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3/23 - UW 19 Flashcards

1
Q

How does the kidney respond to CHF?

A

Decreased renal perfusion leads to increased RAAS activation, increasing vasoconstriction and exacerbating heart failure.

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2
Q

What are some sx of hypothyroidism in children?

A

Lethargy, feeding issues, macroglossia, constipation, umbilical hernia, large fontanels, dry skin, hypothermia, prolonged jaundice

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3
Q

What are 3 mitochondrial syndromes?

A
  1. Leber hereditary optic neuropathy (bilateral vision loss)
  2. Myoclonic epilepsy with ragged-red fibers (myoclonic sz and myopathy associated with exercise)
  3. Mitochodrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS)
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4
Q

When to give MAOIs?

A

Atypical or refractory depression. Presents as depression with:

  • mood reactivity
  • rejection sensitivity
  • increased sleep and appetite
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5
Q

Serum AFP is indicative of what liver pathology?

A

Hepatocellular carcinoma

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6
Q

What ligament contains the vessels and nerves supplying the ovaries?

A

Suspensory ligament

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7
Q

Which adrenergic receptor decreases insulin secretion?

A

alpha 2

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8
Q

Which adrenergic receptor increases insulin secretion?

A

beta 2

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9
Q

What is the major stimulator of central chemoreceptors?

A

Increased PaCO2

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10
Q

What is a sign of serious adverse effect in using Lamotrigine?

A

Rash, indicating Stevens-Johnson syndrome (30%)

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11
Q

Triad of hydrocephalus, intracranial calcifications, and chorioretinitis in an infant indicate what pathology?

A

Congenital toxoplasmosis infection

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12
Q

Point tenderness with muscle pain/stiffness exacerbated by exercise indicates what?

A

Fibromyalgia

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13
Q

What is the clinical presentation of dermatomyositis?

A

Bilateral proximal muscle weakness
Heliotrope rash on eyelids
Gottron papules on knuckles
Elevated CK

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14
Q

What is the only DNA polymerase with 5’ to 3’ exonuclease activity?

A

DNA poly I

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15
Q

BH4 a cofactor for the synthesis of what?

A

Tyrosine, dopa, serotonin, nitric oxide

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16
Q

What electrolyte imbalances are seen in primary adrena insufficiency?

A

Hyponatremia, hyperkalemia, hyperchloremia, non-anion gap metabolic acidosis

17
Q

How is Foscarnet activated in herpesviruses?

A

It isn’t! Ha!

18
Q

What bug causes “cat-scratch fever”?

A

Bartonella henselae

19
Q

In what type of leprosy will you see an induration on lepromin skin test?

A

Tuberculoid, milder, with IL-2, IFN-y, IL-12 in tissues (Th1 profile)

20
Q

What would you see on lepromin skin test in lepromatous leprosy?

A

No reaction, as there is no Th1 mediated immunity

21
Q

What receptors does isoproterenol act on?

A 
Beta 1
Beta 2 (selective at lower doses)
22
Q

What receptors does clonidine act on?

A

Alpha 2

23
Q

What receptor does phenylephrine act on?

A

Alpha 1 > Alpha 2

24
Q

Chloramphenicol MOA?

A

Inhibits 50S ribosomal subunit (like the macrolides)

25
Q

What are abx inhibit bacterial 50S ribosomal subunit?

A

Chloramphenicol, macrolides, linezolid

26
Q

What class of antiretrovirals have the following side effects: lipodystrophy, hyperglycemia, P450 inhibition

A

Protease inhibitor

27
Q

What is the main enzyme in the purine salvage pathway?

A

HGPRT

28
Q

By what process are free purine bases (generated during cellular metabolism of nucleic acids) converted back to nucleotides?

A

Phosphoribosylation in the purine salvage pathway (HGPRT enzyme)

29
Q

What is the deficient enzyme in Lesch-Nyhan syndrome?

A

HGPRT (hypoxanthine-guanine phosphoribosyltransferase)

30
Q

Why do you see hyperuricemia in Lesch-Nyhan?

A

HGPRT deficiency, forcing guanine and hypoxanthine into uric acid instead of the purine salvage pathway

31
Q

What HGPRT substrate accumulates in Lesch-Nyhan?

A

PRPP (phosphoribosyl-pyrophosphate)

32
Q

What do you see on eye exam with a CN III mononeuropathy?

A

“Down and out”, inferolateral gaze

May see ptosis due to paralysis of levator palpebrae

33
Q

What are the 2 most common sites for osteoporotic fractures?

A
  1. Vertebral bodies (trabecular bone)

2. Neck of the femur (half trabecular, half cortical)

34
Q

Dilated pupils, lacrimation, and yawning are withdrawal sx for what drug?

A

Opioids

35
Q

Withdrawal from what two substances can lead to sz?

A

Alcohol

Benzodiazepines

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