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3/3 Flashcards

1
Q

Why does SIADH present with euvolemic hyponatremia?

A

The excess ADH leads to water reabsorption, leads to RAAS activation, leads to natriuresis, leading to normalized volume with low sodium

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2
Q

In assessing viral HBV infection, what viral process does HBeAg indicate?

A

HBeAg = viral replication, increased infectivity

Indicates increased risk of neonatal infx if seen in mother

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3
Q

In homocystinuria, what AA becomes essential?

A

Cysteine

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4
Q

What are common sx of homocystinuria?

A 
Hypercoagulability
Premature atherosclerosis
Ectopia lentis (displacement of ocular lens)
Osteoporosis
Mental retardation
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5
Q

Warfarin MoA?

A

Inhibits vit K dependent carboxylation of glutamic acid residues in factors 1972CS

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6
Q

CGD patients are susceptible to infection by what type of bugs?

A

Bacterial and fungal infections that are CATALASE POSITIVE

Staph. aureaus, Burholderia cepacia, Serratia marcescens, Nocardia, Aspergillus

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7
Q

What are some common catalase positive bugs?

A

Staph aureus, burkholderia cepacia, Serratia marscencens, Nocardial, Aspergillus

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8
Q

Tx for trichomonas vaginitis and bacterial vaginosis (Gardnerella)?

A

Metronidazole

Disulfram-like rxn

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9
Q

Tx for chlamydial urethritis?

A

Doxycycline or azithromycin

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10
Q

Tx for candida vaginitis?

A

Fluconazole

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11
Q

Niacin (vit B3) MoA in treating hyperlipidemia?

A

Decreasing synthesis of TG and VLDL

Also increases HDL by 25-30%, best one!

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12
Q

Prominent side effect of niacin?

A

Flushing

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13
Q

Bile acid binding resins effect on TG?

A

Increase

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14
Q

Ezetimibe MoA?

A

Decrease intestinal absorption of cholesterol

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15
Q

What drug reduces tobacco withdrawal cravings and attenuates rewarding effects of nicotine?

A

Varenicline

Partial agonist of nicotinic ACh-Rs

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16
Q

Selective COX2 inhibitor?

A

Celecoxib

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17
Q

Celecoxib MoA?

A

Selective COX2 inhibitor

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18
Q

When is celecoxib (selective COX2 inhibitor) useful?

A

To avoid platelet aggregation impairment

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19
Q

Diphenoxylate MoA?

A

Binds to mu opiate receptors to slow GI motility

Opiate

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20
Q

What to give for secretory diarrhea?

A

Octreotide

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21
Q

What nerve for foot dorseiflexion? Plantar flexion?

A

Dorsiflexion: Common peroneal

Plantar flexion: Tibial

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22
Q

Incomplete obliteration of the processus vaginalis can lead to what two similar pathologies?

A

Hydrocele (small opening remains)

Indirect inguinal hernia (large opening remains)

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23
Q

What is the single most important risk factor in development of intimal tears leading to aortic dissection?

A

HTN

24
Q

What congenital disease is associated with aortic dissection?

A

Marfan syndrome (esp in younger pts)

25
Q

The most common cause of death from TCAs?

A

Arrhythmias from inhibition of Na channel conduction

26
Q

Rule of 2s for Meckel’s diverticulum?

A 
2% of population
2 feet from ileocecal valve
2 inches in length
2% are symptomatic
2 times as likely in males
27
Q

Wernicke’s syndrome triad?

A

Opthalmoplegia, ataxia, confusion

28
Q

In Wernicke’s syndrome, where do you find hemorrhage and necrosis in the brain?

A

Mamillary bodies and periaqueductal gray matter

29
Q

What causes Wernicke’s syndrome?

A

Chronic thiamine (B1) deficiency

30
Q

Thiamine (B1) is a cofactor for which enzymes?

