Deck 3 Flashcards
What are the ANCA positive vasculitides?
Microscopic polyangitis, GAP (wegeners), Churg-Strauss
What happens when taking epinephrine after Phentolamine?
Phent = reversible a antagonist so epi only stimulates B receptors –> decreased blood pressure
Signs of Kawasaki’s and possible complications?
Conjunctival erythema, high fever, oral blisters (strawberry tongue), edema of hands and feet, desquamative rash, enlarged cervical lymph nodes. Ages < 4 years. Acute necrotizing vasculitis of small/ medium vessels. Complication = HEART (changes in coronary arteries- coronary aneurysms with MI)
Dresslers syndrome?
Fibrinous pericarditis post MI. friction rub and chest pain- “DRESS in your FIBER PETTYCOAT”
Amiodarone is used in Vfib. What are side effects?
Pulmonary fibrosis, hypotension, thyroid, hepatotoxicity, occular changes, other arrythmias
Lesions of right side of heart? Aorta?
Right- carcinoid? Aorta- syphilis, endocarditis?
What heart medication causes blurry or yellow vision? Don’t take with what else?
Digoxin. Don’t take with loop diuretics (cause severe hypokalemia)
What happens with Wolff parkinson white? Characteristics of ECG?
Accessory path that goes to ventricles and bipasses AV node leading to AVRT. ECG = delta wave, short PR, long QRS
How do you accentuate mitral valve prolapse?
Decrease LV return (Valsava, standing). Mid systolic click with crescendo-decrescendo murmor …………. Seen in Marfans!
Mnemonic for causes of dilated cardiomyopathy?
ABCCCD: alcohol, Beri beri, Cocksackie, cocaine, Chagas dz, doxorubicin
Symptoms of Hodgkins lymphoma
Asymptomatic lymphadenopathy, fever, night sweats, fatigue, pruritus, unintentional weightloss (B symptoms). More common in young men. Reed sternberg cell
ABVD regimen for Hodgkins lymphoma
Adriamycin, Bleomycin, Vinblastine, Dacarbazine
What medication combined with statins worsens myopathy?
Fibrates- use ezetimide instead
Histology associated with RF?
Aschoff bodies= lymphocytes, plasma cells, activated macrophages called Anitschkow cells
Blood pressure medications indicated for pregnancy?
HCTZ, Bblockers, methyldopa, CCB’s, hydralazine. No ACEI’s or ARB’s!!!
Patent ductus arteriosus is associated with what maternal infection?
Rubella
Classic pentad of thrombotic thrombocytopenic purpura?
fever, thrombocytopenia, microangiopathic hemolysis, neurologic symptoms, renal insufficiency
What can be taken with methotrexate to reduce myelosuppression?
Leucovorin (folinic acid)- derivative of THF
Mnemonic for meds that cause hemolytic anemia in G6PD?
PAINS: Primaquine, Aspirin, Ibuprofen, Nitrofurantoin, Sulfonamides
What is mechanism of TMP-SMX?
Blocks nucleotide synthesis by dihydropteroate synthetase
EBV is associated with what lymphomas?
Hodgkins, Burkitts
Vit B12 is coenzyme for what enzymes?
Methymalonyl CoA mutase (converts methylmalonic acid to succinyl-CoA) and methyltransferase (formation of methionine from homocysteine)
What condition causes smudge cells, or fragile lymphocytes that break in slide preparation?
Chronic lymphocytic leukemia - low grade malignancy of B cells in old people. Can cause autoimmune hemolytic anemia, and hypogammaglobulinemia leading to infections.
ToRCHes organisms that cross the placenta?
Toxoplasmosis, Rubella, CMV, Herpesvirus/ HIV, Syphilis
What does protamine reverse the effects of?
heparin
What about N-acetylcysteine?
Tylenol toxicity
What about methylene blue?
Methemoglobinemia
Tx for lead poisoning?
Dimercaprol and EDTA, or Succimer in kids
What could be complication of large blood transfusion?
Hypocalcemia- blood has citrate to prevent clotting which can cause metabolic alkalosis and bind free Ca. Look for cramping, tingling around mouth, and Chvostek sign (tapping in front of ear)
Symptoms of tuberous sclerosis?
Triad: seizures, intellectual disablity, facial angiofibromas (papules on face). Half will have rhabdomyoma
Which blood malignancy has mediastinal mass?
Lymphoblastic lymphoma
Whats mutated in factor V leiden?
mutation - arginine -> glutamine substitution in factor V makes it resistant to cleavage by protein C. most common inherited cause of hypercoaguability
MOA of doxorubicin?
Generates free radicals and noncovalently intercalates DNA. Can cause dilated cardiomyopathy
What is Wiskott-Aldrich syndrome?
Thrombocytopenia, recurrent infections, eczema. X linked recessive
Roleaux formation?
Stacked RBCs seen in multiple myeloma
M spike on urine electrophoresis is indicative of what?
Multiple myeloma
Gilbert syndrome symptoms?
Decreased expression of uridine glucoronyl transferase that is generally asymptomatic but causes jaundice in times of stress. Higher indirect (unconjugated) bilirubin. Compare to Crigler-Najjar
Deficiency of hexosaminidase A?
Tay Sachs
Deficiency of B-glucocerebrosidase
Gaucher. Also femur is erlenmeyer flask
What drug do you not take with digoxin?
Quinidine- decreases digoxin clearance and displaces it from tissue binding sites
