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299 Cards in this Set
- Front
- Back
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Which RNA viruses are "ss"?
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All except rotavirus
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Which nonenveloped viral forms are NOT infective?
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ds RNA
(-) ssRNA |
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Which DNA viruses are linear?
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All except polyoma-, papilloma-, and hepadnaviridae
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Which non-enveloped forms of viruses are infective?
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dsDNA (except HBV and Pox)
(+) ssRNA |
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Enveloped DNA viruses
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Herpes viruses
HBV Pox |
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Non-enveloped DNA viruses
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Adenovirus
Papilloma Parvo |
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Circular DNA viruses
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Hepadnaviridae
Papillomaviridae Polyomaviridae |
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Non-enveloped RNA viruses
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Norwalk
hepatitis E Rotavirus Picornaviruses |
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Which coping mechanism: separating ideas from accompanying distressing emotions
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Isolation
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7 osteoporosis risk factors
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1. smoking
2. menopause 3. corticosteroids 4. physical inactivity 5. being white 6. low total body fat 7. alcohol |
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MOA: pentostatin
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Adenosine deaminase inhibitor
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Which portion of the heart is closest to the diaphragm?
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Inferior wall of the LV
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Which vitamin is contraindicated in patients taking levodopa?
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B6 ---> enhances levodopa degradation
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What is a patient taking levodopa and an MAOI at risk for?
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Hypertensive crisis
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MC toxicity: levodopa
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Anorexia with N/V
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Toxicity: nitroprusside
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CN- toxicity
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Diagnosis: bacteria grown at 4 degrees Celsius
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L. monocytogenes
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What does a "Southwestern blot" look for?
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Protein that is bound to DNA
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Diagnosis: muscle girdle pain and upregulation of MHC1
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Polymyositis
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Tx: Legionnaire's disease
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Erythromycin
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Which parts of the nephron are most susceptible to ATN?
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Proximal tubule and thick ascending limb
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What drug class raises the risk of statin-induced myopathy?
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Fibrates
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Diagnosis: cancer patient develops ataxia, dysarthria, intention tremor
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Paraneoplastic cerebellar degeneration
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Antibody: paraneoplastic cerebellar degeneration
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Anti-Purkinje cell
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Classic diseases featuring avascular necrosis of the femoral head
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Sickle cell and SLE
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Tremor of basal ganglia dysfunction
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Resting tremor
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Tremor of cerebellar dysfunction
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Intention tremor
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Function: nucleus ambiguus
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Motor nucleus of 9 and 10 (swallowing, etc)
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Function: NTS
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Taste and smell
Visceral sensory for 9 and 10 |
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Function: dorsal motor nucleus of X
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Vagus parasympathetics to heart, lungs, and gut
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Foramen: ophthalmic artery
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Optic canal
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MOA: ethambutol
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Inhibtion of arabinsoyl transferase ---> mycobacterial cell wall defects
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MOA: dapsone
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Anti-folate
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Tx: mycobacterium avium complex
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Azithromycin/clarithromycin + ethambutol
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Bloodwork: uremic platelet dysfunction
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Increased bleeding time with normal platelet count, PT, and PTT
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What is the "on-off" phenomenon in Parkinson's?
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In advanced disease, the idiosyncratic, unpredictable, and dose-independent transition from no symptoms to prominent symptoms while taking levodopa
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Under what conditions would mixed venous oxygen content be elevated?
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When tissue oxygen utilization is impaired
E.g. hemoglobin with abnormally elevated O2 affinity or impaired oxidative metabolism (CN- poisoning) |
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MOA: pentazocine
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Partial μ agonist with some μ antagonist acvitiy
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MOA: aminoaciduria, including high urinary levels of proline and arginine
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Fanconi syndrome
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What is "Berkson's bias"?
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Form of selection bias classically created by selecting hospitalized patients as members of a control group
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What is a classic presentation of T cell ALL?
