Day 3 June 23 Flashcards
MOA of atenolol
SELECTIVE beta 1 blocker - effects heart rate, contractility and renin release and lipolysis by inhibiting production of camp
Where are B1 receptors found?
heart, kidneys
What g protein class are B1 receptors associated with?
Gs (stimulate cAMP production)
are B1 receptors found on vascular SM?
no
Propranolol MOA
blocks B1 and B2
are B2 receptors found in the vascular SM?
yes
which B recetpor is found in the lungs?
B2
are B2 receptors found in the heart?
no
which G protein class are B2 receptors associated with?
Gs
what G protein class are alpha 1 receptors associated with?
q - DAG and IP3 -> Ca release
what effect do alpha 1 receptors have?
vascular smooth muscle contraction, pupillary dilator muscle contraction, increased intestinal/bladder sphinctor contraction
what G protein class are alpha 2 receptors paired to?
Gi -> decreased cAMP
what effect do alpha 2 receptors have?
decrease sympathetic outflow, etc
Bean shaped gram - cocci in pairs is what organism?
N. meningitis
what types of cells have tdt?
immature B and T cells
where is major basic protein found?
the granules in eosinophils
which leukemia stains positive for TRAP?
hairy cell leukemia
what does guaiac positive stool mean?
guaiac is a test for fecal occult blood so it means these is occult blood in the stool
Difference in presentation between rigth and left sided colon cancer?
Right sided tends to grow in masses that bleed and lead to iron deficiency anemia
Left sided tends to encircle the lumen and are more likely to change stool shape or cause obstruction
which TB drug is associated with drug induced lupus?
isoniazid
what is the molecular difference between drug induced lupus and SLE ?
drug-induced lupus has anti histone antibodies
SLE has anti ds-DNA antibodies
what hepatic process is important for isoniazad metabolism?
Phase II acetylation.
Patients who have decreased acetylation are at increasd risk for drug induced lupus in response to taking isoniazid, procainamide or hydralazine
how does adjustment disorder present?
increased anxiety, depressive symptoms and/or disruptive behaviour. Develops within 3 months of a stressor and lasts no more than 6 months after the stressor ends. NO psychotic features
does adjustment disorder have psychotic features?
no
A baby born with findings of a cystic hygroma, lymphedema and coarcation of the aorta are characteristic of what?
Turner syndrome XO
pathophys of granuloma formation in TB?
- infected macrophages present antigen to helper CD4 t cells
- macrophages secrete IL12 inducing t cell differentation to Th1 subtype
- Th1 cells produce IFN GAMMA which activates macrophages, and TNF alpha which recruits more macrophges
- macrophages limit spread of mycobacteria
venous drainage of hemorhoids about the pectinate line? (internal hemorrhoids)
superior rectal vein -> inferior mesenteric vein
venous drainage of hemorrhoids below the pectinate line (external hemorrhoids)?
inferior rectal vein -> internal pudendal vein
which inhaled anesthetic is associated with drug-induced liver-injury
Halothane
how does halothane induced liver injury present?
ranges from asymptomatic ALT elevation to fulminant hepatitis
Symptoms include fever, anorexia, nausea, myalgias, arthralgias, rash and tender hepatomegaly/jaundice
which lab findings are present in ACUTE (fulminant) hepatitis?
increased ALT, elevated PTT from decreased factor VII (shortest half life)
is albumin commonly decreased in acute hepatits?
No - it has a long half life (20 days) so it is more commonly effected in chronic liver conditiosn
which coagulation factor has the shortest half life?
factor VII
which nerves are found within the prostatic fascia?
prostatic plexus which originates from the hypogastic plexus nd goes on to provide parasympethic innervation to the penis (needed for erection)
atropine MOA
competitively inhibits Ach Muscariinic receptor
what is the difference between tertiary and quaternary cholinesterase inhibitors?
ONLY tertiary cross the BBB
is physostigmine a tertiary or quaternary cholinesterase inhibitor?
Tertiary - can cross the BBB and thus treats CNS symptoms of muscarinic antagonists (atropine)
is neostigmine a tertiary or quaternary cholinesterase inhibitor?
quaternary -does not cross BBB
is edrophonium and pyridostigmine a tertiary or quaternary cholinesterase inhibitor?
quaternary -does not cross BBB
valproate MOA
blocks voltage gated Na channels leading to increased GABA release
which bone tumour has cells that express the RANKL?
giant cell tumour
which bone tumour has multinucleated giant cells?
giant cell tumour
which malignant bone cancer has anaplastic small blue cells that resemble lymphocytes?
ewing sarcoma
which genetic abnormality may be present with ewing sarcoma?
11:22 fusion protein
XRAY findings of osteosarcoma?
codmans triangle (elevated periosteum) and suburst pattern of soft tissue
where does chondrosarcoma occur?
in the MEDULLLA of pelvis, proximal femur/humerus
where are the osteosarcoma tumours found?
metaphysis of long bones (often knee)
where are giant cell tumours usually found?
the epiphysis of long bones
where is ewing sarcoma commonly found?
diaphysis
