Deck 10 Flashcards
What environmental exposure is associated with tuberculosis?
Silicosis: impairs macrophage effector arm
What causes TCAD overdose cardiac symptoms? Tx? What receptors are affected?
Blockage of cardiac fast channel Na channels; Tx = sodium bicarb; other receptors = muscarinic, histamine, alpha-1
Tx for status epilepticus?
- IV lorazepam (increased GABA activation) - rapid onset 2. the phenytoin (block Na channels) as long lasting - prevention
COX-2 is an inducible enzyme that is stimulated by what?
IL-1, TNF-a by infiltrating cells
What med should be given for pain in patients with reflux or ulcer disease?
COX-2 selective inhibitors (celecoxib) - COX1 has “housekeeping” roles like gastric mucosal protection
How are CD8 Tcells activated?
IFN-gamma & IL-2 by Th1
Pneumonia with diarrhea, high fever… what do you think of?
Legionnaires disease
What causes straw colored urine discharge to come from umbilical cord?
Patent urachus (from the allantois)
What causes tender umbilical cord with erythema and purulent discharge?
Urachal sinus (failure of distal urachus - from allantois - to close)
Morphology of hep E?
Unenveloped ssRNA
What are risk factors for infant vitamin K deficiency? What are symptoms?
Born with low stores > parental refusal of vit K prophylaxis, exclusive breastfeeding, cystic fibrosis; BLEEDING (intracranial, GI, cutaneous, umbilical, surgical site)
Chest pain radiating to neck or shoulders, worse with inspiration, helps to lean forward?
Pericarditis
In what condition do you see serositis (Pleurisy, pericarditis, peritonitis)?
SLE
Describe histo of reticulocytes?
Slightly larger and bluer (Wright Giemsa stain) because lacks nucleus, but retains basophilic reticular network of ribosomal rRNA
MOA of colchicine?
inhibiting microtubular polymerization: disrupts chemotaxis, phagocytosis, degranulation
Immune deficiency, large granules in phagocytes?
Chediak Higashi: failure of phagosome lysosome fusion in neutrophil (also albinism & neuro defects)
Why should you not take nitrates at night?
Avoid tolerance development- need a nitrate free interval
What organs can utilize ketones? Which can’t?
Brain, kidneys, cardiac/ skeletal muscle; NOT in erythrocytes (no mitochondria) & liver (lacks thiophorase)
What signals are activated in autoimmune MS response?
Helper T cells react to antigens in myelin (oligo) and release IFN-gamma and other cytokines to promote macrophages/microglia and leukocytes
How to differentiate schizoaffective vs major depressive with psychotic?
In MDwP there will be mood symptoms- but can still have hallucinations and delusions
What is an irreversible alpha agonist? Uses?
Phenoxybenzamine- used in treatment of pheo
What does the exfoliatin exotoxin do? How?
Scalded skin syndrome: blisters only in superficial epidermis; act as proteases to cleave desmoglein in desmosones
What is rasburicase used for?
Tumor lysis syndrome: converts uric acid to soluble metabolites
A person with gout undergoing chemo…?
Tumor lysis syndrome- large number of cells are destroyed and release K, P, and nucleic acids»_space; uric acid accumulation in kidneys; give allopurinol or rasburicase
What is major basic protein?
Released from eosinophils; a potent anti-helminthic toxin
What do you give in treatment resistant schizophrenia?
Clozapine
Hypercoagulable state that’s resistant to protein C?
Factor V mutation (leiden); factor Va is usually inactivated by protein C
What causes pigment stones?
Ca salts of unconjug bilirubin from bacterial/helminth infection of biliary tree (releases beta-glucuronidase) or extravascular hemolysis
What occurs in vit D deficiency from Crohns?
Decreased Ca (and P) absorption»_space; rickets or osteomalacia (adults); PTH will be up
Consequences of syringomyelia?
Loss of upper extremity pain/ temp, weakness, hyporeflexia; LE loss of weakness, pain/temp, hyperreflexia; kyphosis
What is mutated in AR polycystic kidney disease?
fibrocystin (PKHD1 gene): found in epithelial cells of renal tubules and bile ducts»_space; dilation of these structures
What would you expect with fetus with autosomal recessive PKD?
oligoghydramnios symptoms- flattened face, limb deformities, pulm hypoplasia
What can long term RA do to cervical spine?
joint destruction with vertebral malalignment (subluxation)
What is / is not found in terminal bronchioles?
Yes = ciliated cuboidal cells, Club cells; No = goblet cells, submucosal mucous lands, & macrophages clear debri from alveoli
What can cause isolated systolic hypertension?
Increased arterial stiffness, incr CO from from aortic regurg or systemic causes (hyperthyroid or anemia)
Language regression, anemia, impoverished kid…?
Lead poisoning (RBC’s show basophilic stippling, microcytic anemia)
What enzyme is deficient with photosensitivity, tea colored urine (w high uroporphyrinogen levels)?
Uroporphyrinogen decarboxylase (porphyria cutanea tarda)
What enzyme is deficient with acute painful abd, neuropsych, red brown urine?
Porphobilinogen deaminase (acute intermittent porphyria)
What heme synth enzymes are inhibited by lead poisoning?
d-ALA & Ferrochelatase
What makes you think conduct disorder vs oppositional defiant disorder?
More aggression and cruelty towards humans, animals, destruction of property, stealing etc.; antisocial is diagnosed after 18 y/o
