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124 Cards in this Set
- Front
- Back
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amlodopine
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long-acting CCB for hypertension
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metoprolol
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cardiospecific B-blocker; associated with bradycardia and hypotension
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foramen of monroe
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conduit btwn lateral and 3rd ventricle
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aquduct of sylvius (cerebral aquduct)
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connects 3rd ventricle to 4th ventricle
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Behcet syndrome
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recurrent oral aphthous ulcers, genital ulcers, and uveitis, possible joint arthropathy and panniculitis (inflammation of subQ fat beneath skin=erythema nodosum); autoimmune vasculitis-immune complexes attacking both large and small blood vessels in body inducing inflammatory response that damages vessel walls and prevents blodd flow to vital organs; HLA-B51; topical corticosteroids
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PAH
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tracer whose cleasrance estimates renal blood blood=freely filtered, secreted, but not reabsorbed; in contrast to inulin used to estimate GFR=freely filtered and not reabsorbed nor secreted
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posterior part of ventral lateral nucleus
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input from deep cerebellar nuclei and projects to primary motor area of cortex; relays info regarding regulation of movement from cerebellum
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doxepin
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1st gen TCA that blocks reuptake of norepi and serotonin at the synapse; can cause sedation
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metyrapone
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inhibits glucocorticois synthesis
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Clearance and half-life relationship
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CL=0.693(Vd)/halflife
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Osgood-Schlatter disease
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young boys in growth spurt=inflammation at tibial tubercle, pain worsens with activity
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Ewing sarcoma presentation
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May have Codman's triangle due to cortex expansion with periosteal displacement by underlying tumor producing onion peel appearance
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osteosarcoma
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sunburst pattern and Codman's triangle
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dermatomyositis
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autoimmune-presents with proximal muscle weakness and skin discolorations; characteristic heliotrope rash of eyelids; associated with malignant neoplasms (like ovarian cancer)
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polymyositis
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symmetric proximal muscle weakness and tenderness without skin involvement; not associated with malignancy
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rimantadine
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inhibits viral uncoating and can shorten duration of infection by influenza A; metabolized by liver; another amantane is amantadine (although has kidney excretion)
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neuraminidase inhibitors (zanamivir and oseltamivir)
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block egress of influenza virions from cell; effective against influenza A and B
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IL-2
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cytokine involved in activation and proliferation of CD4 and CD8 T-cells as well as B-cells; helper T-cells secrete (along with IFN-gamma)
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IL-1
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secreted by macrophages; pyrogen; stimulates T-cells, B-cells, neutrophils, fibroblasts, and epithelial cells for growth and differentiation
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IL-3
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secreted by T-cells in order to support growth and differentiation of bone marrow stem cells
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IL-4
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differentiation of T0 to T-helper-2 cells (which produce more IL-4 and 5 and allow for production of antibodies)
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IL-8
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primary chemotactic factor for neutrophils
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fetal erythropoiesis
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yolk sac weeks 2-10, liver 6-30, spleen 12-28, and bone marrow 18 onward
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lithium toxicity
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hypothyroidism, edema, acne; tremor is most frequent adverse effect; leukocytosis
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vimentin
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CT stain-intermediate filament found in mesenchyme
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cilastatin
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inhibits renal dihydropeptidase I; co-administered w/imipenem to decrease excretion rate of drug-no anti-microbial activity
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bullous pemphigoid
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autoimmune blistering disease w/ tense, supepidermal bullae; caused by IgG antibodies specific for hemidesmosomes=linear deposits of IgG and C3
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negative Nikolsky sign
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superficial skin layers do not exfoliate when slight P applied across the skin; correlates with bullous pemphigoid
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positive Nikolsky sign
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Dx pemphigus vulgaris = potentially fatal autoimmune skin disorder w/ IgG antibody against desmosomes = reticular pattern of IgG around cells of epidermis=superficial skin layers
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dermatitis herpetiformis
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granular IgA deposits at tips of dermal papillae-autoimmune blistering disorder associated with gluten-sensitive enteropathy; classically involves extensor surface of elbows, knees, butt, and back; very pruritic and vesicles often excoriated into erosions
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Wilm's tumor
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nephroblastoma; kids 2-4; deletion of WT1 gene on chromosome 11
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primary internal rotator of shoulder
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subscapularis innervated by upper/lower subscapular nerves (C5-6)
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loperamide
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opioid derivative used for diarrhea
