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206 Cards in this Set

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Hormone increased or decreased in Cushing's Syndrome?
Increased cortisol
Hormone increased or decreased in Conn's Syndrome?
Increased aldosterone
Hormone increased or decreased in Addison's disease?
Primary adrenal insufficiency: decreased cortisol and aldosterone
Hormone increased or decreased in Graves?
Increased T3 and T4
What is the function of MacConkey's agar?
Grow lactose fermenters (lactose and neutral red) while inhibiting gram negatives (crystal violent and bile salts)
What 5 classes of medications are used to treat glaucoma?
1. Anticholinesterase Inhibitors
2. Cholinomimetics
3. Prostaglandin analogs
4. Alpha blockers
5. Acetazolamide (mannitol in emergency)
Pt has angiofibroma, ash-leaf spots of skin depigmentation, history of seizures, and mental retardation.

Condition?
Increased risk of which neoplams?
A.D. Tuberous sclerosis
Cardiac Rhabdomyome, astrocytoma, angiomyolipoma
What is the cause and how do you diagnose achalasia?
Autoimmune destruction of Aurbach's plexus at the LES -> decreased NO release.
Dx with barium swallow of "birds beak"
What are the leading causes of death in 15-24 yo?
1. Injury
2. Homocide
3. Suicide
4. Cancer
What are the leading causes of death in 25-64 yo?
1. Cancer
2. Heart
3. Injuries
4. Suicide
5. Stroke
Glomerular disease with anti-GBM antibodies on immunoflourescence?
Goodpasture's
Glomerular disease with Kimmelstiel-Wilson lesions on light microscopy?
Diabetic glomerulonephritis
Glomerular disease with "spike and dome" appearance on light microscopy?
Membranous glomerulonephritis
Glomerular disease with "tram track" of subendothelial humbs on electron microscopy?
Membranoproliferative glomerulonephritis
Glomerular disease with subepithelial humps on electron microscopy?
Acute post-strep glomerulonephritis
What are the clinical uses for metronidazole?
Giardia
Entaomeoba
Trichomonas
Gardenerella vaginalis
Anaerobes
Pylori (H.)
What are the two MC complications post-MI?
1. Arrhythmias (esp. V-fib)
2. LV failure
3. Dressler's syndrome
What is Dressler's syndrome?
Constrictive autoimmune fibrinous pericarditis (weeks post-MI)
What is the cause of Chronic Granulomatous disease, and consequences?
Lack of NADPH oxidase.
Defective killing post-phagocytosis = opportunistic infections.
What is the WAGR complex?
Wilm's tumor
Aniridia
Genitourinary malformation
Retardation (mental/motor)
Class of: norepinephrine?
Sympathomimetic
(a1>a2>b1)
Class of: metoprolol?
B1 blocker
Class of: timolol?
Nonselective B blocker
Class of: scopolamine?
Cholinergic antagonist
Class of: phenoxybenzamine?
Alpha blocker
Class of: bethanechol?
Cholinergic agonist
Class of: isoproterenol?
B agonist
(b1=b2)
Class of: donezepil?
Antiacetylcholinesterase
Class of: prazocin?
Alpha blockers
Class of: atropine?
Cholinergic antagonist
Class of: propranolol?
B1 blocker
Class of: labetalol?
B1 blocker
Class of: hexamethonium?
Nicotinic antagonist
Class of: atenolol?
B1 blocker
Class of: terbutaline?
Beta agonist
(b2>b1)
Class of: dopamine?
D agonist
(D1=D2 >b1>a1)
Class of: pilocarpine?
Cholinergic agonist
Class of: carbachol?
Cholinergic agonist
Class of: edrophonium?
Acetylcholinestase Inhibitor
Faslodex
Fulvestran

Treatment of hormone receptor positive metastatic breast cancer in postmenopausal women with disease progression following antiestrogen therapy
Class of glycopyrrolate?
Cholinergic antagonist
Class of phentolamine?
Alpha blocker
Class of neostigmine?
Cholinesterase Inhibitor
Class of benztopine?
Cholinergic antagonist
Class of terazocin?
Alpha blocker
Class of pralidoxime?
Cholinesterase regenerator
Class of echothiophate?
Cholinesterase Inhibitor
Class of ipratropium?
Cholinergic antagonist
Class of epinephrine?
Sympathomimetic
(a1, a2, b1, b2)
Class of esmolol?
B1 blocker
Class of oxybutin?
