Fast Facts Flashcards
1
Q
Brain structure responsible for extraocular movements during REM?
A
PPRF, paramedian pontine reticular formation
2
Q
Name teratogens
A
ACE inhibitors (renal) Valproate (neural tube) Phenytoin (cleft palate, heart defects) Lithium (Ebstein anamoly) Tetracycline (discolored teeth) Warfarin (hemorrhage, abortion -- use heparin!) Excessive Vitamin A (abortion)
3
Q
Which parts of the hypothalamus regulates ANS?
A
anterior = para posterior = symp
4
Q
Bells Palsy vs. Stroke
A
Bells involves the forehead
5
Q
Muscles of mastication
A
Masseter, temporalis, medial and lateral pterygoid
6
Q
Horner Syndrome symptoms
A
Ptosis, miosis, and anhidrosis
7
Q
Thyroglossal duct cyst presentation
A
- midline neck mass
- asymptomatic
- ## moves with swallowing
8
Q
Elevated ESR associated with…
A
infection, inflammation, neoplasm, RA, temporal artertits, osteomyolitis, polymyalgia rheumatica
9
Q
Tiotropium used for
A
COPD (inhaled anticholinergic)
10
Q
Competitive vs noncompetitive inhibitor
A
Competitive: binds active site, can be diluted out
Noncompetitive: binds elsewhere, renders inactive, irreversible
11
Q
Km =?
A
[S] at 1/2 Vmax
related to affinity, not quantity
12
Q
How can you increase Vmax?
A
By increasing the number of enzymes
13
Q
Therapeutic Index = ?
A
LD50/ED50
higher is safer
low TI = seizure drugs, lithium, digoxin, warfirin
14
Q
Vd = ?
A
D/C
iv drug/concentration of drug in plasma
15
Q
CL = ?
A
rate of elimination/plasma concentration = (0.7)Vd/half life = K*Vd
16
Q
LD = ?
A
Css * Vd
17
Q
MD = ?
A
Css * CL
18
Q
Half-life %
A
1 = 50% 2 = 75% 3 = 87.5% 4 = 94%
19
Q
Efficacy = ?
A
max effect a drug can produce
20
Q
Potency = ?
A
amount of drug required to produce an effect of a given intensity
21
Q
Partial agonists impact on efficacy and potency?
A
Decreases efficacy (Vmax) Potency is independent
22
Q
Agonist + noncompetitive antagonist impact on Vmax
A
Decreases Vmax
23
Q
Agonist + competative antagonist impact on potency
A
Decreases potency (increases Km)
24
Q
Layers of the epidermis
A
stratum… corneum, lucidum, granulosaum, spinosum, and basalis
25
4 molds that are considered dermatophytes?
trichophytin, microsporum, epidermophytin, malasezia furfur
26
boot-shaped heart
right ventricular hypertrophy
27
continuous machine-like murmur
patent ductus areteriosis
28
tendon xanthomas
familial hypercholesterolimia
29
cafe-au-lait spots
neurofibromatosis type 1
30
tuft of hair on lower back
spina bifida occulta
31
Found in SW U.S. - fungus
coccidioides immitis
32
Found in Mississippi and Ohio River basins - fungus
histoplasma capsulatum
33
San Joaquin Valley Fever
coccioides immitis
34
Rural Latin America - fungus
paracoccidioides brasiliensis
35
Plant thorns - fungus
sporothrix schenckii
36
Found east of Mississippi River - fungus
blastomyces dermatitidis
37
bird and bat droppings
histoplasma capsulatum
38
mold form contains barrel-shaped arthroconidia and associated with dust storms
coccidioides immitis
39
broad-based budding of yeast
blastomyces dermatitidis
40
Multiplebuddings of yeast form - captain's wheel
paracoccidioides brasiliensis
41
causes diaper rash
candida
42
45 degree branching, septate hyphae, opportunistic mold
aspergillis fumigatus
43
irregular, nonseptate hyphae, wide angle branching
mucor or rhizor
44
Know for causing pneumonia in AIDS patients
pneumocystis jirovecii
45
Cause of meningitis in AIDS patients
cryptococcus neoformans
46
Infections associated with birds
Chlamydophila psittaci, histoplasma capsulatum, cryptococcus neoformans, H5N1 influenca virus, west nile virus
47
prophylaxis for cryptococcus in AIDS pts?
fluconazole
48
PCP prophylaxis in AIDS patients
trimethoprim-sulfa
49
sporothrix schenckii treatment
oral potassium iodide and itraconazole
50
oral candidiasis treatment
nystatin and fluconazole
51
systemic candidiasis treatment
amphotericin B
52
criteria for major depressive disorder
2 or more weeks of anhedonia and/or depressed mood plus 5/9 of the following:
Sleep disturbance, Interest decreased, Guilt, Energy decreased, Concentration problems, Appetite changes, Psychomotor retardation, and Suicidal ideation
53
clinical presentation suggestive of lymphoma
- painless lymphadenopathy
| - B symptoms: wt loss, night sweats, fever
54
What histological changes occur in a smoker's trachea
columnar to squamous metaplasia
55
Most common leukemia in children
ALL
56
Most common leukemia in adults in the US
CLL
57
characteristic auer rods in leukemia
AML
58
more than 20% blasts in the marrow (leukemia)
ALL or AML
59
Less than 5% blasts and more mature cells (leukemia)
CLL or CML
60
PAS (+) acute leukemia
ALL
61
Always positive for the Philadelphia chromosome (t 9;22)
CML
62
Acute leukemia positive for peroxidase
AML
63
Solid sheets of lymphoblasts in the marrow
ALL
64
Always associated with BCR-ABL genes
CML
65
Atypical depression
hypersomnia, hyperphagia, mood reactivity, and hypersensitiveity to depression
(Treat with SSRIs)
66
Dysthymia
milder depression >2 years
67
Buproprion
atypical, inhibits NE and D2 reuptake
works well with 5H-T
lowers seizure threshold, stimulant, no sexual side effects
used for smoking cessation
68
Mirtazipine
atypical antidepressant, alpha 2 antagonist
increases NE release and 5H-T (like SNRI)
SE = antihistamine effects (dry mouth, sedation, weight gain)
69
Trazadone
used for insomnia and depression
inhibits 5H-T reuptake
can be added to SSRI or SNRI
SE = priapism ("trazaBONE") and sedation
70
smoker, heavy drinker, new cough and flu-like symptoms, gram stain shows no organisms, but silver stain of sputum shows GNR. DX?