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Medistinal mass with dyspnea, dysphagia, possibly SVC syndrome
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Absolute contraindications to OCPs
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1. hx of thromboembolic disase
2. hx of estrogen-dep. tumor 3. smokers 35+ 4. hypertriglyceridemia 5. liver disease 6. pregnancy |
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Foramen: Inf. gluteal nerve
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Greater sciatic foramen
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Which nerves pass through the greater sciatic foramen?
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Sup. gluteal n.
Inf. gluteal n. Sciatic n. Pudendal n. |
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Diagnosis: peritrichous flagella
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Proteus or E. coli
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S/Sx: fat embolism syndrome
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Neurologic abnormalities
Hypoxemia Petechial rash |
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What is the MC mechanism of death in TCA overdose?
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Na+ channel inhibition ---> arrhythmias
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MOA: cladribine
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Purine analog resistant to adenosine deaminase
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What is the cellular consequence of the delta F508 mutation in CF?
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Prevents posttranslational modification, causing complete CFTR degradation before it reaches the membrane
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What is the mechanism of arrhythmias in TCA overdose?
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Cardiac Na+ channel inhibition
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Diagnosis: painless, waxing-and-waning lymphadenopathy
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Follicular lymphoma
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Diagnosis: claudication with hypersensitivity to nicotine injection
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Buerger's disease
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Presentation of left-sided vs. right-sided CRC
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Right side bleeds, left side obstructs
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Diagnosis: ribose-ribitol-phosphate capsule
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Hib
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Bugs with hyaluronidase
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Staphylococci
S. pyogenes C. dif |
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What is a good antihypertensive drug for someone with bradycardia?
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Nifedipine = peripheral vasodilation can lead to reflexive increase in heart rate, which may normalize the rate in someone with bradycardia
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How are particles 2.5-10.0 um cleared form the respiratory tree?
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Mucociliary clearance
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How are particles <2.0 um cleared from the respiratory tree?
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Phagocytosis
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Diagnosis: vasculitis with contiguous vein and nerve involvement
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Buerger's disease
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MOA: dexrazoxane
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Iron chelating agent used to reduce anthracycline-induced cardiotoxicity
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MOA: amifostine
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Free-radical scavenger used to minimize nephrotoxicity assoc. with platinum and alkylating chemotherapeutics
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Unique toxicity: trazodone
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Priapism
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Which vessel: midshaft humeral fracture
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Deep brachial artery
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Which vessel: supracondylar fracture of the humerus
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Brachial artery
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Which vessel: fracture at the surgical neck of the humerus
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Ant. circumflex humeral a.
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What is a "P body"?
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Foci within the cytoplasm where mRNA regulation and degradation occur
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Which viral hepatitis undergoes nuclear integration?
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HBV
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Androgen kinetics with leuprolide
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Initial surge followed by concordant decrease of both testosterone and DHT
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Define: "hypertensive encephalopathy"
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Neurologic symptoms in the setting of malignant hypertension
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In which structure is the greatest degree of atrophy seen in patients with Alzheimer's disease?
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Hippocampus
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What are the cardiovascular consequences of an AV fistula?
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Rerouting of large volumes of arterial blood into venous circulation ---> increased preload
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Which viral hepatitis: hepatocytes filled with granular "ground glass" substance
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HBV; inclusions = HBsAg
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What two substances does vasopressin increase tubular permeability to?
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Both water and urea
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Pulmonary manifestations of scleroderma
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Pulmonary hypertension
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"Dextrans facilitate Streptococcal adherence to..."
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Fibrin
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Composition: fibrous "cap" of an atherosclerotic plaque
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Subendothelial glycosaminoglycans
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What structures are supplied by the ant. choroidal artery?
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Posterior internal capsule
Optic tracts LGN of the thalamus Choroid plexus Uncus Hippocampus and amygdala |
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What do you see histologically 12-24 hours after an ischemic brain event?
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"Red neurons"
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What is, by far, the most important prognostic factor in poststreptococcal glomerulonephritis?
