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0527 Flashcards

1
Q

what is required to happen before hCG appears in maternal serum?

A

successful implantation, usually on day 6 after ovulation (hCG detected 8-11 days after ovulation)

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2
Q

which antimycobacterial drug is not active against extracellular mycobacteria, including those in necrotic foci and tissue cavities?

A

pyrazinamide (requires acidic environment of macrophage phagolysosomes to be active)

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3
Q

another name for lecithin…

A

phosphatidylcholine.

as in LECITHIN/sphingomyelin ratio measured to determine fetal lung maturity.

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4
Q

major constituents of surfactant

A
  1. dipalmitoyl phosphatidylcholine (lecithin).

2. phosphatidylglycerol.

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5
Q

paroxysmal supraventricular tachycardia

A

heart palpitations.
tachycardic with regular rhythm.

relieved by vagal stimulation: carotid massage or Valsalva maneuver.

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6
Q

fixed wide split

A

ASD

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7
Q

what substances drive angiogenesis?

A
  1. VEGF.

2. FGF.

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8
Q

clozapine SE

A

atypical antipsychotic.
causes agranulocytosis
(and seizures).

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9
Q

cryoglobulinemia

A

serum proteins that precipitate in cold.
contain Immunoglobulin.
assoc with HCV.

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10
Q

EBV is an oncogenic virus that promotes production of…?

A

polyclonal B cells

and heterophil Abs

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11
Q

what causes altered mental status in hepatic encephalopathy?

A

INCREASED activity of GABA system

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12
Q

slow acetylators metabolize which drugs slowly?

A

isoniazid.
dapsone.
hydralazine.
procainamide.

all these will accumulate.

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13
Q

lipofuscin results from?

A

free radical injury

and lipid peroxidation

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14
Q

where is lipofuscin commonly found?

A

heart and liver of aging or cachectic/malnourished pts

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15
Q

why is nifedipine useful for hypertensive pts with bradycardia?

A

it causes peripheral vasodilation while possibly leading to reflex tachycardia

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16
Q

Kussmaul’s sign

A

paradoxical rise in height of JVP during inspiration.

due to increase in venous return that occurs with inspiration while right heart filling is restricted- seen with chronic constrictive pericarditis.

(normally JVP decreases with inspiration)

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17
Q

nitrates primary action

A

VENOdilation- decrease cardiac work by decreasing LV filling volume (preload)

18
Q

elastic recoil limits what?

A

the max volume that can be expired… chest wall resists too much inward deformation during max expiration

19
Q

increased recoil means resp mm. have to…?

A

work harder during expiration to oppose the increased outward recoil that causes decreased expiratory flow rates

20
Q

reflex symp activation due to arterial dilators results in?

A

increased HR.
increased contractility.
increased renin (sodium and fluid retention).

21
Q

morphine tolerance

A

mediated by stimulatory glutamate at NMDA receptors.

reduce with ketamine or dextromethorphan admin.

22
Q

what is the only IV agent that decreases blood pressure while also improving renal blood flow?

A

fenoldopam- decreases syst vasc resistance via arteriolar dilation and natriuresis. improves renal perfusion.

23
Q

cofactor for transamination rxn

A

pyridoxal phosphate (B6)

*also important in DEcarboxylation rxns

24
Q

cofactor for carboxylation rxn

A

biotin

25
Q

skin/mucosal telangiectasias + recurrent nosebleeds =

A

Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia)

rupture of telangiectasias may cause epistaxis, bleeding.

26
Q

familial retinoblastoma most likely to develop what secondary tumor?

A

osteosarcoma

27
Q

psammoma bodies in CNS

A

meningioma

28
Q

complications of prematurity

A
  1. resp distress syndrome.
  2. PDA.
  3. bronchopulmonary dysplasia.
  4. intraventricular hemorrhage.
  5. necrotizing enterocolitis.
  6. retinopathy of prematurity.
29
Q

congenital hypothyroidism

A 
pale dry skin.
myxedema.
macroglossia (BIG TONGUE).
UMBILICAL HERNIA.
coarse facial features.
increased cong heart defects.
jaundice.
poor feeding.
constipation.
muscle hypotonia.
hoarse cry.
30
Q

T4 in infants is important for?

A

normal brain development and myelination

31
Q

most common mets TO brain

A
  1. lung cancer.
  2. breast cancer.
  3. melanoma.
32
Q

lac operon regulated by…

A
  1. negatively by repressor protein binding to operator locus.
  2. positively by cAMP-CAP binding upstream from promoter region (glucose blocks this by decreasing cAMP).
33
Q

S3

A

imbalance between force with which bld is pushed into ventricle and ability of ventricle to accommodate this blood. assoc with:

  1. forceful rapid filling of ventricle that has normal or elevated compliance.
  2. normal or even decreased filling rates when vent compliance is low.
  3. bld flowing into an overfilled ventricle with high ESV.
34
Q

O2 content of blood

A

amt dissolved in arterial bld (not that much) PLUS amt bound to Hb.

depends on:

  1. Hb concentration.
  2. SaO2.
  3. PaO2.
35
Q

akathisia

A

inner restlessness and inability to sit or stand in one position.

often a complication of anti-psychotic tx.

36
Q

incomplete obliteration of processus vaginalias results in…

A

persistent connection between scrotum and peritoneal cavity:

  1. hydrocele: small opening that only allows for fluid to leak through.
  2. indirect inguinal hernia: larger opening that allows abd organs to protrude.
37
Q

complement is mainly produced in?

A

liver

38
Q
  1. hemolytic anemia.
  2. hypercoag state.
  3. decreased blood counts.
A

suspect: paroxysmal nocturnal hemoglobinuria.

without CD55 and 59, complement stays activated.

39
Q

CD55 and CD59 deficiency is diagnostic of?

A

paroxysmal nocturnal hemoglobinuria- unable to inactivate complement

40
Q

common SE of all nitrates

A

headaches and
cutaneous flushing
(vasodilation in
meninges and skin)

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