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41 Cards in this Set
- Front
- Back
Definition of SLE |
Autoimmune disease in which organs and cells undergo damage initially mediated by tissue-binding ABs and immune complexes. |
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Highest prevalence in? |
Black women |
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Pathogenesis of SLE? |
1. Genes: Innate immunity, ac 2. |
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Best screening test |
Antinuclear antibody |
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Clinical manifestations: |
pleural effusions, butterfly rash, heart problems, lupus nephritis, arthritis, raynaud's phenomenon |
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Diagnostic criteria |
have to have 4 or more of these: Malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, |
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ANA staining pattern is what? |
Rim (SLE) most specific Homogeneous (SLE very specific) Speckled Nuclear Diffuse Centromere
others indicate other disorders |
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What happens when they are exposed to sunlight? |
makes any symptoms worse |
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Treatment for lupus? |
No... can use corticosteroids to help control some symptoms |
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which drugs can induce lupus? |
isoniazid, hydralazine, procainamide |
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Why do you usually do a urine catecholamine test? |
Pheochromocytoma |
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What are the main catecholamines? |
dopamine, NE, and Epi |
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Which enzymes are involved in the breakdown of catecholamines? |
MAO and COMT and aldehyde dehydrogenase for NE and Epi |
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Breakdown of NE and epi produces the metabolite, ___________ ______ (____) a major end product of NE and Epi metabolism |
Vanillylmandelic acid (VMA) |
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Dopamine metabolized through the enzymes MAO, COMT, aldehyde dehydrogenase produces what? |
homovanillic acid (HVA) |
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Epi --> ___________ --> VMA
NE--> _____________ --> VMA
both via COMT in which organs? |
Metanephrine; normetanephrine
Liver and kidney makes VMA, ADrenal medulla, liver, and kidney make metanephrine and normetanephrine |
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EPI and NE use which enzyme to become dihydroxyphenylglycol (DHPG). Then what happens to DHPG? |
Monoamine oxidase. THen COMT and aldehyde dehydrogenase transform it into VMA. |
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All of these metabolites can/cannot get excreted in the urine? |
CAN |
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Are the metabolites chemically active? |
nope |
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Elevated urine catecholamines? |
Could mean several things, pheochromocytoma, chocolate, exercise, stress... etc |
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Atenolol is used to treat what? |
Antiarrhythmic so treats arrhythmia |
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Beta 1 receptors use which pathway mediator? |
Gs protein coupled receptor which increases cAMP. causing contraction, HR, Renin, Lipolysis, Saliva |
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Atenolol blocks which receptor? |
Beta1 adrenergic receptor, decreasing HR, contraction |
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Cholinergic system does what to decrease HR, contraction? |
inhibits Beta 1 by acting directly on the receptor |
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increaesd cAMP in SA node causes more ____ permeability |
Ca++ |
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Atenolol blocks the sympathetic regulation of __________. |
hypoglycemia |
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In PVD, what does peripheral mean? |
any medium or small vessels that are not part of the heart, aorta, or brain |
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If someone has shiny skin on their lower leg with less hair than you would expect, which category of disease might they have? |
PVD |
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What are the risk factors for PVD? |
smoking, diabetes (glucose glycocylates endothelial proteins), HTN, increased LDL (bigger and takes up more space) |
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Definition of a cerebral aneurysm? |
weak or thin spot o a blood vessel in the brain, balloons out and fills with blood. |
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Causes of cerebral aneurysm? |
Congenital, trauma or injury, HTN, infection, tumors, atherosclerosis, drug abuse (cocaine) etc. |
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Chronic stress to blood vessels causes decreased _________. so if the pressure decreases your vessel won't do what? |
elasticity; bounce back. |
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Myointimal hyperplasia? |
response to vascular injury. Proliferation of sm muscle cell to regain arterial elasticity... composition of vessel isn't as strong as it was before the damage occurred. |
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4 diff types of cerebral aneurysm? |
Berry (circle of willis) Fusiform (all walls are widening from atherosclerotic placque) Dissecting aneurysm (can occur due to trauma or spontaneously, from tear within the inner and middle layer of wall) Mycotic aneurysm (infection in wall mostly from strep) |
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Risk factors? |
age, women, HTN, ETOH, drug abuse |
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Complications? |
Rupture: hemorrhagic stroke, permanent nerve damage, death, subarachnoid hem (hydrocephalus), vasospasm (spasming can block off brain areas , hemorrhage, fix itself, and then do it again!) |
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Which percentage of patients with ruptured aneurysm survive? |
60% |
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Ejection Fraction is a measure of the ________ of the LV. equation? |
Efficiency so increased % is more efficient!
SV/EDV
Normal = 55-70%
Less than 55% depressed myocardial contractility |
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Another word for EDV is ________ and refers to ________. |
preload, volume (venous pool) |
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Another word for ESV is ________ and refers to _______. |
afterload, pressure (contractility) |
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What increases afterload? |
dliated LV, aortic stenosis, HTN, |