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3/5 Flashcards

1
Q

P450 inducers?

A

Rifampin, Carbamazepine Barbiturates, Griseofulvin, chronic alcohol use

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2
Q

P450 inhibitors?

A

Cimetidine, isoniazid, macrolides, azole antifungals, grapefruit juice

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3
Q

What causes an early diastolic decrescendo murmur?

A

Aortic regurgitation

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4
Q

Why does administration of amyl nitrite reduce an aortic regurge murmur?

A

Causes vasodilation, reducing systemic resistance

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5
Q

What causes a systolic ejection murmur that increases with intensity when standing?

A

Hypertrophic cardiomyopathy (due to a decrease in LV outflow tract size)

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6
Q

What causes a systolic ejection murmur that decreases with intensity when standing?

A

Aortic stenosis

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7
Q

What type of inheritance is classical galactosemia? What is the defective gene?

A

AR, defective galactose-1-phosphate uridyltransferase

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8
Q

Common side effects of nitrates (nitroglycerine, isosorbide)?

A

Headaches and cutaneous flushing

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9
Q

Muscles that Munch (close the jaw)?

A

Masseter, teMporalis, Medial pterygoid

Lateral pterygoid opens jaw

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10
Q

Divisions of CN V exit the skull due to Standing Room Only, from which foramen?

A

Opthalmic: Superior orbital fissure
Maxillary: foramen Rotundum
Mandibular: foramen Ovale

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11
Q

What does heparin inhibit?

A

Factor Xa and thrombin (UFH)

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12
Q

What is lacking in Xeroderma Pigmentosum?

A

Repair enzyme UV-specific endonuclease

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13
Q

UV radiation causes formation of what type of bonds?

A

Covalent bonds between adjacent pyrimidine (thymine) NAs

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14
Q

What vitamin deficiency is associated with Isoniazid?

A

B6, pyridoxine

Supplementation recommended

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15
Q

What is ethosuximide’s MOA in treating absence sz?

A

Blocks T-type Ca channels that rigger and sustain rhythmical burst discharges in thalamic neurons

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16
Q

Which 3 sz medications act by inhibiting neuronal high-freq firing by reducin the ability of Na channels to recover from inactivation?

A

Phenytoin
Carbamazepine
Valproic acid

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17
Q

What is the term for the high bone turnover rate seen in hyperPTH?

A

Osteitis fibrosa cystica

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18
Q

How do nitrites cause poisoning?

A

Oxidizing ferrous (2+) iron to ferric (3+) iron, forming methemoglobin. Shifts oxygen dissociation curve left. Partial pressure of O2 in blood is normal.

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19
Q

What sugar should be avoided in aldolase B def?

A

Fructose (which is also in sucrose)

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20
Q

How to characterize the glomerulus in PSGN?

A

Hypercellular

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21
Q

What are some lab findings in PSGN?

A

elevated titers of anti-streptococcal ab (anti-streptolysin O, andti-DNase B, anti-cationic proteinase)

Low C3 concentration

Serum cryoglobulins

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22
Q

Serum anti-glomerular basement membrane ab are found in what renal pathology?

A

Goodpastures RPGN, often with crescent formation on light microscopy

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23
Q

Serum anti-neutrophil cytoplasmic ab are found in what disease?

A

Granulomatosis with polyangiitis (Wegener’s) RPGN, crescents

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24
Q

What to give for Jimson weed poisoning and atropine overdose?

A

Physostigmine

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25
Q

Atropine overdose sx mnemonic?

A

Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone

(Reverse cholinergic antagonists selective for muscarinic receptors)

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26
Q

What to give for beta blocker overdose?

A

Glucagon

27
Q

What is the mechanism for glucagon rescue of beta blocker overdose?

A

GPCR that increases cAMP, increasing intracellular Ca release during muscle contraction

28
Q

What infx in HIV pts is like TB, but has marked anemia, HSM, elevated alk phos and LDH, and also grows optimally at 41C?

A

MAC! Treat with macrolides (clarithro, azithro) +rifabutin or ethambutol

Prophylaxis with macro

29
Q

What brain tumors show S-100 immunoreactivity?

A

Schwannomas and melanomas

30
Q

What brain tumor is described as bizarre looking glial cells with multiple mitotic figures, pseudopalisading necrosis, and abundant neovascularization and hemorrhage?

A

Glioblastoma (WTF….)

31
Q

What chronic diseases can lead to hyaline arteriolosclerosis?

