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0526 Flashcards

1
Q

TNF-a TX predisposes to?

A

infection- esp REACTIVATION of LATENT TB.

also fungi and atypical mycobacteria.

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2
Q

TNF-a inhibitors

A

infliximab.
adalimumab.
etanercept.

decrease macrophage function.

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3
Q

tinea capitis

A 
isolated pruritic lesions on scalp.
central clearing (ring worm).

TX: terbinafine (squalene epoxidase inhibitor).

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4
Q

TX of male pattern baldness

A

5 alpha reductase inhibitor (Finasteride)

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5
Q

pulmonary circulation

A

low pressure, high flow system.

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6
Q

how does pulmo circ compare to systemic circ?

A

SAME blood flow per minute (rate) in both systems, at rest AND during exercise.

volume output of LV must always equal volume output of RV.

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7
Q

what helps the thin RV keep pace with the stronger LV in order to maintain same volume output?

A

low afterload pressures of pulmo circulation

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8
Q

what vitamin can help treat measles (rubeola)?

A

vit A

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9
Q

why do pts with hyper-IgM syndrome have recurrent sinus and airway infxs?

A

deficient IgA

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10
Q

most effective immunoglobulin opsonin is?

A

IgG

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11
Q

key Ig in providing immunity against bact toxins is?

A

IgG

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12
Q

most common causes of hyper IgM syndrome

A

genetic absence of CD40 ligand on T cells
OR
genetic deficiency of enzymes needed for DNA modification that takes place during isotype switching

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13
Q

what hormone regulates zona fasciulata and reticularis of adrenal gland?

A

ACTH

angiotensin II regulates zona glomerulosa

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14
Q

prolonged ACTH stimulation does what to adrenal cortex?

A

hyperplasia of zona fasciculata and reticularis (excess cortisol production)

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15
Q

hyperplasia of zona glomerulosa is seen with?

A

Conn’s syndrome (increased aldosterone secretion)

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16
Q

what vitamin supp is prescribed with isoniazid tx?

A

vit B6 (pyridoxine)

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17
Q

isoniazid can decrease synth of..?

A

neurotransmitters like GABA (which require B6)

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18
Q

obstructive lesion in mainstem bronchus results in…?

A

prevention of ventilation of entire lung = LUNG COLLAPSE.

CXR: unilateral pulmo opacification.
deviation of mediastinum (trachea) toward opacified lung.

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19
Q

pulmonary edema CXR

A

bilateral fluffy-appearing infiltrates

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20
Q

pneumothorax CXR

A

increased LUCENCY on affected side

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21
Q

psoas muscle

A

hip flexor (along with iliacus, same insertion point).

originates from transverse processes and lateral aspects of T12-L5 vertebrae.

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22
Q

psoas abscess

A

due to direct spread of infx OR hematogenous seeding.

RF: DM, IVDU, HIV, immunosupp.

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23
Q

psoas sign

A

pain exacerbated by mvmts that cause psoas to be stretched or extended (ex: extension of hip)

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24
Q

injx in superomedial quadrant of butt

A

risk of injury to gluteal nerves

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25
Q

injx in inferomedial quadrant of butt

A

risk of injury to sciatic nerve

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26
Q

where is it safe to give IM injxs in butt?

A

superoLATERAL quadrant

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27
Q

competitive antagonist

A

change ED50.

shift curve to the right.

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28
Q

noncompetitive antagonist

A

change Emax.

shift curve down.

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29
Q

apocrine glands

A

secrete “sweat” into hair follicles.
functional at puberty.

usually odorless but can become MALODOROUS due to skin commensal bact decomposition.

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30
Q

eccrine (merocrine) glands

A

in most of body.

secrete watery sweat of Na and Cl directly to skin surface.

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31
Q

uniform distribution of T tubules ensures…?

A

coordinated contraction of all myofibrils- transmits depol from sarcolemma to sarcoplasmic reticulum

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32
Q

supraspinatus tendon prone to impingement between…?

