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373 Cards in this Set
- Front
- Back
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deletion in the long arm of what chromosome causes:
1. facial abnormalities (dysmorphia, cleft palate) 2. cardiac abnormalities (tetralogy of fallot, interrupted aortic arch) 3. immunological abnormalities (DiGeorge syndrome) |
Chromosome 22
(George Alago got married when he was 22 y/o) |
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what are the 2 main cardiovascular anomalies that present with cyanosis at birth?
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transposition of the great vessels and tetralogy of fallot
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what are 3 major cyanotic heart diseases that can be caused by abnormal migration of neural crest cells through the primitive truncus arteriosus and bulbus cordis?
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1. tetralogy of fallot
2. transposition of the great vessels 3. persistent truncus arteriosus (associate neural crest cells with the great vessels que estan en la cresta del corazon) |
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precision is aka?
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reliability
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1. what is the outcome of homocystinuria?
2. what is the most common cause? 3. what amino acid is essential in their diet? |
1. hypercoagulability, premature atherosclerosis, ectopia lentis, osteoporosis, & mental retardation
2. a defect in cytathionine synthase 3. these patients cannot form cysteine from homocysteine and therefore need it in their diets |
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what 2 syndromes are caused by thiamine (B1) deficiency?
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beriberi and wernicke-korsakoff syndrome
(B1 is the #1 vitamin because it is veryvery important even for alcoholics) |
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what is the difference between dry and wet beriberi?
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dry - is symmetrical peripheral neuropathy accompanied with sensory and motor impairments
wet = dry + cardiac involvement {cardiomegaly, CHF, cariomyopathy, peripheral edema, tachycardia} (you add water to make beriberi wet) |
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what type of questions should be asked at the beginning of the clinical history to obtain the most information from the patient?
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OPEN-ENDED QUESTIONS!
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what bacteria is most commonly associated with intravenous drug users endocarditis? 2nd most common?
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1. S. aureus
2. P. aeroginosa |
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review pharyngeal arches
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http://en.wikipedia.org/wiki/Branchial_arch#Use_in_staging
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Number needed to treat =
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= 1/Absolute risk
Absolute risk = event rate in placebo group - event rate in treatment group |
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what is the mechanism of diptheriae toxin?
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the A subunit transfers a ribose from NAD to a histidine on EF-2 which becomes inactive and thus inhibit protein synthesis
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name the toxin released by C. perfringens.
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Lecithinase, an enzyme that degrades membrane phospholipids including lecithin
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mechanism of pertussis toxin?
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AB exotoxin stimulates intracellular G proteins to increase cAMP leading to increase insulin, lympocyte and neutrophil disfunction, and increase histamine
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shigella and EHEC toxin mechanism?
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inactivation of 60S ribosomal subunit
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how does S. viridans adhere to cardiac valves?
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it synthesizes dextran from sucrose and dextran facilitates adherance to fibrin wich are deposited at sites of endocardial trauma.
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how to treat S. epidermidis infection of catheters?
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vancomycin with rifampin or gentamicin due to widespread antibiotic resistance especially in nosocomial infection
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what is power?
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Power = 1-beta (type II) error
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Beta (type II) error?
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Beta error is stating that there is no difference when there is one.
(Blocked vision) |
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Alpha (type I) error?
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alpha error is stating that there is a difference when there is not. corresponds with p-value.
(ah [I] saw) |
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1. what is a chi-square test used for?
2. T and Z tables? 3. ANOVA? |
1. to compare the proportions of a categorized (high vs. low) outcome [not mean values]
2. to compare two means 3. to compare 3 or more means |
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odds ration =
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= ad/bc
(cris-cross on 2x2 table) |
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relative risk =
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= (a/a+c) / (b/b+d)
= sensitivity / specificity |
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what are the cardiovascular associations of the following:
1. Down syndrome 2. DiGeorge syndrome 3. Friedreich's ataxia 4. Marfan syndrome 5. tuberous sclerosis |
1. endocardial cushion deformities (ostium primum ASD, regurgitant AV valves)
2. tetralogy of fallot and interrupted aortic arch 3. hypertrophic cardiomyopathy 4. cystic medial necrosis of aorta 5. valvular obstruction due to cardiac rhabdomyomas |
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what is S. bovis endocarditis or bacteremia indicative of?
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GI lessions (colon cancer)
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what is the epithelium lining of the following?
1. ovary 2. fallopian tube 3. uterus 4. endocervix 5. ectocervix 6. vigina |
1. simple cuboidal
2. simple columnar 3. simple (pseudostratified) columnar 4. simple columnar 5. stratified squamous 6. stratified squamous non keratinized |
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Relative Risk =
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mortality (incidence) in exposed group / mortality (incidence) in unexposed group
- if RR =1 there is no association -if RR>1 exposure associated with increased disease -if RR<1 exposure is associated with decrease disease occurrence |
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to be statistically significant a confidence interval must NOT contain the null value of 1. what does this mean in terms of p-value?
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when confidence intervals lack the null value of 1 this equates to finding that the p-value is less than 0.05 thus statistically significant
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the following nuclei release which neurons:
1. raphe nuclei 2. nucleus ceruleus 3. nucleus basalis of meynert 4. caudate and putamen 5. substacia nigra |
1. serotonin --> insomnia and depression
2. NE 3. acetylcholine --> alzheimers dz 4. GABA --> huntington dz 5. dopamine --> parkinson's dz |
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botulinum toxin mechanism :
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prevents presynaptic release of Ach
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1. Wernicke syndrome triad:
2. what is found at atopsy 3. cause 4. diagnostic for thiamine def |
1. opthalmoplegia, ataxia, and confusion
2. the foci of hemorrhage and necrosis is in the mamillary bodies and preaqueductal gray matter 3. thiamine deficiency which is a cofactor for - pyruvate dehydrogenase - alpha-ketogluterate dehydrogenase - transketolase 4. and increase in erythrocyte transketolase levels after thiamine infusion |
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treatment for Giardia lamblia?
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metronidazole
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Atributable risk percent =
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(risk in exposed - risk in unexposed) / risk in exposed
OR = RR-1/RR |
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deficiency in what enzyme gives hypoglycemia and hypoketonemia?
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medium chain acyl-CoA dehydrogenase (MCAD)
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chronic transplant rejection results from injury to:
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graft vascular edothelium mediated by antibodies formed by recipient after transplant
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case fatality rate =
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# fatal cases / # people with dz
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coenzymes required for pyruvate dehydrogenase and alpha-ketogluterate dehydrogenase
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Thiamine
Lipoic acid CoA FAD NAD+ (Tender Loving Care For Nancy) |
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Relative risk reduction =
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(risk for control grp - risk for treatment grp) / risk for control grp
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symptoms for ataxia talangiectasia
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cerebellar ataxia, telangiectasias, increased risk of sinopulmonary infections due to immune deficiency
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tetrahydrobiopterin is a cofactor in the synthesis of what 4 compounds?
