non-traumatic: aneurysm, AVM |
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EDH |
MMA; Compression, then herniation of the brain; CN3 palsy (down and out); "lucid interval" |
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SDH |
Bridging veins; elderly, alcoholics, trauma(whiplash, shaken baby) |
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ICH(parenchymal hemorrhage) |
HTN, vascular malformations, vasculitis, amyloid angiopathy, tumors, anticoagulant |
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Intraventricular hemorrhage |
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Ischemic stroke causes |
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Thrombolytics |
tPA, streptokinase, Urokinase |
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Contraindications to thrombolytics |
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Areas of the brain most susceptible to ischemia |
Cerebellum, neocortex, hippocampus, watershed areas |
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Rpaid-fire |
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Anterior hypothalamus |
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Tuberal hypothalamus |
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Posterior hypothalamus |
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Lesions to amygdala |
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Mammillary body lesions |
Due to thiamine deficiency |
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Cranial nerves |
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CN1(olfactory) |
Exits at cribriform plate |
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Eye movements |
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Pupillary light reflex |
CN2: afferent; CN3: efferent |
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Trigeminal nerve |
Ophthalmic (sensory, superior orbital fissure); maxillary (sensory, foramen rotundum); mandibular (sensory and motor, foramen ovale) |
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Corneal reflex |
Ophthalmic branch of CN5; temporal branch of CN7 |
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Jaw muscles(V-3) |
Closing: temporalis, medial pterygoid, masseter; open: lateral pterygoid |
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Cavernous sinus |
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CN7(facial) |
Exits at internal acoustic meatus; temporal, zygomatic, buccal, marginal mandibular, cervical; |
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Causes for facial palsy |
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Facial nerve Vs. cortex lesions |
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CN9(glossopharyngeal) |
Exits at jugular foramen(with CN10&11) |
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Vagus lesions |
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CN12(hypoglossal) lesion |
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Gag reflex |
Tests CN9&10 |
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Cavernous sinus infections |
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Dorsal column-medial lemniscus pathway |
Fine touch, vibration, proprioception; decussates in medulla-> medial lemniscus |
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Spinothalamic tract |
Pain and temperature; ascend 1-2 levels(lissauer's tract), decussates in the anterior white commissure-> thalamus |
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Corticospinal tract |
Motor, decussates in the caudal medulla->medullary pyramids |
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Rostral midbrain |
Superior colliculus lesion-> paralysis of upward gaze |
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Caudal midbrain |
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Pons blood supply |
Medial(basilar artery: median and paramedian branch); lateral(AICA) |
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Medulla blood supply |
Medial: anterior spinal artery; lateral: PICA |
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Vagal nuclei |
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Horner syndrome |
Ptosis, miosis, anhydrosis |
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Spinal cord anatomy |
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Romberg test |
Test of dorsal column functions, proprioception in the legs, not the cerebellum |
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Parietal lobe lesions |
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Brain stem lesion |
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The rule of fours |
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Medial/median brain stem lesions |
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Lateral brain stem lesions |
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Wallenberg syndrome (lateral medullary syndrome) |
No motor weakness |
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Intranuclear ophthalmoplegia |
Lesions medial longitudinal fasciculus, lesion eye cannot adduct, normal side abduct with nystagmus; common cause: multiple sclerosis, medial pontine stroke |
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Locked-in syndrome |
Basilar artery stroke that affects bil. Pons, or central pontine myelinolysis |
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Weber syndrome |
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CSF flow |
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Normal pressure hydrocephalus |
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Hydrocephalus |
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Idiopathic intracranial hypertension(pseudotumor cerebri) |
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Idiopathic intracranial hypertension Tx |
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Lumbar puncture path |
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Tension headache |
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Migraine |
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Cluster headache |
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Tension headache and migraine Tx |
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Contraindications of triptans |
CAD, prinzmetal angina, pregnancy |
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Tx for cluster headaches |
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Headache-1 |
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Headache-2 |
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Headache-3 |
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Adult brain tumors |
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Pediatric brain tumors |
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Herniation syndrome |
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Schwannoma |
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Hamangioblastoma |
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Pilocytic astrocytoma |
Corkscrew-like Rosenthal fibers |
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Medulloblastoma & Ependymoma |
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Medulloblastoma & Ependymoma-2 |
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Neuronal pigmentation/inclusions |
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Alzheimer's disease |
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Alzheimer's drugs |
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Dementia with Lewy bodies |
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Frontotemporal dementia |
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Creutzfeldt-Jakob disease |
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Other causes of dementia |
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Dementia workup |
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Causes of delirium |
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Delirium |
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Delirium Vs. dementia |
