Deck 10 Flashcards
What flu (A & B) prophylaxis can you give to at risk populations?
Neuramidase inhibitors: Oseltamavir, zanamivir. Prevent release of viral progeny from cells. Both A & B Tx and prophylaxis
What condition is type III collagen mutation?
Ehlers-Danlos. Joint hypermobility, skin fragility, berry aneurysms (spontaneous rupture) -> SAH
Muscles from what branchial arch are innervated by recurrent laryngeal?
6th. Cricothyroid is from 4th arch (superior laryngeal N)
What are the dumbbelss symptoms from increased acetylcholine?
Diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, lacrimation, sweating, salivation
Describe Job syndrome? What isn’t being made?
Hyper IgE syndrome: Failure of helper Th17 cells to make IFN-gamma -> impaired recruitment of neutrophils. Recurrent staph abscess, pruritic eczema, coarse facies, retained primary teeth, high serum eosinophils
Phenytoin (anti-seizure) blocks absorption of what nutrient?
Folate
What dz is caused by GAA repeat?
Friedrich ataxia
What inheritance/ chromosone is Wermers syndrome (MEN1)?
Autosomal dominant- chr 11
What enzyme is deficient in Lesch Nyhan? What does this do?
HGPRT; inactivates purine salvage pathway- guanine and hypoxanthine are lost in urine
Symptoms of Lesch Nyhan? What cell on CBC?
Yellow orange granules, self mutilation, dystonia; Hypersegmented neutrophils- since ^ are being lost, use B12 and folate for de novo purine synthesis
What structure runs on top of spermatocord?
Ilioinguinal nerve (from L1)
What does cyanide inhibit?
Last step in oxidative phosphorylation- modifies iron in cytochrome oxidase
Chediak-Higashi is inherited how? Failure of what?
Autosomal recessive- failure of phagolysosome formation (microtubule dysfunction impairing fusion). Recurrent staph and strep infections
What condition has CTG repeat?
Myotonic dystrophy
CGG repeat?
Fragile x
What dangerous compound is produced from sodium nitroprusside in malignant hypertension? What should you also give to prevent this?
Cyanide; Sodium thiosulfate
Aspirin toxicity?
hyperventilation, nausea, TINNITUS, sweating, abd pain, dizziness, cerebral edema, seizures, metabolic acidosis, respiratory alk….. Give sodium bicarb
What should you give in TCAD overdose?
Sodium bicarb- TCAD in neutral form so less likely to cause arrythmia or cardiac toxicity. Also increases extracellular H gradient attenuating TCA induced blockade of cardiac rapid Na channels
Side effects of acyclovir?
Neurotoxicity (confusion, tremor, delirium, seizures) and renal toxicity
What are positively charged amino acids found in histones?
Arginine and Lysine - FA pg. 92
What chromosone is the globin locus (thalassemia) found on?
Chr. 11
Tx for walking pneumonia?
Macrolides (bind 23s ribosomal RNA of 50s ribosome) or tetracyclines
What does a macrophage and T cell secrete to eachother to kill intracellular pathogens?
Mx secretes IL-12 for naïve t cell to differentiate into Th1. T cell secretes IFN-gamma to increase antigen presenting and lysosome production
Side effects of tuberculosis meds?
Isoniazid: B6 deficiency (parasthesias, ataxia, mental status). Ehtambutol: optic neuropathy (visual acuity, or color blindness). Rifampin: GI, CNS, dermatologic, hematologic (thrombocytopen, hemolytic anemia). Pyrazinamide: hepatotoxicity, gout
What is the rate limiting step of glycolysis? What inhibits this enzyme?
PFK- inhibited by citrate
What are the mediators in anaphylactic shock?
C3a & C51 bind to IgE causing histamine to release. C3a & C5a circulate and cause anaphylaxis
Protuberant abdomen, palmar erythema, gynecomastia make you think of what disease?
Liver disease
Hepatic encephalopathy results from build up of what?
Ammonia
What is the process for elimination of ammonia?
Transferred onto a-ketoglutarate forming glutamic acid. In all tissues except muscles, glutamic acid is turned to glutamine by adding another ammonia (glutamine synthetase)= non toxic carrier. Glutamine is turned to glutamate in liver + ammonia which enter urea cycle.
What causes defect in type 1 collagen? Characteristics?
Osteogenesis imperfecta= injuries from minor trauma, discolored teeth, osteopenia, blue sclera, short, progressive hearing loss
What is the deficiency with a-ketoacid dehydrogenase?
MSUD
What is the deficiency with Cystathione synthase?
Homocystinuria
What is the deficiency with Homogentisic acid oxidase?
Alkaptonuria
What is the deficiency with Phenylalanine hydroxylase?
PKU
In someone with manic-depression (type II), what mood stabilizer would you give/ what SE?
Lithium: side effect = nephrogenic diabetes (Doesn’t respond to ADH and can’t concentrate urine). Could also give valproate/ carbamazepine
Diagnosis of a kid with hypocalcemia and frequent viral/ fungal infections?
DiGeorge: failure of 3rd/4th pharyngeal pouch (absent PTH and thymus)
Symptoms of pellagra? What enzyme is deficient? What amino acid is precursor?
Dermatitis, Diarrhea, CNS Disturbances. Deficient in niacin. Tryptophan is precursor
Condition results in inability to reabsorb neutral amino acids?
Hartnup dz
What ratio is elevated in liver dz? What metabolic effects does this have?
NADH:NAD+ . Inhibits gluconeogenesis (Pyruvate is diverted to citrate, OA is diverted to malate) and fatty changes in liver
What meds can decrease effectiveness of ‘conazoles?
PPIs- decreasing stomach acid reduces absorption
What part of optic tract is damaged with someone who can’t recognize faces?
Damage to fusiform nucleus- inferior temporal lobe»_space; meyers loop
What nerve - pulls tympanic membrane medially?
CN V (tensor tympani) vs stapedius of CN VII
