4/22 overall Flashcards
chemotactic factors that call in neutros:
C5a, IL-8, LTB4, kallikrein, platelet-activating factor.
alpha mnemonic:
PA SAW 1
- p=alpha
- saw = false positive
- 1 = type 1 error.
Lupus causes auto-abs against blood cells.
-does that include platelets? is there thrombocytopenia?
yes
are reticulocytes nucleated?
NO.
Supraspinatus (suprascapular nerve)
-function:
-abducts arm initially (before the action of the deltoid).
which drug to you give to control uterine hemorrhage?
oxytocin.
which leukemia has inc. basophils?
CML
What drug is given in emergencies w/radiation exposure?
potassium iodide.
organophosphate poisoning
-what do you give first? second?
atropine first, pralidoxime second.
Is smoking a risk factor for peptic ulcers?
yes
liver hypnozoite: Tx:
primaquine
ABXs
-are they good for salmonella or shigella?
- good for shigella.
- may prolong excretion of salmonella.
ABXs
-are they good for salmonella or shigella?
- good for shigella.
- may prolong excretion of salmonella (you’ve never heard of anyone getting ABXs for salmonella poisoning) - they didn’t give typhoid mary ABXs).
ABXs
-are they good for salmonella or shigella?
- good for shigella.
- may prolong excretion of salmonella (you’ve never heard of anyone getting ABXs for salmonella poisoning).
-azine =
typical antipsychotics
-apine =
atypical antipsychotics
lentigo = ?
hyperplasia of melanocytes.
lentigo maligna =
melanoma in situ.
lentigo = ?
hyperplasia of melanocytes.
-restricted to the cell layer directly above the basement membrane of the epidermis where melanocytes normally reside. This is in contrast to the “nests” of multi-layer melanocytes found in moles (melanocytic nevi). Because of this characteristic feature, the adjective “lentiginous” is used to describe other skin lesions that similarly proliferate linearly within the basal cell layer.
lentigo vs freckle
Lentigines are distinguished from freckles (ephelis) based on the proliferation of melanocytes. Freckles have a relatively normal number of melanocytes but an increased amount of melanin. A lentigo has an increased number of melanocytes.
almond scented breath
-which poison?
cyanide.
Why do you get hypoalbuminemia in MM?
-lower levels are associated w/greater severity of MM.
-
MM
- Sxs:
- mnemonic:
Think CRAB: HyperCalcemia Renal insufficiency Anemia Bone lytic lesions/Back pain
MM
- Sxs:
- mnemonic:
Think CRAB: HyperCalcemia Renal insufficiency Anemia Bone lytic lesions/Back pain
*dont forget about the anemia! Plasma cells crowd out other elements and you get pancytopenia.
infantile coarctation: preductal or postductal?
preductal.
pre comes before post, infant before adult
glycogen phosphorylase
-builds or degrades glycogen?
degrades.
phosphorylase kinase
-what does this activate?
glycogen phosphorylase which degrades glycogen.
phosphorylase kinase
- what does this activate?
- mnemonic:
glycogen phosphorylase which degrades glycogen.
-PK = you need glucose in your blood to do a PENALTY KICK so you want glycogenlolysis go go down.
phosphorylase kinase
- what does this activate?
- mnemonic:
glycogen phosphorylase which degrades glycogen.
-PK = you need glucose in your blood to do a PENALTY KICK so you want glycogenlolysis go go down.
Is glucokinase induced by insulin?
yes
Is glucokinase induced by insulin?
yes.
“Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis.
Mnemonic for Tuberous Sclerosis.
MARS = mitral regurg, ash-leaf, retarded, shagreen.
glipizide
-what is it?
sulfonylurea.
simple partial vs complex partial seizures
-whats the difference?
Complex partial = you lose consciousness and you dont have memory of the event.
simple partial vs complex partial seizures
-whats the difference?
Complex partial = you lose consciousness and you dont have memory of the event.
- both usually in temporal lobe.
- both only involve 1 area of brain.
1st pharyngeal arch
- which nerve?
- which “letter”?
CN 5
-“M”
2nd pharyngeal arch
- which nerve?
- which “letter”?
CN 7
-“S”
Cricothyroid
-inn?
recurrent laryngeal n. innervates all muscles of larynx except the cricothyroid. The cricothyroid is inn. by the external branch of the superior laryngeal nerve.
choriocarcinoma
-malignancy of what tissue?