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tyrosine, dopa, serotonin, and NO
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antibodies produced in response for M. pneumoniae? also associated with epstein-barr virus
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cold agglutinings - directed against antigens in M. pneumo cell mem which happen to be homologous with antigens present on RBCs surface
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what is the composition of
1. embryonic hemoglobin 2. fetal hemoglobin |
1. 2 zeta & 2 epsilon chains
2. 2 alpha & 2 gamma chains |
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niacin can be synthesized endogenously from:
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tryptophan (helps the orphan get niacin)
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enzymes that convert
1. glucose to sorbitol 2. sorbitol to fructose |
1. aldose reductase
2. sorbitol dehydrogenase |
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what is the treatment for homocystinuria?
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pyridoxine (B6)
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which protein is a major virulence factor for S. pyogenes which inhibits phagocytosis and activation of compliment?
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protein M
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mechanism of tetanus toxin?
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inhibits the inhibitory internuerons that regulate motor neurons
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reaction formation?
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replacement of an unacceptable thought with an emphasis on the opposite
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what are 3 viruses and 3 bactaria that can cause myocarditis?
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viruses: coxacke B, Rubella, cytomegalovirus
bacteria: S.aureus, C. diphtheria, H. inflenza |
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this type of endicarditis affects normal valves and is most often cuased by S. aureus
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acute endocarditis
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this type of endocarditis affects previously damaged valves and is most often caused by S. viridans
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subacute endocarditis
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what are the following aneurysms associated with:
1. berry 2. dissecting 3. atherosclerotic 4. syphilitic 5. mycotic 6. microaneurysm |
1. polycystic kidneys disease - circle of willis
2. hypertension and marfan's syndrome - ascending aorta 3. hypertension - abdominal aorta 4. syphilis - ascending aorta 5. salmonella - abdominal aorta 6. diabetes and hypertension |
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aschoff bodies found in what disease
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acute rheumatic heart disease
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the following embryonic veins give rise to:
1. umbilical 2. vitelline 3. cardinal |
1. degenerates
2. form veins of portal system 3. form veins of systemic circulation |
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define "water-hammer" pulse
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bounding femoral and carotid pulses marked by abrupt distention and quick collapse - seen in Aortic Regurgitation in which one also sees head-bobbing (de Musset sign)
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3 sympathetic effects during exercise:
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1. increase CO
2. increase venous system contraction 3. increase contraction of arterioles in all tissue except muscles |
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what are the function of the following lipoproteins:
1. apo A1 2. apo B48 3. apo B100 4. apo CII 5. apo E |
1. activates LCAT to produce cholesterol esters
2. secreted by intestine- receptor-lipoprotein interaction 3. secreted by liver- causes uptakek of LDL by extrahepatic cells 4. activates LPL 5. uptake IDL remnants by liver |
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which 2 murmurs become more audible with the valsalva maneuver and the standing position?
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mitral valve prolapse and hypertrophic cardiomyopathy
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pentalogy of cantrell:
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1. omphalocele
2. diaphragmatic hernia 3. cleft sternum 4. absent pericardium 5. intracardiac defects |
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beckwith-wiedemann syndrome:
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1. gigantism
2. macroglossia 3. umbilical defect 4. hypoglycemia |
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retroperitoneal organs?
(mneumonic) |
S uprarenal glands
A orta/IVC D uodenum (2nd, 3rd, 4th parts) P ancreas (head, neck, body) U reters C olon (ascending & descending) K idneys E sophagus (part) R ectum (distal) |
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lesions of the following cause?
1. Lateral hypothalamic area (LHA) 2. Ventromedial nucleus of the hypothalamus (VNH) |
1. LHA: anorexia (L for long and skinny)
2. VNH: obesity (your ventral area gets chubby) |
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what is leptin?
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a hormone secreted by adiposites that acts on the hypothalamus and decreases appetite and increases metabolism.
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what is peptide YY?
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produced by small intestine and colon to reduce appetite in response to eating.
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Macrocytic anemia + hypersegmented neutrophils = ?
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B12 and folate deficiecies
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structures passing trough the superior orbital fissure?
(Superior Orbital Fissure No Tiene Los Interiores AmplioS) |
S uperior division of the oculomotor nerve (CN III)
O pthalmic vein F rontal nerve (branch of ophthalmic nerve CN V1) N asociliary (branch of ophthalmic nerve CN V1) T rochlear nerve (CN IV) L acrimal nerve (branch of ophthalmic nerve CN V1) I nferior division of oculomotor nerve (CNIII) A bducens nerve (CN VI) S ympathetic fibers |
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in what 4 cancers do you find psammoma bodies?
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1. P apillary carcinoma of thyroid
2. S erous... 3. A denocarcinoma of ovaries 4. M eningioma 5. M esothelioma |
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most renal calculi are composed of calcium salts. what would be the lab abnormalities?
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normocalcemia with hypercalciuria
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what enzyme contribute to the green color of ecchymoses?
Heme----->biliverdin |
heme oxygenase
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1. Acute post strep glomeruloneprhitis and 2.acute rheumatic fever associated with?
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1. strep skin infection or strep pharyngeal infection
2. group A strep throat infection ONLY! |
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what are 2 things are caused by C. perfringens?
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late onset food poisoning and gas gangrene
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which artery is most likely to be damaged with a femoral neck fracture?
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medial circumflex
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pemphigus vulgaris?
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autoantibodies against desmosomes. presents as bullous dz that results in painful flaccid bullae (that spread laterally with pressure and erosions of skin and mucosa)
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bullous pemphigoid?
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autoantibodies agains hemidesmosomes. the bullae remain intact and mucosal involvement is uncommon
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oral bioavailability?
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AUC for oral/AUC for IV
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heteroplasmy?
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coexistence of both mutated and wild type versions of mitochondrial DNA genes in a specific proportion in an individual
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where do lipids get digested and absorbed?
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digested in duodenum and absorbed in jejunum
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what is a likely cause of zanker's diverticulum?
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cricopharyngeal motor dysfunction
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how does digoxin toxicity manifest?
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changes in color vision, anorexia, headache, fatigue, confusion, vomiting, nausea, hyperkalemia, and arrhythmia
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what causes an annular pancreas?
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failed migration of the ventral pancreatic bud
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VIP causes?
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relaxation of GI smooth muscle, inhibition of H+ secretion, and stimulation of pancreatic bicarbonate and chloride secretion
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what is the most common infectious agent assc with Guillan-Barre?
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Campylobacter jejuni
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what are the 2 indicators of liver failure (poor prognosis)?
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albumin level and prothrombin time (PT)
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increase activity of what enzyme has been found in colon adenocarcinomas and inherited polyposes syndrome?
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COX-2
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chronic cholecystitis --> porcelain gallbladder --> ?
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gall bladder carcinoma
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sings of adenocarcinoma at the head of the pancreas?
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compresses bile duct therefore courvoisier sign (palpable but not-tender gallbaldder), weight loss, and obstructive jaundice (assc with pruritus, dark urine, and pale stools)
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risk factors for pancreatic cancer?
