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Imhotep 2 > 3/15/16 > Flashcards

3/15/16 Flashcards

1
Q

Converted to pyridoxal phosphate and participates as a cofactor in transamination reactions (ALAS cofactor)

A
  • Pyridoxine (Vitamin B6)
  • Given with isoniazid
  • Succinyl CoA to aminolevulinic acid done by ALAS and its B6 cofactor
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2
Q

Treats: leukemias, Hodgkin and non-Hodgkin’s lymphoma, Wilm’s Tumor, and choriocarcinoma. Can cause NEUROTOXICITY including areflexia (absent reflexes) and peripheral neuritis (tingling in extremities)

A
  • Vincristine (binds tubulin to inhibit microtubule formation)
  • Vinca alkaloid
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3
Q

Alkylating agent also known as mustard gas. Used to treat testicular cancer, breast cancer, and lymphomas

A

Ifosfamide

-Note all alkylating agents can cause myelosuppression

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4
Q

Paclitaxel ADR:

A

Myelosuppression

HYPERSENSITIVITY (remember skin are also site of stem cells)

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5
Q

During exercise, there is increased sympathetic outflow→vasoconstriction (alpha 1) of splanchnic regions, kidney, skin, and inactive muscles…so why during exercise is there a cumulative DECREASE in TPR?

A

Selective vasodilation of active musculature is achieved because metabolic factors such as lactate, potassium, and adenosine overcome sympathetic effects in these areas (overall leads to a cumulative decrease in TPR).

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6
Q

Exercise leads to vasodilation in skeletal muscle beds→ decreased TPR. What happens to the following in exercise? CO? Pulmonary resistance? Venous oxygen pressure?

A 
Increased CO (due to increased HR) via sympathetic activity
Decreased pulmonary resistance→increased pulmonary flow→better gas exchange
Venous oxygen pressure is decreased due to maximum oxygen being unloaded to the tissues
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7
Q

Right sided heart valve pathology…first two things you suspect?

A

IV drug use or carcinoid tumor

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8
Q

AFP tumor marker

A
  • Gonadal germ cell tumors (yolk sac carcinoma)

- Hepatocellular carcinoma

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9
Q

CA-125 tumor marker

A
  • Monitor the response to treatment and detect recurrence of …
  • OVARIAN CANCER
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10
Q

Carbohydrate antigen 19-9 (CA-19-9) tumor marker:

A

Monitor progress of pancreatic adenocarcinoma

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11
Q

Hunter Syndrome Inheritance

A

X-linked recessive deficiency in iduronate sulfatase

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12
Q

What is seen in HURLER syndrome (AR) but is absent in Hunter syndrome (XR)? Both are lysosomal storage disorders with accumulation of heparan sulfate and dermatan sulfate (Mucopolysaccharidoses)

A

-Corneal clouding is absent in Hunter syndrome

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13
Q

Mucopolysaccharidoses Lysosomal Storage Disorder: Hunter Syndrome (X-linked recessive)

A

Deficiency in iduronate sulfatase→builds up of heparin sulfate and dermatan sulfate
Mild Hurler + aggressive behavior (NO corneal clouding)

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14
Q

Minimal change disease first line treatment

A

Corticosteroid → Prednisone

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15
Q

Immunosuppressive agent that binds FK-binding protein to inhibit SECRETION of IL-2

A

Tacrolimus

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16
Q

Immunosuppressive agent that acts as an antagonist to PURINE metabolism (fucks up cell proliferation)

A

Azathioprine

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17
Q
  • MTOR-receptor (mammalian target of rapamycin)

- Binds FK-binding protein→ acts to block SIGNAL transduction of IL-2 receptor

A

Sirolimus

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18
Q

Warfarin metabolism

A 
CYP450 system (CYP2C9 member)
Inducers of CYP450 cause increased metabolism of warfarin
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19
Q

CYP-450 Inducers: Chronic alcoholics Steal phen-phen and Never Refuse Greasy Carbs

A
  • Chronic alcohol use
  • St. John’s wort
  • Phenytoin
  • Phenobarbital
  • Nevirapine
  • Griseofulvin
  • Carbamazepine
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20
Q

Inhibitors of P-450: AAA RACKS IN GQ Magazine

Try this one instead: Crack Amingos GQ

A
  • Acute Alcohol Abuse
  • Ritonavir
  • Amiodarone
  • Cimetidine/ciprofloxacin
  • Ketoconazole
  • INH (isoniazid)
  • Grapefruit juice
  • Quinidine
  • Macrolides (except azithromycin)
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21
Q

Patients with chronic renal insufficiency are at risk for developing renal osteodystrophy due to decreased conversion of vitamin D from its inactive (25-hydroxyvitamin D) to its active (1,25 dihydrocholecalciferol) forms. How do you treat renal osteodystrophy?

A

-Calcium, phosphate binders, and calcitriol (synthetic vitamin D3) supplementation

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22
Q

Toxoid vaccine (example diphtheria-tetanus-pertussis vaccination)

A
  • Toxoid = toxin like
  • No longer toxic like toxin but maintains some antigenic similarity (share enough epitopes)
  • CROSS REACTIVITY of TOXOID via van der Waals forces
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23
Q

Shigella flexneri vaccine is created how?

A

By linking shigella to an exoprotein A of Pseudomonas aeruginosa as a carrier

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24
Q

MMR and varicella are what types of vaccines?

