Step 1

Front 1

P-450 Inhibitor (PICK EGS)

Back 1

Protease inhibitor
Isoniazid
Cimetidine
Ketoconazole
Erythromycin
Grapefruit juice
Sulfonamides

Front 2

Small Vd or Volume of distribution

Back 2

High plasma concentration

Front 3

P-450
Inducers
(BCG PQRSEN)

Back 3

Barbiturates
Carbamazepine
Griseofluvin
Phenytoin
Quinidine
Rifampin
St. John's Wart
ETOH chronic
Nicotine

Front 4

Loading Dose

Back 4

= (Cp * Vd)/F

Front 5

t 1/2

Back 5

= (0.7*Vd)/Cl

Front 6

Maintenance Dose

Back 6

= Cl*Cpss

Front 7

ETOH elimination

Back 7

0 then 1st order

Alcohol dehydrogenase is saturated so its 0 order.
After alcohol dehydrogenase is no longer saturated, 1st order

Front 8

Clearance

Back 8

= rate of elimination/plasma drug [ ]
or
= Vd * Ke

Front 9

Therapeutic Index

Back 9

Median Toxic Dose/Median Effective Dose

Front 10

Safer Drugs TI

Back 10

High

Front 11

Comp. Antagonist

Back 11

decrease POTENCY
Vmax unchanged
Decreased Affinity

cross each other

Front 12

Non-Comp. Antagonist

Back 12

decrease EFFICACY
Vmax DECREASED
affinity UNCHANGED

Front 13

Sulfonylureas & s/e

Back 13

1st Gen.
Tolbutamide
Chlorpropamide

2nd Gen.
Glyburide
Glimepiride
Glipizide

s/e
disulfuram effx 1st Gen.
hypoglycemia 2nd Gen.

Front 14

Biguanides & s/e

Back 14

Metformin

Lactic Acidosis

avoid in pts with RF, CHF, & Liver failure

Front 15

Glitazones & s/e

Back 15

Pioglitazone
Rosiglitazone

Wght Gain, edema, hepatotoxicity, & cardiotoxicity

Front 16

Alpha-Glucosidase Inhibitors & s/e

Back 16

Acarbose
Miglitol

GI disturbances

Front 17

Mimetic & s/e

Back 17

Pramlintide

Hypoglycemia, nausea, & diarrhea

Front 18

GLP-1 Mimetic & s/e

Back 18

Exenatide

N/V and Pancreatitis?

Front 19

Sulfonylureas

MOA

Back 19

close K+ channel in beta-cell = depolarization = increase Ca+ influx = INSULIN RELEASE

Front 20

Metformin

MOA

Back 20

Insulin Sensitizer

decrease
gluconeogenesis
serum glucose
increase
glycolysis

Front 21

Glitazone

MOA

Back 21

Increase
target cell response to insulin
PPAR-gamma

Front 22

alpha-glucosidase inhibitor

Back 22

Inhibit
intestinal brush border alpha- glucosidase

decreased
post-prandial hyperglycemia

Front 23

Exenatide

MOA

Back 23

increase insulin secretion

decrease glucagon

slow gastric emptying

reduce appetite and promote satiety

Front 24

CD surface marker found on all T-cells
except NK-cells

Back 24

CD-3

Front 25

Found on NK-Cells

Back 25

CD-16

Front 26

inhibits C9 binding

Back 26

CD-55 & CD-59

Front 27

Borderline

Back 27

Cluster B
unstable mood and interpersonal relationships
impulsiveness
sense of emptiness/loneliness
F > M
Splitting = defense mechanism
Suicide

Front 28

The relation of the Pulmonary Artery to the bronchus in the hilus?

Back 28

RALS

Right = Ant.
Left = Sup.

Front 29

Primary Pulmonary HTN

Back 29

mutated BMPR-2 gene

Front 30

Alveolar Gas Equation

Back 30

PAo2 = PIo2 - (PAco2/R)

R = 0.8 & PIo2 = 150

Front 31

A-a gradient

Back 31

PAo2-Pao2

nl = 10-15

Front 32

Response to excercise

Back 32

V/Q ratio from apex to base becomes more uniform

No change in Pao2 & PaCO2, but increased Venous CO2 content

Front 33

NF-kB

Back 33

transcription factor that induces production of TNF-alpha

Front 34

Pathway of the sperm

Back 34

SEVEN UP
Seminiferous Tubules
Epididymis
Vas Deferens
Ejaculatory ducts
nothing

Urethra
Penis

Front 35

Acrosome derivation
Middle piece "
Flagellum "

Back 35

Golgi
Mitochondria
Centriole

Feeds on Fructose

Front 36

Female
Meosis I

Back 36

arrested in prOphase 4n - 2n
until Ovulation

Front 37

Female
Meosis II

Back 37

arrested in Metaphase until fertilization
2n-n

Front 38

Klinfelter Syndrome
XXY

Back 38

Dysgenesis of seminiferous tubules
decrease Inhibin
Increase FSH
abnormal Leydig cell fx
decrease testosterone
Increase LH & Estrogen