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age 65-75, smoking, diabetes mellitus, chronic pancreatitis, genetics (MEN, HNPCC, familial adenomatous polyposis)
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what effects do estrogen and progesterone have on cholesterol and gallbladder respetively?
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estrogen induces hypersecretion of cholesterol and progesterone induces gallbladder hypomotility
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1. aldolase B
2. aldose reductase |
1. dificiency leads to fructose intolerance
2. turns galactose to galactitol causing cataracts |
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out of all GLUT transporters which one is responsive to insulin?
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GLUT-4 foun in muscle and adipose
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where do you find
1. GLUT 1 2. GLUT 2 3. GLUT 3 4. GLUT 4 5. GLUT 5 |
1. RBCs and CNS
2. hepatocytes & pancratic Beta cells 3. placenta, brain, & kidneys 4. nuscle and adipocytes 5. sperm and GI |
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major sign of irreversible myocardial cell injury?
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mitochondrial vacuolization
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a PDA with right to left shunt will result in?
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cyanosis of the lower extremities
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what enzyme do macrophages secrete during chronic inflammatory progression of an atheroma?
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metalloproteases which degrade collagen which contribues to a weak fibrous cap, increasing the probability of plaque rupture leading to an MI
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how would you treat loss of consciousness due to hypoglycemia in the non-medical and medical setting?
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use IM glucagon in non medical stting and IV glucose in medical setting
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what is reverse T3?
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T4 can either be converted to more active T3 or to the inactive rT3
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what are the gene changes in the following cancers?
1. medullary thyroid cancer 2. follicular thyroid cancer 3. anaplastic thyroid cancer |
1. RET activation (proto-oncogene)
2. RAS overexpression 3. inactivation of p53 |
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Conn syndrome characteristics?
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(increase sodium in compensated by ANP)! increase aldosterone, decrease plasma renin, hypertension, hypokalemia (has an inhibitory effect on insulin action and secretion therefore pts may have impared glucose tolerance)
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in the epineprhine synthesis pathway, which enzyme is under the control of cortisol?
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phenyletholamine-N-methyltranferase (PNMT)
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hamartoma?
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abnormal growth of normal tissue
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the drug metyrapone is used for testing? mechanism?
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test hypothalamic-pituitary-adrenal (HPA) feedback loop interruption. it inhibits 11-beta-hydroxylase which converts 11-beta-deoxycortisol to cortisol
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hCG has structural similarity to what other hormone?
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TSH, therefore, leading to hyperthyroidism. also similar to LH and FSH
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what produces hCG?
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placenta but also by tumors like hydatidiform moles, choriocarcinomas
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what is AFP a marker of?
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germ cell tumors of testes and hepatocellular carcinoma
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warfarin mechanism?
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blocks glutamate residue carboxylation of clotting factors 2, 7, 9, & 10
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name 2 direct thrombin inhibitors (DTIs)
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lepirudine and argatroban
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what oxidase-positive, pigment producer causes "hot tub folicullitis"?
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P. aeroginosa
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7 possible symptoms of edometriosis?
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1. nodularity of uterosacral ligaments
2. uterus retroversion 3. chocolate cysts 4. dysmenorrhea 5. dyspareunia 6. dyschezia 7. infertility |
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effect of estrogen on thryroid hormones?
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increase TBG, increase bound T4 and T3, but free hormones remain normal
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5 dzs with trinucleotide repeats?
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1. fragile x
2. fredericks ataxia 3. huntingtons 4. prader willi 5. myotonic distrophy |
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only dz assc with dinucleotide repeat?
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HNPRC (lynch syndrome)
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troussou sign (migratory thrombophlebitis) is assc with what 2 cancers?
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pancreatic and ovarian cancer
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secretory diarrhea caused by what 4 things?
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1. VIPoma
2. cryptospordium 3. vibrio cholera 4. ETEC |
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what causes endometrial hyperplasia? what tumor is most likely assc?
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caused by hyperestrogen. assc with granulosa cell tumor
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eosinophil mechanism?
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stimulated by IgE bound to a parasitic cell; they destroy parasites via antibody-dependent cellular cytotoxicity (ADCC) with enzymes from teh cytotoxic granules
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mechanism of how hypoestrogenic states cause osteoporosis?
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decrease estrogen leads to over expression of RANK receptors which are essential in the formation and differentiation of osteoclasts therefore increaseing osteoclastes and bone resorption
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what is neurophysin?
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a carrier protein for oxytocin and ADH
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which 2 insulin preparations are the best option for postprandial hyperglycemia?
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lispro and aspart
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ANP and NO have what 2nd messenger in common?
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cGMP
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symptoms of primary biliary cirrhosis?
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pruritus, fatigue, hepatosplenomegaly, evidence of cholestasis (xanthelasma, pale stool), jaundice, steatorrhea, portal hypertension, osteopenia.
Histologic findings: destruction of interlobulaar ducts by granulomatous infiltration |
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what 3 substances convert plasminogen in to plasmin? what inhibits it?
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1. streptokinase
2. urokinase 3. tPA inhibited by aminocaproic acid |
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name 2 fibrinolytics? one side effect?
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reteplase and tenecteplase
reperfussion arrhythmias |
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integrins are part of normal cell adhesion to the extracellular matrix in which they bind to what 3 molecules?
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1. collagen
2. fibrinectin 3. laminin |
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what 5 things may cause nyctalopia (night blindness)?
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1. hereditary retinitis pigmentosa
2. toxic retinopathy due to phenothiazines and chloroquine 3. vit A deficiency 4. congenital rubella and syphilis 5. diabetic retinopathey |
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how does N-acetylcysteine stop acetaminophen toxicity?
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by acting as a glutathione substitute and by providing sulfhydryl groups to enhance the non toxic sulfation eliminaton of acetaminophen
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staph species use protein A to do what?
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to bind the Fc portion of IgG
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cytinuria is defect in the transport of what 4 aas?
what is the clinical manifestation? |
C ystine
O rnithine L ysine A rginine nephrolithiasis with hexagonal crystals |
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which ligament supplies nerves and vessels to the ovary?
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suspensory ligament
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name 3 drugs that inhibit dihydrofolate reductase?
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1. trimethoprim
2. methotrexate 3. pyrimethamine |
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1. pleiotropy
2. polyploidy |
1. instances where multiple phenotypic manifestations result rom a single genetic mutation
2. occurs when more than 2 complete sets of homologous chromosomes exist within an organism or cell (ex: partial hydatidiform mole) |
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in what circumstances does 2,3-BPG increase and why?
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in hypoxia and chronic anemia because it decreases the affinity of hemoglobin for oxygen
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hereditary spherocytosis is due to a mutation of what?
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a plasma membrane scaffolding protein called spectrin
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side effects of statins?
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myopathy and hepatitis
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mechanism of mifepristone?
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progesterone antagonist
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which cells secrete mullerian inhibiting factor (MIF) and what happens in their absence?
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sertoli cells. absence leads to both female and male internal genitalia and male external genitalia (leydig cells still work)
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mechanism of terbinafine?
