Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
334 Cards in this Set
- Front
- Back
|
Oxybutynin
|
Rx for urge incontinence
|
|
|
Tolterodine
|
Rx for urge incontinence
|
|
|
Darifenacin and Solifenacin
|
Rx for urge incontinence
|
|
|
Trospium
|
Rx for urge incontinence
|
|
|
Diagnosis of Acute Intermittent Porphyria
|
Increased ALA and Porphobilinogen
(due to deficient HMB synthase aka uroporphyrinogen synthase I) |
|
|
SUPERIOR ORBITAL FISSURE DAMAGE
|
• Carries CN III – eye movement issues
• Carries CN V1 – nasociliary - corneal reflex sensory • Carries CN VII – blinks in corneal reflex not in it • Also there is trochlear nerve abducens and ophthalmic vein |
|
|
Contraindicated medication in C1 Esterase Defciency
|
ACE I -> Increase bradykinin levels. Levels already elevated because kalikernenin activated which increases bradykinin liberation from kinin precursor
|
|
|
Urokinase
|
Similar to tPA
|
|
|
Endoderm Derivatives
|
The endoderm gives rise to all structures derived from the inner lining of the primitive gut tubeincluding the thyroid follicular cells, the epithelial surfaces of the trachea, bronchi and lungs, the liver andbiliary tree, the pancreas, the GI mucosal epithelium and the bladder epithelium.
|
|
|
Aortic Regurg Pressure Tracing
|
Look for dipping of the aortic pressure after aortic valve closure
|
|
|
Use of a two sample T test
|
The two-sample t test is commonly employed to determine if the means of two populations are equal. Severalstatistical approaches can be used, but the basic numerical requirements needed to perform this test are thetwo mean values, the sample variances (eg, standard deviations), and the sample sizes. The t statistic isthen calculated and the p value determined. If the p value is less than 0.05, the null hypothesis (whichassumes that there is no difference between two groups) is rejected, and the two means are assumed to bestatistically different. If the p value is large, then "do not reject" the null hypothesis.
|
|
|
Confidence Interval?
|
means +/- Z(SEM)
For 95% CI Z=1.96 SEM= SE/root(n) |
|
|
Two sample Z test
|
(Choice B) The two-sample z test can also be used to compare two means, but population (not sample) variance are used in calculcations.
|
|
|
ANOVA?
|
(Choice C) The ANOVA (ie, analysis of variance between groups) is closely related to the two-sample t test but can be used to compare more than two groups.
|
|
|
Chi Square?
|
Difference between two or more percentages or proportions of categorical outcomes NOT MEAN VALUES
|
|
|
Pregnancy Nerve block near ischial spine
|
Used if too far to receive epidural anesthesia. The pudendal nerve is derived from the S2 - S4 nerve roots and providessensory innervation to the perineum and genitals (of both sexes) as well as motor innervation to the sphincterurethrae and the external anal sphincter. Additional blockade of the genitofemoral and ilioinguinal nerves would provide complete perineal and genital anesthesia.
|
|
|
Obturator Nerve
|
(Choice D) The obturator nerve is derived from L3 and L4 and serves to provide motor innervation to the medial thigh (adductors).
|
|
|
ANOVA?
|
(Choice C) The ANOVA (ie, analysis of variance between groups) is closely related to the two-sample t test but can be used to compare more than two groups.
|
|
|
Chi Square?
|
Difference between two or more percentages or proportions of categorical outcomes NOT MEAN VALUES
|
|
|
Pregnancy Nerve block near ischial spine
|
Used if too far to receive epidural anesthesia. The pudendal nerve is derived from the S2 - S4 nerve roots and providessensory innervation to the perineum and genitals (of both sexes) as well as motor innervation to the sphincterurethrae and the external anal sphincter. Additional blockade of the genitofemoral and ilioinguinal nerves would provide complete perineal and genital anesthesia.
|
|
|
Obturator Nerve
|
(Choice D) The obturator nerve is derived from L3 and L4 and serves to provide motor innervation to the medial thigh (adductors).
|
|
|
Pancreatic Somatostatin Decreases what?
|
delta cells. Somatostatin secreted from pancreatic "delta cells" decreases the secretion of secretin,cholecystokinin, glucagon, insulin, and gastrin. Somatostainoma causes - steatorrhea, hyper or hypo glycemia and gallstones from decreased CCK
|
|
|
Hepatic drug clearance
|
High volume of distrubution and high lipophylicity (make them more polar and excrete via kidey or bile). kidney is high polarity.
|
|
|
Factious is the same as?
|
Munchausen, feigning symptoms to play the sick role. Malingering is different and to get some sort of external gain
|
|
|
Thalessemias are a problem with what?
|
In beta-thalassemia, mutations affecting the transcription, processing and translation of mRNA lead to a deficiency of beta-globin chains. The underproduction of beta chains in patients with normal alpha chain and heme production leads to increasedformation of HbF and HbA2.(Choice G) Heme production is normal in the thalassemia syndromes. The porphyrias are disorders of the heme production pathway.
|
|
|
Name a problem with protein solubility
|
(Choice C) Protein solubility is affected by sickle cell disease, where deoxygenated HbS polymerizes intocrystals that distort the erythrocyte into sickle-shaped cells.
|
|
|
Vibrio Cholera
|
The clinical case describes infection with Vibrio cholerae. V. cholerae are oxidase-positive, gram-negative,comma-shaped rods that are able to grow on alkaline enrichment medium*** that kills most organisms of thenormal flora of the gut. This morphology may be confused with infection by Campylobacter jejuni, one of themost common causes of diarrhea worldwide, which is a curved motile gram-negative, oxidase positive rod,but this organism is unable to survive alkaline enrichment.
|
|
|
Hemadsorption viruses
|
Influenza and parainfluenza viruses are.
|
|
|
Tertian malaria every 48 hours
|
Vivax and Ovale
|
|
|
Erythrocytic form of malaria?
|
Trophozoites, burst as merozoite. In falciprum you get banna shaped gametocytes taken in by mosquito. Primaquine can only kill hypnaozoites not erthytocyte form - tropho
|
|
|
Release vWF
|
Demeclocyline
|
|
|
Mechanism of antiplatelet drugs
|
Antiplatelet drugs work by one of three basic mechanisms: 1) formation of ligands (aspirin decreasesthromboxane A2 formation), 2) blocking interaction of ligands with receptors on platelets (clopidogrel andticlopidine work as ADP antagonists), or 3) interfering with intracellular signaling (cilostazol and dipyridamoleincrease cAMP by decreasing phosphodiesterase activity). TICLODIPINE CAUSES NEUTROPENIA.
|
|
|
Dapsone SE
|
Can cause agranulocytosis, NSAID thyroid meds can also do this
|
|
|
Hemochromatosis
|
On the short arm of chromosome 6, the hemochromatosis gene (called HFE) encodes an HLA class I-likemolecule that appears to affect iron absorption from the gastrointestinal tract.is therefore one of the most common inherited diseases, as well as one of the most common inborn defects inmetabolism.