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Age (>95% of kids will achieve complete recovery, whereas only 60% of adults will)
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Classic toxicity: foscarnet
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Nephrotoxicity with hypocalcemia and hypomagnesemia
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Classic toxicity: ganciclovir
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Severe peripheral cytopenias
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Which is the only radiolucent kidney stone?
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Urate
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Diagnosis: young man with new-onset murmur and elevated creatinine
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Bacterial endocarditis with immune-mediated glomerulonephritis
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Toxicities: low- vs. high-potency neuroleptics
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High-potency: greater extrapyramidal effects with fewer anticholinergic/antihistaminergic effects
Low-potency: fewer extrapyramidal effects with greater anticholinergic/antihistaminergic effects |
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Which vitamin is recommended for patients at risk for stone formation due to elevated urine oxalate?
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B6
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Diagnosis: cold agglutinins, but no Mycoplasma
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EBV
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What two reactions are catalyzed by 21-hydroxylase?
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Progesterone --> deoxycorticosterone
17-hydroxyprogesterone --> 11-deoxycortisol |
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Renal physiology: role of H(PO4)2-
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A titratable acid ---> H+ excretion as H2PO4-
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Which vitamin deficiency classically in strict vegetarians?
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B12
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Tx: alcohol withdrawal
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Long-acting benzos (diazepam, chlordiazepoxide)
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Toxicities: Ca2+ channel blockers
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Peripheral edema
Flushing Constipation Bradycardia |
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Which drugs can exacerbate lithium toxicity?
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NSAIDs, thiazides (not loops!), and ACEi's
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What is volume status in SIADH?
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Initial volume overload suppresses aldosterone, allowing for increased natriuresis and the establishment of hyponatremic euvolemia
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D/Dx: burr cells on peripheral smear
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Uremia
PK deficiency Microangiopathic hemolytic anemia |
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Where is vitamin A stored?
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Hepatic stellate cells
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MOA: menotropin
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Increases FSH
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Which cell type INCREASES with glucocorticoid use?
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Neutrophils
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How do macrophages make active vitamin D?
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T cells ---> IFNg ---> upregulation of macrophage 1alpha-hydroxylase
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What is the most clinically important side-effect of bile resins?
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Hypertriglyceridemia
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Substitution: HbC
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Glu --> Lys
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Findings: anterior interosseous syndrome
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Pain in the forearm and impaired pincer grasp with the thumb and index finger
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Diagnosis: painless, "beefy-red" genital ulcer
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Donovanosis = Calymmatobacterium granulomatis
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Function: IL-10
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Antiinflammatory cytokine: inhibits Th1 differentiation, MHC II expression, and NFκB ---> downregulates cytokines
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MOA: dipyridamole
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1. thromboxane synthase inhibitor
2. inhibits adenosine reuptake 3. inhibits adenosine deaminase 4. phosphodiesterase inhibition |
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Use: dipryidamole
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Stroke or TIA prevention
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MOA: theophylline
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1. non-specific phosphodiesterase inhibitor
2. adenosine receptor antagonist |
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5 key physiologic effects of theophylline
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Bronchodilation
Positive inotropy Positive chronotropy Increased BP Increased renal blood flow |
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Interactions: theophylline
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CYP modulators
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Overdose symptoms: theophylline
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N/V/D
Tachyarrhythmia Seizure |
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Key cellular role of Akt
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Suppresses apoptosis
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Toxicity: succinylcholine
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Malignant hyperthermia
Hyperkalemia Anaphylaxis |
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What is CD44?
|
Receptor for hyaluronate that can also interact with ECM components like matrix metalloproteinases
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At which amino acids are lipid groups attached on proteins?
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Cysteine
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MOA: aripiprazole
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D2 partial agonist
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What is "childhood disintegrative disorder"?