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inhibits synthesis of ergosterol by inhibiting the enzyme squaline epoxidase
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eyes look ______ a stroke and _____from a seizure
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towards, away
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IGF-1 is aka?
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somatomedin C
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what 2 aas are ketogenic?
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leucine and lysine
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what aas are boht ketogenic and glucogenic?
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phenylalanine, tyrosine, tryptophan, threonine, & isoleucine
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in the treatment of anovulation what 2 drugs are used and how do they work?
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1. menotropin (acts like FSH) - leads to formation of dominant ovarian follicle
2. hCG - stimulates LH surge |
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in contrast to RER, SER contains enzymes for synthesis of what?
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steroids and phospholipids
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list the 3 third generation aromatase inhibitors
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1. anastrozole
2. letrozole 3. exemestane |
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what type of insulin is used in pts with DKA?
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regular insulin
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what are the 2 alpha glucosidase inhibitors of the intestine?
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acarbose and miglitol
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what makes sotalol different from other class 3 anitarrhithmics?
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it's also a beta blocker
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what do the following enzyme deficiencies result in?
1. 17 alpha hydroxylase 2. 21 hydroxylase 3. 11 beta hydroxylase |
1. decrease testosterone & cortisol; increase aldosterone (therfore hypertension & hypokalemia)
2. decrease cortisol & aldosterone; increase testosterone (hypotension & hyperkalemia) 3. decrease cortisol & aldosterone; increase testosterone & 11-deoxycorticosterone (acts like aldosterone therefore hypertension) |
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type 1 diabetes presents acutely with what symptoms?
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polyuria, polydipsia, polyphagia, fatigue, weight loss
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clear indicator of left sided heart failure?
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orthopnea (supine dysnea) that is releaved by sitting
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what are 2 side effect of ACE inhibitors due to increase bradykinins?
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cough and angioedema
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when does pericarditic pain decrease?
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when pt sits up and leans foward
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what is pulsus paradoxus?
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a drop in systoloc blood pressuer of 20 mmHg or more during inspiration. it represents an exaggeration in the normal physiological response to inspiration --> found in cor pulmonale, constrictive pericardial dz, and cardiac tamponade
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what is kussmaul's sing?
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a paradoxical increase in the jugular venous pressuer during inspiration (as opposed to normal decrease) --> found in chronic constrictive pericarditis, cardiac tamponade, restrictive cardiomyopathy, right sided heart failure, and tricuspid stenosis
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which class of antihypertensives are used in pts with left ventricular hypertrophy and remodeling that occurs with MI?
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ACE inhibitors
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symptoms of digitalis toxicity?
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fatigue, blurry vision, change in color perception, nausea, vomiting
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what virus causes pharyngoconjunctival fever in small outbreaks amont ppl living together in close quarters?
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adenovirus
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in what step of the CAC is panthotenic acid used?
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in the conversion of oxaloacetate to citrate
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hawthorne effect?
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tendency of a study population to affect the outcome due to the knowledge of being studied
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pygmalian effect?
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describes researcher's beliefs in the efficacy of treatment that can potentially affect the outcome
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berkson's bias?
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selection bias created by selecting hospitalized pts as the control group
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explain why pts with chron's dz get gallstones?
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because they cannot recycle/absorb bile acids in the terminal illeus and therefore cholesterol precipitates in bile
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what is the endotoxin of N. meningitidis?
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Lipooligosaccharide (LOS)
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what does N. meningitidies LOS cause?
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sepsis, cutaneous petichiae and hemorrhagic bullae, also bilateral adrenal cortical hemorrhage (seen in Waterhouse-Friderichsen)
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what is the first sign of uncal herniation?
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ipsilteal fixed and dialated pupil
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|
bisphosphonates (alendronate) mechanism?
|
inhibit osteoclastic activity by being analogues of pyrophosphate (endogenous regulator of bone turnover).
|
|
|
which chemotherapy drug causes peripheral neuritis as a side effect?
|
vincristine
|
|
|
what is Pure Red Cell Aplasia (PRCA) and what 2 things is it assc with?
|
a rare form of marrow failure characterized by marked hypoplasia of marrow erythroid precursor cells and normal grnaulopoiesis and thrombopoiesis. assc. with tymoma and parvovirus B19 infection
|
|
|
cuase of myasthenia gravis?
|
autoantibodies to Ach receptor (decreases receptor availability) therefore reduced end plate potential
|
|
|
symptoms of myasthenia gravis?
|
ptosis, diploplia, general weakness. --> assc with thymoma
|
|
|
Galactosyl B-1,4-glucose aka?
|
Lactose
|
|
|
side effects of protease inhibitors (-navir)?
|
hyperglycemia lipodistrophy, thrombocytopenia (indinavir)
|
|
|
folate deficiency inhibits the formation of what?
|
deoxythymidine monophosphate (dTMP), therfore, treat with thymidine supplementation
|
|
|
the finding of intestinal pneumonia in an AIDS pt with "owel's eye" inclusion intracellular and cytoplasmic inclusion bodies is indicative of infection with?
|
CMV
|
|
|
what causes HUS?
|
EHEC O157:H7 shiga toxin induces bloody diarrhea before HUS presents
|
|
|
7 risk factor for osteporosis
|
1. smoking
2. menopause 3. corticosteroid therapy 4. physical inactivity 5. Caucasian race 6. low BMI 7. alcohol use |
|
|
which COX predominates in platelets?
|
COX1, therefore, COX 2 inhibitors (colecoxib)do not affect platelets
|
|
|
what is Henoch-Schonlein purpura?
|
a vasculitis that occurs due to deposition of IgA containing immune complexes. Symptoms: palpable lower extremity purpura, abdominal pain, arthralgias, and renal involvement (proteinuria)
|
|
|
lead poisoning manifestations?
|
1. colicky abdominal pain constipation (lead colic)
2. headache, deficits in short term memory 3. peripheral neuropathy (wrist drop or foot drop) 4. bluish pigmentation in gums (lead line) 5. microcytic hypochromic anemia (basophilic stippling) |
|
|
alpha-ketogluterate-------->succiyl coA
enzyme? coenzymes? |
alpha-ketogluterate dehydrogenase complex
TLCFN |
|
|
during gonadal cerebral ischemia, which cells are most susceptible?
|
pyramidal cells of hyppocampus, neocortex, and purkinje cells of cerebellum
|
|
|
where in the kidney is the majority of free water reabsorption?
|
proximal tubule
|
|
|
what bacteria causes bacillary angiomatosis (benign capillary skin papules)?
|
Bartonella
|
|
|
what does the tuberoinfundibular dopaminergic pathway do?
|
connects the hypothalamus and the pituitary gland and is responsible for dopaminergic-dependent prolactin inhibition
|
|
|
which aa is most abundant in collagen?
|
glycine (-Gly-x-y-)
|
|
|
vit B2 (riboflavin) is a precursor for what 2 coenzymes?
