Blocks 41, 42 Flashcards
What interleukin REDUCES the production of pro-inflammatory Th1 cytokines (IL-2 and IFN gamma) and MHC-2 expression? (therefore it has anti-inflammatory properties)
IL-10
In a case of suspected or proven C. diff infection, what contact precautions are observed?
Handwashing
Gowns
Nonsterile gloves
Classic presentation: male infant with abdominal contents protruding through deep inguinal ring and traveling lateral to inferior epigastric vessels
Indirect Inguinal Hernia
Patent processus vaginalis
Classic presentation: Older man with abdominal contents protruding through Hesselbach triangle traveling medial to inferior epigastric vessels.
Direct Inguinal Hernia
Weakness of transversalis fascia
Classic presentation: Woman with abdominal contents protruding through femoral ring and traveling inferior to inguinal ligament.
Femoral Hernia
Weakness of proximal femoral canal
4 y/o boy with severe staph pneumonia. History of recurrent lymphadenitis and skin infections. Dihydrorhodamine flow cytometry testing reveals an absence of the green flurourescence that is characteristic of neutrophils. What is the disease?
Chronic Granulomatous Disease
Lack of NADPH oxidase
Amphotericin B is an antifungal drug notorious for what toxicity?
Renal toxicity
Severe hypokalemia and hypomagnesemia are commonly seen during therapy and often require daily supplementation.
Newborn with fetal growth retardation. Low set ears, small mandible, prominent occiput. Weak cry with increased tone of the extremities, clenched hands with overlapping fingers. Harsh holosystolic murmur heard best at the left sternal border.
Trisomy 18
Edwards Syndrome
47, XX, +18
Acute dystonic reaction (spasmodic torticollis) is a type of extrapyramidal symptom most likely due to initiation of what type of medication?
Antipsychotic Medication
Antagonism of dopaminergic D2 receptors in the nigrostriatal pathway
Citalopram is what type of drug?
SSRI
What drugs are first line therapy for generalized anxiety disorder?
SSRI
SNRI
Alcoholic male with hematemesis. Longitudinal mucosal tears at the gastroesophageal junction.
Mallory-Weiss Syndrome
Secondary to rapid increase of intraabdominal and intraluminal gastric pressure, like when retching.
What are the effects of insulin on the body?
Increases peripheral glucose uptake
Inhibits lipolysis
Inhibits ketoacid formation
Suppresses glucagon release
Pt with progressive dyspnea, fine crackles, clubbing, and diffuse reticular opacities
Interstitial Lung Disease
Fibrotic interstitial tissue –> Decreased lung volumes –> Increased lung elastic recoil –> Increased radial traction (outward pulling)
Increased expiratory flow rates when corrected for the low lung volume
Elastin fibers within alveolar walls normally allow the lung to stretch during active inspiration and recoil during passive expiration. What property of elastin allows this?
Extensive cross-linking between elastin monomers, facilitated by lysyl oxidase.
Arthritis with brief or no morning stiffness (<30 min), hard, bony enlargment of joints, knees, hips, DIP joint, increases with age
Osteoarthritis
DIP = Heberden node
PIP = Bouchard node
Arthritis with prolonged morning stiffness, soft/spongy warm joints, MCP joint, PIP joint, wrists, fever, fatigue, weight loss
Rheumatoid Arthritis
A patient with TB is given a drug and then has symptoms including progressive limitation of physical activity due to fatigue. Conjunctival and palmar pallor. Hemoglobin is low, MCV is low, Hematocrit is low. Blood smear shows ringed sideroblasts. What is going on?
Isoniazid inhibits pyridoxine phosphokinase, leading to pyridoxine (B6) deficiency. Pyridoxine’s active form is the cofactor for delta-aminolevulinate (ALA) synthase, the enzyme that catalyzes the rate-limiting step of heme synthesis. Inhibition of this step can produce microcytic, hypochromic anemia. Iron transported to developing erythrocytes that cannot form heme, accumulate and result in sideroblastic anemia.
Pt with severe HTN at a young age, weakness and parasthesias, suppressed plasma renin
Primary Mineralocorticoid Excess (Hyperaldosteronism)
Hypokalemia
Increased H+ excretion –> increase in bicarb –> metabolic alkalosis
Normal sodium levels
Lesion of what hypothalamic nucleus will cause hyperphagia and obesity?
Ventromedial
Lesion of what hypothalamic nuclei causes anorexia?
Lateral
How do you calculate RBF?
RBF = PAH clearance / (1- hematocrit)
Stenosis characterized by diffuse fibrous thickening and distortion of the mitral valve leaflets along with commissural fusion at the leaflet edges is caused by what?
Rheumatic Mitral Stenosis
Hyponatremia + a lung mass
SIADH
Euvolemic hyponatremia
Profound hyponatremia can cause headache, weakness, altered mental status, and seizures.

