3/28 - UW 30 Flashcards
What type of inheritance is PKU?
AR
What are the first line treatments for afib with SVT?
CCB and beta blockers
In what subset of patients with afib might you give digoxin?
Those with underlying systolic dysfunction
What are some sx of digitalis toxicity?
Head: Fatigue, headache, dizziness, confusion, delirium
Vision: Blurry, color (yellow/green)
GI: N/v, diarrhea, abd pain
Increase in K is correlated to dig level
Tx of digitalis toxicity?
- Oral activated charcoal
- Insulin, Kayexalate, hemodialysis to manage hyperK (NOT calcium gluconate)
- Antibody to dig
How does HIT cause paradoxical thrombosis?
Ab to heparin and Platelet factor IV
What drugs are given for HIT?
Direct thrombin inhibitors (hirudin, lepirudin, argatroban), which do not require antithrombin-III
What drug blocks glutamate residun carboxylation of clotting factors?
Warfarin inhibits vit K dependent y-carboxylation of glutamic acid residues of factors 2, 7, 9, 10
Where are Pancoast tumors and what syndrome do they cause?
They are apical lung tumors that cause Horner syndrome in 50% of patients
What is the triad of Horner syndrome?
Ipsilateral miosis, ptosis, anhidrosis
What condition presents with spongiotic dermatitis (with epidermal spongiosis)?
Eczematous dermatitis
Acanthosis is associated with what condition?
Psoriasis
What is acantholysis?
Loss of cohesion between keratinocytes in the epidermis or adnexal structures. Associated with spongiotic dermatitis, as in eczematous dermatitis
What brain areas are most vulnerable to ischemia from cardiac arrest?
Pyramidal cells of hippocampus (#1)/neocortex
Purkinje cells of the cerebellum
What is thyroid peroxidase responsible for?
Thyroglobulin iodination
What kind of skin presentation is seen with Bartonella in immunocompromised patients?
Bacillary angiomatosis: red/purple papules that resemble Kaposi sarcoma lesions
Tell me about Rickettsia rickettsia.
Rocky Mountain spotted fever.
Tick-borne.
Dogs and exposure to wooded areas or grassy fields.
Prompt doxycycline treatment
What organism characterizes swimming pools and cervical LAD?
Mycobacterium scrofulaceum
What do you get from animal urine?
Leptospirosis, causing conjunctival suffusion
What is the most common cause of inhaled anesthetic hepatotoxicity?
Halothane, can cause liver to be shrunken
Reduced serum albumin levels indicate what time course of liver disease?
Chronic, NOT in acute liver injury, because albumin has half life of 20 days
What is the half life of albumin?
20 days
What lab findings will be seen in patients with inhaled-anesthetic induced hepatotoxicity?
Elevated AST/ALT Prolonged PT (deficiency of factor VII, which has the shortest half life)
Ammonia toxicity in the brain can result from depletion of what molecules?
Glutamate or alpha-ketoglutarate
PRPP is an enzyme for the production of what?
De novo synthesis of purines and pyrimidines
What cells mediate the inflammatory reaction in gouty arthritis?
Neutrophils…duh
If a patient with gouty arthritis can’t take NSAIDs, what should you give them?
Colchicine, which impairs neutrophil migration and phagocytosis
What is Tardive dyskinesia?
Involuntary perioral movements and choreoathetoid movements.
From antipsychotics.
What is the antipsychotic most likely to cause EPS (like Tardive diskinesia)?
Risperidone
What is the antipsychotic least likely to cause EPS?
Clozapine (but it is associated with agranulocytosis)
What parasite’s eggs are found in the stool?
Schistosoma
What parasite’s eggs are found perianal?
Enterobius (pinworms)
What species of Streptococcus is associated with colonic cancer?
Group D strep: S. bovis
What are the conditions associated with Streptococcus bovis?
Subacute Bacterial Endocarditis (even on normal valves) and Colon Cancer
What molecule mediates niacin-induced flushing?
Prostaglandin, so can give aspirin to reduce
In addition to cardiomyocytes, what other cells have beta1 receptors?
JGA cells
Which antihyperlipid is good for lowering TG?
Fibrates (activates PPAR-a)
Which antihyperlipid is good for raising HDL?
Niacin (decreased VLDL synthesis and HDL clearance)
What is Primaquine used for?
To eliminate Plasmodium vivax and ovale latent infections, and to prevent relapse
What abx inhibit 30S?
Aminoglycosides, tetracyclines
What two neoplasms are associated with EBV?
Burkitt lymphoma and nasopharyngeal carcinoma (in the Chinese)
What causes air in the bowel wall in an infant?
Necrotizing enterocolitis
Increase AST and ALT indicate what type of damage?
Hepatocyte injury
Increased alk phos and y-glutamyl transpeptidase indicate what type of damage?
Biliary injury/cholestasis
Low serum albumin, elevated bilirubin, and PT tell what type of damage?
Cirrhosis/liver function
MSUD results from a defect in what enzyme complex?
Branched-chain alpha-ketoacid dehydrogenase
What are the 5 cofactors required by these three enzymes: branched chain ketoacid dehydrogenase, pyruvade dehydrogenase, and a-ketoglutarate dehydrogenase?
"Tender Loving Care For Nancy" Thiamine Lipoate Coenzyme A FAD NAD
