Cards Flashcards
1
Q
treatment of diphtheria
A
- diphtheria antitoxin
- penicillin or erythromycin
- DPT vaccine
2
Q
gray pharyngeal exudate and pseudomembranous pharyngitis
A
diphtheria
3
Q
diphtheria exotoxin
A
AB exotoxin specific for neural and cardiac tissue - ribosylates elongation factor 2 inhibiting protein synthesis
4
Q
treatment of PTSD
A
SSRI
5
Q
blood supply of eye
A
from internal carotid to ophthalmic artery to retinal artery
6
Q
primase uses what to make primer
A
RNA
7
Q
BNP
A
released in response to stretch (volume overload) - causes vasodilation, diuresis, decrease in BP, alleviating symptoms
8
Q
bacteria associated with dairy products
A
Listeria
9
Q
signs and symptoms of ankylosing spondylitis
A
- low back/hip/butt pain
- limited chest expansion
- enthesitis
- systemic symptoms
- anterior uveitis (unilateral pain, photophobia, blurry vision)
10
Q
most common systemic effects of ankylosing spondylitis
A
- respiratory - spine and costovertebral involvement can limit chest wall expansion - should be monitored
- CV - ascending aortitis
- eye - anterior uveitis
11
Q
what part of EKG does beta blockers affect
A
PR interval - decreased AV nodal conduction
12
Q
CD55 and CD 59 deficiency
A
paroxysmal nocturnal hemoglobinuria
13
Q
three characteristic findings of paroxysmal nocturnal hemoglobinuria
A
hemolytic anemia, hypercoagulability and pancytonpenia
increase in complement activation
14
Q
mutation in PMH
A
PIGA gene - synthesis of GPI anchor
15
Q
iliacus vs psoas muscle
A
iliacus comes from the hip (iliac crest) and psoas comes from the spinal processes
16
Q
treatment for acute anxiety
A
benzodiazepine
17
Q
mechanism of benzodiazapine
A
binds allosterically to GABA receptor site, allowing Cl- into the cell
18
Q
meningitis in HIV patients
A
cryptococcus neoformans
19
Q
nonseptate hyphae branching at wide angles
A
mucor and rhizopus
20
Q
germ tubes
A
sprouts of true hyphae from yeast cells - from candida
21
Q
spherules
A
round structures containing endospores - found in coccidioides
22
Q
sporangium
A
structure with spores - present in mold fungi
23
Q
form found in cryptococcus neoformans
A
budding yeast
24
Q
treatment of acute migrane
A
sumatriptan
25
mechanism of sumatriptan
serotonin agonist - inhibit vasoactive peptides, promote vasoconstriction, block pain pathways
26
contraindications of sumatriptan
avoid in patients with cardiac disease due to increase in BP and cardiac events
27
field defect
initial embryonic disturbance leads to multiple malformations
28
measure of anesthetic potency
minimum alveolar potency (MAC) - lower MAC means higher potency
29
PAH
substance that is fully secreted (used to calculate renal plasma flow)
30
creatinine and inulin
substance is neither secreted or reabsorbed - used to calculate GFR
31
differences in antibodies in type A and B and O blood
type A and type B antibodies are IgM, type O antibodies are usually IgG
32
pyridoxine (B6) is needed for...
transamination reactions between an amino acid and an alpha keto acid
33
biotin (B7) is needed for...
carboxylase enzymes (pyruvate carboxylase, acetyl CoA carboxylase, propionyl- CoA carboxylase and 3-methylcrotonyl-CoA carboxylase)
34
folic acid (B9) is needed for...
