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127 Cards in this Set
- Front
- Back
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What percent of your diet should be protein?
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15%
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What percent of your diet should be fats?
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30%
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What percent of your diet should be sugars?
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55%
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What are the main intracellular buffers?
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protein
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What is the main extracellular buffer?
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bicarb
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Which a.a. makes twists and turns?
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proline
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Does an acid or base like to give up hydrogen ions?
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acid like to give up hydrogen ions, a base likes to accept them
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If you have an acid and you want to absorb more, what do you add?
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more acid
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If you have an acid and you want to absorb less, what do you add?
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a base
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Amphetamines are bases that are taken up where? What do they cause the release of?
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taken up presynaptically and cause the release of catecholamines
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What is the smallest amino acid?
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glycine
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What are the 3 aromatic amino acids?
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phe, trp, tyr
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What are the 2 basic amino acids? What charge are basic a.a.?
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lys, arg- + chrg
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What are the 2 acidic amino acids? What charge are acidic a.a.?
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asp, glu- (-) chrg
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What is the only excitatory a.a. in the brain (NMDA pathway)?
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Asp
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What 2 a.a. contain sulphur?
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cys, met
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What are the 3 branched chain a.a.?
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leu, iso, val
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What a.a. is used to make catecholamines and melanin?
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tyrosine
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What a.a. is used to make serotonin?
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tryptophan
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What are the 2 ketogenic a.a.?
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lysine and arginine
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What 4 a.a. are both ketogenic and glucogenic?
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PITT- phe, iso, thr, trp
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What is the pneumonic for the essential a.a.?
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PVT TIM HALL
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How long does plasma glucose last?
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2-4 h
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How long does liver glycogen last?
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24-48 hours
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What enzyme is deficient in PKU?
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phenylalinine hydroxylase
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What is a classic clue for PKU?
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musty odor or blond hair, blue eyes and very fair skin
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What enzyme deficiency causes albinism?
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tyrosinase deficiency
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What causes vitiligo?
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autoimmune antibodies against melanocytes
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What 4 a.a. can cause cystinuria?
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COLA- cystiene, ornithine, lysine, arginine
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What 6 drugs cause drug induced lupus?
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hydralizine, INH, procainamide, penicillamine, pheytoin, ethusuximide
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What is the mcc of mental retardation?
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fetal alcohol syndrome, fragile X, down's
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What is a clue pointing to fetal alcohol syndrome?
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mentioning philthrum
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Porphyrin rings in the urine make it what color?
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red
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Acute intermittent porphyria is what inheritance?
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AR
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In AIP, where are porphyrins deposited?
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visceral organs and around nerves
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What are the symptoms of AIP?
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sever abdominal pain and neuropathy
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What is the treatment for AIP?
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hematin- blocks delta ALA
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What disease leads to skin burns after skin is exposed to sunlight?
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erythrocytic protoporphyria and porphyria cutanea tarda
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What is a clue to opiate use?
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pin point pupil
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What is the most common opiate abused by physicians? Why?
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meperidine- no pin point pupils
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What 2 opiates are used for diarrhea?
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loperimide and diphenoxylate
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What opiate is used as an antitussive?
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dextromethorphan
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What is fentanyl used for?
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anesthetics
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What receptors are opioid receptors?
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mu, delta, kappa
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What is the treatment for a opioid toxicity?
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naloxone- IV
naltrexone- oral |
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When does hemoglobin S disease (sickle cell) present? Why?
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after 6 months because hemoglobin F disappears
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What amino acid is substituted in sickle cell?
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valine for glutamate at position 6
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What does hypoxia cause in sickle cell patients?
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sickle crisis- painful fingers and toes (dactylitis)
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What is aplastic crisis?
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complete bone marrow supression
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What levels do you check when you suspect aplastic anemia?
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reticulocyte count- if they are down, the bone marrow is destroyed
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What is the most common cause of an aplastic crisis?
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parvovirus B19
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What is the treatment for an aplastic crisis?
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tranfusion
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What inheritance is hemoglobin C?
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AR
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What is the substitution in hemoglobin C?
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lysine for glutamate
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Does sickling occur in hemoglobin C?
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no
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What causes the thalassemias?
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gene deletions
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What is the difference between hemosiderosis and hemochromatosis?
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hemosiderosis- bone marrow is overwhelmed by iron
hemochromatosis- iron overload has effected other organs |
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Primary hemochromatosis is what inheritance?
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AR
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What causes primary hemochromatosis?
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too much iron absorbed from the duodenum- HLA A3 on chromosome 6
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What causes secondary hemochromatosis?
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to many tranfusions
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Which NSAID is best for relaxing muscles?
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baclofen
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Which NSAID has moraphine-like analgesic properties?
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ketorelac
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What 2 steroids are given to stimulate surfactant production?
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beclamethasone and betamethasone
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What steroid is given for endometriosis?
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danazol
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What 2 steroids are mast cell stabilizers?
