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3/22 - UW 17 Flashcards

1
Q

What is digital clubbing caused by?

A

Hypoxic conditions: Heart or lung disease, IBD, hyperthyroidism, malabsorption

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2
Q

What kind of nuclear material is in the mitochondria?

A

mtDNA is a small, circular chromosome coding for 14 proteins and their associated rRNA and tRNA

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3
Q

What MRSA tx causes Red Man Syndrome and nephrotoxicity? MOA?

A

Vanc, blocks glycopeptide polymerization be binding to D-alanyl-D-alanine

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4
Q

What is Red Man Syndrome?

A

Due to vancomycin: flushing or rash on face, neck, torso due to nonspecific mast cell degranulation, NOT IgE-mediated

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5
Q

What MRSA tx causes myopathy and CPK elevation, that is inactivated by surfactant? MOA?

A

Daptomycin, depolarizes cellular membrane

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6
Q

What MRSA tx causes thrombocytopenia and optic neuritis, and increases risk for serotonin syndrome? MOA?

A

Linezolid, inhibits 50S subunit

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7
Q

What street drug causes nystagmus?

A

Phencyclindine (PCP)

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8
Q

What street drug causes chest pain and sz?

A

Cocaine

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9
Q

What street drug causes choreiform movements?

A

Meth

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10
Q

Cocaine MOA?

A

Blocks reuptake of DA, NE, 5HT in CNS

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11
Q

Phencyclidine (PCP) MOA?

A

Antagonizes NMDA rececptor

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12
Q

Acyclovir MOA?

A

Guanosine analog: first phosphorylated by viral thymidine kinase (rate limiting step) to monophosphate, then to active triphosphate form

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13
Q

Why are EBV and CMV less susceptible to acyclovir than HSV and VZV?

A

Different thymidine kinase limits ability to activate acyclovir by phosphorylation

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14
Q

Why is CMV more sensitive to ganciclovir than other herpesviruses?

A

Differences in viral DNA polymerase structure

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15
Q

What is the primary site of rRNA synthesis?

A

Nucleolus

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16
Q

What do RNA polymerase I, II, and III do?

A

RPI: rRNA
RPII: mRNA, snRNA, miRNA
RPIII: tRNA, 5S rRNA

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17
Q

What is the fxn of Secretin?

A

Pancreatic BICARB secretion

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18
Q

What is the effect of CCK on the gallbladder? What is it secreted by?

A

Contraction, secreted by duodenal and jejunal I cells

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19
Q

What is the fxn of Gastrin?

A

Secretion of gastric acid, and gastric motility

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20
Q

What is an antidepressant that doesn’t have sexual dysfunction side effects?

A

Bupropion

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21
Q

What CN carries motor innervation to the tongue?

A

Hypoglossal (CN XII), except the palatoglossus muscle (CN X)

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22
Q

What CNs carry general sensory from the tongue?

A

Anterior 2/3: mandibular branch of trigeminal (CN V3)
Posterior 1/3: glossopharyngial (CN IX)
Posterior part of tongue root: CN X

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23
Q

What CNs carry gustatory sensation from the tongue?

A

Anterior 2/3: chorda tympani of facial nerve (CN VII)
Posterior 1/3: glossopharyngeal (CN IX)
Posterior of tongue root: CN X

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24
Q

Jejunal ulcers is strongly suggestive of what neoplasm?

A

Gastrinomas: neuroendocrine tumors of the pancreas, peripancreatic tissue, or duodenum

25
Q

Sx of VIPoma?

A

Intractable diarrhea, metabolic acidosis, hypokalemia

26
Q

With gout, what accumulates in the synovial fluid and forms crystals?

A

Monosodium urate (uric acid salt)

27
Q

With gout, levels of what increases in the serum?

A

Uric acid

28
Q

What is lead time bias?

A

Bias in lead time (time between detection and outcome) due to different detection methods, without actual change in time to outcome

29
Q

What is suggested with fatigue, bradycardia, weight fain, and slowed DTRs?

