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Designated study period: daily cards > April 1 - Cardio, Psych, Derm > Flashcards

April 1 - Cardio, Psych, Derm Flashcards

1
Q

Embryologic development of venous system

A

Three systems during development
1. Umbilical veins: connnect to placenta; degenerate
2. Vitelline veins: drain yolk sac; become portal system, including SMA, etc
3. Cardinal veins: become systemic circulation
In fetus, all drain to the sinus venosus (primitive part of heart)

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2
Q

Wolff-Parkinson-White syndrome: EKG findings, pathophys, complications

A

EKG: short PR interval (QRS comes right after P wave), delta wave (early activation of ventricle via bypass tract)

Pathophys: extra bypass tract that can conduct in both directions between atria and ventricles. Sets up for AV re-entrant tachycardia in which loop occurs through bypass tract and AV node

Complication: A fib can be life threatening because can conduct to ventricles through bypass tract. Need to avoid meds that slow AV node conduction as they increase flow through bypass tract

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3
Q

Myocardial ischemia: timing and effects

A

ATP decreases and results in loss of contractility within 60s of total myocardial ischemia.

Ischemis less thatn 30 mins reversible but with prolonged myocardial dysfunction for a few days after restarting blood flow

Ischemia longer than 30 mins results in large decrease in ATP with loss of cell homeostasis and irreversble injury

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4
Q

Risk factors for aortic dissection

A

HTN is single number one risk factor

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5
Q

NO synthase

A

Converts arginine + NADPH + O2 to NO

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6
Q

Brachiocephalic vein

A

External jugular drains scalp and lateral face to R subclavian vein. R subclavian vein drains arm and dumps to brachiocephalic.

IJV drains brain, neck, face and dump into brachiocephalic.

R lymphatic duct also drains to brachiocephalic

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7
Q

Other condition associated with congenital QT prolongation

A

Sensorineural deafness

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8
Q

Phenoxybenzamine

A

Irreversible alpha1 and alpha2 antagonist used to treat pheochromocytoma

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9
Q

Phentolamine

A

Reversible competitive alpha antagonist used to catecholamine induced HTN crisis

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10
Q

Fenoldopam

A

Peripheral D1 agonist that causes vasodilation, esp of renal artery, leading to diuresis and natriuresis.

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11
Q

Cilostazol

A

Decreases platelet activation and causes direct arterial vasodilation. Used in PAD

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12
Q

Segmented viruses

A

Orthomyxoviruses, reoviruses, bunyaviruses, arenaviruses

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13
Q

Burkitt lymphoma translocation

A

t(8;14) c myc and IgH

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14
Q

Calcineurin inhibitors; names, MOA, ADRs

A

Names: cyclosporine and tacrolimus

MOA: inhibit calcineurin, preventing activation of NFAT and production of I-2

Use: Autoimmune disease and transplants

ADRs: DDIs through CYP metabolism. Nephrotoxicity (constricts renal vessels) leading to HTN. Increased uric acid, hyperglycemia. Cyclosporine also causes gingival hyperplasia and hirsutism

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15
Q

Sirolumus: MOA, ADRs

A

Also called rapamycin

MOA: Inhibits mTOR, decreasing response to IL-2, decreasing B and T cell proliferation

ADRs: marrow suppression, hyperlipidemia, hyperglycemia

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16
Q

Methotrexate: MOA, ADRs

A

MOA: Inhibits dihydrofolate reductase. Prevents conversion of dUMP to dTMP, which requires THF.

ADRs: myelosuppression that is reversible with leucovorin/folinic acid. Stomatitis/mucositis. Abnormal LFTs

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17
Q

Cyclophosphamide: MOA, use, ADRs

A

MOA: alkylating agent that causes cross linking of DNA, inhibiting DNA replication

ADRs: myelosuppression, hemorrhagic cystitis (decreased with hydration and mesna), SIADH

Use: vasculitis, glomerulonephritis, chemo

18
Q

Infliximab: MOA, use, ADRs

A

MOA: anti-TNF monoclonal
Use: RA and Crohns disease
ADR: can reactivate TB

19
Q

Etanercept: MOA

A

Decoy receptor for TNF alpha

20
Q

Linezolid: use and ADR

A

Antibiotic that treats resistant gram positive bugs. Has MAOI activity and can precipitate serotonin syndrome in someone on SSRI

21
Q

Alcoholism pharmacotherapy

A
  1. Disulfiram
  2. Naltrexone: blocks rewarding/reinforcing effects of alcohol and decreases cravings, only one that can be initiated while still drinking
  3. Acamprosate: modulates glutamate transmission at NMDA receptor
22
Q

Fluphenazine

A

High potency first gen antipsychotic, similar to haloperidol

23
Q

Thioridazine

A

Low potency first gen antipsychotic, similar to chlorpromazine

24
Q

TCAD- how cause arrhythmias

A

Cause QT prolongation and QRS widening at high dose by blocking Na+ channels. Leads to arrhythmias

25
Q

Transferance vs displacement

A

Transference: Shifting of emotions or desires associatied with person from PAST to person in PRESENT

Displacement: Expressing unacceptable feelings meant for someone else in present life to someone safer

26
Q

Akathisia

A

Extrapyramidal side effect. Restlessness, inability to sit still, occurs days to weeks after starting antipsychotic.

27
Q

Tourette disorder diag criteria and treatment

A

Both multiple motor and 1+ vocal tic (grunting, throat clearing, yelling, etc). Lasts over a year and onset before age 18

Treatment: antipsychotics, alpha agonists, behavioral therapy

28
Q

Schizophreniform vs schizophrenia

A

Phreniform: 1-6mos
Phrenia: over 6 mos

29
Q

Narcolepsy diag test

A

Low hypocretin-1 in CSF

30
Q

Chronic lymphedema complication

A

Angiosarcoma 10 yrs later

31
Q

Bullous pemphigoid vs pemphigus vulgaris

A

Bullous pemphigoid: ABs against hemidesmosomes

Pemphigus vulgaris: ABs against desmosomes

32
Q

Intraductal papilloma

A

Most common cause of bloody nipple discharge. Papillary cells around fibrovascular core.

33
Q

Fibrocystic change

A

Diffuse small cysts +/- metaplasia. Cyclic breast pain

34
Q

Fibroadenoma

A

Small firm mobile mass. Proliferation of stroma and ducts. Stroma can compress ducts to slits.

35
Q

Perineal body

A

Separates urogenital and anal triangles. Midline epidiotomy goes to it

36
Q

Tuberous sclerosis

A

Auto dom. Renal angiomyolipomas, brain hamartomas, cardiac rhabdomyomas, ash leaf patches

37
Q

Alkaptonuria

A

Tyrosine metabolism disorder (Can’t convert tyrosine to fumarate). Deficient homogentisic acid dioxygenase. Black color to urine, black pigment on collagen, arthropathy in adulthood

38
Q

Malformation

A

Intrinsic cell or tissue defect leads to chain of downstream effects.

39
Q

Deformation

A

Caused by extrnisic mechanical forces

40
Q

Disrupation

A

Breakdown of previously normal tissue

41
Q

Theophylline intoxication

A

Seizures, tachyarrhthmia

Designated study period: daily cards (32 decks)

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