Cholinergic antagonist
Equation of volume of distribution?
Vd =
(amount of drug in body)/ [plasma conc]
Equation for clearance?
CL= (0.7)(Vd) / halflife
Equation for loading dose?
LD = Css x Vd
Equation for maintenance dose?
MD = Css x CL
What agents stimulate release of NE from the presynaptic bouton?
Acetylcholine
Tyramine
Ephedrine
Amphetamines
What agents inhibit the reuptake of NE from the synaptic cleft?
Cocaine
TCAs
Amphetamines
Gout + mental retardation + lip biting?
Lesch-Nyhan
(HGPRT deficiency)
Hypertension + hypokalemia + metabolic alkalosis?
Conn's Primary Hyperaldoseronism
Fever + night sweats + weight loss?
B symptoms (lymphoma)
Adrenal hemorrhage due to meningococcemia?
Waterhouse-Friedrichson
Blue sclera?
Ostoegenesis imperfecta
(type I collagen)
Symptoms of Huntington's disease?
Crazy, chorea, CAG repeats, caudate degeneration, chromosome 'cuatro', age of presentation ~ 'cuarenta'
What nerve is damaged with scapular winging?
Long thoracic nerve
What nerve is damaged with loss of forearm pronation?
Median nerve
What nerve is damaged with loss of finger ab- and ad-duction?
Ulnar nerve
What nerve is damaged with weak lateral rotation of arm?
Suprascapular nerve
What nerve is damaged if pt is unable to abduct arm beyond 10 degrees?
Axillary nerve
HY
Opacities seen on x-ray on both sides of the carina?
Hilar adenopathy = sarcoidosis
HY
Dermatitis + diarrhea + dementia (and possible death) ?
Pellagra = B3 niacin deficiency
HY
Green rings around periphery of iris?
Keyser-Fleischer rings = Wilson's disease
HY
Hyperphagia + hypersexuality + hyperorality + hyperdocility?
Kluver-Bucy Syndrome
(bilateral amygdala lesion)
HY
Nystagmus, intention tremor, scanning speech?
Charcot's triad for multiple sclerosis
HY
Lower extremity purpura, arthralgia, renal disease?
Henoch-Schonlein Purpura
HY
Antimitochondrial antibodies?
Primary biliary sclerosis
HY
Antiplatelet antibodies?
ITP
HY
Newborn with chronic diarrhea, failure to thrive, and chronic candida?
SCID
(adenosine deaminase deficiency)
HY
Child with eczema, course facies, and cold abscesses?
Job's Hyper-IgE Syndrome
HY
Child with partial albinism, peripheral neuropathy, and recurrent infections?
Chediak-Higashi
What are the drugs used to treat pheochromocytoma?
Alpha blockers -
phentolamine (reversible)
phenoxybenzamine (irreversible)
What is the clinical use for ipratropium?
COPD (also asthma)
What is the clinical use for atropine, homatropine, and tropicamide?
Acetylcholinesterase overdose, mydriasis
(decrease airway/gut secretions, decrease motility, decrease urgency in cystitis)
What is the clinical use for benztopine?
Parkinson's
What is the clinical use for scopolamine?
Motion sickness
End of life care
In which order of elimination would you see a linear decrease in plasma concentration plotted against time?
Zero order elimination
What are the two obligate intracellular bacteria, and main facultative one?
Obligate- Chlamydia, Rickettsia
Facultative- Legionella
Which are the spore forming bacteria?
Bacillus
Clostridium
Coxciella
What are the 5 MC encapsulated bacteria?
H. influenza
K. pneumonia
S. pneumonia
N. meningitidis
Salmonella (these have + Quellung)
DOC for anaphylactic shock?
Epinephrine
DOC for cardiogenic shock?
Dobutamine
DOC for septic shock?
norepinephrine
What is the time frame and type of hypersensitivity reaction in hyperacute rejection?
Type II (preformed ab)
Minutes
What is the time frame and type of hypersensitivity reaction in acute rejection?
Type IV
Weeks
What is the time frame and type of hypersensitivity reaction in chronic rejection?
T-cell and ab-mediated obliterative vascular fibrosis
Months-Years
Which antibiotics are used for narrow spectrum anaerobic coverage?
Metronidazole
Clindamycin
What is injured in Erb-Duchenne palsy, and what are the symptoms?
