7.7.16 Flashcards
atherosclerosis: most common vessels involved
#1) abd aorta #2) coronary A #3) popliteal A #4) internal carotid A #5) circle of Willis
which has lower pressure: R vs L heart
R heart d/t lower resistance in pulm vasc
which has lower pressure: RV vs pulm A
RV bc pulm A has resistance to flow from the pulm circ
what is normal diastolic pressure in the RV? RA? central venous? pulm A?
central venous, RA, RV: 1-6mmHg
pulm A: 6-12
what nerves are involved in the pupillary light reflex?
afferent limb: CN II
efferent: CN III
what nerves open/close eye?
CNIII: open
CNVII: close
tibial N: motor fx
- foot: plantarflex, inversion
- toe flex
tibial N: sensory fx
plantar foot
where/how can you injure tibial N?
level of popliteal fossa d/t deep penetrating trauma, knee surg
AV node: location
endocardial surface of RA –> near:
- septal leaflet of tricuspid valve
- orifice of coronary sinus
global cerebral ischemia: what struct is damaged first?
hippocampus
global cerebral ischemia: what cells are most susceptible to damage?
- pyramidal cells of hippocampus & neocortex
- Purkinje cells of cerebellum
metronidazole + alcohol –> leads to?
disulfiram-like rxn (d/t acetaldehyde accum):
- abd cramp
- nausea
- HA
adrenal crisis: ssx
- severe hypotension
- abd pain
- vomit
- weak
- fever
adrenal crisis: tx
- aggressive fluid resuscitation
- glucocorticoid
what is: 1ary biliary cholangitis
chronic autoimmune liver dz –> charact by:
- lymphocytic infiltrates
- destruction of small & mid-sized intrahep bile ducts
spironolactone: AE
antiandrogenic effects:
- gynecomastia
- decrease libido
- impotence
benzodiazepine: MOA
enhance GABA effect at GABA-A receptor –> increased Cl- influx, suppress AP firing
what is: bioavail
fraction of admin drug that reach systemic circ in a chemically unchanged form
bioavail: calc
(area under oral curve)(IV dose) / (area under IV curve)(oral dose)
tetralogy of Fallot: major determinant of severity
degree of RV outflow tract obstruction –> determines degree of R–>L shunting & resulting cyanosis
increased activity of what cell is involved in pathogenesis of Crohn’s dz?
TH1 –> IL2, IFNgamma, TNF –> intestinal injury
noncaseating granuloma: Crohn’s or UC?
Crohn’s
what is special about GLUT4?
it is the only GLUT that is responsive to insulin
what is: lamellar body
organelles in type II pneumocytes that store & transport surfactant to cell surface
SLE: pathophy
loss of immune self-tolerance –> produce autoAb against nuclear antigens –> bind self-Ag –> form immune complex:
- deposit in tissues
- activate complement –> decrease complement levels
what Ab are assoc w SLE?
- ANA
- anti-dsDNA
- anti-Sm
minimal change dz: histology
EM: foot process effacement
LM, IF: normal
minimal change dz: tx
corticosteroid
nephrotic synd: ssx
- edema
- hyperlipid
- hypoalbumin
- proteinuria
costochondritis: cause? type of chest pain?
repetitive activity
pain:
- reproducible w palpation
- worse w mv, change position
deep intracranial hemorrhage: #1 cause
HTN vasculopathy involving small penetrating br of cerebral arteries (Charcot Bouchard aneurysms)
Q fever: who? ssx?
farm workers exposed to waste from cattle, sheep
- retro-orbital HA
- pneumonia
- thrombocytopenia
what is the most common thyroid cancer?
papillary thyroid CA
papillary thyroid CA: histology
large cells w nuclei containing finely dispersed chromatin w ground glass appearance (Orphan Annie eye)
ADH: what part of nephron has highest [] tubular fluid? lowest?
- highest: collecting duct
- lowest: thick ascending limb, DCT
familial dysbetalipoproteinemia: pathophys
AR –> defect in ApoE3, ApoE4 –> decreased clearance of chylomicrons, VLDL remnant –> high chol, TG –> xanthoma, premature atherosclerosis
acute viral hepatitis: histology
hepatocyte necrosis & apoptosis w mononuclear infiltration:
- necrosis: cell swell & cytoplasmic empty
- apoptosis: cell shrink, councilman bodies (eosinophilic dying hepatocyte)
Goodpasture synd: pathophys
autoAb to alpha3 chain of type IV collagen (anti-GBM Ab):
- glomerular BM –> rapid prog GN
- alveolar hemorrhage –> SOB, hemoptysis
Goodpasture synd: histology
- LM: crescent
- IF: linear deposition of IgG, C3
Goodpasture synd: who?
