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83 Cards in this Set

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  • Back
Location of most tubular injuly in ischemic ATN
Straight portion of proximal tubule + medullary thick ascending limb
Main serum abnormality in initiation phase of ATN
BUN and creatinine increased
Main serum abnormalities in maintenance phase of ATN
Progressive BUN and creatinine increase, hyperkalemia, acidosis
Main serum abnormalities in recovery phase of ATN
BUN and creatinine progress toward normal, hypokalemia
Casts seen in ischemic ATN
Hyaline and granular
Vertebral level of kidneys
T12-L3, right slightly lower
Side of kidneys paranephric fat is on, and its relationship to renal fascia
Posterior; superficial
Vertebral level of kidney hilum
L1 or 2
Lymphatic drainage of kidney
Lumbar nodes at renal artery origin
Layer of fat under renal fascia
Perinephric
Structure immediately anterior to right renal artery near midline
IVC
Which renal vein is longer?
Left
Most common causes (not the organism, the cause) of UTI in women
Pregnancy, sex
Minimum number of colonies to diagnose UTI instead of just contamination
10^5
Enzyme blocked by TMP
Dihydrofolate reductase
Enzyme blocked by SMX
Dihydropteroate Synthase
Toxicity of TMP-SMX
Stevens-Johnson, myelosuppresion, mydriasis, agranulocytosis, liver damage
Difference of floroquinolone mechanism in gram + vs gram -
Gram +: Topoisomerase IV inhibitor, Gram - : DNA gyrase inhibitor
More potent: cipro or levofloxacin?
Levofloxacin (especially in gram +)
Possible EKG abnormality with floroquinolones. Why?
Prlonged QTc; blockage of potassium current
Mechanism of disorientation in SIADH?
Osmotic shift of water into brain cells
Main nuclei where ADH is formed
Supraoptic
Method of feedback of ADH secretion
Stretch and baro receptors
Function of Vasopressin 1 vs 2 receptors
1 = vasoconstriction, 2 = water absorption
Mechanism of muscle weakness in SIADH
Hyponatremia
Two markers signifying a tumor is of neuro-endocrine origin
Chromogranin, neuron-specific enolase
Vitamin (not D) whose deficiency can cause osteoporosis
Vitamin C
Three cytokines that increase RANKL activity post-menopausal osteoporosis
IL1, IL6, TNF
Ligand causing differentiation of macrophages into oscteoclasts
RANKL
Heaviest site of GI calcium absorption
Duodenum
Mechanism by which Vit D increases calcium absorption in the gut
Increases production of calcium binding protein in intestinal epithelium
Effect of vitamin D on phosphate levels
Increased
Effect of PTH on Mg excretion
Decreased
First line tx for Paget's disease
Bisphosphonate, calcitonin
SERM used for postmenopausal osteoporosis
Raloxifene
Reason bisphosphonate users are instructed to drink water and remain upright following a dose
Reduce risk of erosive esophagitis
This drug is used to inhibit bone resorption and comes in a nasal spray
Salmon calcitonin
What form of vitamin D should you give someone with kidney failure? Why?
Calcitriol. This is an active form. Precursors can't be converted
Vitamin D analog that can lower PTH and much less likely to precipitate hypercalcemia
Paricalcitol
MOA of cinaclet
Activates calcium-sensing receptor in parathyroid cells to decrease PTH synthesis
Mechanism by which osteoprotegerin decrease bone resorption
Acts as a decoy receptor for RANKL, thereby decreasing osteocyte production
Paget's disease: more common in men or women?
Men
Distal radius fracture in an eldery person: more likely Paget's or osteoporosis?
Osteoporosis
Three common locations of Paget's fractures
Pelvis, skull, femur
What is seen at the center of a rheumatoid nodule?
Fibrinoid necrosis
WBC's seen in a tophus
Macrophages, lymphocytes, giant cells
Shape of pseudogout crystals
Rectangular/rhomboid
Two initial substrates that lead to uric acid production
GMP and AMP
Function of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
Purine salvage pathway. Converts hypoxanthine to IMP and guanine to GMP. Decreases net uric acid
Disease where HGPRT is deficient and its symptoms
Lesch-Nyhan. Hyperurecemia, retardation, self-mutilation, sometimes gout
Inheitence of Lesch-Nyhan
X-linked
Two modifiable risk factors for gout
Alcohol and obesity
Cytokine released when monosodium urate crystals are phagocytized
Leukotriene B4
Visceral organ sometimes affected in gout and problems caused
Kidney - can lead to stone formation, fibrosis, UTI, and even renal failure
Shape of neisseria gonorrhoeae
Cocci
Types of nerve fibers transmitting pain
A-delta and C fibers
Where is CRP produced?
Liver
Generation of ceftriaxone
3rd
Advantage of 3rd gen over 1st gen cephalosporins
Broading spectrum of action (particularly against gram neg), some able to cross BBB
Substrate of COX
Arachidonic acid
Gout drug that pregnant women should not use
Colchicine
What time of day does cortisol peak?
The morning
Effect of ACTH on total cholesterol
Decreased (cortisol production requires cholesterol)
GI consequence of Cushing's
Can induce peptic ulcers
Usefullness of ketoconazole in Cushing's
Reduces all steroid production
Reason for hirsutism in Cushing's
Increase DHEA
Dexamethasone + this drug is a very effect antiemesis treatment for chemotherapy
Granisetron
Hormone, other than cortisol, which ACTH plays a roll in regulating
DHEA
Alternate name for somatomedin C
IGF-1
Since GH fluctuates thorought the day, this is a better serum marker
IGF-1
Timing and source of S3 heart sound
Middle third of diastole, caused by oscillation of blood between walls of ventricles
Cause of S4 heart sound
Atrial contraction forcing blood against a stiff ventricular wall
Mechanism of cataract formation in diabetics
Sorbital accumulation and subsequent osmotic damage
Mechanism of neovascularization in diabetic retinopathy
Microcirculation problems --> Ischemia --> VEGF --> Neovascularization
Outermost and innermost layer of Bruch's membrane?
Choriocapillary layer and pigmented retinal epithelium
Innermost layer of cornea, underlies endothelium
Descemet's membrane
Aceullular structure underlying basement membrane of cornea
Bowman's membrane
Blood supply of retinal receptor layer
Choriocapillary layer
Retinal layer where rod and cone cell bodies are found
Outer nuclear layer
Most external layer of retina
Retinal pigmented epithelium
Two factors seen on sliding scale for insulin dose
Blood glucose and patient's weight
Effect of hyperkalemia of EKG
Tall T waves
MOA of sodium polystyrene sulfonate
Binds to potassium in intenstines and decreases absorption