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theophylline
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anti-spasmodic methylxantine; recommended for maintenance control of COPD symptoms; bronchodilates by inhibiting phosphodiesterase-narrow therapeutic window with grave SE (cardiotoxicity and neurotoxicity); dry mouth common SE
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nucleus solitarius
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sensory info like taste, gut distention via VII, IX, and X
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dorsal motor nucleus
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parasympathetic innervation to heart GI, and lungs
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nucleus ambiguus
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motor innervation of pharynx, larynx, elevates palate; CN IX, X
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Brucella spp
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gram-neg aerobic coccobacilli; invade phagocytic and nonphagocytic cells; unpasteurized food; undulating fever that rises and falls, joint pain, profuse sweating
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visceral leishmaniasis (Leishmania donovani)
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transmitted via sandfly bite; cutaneous, nontender ulcerations, spiking fever, lymphadenopathy, hepatosplenomegaly, pancytopenia; lesion initially painless, erythematous papule which can involve into ulcer; macrophages containing amastigotes; treat with sodium stibogluconate
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drugs associated with pancreatitis
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azathioprine, sulfonamides, tetracycline, furosemide
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risk factors for cholangiocarcinoma
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primary sclerosing cholangitis, infection with Clonorchis sinensis, ulcerative cholitis
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risk factors for hepatocellular carcinoma
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cirrhosis, chemicals (vinyl chloride, aflatoxin, thorotrast), hemochromatosis, Wilson's, AAT disease, schistosomiasis, hepatic adenoma, cigarette smoking, glycogen storage disease type 1
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major side effects of oral retinoids
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suicidal ideations, teratogenicity, hypertriglyceridemia, hypercholesterolemia, elevated liver enzymes
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lateral spinothalamic tract
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sensory neurons that mediate P and T sensation; travel few segments up b4 crossing and synapsing in dorsal horn, then enter contralateral lateral spinothalamic tract
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Clonorchis sinensis
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trematode, liver fluke-infect liver, gallbladder, and bile duct; most common in asia; inflammation and intermittent obstruction of biliary ducts; can lead to cholangiosarcoma; cysts in undercooked or raw fish; detect eggs in stool; treat with praziquantel
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diethylcarbamazine is used in
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antihelmintic-treat filariasis (roundworms); inhibits arachidonic acid metabolism in microfilaria making them susceptible to host immune system; also used to treat Loa Loa, Wucheria brancrofti, and toxocara canis
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niridazole
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antihelmintic; schistosomiasis (trematodes), Dracunculus medinensis (nematode)
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alpha interferon used in
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hep B and C, Kaposi sarcoma, leukemia, malignant melanoma
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gamma interferon used in (aka IFN-gamma)
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pwerful activator of macrophages and accelerates their anti-tumor effects; chronic granulomatous diseaes
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IL-2 can be used as treatment in
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renal cell carcinoma and metastatic melanoma; stimulates proliferation and activation of T and B cells
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IL-11 can be used to treat
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thrombocytopenia; thrombopoietic GF
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drug induced lupus causes
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hydralazine, isoniazid, procainamide, phenytoin
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carbamazepine SE
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agranulocytosis, aplastic anemia, SIADH, SJS
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NF-1
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autosomal dominant; mutation of tumor-suppressor gene on long arm of chromosome 17
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coxsackie virus
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picornaviridae family-nonenveloped, linear, positive sense ssRNA; type A=hand-foot-mouth; type B=associated with carditis
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bosentan
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treats pulmonary hypertension by competitively antagonizing endothelin-1 receptors, decreasing pulmonary vascular resistance; ambrisentan another example
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phosphodiesterase 5 inhibitors
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treat pulmonary hypertension by regluating hydrolysis of cGMP; eg Sildenafil and Tadalafil
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phenytoin mechanisms
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blocks voltage gated sodium channels to increase refractory period of neurons by binding channel in inactive state and slowing rate of recovery; at high concentrations blocks voltage-dependent Ca2+ channels and interferes with release of monoaminergic neurotransmitters (like glutamate)
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memantine
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NMDA receptor antagonist used for Alzheimer's
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california encephalitis
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La Crosse virus=Bunyaviridae family; ss circular RNA with helical and enveloped nucleocapsids; mosquito transmitted; prodromal phase 1-4 days (fever, chills, nausea, vomiting, headache, ab pain) followed by encephalitis (fever, somnolence, mental status change/obtundation); supportive treatment, mortality <1%
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Eastern equine encephalitis
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Alphavirus spp=Togaviridae family; ssRNA linear, icosohedral, enveloped; mosquito transmitted; eastern US
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St louis encephalitis
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Flaviviridae family; ssRNA, icosahedral, enveloped; mosquito transmitted
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Western equine encephalitis
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Alphavirus spp=Togaviridae family; ssRNA linear, icosohedral, enveloped; mosquito transmitted; midwestern/western US
