3/7 Flashcards
What are the most common sx of a primary HSV infx?
Fever, vesiculoulcerative gingivostomatitis, cervical LAD
What are the most common sx of reactivation of a latent HSV infx?
More limited than a primary infx: periorbal blisters aka cold sores
What do multinucleated giat cells with intranuclear inclusions suggest?
HSV or VZV
Fever, vesiculoulcerative gingivostomatitis, and cervical LAD are suggestive of what infx?
Primary HSV infection (secondary would show perioral cold sores)
Where do HSV and VZV reside and reinfect from?
HSV: trigeminal ganglia
VZV: dorsal root ganglia
What sx are seen in reactivation of endogenous, latent CMV?
Interstitial pneumonitis, retinitis, hepatitis, colitis, and/or generalized disease
What lobe is affect in aspirations while standing? While supine?
Standing: basilar right lower lobe
Supine: posterior right upper lobe or superior right lower lobe
What receptors does NE have the most effect on?
Alpha1 and Beta1
What adrenergic receptor mediates vasoconstriction? Vasodilation?
Vasoconstriction: Alpha1
Vasodilation: Beta2
Phenoxybenzamine MOA?
Non selective, irreversible a1 and a2 receptor antagonist
Major use for Phenoxybenzamine?
Pheochromocytoma
Labetalol MOA?
Reversible, competitive a1, b1, b2 adrenergic receptor antagonist
For what sort of overdose would you give Labetalol?
Sympathomimetic overdose (e.g. cocaine)
Phentolamine MOA?
Reversible, competitive, non specific alpha adrenergic antagonist
When might you give phentolamine?
Management of catecholamine-induced hypertensive crises (pheochromocytoma, MAOI crisis, cocaine overdose)
Propanolol MOA?
nonspecific beta adrenergic antagonist
Atropine MOA?
Competitive muscarinic ACh R antagonist
What drug is a non selective, irreversible a1, a2 receptor antagonist?
Phenoxybenzamine
What drug is a reversible, competitive a1, b1, b2 receptor antagonist?
Labetalol
What drug is a reversible, competitive, nonspecific alpha adrenergic antagonist?
Phentolamine
What drug is a nonspecific beta adrenergic antagonist?
Propranolol
What drug is a competitive muscarinic ACh R antagonist?
Atropine
What class is Quinidine?
Class 1A
What class is Lidocaine?
Class 1B
What class is Flecainide?
Class 1C
What class is verapamil?
Class 4
What class is Esmolol?
Class 2
Does amyloidosis cause restrictive or dilated cardiomyopathy?
Restrictive
What are some causes of restrictive cardiomyopathy?
Amyloidosis, sarcoidosis, cancer, inborn metabolic errors
Diastolic dysfunction = restrictive or dilated cardiomyopathy?
Restrictive
Systolic dysfunction = restrictive or dilated cardiomyopathy?
Dilated
What 3 characteristics primarily describes the histology of PSGN?
- Enlarged, hypercellular glomeruli
- “Lumpy bumpy” granular deposits of IgG and C3
- Electron-dense deposits on the epithelial side of the basal membrane
Homocystinuria due to cobalamin (B12) deficiency prevents synthesis of what?
Methionine
What dopaminergic pathway connects the hypothalamus and the pituitary?
Tuberoinfundibular
Classic galactosemia is due to deficiency of what enzyme?
Galactose-1-phosphate uridyl transferase
What is the most important E. coli virulence factor?
Fimbriae (aka pili): type 1 fimbriae, P fimbriae (especially for UTI), S fimbriae
For adhesion to epithelial cells and enterocytes
What vitamin takes years to deplete?
B12 (cobalamin)
Thiazolidinediones (TZD) MOA?
TZDs bind to peroxisome proliferator activating receptor gamma (PPAR-gamma), which regulates expression of adiponectine gene, decreasing insulin resistance
Aminoglycosides MOA?
Inhibits bacterial 30S ribosomal subunit
What is the typically elevated lab value in Gilbert syndrome?
Elevated unconjugated bilirubin (normal LFT, CBC, smear, retic)
Familiar disorder of bilirubin glucuronidation
CYP450 Inducers?
Rifampin, Carbamazepine, Phenobarbital, Phenytoin, Griseofulvin
CYP450 Inhibitors?
Cimetidine, Ciprofloxacin, Erythromycin, Azole antifungals, grapefruit juice, Isoniazid, Ritonavir
What parts of the spinal cord are affected in B12 deficiency?
Dorsal columns, lateral corticospinal tracts (leading to “subacute combined degeneration”)
What parts of the spinal cord are affected in syringomyelia?
Central portions including the lateral spinothalamic tracts and anterior horns
What parts of the spinal cord are affected in tabes dorsalis? (Neurosyphilis)
Dorsal columns and dorsal roots
What parts of the spinal cord are affected in ALS?
Upper and lower motor neuron lesions, lateral corticospinal tracts, anterior horn
What parts of the spinal cord are affected in poliomyelitis?
Anterior horns