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Normal development in all areas during the first several years of life followed by a rapid loss of most or all developmental gains
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Phenotype: Rett syndrome
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No speech
Small hands/feet/head Classic hand-wringing behavior Severe MR/developmental deficits Seizures |
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Which reactions are catalyzed by 17-hydroxylase?
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Pregnenolone --> 17-hydroxypregnenolone
Progesterone --> 17-hydroxyprogesterone |
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List the causes of non-anion gap metabolic acidosis
|
"HARD UP!"
1. hyperalimentation 2. acetazolamide 3. renal tubular acidosis 4. diarrhea 5. ureteroenteric fistula 6. pancreaticoduodenal fistula |
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How does acidosis affect K+ homeostasis?
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Impairs H+/K+ ATPase ---> hyperkalemia
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Causes of respiratory alkalosis
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Hyperventilation
Early salicylate toxicity (---> anion gap acidosis) |
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Causes of metabolic alkalosis
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1. vomiting
2. diuretics 3. hyperaldosteronism 4. antacid abuse/overuse |
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Type 1 RTA
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Defective H+ secretion
Hypokalemic metabolic acidosis Nephrolithiasis |
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Type II RTA
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Defective HCO3- resorption
Hypokalemic metabolic acidosis Hypophosphatemic rickets |
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Type IV RTA
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Hypoaldosteronism
Hyperkalemic metabolic acidosis |
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Diagnosis: hexagonal crystals
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Cystine stone
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Diagnosis: hemihypertrophy of extremity in a kid
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Wilm's tumor
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Four classic causes of renal papillary necrosis
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1. NSAID nephropathy
2. DM 3. pyelonephritis 4. sickle cell |
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Diagnosis: low FENA
|
Pre-renal AKI
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5 key sequelae of uremia
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1. nausea, anorexia
2. fibrinous pericarditis 3. asterixis 4. platelet dysfunction 5. encephalopathy/peripheral neuropathy |
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Four causes of Fanconi syndrome
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1. expired tetracycline
2. cystinosis 3. Wilson's disease 4. cisplatin, HIV drugs |
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Toxicity: acetazolamide
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Peripheral neuropathy
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Two thiazide toxicities not seen with loop diuretics
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Hyperglycemia and hyperlipidemia
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Secondary causes of membranous glomerulonephropathy
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HBV and solid tumors
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Secondary causes of FSGS
|
HIV
Heroin/IVDA Sickle cell Obesity |
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Secondary causes of MPGN
|
HCV
Hematologic malignancy |
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Which hormones does hCG have homology with?
|
LH
FSH TSH |
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What two factors are released by TRH
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TSH and prolactin
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|
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S/Sx: congenital hypothyroidism
|
Protuberant tongue/umbilicus/belly
Neurologic sx Bony abnormalities |
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Which vessel: ST elevation in the inferior leads
|
RCA
|
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What is a potential consequence of an RCA STEMI?
|
SA nodal ischemia ---> bradycardia
|
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How would you treat an RCA STEMI with bradycardia?
|
Atropine
|
|
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What is the best auscultatory indicator of mitral regurgitation severity?
|
Presence/absence of S3
|
|
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Diagnosis: subperiosteal hematomas and painful gums
|
Vit. C deficiency
|
|
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Diagnosis: S100 primary brain tumor
|
Schwannoma
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MC location for a pilocytic astrocytoma
|
Cerebellum
|
|
|
Diagnosis: kid with a partially-solid, partially-cystic cerebellar mass
|
Pilocytic astrocytoma
|
|
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Diagnosis: kid with a CNS tumor featuring "rosettes"
|
Ependymoma
|
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Which cell type is primarily responsible for intimal thickening and fibrosis in atheromatous plaques?
|
Vascular smooth muscle cells
|
|
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Effect of niacin on the vasculature
|
Vasodilation
|
|
|
Composition of lipofuscin
|
Lipid polymers and protein-complexed phospholipids
|
|
|
Diagnosis: yellow-brown pigment within cells
|
Lipofuscin ---> aging
|
|
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Which fiber tracts are most susceptible to vitamin E deficiency?