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cromolyn and nedacromyl
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What 2 drugs increase the storage of triglycerides?
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gemfibrozil and clofibrate
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What is a classic clue for lysosomal storage diseases?
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lysosomal inclusion bodies
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What is the enzyme defect in Gaucher's?
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glucocerebrosidase
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What builds up in Gaucher disease?
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glucocerebroside
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WHat is the enzyme defect in Fabry's?
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alpha-galactosidase A
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What accumulates in Fabry's?
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ceramide trihexose
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What inheritance is Fabry's?
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XR
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What is a clue pointing to Gauchers?
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crinkled macrophages (Gaucher's cells) and erlenmeyer flask legs
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What is a clue pointing to Fabry's?
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renal failure on presentation
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Niemann-Pick is a deficiency in what enzyme?
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sphingomyelinase
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WHat builds up in Niemann-Pick?
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sphingomyelin
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What is a clue pointing to Neimann-Pick?
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cherry-red macula
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What is the enzyme deficiency in Tay-Sachs?
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hexoaminidase A
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What builds up with Tay-Sachs?
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GM2 ganglioside
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What is a clue pointing to Tay-Sachs?
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cherry red macula
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Krabbe's disease is a defect in what?
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beta-galactosidase
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What builds up in Krabbe's disease?
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galactocerebroside
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What is the enzyme defect in Metachromatic leukodystrophy?
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arysulfatase A
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What builds up in metachromatic leukodystrophy?
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cerebroside sulfate
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What does metachromatic leukodystrophy present as?
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MS is a 5-10 year old child
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Hurler's is a defect in what enzyme?
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iduronidase
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WHat builds up in Hurler's?
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heparan sulfate and dermatan sulfate
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What inheritance is Hunter's?
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XR
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What is the enzyme defect in Hunter's?
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iduronate sulfatase
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What builds up in Hunters?
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heparan sulfate and dermatan sulfate
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What is a classic clue to Hurler's?
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gargoylism, corneal clouding
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Does Hunter's have corneal clouding?
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no
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What 2 lysosomal storage diseases present with a cherry red macula?
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Neimann-Pick and Tay-Sachs
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What 2 lysosomal storage diseases are XR?
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Fabry's and Hunter's
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What total cholesterol is considered good?
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< 200
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How do you treat cholesterol levels from 200-240?
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diet and exercise
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How do you treat cholesterol >240?
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medication
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What levels of HDL is considered good?
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>145
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How can you increase HDL slightly?
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moderate alcohol
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What drugs do you use to treat increased cholesterol?
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statins
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What statin is proven to prolong a diabetics life?
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simvastatin
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What statin decreases mortality in men with a familial link?
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atorvastatin
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What is the mechanism of action of the sulfonyureas?
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close the K+ channel in the beta islet cells so the cell depolarizes and releases insulin
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What are the 2 first generation sulfonyureas?
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chlorpropamide and tolbutamide
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What are the 3 second generation sulfonyureas?
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glyburide, glimepiride, glipizide
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What is a major side effect of the second generation sulfonyureas?
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hypoglycemia
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How does metformin work?
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exact mechanism unknown, thought to decrease gluconeogenesis and increase glycolysis
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What is a major side effect of metformin?
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lactic acidosis
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What are the 2 alpha-glucosidase inhibitors used to treat type 2 DM?
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acarbose and miglitol
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How do the alpha-glucosidase inhibitors work?
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delayed sugar hydrolysis and glucose absorption
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What are the 2 major glitazones used to treat type 2 DM?
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pioglitazone and rosiglitazone
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How do the glitazones work?
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increase target cell response to insulin
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What are the 2 short acting insulins to treat type 1 DM?
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lispro and insulin are both short acting
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What is the intermediate acting insulin to treat type 1 DM?
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NPH
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What are the 2 long acting insulins used to treat type 1 DM?
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lente and ultra lente
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What is a major concern about a possible side effect of using insulin to treat type 1 DM?
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hypoglycemia
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What is the dawn effect?
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an increase in blood sugar each morning caused by a normal increase in EP, NE, and cortisol
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What is the treatment for the dawn effect?
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increase regular insulin
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What is the Somoji effect?
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caused by hypoglycemia that occurs in early morning leading to reactive hyperglycemia
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What is the treatment for Somoji effect?
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decrease evening NPH
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What are the classical findings in the glycogen storage disease Von Gierke's?
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big liver and kidney
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What is the enzyme deficiency in Von Gierke's?
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glucose 6 phosphate
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What are the classical findings in Pompe's disease?
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cardiomegaly
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What is the enzyme deficiency in Pompe's?
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lysosomal alpha 1,4 glucosidase
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What is the defect in Cori's disease?
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debranching enzyme alpha 1,6 glucosidase
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What is the classic sign of McArdle's disease?
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muscle cramps during exercise
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WHat is the enzyme defect in McArdle's?
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skeletal muscle glycogen phosphorylase
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