4/3 - UW 43 Flashcards
What process mediates the exopthalmos seen in Grave’s disease?
Lymphocytic infiltrates in the extraocular tissue causes edema and activates retro-orbital fibroblasts to produce glycosaminoglycans, pushing out the eye.
Diffuse injury to the lung vascular endothelium and/or alveolar epithelium that is NOT from cardiogenic causes characterizes what syndrome?
Acute Respiratory Distress Syndrome
Nyctalopia (night blindness) and dry skin suggest deficiency of what vitamin?
Vit. A
A strict vegetarian diet predisposes to deficiency of what vitamin?
B12, cobalamin
Mucocutaneous bleeding (epistaxis, petechiae) suggests what?
Platelet defect
Deep tissue bleeding into joints, muscles, and subcutaneous tissue suggests what?
Coagulopathies
What vitamin is an essential component of NAD and NADP?
Niacin
What AA is a precursor to endogenous production of niacin?
Tryptophan
What is Arginine a precursor to?
NO, urea, ornithine, agmatine, creatine
What is Orotic acid a precursor for?
Pyrimidine
What is the precursor for Creatine?
Arginine
What is the precursor for Pyrimidine?
Orotic acid
What two variables should be checked in working up a metabolic alkalosis?
Volume Status
Urine Chloride
What are the most common causes of metabolic alkalosis?
- Loss of HCl (low urine Cl, correct w saline)
- Thiazide or Loop Diuretics (high urine Cl, correct w saline)
- Mineralocorticoid excess (high aldosterone OR cortisol, high urine Cl, NOT corrected by saline)
Why does vomiting-induced metabolic alkalosis have low urine Cl?
Loss of HCl through vomiting. Low Cl decreases renal Cl excretion, which decreases HCO3 excretion, worsening the alkalosis
Calcification or aneurysm of what vessel would lead to a unilateral nasal hemianopia?
Internal carotid, which would impinge on uncrossed, lateral retinal fibers
Where would a lesion be to cause a “pie in the sky” lesion?
Contralateral temporal lobe (Meyer’s loop)
Where would a lesion be to cause a “pie on the floor” lesion?
Contralateral parietal lobe (dorsal optic radiation)
What is the name of the process that marks a protein for degradation?
Ubiquitination
What are the 3 genes that help promote protein degradation, and mutations can lead to Parkinson?
Parkin
PINK1
DJ-1
Which one has more transcriptional activity, heterochromatin or euchromatin?
Euchromatin (loosely arranged chromatin), formation is promoted by histone acetylation
What is the transporter for glucose into pancreatic beta cells?
GLUT 2
What molecule affects the opening/closure of potassium channels in pancreatic beta cells?
ATP closes it (produced from glycolysis of glucose, pumped in by GLUT2)
What happens after ATP closes the potassium channels in pancreatic beta cells?
Cell membrane depolarizes, opening Ca channels. Ca influx leads to insulin release
What enzyme forms the covalent cross links between collagen fibrils?
Lysyl oxidase
What congenital syndrome is associated with cleft palate and polydactyly?
Patau syndrome (trisomy 13)
What congenital syndrome is associated with macroorchidism and a long face?
Fragile X syndrome
What 2 drugs can be used in lieu of exercise to test exercise-induced ischemia?
Adenosine and Dipyridamole (both selectively vasodilate coronary vessels)
What congenital syndrome is associated with endocardial cushion defects?
Down syndrome
What serious side effect can result from using Ticlodipine?
Neutropenia
What antiplatelet is associated with neutropenia?
Ticlodipine
What antiplatelet has the same MOA as clopidogrel?
Ticlodipine (ADP antagonist)
What 2 antiplatelets are ADP antagonists?
Clopidogrel and Ticlodipine
What DM medication acts by binding to PPAR-y?
Thiazolidinediones (TZDs), increasing insulin sensitivity
What is the worst side effect of amphotericin B?
Renal toxicity (renal vasoconstriction and lowered GFR, ATN) causing hypOkalemia and hypOmagnesemia
What two ions can be lost when using amphotericin B, and should be supplemented?
K and Mg
What are 2 main factors that increase risk of CV events due to oral contraceptives?
Age over 35
Smoking
Which Arnold-Chiari malformation is more severe?
Type II: symptomatic in the neonatal period, with abnormal cerebellum and medulla
What congenital disease causes low-lying cerebellar tonsils that extend below the foramen magnum, causing headaches and ataxia in adulthood?
Arnold-Chiari malformation TYPE I
What hepatic enzyme can metabolize pro-carcinogens into carcinogens?
Cytochrome P450 monooxygenase
Vasculitis with IgA and C3 deposition = ???
Henoch-Schonlein purpura
“Saddle nose” and oliguria = ???
Wegener’s (c-ANCA_
Weak upper extremity pulses?
Takayasu arteritis
What are common clinical manifestations of Hemochromatosis?
Hepatomegaly, abd pain, skin hyperpigmentation, DM (pancreatic islet destruction), impotence, arthropathy, cardiac dysfunction (arrhythmias and cardiomegaly)
Why might you give “zosin” drugs? MOA?
Treatment of BPH and HTN (alpha1 blockers)
What is the first line treatment of essential HTN in the general population?
HCTZ
What is the difference between adult-type and infantile aortic coarctation?
Adult: stenosis is post-ductal
Infantile: stenosis is pre-ductal
What arteries are spared in Polyarteritis nodosa?
Pulmonary
What are some NNRTIs?
Nevirapine
Efavirenz
Delavirdine
What are the most concerning side effects in patients taking NNRTIs?
Acute onset flulike sx, abd pain, and jaundice may indicate HEPATIC FAILURE with ENCEPHALOPATHY
When are severe hepatotoxic reactions most likely to occur when using NNRTIs?
Within the first 6 weeks
Which HAART agent is most likely to cause severe hepatic disease?
NNRTIs
Which HAART agent is Ritonavir?
Protease Inhibitor
Which HAART agent is Enfuvirtide?
Fusion Inhibitor (binds to gp41)
What does the Wright-Giemsa stain?
rRNA