|
Spincerebellar tracts
Dorsal columns Peripheral nerves |
|
|
How do primary and reactivation HSV-1 differ?
|
Primary: lymphadenopathy, swollen gums, painful oral ulcers
Reactivation: A single cold sore |
|
|
MOA: argatroban
|
Direct thrombin inhibitor
|
|
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Diagnosis: "diamond-shaped" systolic murmur
|
Aortic stenosis
|
|
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Which key bacteria are capable of undergoing transformation?
|
S. pneumoniae
N. meningitidis H. influenza |
|
|
5 toxicities of all inhalational anesthetics
|
1. Myocardial depression
2. Respiratory depression 3. Decrease hepatic blood flow 4. Decrease RPF and GFR 5. Increase cerebral blood flow |
|
|
Which is the only inhalational anesthetic that does NOT cause respiratory depression?
|
Nitrous oxide
|
|
|
What is the best serum marker for osteoblast activity?
|
Bone-specific alkaline phosphatase
|
|
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What are urinary hydroxyproline and deoxypyridinoline markers for?
|
Osteoclast activity
|
|
|
What is the most specific marker of osteoclast activity?
|
Urinary deoxypyridinoline
|
|
|
D/Dx: yellow-brown cytoplasmic granules
|
Hemosiderin or lipofuscin
|
|
|
Probable diagnosis: nephrolithiasis in a young patient
|
Hereditary cystinuria
|
|
|
Diagnosis: positive cyanide-nitroprusside test
|
Cystinuria
|
|
|
Diagnosis: severe pruritus at night in a middle-aged woman
|
PBC
|
|
|
Three key causes of decreased pulmonary compliance
|
Pulmonary fibrosis
Insufficient surfactant Pulmonary edema |
|
|
When is S3 heard?
|
Immediately after S2
|
|
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When is S4 heard?
|
Immediately before S1
|
|
|
Hemolysis pattern: E. coli
|
Beta
|
|
|
MOA: fondaparinux
|
Heparin pentasaccharide with Xa specificity
|
|
|
MOA: zileuton
|
5-lipooxygenase inhibitor ---> prevents leukotriene synthesis
|
|
|
Elevation of what is responsible for increased ESR?
|
Fibrinogen, an acute phase reactant
|
|
|
Diagnosis: fever, malaise, dark urine, acholic stools in a college student that just returned from vacation in Mexico
|
HAV
|
|
|
Diagnosis: pancytopenic child with peroxidase-positive peripheral blasts
|
AML
|
|
|
Composition: xanthomas
|
Foam cells
|
|
|
What is the endocardial consequence of infectious endocarditis?
|
Regurgitation, never stenosis
|
|
|
How does heparin affect lipid metabolism?
|
Increases LPL expression
|
|
|
Diagnosis: isolated cystic dilatation of medullary collecting ducts in an otherwise normal kidney
|
Medullary sponge kidney
|
|
|
MC complication: medullary sponge kidney
|
Recurrent nephrolithiasis
|
|
|
Diagnosis: weight loss, jaundice, and palpable but non-tender gallbladder
|
Pancreatic adenocarcinoma
|
|
|
Diagnosis: ST elevation in II, III, and aVF
|
RCA infarct
|
|
|
Diagnosis: ST elevation in V5 and V6
|
Left circumflex infarct
|
|
|
Diagnosis: ST elevation in V1-V4
|
LAD infarct
|
|
|
What is the most important contributor to the elastic properties of elastin?
|
Extensive lysine crosslinks
|
|
|
MCC: SVC syndrome
|
Bronchogenic carcinoma
|
|
|
Where do inhalational anesthetics redistribute to after the brain?
|
Fat and skeletal muscle
|
|
|
Where does thiopental redistribute to after the brain?
