15 Flashcards
Meclizine
First generation antagonist of H1 (can treat motion sickness just like diphendyramine)…shit will make you tired tho so heads up
Somatostatin analogs (octreotide)
inhibit bioactive amine release
CD8+ bronchoalveolar lavage in patient who works with birds
Hypersensitivity pneumonitis
CD22+ on broncoalveolar lavage
also CD19, CD20
Precursor B-cell lymphoblastic leukemia may sometimes involve pleura or present as patchy pulm infiltrates
idiopathic pulmonary fibrosis and bacterial pneumonia bronchioalveolar lavage
Neutrophils
Speed of hemoglobin moving towards anode (+)
A>S>C
schedule daytime naps is a tx for ?
narcolepsy
Chronic relentless HA / N and meningitis
Acanthamoeba, TB, Crytococcus neoformans
1) First line for bipolar?
2) Maintenance Tx for depression of biopolar?
1) Lithium, Valproate, quetiapine
2) Lamotrigine
FSH stimulates the sertoli cells to produce ______ locally, within seminiferous tubules. This _________ is responsible for high LOCAL testosterone concentration. High testosterone levels and FSH are necessary for spermatogenesis
androgen binding protein
Trichotillomania (hair-pulling disorder)
involves recurrent pulling of hair and repeated attempts to decrease or stop behavior
The right middle lobe of the lung lies immediately adjacent to the
the right boarder of the heart/ right atrium
Apixaban, rivaroxaban
direct Xa inhibitors
Tet spell causes
idiopathic, dehydration, hyperventilation
Zonulae occludentes
Tight junctions
Tight junctions are composed of what transmembrane proteins
Claudins and occludins that associate with actin filaments forming a beltlike seal (permits only the passage of substances from the blood to the brain via transcellular movement)
Maculae adherentes
Desmosomes- spotlike junctions that anchor adjacent cells together via keratin intermediate filament interactions. Desmosomes in the stratum spinosum of the skin cause pemphigus vulgaris
Inhibits H/K ATPase in gastric parietal cells
Omeprazole
Rhizomelia
shortened limbs, esp proximally
Exfoliative toxins MOA in SSSS
act as proteases and cleave desmoglein in desmosomes
Pathogenesis of MS
Helper T cells abnormally react to antigens in myelin, causing a release of inflammatory cytokines (eg. INF-gamma) that promote the infiltration of destructive macrophages/microglia and leukocytes. B cells may also play a role as most MS patients have oligoclonal immunoglobulin
Dilation of sinusoids and perivenular hemorrhage is associated with acute venous outflow obstruction within the liver
Budd-Chiari Syndrome
Inter vs Intra
Intra = inside or within
Lacunar stroke involving the ____________ and _________ of the thalamus typically results in complete contralateral sensory loss. Damage to the thalamus may also cause thalamic syndrome, characterized by contralateral burning or stabbing pain over one side of the body.
VPLN and VPMN (ventral posterior thalamus)
Cold extremities due to Raynaud phenomenon are associated with what medications?
Amphetamines (lol)
Ergotamine
Chemo agents
Encephalitis (within days)
Acute disseminated encephalomyelitis (within weeks)
Subacute sclerosing panencephalitis
Measles (rubeola)
Vitamin A helps prevent and treat (even reduce hospital stay haha)
Stomatitis and cheilosis; irritability
Vitamin B6 deficiency
Hemolytic anemia and neurologic abnormalities (ataxia)
Vitamin E def
What can be given to decrease homocysteine levels
vitamin B6 (look this up in biochem you lazy douche)
easy brusing, gum bleeding, hematuria, hematochezia
Vitamin K def
microarray is similar to
Southern and northern blot but involves hybridization of a large number of probs at one (genome DNA or cDNA)
SPEP (serum protein electrophoresis) is a more specific lab test used to determine
if excessive monoclonal immuglobulins are present “M-Peak” (MM, Waldenstrom and some lymphomas)
First component of junctional complex (usually observed at apices of glandular cells)
Tight junctions (zona occludens)
Intermediate junctions (zona adherens)
second component of junctional complex (radiate from cell membrane and hold adjacent cells together)
Small circular adherent patches circumferentially placed around call that compromise the the 3rd junctional component
Desmosomes (contribute to structural cohesiveness of tissues subject to mechanical stress)
Can sense mechanical stress and send signals to modulate activity of surface osteoblasts. Help regulate bone remodeling. Communicate through intracanalicular processes in lamellae with GAP junctions. Exchange nutrients and waste products with neighboring osteocytes
Osteocytes
Major structural role too.
