5/10 Mixed Flashcards
Drug interactions with Lithium causing toxicity
Thiazide diuretics (Hydrocholothiazide)
NSAIDs
ACE inhibitors
Lithium Toxicity: ataxia, tremors/fasciculations
TB Ghon complex
A lower lung lesion (Ghon focus) + ipsilateral hilar adenopathy = Ghon complex
Occurs during initial infection with M. tuberculosis
Ventricular fibrillation
Most frequent mechanism of sudden cardiac death in the first 48 hours after acute MI and is related to electrical instability due to lack of perfusion in the ischemic myocardium
Cystinuria
AR disorder caused by defective transportation of cystine, ornithine, arginine, and lysine across the intestinal and renal tubular epithelium.
Recurrent nephrolithiasis is the only clinical manifestation.
Urinalysis shows pathognomonic hexagonal cystine crystals.
CXR anatomy, structures near the right middle lobe
On PA CXR, the right middle lobe is seen adjacent to the right border of the heart, which is primarily formed by the right atrium.
Internal hemorrhoids
Above the dentate line
Venous component drains into the middle and superior rectal veins, which communicate with the internal iliac and inferior mesenteric veins, respectively.
Which agent will decrease the effects of radiotherapy due to competitive inhibition of iodine transportation?
Perchlorate (Potassium perchlorate) and pertechnetate ions (as well as all iodide isotopes) are absorbed into the thyroid gland via the sodium-iodide symporter. High levels of any one substance will significantly reduce the uptake of the others due to competitive inhibition.
Persistent depressive disorder (dysthymia)
Chronic depressed mood and at least 2 other depressive symptoms lasting for at least 2 years
Where is aldosterone secreted in the adrenals?
Zona glomerulosa
GFR> aldosterone, cortisol, androgens
Rx of myoclonic seizures
Myoclonic seizure: no loss of consciousness or postictal state; brief jerking movements involving both hemispheres at onset
Rx: Lamotrigine, Levetiracetam, Topiramate, Valproic acid
Bisphosphonate (Risedronate) MOA
Inhibits mature osteoclast-mediated bone resorption
Chemically similar to pyrophosphate, attach to hydroxyapatite on body surfaces
Translocation Down Syndrome
Inherited from an unaffected parents with a balanced translocation between 2 acrocentric nonhomologous chromosomes (14 and 21) > unbalanced Robertsonian translocation with 46 chromosomes and 3 effective copies of chromosome 21 [46 XX, t (14;21)]
Epicanthal folds, upslanthing palpebral fissurs, a protruding tongue, excessive skin at the nape of the neck; birth weight and length are below average, hypotonia and weak startle reflex, cardiac defects (VSD)
Internal capsule stroke
Pure motor weakness affecting the contralateral arm, leg, and lower face
Contralateral spasticity/ increased tone (Clasp-knife spasticity), hyperreflexia, and a positive Babinski sign are also present
Compound melanocytic nevi
Round, uniform melanocytes (nevus cells), mitotically quiescent,
complete AV canal septal defect
Most common type of cardiac defect in patients with Down syndrome (autosomal trisomy)
Histopathologic manifestation of chronic hep B
Hepatocellular cytoplasm fills with hepatitis B surface antigen. Highly specific for Hep B.
Finely granular, dull eosinophilic, “ground glass” appearance.
vs. Hep C will have lymphoid aggregates within the portal tracts and focal areas of macrovesicular steatosis
Normal tracheal pO2 is 150 mmHg
Normal alveolar pO2 is 104 mm Hg
Normally perfusion-limited
Situations were O2 equilibration can become diffusion limited
Emphysema, pulmonary fibrosis, exercise
Hyperammonenmia and the brain
Ammonia crosses the BBB and causes excess glutamine to accumulate within astrocytes
Decreases the amount of glutamine available for conversion to glutamate in the neurons, resulting in disruption of excitatory neurotransmission
Bipolar II
Major depressive and hypomanic episodes
Less severe, do not involve psychosis, cause a lesser degree of functional impairment
Three cytogenic abnormalities can lead to down syndrome:
Meiotic nondisjunction
Unbalanced Robertsonian translocations
Mosaicism
Chronic renal allograft rejection
Months to years after transplantation
Worsening HTN and slowly progressive rise in serum creatinine
Mediated by chronic, indirect immune response against donor alloantigens and results in obliterative intimal thickening, tubular atrophy, interstitial fibrosis
Amiodarone
40% iodine by weight
Can cause hypo/hyperthyroidism
Hereditary nonpolyposis colon cancer (HNPCC)/ Lynch syndrome
AD genetic predisposition to colon cancer
Colon adenocarcinoma occurs at a young age
Osgood-Schlatter Disease (OSD)
Injury of secondary ossification center of the tibial tubercle
Common cause of knee pain in young adolescent athletes
Repetitive quad contraction and chronic avulsion cause the proximal patellar tendon to separate from the tibial tubercle
Effect of prolactin on GnRH
Prolactin suppresses GnRh, leading to a reduction in release of LH from the pituitary and decreased testicular testosterone production
Prevention of neonatal tetanus
Hygienic delivery and immunization of women who are pregnant or may become pregnant
Immunized moths provide passive immunity via transplacental IgG
Which pancreatic structure is derived from the ventral pancreatic primordium?
Main pancreatic duct
Raloxidene
SERM, binds to estrogen receptors
Prevents osteoporosis
Prevents estrogen receptor positive breast ca
Class I antiarrhythmic drugs
Block sodium channels, inhibit initial depolarization and prolong QRS duration (Phase 0)
Paraneoplastic cerebrallar degeneration
Small cell lung cancer, breast, ovarian, uterine
Progressively worsening dizziness, limb and truncal ataxia, dysarthria, visual disturbances
Immune response against tumor cells that cross-react with Purkinje neuron antigens
Anti-Yo, anti-P/Q, and anti-Hu
Course of the median nerve
Between the humeral and ulnar heads of the pronator teres, then runs between the flexor digitorum superficialis and the flexor digitorum profundus, before crossing the wrist within the carpal tunnel
Thiazide diuretics
Block Na-Cl symporters in the distal convoluted tubules > enhanced Na, Cl, water excretion
SE: hypokalemia, hyponatremia, hypomagnesemia, hypotension, volume depletion, hypercalcemia
Chronic bronchitis
Thickened bronchial walls, lymphocytic infiltration, mucous gland enlargement, patchy squamous metaplasia of the bronchial mucosa
Cigarette smoking is the leading cause of chronic bronchitis
Most common complication of statin use
Myopathy
Myalgia/myopathy with/without myonecrosis (elevated CK)
Statins
Inhibit intracellular cholesterol biosynthesis via competitive inhibition of HMG-CoA reductase. Leads to enhanced hepatic LDL receptor recycling and increased LDL clearance from circulation.
