Deck 5 Flashcards
Most effective Tx for a specific phobia?
Behavioral therapy (1st line) benzos second line
What class of drug is rivaroxaban and apixaban?
Factor Xa inhibitors
What are direct throjmbin inhibitors?
Argatroban, bivalirudin, dabigatran
What path is inhibited when PT is prolonged?
Extrinsic path
What path is inhibited with aPTT is prolonged?
Intrinsic path
Which medications prolong PT and aPTT but not TT?
Direct Factor Xa inhibitors - Rivaroxaban and apixaban
What does unfractioned heparin do to aPTT, TT, and PT?
Prolonges aPTT and TT because it inactivates Xa and thrombin. PT will remain unchanged
What do beta blockers to do heart on ECG?
prolong PR interval, slow AV node conduction
WHat does it mean if there is a large Arteriovenous concentration gradient of an anesthetic drug?
High tissue solubility and slow onset of action
Complications of prolactinoma?
Lack of estrogen –> osteoporosis and symptoms of menopause
What do nitrates do to heart?
Decrease preload (left ventricular end diastolic volume) via venodilation
Baby with pulm hypoplasia, flat facies, and limb deformities. What is cause?
Potter sequence–> renal agenesis
What medication can treat bipolar + seizures?
Valproate. Inhibits sodium gataed GABA channels
Pathogenesis of lung abscess formation?
neutrophils release cytotoxic granules–> lysosomes
Cause liquefying necrosis in lung
What is Hereditary Pulmonary HTN caused by? What gene?
Smooth muscle proliferation causing arteriolar hyalinization
BMPR2
Loud S2 on auscultation
What nerve is damaged if a person has weakness of shoulder abduction + loss of sensation on upper shoulder?
Axillary nerve- deltoid muscle
Patient with impaired plantarflexion, toe flexion, foot inversion, and loss of sensation on sole of foot. What nerve was injured?
Tibial nerve
Runs through popliteal fossa, deep injuries or surgery can injure it
What converts 7-dehydrocholicalciferol to cholicalciferol?
Sunlight UVB
Why do COPD patients stop breathing when administered high flow O2?
Carotid and aortic bodies are most sensitive to pO2 and will turn off if these are too high. Reduction in peripheral chemoreceptor stimulation
What is high in Trisomy 21 for quad test?
Inhibin A and B-hCG
If QT interval is prolonged, which ion channel affected?
K+ efflux is decreased, leading to longer QT interval and possible ventricular arrhythmias or tosades de pointes
What are antibodies against in pemphigus vulgaris vs bullous pemphigoid?
PV - desmosomes
BP - hemidesmosomes
Where are parietal cells found in stomach? What will be seen in pernicous anemia?
Upper glandular layer
Gastric atrophy in fundus and body of stomach
What is the most common cause of COPD exacerbation?
H. influenzae and rhinovirus
What muscle is responsible for humerus extension, adduction, and internal rotation?
Lat dorsi
What is the latissmus dorsi innervated by?
Thoracodorsal nerve C6-C8
What’s the hawthorne effect?
Subjects change their behavior as a result of knowing they are being studied
Patient with normal 46, XX but shows signs of Turner syndrome. What happened?
Somatic moaicism –> two genetically different cell lines in body
MOA spironolactone causing gynecomastia?
Anti-androgenic effects- blocks androgen receptor and causes decreased testosterone production
What activates medullary cells (chromaffin cells) in adrenal gland to produce Epinephrine and Norepinephrine?
Ach
Where is fistula during gallstone ileus?
Between gallbladder and ileum
WHat is gallbladder ileus?
A stone from gallbladder starts to obstruct the biliary tree and gets lodged in ileum, creating symptoms of SBO
What will you see on CT scan if there is gallstone ileus?
Air in biliary tree***
What is the “new normal” BMI?
18.5
LOL
MOA sumpatriptan in aborting migranes?
Stimulate serotonin 5-HT1B/1D agonists pre and post synaptically to inhibit release of CGRP and inhibit vasodilation
CGRP = calcitonin gene related peptide and substance P
What are PTH, phosphorus, and calcium levels like in osteoporosis?
Normal
When does acute rejection of graft occur?
<6 months
May be humoral or cell-mediated
What happens to clavicle fragments when fractured?
Medial portion is pulled superiorly and posteriorly by SCM. Lateral portion is pulled inferior and anterior by pectoralis major
What is structural heart change when AS occurs?
Increased LV end diastolic pressure
How does Wolf-parkinson-white usually present?
AV reentrant tachycardia
WHat does WPW do to ECG?
Shortens PR interval and widens QRS (delta wave)
Tx anorexia nervosa?
CBT and nutritional rehab
Olanzapine if no response
Tx bullemia nervosa?
SSRI, CBT, nutritional rehab
What is MOA of repaglinide and nateglinide?
(Meglitinides) Increases insulin secretion by inhibiting Beta-cell K+-ATP channels
SHort acting, used for post-parandial glucose spikes
What nerve supplies sensory innervation to perineum and external genitalia?
Pudendal nerve
What nerve supplies the rectum?
Inferior rectal, branch of pudendal. Below dentate line
What is precursor skin lesions to SCC?
Actinic keratosis (looks like whispy white patches on people’s skin)
When does glucose start being excreted in urine?
Above 200mg/dL. This happens because transport maximum of glucose is reached
What type of cells are in ovary?
Simple cuboidal epithelial cells
What type of cells are fallopian tube, uterus, cervix, and vagina?
Fallopian and uterus are simple columnar
Cervix – ectocervix is stratified squamous non-keratinized
Vagina is stratfied squamous non-keratinized
As you go down: Cuboidal —> columnar–> stratified squamous