nucleic acid synthesis
35
rest and nighttime angina with transient ST elevation
Prinzmetal angina
36
dihydroergotamine
used in treatment of acute migraine, can induce vasospastic angina as it constrict smooth muscle
37
characteristic triad of ataxia telangiectasia
cerebellar ataxia, telangiectasia, and increased sinopulmonary infections
38
defect in ataxia telangiectasia
ATM mutation involved in DNA break repair
39
treatment of panic disorder
benzodiazepine
40
Gerstmann syndrome
1. agraphia
2. acalculia
3. finger agnosia
4. left-right disorientation
stoke of the middle cerebral artery affecting angular gyrus of dominant parietal lobe
41
penicillin resistance mechanism
- beta lactamase
- mutated PBP
- mutated porin
42
vancomycin resistance mechanism
- mutated peptidoglycan cell wall
| - efflux
43
quinolone resistance mechanism
- mutated gyrase
| - efflux
44
aminoglycosides resistance mechanism
- enzyme modification
- mutated ribosomal subunit
- mutated porin
45
tetracycline resistance mechanism
- efflux
| - inactivated enzyme
46
rifamycin resistance mechanism
- mutated RNA polymerase
47
length constant
measure of how far along an exon an electrical impulse can propagate
48
how is NO synthesized in endothelial cells
after acetylcholine or bradykinin activation, NO is synthesized from arginine, NADPH and O2
It then forms cGMP, reducing calcium, leading to relaxation
49
positive vs negative skew
```
positive = more examples of extreme positive values
negative = more examples of extreme negative values
```
50
postherpetic neurlagia
stabbing pain that lasts several months after a shingles outbreak
51
most common amino acid in collagen
glycine
52
growth medium of diphtheria
cysteine-tellurite agar
53
reasons for different dosages in isoniazid
acetylation to N-acetyl-isoniazid, representing fast and slow acetylators
54
cells most commonly found in sarcoidosis
CD4+, driving granuloma formation
55
buzzwords for sarcoidosis
bilateral hilar adenopathy, elevated serum calcium and ACE
56
how does sarcoidosis increase plasma calcium
1-alpha-hydroxylase expressed in activated macrophages in lung and lymph node causes PTH independent production of 1,25 vitamin D
57
permissive effect
when one drug/hormone allows another to do a better job
58
synergistic effect
when two drugs preform better than the sum of their individual effects
59
what is necessary for surgical site confirmation
independent verification by 2 health care workers
60
classic characteristic of mitochondrial myopathy
blotchy red muscle fibers on Gomori trichrome stain - "ragged red fibers"
61
abrupt onset of severe headache
subarachnoid hemorrhage
62
association with berry aneurysms of circle of Willis
autosomal dominant PKD
63
characteristics of chancroid in H ducreyi
- deep, painful ulcer with ragged borders
- grey exudate
- inguinal lymphadenopathy
- prevalent in sub-Saharan Africa
64
signs of intestinal ischemia
pain after eating with weight loss
65
drugs most associated with falls
psychotropic drugs
66
Hawthorne effect
tendency of study subjects to change their behavior once they know they are being studied
67
treatment for calcium stone formation
HCTZ
68
complication of echinococcus surgery
anaphylaxsis due to spilling of cysts
69
pulmonary resistance is lowest at...
FRC
70
describe muscle contraction
actin filaments are covered by tropomyosin (long thin structures), when calcium binds to troponin, tropomyosin moves out of the way, allowing myosin to bind
71
components of smooth muscle contraction
calmodulin and myosin light chain
72
von Hippel-Lindau disease
deletion or mutation of VHL tumor suppressor causing renal cell carcinoma, cerebellar hemangioblastomas and pheochromocytomas
73
sickling is promoted by...
low oxygen levels, increase acidity or low blood volume
74
Kayser-Fleischer rings
associated with Wilsons disease (brown in the eyes)
75
end result of Wilsons disease
generation of free radicals due to copper leading to *atrophy of basal gangila
76
medication used for prevention of ischemic stroke
low does aspirin, can lead to GI bleeding
77
location of complement binding on an antibody
heavy chain region near the hinge
78
organism with very high infectious rate
shigella - as few as 10-500 cells
79
Meckels diverticulum is a ________
true diverticulum, all three layers
80
stapedius nerve is a branch of the....
facial nerve
81
IL-8
produced by macrophages that induces chemotaxis and phagocytosis in neutrophils
82
viral meningitis pattern
high protein, normal glucose and lymphocytic predominance
83
stop codons
UAG UAA UGA
84
pseudohyphae
candida
85
lipooligosaccharide (LOS)
present on neisseria, like LPS on other gram negative bugs
86
sickness where first time you are ok, but second time you should be worried
dengue
87
renin is secreted by...
juxtaglomerular cells located in the wall of the afferent arteriole
88
why is it bad to give oxygen to patient with COPD exacerbation
oxygen allows parts of the lung with poor ventilation to receive blood supply leading to an increase in physiologic dead space
89
poisonous mushrooms are inhibitors of....