Legionella pneumophila (Legionnaire's dz)
71
temporal arteritis -- symptoms and lab for dx?
unilateral headache, jaw claudication, blindness/impaired vision
lab = increased sed rate or temporal artery biopsy
72
30 yo woman presents with low grade fever and a rash that worsen with sun exposure, and widespread edema. Dx and labs?
Lupus
| ANA
73
SSRIs
inhibit 5-HT reuptake (longer in synapse)
depression, anxiety, bulimia, OCD, PTSD
take 1 month to start working
fluoxetine, cirtriline, etc.
SE = sexual dysfunction, serotonin syndrome (avoid SSRI, SNRI, MAOIs, Kava kava, St. John's Wort, Tryptophan, cocaine, amphetamines) [hyperthermia, hyperclonus, HTN, THR, flushing, diarrhea, anxiety, delirium] -- mental status, ANS instability, and neuromuscular abnormalities --> treat with cooling and benzos
74
SNRIs
Inhibit 5H-T and NE reuptake
venlofaxaine, duloxitine (- diabetic neuropathy and fibromyalgia)
depression and anxiety
SE = increase in BP, nausea, sedation
75
TCAs
blocks reuptake of NE and 5HT
"-triptylines," "-ipramines," and "-doxapin"
alpha blocking sx, anticholinergic symptoms
SE = sedation, hypotension, dizzy, (hot as a hare, dry as a bone,) lower seizure threshold
overdose= convusions, coma, cardiotox, resp depression, hyperpyrexia, confusion, hallucination (RX with sodium bicarb for urinary excretion.)
76
MAOIs
hinders enzyme that breaks down dopamine and NE
phenylziene, isocarboxazid, tranylcypromine, selegine (Parkinsons)
SE= hypertensive crisis (with tyramine ingestion from foods --increase in BP -> hemorrhage, arrhythmia, stroke,) tachy, arrythmia, serotonin synd. (CV collapse, hyperthermia, muscle rigidity)
77
buproprion
inhibits NE and D2 reuptake
works well with 5-HT
lowers seizure threshold, stimulant, no sexual SE
used in smoking cessation
78
mirtazipine
alpha2 antagonist
increases NE release and 5HT (like SNRI)
SE = antihistamine effects (dry mouth, sedation, weight gain.)
79
trazadone
trazaBONE (SE = priapism and sedation)
used for insomnia
inhibits 5hT reuprtake
can add to SSRI or SNRI
80
Hypothyroidism
Sx: wt gain, wold intolerance, feel tired, skin/hair changes, constipation, lower voice, menorrhagia, slowed mental/physical, slow return phase in reflexes
levothyroxine - synthetic T4 analog
triiodothronine - T3, more unpredictable
T4 converted to T3 in body
81
Cretinism
hypothyroidism in fetus/infant
causes=iodine-deficient diet, thyroid-related enzyme deficiency, thyroid developmental defect, thyroid doesnt descend, transfer of antibodies form mom
sx= impaired physical growth, enlarged tongue, mental retardation, enlarged abdomen
82
Hashimotos's
autoimmune thyroiditis
painless goiter
dense infiltrates of lymphocytes into thyroid (dx=antithyroglobulin or antithyroid peroxidase atb)
5:1 females, increases with ages
HLA-DR5 and HLA-B5
can have transient hyperthyroidism when cells spill T4
increased risk of Bcell lymphoma
83
Subacute (de Quervan) Thyroiditis
```
hyper --> hypo
painful goiter
HLA-B35
females 3:1
recent viral infection causes it
```
84
Thyroid Surgery Complications
recurrent laryngeal nerve injury (hoarseness)
| parathyroid glands
85
Struma Ovarii
thyroid hormone-secreting teratoma
86
Somatostatin's clinical uses
diarrhea and splanchnic circulation (cirrhosis)
pituitary excess: acromegaly, TSH-secreting tumor, ACTH-secreting tumor
GI endocrine excess: carcinoid syndrome, zollinger ellison syndrome, VIPoma, glucagonoma, insulinoma
87
Propylthiouracil
blocks addition of iodine to tyrosine groups on the thyroglobulin --> decreses the synthesis of thyroid hormone
SE = rash, agranulcytosis, aplastic anemia
88
most common thyroid cancer
papillary carcinoma
89
cold intolerance
hypothyroidism
90
enlarged thyroid cells with ground glass nuclei
papillary cancer of the thyroid