A

Hypothyroidism

30
Q

What does the dexamethasone suppression test screen for?

A

Cushing’s syndrome (cortisol excess)

31
Q

What substrates can be formed into propionyl CoA?

A

Isoleucine, valine, threonine, methionine
Cholesterol
Odd cahin fatty acids

32
Q

What cofactor is necessary for the carboxylation of propionyl CoA to methylmalonyl CoA?

A

Biotin, cofactor for propionyl CoA carboxylase

33
Q

What product of methylmalonyl CoA enters the TCA?

A

Succinyl CoA

34
Q

What is the cofactor for isomerization of methylmalonyl CoA to succinyl CoA?

A

B12

35
Q

A newborn with lethargy, emesis, hypotonia, AGMA, ketosis, and hypoglycemia is suggestive of what?

A

Propionyl acidemia

36
Q

Phosphoinositol system?

A

Ligand ginds to Gq, activates PLC, hydrolyzing PIP2 into DAG and IP3. DAG stimulates PKC. IP3 increased intracellular Ca

37
Q

What is visible 12-28 hours after ischemic inj to the brain?

A

Red neurons (eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance)

38
Q

What is visible 3-6 hours after ischemic inj to the brain?

A

No visible changes

39
Q

What is visible 3-5 days after ischemic inj to the brain?

A

Macrophage infiltration and phagocytosis

40
Q

What is visible 1-3 days after ischemic inj to the brain?

A

Necrosis and neutrophilic infiltration

41
Q

What is visible 1-2 weeks after ischemic inj to the brain?

A

Reactive gliosis and vascular proliferation = liquefactive necrosis

42
Q

When does the glial cell form after ischemic inj to the brain?

A

Over 2 weeks later

43
Q

When do you see macrophages after an ischemic inj to the brain?

A

3-5 days

44
Q

What do you see neutrophils after an ischemic inj to the brain?

A

1-3 days

45
Q

DKA is strongly associated with what fungal infection?

A

Mucor species

46
Q

What is the most common cause of lacunar infarcts?

A

hypertensive arteriolosclerosis of small, penetrating arterioles

47
Q

What lymph nodes does the prostate drain to?

A

Internal iliac nodes primarily, as well as external iliacs and sacral

48
Q

What liver disease presents with severe, nocturnal pruritis?

A

Primary Biliary Cirrhosis

49
Q

What is the pathogenesis of primary biliary cirrhosis?

A

Autoimmune destruction of intrahepatic bile ducts and cholestasis

50
Q

Which cholesterol medication has a side effect of gouty arthritis?

A

Niacin

51
Q

Niacin MOA?

A

Decreasing hepatic synthesis of triglycerides and VLDL. Also increase HDL by 25-30%

52
Q

What medications increase serum uric acid levels?

A

Niacin, HCTZ, cyclosporing, pyrazinamide

53
Q

Proopiomelanocortin (POMC) is the precursor for what endogenous peptides?

A

beta-endorphin, ACTH, MSH

54
Q

What is the eponym for esophageal cells showing dysplasia at high risk of adenocarcinoma?

A

Barrett’s esophagus (intestinal type epithelium with goblet cells

55
Q

What are the risk factors for esophageal squamous cell carcinoma?

A

Primary: alcohol and tobacco
Secondary: Plummer-Vinson syndrome, achalasia, corrosive strictures

56
Q

What are the 3 components of a craniopharyngioma (arising from remnants of Rathke’s pouch)?

A
  1. solid (actual tumor cells)
  2. cystic (filled with machinery oil liquid)
  3. calcified
57
Q

What are some sx of congenital hypothyroidism?

A

Jaundice, macroglossia, myxedema, lethargy, hypotonia, hoarse cry

58
Q

Congenital hypothyroidism is associated with what cardiac abnormalities?

A

ASD, VSD

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