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31 Cards in this Set

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How do you treat cyanide poisoning?
1) Nitrites
2) Thiosulfate
3) Hydroxocobalamin (B12)

-Nitrites oxidize Hb from (2+) to (3+) so CN binds methemoglobin vs binding cytochrome oxidase in mitochondria; thiosulfate donates a sulfur so liver rhodanase can turn CN→Thiocyanate; B12 binds up CN
What conditions gives an enlarged uterus that has glandular endometrial tissue w/in the myometrium?
Adenomyosis

Benign but hysterectomy is indicated
What drugs are used in acute coronary syndrome or coronary stenting??
Irreverisble ADP Receptor blockers (prevent GpIIb/IIIa expression and therefore stop platelet aggregation and fibrinogen binding)

"The "PID's"
Clopidogogrel
Ticlopidine
What is pathognomonic for diabetic nephropathy?
Kimmelstiel-Wilson nodules (in nodular glomerulosclerosis)

Acellular, ovoid/spherical, and on the periphery of the glomerulus
What genes are associated w/ Alzheimer's Dz?
Early Onset:
- 21 = APP (cause of early-onset in Down syndrome)
- 1 & 14 = presenilin (2 & 1 resp)

Late Onset = 19 - ApoE4
(ApoE2 is protective)
What neoplasm is a/w a "starry sky" appearance and what causes it?
Burkitt lymphoma d/t overexpression of c-MYC

a/w EBV infection

Starry Sky = sheets of proliferating BCells w/ interspersed normal macrophages ("stars")
What causes acute intermittent porphyria?
Defect in HMB Synthase
(aka porphobilinogen deaminase aka uroporphyrinogen-I-synthase)

Anything that decreases hepatic heme and stimulates ALA synthase will ppt an attack
(e.g. P450 inducers like barbiturates, phenytoin, griseofulvin, EtOH, and even a low calorie diet)
What are the side effects of Phenytoin?
1) CNS = ataxia (cerebellar) and nystagmus (vestibular)
2) Appearance = Gingival hyperplasia (PDGF expression), Coarse features, Hirsutism
3) Heme = Megaloblastic anemia (d/t folic acid interference)
4) P450 Induction
5) Pregnancy = Fetal hydantoin syndrome
Why is there no vaccine for gonorrhea?
d/t rapid antigenic variation of the pilus proteins.
What causes malignant PKU?
a decrease in BH4 (Tetrahydrobiopterin) usually d/t a deficiency in Tetrahydrobiopterin reductase (BH2 → BH4)
What amino acids require Tetrahydrobiopterin in their metabolism?
BH4 needed in:
1) Phe (Tyr & DOPA)
2) Trp (5HT)
3) Arg (NO)
What is the enzymatic problem in maple syrup urine disease? What is a possible tx?
Branched Chain α-Ketoacid Dehydrogenase (BCKDH) complex deficiency.
Cofactors = B1, 2, 3, 5, and Lipoic Acid
Tx = High dose B1 (Thiamine → TPP)
How does increased blood sugar stimulate the release of insulin?
1) Glucose enters pancreatic ß cells via GLUT-2 channels
2) Glycolysis & TCA ensue → ↑ATP
3) ATP binds the KATP channels → closure → depolarization
4) Depolarization → CaV open and let Ca2+ into cell
5) Ca-mediated exocytosis of Insulin in vesicles
What is the genetic predisposition to DM-2?
Defective KATP channels on ßCells in pancreas; don't close properly d/t ATP binding and therefore the cell can' t depolarize properly and release insulin (in response to Glucose that entered and has been turned into ATP)
What is Glyburide and how does it work?
Sulfonylurea drug
Binds the KATP channels in pancreatic ßCells (~ ATP), closing them
This causes depolarization and CaV opening → Exocytosis of insulin in vesicles
What does a high blood/gas partition coefficient (e.g. halothane) indicate?
It is highly soluble in blood, therefore will require more gas to saturate the blood and have a slower onset of action and longer recovery time
What is Etoposide?
Topisomerase II inhibitor - allows it to make ds breaks but not to ligate them back together
Used to Tx Small Cell (lung and prostate) and Testicular
(Small cell and Ball cell)
If someone has Diabetic nephropathy, how can you slow its progression?
ACE-Inhibitors or ARB's
What are the symptoms of Von Hippel Lindau disease?
VHL: (Chromosome 3)
V-oiding (RCC)
H-emagniomas/blastomas (skin, mucosa, organs/retina, brain stem, cerebellum)
L-ots of catecholamines (Pheochromocytoma)
What causes idiopathic thrombocytopenic purpura?
Autoimmune destruction of platelets only; Anti-GpIIb/IIIa
What is Nissl substance?
RER in the cell body of neurons.
What disease is associated w/ t(15;17)?
AML M3 Subtype (APL) - translocates the RARα gene (17) to 15
What are the symptoms of Wernicke syndrome?
Ophthalmoplegia, Ataxia, Confusion = Triad
d/t Thiamine deficiency
What are the symptoms of Korsakoff syndrome?
Complete memory loss & Confabulation
What is anastrozole?
An aromatase inhibitor used to tx breast cancer in post-menopausal women
(also letrozole and exemestane)
What is Buspirone?
First line anxiolitic (for GAD)
5-HT(1A) agonist preferred over benzo's b/c:
- no sedation
- no EtOH interaction
- no tolerance/addiction
What is Wiskott-Aldrich syndrome?
A combined XLR B/T Immunodeficiency characterized by triad:
T-hrombocytopenia
I-nfections (recurrent)
E-czema
What are the types of diseases caused by Aspergillus?
1) Asthma = ABPA (Allergic bronchopulmonary aspergillosis)
2) TB (old) = Aspergilloma (fungus ball colony)
3) HCC = d/t Aflatoxin production
4) Disseminated Dz = Invasive aspergillosis (neutropenia, immunosuppressed)
To what part of the tRNA molecule is an amino acid attached?
The 3' end (opposite from the anticodon)
Between which organisms is novobiocin used to differentiate?
Between the coagulase negative Staph species (G+, Cocci, Catalase +):
- Resistant = Saprophyticus (UTI's in young women)
- Sensitive = Epidermitis (Catheters, Prosthetics)
What is the major RF behind Abdominal Aortic Aneurysms? Thoracic?
AAA = Atherosclerosis (hyperlipidemia)
TAA = HTN