|
|
|
Lead Poisoning
|
Lead Colic
Bluish pigment at gum tooth line Wrist drop Deposit on epiphyseal plate Microcytic Anemia and basophilic stippling |
|
|
Iron Poisoning
|
(Choice B) Iron poisoning is typically separated into four stages. First, nausea, diarrhea, and abdominal painare experienced, often accompanied by hemorrhage, hypovolemia, and shock in severe cases. In stage two, the gastrointestinal symptoms resolve and the patient appears better. By stage three, metabolic acidosis,hepatic dysfunction, and hypoglycemia may set in. Stage four is marked by scarring of the recoveringgastrointestinal tract.
|
|
|
PCT Brush Border Enzymes
|
(Choice A) The brush border enzyme activity of the proximal collecting tubules is responsible for reabsorbingof 2/3 of the sodium and water filtered from the glomerular capillaries into Bowman's capsule. These enzymesare also responsible for reabsorbing filtered glucose, amino acids, phosphate and lactate by cotransport withsodium.
|
|
|
Aldosterone
|
ducts. Under the influence of aldosterone, sodium and water are removed from the tubular fluid actively andpassively, respectively. As a consequence, potassium and hydrogen ions are lost into the tubular fluid. Thus,aldosterone promotes potassium ion and hydrogen ion secretion from the intercalated cells of the renalcollecting tubules.
|
|
|
Parvovirus
|
This patient most likely caught a parvovirus infection from her son. In children, parvovirus B19 infectioncauses erythema infectiosum (fifth disease), which involves a nonspecific prodrome of fever and malaise followed by a bright red rash on the cheeks 5-7 days later. Some children also develop a generalized lacey rash that starts on the arms and spreads to the trunk and legs. In adults, parvovirus can cause arthritis involving the proximal interphalangeal, metacarpal, knee and ankle joints. Like rheumatoid arthritis,involvement is usually symmetric, but unlike rheumatoid arthritis, symptoms generally resolve spontaneously. THE O IN TORCH - can lead to hydrops fetalis.
|
|
|
ATN histological apperance
|
Histologically, overt ATN is characterized by flattening of the epithelial cells, loss of the brush border inproximal tubular cells, and subsequent cell necrosis and denudation of tubular basement membrane(TBM). Muddy brown casts, which are pathognomonic for ATN, are a variant of granular pigmented casts.(Choice A) ATN produces pronounced vasoconstriction of glomerular capillaries. No characteristic changesin glomerular epithelium are noted.
|
|
|
X linked dominant
|
Vitamin D resistence rickets - All daughters of men with it will have it.
|
|
|
Mitochondrial Disease
|
Generally, mitochondrial diseases affect oxidative phosphorylation (e.g. Leber's hereditary opticneuropathy).
|
|
|
Increased ACHesterase in amniotic fluid indicates what?
|
Failure of neural tube fusion in 4th week of pregnancy. Acompanied by increase in AFP. AFP can be found in maternal serum
|
|
|
Variant of normal in a congenital heart anomoulaous connection
|
The foramen ovale is patent in 20-30% of normal adults. Although it usually remains functionally closed, anyabnormality increasing right atrial pressure above left atrial pressure can produce a right-to-left shunt across apatent foramen ovale.
|
|
|
Peroxisome defect
|
-Phytanic acid disease avoid chorophyll
- Peroxisomal diseases are rare inborn errors of metabolism where peroxisomes are either absent or nonfunctional. Very long chain fatty acids or fatty acids with branch points (PHYTANIC ACID) at odd-numbered carbons can not undergo mitochondrial beta-oxidation; these fatty acids are metabolized by a special form of beta oxidation(very long chain fatty acids) or by alpha oxidation (branched chain fatty acids such as phytanic acid) within peroxisomes. These diseases commonly lead to neurologic defects from improper CNS myelination. |
|
|
Proteasomes
|
-Degrade proteins whos function are no longer needed directed by ubiquitin
-material degraded in proteasome then taken into the RER where its combined with MHC I |
|
|
MHC Class II is put together how?
|
MHC II – material phagocytosed and then degraded acidified lysosome-endosome the MHC II bounds to guiding invariant chain routed to endosome by golgi – invariant chain degraded then protein binds to MHC
|
|
|
How to test for B12 Def
|
Methylmalonyl CoA. P-biotin->M-b12->S. screws up myelin
|
|
|
How does b12 trap folate?
|
Homecysteine doesn't convert to methionine. (Folate can't give up it's methyl group to make methionine) (Homocysteine to methionine requires B6)
-elevated levels are a risk factor for thrombosis |
|
|
Alkoptinuria
|
Homogyntisic acid builds up. It is a product of tyorsine metbolism. Disorder has a malfunctioning Homogyntisic Acid Oxidase. It can destroy cartillage and valves and is implicated in CAD.
|
|
|
Homocystinuria
|
-ARD in metabolizing methionine
-can disrupt lens, have a marfinoid apperance -Can't convert homocysteine to cystathionine due to missing cysathionine beta synthase Rx: Low methionine and B6 supps |
|
|
t(21,22)
|
Ewings Sarcoma, also t(11,22)
|
|
|
Loss of part of a chromosome
|
Cri-Du-Chat - 5p
DiGeorge - 22q11 Prader Willi 15q |
|
|
Only hypothalamic releasing hormone to act with cAMP
|
CRH
|
|
|
High Potency Neuroleptic Side Effects
|
EPS - Pseudoparkisonism, dystonia, NMS
Rx - Benztropine and triphenydl -haloperidol fluphenazine pimozide -block the mesolimbic but also hit the nigrostriatal |
|
|
Low Portency Side Effects
|
alpha antihistamine and M1 blockade
- retinal or corneal deposits -thioridizine - long qt -chlorpomazine -sedation weight gain |
|
|
Measels
|
C-cough
C-conjunctivitis C-coyza K- koplick -presenting sx of measle rash two days later |
|
|
Thyroid Peroxidase
|
-Organification of Iodine I- --> I
-formation mono and Diiodiyrosine by coupling thyroglobulin to iodine in the follicle -thyroglobulin synthesis related to TSH activity -formation of T3 and T4 |
|
|
Blocking of T4->T3
|
5-Deiodinase blocking by beta blcokers and PTU and ipodate - graves and thryod storm
|
|
|
Crohn's Disease
|
Mouth to anus anywhere - perianal involvement too with fistulas and stricutures - fistuals can go to other bowel loops or outside
-strictures lead to obstruction -nonbloody diahrrea and LOTS of pain -transmural granulomatous |
|
|
Ulcerative COlitis
|
-always in the rectum and then upwards
-no skip, mucosal and submucosal invovlement -bloody diahrrea and toxic megacolon |
|
|
High Alkaline Phosphatase what's the next move?
|
Test GGT to see if it's biliary tree or bone problem
|
|
|
High unconjugated Bili?
|
Hemolysis possible
|
|
|
High serum ammonia?
|
Liver fucntiong or GI bleed
|
|
|
Sudden severe hypotension in a patient with aortic stenosis?
|
Can be atrial fibriliation, patients with stenosis require that extra aortic kick. Results in lowered preload.
