April 14 Flashcards
What 2 disorders results from a 22q11.2 micro deletion?
DiGeorge syndrome
velocardiofacaial syndrome
FISH–gold standard for dx of micro deletion
IFN a and B are produced by human cells in response to viral infection, what is there role?
Help suppress viral replication by halting protein synthesis and promoting apoptosis of infected cells
Normal or elevated ACTH levels that can be suppressed during high-dose dexamethasone test?
Pituitary adenoma
Ectopic ACTH production –if NOT suppressed
What has activity against pseudomonas?
Piperacillin/ticarcillin
Ceftazaidime/cefepime
Ciprofloxacin/levofloxacin
Imipenem/meropenem
What vessel has to most deoxygenated blood?
Coronary sinus–heart takes more O2 than any other tissue in the body
What is typically seen in CSF when viral infection occurs?
Normal glucose
Elevated protein
Lymphocytic pleocytosis
What are the 3 Dopamine agonist drugs that directly stimulate dopamine receptors?
Ergot–Bromocriptine
Non-ergot (preferred)–Parmipexole and Ropinirole
G6PD deficiency has what type of inheritance pattern?
X-linked recessive
What are the characteristics of drugs with low Vd (3-5L)?
Large/Charged molecules, plasma protein bound
Wilsons disease presents with what brain abnormality?
Basal ganglia atrophy–due to deposition of copper
How does galactokinase deficiency present?
Autosomal recessive disease that develops when infant begins feeding–lactose present in breast milk and routine formula
Galactose appears in blood and urine and infantile cataracts occur due elevated galactitol which is formed from excess circulating galactose by aldose reductase
Effect of substance A is required for the full effects of substance B?
Permissive
Pt with PCOS wants to become pregnant, what should she take and what is the MOA?
Clomiphene citrate–Selective estrogen receptor modulator preventing negative feedback inhibition by circulating estrogen
–Increases LH and FSH–> ovulation
What are the 3 drugs used for pregnancy termination and MOA of each?
Misoprostol–PGE1 agonist–causes cervical shortening and uterine contraction
Mifepristone–Progesterone and glucocorticoid antagonist–prevents further development of the 1st trimester pregnancy
Methotrexate–Folic acid antagonist –inhibits trophoblast division
What can be given to prevent hemorrhagic cystitis seen with cyclophosphamide?
Mesna–thiol group of meson binds toxic metabolites
Or N-acetylcysteine
With what condition can pt develop R-sided varicocele?
Nephrotic syndrome–due to right renal vein thrombosis from loss of antithrombin III in urine
Administration of glucose to thiamine deficient pt can lead to what?
Wernicke encephalopathy –acute confusion, opthalmoplegia, and ataxia due to increased thiamine demand within TCA cycle
Damage to the mamillary bodies –hemorrhagic characteristic
Always infuse thiamine with glucose when thiamine deficiency is suspected
What is power (1-B)?
Represents a study’s ability to detect a difference when one exists
What type of cells are involved in sarcoidosis?
CD4+ T cells
The concentration of what 3 substances decreases as fluid travels through the proximal convoluted tubule?
HCO3-
Glucose
Amino acids
PAH, CR, Inulin and Urea increase
Glycerol can be converted to glucose during gluconeogenesis by using what enzyme?
Glycerol kinase
–Pts with DKA have breakdown of TGs in adipocytes –> glycerol
Hormone sensitive lipase–found in adipose tissue where it functions to break down stored TGs into FFA and glycerol
–during starvation-provides substrates for gluconeogenesis and ketone body formation
PCL attaches to what condyle?
Medial femoral condyle
ACL–attaches to the lateral
Low solubility in blood for inhaled anesthetic=
rapid onset and fast equilibrium with brain
Small amount need to saturate the blood
Where do anal fissures most often occur and why?
Below the Pectinate line. Pain while Pooping; blood on toilet Paper. Located Posteriorly because this area is Poorly Perfused
Associated with low-fiber diets and constipation
Pt presents with itchy breast rash with thick skin resembling an orange peel. Dx?
Inflammatory breast cancer
–Cancerous cells obstruct lymphatic drainage due to spread to dermal lymphatic spaces
Low C1 esterase inhibitor activity leads to increases in ______ activity and therefore ______ are CI with this disorder.
Bradykinin
ACE inhibitors
Hereditary angioedema has decreased C1 esterase inhibitor activity
What is the classic triad of fat embolus?
Hypoxemia
Neurologic abnormalities
Petechial rash
Associated with long bone fractures
What are symptoms of atypical depression and what drug class is used?
Mood reactivity–improved modd in response to positive events
Reversed vegetative symptoms
Leaden paralysis–heavy feeling in arms and legs
MAO inhibitors can be used especially if pt has depression resistant to other tx–like SSRIs, which are first line.
(Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline)
Middle meningeal artery is a branch off what artery?
Maxillary artery–which enters the skull where the frontal, parietal, temporal, and sphenoid bones meet
Skull fractures at this site can cause damage to this vessel leading to epidural hematoma
Renal angiomyolipoma is a benign tumor composed of blood vessels, smooth muscle and fat and is associated with what disease?
Tuberous sclerosis HAMARTOMAS -Hamartomas in CNS and skin -Angiofibromas -Mitral regurgitation -Ash-leaf spots -cardiac Rhabdomyoma -Tuberous sclerosis -autosomal dOminant -Mental retardation -renal Angiomyolipoma -Seizures -Shagreen patches
What is Chi-square test used for?
Used to test the association between 2 categorical variables
What is the difference btw the polysaccharide capsule vaccine and the conjugated vaccine used for strep pneumoniae?
Conjugate vaccines are more immunogenic in infancy due to both T and B cell recruitment
They provide higher, longer lasting antibody titers relative to the polysaccharide
What vitamin deficiency is characterized by symmetrical peripheral neuropathy and can also include high-output CHF?
Thiamine deficiency
Dry beriberi–peripheral neuropathy
Wet beriberi–peripheral neuropathy + CHF
Can also see Wernicke-Korsakoff syndrome
How does Rett syndrome present?
Almost exclusively in girls–ages 1-4
—develop normally and the have loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing –deceleration of head growth
What can occur 4-10 days after a subarachnoid hemorrhage causing an ischemic infarct?
Vasospasm
–use nimodipine to prevent
What is the cause of cataracts and peripheral neuropathy seen with DM pts?
Increased glucose–> conversion to sorbitol–accumulates within some cells and attracts H2O into these tissues leading to osmotic cellular injury
What compound is most likely to be low in a pts CSF if they have Narcolepsy?
Hypocretin-1 –orexin
–Decreased production in the lateral hypothalamus