A
  1. Pyruvate dehydrogenase
  2. alpha-ketoglutarate dehydrogenase
  3. Transketolase
31
Q

Ankylosing spondylitis is a chronic inflammatory disorder of what?

A

Sacroiliac joints and axial skeleton

32
Q

“Bamboo spine” on xray describes what disease?

A

Ankylosing spondylitis

33
Q

What are the seronegative (lacking serum rheumatoid factor) spondyloarthropathies?

A

Ankylosing spondylitis
Reactive arthritis
IBD associated arthritis
Psoriatic arthritis

(Associated with HLA B27)

34
Q

The portal triad that runs through the hepatoduodenal ligament contains what vessels?

A

Hepatic artery
Portal vein
Common bile duct

35
Q

Where are S cells (secretin releasing) located?

A

Duodenum

36
Q

Secretin causes release of bicarb from what organ?

A

Exocrine pancreas

37
Q

Pancreatic juice normally has the same [Na] and [K] as plasma. Is the [HCO3] and [Cl] higher or lower? How do they change with flow rate?

A

[HCO3] is higher than plasma, and goes higher with higher flow rate.

[Cl] is lower than plasma and goes lower with higher flow rate.

38
Q

Digoxin MoA

A

Inhibits Na/K pump, increases intracellular [Na], reducing Ca efflux, increasing intracellular [Ca]

This decreases conductivity through AV node and increases contractility of myocyte

39
Q

Familial chylomicronemia is an AR condition cause by deficiency of what enzyme? What is the common presenting disease?

A

Lipoprotein lipase deficiency, presenting in childhood with recurrent acute pancreatitis

40
Q

Which virus, HBV or HCV, persists in the host genome to continue risk of HCC?

A

HBV, a DNA virus, injects into host chromosome, allowing transcription of HBx protein.

HBx inactivates p53.

41
Q

Systolic crescendo decrescendo murmur

A

Aortic stenosis

42
Q

Malaria tx?

A

Chloroquine if sensitive, mefloquine if chloroquine -resistant

43
Q

Pantothenic acid (coenzyme A) is particularly important for which step of the TCA?

A

First step: oxaloacetate to citrate

44
Q

Multiple ring-enhancing lesions on contrast MRI in an HIV pt points to what bug?

A

Toxoplasmosis

45
Q

Aplastic anemia pathogenesis?

A

BM failure due to deficiency in CD34 hematopoietic stem cells

46
Q

Causes of aplastic anemia?

A

Autoimmune
Infections (parvovirus B19, EBV)
Drugs (carbamazepine, chloramphenicol, sulfonamides)
Radiation/toxins (benzene, solvents)

47
Q

PABA blocks what type of UV rays?

A

UVB (the Bad one)

48
Q

What drug gives red/orange discoloration to secretions (urine, breast milk, tears)?

A

Rifampin

‘rifAMPin AMPlifies’ CYP450
Used for Neisseria meningitidis prophylaxis

49
Q

What is the precursor for serotonin?

A

Tryptophan

50
Q

What is tyrosine the precursor for?

A

Dopamine, NE, Epi, melanin, thyroxine

51
Q

What is the antidote for serotonin syndrome?

A

Cyproheptadine, first gen histamine antagonist with nonspecific 5HT-R anatgonism

52
Q

Slowly growing jaw mass in setting of oral trauma, that drains yellow pus through the skin = what bug?

A

Actinomyces

Normal gram+ oral flora
Tx: penicillin and debridement

53
Q

Borrelia burgdorferi causes what disease?

A

Lyme disease

54
Q

Pasteurella multocida is associated with what type of injury?

A

Animal (usually cat) bites

55
Q

What is the disease and cutaneous lesion associated with Rickettsia?

A

Rocky Mtn Spotted Fever, with palmoplantar erythematous macules that migrate centrally

56
Q

What 2 drugs are given to diabetics to decrease progression of diabetic nephropathy?

A

ACE-I and ARB

Lisinopril

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