People with hypertrophied LV esp elderly need the aortic kick for preload and might be reliant on increased pulmonary pressure. |
|
|
Abnormal Neural Crest migration in the heart can result in what?
|
Tet, transposition of GA, truncus arterosis results from this issue in the TA and bulbis cordis
-DIFFERENT abnromal heart looping results in misplaced inflow and outflow tracts |
|
|
Antiinflammatory Cytokines?
|
TGF - B ( inhibits all T and B and innate) and IL-10 (downregulates Th1 etc
-esp stops monocyte B7 which stops the costimulatory signal to Cd28 T cells which can in turn lead to cells being permantly tolerent |
|
|
Ape Hand Deformity
|
Median Nerve injury
also with loss of pronation and extrinsic finger flexion -thenar eminence flattening |
|
|
MCN
|
Flexors and lateral forearm sensory
|
|
|
Back pain and HLA B27 antigen positive. What should be checked
|
Chest expansion - can lead tohypoventilation
-also has: Inflammation at site of tendon insertion - enthesiopathies - like where the achilles inserts on ankle -Ascending aortitis - dilation of aortic ring and insufficiency -Anterior uveitis |
|
|
D dimer, BT PT PTT all elevated
|
DIC
D Dimer a product of degradation of crosslinked fibrin - consumptive coagulopathy - rattlesnack and ebola |
|
|
Thrombin Time
|
Test of fibrinogn to fibrin abnormality and of heparin function
elevated in disfibrinogenomas |
|
|
antithrombin three
|
Kallikeren and X IX XII XI II
|
|
|
Factor XIII
|
Cross link fibrin polymers- def causes delayed bleeding but does not prolong BT PT or PTT
|
|
|
LPL production where?
|
Located on endothelial cells BUT made by skeletal and heart muscle and uniloculated adipocytes. MULTILOCULATED IS BROWN FAT.
Def in familial hyperchlyo - pancreatitis, eruptive xanthomas and lipemia retinalis signs -TGs -> fatty acids glycerol MAG - activated by apo CII |
|
|
jun protein
|
protoncogene that binds directly to the DNA
|
|
|
Ras
|
protooncogene that codes for a membrane bound g protein coupled receptor - > activates MAP kinase and transcription factors
|
|
|
S-100
|
Similar to calmoduli
-marker for neural crest cells - like melanocytes, Schwann cells and Langerhans cells |
|
|
Kussmaul Sign (elevated JVD) and Pulsus Parodoxus suddenly
|
Cardiac Tamponade
-triadelavated JVD indicated elavated central venous pressure hypotension and distant heart sounds***** -tachycardia -PP is nonspecific but suggstive Ddx - This triad can also be found in tension pneumothorax - but this would have history of trauma and lung abnormalities accompanying** -constrictive peri would take too long |
|
|
Septic shock
|
- hyperdynamic circulatory state so won't have the weak pulses and coldness of other shocks
|
|
|
Pulmonary Hypertension in Hypertensive heart disease
|
backflow pressures causing pulmonary hypertension - thought to have some reactive changes and structural remodelling forming aterial vasoconstriction
-hypoxia induced vasoconstriction is the reason in COPD |
|
|
Dobutamine effects
|
Agonist of B1>B2 - increase LV function also increase heart Rate and o2 consumption which is undesiriable
-also increases conduction velocity which is undesirable and can result in arrhythmias - also decrease vessel resistenc in crease urine |
|
|
lots of fibrin deposotion in Glomerulus
|
crescenteric or RPGN
|
|
|
DiGeorge
|
Migration of neural cells and 3rd and 4th Pouch development - pouch is endoderm - 3rd is inferior PT and thymus 4th is superior PT and calcitonin
|
|
|
2nd brachial cleft
|
obliterated - remnants ar ethe sinus also 3 and 4
1st - external auditory meatus |
|
|
3rd branchial arch
|
Stylopharyngeus and CN IX and great horn of hyoid - posteior 1/3 of tongue
- can lead to pharyngctanous fistula - persistence of cleft and pouch - fustaul between tonisl and lateral neck cleft |
|
|
Fourth branchial arch
|
Superior larnygeal branch
Swallowing pharnyx constrictors and soft palate cricothyroid and levator veli palatini part of posterior 1/3 of tongue -NOTABLE EXCEPT - stylopharyngeus of the 3rd and tensor veli tympanis of the first |
|
|
Branchial arch 6
|
-recurrent laryngeal nerve - all larygneal muscles except cricohyroid
-togehter with fourth make the thyroid cricoid artytneous corniculate and cuneiform cartilages |
|
|
First pouch
|
Middle ear cavity endoderm lining of ear, eustachian tube, mastoid air cells
|
|
|
S-100
|
Similar to calmoduli
-marker for neural crest cells - like melanocytes, Schwann cells and Langerhans cells |
|
|
Kussmaul Sign (elevated JVD) and Pulsus Parodoxus suddenly
|
Cardiac Tamponade
-triadelavated JVD indicated elavated central venous pressure hypotension and distant heart sounds***** -tachycardia -PP is nonspecific but suggstive Ddx - This triad can also be found in tension pneumothorax - but this would have history of trauma and lung abnormalities accompanying** -constrictive peri would take too long |
|
|
Septic shock
|
- hyperdynamic circulatory state so won't have the weak pulses and coldness of other shocks
|
|
|
Pulmonary Hypertension in Hypertensive heart disease
|
backflow pressures causing pulmonary hypertension - thought to have some reactive changes and structural remodelling forming aterial vasoconstriction
-hypoxia induced vasoconstriction is the reason in COPD |
|
|
Dobutamine effects
|
Agonist of B1>B2 - increase LV function also increase heart Rate and o2 consumption which is undesiriable
-also increases conduction velocity which is undesirable and can result in arrhythmias - also decrease vessel resistenc in crease urine |
|
|
lots of fibrin deposotion in Glomerulus
|
crescenteric or RPGN
|
|
|
DiGeorge
|
Migration of neural cells and 3rd and 4th Pouch development - pouch is endoderm - 3rd is inferior PT and thymus 4th is superior PT and calcitonin
