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218 Cards in this Set

  • Front
  • Back
Rx for serotonin syndrome
Cryproheptadine
Rx for neuroleptic malignant syndrome
Dantrolene
or agonists, e.g. bromocriptine
Ragged red fibers indicate
Mitochondrial myopathy
Blotchy red muscle fibers on Gomori trichrome stain indicate
Mitochondrial myopathy
Key sign of mitochondrial myopathy
Ragged red muscle fibers!
Treatment for orotic aciduria?
Oral uridine administration (feedback inhiibits CPS 2 --> decreased orotic acid)
Normal CFTR protein ____ Cl from sweat an _____ Cl in lungs and GI tract
Reabsorbs from sweat
Actively secretes in lungs/ GI tract
Three stop codons
UAG
UGA
UAA
Mucicarmine stain
Cryptococcus
(detects polysaccharide capsule)
(also methenamine silver)
Mechanism of Shiga-toxin
Inactivates 60S ribosomal subunit --> inhibition of protein synthesis
Two bacteria that inhibit EF-2
C. diphtheriae
Pseudomonas
Rx Legionnaire's disease
Erythromycin
Two bugs with cold agglutinins
Mycoplasma pneumoniae
EBV
Bronchiolitis obliterans
Chronic rejection with lung transplant is from inflammation/ fibrosis of bronchiolar walls (NOT vascular, as in most chronic rejection)
Respiratory distress, diffuse neurological impairment, and upper body petechial rash within several days of severe long bone fractures?
Fat embolism syndrome
Effect on which murmurs, and why:
inspiration
R-sided murmurs louder
Effect on which murmurs, and why:
expiration
L-sided murmurs louder
Effect on which murmurs, and why:
Valsalva/ standing
Decreased venous return --> must murmurs softer, except HCM and MVP
Effect on which murmurs, and why: squatting/ passive leg raise
Increased TPR --> most murmurs louder, except HCM and MVP
Effect on which murmurs, and why: handgrip
Increased afterload --> MR, VSD, and AR become louder; HCM softer
How do you differentiate CML from a leukemoid reaction?
Leukocyte alkaline phosphatase:
Decreased in CML
Normal/ elevated in leukemoid rxn
Precocious puberty, paralysis of conjugate vertical gaze, and obstructive hydrocephalus
Germinoma in the pineal gland

(Parinaud syndrome is paralysis of conjugate vertical gaze due to lesion in superior colliculi)
Intestinal biopsy in lactase deficiency shows
Normal appearing villi
Foamy enterocytes on intestinal biopsy indicates
Abeta-lipoproteinemia
Meiosis I is arrested in?
PrOphase until Ovulation
Meiosis II is arrested in?
METaphase until fertilization (when egg met a sperm)
somatomedin C is also known as
Insulin-like growth factor 1 (IGF-1)
A lesion to which hypothalamic nucleus --> anorexia?
Lateral
A lesion to which hypothalamic nucleus --> hyperphagia
Ventromedial
Leptin inhibits which hypothalamic nucleus?
Lateral (which causes hunger)
Leptin stimulates which hypothalamic nucleus?
Ventromedial
Which brain tumor commonly destroys the ventromedial hypothalamic area?
Craniopharyngioma
Hemolytic anemia, hypercoagulable state, and decreased blood counts
Paroxysmal nocturnal hemoglobinuria
Deficiency of CD 55 and CD 59 is diagnostic of?
Paroxysmal nocturnal hemoglobinuria
PNH is caused by impaired synthesis of?
GPI anchor, which is necessary for attachment of CD55/CD59, the "decay accelerating factor" that inhibits complement on RBC membrane
Homogenous sheets of cells with translucent cytoplasm on renal biopsy
RCC (clear cell)
Opsoclonus, myoclonus, truncal ataxia
Paraneoplastic syndrome in neuroblastoma
Aniridia, GU malformations, and mental- motor retardation are associated with which childhood tumor?
Wilms' tumor
What can cause hepatic adenoma to regress?