Front 39

Turner's Syndrome

Back 39

Ovarian dysgenesis
decreased Estrogen
Increased FSH & LH

Front 40

Androgen Insensitivity syndrome
46 XY

Back 40

appears Female
no uterus or uterine tube
testes in labia majora
increased Estrogen, LH, & Testosterone

Front 41

Polycystic Ovarian Syndrome

Back 41

Increased LH
Increased Testosterone = hursutism
Decreased FSH
Tx: Ketoconazole/Spironolactone

Front 42

Dysgerminoma

Back 42

Malignant
Sheets of uniform cells
male seminoma
increased B-HCG

Front 43

Choriocarcinoma

Back 43

Rare
Malignant
pregnancy in mom or baby
Hyper-chromatic, Syncytiotrophoblastic cells
Theca-Lutein cysts
B-HCG

Front 44

Yolk Sac
(endodermal sinus tmor)

Back 44

Aggressive
ovaries, testes, sacrococcygeal of young kids
Schiller-Duval bodies
alpha-fetoprotein

Front 45

Schiller-Duval Bodies

Back 45

blood vessels enveloped by germ cells

Front 46

Teratoma
Female

Back 46

2 or 3 germ layers
Mature = Benign
Immature=Malignant
Can involve any mid-line stx

Front 47

CA-125

Back 47

Ovarian Cancer Marker

Front 48

Meig's Syndrome
ass. c Fibromas

Back 48

Triad
ovarian fibroma
ascites
hydrothorax

Front 49

Seminoma

Back 49

Malignant
painless
most common testicular tumor
15 - 35 y/o
"fried egg"
excellent prognosis
late metastasis

Front 50

Embryonal Carcinoma

Back 50

Malignant
Painful
glandular/papillary
differentiate to other tumors
alpha-feto or B-HCG or BOTH
worse than Seminoma

Front 51

Yolk Sac
endodermal sinus Tumor

Back 51

Schiller-Duval Bodies
primitive glomeruli
alpha-feto

Front 52

Choriocarcinoma

Back 52

Malignant
B-HCG

Front 53

Teratoma
Male

Back 53

Mature = Malignant

Front 54

Yolk Sac
(endodermal sinus tmor)

Back 54

Aggressive
ovaries, testes, sacrococcygeal of young kids
Schiller-Duval bodies
alpha-fetoprotein

Front 55

Schiller-Duval Bodies

Back 55

blood vessels enveloped by germ cells

Front 56

Teratoma
Female

Back 56

2 or 3 germ layers
Mature = Benign
Immature=Malignant
Can involve any mid-line stx

Front 57

CA-125

Back 57

Ovarian Cancer Marker

Front 58

Meig's Syndrome
ass. c Fibromas

Back 58

Triad
ovarian fibroma
ascites
hydrothorax

Front 59

Seminoma

Back 59

Malignant
painless
most common testicular tumor
15 - 35 y/o
"fried egg"
excellent prognosis
late metastasis

Front 60

Embryonal Carcinoma

Back 60

Malignant
Painful
glandular/papillary
differentiate to other tumors
alpha-feto or B-HCG or BOTH
worse than Seminoma

Front 61

Yolk Sac
endodermal sinus Tumor

Back 61

Schiller-Duval Bodies
primitive glomeruli
alpha-feto

Front 62

Choriocarcinoma

Back 62

Malignant
B-HCG

Front 63

Teratoma
Male

Back 63

Mature = Malignant

Front 64

Leydig cell Tumor

Back 64

Benign
Reinke crystals
andro producing
gynecomastia & precocious puberty

Front 65

Testicular Lymphoma

Back 65

Old men

Front 66

Psoriasis

Back 66

Acanthosis
Parakeratotic
Increases Spinosum
Decreased Granulosum
Auspitz Spots
Nail Pitting
Psoriatic Arthritis

Front 67

Pemphigus Vulgaris
vs
Bullous Pemphigoid

Back 67

PV - fatal, anti-Desmosomes, IF throughout, skin & oral mucosa, +Nikolsky's sign(manual separation)

BP-less severe, anti-Hemidesmosomes, linear IF, Eosinophils in the blisters, spares oral mucosa, -Nikolsky's sign

Front 68

Acanthosis Nigricans

Back 68

Hyperplasia of the SPINOSUM

Front 69

Squamous Cell Carcinoma

Back 69

locally invasive
rarely mets
ulcerative red lesion
ass. c chronic draining sinus
Keratin Pearls

Front 70

Basal cell carcinoma

Back 70

Most Common
sun-exposed
NEVER mets
rolled edges
central ulceration
Pearly Papules
Palisading nuclei

Front 71

Melanoma

Back 71

really can mets
S-100 tumor marker
sun-exposure
fair-skinned
Depth correlates with risk of mets
Dark
Irregular borders
Dysplastic Nevus - precursor

Front 72

Lead Poisoning
affected enzyme
accumulated stuff in urine

Back 72

Ferrocheletase & ALA dehydratase

Copropophyrin & ALA

Front 73

Acute intermittent porphyria
affected enzyme
accumulated stuff in urine
Sxs

Back 73

Uroporphyrinogen I synthase

Porphobilinogen & sigma-ALA

5-Ps
Painful abdomen
Pink urine
Polyneuropathy
Psychological disturbances
Precipitated by drugs