|
|
|
2nd brachial cleft
|
obliterated - remnants ar ethe sinus also 3 and 4
1st - external auditory meatus |
|
|
3rd branchial arch
|
Stylopharyngeus and CN IX and great horn of hyoid - posteior 1/3 of tongue
- can lead to pharyngctanous fistula - persistence of cleft and pouch - fustaul between tonisl and lateral neck cleft |
|
|
Fourth branchial arch
|
Superior larnygeal branch
Swallowing pharnx constrictors cricothyroid and levator veli alatini part of posterior 1/3 of tongue |
|
|
Septum Transversum
|
Mesoderm tissue that goes from umbillicus to the pericardium
-gives rise to cells that make diaphragm exists as central tendon --liver grows into it as outouching of foregut |
|
|
Penetrating wound to Left sternal border 4th IC space
|
hits the right ventricle which is the anterior portion of heart
-left lung not stabbed because there is no middle lobe* and superior displaced by cadiac impression |
|
|
Left Atrium
|
Anteriorally you see it between the pulmonary trunk and LV
Makes up most of posterior heart- abuts the esophagus so mass or enlargement can cause dysphagia |
|
|
Left ventricle
|
Lateral Aspect of heart
|
|
|
IVC and the diaphragm
|
T8
(I 8 10 E-ggs A-t 12) |
|
|
Right Atrium
|
Medial Wall of heart
|
|
|
Esophagus anatomy
|
Anterior - Left atrium or trachea AA azygous
Posteior - descending Aorta vertebral bodies (aortic arch loops around left primary bronchus) -no visible lumen |
|
|
Ascending Aorta position
|
posterior right of the pulmonary trunk BUT anterior to SVC
|
|
|
MC Benign Liver tumor
|
Cavernous hemangioma -congential malformations that enlarge by ectasia- blood filled vascular spaces- DO NOT BIOPSY
#2 is hepatic adenoma - danger to rupture - go away when you stop OCP or steroids |
|
|
Lungs ready for birth when
|
>2:1 phosphatidylcholine to sphingolmyelin ratio midway through the 3rd trimeser
|
|
|
Makeshift way to reduce cerebral edema
|
Hyperventilation
|
|
|
Changes in cerebral bloodflow
|
autoregulation keeps it constant between 60 and 140 mmHG
pCO2 is a powerful stimuls -patients with longstanding COPD need this stimulus pO2 below 50 is too |
|
|
Asplenic or SS patients need what vaccines
|
pneumovax, HiB, menigitis PS vaccine
-salmonella has a special Vi antigen that stops phagocytosis and opsonization |
|
|
Major virulence factor of pneumococcus
|
capsule
|
|
|
Chromosomal resistence example
|
quinolones
|
|
|
pamidronate
|
bisphosphanate can cause focal segmental GN
-heroin can too -gold membranous nephropathy |
|
|
Drug induced ATN
|
Cisplatin AG (esp with ceph) Amp B radiocontrast foscarnet
|
|
|
Triamterene
|
like amiloride - ENaC
|
|
|
Renal Interstitial nephritis
|
methicillin- sulfa -ceph - NSAID- cyclosporine- acetazolamide
|
|
|
Thiazide Hypers
|
-Hyperglycemia
-hyperlipidemia - WATCH out in patients with high LDL -hyperuricemia -hypercalcemia |
|
|
increase serum creatnine
|
ACE I
Loop - since huge diuresis decreases renal perfusion - HCTZ doesnt do this as much |
|
|
Alkaline Phosphatase elevation
|
Biliary disease bone disease
-pregnancy malignancy TPN |
|
|
How does fatty acid oxidation inhibitor help angina?
|
lowers o2 needed for the same amount of ATP by increase glucose oxidation
|
|
|
human 70s rRNA
|
mitochondria
|
|
|
Cilostazol
|
Direct vasodilator for Peripheral Artery Disease. ALSO is a PDE inhibitor like dipyridamazole->increase in cAMP counteracts ADP decreases platelet aggregation
|
|
|
Pancreatitis HIV drugs
|
Stavudine Didanosine and Zalcitabine
-also cause peripheral neuropathy - lactic acidosis (all NRTI do that lat) |
|
|
Dementia w/ Eosinophilic Inclusions
|
Lewy bodies oin parkinson's
|
|
|
Fever 1-2 days postop?
|
Atelectasis
UTI 3 days wound 5 days later |
|
|
Fungal meningitis prophylaxis
|
Fluconazole
|
|
|
PCP prevention in sulfa allergy
|
Dapsone
|
|
|
Desmin
|
Rhabdo or Leio
|
|
|
Vimentin
|
Sarcoma - connective tissue stain
|
|
|
S-100
|
Neural, melanoma, astrocytoma
|
|
|
CA-19-9
|
Pancreatic
|
|
|
HyperCa
|
90% hyperpth (solitary adenoma or hyperplasia) or cancer
|
|
|
Trastuzumab toxicity
|
Cardiotoxic
|
|
|
Microtubule effecting drugs
|
-Vinca
-Taxol -Mebendazole - Colchicine -Griseofulvin |
|
|
Testicular Cancer Chemo
|
-Etoposide
-Cisplatin -Bleomycin |
|
|
Def of carbonic anhydrase 2 genetic
|
Osteopetrosis- CN impingement
-normal lab values -defective osteoclasts -pancytopenia |
|
|
Fibrous dysplasia of bone and cafe au lait- what else do yo u see
|
McCune Albright
-see precocious puberty |
|
|
External ear deposition?
|
MCL of Tophus from gout
-also commonly seen in achilles tendon |
|
|
Fungus with erythema nodosum
|
shin subcutaneous fat lesion in histo and coccicoidesmycosis
|
|
|
Proximal muscle weakness and skin rash
|
dermatopolymyositis - elevated CK
-polymyalgia rheumatica - no CK elevation NO weakness jus stiffness and high ESR |
|
|
NSAID for elderly and kidney failure
|
Sulindac
|
|
|
Signet cells in the breast
|
Lobular Carcinoma in situ
|
|
|
hCG resembles what
|
LH FSH TSH
-it supports corpus luteum taking over from LH |
|
|
Acute Gastric Erosions don't penetrate what
|
Muscularis Mucosa
-mucosal lesions that don't pentrate the muscularis -caused by NSAID, stress, alcohol, smoking, bacterial infection, head trauma (cushing) burn (curlers) |
|
|
Gastric Ulcers can pentrates what
|
They can go past to muscularis past the submucosa to the inner and outer mucusal layers
|
|
|
Def of carbonic anhydrase 2 genetic
|
Osteopetrosis- CN impingement
-normal lab values -defective osteoclasts -pancytopenia |
|
|
Fibrous dysplasia of bone and cafe au lait- what else do yo u see
|
McCune Albright
-see precocious puberty |
|
|
External ear deposition?