Cessation of OCPs
Characteristics of polymyalgia rheumatica
Neck, torso, shoulder, and pelvic girdle pain + morning stiffness

Fatigue, fever, and weight loss
Alport's Syndrome causes defects in these three organs
Kidneys (progressive nephritis), ears (deafness), eyes
ADPKD is associated with these three complications
Polycystic liver disease
Berry aneurysms
Mitral valve prolapse
Guillain-Barre Syndrome has a ___ inflammatory infiltrate
Endoneural
Bell's Palsy is a complication of these diseases
ALexander graHam BELL w/ STD
AIDS
Lyme disease
Herpes zoster
Sarcoidosis
Tumors
Diabetes
ADPKD is carried by a mutation on chromosome?
16
RFs for esophageal squamous cell cancer
Alcohol
Achalasia
Cigarettes
Diverticula (e.g. Zenker's)
Esophageal web (Plummer-Vinson)
Esophagitis
Iron-deficiency anemia, atrophic glossitis (beefy red tongue), esophageal web
Plummer-Vinson Syndrome
Werdnig-Hoffman disease presents similarly to?
Poliomyelitis (LMN lesions from destruction of anterior horns --> flaccid paralysis)
Inheritance of Werdnig-Hoffman?
AR (death at 7mo)
Hemochromatosis is caused by a mutation on chromosome?
6 (mutant HFE gene can't detect circulating iron levels, so keeps expressing iron uptake proteins --> increased GI absorption)
Degeneration of this part of the brain occurs in Wilson's disease
Basal ganglia (specifically putamen)
When should supplementary O2 be used in COPD?
Very rarely! These pts have adjusted to hypercapnia, so they depend instead on hypoxia for respiratory drive–increasing their oxygen could decrease that drive.
Three diseases on chromosome 7
Ehlers-Danlos
Osteogenesis imperfecta
CF
3 structural changes in the heart with aging
Lipofuscin deposits
Decreased LV cavity size
Sigmoid-shaped ventricular septum blocking LV outflow tract
Chemo agents: ____ is given with doxorubicin to prevent _____
Dexrazoxane (iron chelating agent)
Cardiotoxicity
Chemo agents: ____ is given with cyclophosphamide or ifosfamide to prevent _____
Mesna (has a thiol group that binds toxic metabolite, acrolein)
Hemorrhagic cystitis
Chemo agents: ____ and ____ are given with cisplatin and carboplatin to prevent ____ and _____
Amifustine (thiol-based cytoprotective free-radical scavenger)
Hydration (IV saline --> chloride diuresis --> cispaltin stays in nonreactive state)
Nephrotoxicity and acoustic nerve damage
Serum levels of ceruloplasmin are increased/ decreased in Wilson's?
Decreased
Rx for Wilson's
Penicillamine (chelator)
Rx for hemochromatosis
Deferoxamine (chelator) and phlebotomy
Tension pneumothorax: ____ breath sounds and ____ to percussion
Absent
Hyperresonance
Fever, rash, oliguria, and eosinophilia 1-2 wks after started a new med
Acute interstitial nephritis
2 reasons the kidney is susceptible to emboli?
Receives 3-5x more blood flow
Few collaterals
2 diseases that stain PAS+
Whipple's
alpha-1 antitrypsin deficiency
Lipid drugs that can increase TG levels?
Bile acid resins
If alk phos is elevated, what test should be done next?
GGT (can distinguish etiology: alk phos is increased in both bone and hepatobiliary diseases, but GGT is specific for hepatobiliary disease)
Polyarteritis nodosa is associated with what infection?
HBV
Fever, ab pain, peripheral neuropathy, muscle weakness, weight loss
Polyarteritis nodosa
Vasculitis associated with antibiotic use (often penicillin)
Microscopic polyangiitis
Formation of microabscesses containing fibrin and neutrophils at the dermal papillae tips
Dermatitis herpetiformis (from IgA and IgG Abs cross reacting with reticulin, a BM anchoring fibril protein)
2 vitamins not in adequate amounts in breast milk?
Vita D and K
Mechanism of N-acetylcysteine in CF
Cleaves disulfide bonds within mucous glycoproteins --> loosens mucous plugs
5 drug classes with antimuscarinic effects
Atropine
TCAs
H1 antagonists
Neuroleptics
Antiparkinsonian rugs
Why do bile acid resins and fibrates increase the risk of gallstones?