|
FMN and FAD
|
|
|
which chemotactic agent is responsible for neutrophil migration to the site of inflammation?
|
Leukotriene B4, C5a, and 5HETE
|
|
|
what 3 microbes cause mononucleosis-like symptoms characterized by negative monospot test?
|
CMV, HHV-6, and toxoplasmosis
|
|
|
morphine mechanism?
|
binds to mu receptors and causes potassium efflux increase therefore hyperpolarizing the neuron
|
|
|
damage to what nerve would give you loss of sensation on the dorsum of the foot, weakness in dorsiflextion, and eversion?
|
peroneal nerve
|
|
|
damage to what nerve would give you loss of plantarflexion, weak inversion, and loss of sensation of the sole?
|
tibial nerve
|
|
|
damage to what nerve would cause loss of sensation on the medial aspect of the leg?
|
saphenous nerve
|
|
|
gross painless hematuria in an older adult should be considered a sign of what until proven otherwise?
|
urothelial cancer
|
|
|
both N. gonorrhoeae and C. trachomatis cause urethritis. what is the treatment for each?
|
ceftriaxone for N. gonorrhoeae
doxycycline and azithromycin (macrolides) for C. trachomatis |
|
|
desmopresin is used for the treatment of hemophilia A, what is the mechanism?
|
it releases von Willerbrand factor and factor VIII from the endothelium
|
|
|
name 3 catalase + organisms that commonly affect pts with CGD?
|
S. aureus
E. coli Aspergillus |
|
|
1. what bacteria produces lecithinase?
2. lecithinase is aka? 3. what does this toxin do? |
1. C. perfringens
2. alpha toxin or phospholipase C 3. destroys erythrocytes, platelets, leukocytes, and endothelial cells --> rapid tissue necrosis observe in gas gangrene |
|
|
chronic loss of upper extremity pain and temp; upper extremity weakness; hyporeflexia; lower extremity weakness and hyperrreflexia; and kyphoscoliosis all indicate?
|
syringomyelia
|
|
|
the clinical presentation of restlessness, agitation, dysphagia, progressing to coma following an exposure to cave bats is strongly suggestive of?
|
rabies encephalitis
|
|
|
epilepsy and blotchy red muscle fibers (red-ragged fibers) are indicative of what group of dzs?
|
mitochondrial myopathies
|
|
|
name 3 characteristic components of craniopharingioma?
|
1. solid
2. cystic 3. calcified |
|
|
what 2 malignancies is alpha-fetoprtein a marker of?
|
hepatocellular carcinoma and yolk sac tumors
|
|
|
what drug that treats depression and insomnia also causes priapism as a side effect?
|
trazadone
|
|
|
what 4 things can lead to renal papillary necrosis?
|
1. sickle cell dz or trait
2. diabetes mellitus 3. analgesic nephropathy 4. severe obstructive pyelonephritis |
|
|
what drug causes mycobacteria to lose their acid-fastness by inhibiting mycolic acid?
|
isoniazid
|
|
|
what morphology does temporal arteritis and takayasu's arteritis have in common?
|
granulomatous inflammation
|
|
|
isolated cardiac amyloidosis is due to deposition of what?
|
abnormally folded atrial natiuretic peptide (ANP)
|
|
|
more than 90% of type 2 diabetics have pancreatic islet deposition of amyloid protein called?
|
amylin
|
|
|
what drug family has been shown to slow the progression of heart failure and CHF?
|
beta blockers (carvedilol in particular)
|
|
|
what family of antibiotics inhibit statin metabolism therefore increasing rhabdomyolysis?
|
macrolides (erythromycin)
|
|
|
in what pathology would you find hemosiderin-laden macrophages?
|
left-sided heart failure
|
|
|
torsades de pointes is caused by?
|
anything that prolongs QT interval
|
|
|
what are Janeway lesions and what dz are they assc with?
|
hemorrhagic macules that may appear on the soles and palms in pts with bacterial endocarditis
|
|
|
what type of vessels does nitroglycering affect the most?
|
veins; dialates veins and decreases preload and oxygen demand
|
|
|
fibrous intimal thickening with endocardial plaques limited only to the right heart are characteristic of what?
|
carcinoid syndrome
|
|
|
the severity of carcinoid syndrome correlates with plasma levels of what?
|
serotonin and urinary excretion of the serotoning metabolite 5-hydroxyindoleacetic acid
|
|
|
in the pathogenesis of atherosclerotic plaques, what promote SMC migration and proliferation?
|
PDGF by platelets
|
|
|
almost all cases of mitral stenosis are caused by?
|
rheumatic fever
|
|
|
______is the agent of choice in treating hypertensive emergencies.
|
Nitroprusside
|
|
|
since nitroprusside is metabolized to cyanide, what would you sue to treat nitroprusside intoxication?
|
sodium thiosulfate
|
|
|
what is the drug of choice for anaphylaxis?
|
epinephrine (due to its stimulation of alpha 1 and beta 1 and 2 receptors)
|
|
|
continuous murmur with systolic accentuation heard best at left infraclavicular region?
|
PDA
|
|
|
what do you treat PDA with?
|
indomethacin
|
|
|
Brain natriuretic peptide (BNP) is elevated in pts with?
|
CHF. it is released by the ventricles when they are stretched. it acts along with ANP and causes vasodilaiton and diuresis
|
|
|
myopathy (increased serum creatinine kinase) is a side effect of?
|
statins
|
|
|
what are the 2 first line drugs used for isolated systolic hypertension?
|
Thiazide diuretics and calcium channel blockers (amlodipine)
|
|
|
what predisposes pts to infective endocarditis?
|
prosthetic heart valves and vlavular inflammation and scarring
|
|
|
hyaline arteriolosclerosis (eosinophylic) is assc with what 2 dzs?
|
non-malignant hypertension and diabetes
|
|
|
what dz is assc with hyperplastic arteriolosclerosis (homogenous onion-like, concentric thickening)?
|
malignant hypertension
|
|
|
congenital QT interval prolongation is assc with what syndrome?
|
Jervell and Lange-Nielsen ysndrome (neurosensory deafness)
|
|
|
how do beta blockers affect the JXG cells?
|
they block beta 1 receptors in JXG cells therefore decreasing renin secretion which lead to angiotensin I and II decreasion but have no effec ton bradykinin
|
|
|
1. diastolic heart failure
2. systolic heart failure |
1. increase only EDP (decrease compliance)
2. increase both EDV and EDP (decrease contraction) |
|
|
which nitrate agent has the highest oral bioavailability?
|
isosorbide mononitrate
|
|
|
one sided kidney atrophy is suggestive of?
|
renal artery stenosis
|
|
|
a bluish neoplasm occurring underneath the nail bed may be either a ___ or ___.
|
glomus tumor (glomangioma) or subungual melanoma
|
|
|
neoplasm assc with arsenic & polyvinyl chloride exposure that is composed of cells that express CD31 (aka PECAM1)?
|
liver angiosarcoma
|
|
|
flattening of the deltoid muscle after a shoulder injury indicates?
