6/1 Flashcards
half life equation in first order kinetics
0.7 (Vd) / CL
loading dose equation
(Cp x Vd) / F
maintenance dose equation
(Cp x CL X dosage interval) / F
Cp is target plasma con
JVP waves
a- RA contraction (absent in afib)
c- RV contraction
x descent- atrial relax and close tricuspid (absent in tricuspid regurgitation)
v - RA filling
y descent- RA empting (absent in cardiac tamponade, prominent in constrictive pericarditis)
which murmurs intensify with handgrip maneuver?
(increase afterload)
MR, AR, VSD
which murmurs intensify with valsalva
MVP
HOCM
which murmurs intensify with squatting
AS
what situations does pulse pressure increase
hyperthryroidism AR aortic stiffening obstructive sleep apnea exercise
what situations does pulse pressure decrease
Aortic stenosis
cardiogenic shock
HF
what can BNP blood test diagnose
HF
complications in first 24 hours of MI
ventricular arrythmia
HF
cardiogenic shock
when can various ruptures happen after MI
papillary muscle- 2-7 days
interventricular septum- 3-5 days
ventricular psuedoaneurysm (contained free wall rupture)- 3-14 days
free wall rupture- 5-14 days
when is pulsus paradoxus seen
cardiac tamponade pericarditis croup asthma obstructive sleep apnea
kussmaul sign
increase in JVP on inspiration (normally decrease)
seen in: (impaired RV filling)
constrictive pericardiits
restrictive cardiomyopathies
RA or RV tumors
what organ does polyarteritis nodosa spare
lung!
Tuberculoid vs lepramatous forms of leprosy
T: Th1 response- activated macrophages- localized inflamm - hypopigmented plaques with decreased sensation
L: Th2- w/in inactivated macropages- disseminated- widespread plaques, leonine face, loss of nose/fingers
which tests deciphers between two types of leprosy
lepromin skin test
T: indurated nodule at site of injection
L: nonreactive because weak Th1
radial head subluxation
most common elbow injury in kids by age 4
annular ligament tears from radial neck and gets trapped in radialhumeral joint
arm at side pronated; pain upon moving
chronic mesenteric ischemia
atherosclerosis of mesenteric arteries
–> ischemia –> pain after meals
hydrocephalus ex-vacuo
central neuronal loss/atrophy–> ventricles expand
normal CSF pressure
ex. AID dementia
young patient with multiple DVTs and a normal PTT, think…
Factor V Leiden mutation- hypercoagulable state by protein C resistance
if it was elevated PTT, think antiphospholipid syndrome
pathogenesis of polymyositis
over-expression of MHC class I on sarcolemma–> CD8 infiltration —> damage
what do you need to know to amplify segment in PCR?
primers of areas flanking target region
malignant hyperthermia
hypersensitivity of skeletal muscles to inahled anesthetics and succinylcholine (think: fever and rigid after surgery)
due to aut dom defect of Ryr- release abnormal large amounts of Ca
treat: dantrolene- muscle relaxant that acts on Ryr
NK1 antagonists examples and Rx
Rx: chemo-induced vomiting (postrema)
aprepitant, fosaprepitant
chronic lymphedema is a risk factor for…
cutaneous angiosarcoma (Stewart-Treves syndrome)
what type of microscopy do you need to see minimal change disease
electron microscopy
how does Mg affect PTH secretion
low Mg –> high PTH
low low Mg –> low PTH
causes of low Mg- diarrhea, aminoglycosides, diuretics, alcohol abuse
which hormones use cAMP signaling
FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, calcitonin, GHRH, glucagon
FLAT ChAMP GG
which hormones use cGMP
ANP, BNP, EDRF (NO) - vasodilators
which hormones use IP3
GnRH, oxytocin, ADH (V1), TRH, Histamine (H1), Angiotensin II, Gastrin
GOAT HAG
which hormones use receptor tyrosine kinase
insulin, IGF-1, FGF, PDGF, EGF
growth factors
which hormones use nonreceptor tyrosine kinase
GH, Erythropoietin, Thrombopoietin
Prolactin, Immunomodulators (cytokines), GM-CSF
GET PIG
what does cortisol inhibit immunologically?
phospholipase A2
IL-2
histamine release
WBC adhesion
metyrapone stimulation test
normally, metyapone blocks last step of cortisol synthesis (11-deoxycortisol to cortisol) so decreased cortisol and increased compensatory ACTH and 11 deoxycortisol response
in primary adrenal insuff: high ACTH but low 11-deoxy
in 2/3 adrenal insuff- both decreased
neuroblastoma
common neural crest tumor of adrenal medulla in kids but can happen anywhere along sympathetic chain
firm, irregular
opsoclonus-myoclonus
high HVA, VMA; N myc
homer wright rosettes
scalloped colloid
graves disease
4 carcinomas that spread hematogenously
renal
hepatocellular
follicular thryoid carcinoma
choriocarcinomas
Treat nephrogenic diabetes
hydrocholorthiazide
indomethacin
amilioride
what is most likely to be injured in a hysterectomy
ureter
varenicline MOA and Rx
MOA: partial agnost of nicotinic Ach receptors
Rx: reduce smoking cravings and attenuates pleasurable effects of smoking
layers that have edema in urticaria vs angioedema
urticaria- superficial dermis
angioedema- deep dermis, subcutaneous
features specific to Graves
pretibial myxedema (lower leg thickening from GAGs)
exopthalmos
LPL deficiency
familial chylomicronemia syndrome- aut rec
acute pancreatitis, xanthomas, HSM, lipemia retinalis
if a middle aged person who is near sighted says their vision is improving , think…
age related presbyopia
moving image focusing from in front of retina (myopia) to further behind retina (presbyopia), but landing in the middle
which cofactor is necessary for the transamination of an amino acid in the urea cycle?
pyridoxine , B6
length constant vs time constant
length constant- how far along nerve AP can propagate
time constant- how long it takes for a change in 63% membrane potential (the lower, the faster)
if you aspirate something, where does it go in lung in supine position?
posterior of right upper lobe or superior segment of lower lobe
vit E deficiency degenerates what
dorsal column
spinocerebellar
peripheral nerves
calcipotriene MOA and Rx
Rx: psoriasis
MOA: activates vitamin D to inhibit keratinocyte proliferation and differentiation
amlodipine tx
non pitting edema
HA, dizzy
which TB drug needs to be activated by catalase peroxidase?
isoniazid
decerebrate posturing vs decorticate posturing
decorticate: above red nucleus (cerebral hemispheres, internal capsule)- flexor posture
decerebrate: at or below level of red nucleus (pons)- extensor posture
