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27 Cards in this Set
- Front
- Back
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For the familial dyslipidemias, what is the dysfunction and what is the key clinical finding/presentation?
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Type 1 = ↓ ApoCII
- acute pancreatitis Type 2 = ↓ LDL-R - achilles tendon xanthoma Type 3 = ↓ ApoE 3&4 - palmar xanthoma Type 4 = ↑VLDL synthesis - eruptive xanthoma |
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What are the anabolic and catabolic effects of prednisone?
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=GC
Anabolic = Liver (for gluconeogenesis) Catabolic = muscle weakness, skin thinning, impaired wound healing, osteoporosis, immunosuppression. |
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What is the most serious SE of digoxin toxicity? What are some associated clinical signs/symptoms?
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Ventricular Tachycardia (d/t HyperK+)
a/w: blurry yellow vision, anorexia (d/t nausea/vomiting/diarrhea) |
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What are the beta-lactamase inhibitors?
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Clavulanic acid
Sulbactam Tazobactam |
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What are the stages of seratonin synthesis from an amino acid?
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1) Tryptophan converted to 5HTP by tryptophan hydroxylase
2) 5HTP → Seratonin (5HT) by amino acid decarboxylase 3) 5HT → 5HIA by MAO (monoamine oxidase) This is why SSRI + MOA-I can lead to seratonin syndrome. |
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What are the symptoms of serotonin syndrome? What is the antidote?
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D-ouble D-own on 5-HT (+ clonus)
D-iarrhea D-iaphoresis 5-HT: 1) HTN 2) Hyperreflexia 3) Hyperthermia 4) Tremor 5) Tachycardia Tx = cyproHepTadine (5HT1 & 2 blocker) |
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What are the SSRI's?
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S-eratonin C-an F-ix P-TSD:
- Sertraline - Citalopram - Fluoxetine - Paroxetine |
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What are the 2 major products of Tryptophan?
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B3 (Niacin) & Seratonin
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What is the most commonly injured nerve in the leg, how is it injured, and what are the consequences?
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COMMON Peroneal (L4-S2)
aka Fibular n. Damaged d/t: - Fibular neck fracture - Lateral leg trauma - Tight casts! Motor - Loss of: - Superficial = foot eversion (lateral leg muscles) - Deep = foot dorsiflexion (anterior leg muscles) Sensory - loss of: - Leg (anterolateral) - Foot (dorsum & b/w the 1st and 2nd digits) |
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What are the drugs associated w/ SJS?
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Stevens-Johnson syndrome (toxic epidermal necrosis - EM involving skin and mucous membranes)
Steven had a RASH after Johnson had a seizure* & gave him a PEC SLAPP: P- PCN E- ethosuximide* C- carbamazapine* S- sulfa drugs L- lamotrigine* A- allopurinol P- phenytoin* P- phenobarbitol* |
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What lipid-lowering agents actually increase TG's? What is 1st line Tx for HyperTG?
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Bile Acid Resins
- cholestyramine - colestipol - colesevelam 1st Line Tx = Fibrates: - gemFIBrozil - cloFIBRATE - bezaFIBRATE - fenoFIBRATE |
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Which thyroid disease often follows a flu-like illness? What are the findings? What's the histology?
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De Quervain's (Subacute) Thryoiditis
Dx = ↑ESR, ↓I-uptake, tender/pain, signs of thyrotoxicosis Histo = granulomatous inflammation (mixed cellular w/ occasional multi-nucleated giant cells) |
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What is the most common cause of a painful thyroid?
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Subacute granulomatous thyroiditis (de Quervain's)
Virally induced (coxsackivirus, mumps) No adenopathy |
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What is the tx for Wilson's Dz?
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Penicillamine = Cu Chelator
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What is Nesiritide and what is it used for?
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Nesiritide is a BNP analog that causes vasodilation (cGMP) and used in Acute Decompensated Heart Failure.
"ABcD of Nessie" A-cute B-NP c-GMP D-ecompensated |
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What serum markers is PBC associated with?
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↑ Anti-Mitochondrial Ab's (IgM)
Cause CD8 Tc mediated destruction of triad bile ducts (granulomatous inflammation) Get pruritis b4 jaundice (late) |
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If a patient has a lung transplant and gets interstitial pneumonia, what infectious agent would you expect? What would you see on Bx?
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CMV - HHV-5 (dsDNA, linear, enveloped)
See "Owl's Eye" inclusion bodies |
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What is the cause and the presentation of ataxia-telangiectasia?
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ATM gene mutation → defective DNA repair & sensitivity to ionizing radiation
trI-A-d: - ataxia (cerebellar defects) - telangiectasias - IgA deficiency → URI's |
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What are examples of mitochondrial inheritance diseases?
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1) Leber hereditary optic neuropathy
2) MERRF = myotonic epilepsy w/ ragged red muscle fibers 3) MELAS = Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes |
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What is secretin, where is it made, and what does it do?
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Secretin
From: S Cells of duodenum (d/t ↑ acid) Action: ↑ pancreatic HCO3- secretion (also ↑ bile secretion & ↓ HCl from stomach) ↑HCO3- neutralizes acid in the duodenum and allows pancreatic enzymes to function |
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What is differential cyanosis and what is a/w it?
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Cyanosis only of the lower extremities.
d/t PDA → unoxygenated blood entering the aorta BELOW the sublcavian artery Closed = Indomethacin Opened = PGE |
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What is the cause and treatment of rose gardener's disease?
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Sporothrix schenckii
Tx = KI or itraconazole |
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What is the name for a sudden loss of neurological function (sensory or motor) w/ no identifiable physical cause? (usually following acute stressor/life event)
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Conversion
Somatoform disorder affecting predominantly young women. |
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What are the structural genes of HIV and their products?
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1) env → gp160 which makes:
- gp120 = attachment - gp41 = fusion & entry 2) gag → p24 = capsid protein 3) pol → RTranscriptase |
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What is the pathophysiology of centroacinar emphysema?
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Heavy smoking causes macrophages to secrete proteases and recruit PMN's; PMN elastase destroys alveolar walls → ↑ lung compliance
"Pink Puffer" w/ barrel-shaped chest. Pursed-lips to ↑ airway pressure |
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What are the causes of cold AIHA?
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Cold agglutinins (IgM) are from:
- CLL - Mycoplasma pneumoniae - Infectious Mononucleosis (EBV) I hate when it's CoLLd in MY-AA-MI |
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What is a Marcus Gunn Pupil?
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An AFFERENT pupillary defect d/t:
- CN II damage (unilateral e.g. MS) - retinal detachment No pupillary constriction in either eye if light shone into affected eye. Consensual constriction if light shone in "good" eye. |
