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Wrongs > 5/11 > Flashcards

5/11 Flashcards

1
Q

Fanconi is a defect in…

A

reabsorption in PCT of kidney

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2
Q

Bartter syndrome

A

aut rec defect in thick ascending loop of Henle

similar to loop diuretics

hypokalemia, metabolic alkalosis

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3
Q

Gitelman syndrome

A

aut rec defect of NaCl in DCT

hypokalemia, metabolic alkalosis

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4
Q

Liddle syndrome

A

Aut dom gain of function mutation: increase Na reabsorption in collecting tubules

presents like hyperaldosteronism- met alkalosis, hypertension, hypokalemia

treat- amilioride

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5
Q

sydrome of apparent mineralocorticoid excess

A

hereditary def of 11beta-hydroxysteroid dehydrogenase (cant convert cortisol to cortisone)

excess cortisol stimulates MR–> hypertension, hypokalemia

or eating too much licorice

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6
Q

renal tubular acidosis (RTA) type 1

A

DISTAL: defect in alpha interacalated cells to secrete H+–> no new HCO3 generated

urine pH > 5.5, hypokalemia, risk for Ca stones

causes: amphotericin B, congenital anomalies, analgesic nephropathy

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7
Q

RTA 2

A

PROXIMAL: defect in PCT HCO3 reabsorption

urine pH<5.5; hypokalemia; risk for rickets

causes: Fanconi, CA inhibitors

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8
Q

RTA type 4

A

hypoaldosteronism–> HYPERKALEMIC –> less NH3 synthesis in PCT –> less NH4 excretion

urine pH<5.5

causes:
- less aldosterone made: diabetic hyporeninism, ACEI, ARBs, NSAIDs, heparin, cyclosporine, adrenal insuff
- aldosterone resistance (K sparing diuretics, TMP/SMX)

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9
Q

uremia

A

increase in BUN

nausea, anorexia
pericarditis
asterixis
encephalopathy
platelet dysfunction
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10
Q

which drugs can cause acute interstitial nephritis

A 
diuretics
nsaids
penicillins, cephalopsporins
PPIs
rifampin
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11
Q

renal papillary necrosis associations

A

sickle cell
acute pyelonephritis
analgesics (NSAIDs)
DM

SAAD

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12
Q

what is the type of junction in endothelial BBB?

A

tight junctions

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13
Q

cryptococcus neoformans enters via which route?

A

respiratory

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14
Q

asbestos on imaging

A

pleural thickening with calcification

posterolateral midlung zone (6-9th rib)

pleural effusions can occur

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15
Q

how does fragile x mutation inactivate the gene?

A

once you get over 200 CGG repeats, the gene FMR1 becomes hypermethylated, silencing the gene

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16
Q

Ghon complex

A

lower lobe lung lesion + ipsilateral hilar adenopathy (calcified lymph node)

seen in primary TB- initial infection

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17
Q

Bloom syndrome

A

aut rec BLM mutation- defective helicase

growth retardation, facial anomalies, photosensitivity, immunodeficiency

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18
Q

JAK kinase is a receptor for

A

GH, prolactin

cytokines

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19
Q

insulin activation pathway

A

1) tyrosine kinase receptor
2) phosphorylate IRS
3) IRS then stimulates two pathways:
- RAS/MAP kinase (cell growth, DNA synthesis)
- PI3K (protein phosphatase)- glycogen, lipid, protein synthesis

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20
Q

where on the antibody is the site for complement attachment (C1)

A

the higher Fc region (above phagocytic attachment site)

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21
Q

anesthesia’s effect on brain

A

decrease vascular resistance (increase cerebral blood flow)

can lead to increased intracranial pressure

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22
Q

which anesthetics are preferred in asthmatics

A

halothane and sevaflurane- bronchodilation

since other anesthetics suppress mucociliary clearance–> atelctasis

23
Q

inhaled anesthetics on kidney

A

decrease GFR
increase vascular resistance
decrease RPF

24
Q

what is the intrapleural pressure at FRC?

A

-5 cm H20

25
Q

what disease is silicosis associated with and why?

