Deck 6 Flashcards
What heart complication does the rubicin chemo agents cause? Tx?
Dilated cardiomyopathy; swelling of sarcoplasmic reticulum is first sign then myocyte loss; prevent with dexrazoxane (iron chelating agent that prevents free radicals)
Which cytokine mediates formation of pus?
IL-8: Mx and endothelial cells secrete to recruit neutrophils to site of infection & induces phagocytosis
What Tx for drug (antipsychotic) induced parkinsonism?
Centrally acting antimuscarinic (trihexyphenidyl, benztropine)
What are examples of multifactorial inheritence?
Spina bifida, cleft lip and palate, DM, CAD, HTN
What are most common non-cardiac causes of pulsus paradoxis?
Asthma & COPD- incr intrathoracic pressure transmitted to extrathoracic structures and leads to excessive drop in blood pressure with inspiration
How is hereditary PAH transmitted?
Autosomal dom - BMPR2 mutation: dysfunctional endothelium and smooth muscle proliferation
How can you distinguish MAC from tuberculosis? What prophylaxis Tx in HIV?
MAC = anemia, hepatoSPM, elevated alk phos/ lactate dehydrogenase, grows better at 41 C; give azithromycin for prophylaxis in HIV
What causes decrease in systolic pressure in pulsus paradoxis?
Inspiration: incr venous return expands into restricted LV and decreases EDV and SV
What is the cause of Turner XO?
Paternal meiotic nondisjunction (loss of parental X chromosone in sperm)
What causes diastolic HF? What are diagnostic findings?
Decr ventricular compliance from impaired relaxation (ischemia, HCM) or incr stiffness (amyloid, HCM); Incr end-diastolic pressure, NORMAL end-diastolic volume and LV ejection fraction
Vascular lesion w IgA and C3 deposition, rash on legs, abd pain, arthralgias…?
Henoch-Schonlein Purpura
What incr risk of squamous cell of esophagus?
Smoking, alcohol, achalasia
Describe Friedrich Ataxia- inheritance? Symptoms? Population?
Aut recessive- kids 5-15; difficulty walking (ataxia), HCM, kyphoscoliosis, foot abnormalities, DM
What causes S-100 immunoreactivity?
Neural crest origin: Schwannoma (schwann cells), melanoma
Histo of schwannoma?
Biphasic pattern with areas of dense elongated cells with oval nuclei (Antoni A) + less dense myxoid region (Antoni B);
What nerve is not affected in schwannoma? Most common site?
All but CN II (Oligo covered); most common = cerebropontine angle @ CN VIII -> bilateral acoustic neuroma
How does body compensate for incr fluid in HF?
Shunted to lymph system; when overwhelmed -> edema
What happens in lesion of dominant parietal lobe (Gertsmann syndrome)?
Agraphia (can’t write), acalculia, left-right disorientation, inability to identify fingers on hand
What happens in lesion of Lateral medulla?
Wallenburg (PICA): loss of pain/ temp of ipsi face/ contra body, ipsi bulbar weakness (nucleus ambiguus), vertigo (vestib nuclei), ipsi limb ataxia (inf cerebellar peduncle), Horners
What happens in lesion of Medial medulla?
(anterior spinal artery) = contra hemiparesis (lat corticospinal), contra hemisens loss (lat dorsal column medial lemniscus), ipsi tongue paralysis (XII nucleus)
What exacerbates HCM? What meds should you avoid/ give?
Worsens with decr LV volume (decr preload or SVR) because outflow obstruction; avoid vasodilators & diuretics; Tx: negative inotropics (reduce LVOT obstruction) = BBs, nondihydropyrodine CCBs (verap, dilt)
What would cause resistance to anti-EGFR therapy
KRAS mutation (proto-oncogene that encodes transducer) Qid: 12049
Difference between LGN & MGN?
MmmmmmGN: auditory & LoookGN is visual (in thalamus- recieves optic tract)
Where do dihydropyridine CCBs act?
Arterial smooth muscle- little cardiac activity = safe in arrythmias (vs. verap/ dilt)…. Can cause reflex tachy
Which LE lymph tract bypasses popliteal nodes to inguinal?
Medial
What happens in Wolf-Parkinson-White? EKG changes?
AV accessory pathway (random palpitations)- Short PR, Widened QRS, delta wave (slurred, broad upstroke of QRS)
Back up Tx for CMV? Complications?
Foscarnet: pyrophosphate analog; can cause hypocalcemia (can chelate Ca) and hypomagnesia
What causes scarlet fever? Symptoms?
GAS; fever, malaise, abd pain, sore throat, red strawberry tongue… then blotchy rash, “sandpaper like rash” (sunburn with goose pimples)
What damage causes hemiballismus?
Subthalamic nucleus (commonly lacunar stroke)
Winters formula? Tells you what?
Tells you if appropriate CO2 compensation = (1.5 x HCO3) + 8 +- 2
What is prinzmetal angina? Possible triggers?
Transient attack of coronary vasospasms; Triggers = cig smoke, cocaine/ amphetamines, ergot alkaloids
What is CREST syndrome?
Systemic sclerosis from collagen: Calcinosis, Raynouds, Esophageal dysmotility, Sclerodactyly (skin thickening/ tightening over fingers), Telangiectasias
What catalyzes first step in B-oxidation and is most common deficient enzyme?
Acyl Coa synthase
Which pneumocytes act as progenitor/ stem cells?
Type II
What serological testing is positive in celiacs?
Elevated IgA, anti-endomysial, anti-TTG antibodies
What muscles are most commonly affected in myasthenia gravis?
Extraocular, bulbar (chewing, dysphagia)
Cause and presentation of polymyositis?
CD8 lymph mediated damage to muscles; symmetric proximal muscle weakness
What often accompanies lambert eaton? What is cause?
Often involves small cell lung cancer; autoantibodies against presynaptic Ca channel; proximal weakness that improves with use
What is cause/ symptoms of lymphogranuloma venereum?
Chlamydia serotypes L1-L3; initially painless small ulcer followed by swollen painful coalescing lymph nodes (buboes), intracytoplasmic inclusion bodies
What ligament is injured in valgus stress injury?
MCL