Upper limb of brachial plexus (C5-C6)
Limb hands medially rotated, forarm pronated
What adrenergic receptor dominates and what is the effect in vascular smooth muscle?
a1
vasoconstrition -> raise BP
What adrenergic receptor dominates and what is the effect in renal vasculature?
D1
renal vasodilation
What adrenergic receptor dominates and what is the effect in the heart?
B1
increased HR and contractility
What adrenergic receptor dominates and what is the effect in pulmonary bronchioles?
B2
bronchodilation
What adrenergic receptor dominates and what is the effect in presynaptic neurons?
a2
decreases sympathetic outflow
What adrenergic receptor dominates and what is the effect in pupillary sphincter?
a1
mydriasis
What adrenergic receptor dominates and what is the effect in kidney JG cells?
b1
increases renin release
What adrenergic receptor dominates and what is the effect in beta cells of the pancreas?
b1
decreases insulin release
What adrenergic receptor dominates and what is the effect in alpha cells of the pancreas?
a2- increases glucagon release
What adrenergic receptor dominates and what is the effect in the liver?
b1- increases lypolysis
HY
Elastic skin, joint hypermobility?
Ehlers-Danlos (collagen type III)
HY
Enlarged hard left supraclavicular node?
Virchow's node (MCC abdominal metastases)
HY
Large "bull's eye" rash?
Erythema chronica migricans (Lyme dz via Ixodes tick -> Borrelia burdorferi)
HY
Strawberry tongue?
Scarlett Fever
(Kawasaki's dz, and TSS too)
HY
Resting tremor, rigidity?
Parkinsons
HY
Rash on palms and soles?
Secondary syphillis
Coxsackie (foot and mouth dz)
Rocky Mt Spotted Fever
What cytokines are secreted by Th1 cells?
IFN-gamma
IL-2
What cytokines are secreted by Th2 cells?
IL-4, IL-5, IL-6, IL-10
What are the down stream effects of the Gq protein cascase?
PLC --> PIP2 --> (IP3 --> Ca2+) and (DAG --> PKC)
What are the down stream effects of the Gs protein cascase?
Adenylate cyclase --> increased cAMP
What are the down stream effects of the Gi protein cascase?
Inhibits adenylate cyclase --> decreased cAMP
What class is imipramine?
TCA
What class is amitryptiline?
TCA
What class is desipramine?
TCA
What class is nortriptiline?
TCA
What class is clomipramine?
TCA
What class is doxepin?
TCA
What class is amozapine?
TCA
What class is fluoxetine?
SSRI
What class is paroxetine?
SSRI
What class is sertraline?
SSRI
What class is sertraline?
SSRI
What class is citalopram?
SSRI
What class is fluvoxamine?
SSRI
What class is venlafaxine?
SNRI
What class is duloxetine?
SNRI
What class is desvenlafaxine?
SNRI
What class is sibutramine?
SNRI
What class is milnacipram?
SNRI
What class is nefazodone?
SNRI
What class is phenelzine?
MAOI
What class is trancypromine?
MAOI
What class is isocarboxazid?
MAOI
What class is selegiline?
MAOI
What class is bupropion?
Atypical - increases NE and dopamine
What class is mirtazapine?
a2 antagonist
What class is maprotiline?
NRI
What class is trazodone?
SRI
Which drugs are tetracyclic?
mirtazapine and trazodone
How does the drug dose response curve change with addition of a competitive agonist?
Shifts right = decreased potency
How does the drug dose response curve change with addition of a noncompetitive agonist?
Shifts down = decreased efficacy
HY
"worst headache of my life" ?
Subarachnoid hematoma
HY
Waxy casts in urine?
Chronic renal failure
HY
Neuropathy + AV node block?
Secondary Lyme dz
HY
Port-wine stain in ophthalmic division of trigeminal nerve?
Sturge-Weber
HY
Urethritis, conjuctivitis, arthritis?
Reiter's syndrome (asc'd with HLA B27)
HY
Lack of GpIIb/IIIa --> defect in platelets --> prolonged bleeding time?
Glanzmen's thromasthenia
HY
Painless jaundice?
Cancer in head of pancreas
What nerve is at risk in a injury/fracture of the shaft of the humerus?
Radial nerve
What nerve is at risk in a injury/fracture of the sugical neck of the humerus?
Axillary nerve
What nerve is at risk in a injury/fracture of the supracondyle of the humerus?
Median nerve
What nerve is at risk in a injury/fracture of the medial epicondyle of the humerus?