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Rapid-fire |
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Parietal lobe lesions |
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Ach receptors |
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Parasympathetic activation & cholinergic excess |
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Organophosphate poisoning |
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Myasthenia gravis |
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Ach easterase inhibitors Tx for Alzheimer's |
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Direct cholinergics |
Bethanechol(postop ileus, urinary retention); Carbachol (glaucoma); Pilocarpine(stimulates sweat, tears, saliva); Methacholine (asthma challenge test) |
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Indirect cholinergics(AchE inhibitors) |
Neostigmine (postop&neurogenic ileus); urinary retention, MG, neuromuscular blocking agent); Pyridostigmine(long time MG), Edrophonium(MG:diagnosis); Physostigmine (anticholinergic & atropine toxicity) |
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Rapid-fire |
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Parasympathetic inhibition |
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Contraindications for anticholinergics |
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Meds with anticholinergic effects |
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Meds for urinary incontinence |
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Muscarinic antagonists |
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Tongue innervation |
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Alpha-1 receptors |
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Alphal-2 receptors |
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Beta-1 receptors |
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Beta-2 receptors |
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Receptor distribution |
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Epinephrine |
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Norepinephrine |
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Dopamine |
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Isoproterenol |
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Dobutamine |
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Phenylephrine |
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Albuterol, levalbuterol, salmeterol |
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Terbutaline |
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Clonidine |
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Amphetamine |
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Ephedrine |
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Cocaine |
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Alpha-1 blockers |
Prazosin, Doxazosin, Terazosin; decreased BP, treat BPH, side effects: postural hypotension, reflex tachycardia |
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Tamsulosin |
Alpha-1A,D blocker, treat BPH, less effect on BP |
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Nonselective alpha blockers |
Phenoxybezamine(pheochromocytoma), phentolamine |
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Nonselective beta blockers |
Propranolol, Timolol, Nadolol |
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Beta-1 blockers |
Metoprplol, Atenolol, Esmolol |
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Weak beta-1&2 agonists |
Acebutolol, Pindolol; act as blockers, used in patients with HTN and bradycardia |
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Nebivolol |
Beta-1 blocker, also caused NO- derived vasodilation |
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Aplha-1/beta-1 blockers |
Carvedilol, Labetalol |
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Use of beta blockers |
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Adverse effects of beta blockers |
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Beta blocker notes |
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Alpha-2 agonist |
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Cholinergic nerve |
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Noradrenergic nerve ending |
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Metabolism of NE |
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Metabolism of catecholamines |
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Catecholamine synthesis |
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Treatment for idiopathic intracranial hypertension |
Acetazolamide(pseudotumor cerebri, glaucoma, altitude sickness) |
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Gq protein receptors |
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Gi/Gs protein receptors |
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Main pathway for tyrosine kinase receptor |
Active Ras protein-> protein kinase 1,2,3 |
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G Protein notes |
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Muscarinic receptors |
M1: enteric nevous system, M2: decrease contractility and heart rate, M3: increase bladder contraction and gut peristalsis |
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Dopamine receptor |
D1: relax rebal and vascular smooth muscle; D2: found in the brain |
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Histamine receptors |
H1: Nasal secretion, bronchial mucus production, pruritus, bronchoconstriction; H2: gastric acid secretion |
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Vasopressin receptors |
V1: vascular smooth muscle contraction, V2: ADH receptors |
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Km |
[S] at 1/2 Vmax |
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Km, Vmax relationship |
Km: enzyme's affinity for substrate (low Km-> high affinity) Vmax: affect by number of enzymes |
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Inhibitors |
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Pharmacokinetics |
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Half-life |
94% after 4 half-life |
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Efficacy |
Maximum drug effect , dose independent |
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Potency |
Same effect by different dosage of different drugs, dose dependent |
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Therapeutic index |
LD50/ED50, higher the better |
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Drug with low therapeutic index |
Seizure Drugs, lithium, digoxin, warfarin |
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Phase 1 vs. phase 2 reactions |
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Phase notes |
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P450 inhibitors |
Crack Amigos |
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P450 inducers |
Guiness, coronas, and PBRs induce chronic alcoholism |
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Ethanol metabolism-1 |
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Ethanol metabolism-2 |
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Disulfiram-like reactions |
Metronidazole, certain cephalosporins, procabazine, 1st- generation sulfonylureas |
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Zero order elimination |
Phenytoin, ethanol, aspirin |
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First order elimination |
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Acid/base and drug elimination |
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Drug suffix-1 |
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Drug suffix-2 |
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Drug suffix-3 |
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Drug suffix-4 |
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Drug side effects-1 |
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Drug side effects-2 |
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Drig side effects-3 |
