3/26 - UW 27 Flashcards
How does vit K activate factors 7, 9, 10?
Vit K is the cofactor for hepatic microsomal carboxylase, which converts glutamyl residues into y-carboxyglutamates
Sources of dietary vit K?
Dark leafy greens, green tea, beef liver
What 4 populations tend to have vit K def?
- malabsorption
- abx tx reducing intestinal flora
- neonates
- generalized liver disease
What is the Hawthorn effect?
Observer effect: tendency for study subjects to change the observed behavior
What is Berkson’s bias?
Selection bias due to selecting hospitalized patients as the control group
What is the Pygmalion effect?
The researcher’s belief in the efficacy of a tx can affect outcomes
What is the effect of low dose epinephrine on dBP?
Decrease, due to b2 > a1
What is the effect of high dose epinephrine on dBP?
Increase, due to a1 > b2
What receptors does Phenylephrine act on?
alpha adrenergic agonist
What receptors does Isoproterenol act on?
Beta-adrenergic agonist
What is characteristic of bacterial meningitis on CSF?
Neutrophils, low glucose, high protein
What is characteristic of viral meningitis on CSF?
Lymphocytes, normal glucose, high protein
Sudden onset tachypnea and chest pain in a hospitalized patient should suggest what?
PE, especially with immobilization and recent surgery
What receptor mediates vagal effect on bronchial smooth muscles?
Muscarinic, M3, ACh receptors
In what type of membranous nephropathy (idiopathic or secondary) do you see elevated serum PLA2R?
Idiopathic, but not secondary (e.g. SLE-induced)
What is Dupuytren’s contracture?
Benign, slowly progressive fibroproliferation of the palmar fascia, eventually contracting the fingers into flexion.
What molecule accumulates in Fabry disease? What is the deficiency?
Ceramide trihexoside accumulates due to alpha-galactosidase A deficiency
What is acroparesthesia?
Episodic, debilitating, burning neuropathic pain in the extremities
What causes vitiligo?
Loss of epidermal melanocytes
How do nitrates and phosphodiesterase inhibitors combine to cause profound hypotension?
NO increases cGMP, and phosphodiesterase inhibitors decrease cGMP breakdown
Stimulation of what receptors leads to pupillary dilation?
alpha1
Stimulation of what receptors leads to uterine relaxation?
beta2
What end organs does beta2 act on? Effect?
Peripheral vasculature (vasodilation)
Bronchi (bronchodilation)
Uterus (relaxation…“dilation”)
What end organs does alpha1 act on? Effect?
Peripheral vasculature (constriction) Internal urethral sphincter (constriction) Pupillary dilator muscle (constriction)
How does the nicotinic ACh receptor work?
5 subunits. Opens when ACh binds to BOTH binding sites. Allows immediate INFLUX OF Na and Ca, and EFFLUX OF K
What enzyme converts 6-mercaptopurine and 6-thioguanine to active metabolites?
HGPRT
What enzyme degrades 6-mercaptopurine and 6-thioguanine to inactive metabolites?
Xanthine oxidase and Thiopurine methyltransferase (TPMT)
What is a xanthine oxidase inhibitor?
Allopurinol
Where are most anal fissures?
Longitudinal tear in the mucosa of the DISTAL anal canal at the POSTERIOR midline
What are the criteria for bulimia nervosa?
Recurrent binge eating WITH compensatory behaviors (purging or nonpurging), occuring 2x/wk for >3mo
Loss of what enzyme characterizes CGD?
NADPH oxidase
What color will the NBT test be in CGD patients?
Remain yellow
What is the most common mutation to induce adenomatous polyps?
APC, with progression K-ras, p53, DCC
What dermatologic condition has a rough texture with overlying whitish scale?
Actinic keratoses