RNA polymerase 2 halting mRNA synthesis
90
Paget's disease
excessive osteoclastic resorption followed by increased bone formation by osteoblasts
91
2 factors for osteoclast differentiation
1. macrophage colony stimulating factor (M-CSF)
| 2. receptor for activated factor kappa-B ligand (RANK-L)
92
osteoprotegerin (OPG)
decreases binding of RANK to RANK-L leading to decreased osteoclast activity
93
clinical features of fragile X
developmental delay, macrocephaly, long narrow face, prominent forehead, chin and ears, macroorchidism
94
CO (reversibly/irreversibly) binds to heme
reversibly
95
major immune mechanism against giardia
secretory IgA production
96
major risk increase in sleep apnea
pulmonary hypertension and right heart failure
97
most important mechanism for s epidermidis
formation of biofilm by synthesis of polysaccharide matrix
98
acute serum sickness
deposition of immune complexes, small vessel vasculitis with fibinoid necrosis and neutrophil infiltration
99
cause of serum sickness
administration of antigenic proteins or nonhuman immunoglobluins
100
water goes under the bridge
ureter travels under gonadal artery and vein (and over internal iliac artery)
101
components of H flu capsule
polyribosylribitol phosphate (PRP)
102
activator of muscle phosphorylase kinase
intracellular calcium
103
activator of liver phosphorylase kinase
epinephrine and glucagon, which increases cAMP
104
location of AV node
endocardial surface of right atrium near insertion of septal leaflet of the tricuspid valve and the orifice of the coronary sinus
105
selective drugs for coronary artery dilation
adenosine and dypryridamole
106
coronary steal
providing coronary artery dilators and making ischemia worse
- collateral flow is provided and vessels are maximally dilated, drugs cause restricted vessels to dilate leading to less flow to collaterals
107
use for adenosine and dypryridamole
simulate coronary artery dilation by exercise - allows for detection of ischemia
108
heart association in Turner syndrome
aortic coarctation and bicuspid aortic valve
109
SVC obstruction vs brachiocephalic vein obstruction
SVC is bilateral, brachiocephalic is unilateral
110
rise in creatine kinase
marker of cell death of muscle
111
gene in pulmonary hypertension
BMPR2
112
physical exam of pulmonary hypertension
loud P2
113
characteristics of X linked agmmaglobulinemia
recurrent sinopulmonary infections, giardia, failure to thrive, low Ig
114
mutation in X linked agammablobulinemia
Bruton tyrosine kinase - failure of B cells to develop (CD19 and CD20)
115
fungus found in wood
blastomyces - southeastern US
116
drug for treating pulmonary hypertension
bosentan - boss man stan
117
progression of hemangiomas
initially progress and then regress
118
vagus vs glossopharyngeal nerve in carotid body/sinus stimulation
Vagus - aortic arch baroreceptors
glossopharyngeal - carotid sinus/body receptors
119
careful monitoring of angina is needed with what two medications taken together
beta blockers and CCBs (both can cause bradycardia)
120
pathogenesis of CF
misfolded protein and failure of glycosylation is targeted for destruction before it can reach the surface, then the channel doesn't work
121
bacterial association with colon cancer
strep bovis (S gallolyticus)
122
enlarged cells with intranuclear and intracytoplasmic inclusions
CMV - owls eye
123
P450 inducers
- carbamazepine
- phenobarbital
- phenytoin
- rifampin
- griseofulvin
124
P450 inhibitors
- cimetidine
- ciprofloxacin
- erythromycin
- azoles
- grapefruit juice
- isoniazid
- ritonavir
125
drug used for stress test
adenosine - only lasts 10 seconds
126
heart block drug that causes flushing
adenosine
127
final synthesis step of elastase
lysyl oxidase deaminates lysine facilitating formation of desmosine cross links - gives it rubber like properties
128
most susceptible arteries to atherosclerosis
lower abdominal aorta and coronary arteries
129
spore forming bacteria
bacillus anthracis from clostridium
130
antiarrhythmic with very little risk of torsades de pointes
amiodarone
131
MI in AvL and V1
lateral leads - left circumflex artery
132
normal morphologic change of heart
decreased left ventricle, sigmoid septum, increased interstitial connective tissue, lipofuscin pigment
133
lipofuscin pigment
brownish pigment in normal aging of cardiomyocytes, the results of indigestible membrane lipid oxidation
134
chlorothiadone is a...