|
MCL of Tophus from gout
-also commonly seen in achilles tendon |
|
|
Fungus with erythema nodosum
|
shin subcutaneous fat lesion in histo and coccicoidesmycosis
|
|
|
Proximal muscle weakness and skin rash
|
dermatopolymyositis - elevated CK
-polymyalgia rheumatica - no CK elevation NO weakness jus stiffness and high ESR |
|
|
most common cause of EDS
|
sleep apnea
-can be due to hypothyroidism -normal blood gases as opposed to obesity hypoventilation syndrome |
|
|
Aromatase deficiency in embryo
|
-maternal and baby get a high dose of androgens - virilizations
-normal sized uterus but amiguous external genetalia -grow older males have osteoporosis females have tall stature and primary amennorhea |
|
|
Splenic Sequestration Sx
|
Large Spleen
Platelts dont drop below 30k which would hapen in ITP -occurs in disorders that cause splenomegaly like portal HTN -generally no abnormal bleeding |
|
|
TTP
|
missing the ADMST3 - antibody or genetic
-enhanced by endothelial damage -platelty consumption causes the thrombocytopenia |
|
|
SCC of esophagus
|
Iron def, achalasia, nitrosamine, lye
-MCC smoking next alcohol |
|
|
Kayexelate for what?
|
High K levels
Amount of K elevated can let one know how much digoxin was taken |
|
|
OCP contraindications
|
Random ones : hyperTG decompensated liver disease
|
|
|
MCL for colorectal cancer
|
Rectosigmoid colon
#2 is Ascending |
|
|
Reiter's
|
Outside of triade MCC assymetrric arhritis in young males
-can cause sacroillitis -following urethritis or diahhrea -nongonnocalacal or shigell felxnari C jejuni salmonella -sterile pustules keratotic scales (keratoderma blenorhagicum) -aortic regurgitation |
|
|
SAureus protein A found on cell wall does what?
|
Binds the Fc portion of IgG
-strep's virulence stops C3 -IgA cleaves in pneumococcus and neisseria -hemolyssin secreted causes lyses of WBC and RBC -superantigens not bound to cell wall |
|
|
Arsenic Poisoning DOC
|
Succimer or dimercaporal - displaicing aresenic from sulfyl hydryl groups
-this itself is nephrotoxic -arsenic causes SCC and liver angiosarcoma long run -almond garlic breath -CaEDTA - mercury and lead |
|
|
Viruses with one large polycystronic precursor cleaved which thus requires protease
|
Picovirus and other SS+RNA
|
|
|
Why is radial nerve vulnerable to injury?
|
Is in the radial groove
-largest arm nerve |
|
|
Impaired abduction of fingers?
|
Median and ulnar nerve damage
|
|
|
Thumb adduction impairment?
|
Ulnar nerve
|
|
|
Alanine Transamination
|
glutamate + pyruvate ⇌ α-ketoglutarate + alanine
|
|
|
Leucine forms what
|
Acetoacetate and ACetyl CoA
Isoleucine and Valine form Succinyl CoA |
|
|
Medial Circumflex Associations
|
-Injury causes avascular necrosis of femoral head and neck
-vulnerable to femoral neck fractures |
|
|
Obturatory Artery
|
Gives branch that feeds ephiphyseal plate so very important to kids
|
|
|
DNA pol I exonucleause activity
|
This one removes RNA primer and replaces with DNA. ONLY ONE WITH 5'->3' activity**
Also like all three DNA pol has 3'->5' |
|
|
Exonuclease vs Endonuclease
|
Exo - remove nucleotides from end of DNA molecule
Endo - cut at very specific sites |
|
|
Why doesnt a pregnant woman lactate?
|
High E and P suppress while they develop breast growth and development
-first trimester CL makes progesterone and estrdiol*** -2nd and 3rd placenta makes it and fetal adrenal makes estrogen with placental help** |
|
|
hCG purpose?
|
preserve the corpus luteum in the first trimester till placenta can take over E and P production
-peaks at week nine |
|
|
Cross Sectional Study?
|
Simulatanously measures exposure and outcome
|
|
|
Case Control?
|
Select case and control then determine exposure status.
|
|
|
Cohort
|
Get a group of people determine their exposure status and then see if they develop disease over time - Relative Risk
|
|
|
Case Control
|
Odds/ratio
Patients with COPD had a higher odds of smoking than patients without COPD |
|
|
Patient has recently Dx diabetes, anemia and a necrolysing migratory erythemea and groin rash
|
Glucagonoma Dx with serial glucagon measurements
|
|
|
VIPoma
|
diahrrea, hypoK and metabolic acidosis
|
|
|
Patient has purulent urethritis what is the Rx
|
Must treat for both G and C
-ceftriaxone -doxy or macrolide |
|
|
What gen ceph do you use for meningitis
|
3rd and bove
|
|
|
Drugs that can cause bone loss
|
Phenytoin, prednisone
|
|
|
Functional Mitral regurgitation
|
Mitral Valve normal but ischemia or LV dilation causes regurgitation
|
|
|
Neuropathic pain Rx
|
TCA, duloxetine (stimulant SE) (SNRI) gabapentin capsacin cream carbamezapine
-only TCA is antimuscarinc |
|
|
Bad SE of inhalational anesthetics
|
increased ICP from increased brain BV dilation, hypotension, myocardial depression, drop in BP, decreased renal
|
|
|
STN is what?
|
An inhibitor of movement thus lesion=hemiballismus but can also help stop parkinsons
|
|
|
Stroke causes blindness what artery?
|
Posterior Cerbral
|
|
|
Dysarthria can be caused by what?
|
Cerebellar vermis lesion. accompanied by truncal instability. Seen in kids with medulloblastoma and nystagmus
|
|
|
Agraphia and acalcula
|
Gerstman Left Parietal lobe lesion - also L R disorientation can't tell fingers apart
RP lesion - hemisensory neglect |
|
|
Paralysis of upwards gaze?
|
Superior colliculus lesion
|
|
|
Lesion causes down and out?
|
PCA - CN III palsy
ACA - would cause bitemporal hemi |
|
|
Vertical Diplopia?
|
Trochlear Nerve damage - most noticable when looking towards the nose
|
|
|
GLUT
|
GLUT 1 - basal uptake (brain rbc etc)
GLUT 3 - basal uptake GLUT 2 - uptake and release(*** unique liver) of glucose by liver and islet glucose sensor (HIGH Km -> low affinity) GLUT 4 - insulin stimulate glucose uptake - muscle and adipose - recruitment aka exocytosis of transporter |
|
|
Hemolytic Anemica with elevated BPG
|
Pyruvate Kinase
- no heinz bodies <-oxidative damage |
|
|
What type of channels is CFTR
|
ATP gates Ca++ channel
|
|
|
Triple Test in Pregnancy
|
At 16-18 weeks
MCC of AFP elevation is wrong timing of test Confirm age with US |
|
|
Hawthorne effect
|
study population changing behavior after knowing they're being studied
|
|
|
Ureters and bladder in what compartment?
|
Reteroperitoneum
|
|
|
How does diphtaria toxin work?
