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Final FA review > 4/12 overall > Flashcards

4/12 overall Flashcards

1
Q

macula adherens

-aka?

A

desmosomes

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2
Q

zona occludens

-aka?

A

tight junction

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3
Q

tight junction, zona occludens, adherens junction.

-which one relies on calcium?

A

adherens junction

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4
Q

SSRIs

  • name them:
  • mnemonic:
A

Flashbacks paralyze senior citizens.

-Fluoxetine, paroxetine, sertraline, citalopram.

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5
Q

Paget disease of bone

-mechanism?

A
  • Lytic—osteoclasts
  • Mixed—osteoclasts + osteoblasts
  • Sclerotic—osteoblasts
  • Quiescent—minimal osteoclast/osteoblast activity
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6
Q

Paget disease of bone

-serum values? whats inc/dec/normal?

A
  • Ca, PTH, phosphorous = normal.

- inc. ALP.

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7
Q

Paget disease of bone

-presentation:

A

Hat size can be increased; hearing loss is common due to auditory foramen narrowing.

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8
Q

60 yo man presents w/lytic bone lesion & hearing loss.

-normal lab values except inc. ALP.

A

Paget’s disease of bone.

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9
Q

Which protein is secreted along w/insulni in 1:1 ratio?

A

C-peptide

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10
Q

Low serum IgM and normal IgG.

-which disease?

A

Wiskott Aldrich Syndrome

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11
Q

Which drug class can treat both positive and negative Sxs of schizophrenia?

A

atypical anti-psychotics.

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12
Q

Typical anti-psychotics

-do they treat positive/neg/both Sxs of schizo?

A

primarily the positive Sxs.

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13
Q

Atypical anti-psychotics

  • name them:
  • mnemonic:
A

“It’s really fuckin ATYPICAL to be CO-Z on the RAQ”

  • clozapine
  • olanzapine
  • ziprasidone
  • risperidone
  • aripiprazole
  • quetiapine
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14
Q

Which atypical antipsychotic can cause agranulocytosis?

-mnemonic?

A

Must watch clozapine clozely!

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15
Q

MAO inhibitors

  • mnemonic:
  • name them:
A

MAO Takes Pride In Shanghai

  • Tranylcypromine
  • Phenelzine
  • Isocarboxazid
  • Selegiline (selective MAO-B inhibitor).
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16
Q

“floppy baby”

-what can cause?

A

Werdnig-Hofman, botulism.

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17
Q

Serotonin syndrome

-most likely caused by combo of which drugs?

A

MAO inhibitors w/either SSRI or TCA.

-usually dont see it w/SSRI + TCA.

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18
Q

Most common source of metastases to liver?

A

Colon

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19
Q

Most common source of metastases to bone?

A

Prostate, breast.

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20
Q

Most common source of metastases to brain?

A

Lung

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21
Q

hydrops fetalis

-explain the mechanism.

A
  • severe fetal anemia → fetal CHF → massive edema.
  • ie. hemolytic disease of Rh+ newborn. Type 2 HSR. Mothers IgG anti-Rb destroys RBCs of newborn in utero. The severe anemia leads to fetal CHF and massive edema = hydrops fetalis.

*can also happen w/parvovirus or any other disease process that destroys fetal RBCs.

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22
Q

Congenital CMV

-Sxs:

A

Hearing loss, seizures, petechial rash, “blueberry muffin” rash.

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23
Q

hemolytic disease of newborn

-aka?

A

erythroblastosis fetalis.

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24
Q

Strep pyogenes pharyngitis

-Tx:

A

beta-lactam.

-penicillin or cephalosporin.

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25
Q

After ELISA & confirming w/western blot, whats the next step in management of suspected HIV pt?

A

Quantify viral load & get CD4 cell count.

-do this before you start treatment.

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26
Q

What type of bone lesions do prostate mets cause?

-blastic or lytic?

A

osteoblastic.

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27
Q

damage a nerve that leads to hoarsness - which nerve MUST it be?

A

recurrent laryngeal.

-not external laryngeal under any circumstances.

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28
Q

Can you damage recurrent laryngeal n. during surgery to have parathyroids removed?

A

yes.

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29
Q

Which Sxs are common to all congenital infections?

A

Hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation (ie. microcephaly).

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30
Q

Acetyl-CoA carboxylase:

  • FA synth or oxidation?
  • what rxn does it catalyze?
  • cofactor?
A

acetyl-CoA (2C) => malonyl-CoA (3C)

-biotin.

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31
Q

To get a type 4 HSR like contact dermatitis, does that happen after 1 exposure do does it need to be re-exposure?

A

re-exposure.

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32
Q

Mode of resistance to aminoglycosides?

A

plasmid-mediated acetylation/adenylation/phosphorylation.

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33
Q

Multiple myeloma

-whats the neoplastic cell and where does it arise?

A

Monoclonal plasma cell (“fried egg” appearance) cancer that arises in the marrow and produces large amounts of IgG (55%) or IgA (25%).

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34
Q

“Fried egg” appearance on H&E stain.