thiazide diuretic
135
metabolic effects of thiazide
- hyponatremia = duh
- hypokalemia = K wasting
- hypercalcemia = increased resorption
- hyperglycemia/hypercholesterolemia = insulin resistance
- hyperuricemia = increased resorption
136
gene defect in hypertrophic cardiomyopathy
beta-myosin heavy chain and myosin binding protein C
137
gene defect in X linked familial dilated cardiomyopathy
dystrophin
138
bacteria that lack peptidoglycan cell walls
mycoplasma
139
antidote to NE infusion
alpha 1 blocking drug, phentolamine
140
AV node artery comes from....
whatever side of the heart is dominant (usually right)
141
green inspissated mass means....
meconium ileus
142
most likely causes of death due to CF
pneumonia, bronchiectasis and cor pulmonale
143
organism responsible for croup
paramyxovirus
144
squamous metaplasia in CF caused by...
vitamin A deficiency
145
migratory thrombophlebitis should raise suspicion for...
cancer - hypercoagulabilty
146
Trousseau syndrome
association of migratory thrombophlebitis with cancer
147
first thing that happens in infective endocarditis
disruption of normal endocardial surface leading to a sterile fibrin-platelet nidus for bacteria to land on
- bacteria don't just land on nothing
148
CREST syndrome
```
C - calcinosis
R - raynauds
E - esophageal dysmotility
S - sclerodactyly
T - telangiectasias
```
149
ivabradine
slows heart rate with no effect no cardiac contractility -selectively inhibits funny sodium channels
150
subclavian steal
when subclavian artery is occluded, blood is shifted around vertebral arteries to past point of blockage
151
most likely place for gallstone ileus to form
ileum
152
most likely organisms in secondary pneumonia
S pneumonie, s aureus, h flu
153
trachea vs esophagus on CT
trachea is open b/c its filled with air
| esophagus is usually collapsed
154
cells responsible for killing with no MHC I
NK cells
155
drugs that improve survival in CHF
beta blockers, ACE inhibitors, ARBS, and aldosterone agents
156
what prevents lung ischemia in PE
dual blood supply
157
cells responsible for fibrous core in atheroma
smooth muscle cells (act like fibroblasts)
158
second test to do after high alk phos
hepatic gamma-glutamyl transpeptidase (GGT) - more specific for gall bladder disease
159
how is digoxin cleared
renally - need to check levels due to small therapeutic window
160
intracellular mechanism of BNP/ANP
linked to guanylyl cyclase leading to rise in cGMP leading to vasodilation
161
how does hep B help hep D survive
hep B provides external coat surface antigen in order to penetrate hepatocyte
162
mechanism of action of ipratroprium
blocks acetylcholine at muscarinic receptors, preventing bronchoconstriction in asthma
163
fenoldopam
peripheral dopamine-1 receptor agonist for malignant hypertension
- vasodilation of arteries
- increased renal perfusion, diuresis and natriuresis
164
end result of NO use
smooth muscle relaxation by myosin dephosphorylation
165
gall bladder disease with IBD
primary sclerosing cholangitis
166
primary biliary sclerosis
- destruction of intrahepatic interlobular bile ducts by granulomatous inflammation
- pruritus and fatigue in middle aged women
- signs of cholestasis and hypercholesterolemia
167
mechanism for hepatic encephalopathy in GI bleed
- liver can not detoxify ammonia
| - bleeding causes increased nitrogen delivered to gut leading to an increase in ammonia
168
order of most common lung tumors
1. non-small cell
a. adenocarcinoma (non smoker)
b. large cell
c. squamous cell
2. small cell
169
how is copper excreted
hepatic excretion in bile
170
gastric varices are caused by obstruction of what vein
splenic vein....runs across the stomach
171
lung function studies (FEV1/FVC)
- lower in COPD
| - higher in restrictive
172
most common cause of viral meningitis
enterovirus (coxsackie, polio)
173
main ecoli antigen in meningitis
K1 capsular antigen - allows survival in blood to get to CSF
174
verortoxin
shiga like toxin in EHEC
175
beta endorphin is derived from....
POMC, also produces ACTH and MSH
176
part of brain affected in Wernicke-Korsakoff
mamillary body
177
drug that causes gingival hyperplasia
phenytoin
178
treatment for Wilsons disease
D-penicillamine (copper chelator)
179
serotonin releasing neurons are in...
raphe nuclei
180
norepinephrine releasing neurons are in...
locus ceruleus
181
Wernicke and Broca are supplied by what artery
middle cerebral
182
route of invasion of neiserria
pharynx - blood - choroid plexus - meninges
183
IVH in neonates originates in...
germinal matrix