|
anterior dislocation of the humerus
|
|
|
propionyl CoA is derived from which aas?
|
valine, isoleucine, methionine, and threonine
|
|
|
what is the drug of choice for trigeminal neuralgia?
|
carbamazepine
|
|
|
glomerulonephritis, photosensitive skin rash, and arthralgias, plus hypercoagulability, and miscarriages in a young female are indicative of?
|
SLE
|
|
|
how are PTH and calcium levels in a pt with chronic renal failure?
|
PTH is elevated and calcium is normal to low (with high serum phosphorus)
|
|
|
what is the capsule component found on HIb vaccine?
|
polyribosyl-ribitol-phosphate
|
|
|
what bacteria causes epiglottitis?
|
HIb
|
|
|
in what tubule of the kidney does ADH act on?
|
medullary segment of collecting duct
|
|
|
what is the most common cause of intracerebral hemorrhage?
|
hypertension. Occurs due to rupture of charcot-bouchard aneurysms (basal ganglia or internal capsule)
|
|
|
what 3 dzs are assc with berry aneurysms?
|
PKD, marfan, ehler's-danlos
|
|
|
what 2 things prevent calculi formation?
|
increasing citrate and fluid intake
|
|
|
what does the protein kinesin do?
|
is a microtubule associated motor protein whose function is anterograde transport of neurotransmitter-containing secretory vesicles down axons to synaptic terminals
|
|
|
a lesion in what anatomical part causes the following symptoms?
1. pure motor hemiparesis 2. pure sensory stroke 3. ataxia-hemiplegia syndrome 4. dysarthria-clumsy hand syndrome |
1. posterior limb of internal capsure
2. VPL or VPM thalamus 3. base of pons 4. base of pons or genu of internal capsule |
|
|
what is pathognomonic for acute pyelonephritis?
|
WBC casts
|
|
|
pts with CGD are at increase risk for infections with what 5 organisms?
|
1. S. aureus
2. Pseudomonas Capacia 3. Serratia marcescens 4. Nocardia 5. Aspergillus |
|
|
what kind of media is required for Legionella pneumophila to grow?
|
charcoal-yeast agar supplemented with cysteine
|
|
|
what do the following serotypes of chlamydia cause?
1. A-C 2 D-K 3. L1-L3 |
1. trachoma (occular infection) in children
2. urogenital (sexually transmitted) infections and inclusion conjunctivitis 3. lymphogranuloma venerum |
|
|
what is the drug of choice for chemoprophylaxis meningococcal meningitis?
|
Rifampin
|
|
|
young pt w/ recurrent skin infections without pus formation and delayed detachment of umbilical cord and poor wound healing?
|
Leukocyte adhesion deficiency results from autosomal recessive absence of CD18 w/ch leads to the inability to synthesize integrins
|
|
|
what is the DOC for drug induced parkinsonism?
|
benztropine and trihexyphenidyl
|
|
|
shigella invades the GI by first invading what cells?
|
M cells in peyer's patches
|
|
|
Von Hippel-Lindau?
|
capillary hemangioblastomas in the retina and or cerebellum as well as congenital and or neoplasms in the kidney, liver, and pancreas
|
|
|
what is the most common cause of retinitis in HIV + pts?
|
CMV
|
|
|
oseltamivir moa?
|
inhibits viral release - it's a neuraminidase inhibitor
|
|
|
symptoms of phencyclidine intoxication?
|
aka PCP, feelings of detachment, aggressiveness, slurred speech, ataxia, involuntary movements, exaggerated gait, vertical nystagmus
|
|
|
what does IL-5 do?
|
enhances class switching to IgA & stimultes producion and activation of eosinophils
|
|
|
what is the allantois and urachus?
|
embryonic structures (the urachus is a remnant of the allantois that connects the bladder with the yolk sac). Failure of the urachus to obliterate by birth results in a patent urachus. this condition presents with urine discvharge from the umbilicus
|
|
|
what biochemical processes occur in the mitochondria?
|
1. beta oxidation of fa
2. ketogenesis 3. CAC 4. urea cycle 5. pyruvate carboxylation |
|
|
what medication should be administered immediately after arsenic poisoning?
|
dimecarpol
|
|
|
moa of dimecarpol?
|
a chelating agent that displaces arsenic ions from sulhydryl grps of enzymes and facilitates their excretion
|
|
|
most common cause of chronic pancreatitis?
|
alcohol abuse
|
|
|
enterovirus family include what 3 viruses?
|
coxsackie, echo, & poliovirus
|
|
|
mode of transmission of enteroviruses?
|
fecal-oral
|
|
|
most common causes of aseptic meningitis?
|
enteroviruses: echo and coxsackie
|
|
|
most common cause of common cold?
|
corona, rhino, and adenovirus
|
|
|
metalloproteases?
|
enzymes that degrade extracellular matrix
|
|
|
1. general sensation from the anterior 2/3 of tongue?
2. general sensory posterior 1/3 of tongue? 3. general sensory for tongue root? 4. gustatory innervation of anterior 2/3 of tongue? 5. gustatory innervation of posterior 1/3? 6. tongue root, taste buds of larynx, upper esophagus? 7. motor innervation of tongue? |
1. mandibular division of trigeminal
2. glossopharyngeal 3. vagus 4. facial nerve 5. glossopharyngeal 6. vagus 7. hypoglossal (with the exception of the palatoglossus muscle which is innervated by the vagus) |
|
|
mast cell activation marker?
|
tryptase
|
|
|
DOC for the treatment of heparin-induced thrombocytopenia?
|
direct thrombin inhibitors (hirudin, lepirudine, argatraban)
|
|
|
w/ch artery runs with the radial nerve in the humeral shaft?
|
deep brachial artery
|
|
|
Niemann-pick?
|
autosomal recessive dz characterized by defect of the sphingomyelinase enzyme resulting in accumulation of sphyngomyelin. pts present in infancy w/ loss of motor skills, hepatosplenomegaly, hypotonia, cherry-red macula spot. foamy histiocytes are classic finding.
|
|
|
Tay-sachs?
|
deficiency of enzyme hexosaminidase A. causes GM2 ganglioside accumulation
|
|
|
Hurler syndrome?
|
mucopolysaccharoidosis where heparan sulfate and dermatan sulfate accumulate due to a deficiency of alpha-L-iduronidase
|
|
|
Gauche dz?
|
glucocerebroside accumulates w/in phagocytes due to a deficiency of flfucocerebrosidase
|
|
|
von-Gierke dz?
|
deficiency of glucose-6-phosphatase
|
|
|
pompe dz?
|
deficiency of lysosomal alpha-1,4-glucosidase
|
|
|
Fabry dz?
|
deficiency of alpha-galactosidase A. causes ceramide trihexoside to accumulate. symptoms: angiokeratomas, acroparesthesia, hypohidrosis, renal failure
|
|
|
Lesch-nyhan?
|
disorder of uric acid metabolism caused by a deficiency of enzyme hypoxanthine guanine phosphoribosyl tranferase (HGPRT)
|
|
|
bosentan moa?
