3/23 - UW 19 Flashcards
How does the kidney respond to CHF?
Decreased renal perfusion leads to increased RAAS activation, increasing vasoconstriction and exacerbating heart failure.
What are some sx of hypothyroidism in children?
Lethargy, feeding issues, macroglossia, constipation, umbilical hernia, large fontanels, dry skin, hypothermia, prolonged jaundice
What are 3 mitochondrial syndromes?
- Leber hereditary optic neuropathy (bilateral vision loss)
- Myoclonic epilepsy with ragged-red fibers (myoclonic sz and myopathy associated with exercise)
- Mitochodrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS)
When to give MAOIs?
Atypical or refractory depression. Presents as depression with:
- mood reactivity
- rejection sensitivity
- increased sleep and appetite
Serum AFP is indicative of what liver pathology?
Hepatocellular carcinoma
What ligament contains the vessels and nerves supplying the ovaries?
Suspensory ligament
Which adrenergic receptor decreases insulin secretion?
alpha 2
Which adrenergic receptor increases insulin secretion?
beta 2
What is the major stimulator of central chemoreceptors?
Increased PaCO2
What is a sign of serious adverse effect in using Lamotrigine?
Rash, indicating Stevens-Johnson syndrome (30%)
Triad of hydrocephalus, intracranial calcifications, and chorioretinitis in an infant indicate what pathology?
Congenital toxoplasmosis infection
Point tenderness with muscle pain/stiffness exacerbated by exercise indicates what?
Fibromyalgia
What is the clinical presentation of dermatomyositis?
Bilateral proximal muscle weakness
Heliotrope rash on eyelids
Gottron papules on knuckles
Elevated CK
What is the only DNA polymerase with 5’ to 3’ exonuclease activity?
DNA poly I
BH4 a cofactor for the synthesis of what?
Tyrosine, dopa, serotonin, nitric oxide
What electrolyte imbalances are seen in primary adrena insufficiency?
Hyponatremia, hyperkalemia, hyperchloremia, non-anion gap metabolic acidosis
How is Foscarnet activated in herpesviruses?
It isn’t! Ha!
What bug causes “cat-scratch fever”?
Bartonella henselae
In what type of leprosy will you see an induration on lepromin skin test?
Tuberculoid, milder, with IL-2, IFN-y, IL-12 in tissues (Th1 profile)
What would you see on lepromin skin test in lepromatous leprosy?
No reaction, as there is no Th1 mediated immunity
What receptors does isoproterenol act on?
Beta 1 Beta 2 (selective at lower doses)
What receptors does clonidine act on?
Alpha 2
What receptor does phenylephrine act on?
Alpha 1 > Alpha 2
Chloramphenicol MOA?
Inhibits 50S ribosomal subunit (like the macrolides)
What are abx inhibit bacterial 50S ribosomal subunit?
Chloramphenicol, macrolides, linezolid
What class of antiretrovirals have the following side effects: lipodystrophy, hyperglycemia, P450 inhibition
Protease inhibitor
What is the main enzyme in the purine salvage pathway?
HGPRT
By what process are free purine bases (generated during cellular metabolism of nucleic acids) converted back to nucleotides?
Phosphoribosylation in the purine salvage pathway (HGPRT enzyme)
What is the deficient enzyme in Lesch-Nyhan syndrome?
HGPRT (hypoxanthine-guanine phosphoribosyltransferase)
Why do you see hyperuricemia in Lesch-Nyhan?
HGPRT deficiency, forcing guanine and hypoxanthine into uric acid instead of the purine salvage pathway
What HGPRT substrate accumulates in Lesch-Nyhan?
PRPP (phosphoribosyl-pyrophosphate)
What do you see on eye exam with a CN III mononeuropathy?
“Down and out”, inferolateral gaze
May see ptosis due to paralysis of levator palpebrae
What are the 2 most common sites for osteoporotic fractures?
- Vertebral bodies (trabecular bone)
2. Neck of the femur (half trabecular, half cortical)
Dilated pupils, lacrimation, and yawning are withdrawal sx for what drug?
Opioids
Withdrawal from what two substances can lead to sz?
Alcohol
Benzodiazepines
