4/2 - UW 41 Flashcards
What is the first line treatment for benign essential tremor?
Primidone
What are the metabolites of Primidone?
Phenobarbital and Phenylethylmalonamide
What component of the dimeric, secretory IgA is not produced by plasma cells? What produces it?
The Secretory Piece is produced by epithelial cells
In what form is IgA in the serum?
Monomer
Which embryonic aortic arch derives the ductus arteriosus?
PDA = 6th aortic arch
What are the derivatives of the third embryological aortic arch?
Common carotid, proximal internal carotid
What are the derivatives of the fourth embryological aortic arch?
L: Aortic Arch
R: Proximal right subclavian artery
What motion is the Obturator nerve responsible for?
Thigh adduction
What motions is the Common Peroneal nerve responsible for?
Foot eversion, dorsiflexion, toe extension
What joint pathology can be seen with Crohn’s disease?
Ankylosing spondylitis
What is the most common area of the GI tract to be involved in Crohn’s disease?
Terminal ileum
How does Crohn’s lead to increased oxalate kidney stones, B12 and folate deficiency, and gallstones?
Bile acids are normally reabsorbed in the terminal ileum, where Crohn’s affects most.
Loss of bile = gallstones
Poor fat absorption = lipids bind Ca, then excreted
Poor B12/folate absorption
What percent of filtered Na is reabsorbed by the kidneys?
99%
What percent of filtered urea is reabsorbed by the kidneys?
40-50%
Where does the Inferior Mesenteric VEIN drain to?
IMV to Splenic V. to Portal Vein (of course! to go to the Liver!)
What enteric organism requires very few cells to infect?
Shigella (as few as 10)
Muscle tissue can be identified by staining for what?
actin, caldesmon, desmin
What is the clinical presentation of Kallman syndrome?
Delayed puberty and anosmia (GnRH neurons fail to migrate from olfactory placode)
Hilar lymphadenopathy with elevated ACE in African American female = ???
Sarcoidosis
What is the most common liver biopsy finding in sarcoidosis?
Granulomas (portal triad area > lobular parenchyma)
What are the most common causes of hepatic centrilobular necrosis?
(necrosis surrounding terminal hepatic vein)
R sided HF, drugs/toxins, fulminant hepatitis
What causes periportal hepatic fibrosis?
Chronic viral hepatitis
What is the most common treatment for agitation?
Haloperidol
What drug is most commonly associated with Neuroleptic Malignant Syndrome (NMS)?
Haloperidol
What are the 4 clinical features of Neuroleptic Malignant Syndrome (NMS)?
- Hyperthermia
- Muscle rigidity
- Autonomic instability
- Altered mental status
How does Tardive dyskinesia present clinically?
Persistent lip smacking
Rhythmic tongue/chewing movements
Ipratropium MOA?
Antimuscarinic, used for reversing vagally mediated bronchoconstriction in asthma
Theophylline (and aminophylline) MOA?
Phosphodiesterase inhibitor, increasing cAMP and bronchial dilation
What is Zileuton’s role in asthma therapy?
Prophylaxis (by inhibiting lipoxygenase pathway, reducing leukotriene production)
What is WDHA syndrome and what causes it?
Watery Diarrhea, Hypokalemia, Achlorhydria (WHDA) caused by VIPoma
What neurotransmitter modulates morphine tolerance?
Glutamate
What is Ketamine used for? MOA?
Blocks morphine tolerance by blocking NMDA receptors, preventing glutamate from increasing tolerance.
Aside from proximal muscle weakness, what other clinical presentations can occur with Lambert-Eaton (LEMS)?
Note: PROXIMAL muscle weakness
Cranial nerve involvement (esp oculobulbar): diplopia, ptosis, dysarthria, dysphagia
Autonomic: dry mouth, impotence
Malignancy: Small Cell Carcinoma of the lung (cause of LEMS)
What molecules activate JAK-STAT pathway?
GH, Prolactin, IL-2, cytokines
What is measured by the Ristocetin aggregation test?
vWF dependent platelet aggregation
What are the 3 most common primary brain tumors in adults?
- Glioblastoma multiforme (from astrocytes, cerebral, necrotic/hemorrhagic, poor prognosis)
- Meningiomas (benign, attached to dura)
- Acoustic neuromas (Schwannoma from Schwann cells of CN VIII, at cerebellopontine angle)
How do Oligodendrogliomas appear? Glioblastoma multiforme?
Oligodendrogliomas are well circumscribed gray masses, with possible calcifications
Glioblastoma multiforme are soft, poorly defined, with areas of necrosis or hemorrhage
What does prostacyclin do?
Inhibits platelet aggregation and adhesion to vascular endothelium, vasodilates, increases vascular permeability, stimulates leukocyte chemotaxis
Where is prostacyclin released from?
Capillary endothelium
What is the “opposite” of prostacyclin?
Thromboxane A2 (enhances platelet aggregation and vasoconstriction)
What factor is Hageman factor?
Factor XII
What does Kallikrein do?
Converts kininogen into bradykinin
What vitamin maintains orderly differentiation of specialized epithelia (eg ocular conjunctiva, respiratory and urinary tracts, pancreatic and exocrine ducts)?
Vitamin A! That’s why it affects vision!
