Deck 4 Flashcards
Lung histology showing lymphocytic infiltrates, broncial thickening, enlargement of mucous glands and patchy squamous metaplasia of bronchial mucosa. What caused it?
chronic bronchitis, from too much smoking
Why does propofol have short action of duration?
It’s lipophilic and gets distributed to areas of high blood flow like brain, liver, kidneys. redistribution in other tissues accounts for short duration of action
What connects lateral ventricles with 3rd ventricle?
IV foramen of Monroe
What connects 3rd ventricle to 4th ventricle?
Cerebral aqueduct
Where are foramina of lushka and magendie?
after 4th ventricle
What is a drug cause of respiratory acidosis?
Heroin - hypoventillation
What are the stop codons?
UAA UAG UGA –> stimulate releasing factor proteins to release polypeptide from ribosome and dissolution of ribosome-mRNA complex
What are physiological changes in someone with Hypertrophic cardiomyopathy?
Reduced LV size
Enlarged Septum, asymmetric LV wall thickness
Enlarged L atrium
Normal/increased EF
Poorly developed coronary capillary network
What are effects of PTH on bone, calicum, phosphate, and vit D?
Bone- increases resorption
increases calcium reabsrption from urine
Decreases phosphate reabsorption
Increases vit D, which increases GI absorption of Calcium and phosphate
What drug do you use to Tx hypertensive emergency? MOA?
Fenoldopam, dopamine 1 receptor agonist
Vasodilates arteries, esp renal arteries**
Very good to give in ppl with AKI
What does ingesting rat poison do? What is Tx?
Depletes vit K clotting factors, similar to wafarin toxicity. Risk of GI bleeds
Tx FFP
What does bladder scan show in people with diabetic autonomic neuropathy?
Increased post-void residual volume, overflow incontinence
Child with abdo pain, arthralgia, and purpuric rash. What is it?
HSP - IgA and C3 deposits, small vessel vasculitis, related to recent infection
Child with hemolytic anemia, thrombocytopenia, and bloody diarrhea. What is it?
HUS - E Coli O:157
What is the most common benign lung lesion?
Hamartoma “coin lesion” on x-ray
What is seen in lung hamartomas on biopsy?
Hyaline cartilage**, fat, smooth muscle cells
Which drugs increase systolic and diastolic BP and lower HR?
Alpha-1 adrenergic agonists (phenylephrine, methoxamine)
Vasoconstriction of blood vessels, stimulation of baroreceptors and increase in vagal tone as reflex
What type of cancer does PCOS put you at risk for?
Endometrial carcinoma (lack of progesterone, which has growth inhibitory effects on endometrium)
What medication inhibits testosterone synthesis?
Ketoconazole
What medications inhibit peripheral conversion of testosterone to DHT?
5-alpha reductase (finasteride)
What medications block androgen receptor binding?
Flutamide, cyproterone, spironolactone
MOA flutamide?
Competitive testosterone receptor inhibitor
What med is given along with flutamide?
GnRH agonists like leuprolide (have paradoxical effect on Leydig cells with long term use)
What are syptoms of neonatal addiction to opoids?
Sweating, sneezing, pupillary dilation, tachypnea, jittery baby, irritability, tremors, irritability, poor feeding
What do HPV 6, 11 cause?
genital warts
What do HPV 16, 18, 31 cause?
Anal, cervical, vaginal, vulvular carcinoma
What does HPV 1-4 cause?
Skin warts
Where does lateral vs medial foot drain in lymphatics?
Medial –> follow great saphenous vein and drains directly to inguinal nodes
Lateral –> drains to popliteal AND inguinal nodes
Which HIV drug doesn’t require intracellular activation by kinases?
Foscarnet
Binds and inhibits DNA polymerase
What type of hypersensitivity reaction is PSGN?
type III (immune complexes of antigens and IgG)
What do you give men with prostate ca being treated for gynecomastia?
Tamoxifen (SERM)
MOA dexamethasone in lung maturation?
Increases DPPC (lecthin) and surfactant, decreases surface tension, increases type II pneumocyte production
What is PNH?
Complement mediated hemolysis, absence of CD55
What are symptoms of PNH?