A

Oligodendroglia, plasma cell (MM), seminoma & dysgerminoma.

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35
Q

Ribavirin

-tox:

A

Hemolytic anemia. Severe teratogen.

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36
Q

Can dopamine cross BBB?

A

No, but L-DOPA can.

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37
Q

Epidural hematoma

-where does it form?

A

forms btwn the outer and inner dural layers.

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38
Q

Which brain hematoma leads to CN 3 palsy & why?

A

Leads to uncal hernation which can cause CN III palsy.

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39
Q

Sotalol & ibutilide

  • what are they?
  • tox?
A 
K channel blockers (class III)
-torsades de pointes.
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40
Q

Odds Ratio: formula

A

(a/c)/(b/d)

ab
cd

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41
Q

aspirin poisoning

-how long til the metabolic acidosis kicks in?

A

2-3 hours.

42
Q

Aortic arch baroreceptors

  • what do they respond to?
  • does that inc or dec. AP firing rate?
A
  • responds only to INC. in BP.

- vagus n to solitary nucleus.

43
Q

carotid sinus

  • what do they respond to?
  • does that inc or dec. AP firing rate?
A
  • responds to inc or dec. in BP.
  • CN9 to solitary nucleus.

*Hypotension => dec. AP firing.

  • vasculature has resting sympathetic tone, the baroreceptors put the brakes on it.
  • so when BP drops, the brakes are released.
44
Q

beta-thal

-mechanism?

A

Point mutations in splice sites and promoter sequences => dec. β-globin synthesis.

*alpha-thal there are gene deletions. Not so in beta-thal. In beta-thal it fucks up the mRNA step.

45
Q

beta-thal

-is it a mutation resulting in a defective beta-globin protein?

A

NO

  • due to mutations that result in defective txn, processing, or translation of beta-globin mRNA.
  • ie. abnormal splicing.
46
Q

Conn syndrome & hyperaldo.

-what will serum sodium be?

A
  • NORMAL due to aldo escape via ANP/BNP.

- do not be tricked into saying hypernatremia bc excess aldo resorbs more Na!

47
Q

Baby crawls

-how old?

A

8 months

48
Q

Baby stands

-how old?

A

10 months

49
Q

Baby pincer grasp

-how old?

A

10 months

50
Q

baby says mama/dada

-how old?

A

10 months

51
Q

baby uses fork/spoon

-how old?

A

20 months

52
Q

Cubes stacked

-formula to know how old the baby is:

A

number = age (yr) × 3

53
Q

b-HCG

-marker for what?

A
  • Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease).
  • testicular cancer.
54
Q

What marker used to monitor ovarian cancer progression?

A

CA-125

55
Q

Alkylating agents most commonly lead to what types of cancer?

A

Leukemia/lymphoma

56
Q

Erythropoietin = paraneoplastic hormone of which cancers?

A

Renal cell carcinoma, thymoma, hemangioblastoma, hepatocellular carcinoma, leiomyoma, pheochromocytoma.

57
Q

Psammoma bodies seen in which diseases?

-mnemonic?

A

PSaMMoma bodies are seen in:

  • Papillary carcinoma of thyroid
  • Serous papillary cystadenocarcinoma of ovary
  • Meningioma
  • Mesothelioma
58
Q

duloxetine

-what is it?

A

SNRI

59
Q

3 Cs of TCA toxicity:

A

Convulsions, Coma, Cardiotoxicity (arrhythmias); also respiratory depression, hyperpyrexia.

60
Q

Which TCA has fewer anti-cholinergic s/e and is good for elderly?
-mnemonic:

A

nortriptyline

-Use nortriptyline so the old people wont “tryp”.

61
Q

Inc. creatinine level for pt taking meds for GERD.

-why?

A

H2 blockers (cimetidine & ranitidnie) can dec. renal excretion of creatinine.

62
Q

Male pt taking meds for peptic ulcer develops breasts.

-how?

A

cimetidine (H2 blocker) has anti-androgen effects.

*its a P450 inhibitor and steroid synth enzymes = P450 enzymes.

63
Q

PPIs

-what type of inhibitors are they?

A

Irreversible inhibitors.

64
Q

PPIs

-tox:

A

P450 inhibitors

-Increased risk of C. difficile infection, pneumonia. Hip fractures, dec. serum Mg2+ with long-term use.

65
Q

Pt is on PPIs, what will gastrin level be?

A
  • PPIs can also inc. gastrin prod 2-4 fold b/c they inc. pH of stomach. A low pH in stomach is what has neg. feedback on gastric production.
  • Omeprazole associated w/hypergastrinemia.
66
Q

antacid use

-can cause hypo/hyperkalemia?

A

hypokalemia

67
Q

Metoclopramide

  • mech:
  • use:
  • tox:
A
  • D2 receptor antagonist.
  • Diabetic and post-surgery gastroparesis, antiemetic.
  • parkinsonian effects, has drug effect w/digoxin & diabetic agents.
68
Q

Serotonin & dopamine in CTZ

-are they pro or anti vomit?