A

humeral head and acromion

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33
Q

ABPA can result in?

A

transient recurrent pulmo infiltrates and eventual proximal bronchiectasis

34
Q

what occurs before herpes zoster rash appears?

A

burning sensation/unilateral pain in dermatomal distribution

35
Q

telomerase

A

reverse transcriptase (RDDP).
adds TTAGGG repeats to 3’ ends of DNA in telomere region.
expressed in stem cells (and cancer cells).

36
Q

which cells have long telomeres?

A

stem cells- proliferate indefinitely. telomeres shorten with each cell division.

*adult somatic cells have short telomeres.

37
Q

alcohol disinfectant (isopropanol, ethanol)

A

disrupts cell membranes.
denatures proteins.

cannot kill bact spores.

38
Q

chlorhexidine disinfectant

A

disrupt cell membranes.
coagulation of cytoplasm.

cannot kill bact spores.

39
Q

hydrogen peroxide disinfectant

A

produces destructive free radicals that oxidize cellular components.

CAN kill bact spores.

40
Q

iodine disinfectant

A

halogenation of proteins and nucleic acids.

CAN kill bact spores.

41
Q

acute monoarticular arthritis in young adult

A

septic arthritis due to gonococcus

42
Q

which vitamins are lacking in breast milk?

A

vit D and K

43
Q

tetracycline during pregnancy

A

can cause fetal bone growth retardation and discoloration of deciduous teeth (brown/gray/yellow staining)

*also contraindicated in kids < age 8

44
Q

cardiorespiratory response in exercise

A

HR and CO increase to meet increased tissue oxygen demands.

RR increases to eliminate excess CO2.

O2 and CO2 content in arterial blood remains close to resting values (changes occur in venous blood: decrease PO2, increase PCO2)

45
Q

PaO2 and PaCO2 at high altitude

A

lower than normal due to hypoxemia and consequent hyperventilation and resp alkalosis

46
Q

adverse effect of oxygen therapy in neonatal RDS

A

retinal damage (neovascularization) due to stimulation of VEGF.

possible retinal detachment with blindness.
aka retinopathy of prematurity or retrolental fibroplasia.

47
Q

nucleolus

A

site of:
rRNA synthesis from rDNA.
ribosomal prot synth.
ribosome formation.

(RNA pol I activity)

48
Q

how does risperidone cause amenorrhea?

A

risperidone (and other antipsychotics) causes hyperprolactinemia via anti-dopaminergic action on D2 receptors…

lack of inhibition of PRL-producing lactotrophs. PRL inhibits GnRH from hypothalamus, causing hypogonadism.

49
Q

contracture during wound healing

A

due to excessive matrix metalloproteinase activity and myofibroblast accumulation in wound margins (excessive wound contraction)

produce deformities of wound and surrounding tissues

*palms, soles, anterior thorax, serious burn sites

50
Q

wound dehiscence

A

rupture of previously closed wound.
can be due to insuff granulation and scar tissue formation, inadequate wound contraction, or excessive mech stress.

*abd wounds

51
Q

keloid vs hypertrophic scar

A

BOTH consist of conn tissue rich in fibroblasts, myofibroblasts, collagen.

KELOID: extend beyond wound borders. recur after resection. DISORGANIZED collagen bundles.

HYPERTROPHIC: limited to area of wound. PARALLEL collagen bundles.

52
Q

where is V/Q ratio lowest?

A

at lung bases.

both ventilation and perfusion are highest at base BUT perfusion is HIGHER.

53
Q

what does negative free energy mean?

A

rxn favors product formation (product’s free energy lower than substrate’s free energy)

54
Q

groups formed in case-control study

A

CASE: subjects with disease of interest.

CONTROL: subjects without disease of interest.

55
Q

statistical power (1-beta)

A

probability of rejecting null hypothesis when it is truly false.

aka PROBABILITY OF FINDING TRUE RELATIONSHIP.

depends on sample size and
difference in outcome between two test groups.