Increase cholesterol synthesis and excretion
Initial injury in thoracic aortic aneurysms?
Initial injury in AAAs?
Vaso vasorum obliteration
Intimal streak (atherosclerosis)
Fulminant liver disease one week after open cholecystectomy
Halothane toxicity --> fulminant hepatitis
Why does central retinal artery occlusion present with a cherry red spot on the macula?
Macula has separate blood supply (choroid artery), so is not affected by retinal artery occlusion like the rest of the retina
Only lab abnormality of sickle cell trait?
Will sickle when sodiummetabisulfite is added
HFE gene is on the short arm of chromosome
6
Renal papillary necrosis is associated with these four conditions:
DM
Acute pyelonephritis
Chronic phenacetin use (e.g. acetaminophen)
SCD (or trait)
Granular, muddy brown casts
Acute tubular necrosis
3 causes of papilledema
Malignant HTN
Communicating hydrocephalus
Guillain-Barre
Medial calcification
Monckeberg (asymptomatic)
Differential cyanosis
Cyanosis in lower, but not upper, extremities

Indicative of PDA
Potency of inhaled anesthetic =
1/MAC
MAC = minimum alveolar concentration at which 50% of population is anesthetized
Atypical lymphocyte
EBV
Auspitz sign
Psoriasis (bleeding spots when scales are scraped off)
Acanthosis (increased stratum spinosum), parakeratosis, and decreased stratum granulosum
Psoriasis
Intraepidermal vesicles, hyperkeratosis, acanthosis, spongiosus, inflammation
Atopic dermatitis
Nitroprusside toxicity and treatment?
Cyanide toxicity (releases CN)
Rx: sodium thiosulfate (donates sulfur to liver rhodanase to enhance metabolism/ detox of cyanide --> thiocyanate)
Pathogenesis of vitiligo vs. albinism?
Absent melanocytes
Poor melanin formation in melanocytes
Melanosome aggregates within the cytoplasm of melanocytes manifests as
Cafe au lait spots
Councilman body
Apoptotic hepatocyte (acidophilic/ eosinophilic)
Secondary complication risk from subarachnoid hemorrhage?
Vasospasm 2-3 days later
Treatment/ prevention of SAH-associated vasospasm?
CCBs
Argatroban is a?
Direct thrombin inhibitor
Which vasculitis extends into contiguous veins and nerves?
Buerger's disease (thromboangiitis obliterans)
Auer rods stain with?
Peroxidase
What substance mediates malignancy-associated hypercoagulability?
Thromboplastin
Firm and brown spleen in SCD pt
Autosplenectomy (occurs in all pts by 8-10yo); due to vascular occlusion from extensive ingestion of sickled cells by splenic macrophages
Port-wine stain is associated with these 3 other manifestations
Sturge-Weber disease:
Ipsilateral leptomeningeal angiomatosis (intracerebral AVM)
Seizures
Early-onset glaucoma
Hemiballismus is usually due to a ____ near _____
Lacunar stroke
Subthalamic nucleus
Potential complication of CMV retinitis
Retinal detachment
Two foods that don't contain gluten
Oats and rice
Abetalipoproteinemia is an inability to form
Chylomicrons
PE causes what acid/base disturbance?
Hyperventilation --> respiratory alkalosis
Most common cause of aortic aneurysms?
Atherosclerosis
How does HBC cause HCC?
Integrates into host DNA (vs. HCV: injury and inflammation --> genetic instability)
Waxing and waning lymphadenopathy
Follicular lymphoma
Hyperpigmented mouth
Peutz-Jeghers Syndrome (+ hamartomas throughout GI tract and increased risk of colon and other cancers)
- AD
Weight loss drug?
Orlistat
Mechanism of Orlistat?
Intestinal lipase inhibitor
2 causes of renal artery stenosis
Atherosclerosis
Fibromuscular dysplasia (females)
Bromocriptine: mechanism and 2 uses
Dopamine agonist
PD and hyperPRL
How to prevent cyclosporine nephrotoxicity?
Mannitol diuresis
Complication of alkaptonuria?
