9/1 cleanup Flashcards
Hyperchylomicronemia
- LPL deficiency or CII deficiency
- Increased cylomicrons, TG, cholesterol
- Pancreatitis, hepatosplenomegaly, pruritic xanthomas
Familial hypercholesterolemia
- Absent or defective LDL receptors
- High cholesterol, accelerated atherosclerosis, tendon xanthomas, corneal arcus
Dysbetalipoproteinemia
- Defective apo e
- Absent chylomicrons and VLDL
- Premature atherosclerosis, tuberoeruptice xanthomas, canthoma striatum palmare
Hypertryglyceridemia
- Hypertriglyceridemia can cause acute pancreatitis
- Hepatic overproduction of VLDL
Methionine synthase requires what vitamin? Wha about cystathionine?
- Methionine:B12
- Cystathionine: B6
Posterior wall of the ventricle is supplied by
PDA
Posterior wall of left ventricle is caused by
Left circumflex
Ventricular free wall rupture occurs when?
5-14 days after MI
What are the main side effects of niacin
Flushing, hyperglycemia and hyperuricemia
cAMP horomones
FLAT ChAMP
- F = FSH
- L = LH
- A = ACTH
- T = TSH
- C = CRH
- h = beta HCG
- A = ADH
- M = MSH
- P = PTH
cGMP hormones
BNP, ANP, EDRF
IP3 hormones
GOAT HAG
- G = GnRH
- O = Oxytocin
- A = ADH (V1)
- T = TRH
- H = Histamine
- A = Angiotensin II
- G = Gastrin
Intracellular receptor
Progestrone, estrogen, testosterone, cortisol, aldosterone, T3 and T4, Vitamin D
RTK hormones
Insulin, IGF1, FGF, PDGF, EGF
Nonreceptor Tyrosine Kinase
PIGGlET
- Prolactin
- Immunomodulators
- GH
- G-CSF
- Erythropoietin
- Thrombopoietin
The ampulla of vater is derived from what part of the pancreas?
Ventral bud
What things are secreted from the body of the stomach
- Parietal cells: HCl, Intrinsic factor
- Chief cells: Pepsinogen
Hormones released from the antrum
- D cells: Somatostatin
- Mucous cells: Mucus
- G cells: Gastrin to circulation
Vagus nerve stimulates what cells
- Parietal cells
- G cells
- D cells
What hormones are released in the duodenum?
- I cell: CCK
- S: Secretin
- K: GIP
What is the pathogenesis of calculous cholecystitis?
Most common type and is caused by gallstone impaction in cystic duct resulting in inflammation; can cause secondary infection
What is acalculous cholecystitis?
Due to gallbladder stasis, hypoperfusion or infection(CMV); seen in critically ill patients
What are the H2 blockers
Cimetidine, ranitidine, famotidine, nizatidine
Proton pump inhibitors
Omeprazole, lansoprazole, esomeprazole, pantoprazole, dexlansoprazole
What is fibromyalgia
Chronic widespread musculoskeletal pain aassociated with tender points, stiffness, parethesias, poor sleep, fatigue, cognitive disturbance
What is some illness anxiety disorder?
Excessive preoccupation with acquiring or having an illness, despite reassurance and eval
Treatments for narcolepsy
Daytime stimulants, nighttime sodium oxybate
Potency of estrogen types in order
Estradiol>estrone>estriol
What are the types of androgens and where are they produced?
DHT and testosterone (Both in the testes), Androstenedione (ADrenal)
Number 1 risk factor for cervical invasive carcinoma
Multiple sexual partners……. hten smoking, early intercourse, HIV infection
Fibrocystic changes of the breast?
Premenopausal women over 35 which presents with premenstrual breast pain or lumps; often bilateral and multifocal. Nonproliferative lesions include papillary apocrine change/metaplasia, stromal fibrosis.
Sclerosin adenosis
Acini and stromal fibrosis, associated with calcifications
Epithelial hyperplasia
Cells in terminal ductal or lobular epithelium causing increased risk of carcinoma with atypical cells
What is the pathophysiology of inflammatory breast cancer
Dermal lymphatic invasion by breast carcinoma leading to peau d’orange; neoplastic cells block lymphoatic drainage
Methemoglobin treatment
Methemoglobinemia can be treated with methylene blue and vitamin C
Carboxygemoglobin
Hb bound with CO leading to decreased oxygen binding capacity with left shift
Adenocarcinoma mutations
KRAS, EGFR, ALK
Define lead time bias
Early detection is confused with increased survival
What do alcohols do for disenfection?