|
Fat and skeletal muscle
|
|
|
Underlying defect in Friedreich's ataxia
|
Mitochondrial dysfunction
|
|
|
Diagnosis: epilepsy patient with generalized lymphadenopathy
|
Phenytoin toxicity
|
|
|
Which abx impaired ribosome translocation?
|
Macrolides + clindamycin
|
|
|
Which abx impairs ribosomal peptidyl transferase activity?
|
Chloramphenicol
|
|
|
Which abx impair aminoacyl-tRNA interaction with the ribosome?
|
Tetracyclines
|
|
|
Which abx inhibit initiation of peptide synthesis?
|
Aminoglycosides
|
|
|
Most significant toxicity: valproate
|
Substantial hepatotoxicity
|
|
|
Toxicity: PDE inhibitors
|
Vasodilation
|
|
|
Fertility tx in PCOS
|
Clomiphene
|
|
|
MOS: clomiphene
|
SERM that prevents estrogen feedback at the hypothalamus ---> increased FSH, LH release
|
|
|
Diagnosis: patient with pancreatic calcifications and hepatomegaly
|
Chronic alcohol abuse
|
|
|
Diagnosis: mid-systolic click
|
MVP
|
|
|
Classic pineal germinoma triad
|
1. Precocious puberty
2. Parinaud's syndrome 3. Obstructive hydrocephalus |
|
|
MC pineal tumor
|
Germinoma
|
|
|
2nd MC location for CRC
|
Ascending colon
|
|
|
Diagnosis: 30-year-old woman with rash, photosensitivity, joint pain, and proteinuria
|
SLE
|
|
|
2nd MCC of dementia
|
Multi-infarct dementia
|
|
|
Diagnosis: acute oliguria with oxalate stones
|
Ethylene glycol toxicity
|
|
|
Diagnosis: sustained muscle contractions, frontal balding, cataracts, and gonadal atrophy
|
Myotonic dystrophy
|
|
|
Which fungus is most likely to cause a chronic pneumonia in an immunoCOMPETENT patient?
|
Blasto
|
|
|
Diagnosis: round yeast with doubly refractory walls
|
Blasto
|
|
|
Treatment: bronchopulmonary aspergillosis
|
Steroids
|
|
|
Who is most at risk for developing aspergillosis?
|
Neutropenics
|
|
|
Diagnosis: GNR that doesn't ferment sorbitol and doesn't produce glucuronidase
|
E. coli O157:H7
|
|
|
What is the chance of conversion to chronic HBV infection in an infant versus an adult?
|
90% in an infant, but <5% in an adult
|
|
|
Why would an HBV+ neonate only show mild hepatic injury?
|
HBV isn't a cytotoxic virus; damage is purely immune-mediated ---> neonates have weak immune systems ---> mild hepatic damage
|
|
|
How does EBV infection afffect B cells?
|
Promotes polyclonal proliferation and heterophile antibody production
|
|
|
5 key pathogens to fear in NADPH oxidase deficiency
|
1. S. aureus
2. Psuedomonas cepacia 3. Serratia macescens 4. Nocardia 5. Aspergillus |
|
|
How do you reduce HSV2 recurrence?
|
Daily acyclovir
|
|
|
Which viral hepatitis: an aversion to smoking
|
HAV
|
|
|
Congenital rubella triad
|
1. sensorineual deafness
2. cataracts 3. cardiac defects e.g. PDAs |
|
|
MC consequence of adult rubella infection
|
Polyarthritis
|
|
|
Fundamental etiology of Shigellosis
|
Mucosal invasion
|
|
|
How does Shigella invade the GI mucosa?
|
Uptake via M cells within Peyer's patches
|
|
|
Classic lung finding: Histoplasmosis
|
Hilar lymphadenopathy
|
|
|
Classic lesions of disseminated Histoplasmosis
|
HSM and oral ulcers
|
|
|
MCC of death: Diphtheriae
|
Cardiomyopathy
|
|
|
Which are the four key long-acting benzos?
|
Diazepam
Chlordiazepoxide Chlorazepate Flurazepam |
|
|
Which are the three key short-acting benzos?
|
Alprazolam
Triazolam Oxazepam |
|
|
What is the drug-of-choice for gestational diabetes?
|
Insulin
|
|
|
Intestinal histology: lactase deficiency
|
Nothing! No identifiable abnormality!
|
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Which class of benzodiazepines is associated with a higher risk of withdrawal symptoms?