Radial nerve
What nerve is at risk in an anterior shoulder dislocation?
Axillary nerve
What nerve is at risk in a injury/fracture of the carpal tunnel?
Median nerve
What are the 4 phagocytic immunodeficiencies?
Leukocyte Adhesion Def type I
Chediak-Higashi
Chronic Granulomatous Dz
Job's Hyper-IgE
What are the 3 x-linked immunodeficiencies?
SCID
Wiskott-Aldrich
Bruton's agammaglobulinemia
(sometimes- CGD and Job's)
HY Personality disorder?
Excessive need to be taken care of, submissive, clinging behavior
Dependent
HY Personality disorder?
Low self-confidence, fears of separation and losing support
Avoidant
HY Personality disorder?
Grandiosity, feels entitled, lack of empathy
Narcissistic
HY Personality disorder?
Suicide attempts (15% mortality), unstable mood and behavior
Borderline
HY Personality disorder?
Sense of emptiness and loneliness, impulsiveness
Borderline
HY Personality disorder?
Odd appearance, thoughts, and behavior, social akwardness (no psychosis)
Schitzotypal
HY Personality disorder?
Controlling, perfectionistic, orderly, stubborn, indecisive
Obsessive-compulsive
HY Personality disorder?
Criminality, unable to conform to social norms, disregard for others rights
Anti-social
What is the mode?
The most frequently occuring result/number
What is the median?
The result in the absolute center of all the results (after place ascending or descenting order)
What is mean?
All results added, and divided by n
How does positive skew look on a graph?
Asymmetry with tail on right
How does negative skew look on a graph?
Asymmetry with tail on the left
What cells have CD14?
Macrophages
What cells have CD16?
Macrophages and NK cells
What cells have CD3?
T cells
What cells have CD8?
Cytotoxic T cells
What are some main features of Rett disorder?
Girl, mid-line hand wringing, small head circumference
What are some main features of Asberger syndrome?
Can function, fascination with ordinary objects, can communicate
What are some main features of autism?
Low IQ, poor communication abilities
What heart defect is asc'd with chromosome 22q11 deletions?
Truncus arteriosus
Tetrology of Fallot
What heart defect is asc'd with Down syndrome?
Cardiac cushion defects
What heart defect is asc'd with congenital rubella?
PDA
Pulmonary artery stenosis
What heart defect is asc'd with Turner's syndrome?
Coarctation of the aorta
What heart defect is asc'd with Marfan's syndrome?
Aortic insufficiency
What innervates taste in the anterior 2/3?
CN VII Facial
What innervates taste in the posterior 1/3?
CN X Vagus
What innervates tongue motor control?
CN XII Hypoglossal
What innervates anterior 2/3 of tongue sensation?
CN V2 Maxillary branch of Trigeminal
What innervates posterior 1/3 of sensation?
CN IX Glossopharyngeal
HY
Bamboo spine on x-ray?
Ankylosing spondylitis
HY
Anti-histone antibodies?
Drug-induces SLE
HY
Webbed neck, short stature?
Turner's syndrome
HY
Painful, raised lesions on palms and fever?
Infective endocarditis
HY
Dry eyes, dry mouth, arthritis?
Sjongren's syndrome
What percent of the sample will fall within 1, 2, or 3 standard deviations?
1 = 68%
2 = 95%
3 = 99%
What conditions are asc'd with an elevated ESR?
Infections, inflammation, cancer, pregnancy, SLE
What conditions are asc'd with a decreased ESR?
Sickle cell, polycythemia, CHF
What are the toxic side effects of TCAs?
Convulsions, coma, cardiotoxic, antiCholinergic
(hyperpyrexia, and respiratory depression)
What anti-seizure drugs are also used to treat bipolar disorder?
Carbamazepine
Valproate
Lamotrigine
What are the clinical uses of tetracylines?
VACUM THe BedRoom
Vibrio cholera, Acne, Chlamydia, Urea uralytica, Mycoplasma pneumonia, Tularemia, H pylor, Borrelia burgdorferi, Rickettsia
What are the clinical uses of macrolides?
PUS
Pneumonia, atypicals
URIs
STDs
What are the clinical uses of 2nd gen. cephalosporins?
HEN PEKS
H influenza, Enterobacter, Neisseria, Proteus mirabilis, E coli, Klebsiella pneumonia, Serratia marcescens
What brain structure is responsible for extraocular movements during REM sleep?
PPRF