3/17 Flashcards
What diseases might you give sulfasalazine for? MOA?
IBD
Inhibit cytokine, PG, leukotriene synthesis during inflammation
What causes failure to thrive in young CF patients?
Malabsorption due to obstructive fibrosis and progressive insufficiency of the exocrine pancreas. Pancreatic lipase supplementation is needed.
Neural tube defects lead to increased WHAT in amniotic fluid?
AFP and AChE
What are the two examples of anterior neural tube defects?
encephalocele (herniation of brain tissue through cranial defect)
anencephaly (total absence of brain and calvarium)
What are three examples of posterior neural tube defect?
Spina bifida occulta
Meningocele
Meningomyelocele
What is Hirschsprung’s disease?
Failure of neural crest cells to migrate to intestinal wall
Leads to absence of myenteric and submucosal nervous plexi in a segment of colonic wall
What reabsorbs CSF?
Arachnoid granulations
What is suggested by fever, jaundice, and anorexia in an IV drug user?
Acute viral hepatitis
What are Councilman bodies?
Acidophilic (apoptotic) bodies found in apoptotic hepatocytes, which can be seen in acute viral hepatitis
Where are Peyer’s patches located?
Ileum
Where are Brunner’s glands and crypts of Lieberkuhn located?
Duodenum
What artery supplies the femoral head?
Obturator artery
Why is the obturator artery clinically significant in children?
It supplies the femoral head proximal to the epiphyseal growth plate
Sx of paresthesias, weakness, dizziness, n/v, hyporeflexia, and diarrhea after consuming fish points to what toxin?
Tetrodotoxin from puffer fish
What toxins inhibit protein synthesis?
Diptheria toxin, exotoxin A (pseudomonas), shiga toxin, shiga-like toxin (EHEC, incl O157:H7)
How do diptheria toxin and exotoxin A work?
Ribosylate and inactivate elongation factor-2, inhibiting human cell protein synthesis
What is the best auscultatory indicator of Mitral stenosis severity?
A2-OS interval, shorter = worse
A2 is the aortic component of S2
Hypopigmented or hyperpigmented skin patches are associated with what organism?
Malassezia furfur fungus
Called tinea versicolor (or pityriasis versicolor)
What are the cutaneous mycoses?
Dermatophytosis
Pityriasis versicolor
What type of mycosis is sporotrichosis?
Subcutaneous
What are the mycoses with systemic involvement (esp the lungs)?
Histoplasmosis, coccidioidoses, blastomycosis
What are the opportunistic mycoses?
Candida, Aspergillus, Mucor, Rhizopus
What organism has a “spaghetti and meatball” appearance?
Malassezia furfur
How do you diagnose pityriasis (tinea) versicolor?
KOH tx of skin scrapings
Dextrans produced by Viridans group streptococci allow it to attach to what?
Fibrin
What type of genetic material does parvovirus B19 have?
non-enveloped linear (-) ssDNA
Genetic material of EBV?
enveloped ds DNA
What viruses have circular dsDNA?
Nonenveloped: HPV, JC virus (PML in HIV), BK virus (renal infx)
Enveloped: HBV is partially circular, but also dsDNA
Patients should be tested for what before receiving TNF-a inhibitor like Etanercept?
Latent TB infx or any other underlying infx
Why would you administer Etanercept? MOA?
For moderate to severe RA
TNF-a inhibitor
What do you give an alcoholic with pneumonia? Why?
Clindamycin, to cover anaerobes from oral flora, commonly the cause of aspiration PNA in alcoholics
What are the sx of theophylline toxicity?
Abd pain, vomiting, seizures
What drugs cause lupus?
Hydralazine
Procainamide
Isoniazid
Especially with slow acetylators
Bleeding, secretory diarrhea, and partial intestinal obstruction indicate what type of adenomatous polyp?
Villous adenoma
What does adding cyanide then nitroprusside to urine test for?
Detects sulfhydryl groups, particularly for cystine, which turns it purple, indicating cystinuria
What is tamoxifen’s effect on breast? Endometrium? Bone?
Breast: reduce cancer
Endometrium: increase hyperplasia/cancer risk
Bone: reduce osteoporosis
Tubular proteinuria is associated with loss of what kinds of proteins?
Low molecular weight proteins, e.g. b2-microglobulin, Ig light chains, amino acids, retinol binding protein
Overload proteinuria is associated with loss of what kinds of proteins?
Low molecular weight proteins that are filtered by the GBM, but overwhelm the reabsorption by proximal tubule.
E.g. overproduction of Ig light chain in multiple myeloma
What are the causes of functional proteinuria?
Exercise, high fever, emotional stress, cold exposure
What function do ApoE3 and ApoE4 serve?
Uptake of chylomicrons and VLDL by hepatic apolipoprotein receptors
What function does ApoB-100 serve?
Uptake of LDL by receptor mediated uptake in extrahepatic tissues
ApoA-I function?
LCAT activation for cholesterol esterification into HDL
ApoB-48 fxn?
Chylomicron assembly and secretion
ApoC-II fxn?
Lipoprotein lipase activation