A

Live attenuated (weakened form of infectious agent or killed version of virus is given to patient)

25
Q

Hemolytic anemia lab values (secondary to drug…Ribavirin)

A
  • Decreased serum haptoglobin (binding to Hb from lysed cells)
  • Increased lactate dehydrogenase (released from lysed cells)
  • Indirect hyperbilirubinemia
26
Q

Saquinavir

A
  • Protease inhibitor used to treat HIV

- ADR: nausea, diarrhea, and hyperglycemia

27
Q

PrPSC (misfolded protein) accumulates in CNS as amyloid plaques

A

Creutzfeldt-Jakob

28
Q

Achondroplasia and Marfan’s Inheritance

A

Autosomal DOMINANT mutation in FGFR3

Autosomal DOMINANT mutation in Fibrillin 1

29
Q

ATRA (All-trans retinoic acid) is also known as…

A

Tretinoin

-Induce remission in APL

30
Q

Oprelvekin (interleukin-11)

A
  • Thrombopoietic growth factor

- Used to combat thrombocytopenia

31
Q

Myxopapillary ependymomas

A 
Adults = spinal cord (especially filum terminale)
Children= fourth ventricle
32
Q

Pilocytic astrocytomas

A
  • Low-grade astrocytomas typically found in posterior fossa of children.
  • Uncommon in adults
33
Q

What is the active form of prednisone?

A

Prednisolone (catalyzed by 11-beta-hydroxysteroid dehydrogenase)

34
Q

Selective alpha-1 antagonist that is used to treat HTN and urinary retention in the setting of benign prostatic hyperplasia

A

Doxazosin

35
Q

Activated form of methionine is a very common methyl group donor:

A

S-adenosyl-L-methionine

36
Q

Homogentisic acid builds up in the body and polymerize to form alkapton bodies, deposit to cause dark urine and dark cartilage. Patients suffer from decreased joint mobility and arthralgia; but are otherwise healthy.

A

Congenital deficiency of homogentisic acid oxidase = Alkaptonuria (AR)
Disruption in tyrosine degradation pathway

37
Q

-Ablating part of the Globus Pallidus Internal (GPi) segment would reduce tonic inhibition of the thalamus in REFRACTORY Parkinson’s cases.

A

Pallidotomy

38
Q

Fungal meningitis and encephalitis CSF findings:

A

High opening pressure
Increased WBC w/lymphocytic and monocytic predominance
High protein
Low glucose

39
Q

India Ink showing encapsulated yeast is suggestive of Cryptococcus…if Cryptococcus meningitis…how do you treat?

A

Amphotericin B and flucytosine → when clinical improvement is seen you can drop these to and start FLUCONAZOLE for the next 8 weeks

40
Q

When a temperate bacteriophage carry genes that transform the phenotype of the host once incorporated this is called LYSOGENIC CONVERSION. Examples of this that increase pathogenicity include:

A

GAS- scarlet fever
Corynebacterium diphtheriae- diphtheria
Clostridium Botulinum- botulism

41
Q

Lesch-Nyhan syndrome inheritance

A

-X-linked recessive

42
Q

PCOS (polycystic ovarian disease) drugs used to treat:

A

Spironolactone- anti-androgen (will reduce hirsutism)

Oral contraceptives, gonadotropin analogs, clomiphene

43
Q

Minoxidil

A

Rogaine (hair growth)

44
Q

GAA trinucleotide repeat

A

Friedreich’s Ataxia

45
Q

CTG trinucleotide repeat

A

Myotonic dystrophy

46
Q

Fragile X trinucleotide repeat

A

CGG

47
Q

ANP is released by cardiac myocytes in response to increased atrial stretch during times of volume expansion

A

Volume contraction (ex: furosemide) would cause ANP levels to drop

48
Q

Prevents an ethical physician from giving in to a patient’s request for unnecessary testing

A

The principle of nonmaleficence

49
Q

Methemoglobinemia may occur as an adverse effect of oxidizing agents such as:

A

Sulfonamides
Dapsone
Nitro drugs (?)
Local anesthetics (ex: benzocaine)

50
Q

Methemoglobinemia first line treatment is methylene blue (increases conversion of Fe3+ back to Fe2+)…what is an alternative treatment?

A

Ascorbic acid (Vitamin C)

51
Q

NAC (N-Acetylcysteine). Name 3 mechanisms

A
  • Increases glutathione (because is a precursor)
  • Binds N-acetyl-p-benoquinone imine directly
  • It enhances conjugation with sulfates into a water-soluble product
52
Q

Cyanide Toxicity treatment

A
  • Sodium thiosulfate
  • Sodium nitrates
  • Amyl nitrates
53
Q

Esophageal varies and ascites suggest portal hypertension

A

Think chronic alcoholism

54
Q

Follicular thyroid carcinoma mutation

A

RAS

55
Q

Alcohol fucks shit up in weeks 3-8 of gestation…how?

A

Inhibition of cell migration
Impairment of cell differentiation
Impaired or excessive apoptosis
Alteration in cell metabolism

56
Q

Papillary thyroid carcinoma mutation (most common thyroid malignancy)

A

Braf

Exposure to radiation

57
Q

MERRF (myoclonic epilepsy with ragged red fibers)

A

Mitochondrial inheritance

58
Q

GM-CSF acts to stimulate the growth of the common progenitor stem cell of neutrophils, basophils, eosinophils, macrophages, and platelets:

A

The myeloid stem cell

Imhotep 2 (9 decks)

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