April 19 Flashcards
What is the the pharmacotherapy used for restless leg syndrome?
Dopamine agonist–Pramipexole
Greater that 2 wks of hallucinations or delusions without major mood episode + periods of concurrent major mood episode with schizophrenic symptoms?
Schizoaffective disorder
What vitamin supplementation is recommended during measles infection?
Vit A–helps prevent ocular complications, reduces other comorbidities, recovery time and length of hospital stay
G6PD deficiency causes impaired conversion of what to what??
Glucose-6-phosphate–> 6-phosphogluconate
–leads to a disorder in the hexose monophosphate pathway that results in episodes of hemolytic anemia due to oxidative stress
What is the role of selective COX-2 inhibitors (celecoxib)?
Decrease inflammation by inhibiting COX-2 but have no effect of COX-1 minimizing GI toxicity
AD inherited disorder presenting with recurrent nose-bleeds and pink spider-like lesions on oral and nasal mucosa, face and arms?
Hereditary hemorrhagic telangiectasia–Osler-Weber-Rendu syndrome
When unvaccinated pt is exposed to diphtheria what type of tx are they given?
Diphtheria antitoxin–passive immunity
Then penicillin or erythromycin
Then DPT vaccine–active immunity
What receptor acts to initiate the extrinsic pathway of apoptosis?
Fas receptor
Pt is osteoporosis has ______ PTH and ______ Ca levels?
NORMAL!!!!
What are the clinical features of granulosa cell tumor of the ovary?
Large, unilateral adnexal mass
Increased estrogen–endometrial hyperplasia, precocious puberty
Increased inhibin
Histo–Call exner bodies –coffee bean nuclei and yellow theca cells with lipid
What is the most commonly associated cancer seen with Pure red cell aplasia, which presents with anemia with low reticulocytes?
Thymoma
What are the responsibilities of the attached ribosomes?
Synthesis of most secretory proteins, the integral membrane proteins of the nucleus and cell membrane, and proteins within the ER, golgi network, and lysosomes
Free ribosomes–translate proteins within the cytosol
Acute tubular necrosis caused by ischemia is most likely to result in damage to what structure(s)?
PCT and thick ascending limb
Nephrotoxic–> PCT susceptible to injury
What enzyme is deficient in pt with classic galactosemia and what does this enzyme do?
Galactose-1-phosphate uridyltransferase
Galactose-1-P —> UDP-Galactose + Glucose-1-P
Sym: failure to thrive, jaundice, hepatomegaly, infantile cataracts, intellectual disability –soon after breastfeeding has begun
Attributing ones owns feelings to others?
Projection
Pts with hypertrophic cardiomyopathy can develop LV outflow tract obstruction which is caused by…
Abnormal systolic anterior motion of the anterior leaflet of the mitral valve toward the hypertrophied interventricular septum
What are the 1st generation antihistamines and what do they cause?
Diphenhydramine, dimenhydrinate, chlorpheniramine
Sedation
Antimuscarinic
Anti-a-adrenergic–hypotension and postural dizziness
Niacin is synthesized endogenously from …
Tryptophan
What brain tumor is S-100 +?
Schwannoma
Pt with absence seizures and generalized tonic clonic seizures should be given what?
Valproate –effective against both
What is the medical tx for cholesterol gallstones in a pt refusing surgery?
Bile acid supplement–hydrophobic bile salts decrease biliary cholesterol secretion and increase biliary bile acid concentration
What does salmonella have that allows for it to cause osteomyelitis in sickle cell pts?
Capsule–Vi antigen protecting the bacteria from opsonization and phagocytosis
What is the MOA of rifaximin and what is it used for?
Decreases intraluminal ammonia production
–used with hepatic encephalopathy
Lactulose also used which increased conversion of ammonia to ammonium ion (NH4+)
Nephrotic syndrome characterized bt diffuse capillary and GBM thickening without increased cellularity, IF shows granular as a result of immune complex deposition and EM shows “spike and dome” appearance with sub epithelial deposits?
Membranous nephropathy
Postural skeletal muscles such as soleus and paraspinal muscles contain what type of muscle fibers?
Type I slow twitch —red muscle fibers myoglobin rich
45 y/o female pt presents with hx of pruritis and fatigue who has pale stool and xanthelasma. Liver biopsy shows lymphocytic infiltrate with granulomatous inflammation. Dx?
Primary biliary cirrhosis –autoimmune reaction causing destruction of the interlobular bile ducts
What converts testosterone to DHT and what happens when this is deficient?
5a-reducatase
–In male fetus the internal genitalia will develop normally because it is under the influence of testosterone–However, the external genitalia do NOT develop properly due to the lack of DHT–resulting in male pseudohermaphroditism
Where is the most common site for thrombus formation in pts with Afib?
Left atrial appendage
Keratin is a marker for…
epithelial cell origin
An infection of a fetus will parvovirus B19 can cause what symptoms?
Hydrops fetalis –severe anemia, heart failure, pleural effusion, pericardial effusion, and ascites
–Adult shows arthralgia with or without rash
What are the clinical features of primary hyperaldosteronism?
HTN
Hypokalemic alkalosis–muscle weakness and paresthesia
dx–Elevated aldosterone level + low renin activity
No edema due to aldosterone escape mechanism
How does trigeminal neuralgia present and what is used for tx?
Repetitive, unilateral, shooting pain (“stabbing”) in the distribution of CN V that lasts
An echocardiogram with aorta lying anterior to the pulmonary artery is diagnostic of what condition, which is caused by failure of what?
Transposition of the great vessels
–Caused by failure of the fetal aorticopulmonary septum to spiral normally during septation of the truncus arteriosus
Synovial fluid analysis of pseudo gout will show what?
Rhomboid-shaped calcium pyrophosphate crystals –positively birefringent under polarized light
–Knee joint is involved in > 50% of cases
Dermatomyositis is an autoimmune disease that affects the muscles and skin and has a strong association with what?
Malignancy
- Lung
- Colorectal
- Ovarian
Where does the majority of water get reabsorbed in the kidney regardless of hydration status?
PCT–passively with reabsorption of solutes
________ occurs when the investigators decision is affected by prior knowledge of the exposure status.
Observer bias
Changes in host range are most commonly caused by a mutation in the viral encoded _______ that mediates virion attachment to the host cell plasmalemma receptors.
Surface glycoprotein
What does ANP and BNP result in and what causes them to be elevated?
Increased blood volume and atrial pressure–ANP
Increased ventricular tension–BNP
Acts via cGMP–causes vasodilation and decreased Na reabsorption at the renal collecting tubule
–dilates afferent renal arterioles and constricts efferent arterioles–promoting diuresis and contributing to aldosterone escape mechanism
How does erythema multiforme present and what is it associated with?
Presents with multiple type of lesions–macules, papules, vesicles, target lesions
Associated with:
- Infections–Mycoplasma and HSV
- Drugs–sulfa, B-lactams, phenytoin
- Cancers
- Autoimmune disease
NF-kB is involved in the production of what?
Cytokines
What is the most important mediator of septic shock?
TNF-a
Presents with tetrad:
- Hypotension
- Tachycardia
- Tachypnea
- Markedly elevated or decreased body temperature