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Short-acting ---> rapid-clearance, rapid-onset of withdrawal symptoms in patients who are dependent
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What is the most significant environmental risk factor for pancreatic adenocarcinoma?
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Smoking
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Epileptic with acute intermittent porphyria suffers an acute exacerbation after changing medications. What happened?
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Phenobarbital upregulates hepatic heme synthesis, can precipitate porphyric episodes
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D/Dx: patient with fatigue, elevated CK
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DMD
Poly/dermatomyositis Statin myopathy Hypothyroid myopathy |
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Classic findings of serum sickness
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Arthralgias, urticaria, glomerulonephritis, and lymphadenopathy 5-10 days after starting a new drug, classically a sulfa drug
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What is the acid/base disturbance seen several hours after salicylate toxicity?
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Mixed metabolic acidosis (low HCO3-) and respiratory alkalosis (low pCO2) with a normal or only mildly abnormal blood pH
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What is the most common first manifestation of alcohol withdrawal?
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Tremor
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Interpretation: loud S2 over the L sternal border
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Suggests increased PA pressure
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Histology: PBC
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Granulomas and lymphocytes
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Why does Crohn's presidpose to oxalate renal stones?
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Chronic malabsorption leads to elevated lipid levels in the bowel lumen, which can chelate Ca2+, which normally binds oxalate; without Ca2+, there is increased oxalate absorption and increased stone formation
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MOA: cilostazol
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PDE3 inhibitor ---> anti-platelet vasodilator
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1st-line therapy for myoclonic seizures
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Valproate
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How does UC-related CRC differ from sporadic CRC?
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1. occurs earlier
2. multifocal 3. p53 mutations BEFORE APC mutations 4. proximal colon rather than distal |
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What cell is important in preventing disseminated Candidiasis?
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Neutrophils
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How do you kill HAV?
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Bleach, chlorination, or boiling
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How do you kill HAV?
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Bleach, chlorination, UV light, or boiling
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Why is host IgG ineffective at conferring immunity to HCV?
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Rapid HCV antigenic mutation
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Why would you expect to see an ACTH surge after administration of metyrapone?
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Blocks conversion of 11-deoxycortisol into cortisol ---> no cortisol produced ---> low peripheral cortisol ---> ACTH surge
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What is the classic presentation of diffuse esophageal spasm?
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Pain that closely mimics angina pectoris
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Classic hepatic histology: viral hepatitis
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Periportal "ballooning degeneration"
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What is different about the formation of gastric vs. duodenal ulcers?
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Gastric ulcers are formed because of a decreased mucous layer; duodenal ulcers are formed because of excess gastric acid production
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Patient with stable, treated hyperthyroidism develops a fever without other symptoms. What are you worried about?
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Agranulocytosis from methimazole/propylthiouracil
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What is the most common abnormality predisposing to the development of infective endocarditis?
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MVP
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Diagnosis: gastroenteritis transmitted from domestic animals
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Campylobacter
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What is the most important E. coli virulence factor in neonatal meningitis?
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K-1 capsular antigen
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Which antimycobacterial drug is most effective against intracellular TB?
|
Pyrazinamide
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Which antimycobacterial requires an acidified phagolysosome to function?