Control short-term release and deposition of calcium. Plasma calcium directly dictates their activity thus calcitonin indirectly influences their metabolic activity
Characterized by defective T-cell DEVELOPMENT and B cell dysfucntion
SCID (Defect in T Cell development (ex: IL-2 gamma chain) leading to loss of both cellular and humoral immunity
SCID presents similar to congenital HIV
just so ya know
RAS mutation
colorectal and pancreatic
TK (growth factor ligand binds receptor–>autophosphorylation)
Resides in atrioventricular groove on posterior aspect of the heart
coronary sinus
What is normally damaged by sudden deceleration and pivots on an extended knee during sports activity? Tests?
ACL
Lachman Test, Anterior drawer test
Sarcomere:
_____ line is dark AF. Composed of thin filaments which are composed of actin, tropomyosin, and troponin anchor to the _____ line
Z
Child under 6 years old does not understand
death
_________ last from 3 days to 1 month; while PTSD lasts more than a month
Acute stress disorder
Common cause of spontaneous bacterial peritonitis and nosocomial pneumonias as well as UTIs
Klebsielllla ellla ellla ellla eyyyy
CEA is a _________ produced in embyonic pancreas liver and intestine. Monitor for pancreatic gastric and breast cancer. Also seen in benign shit… IBD, COPD, cirrhosis, pacreatitis. Also higher in smokers.
glycoprotein involved in cell adhesion
Adjunct chemo recommended for node-positive colorectal cancer?
Oxaliplatin-based regimen
dyspnea with croup (brassy barking cough, dyspnea and recent history of URI = viral laryngotracheitis. Parainfluenza MC
due to inflamed subglottic tissue obstructing upper airway
High circulating homocysteine levels, MARFANOID HABITUS, and increased risk for premature atherosclerotic cardiovascular disease
Homocystinuria (AR)
Cystathionine synthase deficiency
Osteogenesis imperfect not only have decreased bone mass and fractures and dat blue sclera but also
dental abnormalities and hearing loss
ADPKD is a rare disorder of __________.
Tubular epithelial cells
Numerous parenchymal cysts
Cardiac valvular disease and cerebral aneurysms
Fibrillin-1 (Marfans) is an extracellular glycoprotein that acts as a
scaffold for elastin
It is abundant in zonular fibers of lense, periosteum, and aortic media.
Root dilation with dissection = common cause of death
EG caused by Pseudomona bacteremia is due to what factors?
Exotoxin A- protein synthesis inhibition
Elastase- degrades elastic…important for BV destruction
Phospholipase C (degredes cellar membranes
Pyocyanin- generates reactive oxygen species
Superinfection of preexisting skin lesion (eczema, minor trauma)
Impetigo
Superficial skin lesion characterized by painful erythematous plaque with well raised well demarcated boarders
erysipelas
HSV-2 reactivation in
S2,S3,S4 dorsal roots MC
Digoxin vs. Amiodarone toxicity
DIGOXIN HAS HYPERKALEMIA
Linezolid has MAOI activity
watch out for serotonin store
Bone mass in adult is determined by
peak bone mass and the rate of bone loss
Teriparatide
recombinant PTH- stimulates maturation of pre-osteoblasts into bone forming osteoblasts that lay down collagen and mineralize the matrix.
Also increases GI calcium absorption and renal reabsorption (decreased urinary calcium)
Incidentalomas
MRI and CT not used in initial workup b/c 5-10% of healthy people will show mass like lesions…even in brain (the dean)
Cortisol in normal person highest when and lowest when
highest in morning
lowest at evenings
In Cushing Syndrome, normal circadian rhythm is lost.
Measure of cortisol in evening is more sensitive and specific (since levels should technically be lowest at this point)
Sodium cyanide-nitroprusside test
qualitative screening for cystine in urine
1) Cyanide added (cystine to cysteine)
2) Nitroprusside added- reacts with sulfhydrl group on free cysteine, causing a RED-PURPLE discoloration (positive test)
Tenesmus (painful straining of defecation) and small-caliber stool are characteristic of
RECTAL adenocarcinoma
Left-sided colon cancers tend to infiltrate the intestinal wall and encircle the lumen (napkin ring)
constipation and symptoms of obstruction
Often causes hematochezia
Rectosigmoid cancer (hematochezia like UC but no fever)
Constipation that alternates with diarrhea
IBM
Recurrent grossly bloody stool associated with abdominal discomfort and low-grade fever
Ulcerative colitis…risk factor for colon cancer
Right sided colon cancer presentation
exophytic mass
No intestinal obstruction…larger lumen in ascending. Also stool is more liquid here. Present with IDA (fatique pallor) due to occult blood loss. Nonspecific symptoms such as anorexia, malaise and unintentional weight loss
Drugs to avoid in elderly?
Anticholinergics (ex. first generation antihistamines), alpha blockers, TCA, sulfonylureas, and sedating pain medication