Debilitating arthralgias
Transmembrane proteins are composed of?
Hydrophobic (nonpolar) aas
Cellular ischemia promotes influx of _____ and efflux of _____?
Na, Cl, H2O, and Ca
K+ and H+
Hallmark of ischemic injury?
Cytoplasmic Ca accumulation
Inferior mesenteric vein drains to the
Poral vein
GPCRs work via ____ hydrolysis
GTP
E6 ____, E7 _____
shuts off p53
shuts off Rb
3-hydroxybutyrate, acetone, and acetoacetate are
Ketone bodies
____ soluble materials cross the placenta, while _____ don't
Lipid
Water
Complication of mumps?
Sexual dysfunction
Genetic shift causes
Pandemics
Genetic drift causes
Epidemics
Antigenic drift is another way of describing
Random mutation
Genetic shift occurs due to
Genetic reassortment
No genetic exchange occurs with
Phenotypic mixing (just get surface proteins)
Thrombotic complication of mucormycosis?
Cavernous sinus
Sign of cavernous sinus thrombosis?
CN VI palsy (lateral gaze palsy)
Systemic Rx for psoriasis?
Retinoids
Galactosyl beta-1,4-glucose is also known as?
Lactose
Decreased intestinal lactose activity with age due to?
Decreased gene expression
Hyperorality, hyperphagia, hypersexuality, disinhibition
Kluver-Bucy Syndrome
Kluver-Bucy syndrome is due to lesion where?
Bilateral amygdala
Contraction alkalosis mechanism?
Volume loss --> increased aldosterone --> decreased H+ and K+
Lumbar kyphosis: contracture of?
Anterior abdominal muscles
Lumbar lordosis: contracture of?
Hip flexors (weakness of hip extensors)
Antipsychotics are dopamine ____
Antagonists
2 lung volumes that increase in COPD?
RV > TLC
What are incretins (and one example)
GI hormones secreted by gut mucosa that stimulate insulin secretion in response to a sugary meal
GLP-1
Carbonic anhydrase actiivty in bone
Bone remodeling (osteoclast activity)
Negri bodies are _____ in the _____, pathognomonic for _____
Eosinophilic cytoplasmic inclusions
Hippocampal neurons
Rabies virus
Pharnygeal muscle spasms
Rabies
Path of rabies
Wound --> neuron axons --> salivary glands
Xanthogranulomatous pyelonephritis
Infectious renal phlegmon
GBS can be caught from
Mother's vagina
Kartagener's is a ____ defect
Dynein
Dynein moves ____
Retrograde
Kinesin moves ____
Anterograde
Achalasia has ___ pressure at the LES
High
Flask-shaped ulcer after submucosal abscess of colon ruptures
Entamoeba histolytica
Bloddy diarrhea or red-brown liver abscess
Entamoeba histolytica (amoebiasis)
Transmission of entamoeba histolytica
Cysts in water
Diagnosis of entamoeba histolytica
Serology or trophozoites or cysts in stool; RBCs in cytoplasm of entamoeba
Rx of amebiasis
Metronidazole and iodoquinol
Rx for Crigler-Najjar
Phenobarbital (increases liver enzyme synthesis), but only for Type II (less severe)
Defect in Crigler-Najjar
Absent UDP-glucuronyl transferase
What is kernicterus
Bilirubin deposition in brain
Two causes of elevated unconjugated bilirubin in newborns
Gilbert's (mildly decreased UDP-glucoronyl transferase or decreased bilirubin uptake)
Crigler-Najjaar
Toxicity of amphotericin
Nephrotoxicity --> decreased GFR, dose dependent
Which also causes electrolyte abnormalities (hypokalemia and hypomagnesemia)
Fever/ chills (infusion related)
Arrhythmias (precipitated by hypokalemia)
IV phlebitis
Anemia (from decreased EPO)
Preventive strategies for pts on amphotericin
Hydration (to reduce nephrotoxicity)
Supplement K and Mg
Form of amphotericin that reduces toxicity
Liposomal
Drug that inhibits rental tubular secretion of penicillins/ cephalosporins?
Probenecid
What acts as a mineralocorticoid in the hypertensive CAHs?