A

pro-vomit

-thats why serotonin antagonist (ondansetron) and dopamine antagonist (metoclopramide) are anti-emetics.

69
Q

aprepitant

-what is it?

A

anti-emetic.

-NK1 receptor antagonist. Blocks neausea from pain.

70
Q

How does inc. progesterone lead to gallstones?

A

Progesterone:

  • reduces gallbladder emptying
  • reduces bile acid secretion
  • gallbladder hypomotility can lead to gallstones
71
Q

Can you see cholesterol gallstones on CXR?

A

Usually no bc they are radiolucent.

-sometimes have some calcification so can see them a little.

72
Q

Brown pigment stones

  • which bugs can cause it?
  • use of which enzyme and build up of what?
A
  • E.coli, Ascaris lumbercoides, clonorchis sinensis.
  • beta-glucoronidase
  • unconjugated bili.
73
Q

How would biliary colic present w/o pain?

A

in a diabetic w/peripheral neuropathies.

74
Q

rare primary infection of gallbladder - which bug?

A

CMV

75
Q

Branches of celiac trunk:

A

-common hepatic, splenic, left gastric.

76
Q

periventricular plaques in brain

-what disease?

A

MS

77
Q

Which cellular compartment responsible for adding mannose-6-phosphate to proteins for trafficking to lysosomes.

A

cis golgi.

78
Q

Which drugs can cause pulm. fibrosis?

-mnemonic?

A

Breathing Air Badly from Medications.

-Bleomycin, Amiodarone, Busulfan, Methotrexate.

79
Q

Bleomycin

  • mech?
  • use?
  • tox:
A

Induces free radical formation, which causes breaks in DNA strands.
-Testicular cancer, Hodgkin lymphoma.
-Pulmonary fibrosis, skin changes, mucositis. Minimal
myelosuppression.

80
Q

Trastuzumab (Herceptin)

  • tox:
  • mnemonic:
A

“HEARTceptin” damages the HEART.

-Cardiotoxicity

81
Q

Bleomycin

-which phase does it act in?

A

G2

82
Q

Doxorubicin (Adriamycin), daunorubicin

  • mech:
  • tox:
  • tox mnemonic:
A

Generate free radicals & Intercalate in DNA.

  • dilated cardiomyopathy, myelosuppression, alopecia.
  • “rub” = “ruby red” = cardiotox.
83
Q

Doxorubicin (Adriamycin), daunorubicin

-what do you give to prevent the cardiotox?

A

Dexrazoxane

84
Q

Busulfan

  • mech:
  • use:
A
  • cross links DNA.

- CML & ablate pt’s bone marrow before bone marrow transplantation.

85
Q

Busulfan

-tox:

A 
Severe myelosuppression (in almost all cases), pulmonary 
fibrosis, hyperpigmentation.
86
Q

anti-jo1

-which disease?

A

dermatomyositis & polymyositis.

87
Q

Which beta-lactam can cause seizure?

A

carbapenems.

88
Q

Hirschsprung disease

-associated w/what disease?

A

Down syndrome

89
Q

Hypoglossus nerve.

-innervates all tongue muscles except ____ which is innervated by ____.

A

-inn. all intrinsic tongue muscles except palatoglossus which is inn. by CN 10.

90
Q

CN 9

-whats the only muscle it innervates?

A

stylopharyngeus.

91
Q

recurrent laryngeal n. innervates all muscles of

larynx except the _____ which is innervated by ___,

A
  • cricothyroid.

- The cricothyroid is inn. by the external branch of the superior laryngeal nerve.

92
Q

SLE

  • nephritic syndrome:
  • nephrotic syndrome:
A
  • Nephritic—diffuse proliferative glomerulonephritis.
  • Nephrotic—membranous glomerulonephritis.

*both will end in “itis” bc theyre both immune complex mediated.

93
Q

SLE skin/msk Tx:

A

hydroxychloroquine

94
Q

SLE lupus nephritis Tx:

A

cyclophosphamide + glucocorticoids.

95
Q

Proton pump in stomach:

-H & what other ion?

A

H/K ATPase.

96
Q

Do lithium and sodium compete for resorption?

A

No, lithium follows Na as its being resorbed.

97
Q

Does diabetes insipidus cause hypo or hypernatremia?

A

Cause hypernatremia bc you’re pissing out so much volume that renin/aldo kicks in and saves a bunch of sodium.

98
Q

Which drug can be used for choriocarcinoma & ectopic pregnancy?

A

MTX

-can be abortifacent.

99
Q

Which drug can be used for choriocarcinoma & ectopic pregnancy?

A

MTX

-can be abortifacient.

100
Q

proinsulin polypeptide precursor is cleaved into what products?

A

insulin + c-peptide (both are secreted).

101
Q

What do the cells involved in MEN syndromes have in common?

A

they are all neural crest origin!

102
Q

Infected w/diphtheria, whats the most important treatment?

A 
The antitoxin (passive immunization).
-the antibiotics & DPT vaccine come secondary.

*this is true for all toxin mediated bugs.

Final FA review (52 decks)

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