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Drug side effects-4 |
Treat with IV MgSO4 |
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Drug side effects-5 |
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Drug side effects-5 |
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Drug side effects-6 |
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Drug side effects-7 |
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Drug side effects-8 |
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Drug side effects-9 |
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Drug side effects-10 |
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Drug side effects-11 |
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Drug side effects-12 |
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Drug side effects-13 |
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Drug side effects-14 |
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Drug side effects-15 |
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Drug side effects-16 |
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Drug side effects-17 |
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Drug side effects-18 |
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Drug side effects-19 |
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Drug side effects-20 |
Drug-induced lupus |
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Drug side effects-21 |
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Drug side effects-22 |
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Drug side effects-23 |
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Drug side effects-24 |
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Drug side effects-25 |
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Drug side effects-26 |
Quindine, Quinine |
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Drug side effects-27 |
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Drug side effects-28 |
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Drug side effects-29 |
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Drug side effects-30 |
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Drug side effects-31 |
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Antidote-1 |
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Antidote-2 |
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Antidote-3 |
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Antidote-4 |
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Spiral septum defect |
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Heart development |
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Fetal shunting |
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PDA |
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Eisenmenger syndrome |
Cyanosis, shortness of breath, clubbing |
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Coarctation of aorta |
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5 causes of cyanotic disease(right to left shunt) |
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Ebstein anomaly |
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TOF |
Boot-shaped heart |
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Causes of congenital heart anomaly-1 |
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Causes of congenital heart anomaly-2 |
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Causes of congenital heart anomaly-3 |
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Rapid-fire |
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Cardiac output |
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Fick principle |
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MAP |
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Contractility |
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Heart failure |
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Heart failure mechanism |
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Renin production |
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Left-sided heart failure |
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Beta-blockers for heart failure |
Metoprolol, carvedilol, bisoprolol |
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Vasodilators for CHF |
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Digoxin toxicity |
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Tx for digoxin toxicity |
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Tx for acute CHF |
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Capillary hydrostatic pressure |
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Capillary permeability (Kf) |
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Plasma oncotic pressure |
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Interstitial oncotic pressure |
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Tx for shock |
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Cause of hypovolemic shock/cardiogenic shock |
Hypovolemic: blood loss, burn Cardiogenic: AMI, PE, CHF, arrhythmias, cardiac tamponade, Tension pneumothorax, cardiac contusion |
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Femoral vessels |
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Central line locations |
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Pharmacokinetics equations |
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Pressure volume loop |
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Pressure volume loop variations |
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S3 heart sound |
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S4 heart sound |
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Wild splitting of S2 |
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Paradoxical splitting of S2 |
AS, LBBB |
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Jugular venous waves |
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Auscultation BN of the heart |
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Benign heart sounds |
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Breathing murmurs |
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Hand grip |
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Valsalva maneuver |
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AR PE |
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AR causes |
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MS PE |
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MS causes |
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Rapid fire |
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AS |
Pulsus parvus et tardus |
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Causes of AS |
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MR |
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MR-2 |
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Causes of MR |
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TR |
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Causes of TR |
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Murmurs |
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Murmurs-2 |
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Myocytes action potential |
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Pacemaker action potential |
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Pharmacokinetics equations |
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Antiarrhythmic drugs |
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|
|
Na channel blockers |
|
|
|
Procainamide |
|
|
|
Drug-induced lupus |
|
|
|
Quinidine |
|
|
|
Lidocaine |
|
|
|
Flecainide and propafenone |
|
|
|
Beta-blockers |
|
|
|
Beta blockers, clinical uses |
|
|
|
Beta blockers, adverse effects |
|
|
|
K channel blockers |
Toxicity: Torsades de pointes |
|
|
Amiodarone |
|
|
|
Photosensitivity |
|
|
|
Amiodarone-2 |
|
|
|
CCB |
|
|
|
CCB side effects |
|
|
|
Lewis notes |
|
|
|
Adenosine |
|
|
|
Adenosine toxicity |
|
|
|
K and Mg |
|