Denature proteins and disrupt cell membranes
What things are sporicidal
Hydrogen peroxide, iodine and iodophores, autoclave
What robertsonian translocation occurs that causes down syndrome
Between 14 and 21
Osteogenesis imperfecta featuers
- Multiple fractures with minimal trauma; may occur during the birth process
- Blue sclera due to translucent connective tissue over choroidal veins
- Some forms have tooth abnormalities including opalescent teeth that wear easily due to lack of dentin
- Hearing loss
Ehlers Danlos features
- Hyperextensible skin, tendency to bleed and hypermobile joints
- Classical type: caused by a mutation in type V collagen
- Vascular type: Type 3 collagen deficiency
- Hypermobility type: Most common
RET gene disorders
Men2a and Men2b
Pringle maneuver
Ligament may be compressed between thumb and index finger placed in omental foramen to control bleeding
What is the cause of physiologic neonatal jaundice
UDP-glucuronosyltransferase
Busulfan
- Cross link DNA
- CML also used to ablate patients bone marrow before bone marrow transplantation
- Severe myelosuppression, pulmonary fibrosis, hyperpigmentation
Person has noise induced hearing loss, what sounds should come back first
High frequency
What are the issues afoot with klinefelter syndrome
- Dysgenesis of seminiferous tubules leading to decreased inhibin B and increased FSH
- Abnormal leydig cell function leads to decreased testosterone and increased LH and increased estrogen
What are the risks of blood transfusion
- Possible infection transmission
- Transfusion reactions
- Secondary hemochromatosis
- Hypocalcemia (citrate chelates Ca2+)
- Hyperkalemia
What is produced by eosinophils?
- Histaminase
- MBP
- Eosinophil peroxidase
- Eosinophil cationic protein
- Eosinophil derived neurotoxin
Specific granueles of neutrophils
- Leukocyte alkaline phosphatase
- collagenase
- lysozyme
- lactoferrin
Azurophillic granules
- Proteinases
- Acid phosphatase
- myeloperoxidase
- beta-glucuronidase
What is the major cause of neuronal death in huntington disease
NMDA=R binding and glutamate excitotoxicity
Difference between metachromatic leukodystrophy and adrenoleukodystrophy
- Metachromatic leukodystrophy - AR lysosomal storage disease where formed myelin is destroyed by buildup of sulfatides
- Adrenoleukodystrophy - VLCFA leading to build up in nervous system, adrenal gland, testes, leading to progressive disease leading to long term coma/death
Mirabegron
Beta3 agonist for urinary urge incontinence and overactive bladder
D1 vs D2 receptors
- D1 = relaxes renal vascular smooth muscle, activates direct striatum
- D2 = Modulates transmitter release in the brain, inhibits direct striatum
General side effects of vancomycin
NOT trouble free
- Nephrotoxicity
- Ototoxicity
- Thrombophlebitis
Which is the only NRTI that is a nucleotide rather than a nucleoside
Tenofovir
NRTIs
Abacavir, Didanosine, emtricitabine, lamivudine, stavudine, tenofovir, zodovudine
Integrase inhibitors have what toxicity
Creatinine kinase increase
Chloroquine adverse effects
Retinopathy, pruritis
Drugs used for mite therapy
Permethrin, malathion, lindane
Mech of sofosbuvir
- HCV RNA dependent RNA polymerase acting as a chain terminator
- Can cause fatigue, headache, nausea
Mech of ribavirin
- HepC Inhibit synthesis of guanine nucleotides
- Hemolyric anemia, teratogenic
Simeprevir mech
- HVC protease inhibitor preventing replication
- Photosensitivity, rash
HLAb5701
Abacavir
Use of amoxicillin, ampicillin, aminopenicillins
HHELPSS
- H flu
- H pylori
- E coli
- Listeria
- Proteus
- Salmonella
- Shigella
Daptinomycin mech and AE
- Disrupts cell membrane of gram + cocci with transmembrane channels
- Causes myopathy and rhabdomyolysis
Prophylaxis for endocarditis for surgical or dental procedures
Amoxicillin
Prophylaxis for gonorrhea
Ceftriaxone
Pregnant woman carrying group B strep prophylaxis
Penicillin g or amp
Isoniazid adverse effects
- Hepatotoxicity
- Druge induced SLE
- Anion gap acidosis
- Vitamin B6 deficiency
- ALWAYS ADMINISTER WITH B6
Amphotericin adverse effects
Hypotension, nephrotoxicity, arrythmias, anemia, IV phlebitis ALWAYS HYDRATE WITH AMPHO
Second generation cephalosporins
Fake Fox Fur, cefaclor, cefoxitin, cefuroxime
First line for absense seizures
- Ethosuximide, but lamotrigine can work
First line for status epilepticus
- Acute: Benzos
- Prophylaxis: Phenytoin, fosphenytoin
Tonic clonic seizures first line
- Phenytoin, fosphoymcin or Valproic acid
Partial seizure first line
Carbamazepine
Topirimate side effects
Sedation, mental dulling, kidney stones, weight loss, glaucoma
Vigabatrin mechanism and AE
Gaba increase by inihibiting transaminase, leading to permanent visual loss
Order type 1 antiarrythmics in terms of Na+ channel affinity
1C, 1A, 1B
Dihydropryidines treat what
Hypertension, angina (including prinzmetal) raynaud phenomenon
NImodipine is for….
Subarachnoid hemorrhage
Nicardipine, clevidipine:
Hypertensive urgency and emerghency
Non-Dhps treat
Hypertension, angina, atrial fibrilation
PCSK9 inhibitors use
Decreased LDL by inactivation of LDL receptor degradation
Can cause myalgias, delirium, dementia
Acute treatment of serotonin syndrome
Cyproheptadine
Within 2 weeks of MI, what are the major complications occur?
- Free wall rupture, tamponade
- Papillary muscle rupture leading to mitral regurg
- LV pseudoaneurysm
Cilostazol and dipyridamole
- PDE inhibitors in platelets leading to inhibition of aggregation and vasodilation
- Causes nausea, headache, facial flushing, hypotension, abdominal pain
Ticlopidine AE
Neutropenia