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West Nile encephalitis
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Flaviviridae family; ssRNA, icosahedral, enveloped; mosquito transmitted; throughout US
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black widow
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painful bite, neurotoxin=muscle cramping, ab pain, weakness, and tremor; rarely life-thretening
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brown recluse
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necrotic bites; venum cytotoxic and hemolytic, but is NOT neurotoxic
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sirolimus
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creates a complex with intracellular immunophilin (FKBP) and binds to mTOR inhibiting T-cell proliferation in response to IL-2; normally given with cyclosporine and corticosteroids after kidney transplant; SE=hyperlipidemia, thrombocytopenia, leukopenia
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sulfonamides and warfarin
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displace warfarin from plasma proteins, increasing anticoagulation effects (prolonged PT)
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ataxia-telangiectasia
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autosomal recessive; presents as ataxia ~2 yrs old; cerebellar atrophy due to loss of Purkinje cells leading to gait disturbances; abnormal blood vessel formation (telangiectasias) common in eyes, bridge of nose, ears, and extremities; skin loses elasticity; difficultly corrdinating head and eye movements due to periodic nystagmus of eyes; frequent sinus/lung infections due to deficiency of IgA
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Osler-Weber-Rendu syndrome
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vascular disorder-epistaxis, GI bleeding, iron deficiency anemia, and telangiectasias; AV malformations in pulmonary, hepatic, and cerebral circulations=embolic strokes, hemorrhagic strokes, and brain abscesses
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Wiskott-Aldrich syndrome
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congenital X-linked recessive immunodeficiency; thrombocytopenia, eczema, and humoral immunodeficiency due to decreased IgM (IgA and IgE may be elevated)
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5 categories of teratogen safety A, B, C, D, and X
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A=studied in pregnant women and pose minimal risk; B=have not been shown to pose significant risk, but no adequate studies; C=studied in animals and show adverse effects, no adequate studies in humans; D=evidence of fetal risk, but benefits may be acceptable; X=animal or human studies show adverse fetal effects
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clonidine, guanfacine
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alpha-2-adrenergic agonists; reserved for ppl who respond poorly to trial of stimulants in ADHD or have unacceptable SE; centrally acting antihypertensive meds-block NE release in brain
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Colorado tick fever
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dsRNA virus genus Coltivirus family Reoviridae; nonspecific febrile illness (50% saddleback fever=cycles with fever 2-3 days, absence 2-3 days); most do not have rash
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ehrlichiosis
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infection of WBC (human monocytic and human granulocytic); tick-borne (lone star); obligate intracellular gram-neg bacterium in Rickettsiae family
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Renal tubular acidosis 2
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proximal; inhibits bicarb reabsorption; associated with hypokalemia and hypophosphatemic rickets
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treatment of Legionnaires
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respiratory fluoroquinolones (levo, moxi, and gemifloxacin) and newer macrolides (azithro, clarithro, and roxithromycin)
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intertrigo
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superficial fungal infection of body folds (like under breasts) caused by Candida spp.; causes redness, erosion of tissue, with small dot-like satelite lesions along periphery; treated with topical antifungals like nystatin or miconazole
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drugs with disulfiram-like rxn to alcohol
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cephalosporins (cefoperazone 3rd and cefamandole 2nd), procarbazine, 1st gen sulfonylureas, metronidazole
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esophagus levels
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T3-6 R
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stomach levels
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T5-10 L
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duodenum levels
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T6-8 R
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small intestine levels
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T8-10 R or bilaterally
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steady state concentration
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4-5 half-lives
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nitroglycerin MOA
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increase formation of cGMP through stimulation of guanylate cyclase, leading to activation of myosin light chain phosphatase=vasodilation through dephosphorylation of myosin light chains
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sturge-weber syndrome
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rare congenital disorder that affects blood vessels, mostly capillaries; facial capillary malformation (port-wine stain)-up to 96% at birth; congenital hamartomatous malformations that may affect eye, skin, CNS; iris heterochromia in 10%85% generalized motor seizures; 60% mental retardation; 40-50% choroidal hemangioma
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CO2 and local anethetics
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direct depressant effect on neurons and diffuses across membrane=decreases pH, increasing pronation of aneththetic and trapping them within cell=increases concentration inside cell and increasing binding rate
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damage is where with afferent pupillary defect (aka Marcus Gunn pupil)
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retina or optic nerve-efferent pathway
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2nd gen sulfonylureas
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glyburide, glimepiride, glipizide
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CD5
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found on T cells during thymic maturation, but also on B1 B cells (subset of IgM secreting B cells involved in complement system)
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CD14
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expressed on macrophages and less on neutrophils/dendritic cells; receptor for bacterial LPS
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CD56
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NK cells
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myeloblasts in AML