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Pyrazinamide
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What is the relationship between glucose and cAMP in bacteria with the lac operon?
|
Inversely proportional: glucose inhibits adenylyl cyclase, decreasing cAMP and decreasing binding of Catabolite Activating Protein to the lac operon and upregulating lactose-related genes
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1st-line tx: postherpetic neuralgia
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Gabapentin
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|
|
Three main uses of valproate
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Tonic-clonic
Myoclonic Absence |
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MOA: vigabatran
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GABA transaminase inhibitor
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Toxicity: gabapentin
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Peripheral edema
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MOA: valproate
|
GABA and Na+ channel activity
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Toxicity: phenytoin
|
Drug-induced lupus
Gingival hyperplasia Nystagmus Folate-def. anemia |
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MOA: tiagabine
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GABA reuptake inhibitor
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Toxicity: ribavirin
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Hemolytic anemia
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MC toxicity: ganciclovir
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Myelosuppression
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MOA: ribavirin
|
Inhibits GTP synthesis
|
|
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Toxicity: NRTIs
|
Neutropenia
Megaloblastic anemia Pancreatitis Peripheral neuropathy Lactic acidosis |
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|
Toxicity: NNRTIs
|
Neuropsychiatric disturbances
Neutropenia/anemia Peripheral neuropathy Rash |
|
|
MOA: cytarabine
|
Activated intracellularly ---> DNA pol. inhibitor
|
|
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Toxicity: procarbazine
|
MAOI
|
|
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Toxicity: traztuzumab
|
Cardiotoxicity
|
|
|
S/Sx: Entamoeba histolytica
|
Bloody diarrhea + liver abscesses
|
|
|
S/Sx: visceral leishmaniasis
|
Spiking fevers, HSM, pancytopenia
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|
|
Diagnosis: macrophages filled with aflaggelate amastigotes
|
Visceral lesihmaniasis
|
|
|
Cause: Janeway lesions vs. Osler nodes
|
Janeway = painless = embolic
Osler = painful = immune complex |
|
|
Tx: S. epidermidis endocarditis
|
Vancomycin + rifampin
|
|
|
"Comma-shaped," oxidase + GNRs
|
Vibrio (grows on alkaline media)
Campylobacter (does NOT grow on alkaline media) |
|
|
Which HBV protein forms spheres and tubules in the peripheral circulation?
|
HBsAg
|
|
|
Where in the viral particle is HBsAg found?
|
Envelope
|
|
|
Where in the viral particle are HBcAg and HBeAg found?
|
Nucleocapsid
|
|
|
Important toxicity: ziprasidone
|
QT prolongation
|
|
|
Menetrier's disease
|
Gastric hypertrophy
Parietal cell atrophy Mucosal hyperplasia Protein wasting |
|
|
Disease association: Menetrier's disease
|
CMV
|
|
|
Autoantibodies: PSC
|
p-ANCA
Anti-smooth muscle ANA |
|
|
Ca2+ levels in Williams syndrome
|
Hypercalcemia secondary to increased sensitivity to vit. D
|
|
|
Defect: Hyper-IgM syndrome
|
CD40L deficiency
|
|
|
Reversible or irreversible: pyknosis, karyolysis, karyorrhexis
|
Irreversible
|
|
|
Cardiac toxicity: macrolides
|
QT prolongation
|
|
|
MOA: guanethidine
|
Blocks NE release
|
|
|
MOA: vesamicol
|
Blocks ACh uptake into vesicles
|
|
|
MOA: metryrosine
|
Blocks Tyr ---> DOPA
|
|
|
MOA: reserpine
|
Blocks DA uptake into vesicles
|
|
|
MOA: hemicholinium
|
Blocks choline uptake by cholinergic neurons
|
|
|
MC toxicity: reserpine
|
Nasal congestion
|
|
|
How does ATII affect NE?
|
Potentiates NE release
|
|
|
MOA: tropicamide
|
Muscarinic antagonist
|
|
|
Conduction speeds through cardiac tissues
|
Purkinje > atria > ventricles > AV node
|
|
|
Cushing triad of elevated ICP
|
Bradycardia, HTN, and respiratory depression
|
|
|
Insulin and Na+ metabolism
|
Insulin ---> Na+ retention
|