|
Ribosylation of EF2
|
|
|
Pertussis toxin
|
Inactivate Gi -> increase cAMP-> increase insulin, PMN and leukocyte dysufncitong and histamine sensitivity
|
|
|
Topical Corticosteroids
|
Dermal ATrophy - > lowers ECM collagen and GAG
|
|
|
CD31
|
Normal - macrophage testing senescence on Blood Cells
Marker for vascular tumors |
|
|
Lesion of what artery can cause locked in?
|
Basilar overlying the pons
|
|
|
TCA side effects
|
REMEMBER LONG QT
Anti M Anti Alpha Anti H1 |
|
|
Fibroblast growth factor
|
important for bone and vascular growth and wound healing
-mutated recetor= dwarfism -stimulates osteoclasts just like transforming growth factor |
|
|
Calceneurin function
|
Dephosphorylates NFAT ->enters nucleus and binds IL2 promotor
->growth and response of T cells Cyclosporine and tacromlimus block |
|
|
Neurofibromin function
|
Suppresses Ras - activator of cell growth and proliferation
|
|
|
ALA formed by what precurors
|
Succinyl CoA - also in TCA cycle
Glycine B6 cofactor |
|
|
Inhalational Anesthetic fxn
|
Work on GABA
-all except NO are resp depressent -reduce clearance of mucos -increase ICP -decrease hepatic BF and GFR |
|
|
Nontypeble H Flu (unencapsulated)
|
cause acute otitis media, sinusitis and bacterial conjuctivitis only 2nd to strep pneumoniae
- the vaccine HiB prevents meningtis and epiglottitis , pneumonia and sepsis- used to be a big cause of this -used to be 50% of bac meningitis -given at 2 mos |
|
|
Delusional Disorder
|
nonbizzare delusions, can maintain normal social functioing
-typically have one fixation -followed, cheated on poisoned vs aliens -auditory hallucionations also accompnay paranoid schizophrenia not in delusional |
|
|
WPW Triad
|
Short PR (doesnt have the AV slowing), Delta wave before QRS and long QRS
|
|
|
DIC findings
|
Prolonged PTT and PT
MAHA and thrombocytopenia Low fibrinogen D-Dimer - fibrin split products Low factor V and VIII |
|
|
Protein C and S
|
S is the cofactor of C
Degrades V and VIII |
|
|
Metyrapone
|
Inhibits 11B steroidhydroxylase
Rx Cushings Dx Adrenal Insufficiency - if levels don't rise after administration of precursors somethings wrong with the HPA axis If they rise then theres an adrenal problem |
|
|
C1INH Def Angioedema
|
Increase kallirenin activation -> increase bradykinin
|
|
|
ETC
|
Complex I - inhibited by barbituate adn rotenone
Complex II - Succinate DH - FADH2 CoQ - transfer II to III e- - heme Comp III - heme b/c1 Cyto C - heme Comp IV - cyanide and CO hit it - aka Cyto a/a3 - also heme Comp V - ATPase - proton go down gradient - oligomycin inhibits Uncoupler - 2,4 Dinitrophenol, asprin, thermogenin from multiloculated fat |
|
|
Lesion of SC
|
Conjugate vertical gaze paralysis - Parinaud's syndrome
|
|
|
TCA MC of Death
|
Inhibition of Na+ channels->refractory hypotension and arrhythmias prolonged QRS QT and low inotropy
Administer hypertonic sodium bicarb |
|
|
What is albendazole used for?
|
Echinococcus
|
|
|
Incus origin
|
3rd associated neural crest
also malleus but not stapedius -also palate vomer zygoma mandible maxila temporal bone palate |
|
|
Use of nontreponemal tests?
|
Screening and for watching progression after Rx. Treponeme will be positive regardless
|
|
|
How do OCP work?
|
Inhibit gonadotropins -> no LH spike for ovulation
|
|
|
Can't produce ATP
|
Chylamdiae rickettisae thus intercellular
|
|
|
Cystic degeneration of the putamen
|
Wilson's Disease
|
|
|
Aspergillus in the brain
|
Neutropenic patients post transplant not HIV
|
|
|
Stroke + lactic acidosis
|
mitochondrial disease
|
|
|
TGF-beta
|
IgA switching
|
|
|
Ischemic COlitis
|
Atherosclerotic narrowing of SMA or IMA - pinpoint pain when eating -> feat ing of eaiing
DIFFERENT THAN ACUTE ISCHEMiA (emolism, thrmobosis, shock, mesenteric vein thrombosis) |
|
|
Conduction of Atria or ventricle faster
|
Atria
|
|
|
Golden tumor clear cells
|
Renal CC reflecting its high lipid content... also look for high EPO flank mass and hematuria and PTHrP
|
|
|
Dysathria
|
Neuro disorder charecterised by poor articulation - CNS - CN -basal ganglia - stroke etc
|
|
|
Myoglobin
|
Resembles induvidual subunits of hemoglobin -> much higher O2 affinity
|
|
|
How is collagen made insoluble in its production?