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immature cells with large nuclei, prominent nucleoli, and pale blue cytoplasm
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ALL
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express CD10; stain positive for terminal deoxynucleotidyl transferase and neg for myeloperoxidase
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CLL
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males 7th decade; painless cerical lymphadenopathy; mucocutaneous bleeding and petechiae due to thrombocytopenia; smudge cells; B cell antigens and CD5 positive
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CML
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t(9;22)-BCR-ABL1; systemic complaints of fatigue, malaise, weight loss, hepatosplenomegaly; elevated WBV with associated anemia and thrombocytosis' leukocyte alkaline phosphatase stains absent in granulocytes; treat with imatinib
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Chediak-Higashi syndrome
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autosomal recessive; recurrent pyogenic infections, oculocutaneous albinism, progressive neurologic abnormalities, and coagulation defects; abnormal lysosomal trafficking protein that results in defective phagolysosome formation
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Chediak-Higashi syndrome Diagnosis is made by
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peripheral smear with giant cytoplasmic granules in leukocytes
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hyperimmunoglobulinemia E (aka Job syndrome)
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autosomal dominant with triad of eczema, eosinophilia, and recurrent skin and pulmonary infections; do not typically have atopy to food or seasonal allergies; associated with multiple CT and skeletal abnormalities (scoliosis, hyperextensibility, pathologic fractures, retained primary dentition, craniosynostosis, and vascualr abnormalities)
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nitroblue tetrazolium dye test
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used to detect presence of NADPH oxidase-enzyme used by neutrophils to make oxygen radicals for killing bacteria; positive when enzyme normal; would be negative in chronic granulomatous disease
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Clopidogrel MOA
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inhibits platelet aggregation by irreversibly blocking ADP receptors-this stops glycoprotein Iib/IIIa protein expression and inhibits fibrinogen binding
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abciximab and tirofiban MOA
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block glycoprotein 2b/3a receptors
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lithium MOA
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block actions of 2nd messengers phosphoinositol and cAMP
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eye SE of sildenafil mechanism
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weakly inhibits PDE-6 (on top of regular MOA of PDE-5)-required for transformation of light into electrical signals=cyanopsia or blue vision
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chromoblastomycosis
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chronic fungal skin infection caused by traumatic inoculation; begins as warty nodule and over time spreads over skin and subQ tissue forming plaques and nodular tissue resembling cauliflower-like lesions; skin scrapings using KOH=thick-walled, cigar-colored, sclerotic cells (Medlar bodies)
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histopath of psoriasis
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neutrophils btwn layers of parakeratotic stratum corneum
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dyshidrotic eczema
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spongiotic vesicles with dermal lymphocytic infiltrate; aka acute palmoplantar eczema; pruritic vesicular eruption on palms/soles that may also form tense bluuae; cause unknown
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when is there forehead sparing
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within cortex or other associated UMN pathway due to bilateral projections
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porphyria cutanea tarda
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deficiency in uroporphyrinogen decarboxylase-deposition of porphyrins in skin; cutaneous fragility causing blistering of hands, forearms, and face; tea-colored urine, changes in hair growth (increased facial decreased scalp hair), increased skin pigmentation
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bupropion
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antidepressant used for smoking cessation; inhibits uptake of norepi and dopamine
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buspirone
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anxiolytic-doesn't cause sedation, CNS depression, or dependence; unknown mechanism-bind serotonin and dopamine D2 receptors possibly
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Thrombotic thrombocytopenic purpura
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fever, neurologic symptoms, kidney failure, anemia, thrombocytopenia (FAT RN)
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HUS
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few days after infectious bloody diarrhea; complication of EHEC (O157:H7); anemia, thrombocytopenia, acute renal failure
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K sparing diuretics
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spironolactone, amiloride, triamterene
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phenylephrine
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alpha agonist- increases BP; reflex bradycardia
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phentolamine
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alpha-1-blocker; reduce BP
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methacholine
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muscarinic agonist-vasodilation mediated via NO synthesis; directly slows down HR (not inhibited by ganglion blocker)
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isoproterenol
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non-selective beta agonist; vasodilation via b2 and direct increase in HR via b1
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terbutaline
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selective b2-agonist
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sotalol
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class III antoarrhythmic with beta blocking and K channel blocking abilities; prolong QT by blocking repolarization phase
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quinidine
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class Ia with some K+ blocking ability; prolong QRS
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Digoxin
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class V; prolongs PR interval
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severe side effect of macrolides (erythomycin, azithromycin)
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prolonged QT interval; used in pen allergic ppl
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aspirin MOA
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irreversible COX inhibitor=stopps formation of arachidonic acid=less prostaglandins and thromboxane
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