|
endothelin-receptor antagonist therefore causeing vasodilation. used for the treatment of pulmonary hypertension.
|
|
|
pleural thickening and calcifications along the lower lung fields and diaphragm indicate exposure to what?
|
asbestos
|
|
|
heliotrope rash and gottron papules are specific for what?
|
dematomyositis
|
|
|
what are primary CNS lymphomas?
|
occur in immunocompromised pts. these tumors arise from B cells and are universally associated with EBV
|
|
|
what do the cold agglutinins of M. pneumoniae do?
|
cross-react w/ RBCs rsulting in anemia
|
|
|
how does hypokalemia manifest in ECG?
|
T-wave flattening, ST-segment depression, prominent U wave
|
|
|
which 2 enzymes serve in the evaluation of biliary tract?
|
alkaline phosphatase and gamma-glutaryl transferase
|
|
|
congenital rubella syndrome?
|
head (microcephaly, mental retardation); eyes (cataracts); ears (deafness); heart (PDA, pulmonic stenosis).
|
|
|
1. what is the most common location for a brain germinoma?
2. histologically germinomas are similar to? 3. symptoms? |
1. pineal region
2. testicular seminomas 3. precocious puberty (caused by beta-hCG production), parinaud syndrome (paralysis of upward gaze and convergence), and obstructive hydrocephalus |
|
|
zidovudine moa?
|
does not have 3-OH group therefore making 5'-->3' phophodiester linkage formation impossible
|
|
|
1.jaw pain that starts int he middle of a meal is characteristic for?
2. sympoms? 3. if suspected which test should be performed? |
1. temporal arteritis.
2. tongue claudication, headache, scalp tenderness and vision loss 3. ESR (increased) |
|
|
what virus causes aplastic crisis in pts with sicle cell anemia?
|
parvovirus B19
|
|
|
NSAID-associated chronic renal injury is morphologically characterized by?
|
papillary necrosis and chronic interstitial nephritis
|
|
|
organophosphate poisoning symptoms?
mechanism? treatment? |
excessive salivation, lacrimation, diaphoresis, urinary incontinence, diarrhea, emesis, miosis, & bradycardia.
binds irreversibly to cholinesterase. treat with muscarinic antagonist (atropine) in addition to pralidoxime (PAM), a cholinesterase ezyme reactivator |
|
|
Theyer-martin selective medium components?
|
chocolate (heated blood) agar that contains vancomycin to inhibit growth of gram + organisms, colistin and trimethoprim to inhibit growth of gram - organisms other than Neisseria, and nystatin to inhibit growth of fungi.
|
|
|
follicular lymphoma is caused by a translocation b/w what w chromosomes?
|
t(14,18) w/ch cuases BCL2 overexpression
|
|
|
toxins from what 2 bacteria act by ribosylating and inactivating EF-2?
|
diphtheria and pseudomonas
|
|
|
what are the 2 toxins of S. aureus and what do they do?
|
1. enterotoxin - superantigen that acts locally in the GI causing vomiting
2. TSS- superantigen that stimulates T-cells leading to widespread cytokine release and shock |
|
|
toxin released by C. difficile & mechanism?
|
cytotoxin B- induces actin depolymerization leading to mucosal cell death, necrosis of colonic mucosal surfaces and pseudomembrane formation
|
|
|
toxin released by C. botulin & mechanism?
|
botulinum toxin - blocks presynamptic release of Ach at the neuromuscular junction resulting in flaccid paralysis
|
|
|
toxin released by B. pertussis & mechanism?
|
pertussis toxin- activates adenylate cyclace via ADP ribosylation, increases cAMP production, causes increase histaminen sensitivity and phagocyte dysfunction
|
|
|
toxin rleased by V. cholerae and mechanism? and similarity to what other toxin?
|
cholera toxin similar to pertussis toxin. activates adenylate cyclase via ADP ribosilation, increasing cAMP causes secretory diarrhea, dehydration, and electrolyte imbalances
|
|
|
multiple myeloma is assc with?
|
AL amyloidosis. amyloid is composed of light chains of amonoclonal immunoglobulins.
|
|
|
HLA-B27 is assc with?
|
reactive arthritis spondyloorthropathiees that occure after infection
|
|
|
what is the substance added to stored blood that is responsible for chelating calcium and magnesium?
|
citrate
|
|
|
what virus binds to the following cell surface rectptors:
1. CD4 2. CD21 3. erythocyte P antigen |
1. HIV gp120
2. EBV gp350 3. parvovirus B19 |
|
|
what are the 2 important side effects of clozapine?
|
agranulocytosis and seizures
|
|
|
what is axonal reaction and what do you see?
|
the changes in the body of a neuron after the axon has been severed. Enlarged cell body rounding peripheral displacement of nucleus and dispersion of nissl bodies to the periphery
|
|
|
clinical manifestations of Patau (trisomy 13) syndrome?
|
1. head and neck: cleft lip/palate, microphthalmia/anophthalmia, deafness, scalp defects
2. CNS: mental retardation, micocephaly, holoprosencephaly, absent olfactory nerve, neural tube defects 3. extremities: polydactyly, rocker bottom feet 4. cardiac: PDA, atrial septal defect, VSD 5. renal: PKD 6. GI: omphalocele, umbilical hernia, pyloric stenosis |
|
|
what drug can assist in the prevention of cerebral vascular spasm following subarachnoid hemorrhage?
|
calcium channel blockers specially nimodipine
|
|
|
diarrhea, wt loss, epigastric region calcifications in a pt w/ chronic alcoholism suggests?
|
chronic pancreatitis w/ch leads to exocrine insufficiency and malabsorption
|
|
|
a mutation in the CFTR gene on Chrm 7 leads to?
|
a misfolding of the transmembrane ATP-gated chloride channel
|
|
|
what does the obturator nerve innervate?
|
muscles of the medial (adductor) compartment of the thigh
|
|
|
clinical symptoms of fragile x?
|
macro-orchidism, long face, large jaw, large elevated ears, autism, 2nd most common cause of mental retardation, mitral valve prolapse
|
|
|
wiskott-aldrich syndrome triad?
|
T hrombocytopenia
I nfections E czema |
|
|
why does infection w/ N. gonorrhoeae does not result in lasting immunity?
|
b/c the ability of these bacteria to modify their outer membrane proteins by the process of antigenic variation
|
|
|
1.what is the ost common appendicular tumor?