Front 74

Porphyria cutanea tarda
affected enzyme
accumulated stuff in urine

Back 74

Uroporphyrinogen decarboxylase

Uroporphyrin(tea-colored)

Front 75

t(9:22)

Back 75

CML
Philadelphia
bcr-abl

Front 76

t(8:14)

Back 76

Burkitt's lymphoma
c-myc

Front 77

t(14:18)

Back 77

Follicular lymphoma
bcl-2

Front 78

t(15:17)

Back 78

M3 type AML
trans-retinoic acid responsive

Front 79

t(11:22)

Back 79

Ewing's sarcoma

Front 80

t(11:14)

Back 80

Mantel cell lymphoma

Front 81

ALL

Back 81

Children
TDT+
Most responsive to tx
spread to CNS & Testes

Front 82

AML

Back 82

Adults
Auer rods
M3 responds to all trans-retinois acid Vit A

Front 83

CLL

Back 83

>60y/o
Smudge cells
Indolent course
Warm antibody IgG
similar to SLL

Front 84

CML

Back 84

t(9:22) bcr-abl
transform for AML2/3 or ALL1/3
Blast Crisis
very low Leukocyte ALP
Tx: Imatinib

Front 85

Plummer-Vinson Syndrome

Back 85

Dysphagia(webs)
Glossitis
Iron deficiency anemia

Front 86

FAP
Familial Adenomatous Polyposis

Back 86

AD mutation of APC on chromosome 5q

Two-hit
Thousands of polyps
always rectal involvement

Gardener's-FAP c osseous & soft tissue tumors, retinal hyperplasia

Turcot's-FAP c brain involvement

Front 87

HNPCC or Lynch syndrome

Back 87

mutations of DNA mismatch repair genes-progress to CRC

Proximal colon always involved

Front 88

Peutz-Jeghers syndrome

Back 88

Benign polyposis syndrome
increase risk of CRC
can go visceral
Hamaromatous polyps of colon & small intestine
hyperpigmented mouth, lips, hands, & genitalia

Front 89

Gilbert's syndrome

Back 89

mildly decrease UDP-glucuronyl transferase or decrease bilirubin uptake
asymptomatic
elevated unconjugated bilirubin

Front 90

Crigler-Najjar syndrome, type I

Back 90

absent, UDP-glucuronyl transferase
pts die within few years

Front 91

Crigler-Najjar syndrome, type II

Back 91

less severe & responds to Phenobarbital which increases liver enzyme synthesis

Front 92

Dubin-Johnson syndrome

Back 92

Conjugated HYPERbilirubinemia d/t defective liver excretion
Black liver

Rotor's syndrome-similar but milder with no Black Liver

Front 93

cAMP
endocrine hormones
(FLAT CHAMP)

Back 93

FSH
LH
ACTH
TSH
CRH
hCG
ADH(V2)
MSH
PTH
Calcitonin
Glucagon

Front 94

cGMP

Back 94

NO
EDRF
ANP

Front 95

IP3

(GGOAT)

Back 95

GnRH
GHRH
Oxytocin
ADH(V1)
TRH

Front 96

Steroid Receptor

Back 96

Gluccocorticoid
Estrogen
Progesterone
Testosterone
Aldosterone
Vit. D
T3/T4

Front 97

Tyrosine Kinase

Back 97

Insulin
IGF-1
FGF
PDGF
Prolactin
GH

Front 98

Histiocytosis X
Langerhans cell histiocytoses

Back 98

monocyte lineage
Proliferative
S-100 & CD1a
Birbeck Granules(tennis rackets)

Front 99

Friedreich's Ataxia

Back 99

AR; Tri-nucleotide repeat-
GAA=frataxin gene
impaired Mitochondrial fx
Staggering gait
frequent falls
nystagmus
dysarthria
hypertrophic cardiomyo[athy
childhood= kyphoscoliosis

Front 100

Parinaud Syndrome

Back 100

paralysis of conjugate vertical gaze
d/t lesion of sup. colliculi

Front 101

Sup. Oblique

Back 101

ABducts
Intorts
Depresses

Lesion=diplopia with downward gaze

Front 102

Sonic Hedgehog Genes

Back 102

patterning along Anterior-Posterior axis

Front 103

Wnt-7 gene

Back 103

apical ectodermal ridge
proper organization along Dorsal-Ventral axis

Front 104

FGF-gene

Back 104

apical ectodermal ridge
mitosis of underlying mesoderm & provide for Lengthening of limb

Front 105

Homeobox gene

Back 105

Segmental organization

Front 106

Treacher Collins Syndrome

Back 106

1st arch Neural Crest Fails to migrate
Mandibular hypoplasia
facial abnormalities

Front 107

Congenital Pharyngocutaneous Fistula
3rd Arch

Back 107

persistence of cleft & pouch
fistula between tonsillar area
cleft in lateral neck