|
Cleavage of terminal disulfide bonds
|
|
|
COPD respiration
|
Hypoxic Drive - don't treat with O2
normal people have a CO2 related drive |
|
|
Drugs that can cause kidney issues
|
Heroin, Pamidronate -> focal segmental
Gold therapy, captopril->membranous ATN - AG cisplatin foscarnet tubular obsturction - sulfonamide, acylovir, methotrexate Interstitial nephritis - methicillin, nsaid, allopuronal, acetazolamide |
|
|
MCC Multiple liver abscesses
|
Ascending cholangitis caused by E coli
-triad of fever jaundice and RUQ pain ->from biliary infection and duct obstruction combo |
|
|
Clonorchis
|
Cyst in fish -> cholangiocarcinoma
|
|
|
Granulomatous Hepatitis
|
Either Tb or histoplasma
|
|
|
Schistosoma mansoni
|
Fibrotic response in portal vein due to the eggs-> protal HTN and associated findings
|
|
|
NEonatal hepatitis
|
Multofactorial has multinucleated giant cells - can be CMV or alpha1 erlated etc
|
|
|
Reye's
|
-post chicken pox or flu + salicylates
-fatty liver iwthout nuclear displacement DEFECTIVE UREA CYCLE and BETA OXIATION->encaphalopathy and fatty change |
|
|
HELLP
|
hemolytic anemia with schistocytes, elevated transminases due to liver cell necrosis arond triads, low palteltes due to DIC
|
|
|
Fulminant hepatitis
|
Neutrophils in alcohol, T lymphocytes in hep
increase in PT and ammonia - decrease in transaminse** |
|
|
Hpatic Infarction
|
Uncommon due to dual blood supply
-caused by transplant rejection or PAN |
|
|
Portal Vein thrombosis
|
->ascities portal HTN NO hepatomegaly
->bacterial gases PCV or HC carcinoma causing tumor invasion of the portal vein |
|
|
Peliosis Hepatitis
|
Sinsusoidal dilation due to blood
ANABOLIC STEROIDS -bartonella henselae |
|
|
Centrilobular Hemorrhagic Necrosis
|
LHF or RHF
-Hyperperfusion causing necrosis around zone 3 or RHG backing up into cenral vein and sinusoids -NUTMEG LIVER from necrosis may progress to cardiac cirrhosis from brigrosis |
|
|
Posthepatic obstruciton causes
|
Hepativc Vein thrombsosi -PCV MCC OCP hepatocelluar carcinoma again
-HIGH MORTALITY painful large liver |
|
|
Alcohol related fatty change
|
Fatty change MC alcohol disease -> substrates of alcohol met used to make liver TG - tender heatomegaly with no inflammation
-increase Acetyl CoA and G3P which promotes formation of fatty acids and TG |
|
|
Alcoholic Hepatitis
|
Acetaldehyde Def -> collagen synthesis around central vein
MALLORY BODIES - ubquitinated and damged cytokeratin IF in hepatocytes -ainful, neutrophil, ascities, hepatic encephalopathy |
|
|
ACute hepatitis
|
INH, halothane, tylenol METHYLDOPA
|
|
|
-Cholestsis
-Fatty change -Fibrosis |
OCP and steroids - interfere with bil secretion
-Last two methotrexate and amiodarone cause |
|
|
-Interhepatic Cholestasis
VS Extrahepatic |
pregnancy - benign OCP (estrogen) and steroids - interfere with bile secretion, neonatal hepatitis
-EXTRA- MCC gall stone, primary scleroising perocholangitis, extrahepatic iliary artresia, head of pancrease carcinoma ALL - green distend in liver, cholesterol reflux causing uticaria, no urobilin in urine increase CBili, increase ALP GGT |
|
|
Extrahepatic biliary Artresia
|
Proliferation of bile duct wihtin triads***, inflammatory destruction of extrahepatic bile ducts***
-> LIVER TRANSPLANT IN KIDS |
|
|
Primary Scelrosing Pericholangitis
|
Fibrosis intra and extra heaptic
_ UCLERATIVE COLITIS INCREASED RISK OF CHOLANGIOCARCINOMA |
|
|
Cirrhosis Defined as
|
Irreversible diffuse fibrosis of the liver with formation of regenerative nodules
-liver cells can regrow but not most components not there- no triads and sinusoids- compress everything else so intrasinusoidal hypertension and increased portal HTN as a result |
|
|
MCC of cirrhosis
|
Alcohol
-next is HBV and HCV (postnecrotic cirrhosis increasing cancer risk) -next is primary biliar crirrhosis -hemochromatosis, wilso's alpha1 antitruspin and galactosemia*** |
|
|
Hepatic Encephalotpathy
|
Increase in aromatic AA -> converted to false NT like
Reversible GABA->MS change, somnolence, asterixis, coma and death ini late stage. Ammonia comes from AA met and also from bacterial ureases |
|
|
Portal Vein
|
Most people its splenic + IMV
portal HTN can lead to hypersplenism -> cytopenias -hepatorenal syndrome - from hypotension Ascites - portal HTN hypoalbumnemia and increased aldo ( liver can't met and from low pressure) -hyperestrimism -spotaneous pertitonitis - strep in kid adult e coli etc |
|
|
PBC
|
Granulomatous destruction of ile ducts WITHING protal triads
-women 40-50 goes to cirrhosis pruritis BEFORE jaundice since theres a reserve ANTIMITOCHONDRIAL ANTIBODIES DDX - secondary biliary cirrhosis w/ cystic fibrosis eg NO antimitochondrials abs or increase in IgM |
|
|
Hemosiderosis is what
|
Secondary Hemochromatosis
- both lead to Bronze diabetes, cirhossis with high risk of cancer and to malabsorption from pancratic destruction Rx phlebotomy - heart issues |
|
|
Wilsons is due to waht
|
Low Creuloplasmin -> Cu has to be unbound till degraded in liver and extreted by bile which is also low since it codes for hepatocyte transort into bile
- can be in putamen or STN TOTAL SERUM COPPER IS LOW*** good for dx in early stage late there increased in serum and urine |
|
|
Cirrhosis odd lab value
|
Lactic acidosis -> lower lactate to pyruvate
-Hypocalcemia from lower albumin low Vit D 25 version |
|
|
Paraneoplastic with hepatocellular car.
|
AFP, EPO, fake insulin -> hypoglycemia
|
|
|
Cholangiocarcinoma feel palpable gall bladder
|
-most common malignancy of bile ducts
Caused by PS pericholangitis in US or Clonorhics sinesis (LIVER FLUKE worldwide MC) thororast, choledochal cyst (children abdominal pain with jaundice) Sx - obstructive jaundice and PALPABLE GALLBLADDER** aka couvossier sin |
|
|
Screen of choice in abdomen
|
Gallbladder - US
Pancreas CT |
|
|
Gall Stone
|
Cholesterol - increase chol, decrease salt and lecithin - fat female fertile lipid lowering drugs
Pigment = extravascular HA like sickle cell or spherocytosis, calcium radioopaque Brown = sign of infetion Related - gall stone illeus cholecystitis gallbladder cancer acute pancreatitis |
|
|
Acute Cholecystitis
|
Stoen causes presure-> ischemia -> E coli growth
Lecithin converted into toxic lyslecithin N,V 15-30 min postmeal- RUQ Jaundice might mean stone in the duct PAIN radiating to the righgt scapula*** |
|
|
Chronic Cholecystits
|
MCC gallbladder issues - thick walled rpeated attacks of minor infllmation
-severe persistence pain 1-2 hrs after meal |
|
|
Gallbladder cancer
|
Hx: old lady with palpable gallbladder
-usually 95%from gall stone porcelain gallbladder - calcified from chornic cholecystitis |
|
|
Acute Pancreatitis MCC
|
Alcohol abuse
Activaton of pancreatitic proenzymes -also done by back pressure from gal stone in terminal CBD -thiazide or alcohol injury -IFX- CMV mumps -HYPERCALCEMIA shock ischemia ->activation of enzyme -trauma like seatbelt |
|
|
Pancreatitis OUTCOME
|
ARDS - hypoxemia from phosphliapse destroying surfactant-> atelecasis and intrapulmonary shutning
Shick Fever N V ENZYMATIC FAT NECROSIS-> Hypocalcemia as it binds to fattacid for saponification Hyperflycemia Amylase Increase first lipase more specific Abdominal mass pseudocystic false capsule DIC |
|
|
CHronic Pancreatitis MCC
|
Alcohol abuse again, CF in kids, malnitirtion, pancreas divisum ( two seperate ducts)
-Dx see chain of lakes of calcified dilations THUS PANCRATIC CT FOR CALCIFICATIONS BEST STUDY |
|
|
Pancreas Cancer Mutation
|
K-RAS
Smoking cause followed by chonic pancreatitis -arisde from duts not aciine CA-19-9 GS more specific than CEA |
|
|
Direct thrombin inhibitors
|
Lepirudin, agrotaban
|
|
|
Interferon A and B
|
Impair the production of viral proteins by stimulating production of antiviral proteins - don't impact cellular mRNA
- |
|
|
CN that can't develop schwannoma
|
CN II
|
|
|
Cortical Collecting Ducts
|
Aldosterone
|
|
|
Mu receptor action
|
K efflux-> hyperpolarize*****
|
|
|
Kussmaul sign DDX
|
JVD in inspiration
-constrictive pericarditis (CHRONIC not ACUTE***, also had a pericardial knock), constrictive cardiomyopathy, tamponade, tricuspid steonsis, right sided heart failure |
|
|
Pulsus Parodoxus DDx
|
Cardiac tamponade, constrictive perdicardiits, cor pulmonae (acute ashtma or COPD)
|
|
|
Delivery of lymphatics BV to ovary, nerves etc
|
Suspensory ligament, ovarian artery from aorta.