-cytotrophoblasts, syncytiotrophoblasts; no chorionic villi present.
Which vessel supplies posterior 1/3 of IV septum and posterior walls of ventricles?
Posterior descending/interventricular artery (PDA).
-85% of time given off RCA.
Which vessel supplies right ventricle?
Acute marginal artery.
-branch of RCA.
ant. pit
- acidophils: mnemonic?
GPA
-GH, prolactin = acidophils.
ant. pit
- basophils: mnemonic?
B-FLAT:
Basophils—FSH, LH, ACTH, TSH.
Congenital Rubella
-Sxs:
PDA (or pulmonary artery hypoplasia), cataracts, and deafness.
-with or w/o “blueberry muffin” rash
Congenital Rubella
-Sxs:
PDA (or pulmonary artery hypoplasia), cataracts, and deafness.
-with or w/o “blueberry muffin” rash.
Congenital CMV
-Sxs:
Hearing loss, seizures, petechial rash, “blueberry muffin” rash.
Muscle fibers in stool
-indicate what?
The presence of many muscle fibers may indicate possible steatorrhea or a diarrhea with rapid transit time..
hepatic bruit
-potential cause?
tumor obstructing arterial flow in liver.
pure RBC aplasia
-associated w/what tumor?
thymoma.
pure RBC aplasia
-associated w/what tumor?
thymoma.
*so is myasthenia gravis.
Cyclosporine
-mech:
Calcineurin inhibitor; binds cyclophilin. Blocks T cell activation by preventing IL-2 transcription.
Cyclosporine
-mech:
Immunosuppressant: Calcineurin inhibitor; binds cyclophilin. Blocks T cell activation by preventing IL-2 transcription.
Cyclophosphamide, ifosfamide
-mech:
alkylating agent:
- Covalently X-link (interstrand) DNA at guanine N-7.
- Require bioactivation by liver.
Bleomycin or busulfan
- Used for testicular cancer.
- mnemonic?
Bleomycin
-leo dicaprios radical fans suck his balls.
serotonin syndrome vs hypertensive crisis
-which one causes myoclonus?
serotonin syndrome
St. John’s Wart
- what is it?
- watch out for what interaction?
- SSRI.
- serotonin syndrome.
St. John’s Wart
- what is it?
- watch out for what interaction?
- SSRI.
- serotonin syndrome. Dont use w/MAO inhibitor.
Myotonic type 1
- whats its trinucleotide repeat?
- mnemonic:
CTG
-cataracts, testicles gone.
How does drinking formula w/lactose in it suddenly cause hypoglycemia in lactose intolerant child?
bc you quickly dec. the available phosphate so the child can not use gluconeogenesis or glycogenolysis.
ATP exists in a 1:1 complex w/magnesium.
-so if you’re depleted of ATP, will you have high or low serum magnesium?
high, bc now you have more free Mg.
albendazole and mebendazole
- mech:
- use:
- interrupt MT function.
- Strongyloides stercoralis, Toxocara canis, neurocysticercosis.
albendazole and mebendazole
- mech:
- use:
- interrupt MT function.
- parasites.
acrolein
-what is it?
the toxic compound from cyclophosphamide that causes hemorrhagic cystitis.
-prevent it w/mesna or n-acetyl-cysteine.
physiological antagonist
-what is it?
drug that counteracts the effects of the agonist by binding to a different receptor and producing opposite effects.
dopamine in mesocorticol pathway
-responsible for what?
negative Sxs of schizo.
-typical antipsychotics dont target this.
dopamine in mesolimbic pathway
-responsible for what?
positive Sxs of schizo.
-typical antipsychotics target this.
anti-psychotic EPS Sxs
-dopamine blocked in which pathway?
nigrostriatal.
dopamine in mesocorticol pathway
- responsible for what?
- mnemonic?
negative Sxs of schizo.
-typical antipsychotics dont target this.
-neg people are always so “critical” aka “corticol”.
dopamine in mesolimbic pathway
- responsible for what?
- mnemonic?
positive Sxs of schizo.
-typical antipsychotics target this.
-psychotic people w/pos. Sxs always down to play “limbo”.
Waldenstrom vs MM
-what are the hyperviscosity Sxs you see in waldenstrom?
nosebleeds, headaches, visual disturbances.
Waldenstrom vs MM
-what are the hyperviscosity Sxs you see in waldenstrom?
nosebleeds, headaches, visual disturbances.