56
Q

p value

A

probability of making a type I error

ex: p = 0.05 means researchers accept 5% probability that a difference perceived as true is actually due to chance

57
Q

which type of kidney stones are visualized with ULTRASOUND?

A

uric acid (radiolucent = not seen on plain abdominal XR).

*can also use CT scan

58
Q

CEA

A

carcinoembryonic Ag- elevated in colon cancer and other malignancies.

  • can be used to detect disease RECURRENCE, not for diagnosis.
  • higher in smokers.
59
Q

piperacillin-tazobactam is effective against?

A

gram neg enteric rods, including pseudomonas and bacteroides (ANAEROBIC)

60
Q

sternocleidomastoid attachments

A

origin: medial clavicle and manubrium (sternum).
insertion: mastoid process of skull.

61
Q

SCM function

A

turn head in opposite direction

62
Q

anti-snRNP Abs

A

mixed conn tissue disease.

snRNP = part of spliceosome, which removes introns from pre-mRNA during processing in nucleus.

63
Q

adrenal crisis

A

hypotensive, tachycardic, hypoglycemic.

h/o of adrenal insuff: vom, abd pain, weight loss, hyperpigmentation.

TX: immediate stress-dosecorticosteroids.

64
Q

epinephrine is used as TX in?

A

anaphylaxis.
severe asthma.
cardiac arrest.

65
Q

dopamine infusion

A

vasopressor action.

for shock and refractory cardiac failure.

66
Q

tophi

A

nodules formed by accumulation of monosodium urate in SQ tissues

67
Q

nodular densities,

eggshell calcifications of hilar nodes

A

silicosis

68
Q

fibrocalcific parietal pleural PLAQUES in posterolateral mid-lung zones and over diaphragm (lower lobes)

A

asbestosis

69
Q

which pneumoconiosis is assoc with possible pleural effusion?

A

asbestosis

70
Q

avascular necrosis of femoral head

A 
SHAT:
Sickle cell, SLE.
High-dose steroids.
Alcoholism.
Trauma.

acute onset hip pain exacerbated by weight bearing. restricted movement.
no swelling, erythema, temp change.
DX: MRI.

71
Q

Ghon complex is formed during..?

A

initial infx with M.tuberculosis.

lower lobe lesion + ipsi hilar adenopathy (calcified node).

72
Q

JAK

A

non-receptor tyrosine kinase.

assoc with EPO receptor that binds cytokine to activate JAK for signal transduction.

73
Q

amlodipine side effect

A

flushing.
peripheral edema.

*used in HTN tx.

74
Q

repeated and prolonged kneeling can cause?

A

prepatellar bursitis.

roofers, carpenters, plumbers.

75
Q

what does hypocapnia imply?

A

(low arterial PaCO2)

indicates ongoing alveolar HYPERventilation.

(decreased arterial PaO2 also)

76
Q

amatoxins bind?

A

RNA pol II (halts mRNA synth)

77
Q

what improves Graves’ ophthalmopathy (proptosis, EOM dysfunction)?

A

high-dose glucocorticoids: decrease inflammation and extraocular volume

78
Q

hyponatremia + lung mass =

A

SIADH:
concentrated urine.
low plasma sodium/osmo.
NORMAL ECF volume.

79
Q

most common location for colon cancer

A 
rectosigmoid colon (LEFT sided)-
infiltrative, encircles lumen.
cause obstruction.
altered bowel habits.
abd distention.
nausea, vomiting.
80
Q

2nd most common location of colon cancer

A 
ascending colon (RIGHT sided)-
bulky protruding mass.
more likely to bleed.
iron def anemia.
occult blood in stool.
81
Q

metformin contraindications

A

any situation that may precipitate lactic acidosis-

renal failure.
liver dysfunction.
CHF.
alcoholism.
sepsis.
82
Q

what does medullary carcinoma of thyroid look like?

A

extracellular deposits of amyloid formed by calcitonin secreted from neoplastic parafollicular C cells (nests of polygonal or spindle-shaped cells).

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