-ligate before surgery ROUND LIGAMENT - links uterus to the external genetalia by the inguinal canal Ovarian ligament just holds them |
|
|
Uterine artery is where?
|
Transverse cervical ligament - ligate during hysterectomy
|
|
|
MHC class I made of?
|
B2 globulin and heavy chain
|
|
|
Green color in sputum?
|
Myeloperoxidase - heme containing molecule
|
|
|
OCP result in a deficiency of what vitamin?
|
B6
|
|
|
Addressin
|
High endothelial venus binding the L selectings on lymphocytes
|
|
|
Asplenic patients are susceptible to thisi paracite
|
babesia microti - stays in RBC
|
|
|
N formyl methionine affeect the immune repsonse how
|
bind phagocyte -> trigger G protein
|
|
|
IgCAM
|
on enodthelial cell attaches to integrin of the PMN
-integrin isssues = LAD since CD18 missing and its a b2 microglobulin Dx with flow cytometry increase bacterial not viral infx |
|
|
OCP result in a deficiency of what vitamin?
|
B6
|
|
|
Addressin
|
High endothelial venus binding the L selectings on lymphocytes
|
|
|
Asplenic patients are susceptible to thisi paracite
|
babesia microti - stays in RBC
|
|
|
N formyl methionine affeect the immune repsonse how
|
bind phagocyte -> trigger G protein
|
|
|
IgCAM
|
on enodthelial cell attaches to integrin of the PMN
-integrin isssues = LAD since CD18 missing and its a b2 microglobulin Dx with flow cytometry increase bacterial not viral infx |
|
|
Ipsilateral hyperacusis and inaility to taste anterior 2/3
|
bell's palsy
|
|
|
Heat shock proteins
|
hold cortisol receptors keeps from dimerizing
|
|
|
LVEDP=?
|
PCWP normally
|
|
|
Direct thrombin inhibitors
|
Agrotoban and -rudins
|
|
|
Dipirdimazole and cilastazol
|
inhibit platelet PDE
increase cAMP which in turn decreases platelt aggregation Cil - also vasodilates |
|
|
Anastrazole
|
decreases aromatase
|
|
|
pancreatic enzyme which doesnt require trypsin activation
|
liapse
|
|
|
Absent P wave?
|
A fib
-MCC chronic arrythmia |
|
|
Phenylalanine delation?
|
MCC of cystic fibrosis
|
|
|
Recall bias seen in what type of study?
|
Case/Control
|
|
|
Patients who have cancer more likely to enroll in study. Less applicable to general population.
|
Selection bias - subjects put into groups without thought of confounding factors
|
|
|
MCC of deatha fter infancy in Marfans?
|
Aortic dissection
|
|
|
Chemo with jaundice
|
6mp or MTX
|
|
|
bHCG secretion happens when?
|
When the blastocyst starts its between 6 8-11 days after fertilization detecteable in serum because thats when implantation occurs
|
|
|
impair phagosome lysosome fusion
|
Tb leprosy erlichia legionella
|
|
|
What are the complications post SA hemoraghe
|
Rebleeding and vasospasm CCB often dosed
=vasospasm leads to focal defecit |
|
|
What is THE virulence factors of Tb
|
Cord factors a mycoside - inactivates PMN, mitochondria and causes TNF alpha release
-without this no virulence -measures by seesing serpentine cords on culture SULFATIDES another virulence factor allow habitation of macrophage |
|
|
Pancreas embryology
|
Ventral bud just does uncinate process part of the head and main duct
-pancrease divisum dorsal contribution to duct does not go away and two seperate pancrei, clinically silent |
|
|
Light reflex controlled by what
|
pretectal nucleus, bypassing Lateral GN
|
|
|
Panic disorder pathology
|
Locus cereulues located in central pontine thoguht to be implicated, contains lots of NE
|
|
|
Anorexia brain
|
Raphe Nucleus and reticular formation, 5ht, also has to deal with depresson and insomnia
|
|
|
Diabetic moms
|
transposition of the great arteries
|
|
|
Primary oocyte
|
arrested at prophase I
|
|
|
Secondary oocyte
|
arrested at meiosis II till fertilization
|
|
|
Ritordrine
|
B2 agonist - relax uterurs = tocolysis
also MgSo4 Dinoprostone- causes contraction |
|
|
Aminocaproic acid
|
inhibits fibrinolysis used to stabalize situation when fibrin dissolution is osurce of bleed
|
|
|
Desmopressin alternate use
|
Increase VIII for vWF and Hemo A
|
|
|
See fibroids think
|
blood loss and anemia
|
|
|
Cyt thyroid carilage to establish airway. what is cut?
|
Cricothyroid ligament
|
|
|
MCC viral pneumonia
|
adenoviruys rsv influenza
|
|
|
Pancreaticoduodenal comes from where?
|
Gastroduodenal which comes off common hepatic. Right gastroepiploic also comes off of it
Right Gastric comes off common hepatic |
|
|
Putting pressure on the portal triad you want your figners where..
|
Epiploic foramen of winslow (omenal formane) within the hepatodudodenal ligament. This connects the lesser and greater sacs.
-gastrohepatic ligament is often ligated to access the lesser sac** - this contains the R and L gastric arteries |
|
|
Atropine effect on acid secretion
|
Stops parietal acid secretion but NOT gastrin release from G cells since GRP is used NOT ach
|
|
|
Pirenzapine
|
antimuscarinic peptic ulcer
|
|
|
Propantheline
|
Antimuscarinc peptic ulcer
|
|
|
Billiary Obstruction
|
OCP anabolics chlorpromazine
Hydraylzine quindine methyldopa cause hepatic granulomas |