11-deoxycorticosterone
Cough-induced syncope: typical pt and mechanism
Overweight male with COPD
Decreased venous return
Mictruition syncope (when rising from bed to urine): mechanism
Orthostatic hypotension from peripheral pooling
Syncope from stimulation of _____ sinus?
Carotid (increases vagal tone --> bradycardia)
Ataxia telangiectasia is a defect in ___ gene that is important in ____
ATM gene
DNA repair
Photosensitivity, short stature, erythema, telangiectasias (+ lymphoproliferative and GI malignancies
Bloom syndrome (defective DNA helicase)
Palmar erythema is a manifestation of
Hyperestrogenemia
NEurofibromas contain ____ cells
Schwann (+ fibroblasts)
NF-1 chromosome?
17
Fexofenadine: class
2nd generation H1 antagonist (+ (des) loratidine, cetirizine
In ulcerative colitis, ______ (immune cell type) accumulate in the _____
Neutrophils
Crypt lumina (crypt abscess)
Ovarian atresia occurs via
Apoptosis
Demeclocycline is used to treat?
SIADH
Mechanism of paclitaxel in coronary artery stents?
Inhibits intimal hyperplasia (Sirolimus also used)
Only 2 RNA viruses that replicate in the nucleus?
Retroviruses and influenza
Somatization disorders requires 4 ____ symptoms, 2 ___ symptoms, and 1 each of ___ and ____ symptoms
Pain
GI
Sex
Pseudoneurological
Huntington's is an increase in ____ repeats (not CAG)
polyglutamine
Pseudodementia occurs in ____ pts
Psychiatric
CAH pts develop this acid-base abnormality
Metabolic alkalosis
Location of psoas abscess
Groin
MHC genes are on chromosome
6
HLAs are involved in
Antigen presentations
Minute ventilation =
Alveolar ventilation + dead space ventilation
Dysmenorrhea + dyspareunia
Endometriosis (+ infertility)
2nd most common CMV infection
Colitis
NRTIs and NNRTIs have no effect on cells that
Have already had HIV integrated into their genomes
LE edema can be caused by obstruction of
IVC
Glycogen storage disease caused by a defective lysosomal enzyme
Pompe's
Chronic HBV w/ high vs. low infectivity
HBeAg + vs anti-HBeAg _
Clopidogrel must he activated by
P450 system
As prevalence increases, what happens to PPV and NPV?
Both increase
Definition of low birth weight
<2500g
Normal grief lasts how long?
2 months
Why is imipramine used to treat enuresis?
Decreases Stage 4 sleep
Etiology of narcolepsy
Low levels of orexin (hypocretin)
Rx: of narcolepsy
stimulants and sodium oxybate (GHB)
Ethical situation with alcoholic
Temporary incapacitation, so can't make own health decisions
2 positively charged aas
Lysine and arginine (with histidine, are the basic aas)
Heterochromatin is formed by _____ while euchromatin is formed by _____
DNA methylation
Histone acetylation
Rx of orotic aciduria
Uridine (causes feedback inhibiiton of CPS2)
Single stranded binding proteins
Prevent DNA strands from reannealing
DNA repair disease with hypersensitivity to ionizing radiation
Ataxia telangiectasia
Process of nucleotide excision repair
Endonucleases cleave oligonucleotide containing damaged bases; DNA polymerase and ligase fill and reseal the gap
alpha-amanitin inhibits ____ --> ____ failure
RNA Pol II
Liver
What disease has antibodies to spliceosomal snRNPs?
Lupus
____ targets ribosomes to the RER
Signal recognition peptides
Addition to _____ to lysosomal proteins targets the protein to the lysosome
Mannose-6-phosphate
Disease with failure of addition of mannose-6-phosphate
I-cell disease
Coarse facial features, clouded corneas, restricted joint movement, hgh plasma levels of lysosomal enzymes
I-cell disease
Type III cartilage is called ____ and is found where?
Retiulin
Skin, vessels, uterus, fetal tissue
Three complications of Ehlers-Danlos
Joint dislocation, berry aneurysms, organ rupture
Type of collagen most frequently affected in Ehlers-Danlos
Type III