YA M
what is the most common cause of spontaneous lobar hemorrhage? most common site?
cerebral amyloid angiopathy
- occipital lobe
- parietal
dapsone: AE
hemolytic anemia –> esp G6PD def
what is the most common cause of calcium kidney stone dz?
idiopathic hypercalciuria
calcium nephrolithiasis: RF
- hypercalciuria
- hyperoxaluria
- hyperuricosuria
- low urine vol
- hypocitraturia
what reduces peripheral metab of levodopa?
- DOPA decarboxylase inh –> carbidopa
- catechol-O-methyltransferase inh –> entacapone
what is the most common lung cancer? location? histology?
adenocarcinoma –> esp F, nonsmoker
peripheral
glandular or papillary struct
preg, OCP –> cholelithiasis –> pathophys?
- estrogen: induce chol hypersecrete
- progesterone: induce gallbladder hypomotility
IV drug –> bioavail fraction?
1
maintenance dose: calc
(steady state plasma []) x (clearance) / (bioavail fraction)
half life: calc
(vol of dist) X (0.7) / (clearance)
loading dose: calc
(vol of dist) X (steady state plasma []) / (bioavail fraction)
IV abx --> 1st order kinetics: - Vd = 70L - CL = 0.5L/min - steady state 4mg/L how much should be admin 6hr to maintain steady state?
maintenance dose = Cpss x CL / [bioavail fraction] = (4mg/L)(0.5L/min)/1 = 2.0mg/min = 2.0mg/min x (60min/hr) x 6hr = 720mg q6hr
renal, hepair impairment –> how should you adjust dosing?
- loading dose: no change
- maintenance dose: decrease
neonatal intraventricular hemorrhage: what is? where?
- common comp of prematurity that can lead to longterm neurodev impairment
germinal matrix
ARDS –> what changes will be seen:
- pulm cap permeability
- lung compliance
- work of breathing
- vent: perfusion matching
- PCWP
- pulm cap permeability: increased –> interstitial & alveolar edema, exudate formation
- lung compliance: decreased
- work of breathing: increased
- vent: perfusion matching: mismatched
- PCWP: normal
how does HBV increase risk for hepatocell CA? how does this differ from HCV?
HBV:
- integrate DNA into host genome –> continue transcribe HVx protein (oncogenic viral protein) –> inactivate p53
- active hepatitis infect –> cause regenerative hyperplasia –> increase # of cell divisions –> increase chance for genetic mutation
HCV –> RNA virus w no reverse transcriptase –> not integrate into host genome
what is: CD14
surface marker for monocyte-macrophage cell lineage
inhalation anes: AE
- increase cerebral blood flow
- myocardial depression
- hypotension
- resp dep
- decreased renal fx
PSGN: histology
- LM: enlrg, hypercell glomeruli
- IF: lumpy-bumpy granular deposits of IgG, C3
- EM: subepi humps
vitiligo: charact by?
loss of epidermal melanocytes
minor –> can consent to:
- prenatal care
- STD dx/tx
- contraception
- drug/alcohol rehab
CREST synd: manifestation
- calcinosis
- Raynaud’s phenomenon
- esophageal dysmotility
- sclerodactyly
- telangiectasia
what Ab is assoc w CREST synd?
anti-centromere Ab
what Ab is highly specific for systemic sclerosis (diffuse scleroderma)?
Anti-DNA topoisomerase I (Scl-70) Ab
systemic sclerosis: 2 types
- diffuse scleroderma: diffuse skin & visceral involvement
- CREST synd: localized skin involvement, more benign
Aspergillus:
- colonization –> leads to?
- invasion –> leads to?
- colonization: aspergilloma (mycetoma)
- invasion: pulm aspergillosis
aspergilloma: features
- fungus ball that shifts when pt change position
- asymptomatic or cough/hemoptysis
aspergillus –> leads to?
- immunosupp, neutropenic: opportunistic infect –> invasive pulm aspergillosis
- preexisting lung cavity: aspergilloma
- asthma: lung HSN –> allergic bronchopulm aspergillosis
ant portion of medial pons –> infarct –> leads to?
- dysarthria
- contralat ataxic hemiparesis
trigeminal N: arises from?
level of middle cerebellar peduncle at lat aspect of mid-pons
asbestos exposure –> leads to what malig?
#1) bronchogenic carcinoma #2) mesothelioma
asbestos exposure –> leads to?
- asbestosis: diffuse pulm fibrosis + asbestos bodies
- pleural dz:
- malig: bronchogenic CA, mesothelioma