2. what substance do they secrete? 3. symptoms? 4. treatment? |
1. carcinoids
2. serotonin 3. flushing, asthma-like symptoms, diarrhea, syncope 4. octreotide |
|
|
what is the preferred dz-modifying treatment for pts w/ moderate to severe rheumatoid arthritis?
|
methotrexate
|
|
|
dry cough, pulmonary infiltrates, hilar adenopathy, and non-caseating granulomas in an African American female indicate?
|
sarcoidosis
|
|
|
acute obstruction of the small airways in infants is most commonly secondary to what virus?
|
RSV
|
|
|
how does rubella infection affect the mom and fetus?
|
polyarthralgias in the mom and deafness, cataracts, cardiac manifestations (PDA) in the fetus
|
|
|
w/ch fungus can survive intracellularly w/in macrophages and cause systemic infection in imunocompromissed pts?
|
histoplasma
|
|
|
universal enhancers of cyP450
|
Rifampin, phenobarbital, phenytoin
|
|
|
what are reed-sternberg cells assc. w/?
|
aka "owls eyes" Hodgkin's lymphoma
|
|
|
polycystic ovarian syndrome is clinically characterized by?
|
obesity, hyperandrogenism, oligomenorrhea, infertility, enlarged ovaries w/ multiple cysts
|
|
|
Rifampin moa?
|
blocks action of bacterial DNA-dependent RNA plymerase therefore inhibiting TC
|
|
|
most homobox-containing genes code for w/ch proteins?
|
transcription regulators
|
|
|
what results from suppression of cholesterol 7-alpha-hydroxylase activity?
|
reduced conversion of cholesterol to bile acids, resulting in excess cholesterol secretion in bile
|
|
|
clinical manifestations for von Hippel-Lindau dz?
|
renal cysts, renal cell carcinomas, hemangioblastomas of cerebellum and retina
|
|
|
moa of cromolyn and neolocromil?
|
used for asthma. inhibit mast cell degranulation
|
|
|
clinical manifestations of tuberous sclerosis?
|
cortical tubers and brain hamartomas, seizures, mental retardation, cardiac rhabdomyomas, facial angiofibromas, leaf-shaped patches of skin lacking pigment, & renal angiomyolipoma
|
|
|
the GFR can be calculated using what 3 things?
|
creatinine clearance, inulin clearance, or straling equation
CL = Ux [urine flow] / Px GFR=Kf (PG - PB) - (oncoticG - OncoticB) |
|
|
what is diffuse esophageal spasm (DES) and what should be ruled out first?
|
uncoordinated contractions of the esophagus that cause chest pain, w/ch may mimic unstable angina and therefore this should be ruled out first
|
|
|
what cells does EBV infect and how do you test for this virus?
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EBV is an oncogenic virus that promotes polyclonal B cell proliferation and heterophil antibody production. the monospot test is a hightly specific diagnostic test
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entacapone moa?
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COMT inhibitor that prevents L-dopa methylation in the periphery and therefore increase dopamine availability to the brain
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what do pol gene mutations and env gene mutations indicate in an HIV infected pt?
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pol gene - resistance to HIV reverse transcriptase inhibitors and HIV protease inhibitors
env gene - enable escape from host neutralizing antibodies |
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dysphagia and spoon nails (koilonychia) are specific for?
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Iron deficiency anemia
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the rapid urease test is used for the diagnosis of?
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H. pylori. urease will convert urea to CO2 and ammonia and acuse a pH increase
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Rituximab moa?
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monoclonal antibody directed against the CD20 antigen in B cells used to treat lymphomas
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whipple dz?
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caused by Tropheryma whippelii. it involves the small intestine, joints, and CNS. this bacteria proliferates only w/in macrophages w/ch are shown to be packed w/ both rod-shaped bacilli and PAS-positive, diastase resistant granules.
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w/ch cancer is assc. w/ aflatoxin-induced mutation of the p53 gene?
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hepatocellular carcinoma
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what is the most important muscle in achieving the increase intraabdominal and intrathoracic pressure of the valsalva maneuver?
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rectus abdominis
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what is ecthyma gangrenosum and what bacteria is it assc. w/?
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a cutaneous necrotic dz assc. w/ P. aeroginosa
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treatment fo choice for Listeria?
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Ampicillin
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clinical manifestations of Salmonella typhi?
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escalating fever, watery diarrhea, hepatoslenomegaly, "rose spots" on abdomen, hemorrhagic enteritis w/ bowel perforation
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what can you tell me about cerebral circulation in pts w/ COPD?
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decrease cerebral vascular resistance therefore increase ICP
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what symptom differentiates b/w rubella and rubeola?
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postauricular lymphadenopathy indicates rubella
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leading cause of chronic bronchitis?
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cigarette smoking
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what do you use to reverse the symtoms of atropine toxicity?
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physostigmine b/c it has a tertiary amine and therefore has CNS penetration
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Mallory-weiss syndrome is assc. w/?
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alcoholism
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hydrocephalus exvacuo?
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ventricular enlargement occurs due to brain atrophy and is not accompanied by increase in CSF pressure. Assc. w/ advanced HIV
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alkaptonuria?
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autosomal recessive disorder in which the lack of homogentistic oxidase blcoks the metabolism of phenylalanine and tyrosime at the level of homogenistic acid w/ch when excreted int he urine imports a black color. this dz also causes ochronosis, a blue black pigmentation in ears, nose, and cheeks
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how does allopurinol increase the concentration of 6-mercaptopurine?
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by inhibiting xanthine oxidase w/ch degrades 6-mercaptopurine in the liver
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increase in transaminases and decrease in ceruloplasmin...Rx?
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wilson's dz
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when IgA nephropathy is accompanie by external symptoms (abdominal pain, purpuric skin lesions) the Dx is?
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Henoch-schonlein purpura
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how do you treat for gonorrhea and for concomitant infection w/ chlamidia?
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for gonorrhea treat with ceftriaxone and for chlamidia treat w/ azithromycin
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drug induced lupus has been linked to drugs that are metabolized by?
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N-acetylating in liver. for example hydralazine and procainamide
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1. subarachnoid hemorrhage occurs due to?
2. what is the major cause of morbidity and mortality in pts recovering from SAH? 3. what would prevent vasospasms? |
1. rupture of saccular (berry) aneurysms or arteriovenous malformation
2. severe vasospasms 3. nimodipine, Ca++ channel blockers |
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benzodiazepine w/ shortest half life also used for acute anxiety?
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alprazolam
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most common benign liver tumor?
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cavernous hemangioma
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lacunar infarction are the result of?
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lipohyalinosis and atherosclerosis in deep penetrating vessels supplying the basal ganglea due to hypertension and DM
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w/ch antibiotic gives disulfaram effects? what does this treat?
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Metronidazole used to treat trichomonas and vaginitis
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actinic keratoses may progress to ______.
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squamous cell carcinoma
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what causes "apple peel" atresia of the small intestine?
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occlusion of the superior mesenteric artery
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treatment of alcohol withdrawal?
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benzodiazepines
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what is the only gram + bacteria to produce LPS endotoxin?
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Listeria
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most common cause of candida vaginitis?
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antibiotic use
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warfarin-induced skin necrosis occurs in pts w/ what type of deficiency?
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protein C or S
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bruton's agammaglobulinemia?
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X-linked immunodeficiency resulting in absence of B cells and all forms of immunoglobulin due to a defect in B cell maturation therefore germinal centers and primary lymphoid follicles will not form w/in lymph nodes
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duodenal enteropeptidase function?
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activates trypsin from trypsinogen
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