Nocturnal hemoglobinuria Hemolytic anemia (elevated bili and LDH) thrombocytopenia pancytopenia Hemosiderosis (Iron deposition in kidney)*** -->CKD
Difference between schizophrenia, schizoaffective, and schizophreniform disorder?
Schizophrenia –> delusions and hallucinations > 6 months
Schizophreniform –> delusions and hallucinations 1-6 months
Schizoaffective –> delucions and hallucinations >2 weeks without any mania or depression + prominent mood disorder
Where does femoral herniation occur?
Medial to femoral artery and vein. Goes beneath the inguinal ligament
What are borders of Hesselbach triangle?
Inferior epigastric arteries, inguinal ligament, and rectus sheath
Where do direct hernias occur?
Medial to inferior epigastric arteries
In Hesselbach’s triangle
Where do indirect hernias occur?
Lateral to inferior epigastric arteries
Through deep inguinal ring
What does hydatitiform mole show on immunochemistry staining?
p57-negative (absence of maternal genome)
p57-positive in partial moles (XXX or XXY, containing maternal and paternal DNA)
How do you calculate the Odds Ratio?
(a/b)/(c/d)
odds in exposed group/ odds in unexposed group
When do you use ANOVA?
When comparing multiple means in different groups
What is risk associated with familial chylomicronemia syndrome?
Acute pancreatitis & lipemia retinalis from hypertrycliceridiemia
- This occurs due to complete lack of LPL and inability to clear chylomicrons
What condition is associated with xanthelasmas?
Familial hypercholesterolemia
What happens to vascular resistance and MAP during exercise?
Decrease in both systemic vascular resistance and MAP due to arteriolar vasodilation
What happens to systolic BP during exercise?
Increase
What should vastectomy patients be advised of after surgery?
Viable sperm for 3 months or 20 ejaculations after procedure
What is countertransferene (psych)
Unconcious beliefs and attitudes from past experiences that influence medical judgment
SE of amytriptyline?
Anticholinergic effects
Hypotension, urinary retention, constipation, confusion
What is the course of the median nerve?
At elbow - medial side of anticubital fossa, between humerus and ulna under pronator teres
In forearm - between flexor digitorum superficialis and flexor digitorum profundus
What does obturator nerve supply?
Thigh adductors (adductor longus, brevis, and magnus) and medial sensation to thigh
What medication can precipitate opiod withdrawal in people who are opiod tolerant that have chronic pain?
Bupenorphrine - partial opiod agonist that binds with HIGH AFFINITY but has LOW POTENCY - someone who is addicted to opiods will definitely have withdrawal symptoms
What antiarrhythmics are used to treat ischemia-indcued ventricular arrhythmias?
Class IB- Lidocaine. They bind NOACTIVE Na+ channels
What does prolactinoma put you at risk of?
Osteoporosis
Prolactin inhibits GnRH and suppresses estrogen levels
What are causes of secondary hyperaldosteronism? (High ALD and renin)
JC cell tumor (renin secreting tumor), malignant HTN, RAS, diuretic use
What is Capitation?
Insurance plan where there is a fixed fee to cover all medical expenses
What is Cilostazol used for?
Peripheral artery disease. Inhibits platelet aggregation and vasodilates arteries. Phosphodiestrase inihbitor
What do opiods do to electrolytes?
Presynaptic neuron: inhibit Ca2+ influx
Postsynaptic neuron: inhibit K+ efflux
What are recommended meds for generalized seizures?
Valproic acid, levatiracetam, topiramate, lamotrigine
What are recommended meds for focal seizures?
Carbamazepine, gabapentin, phenytoin, pheobarbital
What med treats both absence and tonic clonic seizures?
valproic acid
What med should you give to prevent people at risk for colorectal carcinoma?
Aspirin (inhibits COX-2)
Where does RCC usually metastasize? What do you see on histology?
Lungs. Abundant clear cytoplasm
What peptidase inhibitor stops trypsin from being activated?
SPINK-1
Stops trypsin from digesting pancreas
Hereditary pancreatitis if deficient
What area of throat gets infected with HPV and why?
True vocal cords- contains stratified squamous epithelium
HPV 6, 11
What is the region of highest osmoalrity in kidney?
Medulla
Where is action of ADH greatest?
Medullary portion of collecting duct (absorbs water and urea)