A

TB

silicosis impairs macrophages

26
Q

tibial nerve injury

A

from injury to popliteal fossa

problem with foot inversion, plantar flexion, and toe felxion
problem with sensory stimulation of plantar side of foot

27
Q

which muscle most affected in rotator cuff injury

A

supraspinatus

impingement between acromion and humeral head

28
Q

symptoms of radial injury in the supinator canal

A

weakness on finger/thumb extension (finger drop)

cause: repetitive pronation/supination movements

extensor muscles and cutaneous stimulation fine because that would need a more proximal injury

29
Q

bacteria that produce dextrans from sucrose

A

strep viridans

30
Q

Afferent and efferent limbs of the carotid sinus baroreceptor

A

afferent- Hering branch of CN IX to the medulla

efferent- CN X

31
Q

symptoms of Meckel’s diverticulum

A

painless GI bleeding

possible intrussception- colicky pain and currant jelly stools

32
Q

which drugs can help post-op urinary retention

A

muscarinic agonist (eg. bethenacol)

alpha one antagonist

33
Q

ACE effect on bradykinin

A

ACE usually degrades bradykinin

so ACEI leads to increased bradykinin

34
Q

bicuspid aortic valve complication

A

aortic stenosis around age 50

35
Q

where in the lungs does TB reactive

A

upper lobe bear apex

36
Q

where in the nephon is water reabsorbed the most?

A

proximal tubule (regardless of hydration status)

37
Q

patients with MS develop which type of incontinence?

A

first: urge incontinence- detrusor overactivity from lack of CNS inhibition

later- bladder becomes dilated and atonic- leading to overflow incontinence

38
Q

which agents help treat urge incontinence

A

muscarinic antagonist

39
Q

how does kidney try to compensate metabolic acidosis?

A
  • increase HCO3 reabs.
  • increase H+ secretion
  • excrete buffers (HPO4, NH3) to combine with H+ to form H2PO4 and NH4
40
Q

Is PAH secreted or reabsorbed?

A

secreted, not reasborbed

41
Q

3 phases of acute tubular necrosis

A
  1. initiation- 36 hours- ischemic or toxic injury
  2. maintenance- 1-2 weeks- tube damage- oliguria, metabolic acidosis, hyperkalemia; necrosis and casts; decrease GFR
  3. recovery- re-epithelization of tubules- GFR recovers, casts clear
42
Q

recurrent pneumonia, absent vas deferens, digital clubbing. Think…

A

cystic fibrosis

43
Q

what are sources of NAD+?

A

niacin, tryptophan

44
Q

in hardy-weinberg, for a really rare aut rec disorder, what is p in the probability of being a carrier (2pq)?

A

p=1

45
Q

what can help prevent wrong-site surgery?

A

independent verification of site by 2 health care workers

46
Q

wet vs dry age-related macular degeneration

A

dry: gradual vision loss from chronic oxidative damage leading to subretinal inflammation and bm thickening- drusen deposits

progressive thickening–> hyoxia–> VEGF–>

wet: acute vision loss with metamorphopsia (distortion of straight lines). greyish-green subretina.

47
Q

valproate teratogen anomaly

A

neural tube defect (meningocele…)

48
Q

what causes annular pancreas

A

abnormal migration of the ventral pancreatic bud

49
Q

what can happen when baby goes down canal with genital warts?

A

HPV can infect other stratified squamous epithelium, like true vocal cords- weak cry, stridor, hoarse

can acquire respiratory papillomatosis

50
Q

what can precipitate thiamine def/wernicke encephalopathy

A

glucose infusion

because thiamine is a cofactor for one of the enzymes in glucose metabolism

51
Q

what should be a clue that the maculopapular rash on the immigrant is rubella and not measles?

A

postauricular/occipital LAD

rubella rash also faster?

52
Q

myotonic dystrophy

A

aut dom CTG trinucleotide repeat disease for myotonia-protein kinase gene

mostly affects type 1 fibers

symptoms: slow relaxation of muscle (hard to loosen grip after handshake), cataracts, balding, gonadal atrophy

53
Q

hypertensive crisis pathology

A

onion-like concentric thickening- hyperplastic arteriolosclerosis

54
Q

hypothyroid myopathy

A

muscle pain, cramps and weakness of proximal muscles

delayed tendon reflexes

other symptoms of hypothyroidism present

ELEVATED CK

Wrongs (36 decks)

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