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4/3 - UW 43 Flashcards

1
Q

What process mediates the exopthalmos seen in Grave’s disease?

A

Lymphocytic infiltrates in the extraocular tissue causes edema and activates retro-orbital fibroblasts to produce glycosaminoglycans, pushing out the eye.

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2
Q

Diffuse injury to the lung vascular endothelium and/or alveolar epithelium that is NOT from cardiogenic causes characterizes what syndrome?

A

Acute Respiratory Distress Syndrome

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3
Q

Nyctalopia (night blindness) and dry skin suggest deficiency of what vitamin?

A

Vit. A

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4
Q

A strict vegetarian diet predisposes to deficiency of what vitamin?

A

B12, cobalamin

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5
Q

Mucocutaneous bleeding (epistaxis, petechiae) suggests what?

A

Platelet defect

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6
Q

Deep tissue bleeding into joints, muscles, and subcutaneous tissue suggests what?

A

Coagulopathies

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7
Q

What vitamin is an essential component of NAD and NADP?

A

Niacin

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8
Q

What AA is a precursor to endogenous production of niacin?

A

Tryptophan

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9
Q

What is Arginine a precursor to?

A

NO, urea, ornithine, agmatine, creatine

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10
Q

What is Orotic acid a precursor for?

A

Pyrimidine

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11
Q

What is the precursor for Creatine?

A

Arginine

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12
Q

What is the precursor for Pyrimidine?

A

Orotic acid

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13
Q

What two variables should be checked in working up a metabolic alkalosis?

A

Volume Status

Urine Chloride

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14
Q

What are the most common causes of metabolic alkalosis?

A
  1. Loss of HCl (low urine Cl, correct w saline)
  2. Thiazide or Loop Diuretics (high urine Cl, correct w saline)
  3. Mineralocorticoid excess (high aldosterone OR cortisol, high urine Cl, NOT corrected by saline)
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15
Q

Why does vomiting-induced metabolic alkalosis have low urine Cl?

A

Loss of HCl through vomiting. Low Cl decreases renal Cl excretion, which decreases HCO3 excretion, worsening the alkalosis

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16
Q

Calcification or aneurysm of what vessel would lead to a unilateral nasal hemianopia?

A

Internal carotid, which would impinge on uncrossed, lateral retinal fibers

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17
Q

Where would a lesion be to cause a “pie in the sky” lesion?

A

Contralateral temporal lobe (Meyer’s loop)

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18
Q

Where would a lesion be to cause a “pie on the floor” lesion?

A

Contralateral parietal lobe (dorsal optic radiation)

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19
Q

What is the name of the process that marks a protein for degradation?

A

Ubiquitination

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20
Q

What are the 3 genes that help promote protein degradation, and mutations can lead to Parkinson?

A

Parkin
PINK1
DJ-1

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21
Q

Which one has more transcriptional activity, heterochromatin or euchromatin?

A

Euchromatin (loosely arranged chromatin), formation is promoted by histone acetylation

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22
Q

What is the transporter for glucose into pancreatic beta cells?

A

GLUT 2

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23
Q

What molecule affects the opening/closure of potassium channels in pancreatic beta cells?

A

ATP closes it (produced from glycolysis of glucose, pumped in by GLUT2)

24
Q

What happens after ATP closes the potassium channels in pancreatic beta cells?

A

Cell membrane depolarizes, opening Ca channels. Ca influx leads to insulin release

25
Q

What enzyme forms the covalent cross links between collagen fibrils?

A

Lysyl oxidase

26
Q

What congenital syndrome is associated with cleft palate and polydactyly?

A

Patau syndrome (trisomy 13)

27
Q

What congenital syndrome is associated with macroorchidism and a long face?

A

Fragile X syndrome

28
Q

What 2 drugs can be used in lieu of exercise to test exercise-induced ischemia?

A

Adenosine and Dipyridamole (both selectively vasodilate coronary vessels)

29
Q

What congenital syndrome is associated with endocardial cushion defects?

A

Down syndrome

30
Q

What serious side effect can result from using Ticlodipine?

A

Neutropenia

31
Q

What antiplatelet is associated with neutropenia?

A

Ticlodipine

32
Q

What antiplatelet has the same MOA as clopidogrel?

A

Ticlodipine (ADP antagonist)

33
Q

What 2 antiplatelets are ADP antagonists?

A

Clopidogrel and Ticlodipine

34
Q

What DM medication acts by binding to PPAR-y?

A

Thiazolidinediones (TZDs), increasing insulin sensitivity

35
Q

What is the worst side effect of amphotericin B?

A

Renal toxicity (renal vasoconstriction and lowered GFR, ATN) causing hypOkalemia and hypOmagnesemia

36
Q

What two ions can be lost when using amphotericin B, and should be supplemented?

A

K and Mg

37
Q

What are 2 main factors that increase risk of CV events due to oral contraceptives?

A

Age over 35

Smoking

38
Q

Which Arnold-Chiari malformation is more severe?

A

Type II: symptomatic in the neonatal period, with abnormal cerebellum and medulla

39
Q

What congenital disease causes low-lying cerebellar tonsils that extend below the foramen magnum, causing headaches and ataxia in adulthood?

A

Arnold-Chiari malformation TYPE I

40
Q

What hepatic enzyme can metabolize pro-carcinogens into carcinogens?

A

Cytochrome P450 monooxygenase

41
Q

Vasculitis with IgA and C3 deposition = ???

A

Henoch-Schonlein purpura

42
Q

“Saddle nose” and oliguria = ???

A

Wegener’s (c-ANCA_

43
Q

Weak upper extremity pulses?

A

Takayasu arteritis

44
Q

What are common clinical manifestations of Hemochromatosis?

A

Hepatomegaly, abd pain, skin hyperpigmentation, DM (pancreatic islet destruction), impotence, arthropathy, cardiac dysfunction (arrhythmias and cardiomegaly)

45
Q

Why might you give “zosin” drugs? MOA?

A

Treatment of BPH and HTN (alpha1 blockers)

46
Q

What is the first line treatment of essential HTN in the general population?

A

HCTZ

47
Q

What is the difference between adult-type and infantile aortic coarctation?

A

Adult: stenosis is post-ductal

Infantile: stenosis is pre-ductal

48
Q

What arteries are spared in Polyarteritis nodosa?

A

Pulmonary

49
Q

What are some NNRTIs?

A

Nevirapine
Efavirenz
Delavirdine

50
Q

What are the most concerning side effects in patients taking NNRTIs?

A

Acute onset flulike sx, abd pain, and jaundice may indicate HEPATIC FAILURE with ENCEPHALOPATHY

51
Q

When are severe hepatotoxic reactions most likely to occur when using NNRTIs?

A

Within the first 6 weeks

52
Q

Which HAART agent is most likely to cause severe hepatic disease?

A

NNRTIs

53
Q

Which HAART agent is Ritonavir?

A

Protease Inhibitor

54
Q

Which HAART agent is Enfuvirtide?

A

Fusion Inhibitor (binds to gp41)

55
Q

What does the Wright-Giemsa stain?

A

rRNA

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