A

NONmalignant HTN, DM

Underlying vessel wall is maintained, but intima is thickened and lumen is narrowed

32
Q

What type of arteriolosclerosis is produced by malignant HTN?

A

Hyperplastic arteriolosclerosis

Homogenous, onion-like, concentric thickening of arteriole walls

33
Q

Heavy cigarette smokers can get calf, foot, or hand intermittent claudication, superficial nodular phlebitis, and cold sensitivity have what disease?

A

Thromboangiitis obliterans (Buerger’s disease)

34
Q

Significant risk factor for mesothelioma?

A

Asbestos (insulation, ship building, mining)

35
Q

Toxic shock syndrome is mostly from what bug?

A

Staph aureus

36
Q

Toxic shock syndrome activates what immune cells?

A

Macrophages and T cells

37
Q

What are some histological markers of eczema?

A

Intraepidermal vesicles, superficial epidermal hyperkeratosis (scales), epidermal hyperplasia (acanthosis), chronic inflammatory infiltrate

38
Q

What are the only 2 purely ketogenic AAs?

A

Lysine and Leucine

39
Q

What is more distal, airway epithelial cilia, or goblet cells?

A

Cilia, present throughout the respiratory bronchioles. Goblet cells end in the bronchi.

40
Q

Is excess neutrophil elastase activity in alveoli associated with panacinar or centriacinar emphysema?

A

Panacinar, more common in lower lung fields due to higher perfusion. Can be due to alpha1antitrypsin deficiency.

41
Q

Is smoking associated with panacinar or centriacinar emphysema?

A

Centriacinar, with greater upper lobe distribution due to destructive proteases released by macrophages/neutrophils

42
Q

Is alpha 1 antitrypsin deficiency associated with panacinar or centriacinar emphysema?

A

Panacinar

43
Q

What molecules/hormones increase gastric acid secretion? (3 things)

A

Histamine, ACh, gastrin

44
Q

What molecule inhibits gastric acid secretion?

A

PGE2

45
Q

What syndrome causes excess gastrin secretion?

A

Zollinger-Ellison syndrome

46
Q

vWF protects what clotting factor from degradation?

A

Factor VIII, so vWF deficiency can cause a prolonged bleeding time and PTT, with a normal platelet count.

47
Q

In what disorder do you see an isolated PTT prolongation? What medication?

A

Hemophilia A (X linked disorder caused by factor VIII deficiency)

Heparin (antithrombin associated inhibition of factors II and X)

48
Q

What do you see on PT, PTT, platelet count, and bleeding time with uremic platelet dysfunction?

A

Normal PT, PTT, platelet count

Increased bleeding time

49
Q

Acute extrapyramidal symptoms are related to which neurotransmitter?

A

D2

50
Q

Which Staph species is associated with foreign bodies?

A

Staph epidermidis (forms biofilm)

It is coagulase neg, part of normal skin flora

51
Q

Which Staph species has protein A?

A

Staph Aureus (protein A binds to Fc region of Ig, inhibiting opsonization and phagocytosis)

52
Q

What are the 3 phases in Paget disease of bone?

A
  1. Osteolytic (osteoclast dominant from excessive RANK signaling and NK-kB activation)
  2. Mixed (osteoclast/osteoblast) with abnormal new bone
  3. Osteosclerotic (osteoblast dominant forming dense hypovascular mosaic pattern of lamellar bone with prominent cement lines)
53
Q

Aqueous humor is produced by what cells?

A

Ciliary epithelial cells

54
Q

What type of medications precipitate narrow angle glaucoma?

A

Anticholinergics, more acute presenting with h/a and eye pain

55
Q

What drugs decreases secretion of aqueous humor? From where?

A

Timolol (nonselective beta blockers)
Acetalzolamide (carbonic anhydrase inhibitor)

Decrease secretion by ciliary epithelial cells

56
Q

What drugs increase outflow of aqueous humor?

A 
Prostaglandin F2a (latanoprost, unoprostone, travoprost)
Cholinomimetics (pilocarpine, carbachol)
57
Q

What is the first line tx for Enterobiasis (dx by scotch tape test)

A

Albendazole

58
Q

Virus that causes Mono?

A

EBV

59
Q

Causes of mononucleosis-like sx?

A

CMV, toxo

60
Q

Which cholesterol drugs increase risk for gallstones?

A

Fibrates and bile acid binding resins (cholestyramine, colestipol, colesevelam)

61
Q

What does an intimal tear precede?

A

Aortic dissection

62
Q

What does an intimal streak precede?

A

AAA

63
Q

What to give for Succinylcholine slow metabolisers?

A

neostigmine

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