*lytic bone lesions are absent in waldenstrom.
infusion rate
-whats the equation?
infusion rate = Cp (Cl)
p value = chance of type 1 error
-do NOT look to p value for chance of type 2 error.
PA SAW 1
statistical power (1-beta) -what increases power of a study? 3 things:
- inc. sample size.
- effect size increases.
- easier alpha-criterion.
statistical power (1-beta) -what increases power of a study? 3 things:
- inc. sample size.
- effect size increases (easier to spot a more dramatic effect).
- easier alpha-criterion.
statistical power (1-beta) -what increases power of a study? 3 things:
- inc. sample size.
- effect size increases (easier to spot a more dramatic effect).
- easier alpha-criterion (you’re willing to accept more type 1 error aka more false positives).
statistical power (1-beta)
- definition:
- what increases power of a study? 3 things:
Capacity to detect a difference if there is one.
- inc. sample size.
- effect size increases (easier to spot a more dramatic effect).
- easier alpha-criterion (you’re willing to accept more type 1 error aka more false positives).
case report vs case series
-whats the difference?
case report: n = 1.
case series: n > 1.
*thats the only difference.
case series
-what is it?
case report on bunch of pts - you look and see whats common amongst all your pts that have that certain disease.
case series
-what is it?
case report on bunch of pts - you look and see whats common amongst all your pts that have that certain disease.
-you make a list of criterion = what you see in common w/every pt that has the disease.
case series
-limitation?
all we have are case reports of diseases people - we can’t compare them to healthy people.
case series
-limitation?
all we have are case reports of diseases people - we can’t compare them to healthy people.
*there is NO control group!
after case series, whats the next step?
cross-sectional study aka a prevalence study
-see how many people have the disease - see how many fit the criteria for the disease that you determined using the case series.
Can cross-sectional study prove causality?
No.
- you can prove that A and B are there, but not which came first.
- its a snapshot.
Step following cross-sectional study:
- we want to answer what causes/facilitate the disease.
- which study do we use?
case-control study.
-disease vs no-disease retrospective study.
Step following cross-sectional study:
- we want to answer what causes/facilitate the disease.
- which study do we use?
case-control study.
-disease vs no-disease retrospective study. Look back in time for the presence of some risk factor.
Step following cross-sectional study:
- we want to answer what causes/facilitate the disease.
- which study do we use?
case-control study.
-disease vs no-disease retrospective study. Look back in time for the presence of some risk factor.
case-control study
-define:
-disease vs no-disease retrospective study. Look back in time for the presence of some risk factor.
case-control study
-define:
- disease vs no-disease retrospective study. Look back in time for the presence of some risk factor.
- looking for presence/absence of risk factors in their past.
what comes after a case-control study?
cohort study aka confirmational study.
cohort study
-describe it:
groups followed over time - prospective.
cohort study
-describe it:
groups followed over time - prospective.
- 2 groups are risk-factor vs no risk factor. Follow them and see what their relative risk of developing the disease is.
- basically the exact opposite of case-control.
case-control vs cohort study
-difference:
- case-control: get ppl w/disease & w/o disease - look back in their past and find presence/absence of risk factor. Retrospective.
- cohort study: Get ppl w/risk factor & w/o risk factor. Follow them and figure out relative risk of getting the disease.
- they’re basically the exact opposite.
cohort study
-describe it:
groups followed over time - prospective.
- 2 groups are risk-factor vs no risk factor. Follow them and see what their relative risk of developing the disease is.
- basically the exact opposite of case-control.
*cohort study gives you incidence rate.
sequence starting from case report
case report => case series => cross sectional study => case-control study => cohort study.
Cohort:
- relative risk: divide
- attributable risk: ______
subtract.
incidence rate in exposed / incidence rate in unexposed
- what equation is this for?
- used in what type of study?
relative risk
-cohort study.
NNT and NNH equations:
- NNT = 1/(incidence in untreat - incidence in treated)
- NNH = 1/(incidence in exposed - incidence in unexposed)
Odds ratio
- equation?
- how do you know which one is A cell and which one is D cell?
AD/BC
- A cell = risk factor + disease.
- D cell = diagnoal from A cell.
- thats all you need to know - you dont need to differentiate btwn B and C bc you will multiply them.
Efficacy and side effects
-determined in which phase of clinical trial?
3