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Imhotep > Flash RX 259 > Flashcards

Flash RX 259 Flashcards

1
Q

Stratified columnar epithelium

A
  • Conjunctivae of eye

- Male urethra (some parts)

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2
Q

Simple squamous epithelium

A
  • Alveoli
  • Loops of Henle
  • Blood vessels
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3
Q

Diabetic nephropathy

A
  • Non-specific linear deposition of albumin, IgG, or complement (no complexes)
  • Non-enzymatic glycosylation of EFFERNT arterioles leads to increased GFR, which in turns EXPANDS MESANGIUM
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4
Q

Renal amyloidosis (primary, AL)

A
  • Deposits of immunoglobulin light chains

- Biochemical property that causes them to form amyloid fibrils after being processed by macrophages

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5
Q

Renal amyloidosis (secondary, AA)

A
  • Amyloid due to the deposition of Beta-pleated sheets of

- Serum amyloid A protein (acute phase reactant)

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6
Q

vWF increased PTT and bleeding time b/c

A
  • Defect in platelet adhesion

- Decreased survival of factor VIII (not being stabilized)

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7
Q
  • Low molecular weight heparin
  • Inhibits factor Xa
  • Used in patients with A-fib (to prevent thrombus formation)
A

Enoxaparin

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8
Q

PAN (more common in men or women)

A

MEN

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9
Q

PAN

A
  • NEGATIVE for ANCA

- May have low titers of anti-NUCLEAR Abs or Rheumatoid factor

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10
Q

Frame-shift mutation (ex DMD)

A
  • Lead to garbled codons downstream

- Frequently stop codons arise

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11
Q

Quinidine (class Ia antiarrhythmic) ADR

A

-Cinchonism (tinnitus, HA, thrombocytopenia and Torsades des pointes)

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12
Q

Robertsonian translocations

A

-Down syndrome and recurrent fetal loss

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13
Q

PAN necrosis type

A
  • FIBRINOID necrosis
  • Due to inflammation of arterial wall→immune complex deposition→necrosis→loss of elasticity
  • Beads on a string
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14
Q

TB necrosis

A
  • Caseating

- Tubercle (granuloma) w/ central caseous necrosis and often Langhans’ giant cells

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15
Q

Most common benzodiazepine used in preventing and treating delirium tremens? What about in cases of liver dysfunction?

A
  • Chlordiazepoxide

- Liver dysfunction = lorazepam

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16
Q

Management of delirium tremens

A

-Benzo (Chlordiazepoxide)
-Monitor vitals
-IV hydration
-Thiamine/folic acid/multivitamins
-Labs
ALSO: TB TEST and Pneumococcal and Influenza vaccination

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17
Q

Lateral Rectus Action and Innervation

A
  • Abduct eye

- CN VI

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18
Q

Drugs that disrupt angiotensin-renin system (ACEI and ARBS) are contraindicated in:

A

Pregnancy→due to secondary fetal defects of heart and kidneys

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19
Q
  • HCTZ
  • Aplha-methyldopa (good for acute HTN→fast acting)
  • Labetalol (good for acute HTN→fast acting)
  • Nifedipine
A

Antihypertensive agents that are safe for pregnant hoes (Hypertensive Moms Love Nifedipine)

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20
Q

Antihypertensive agents that are safe for pregnant hoes (Hypertensive Moms Love Nifedipine)

A
  • HCTZ
  • Aplha-methyldopa (good for acute HTN→fast acting)
  • Labetalol (good for acute HTN→fast acting)
  • Nifedipine
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21
Q
  • Adult T-cell lymphoma
  • Cutaneous lesions
  • LAD
  • HSM
  • Endemic in Japan and Caribbean
A

Human T-lymphocyte leukemia virus

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22
Q
  • Symptomatic relief for heart failure
  • HYPERkalemia toxicity (hypokalemia and hypomagnesemia potentiates effect leading to toxicity but is not a toxicity)
  • Blurry and/or yellow vision
A

Digoxin

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23
Q

Do loops or thiazides have potential for hypercalcemia?

A

Thiazides (good for osteoporosis patient)

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24
Q

Digoxin toxicity

A

N/V
Blurry yellow vision
Hyperkalemia
ECG abnormalities

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25
Q

Treatment for Digoxin Toxicity

A
  • Normalization of electrolytes
  • Administration of Lidocaine
  • Anti-digitalis Fab
  • Magnesium
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26
Q

Digoxin

A
  • Symptomatic relief for heart failure
  • HYPERkalemia toxicity (hypokalemia and hypomagnesemia potentiates effect leading to toxicity but is not a toxicity)
  • Blurry and/or yellow vision
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27
Q

Goodpasture Triad

A
  • Circulating anti-GMB
  • Nephritis
  • Diffuse pulmonary hemorrhage
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28
Q
  • Crescent formation glomerulonephritis
  • PR3-ANCA / c-ANCA (anti-proteinase 3)
  • Upper and lower respiratory tracks also involved
A

Granulomatosis with Polyangiitis (Wegener)

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29
Q
  • OVERLY ROUND RBC’s (missing central pallor and biconcave shape)
  • MCHC increased (results from decreased RBC volume and a stable Hb molar amount)→higher the MCHC the darker the RBC
  • MCV is decreased
  • Increased RBC fragility
  • Hemolytic anemia
A

Spherocytosis

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30
Q

White pupillary Reflex

A

Retinoblastoma (AD)
RB on chromosome 13
-Presents with crossed eyes and lack or response to visual stimuli
-Need that second mutation for neoplastic transformation

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31
Q

Significant proteinuria in nephrotic syndrome

A

-Decreased glomerular capillary oncotic pressure→leads to increase in GFR
GFR= Kf (Pgc –Pbs)- (Oncotic GC- Oncotic BS)
Bs=bowman space
Gc=glomerular capillary
Kf= filtration constant
THINK ON THIS CARD YOU KNOW THIS…LOOK AT BRS if you still do not

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32
Q
  • STAGHORN CALCULUS (STRUVITE-based stones usually)
  • Recurrent UTI
  • ALKALINATION of urine
A

Proteus and Klebsiella genera (urease-producing)

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33
Q

Positive direct Coombs test

A

-Suggest AUTOIMMUNE hemolytic anemia

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34
Q

Hospital acquired or drug resistant UTI (gram negative, anaerobic bacillus)

A

Pseudomonas aeruginosa

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35
Q

Spherocytosis

A
  • OVERLY ROUND RBC’s (missing central pallor and biconcave shape)
  • MCHC increased (results from decreased RBC volume and a stable Hb molar amount)→higher the MCHC the darker the RBC
  • MCV is decreased
  • Increased RBC fragility
  • Hemolytic anemia
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36
Q

Retinoblastoma (AD)

A

RB on chromosome 13

  • Presents with crossed eyes and lack or response to visual stimuli
  • Need that second mutation for neoplastic transformation
  • White pupillary reflex
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37
Q

How do you calculate urine flow rate?

A
  • Use three parameters (GFR, plasma inulin, urinary inulin)
  • NOTE: GFR can be approximated by creatinine clearance

Urine flow rate= GFR X [inulin] p / [inulin] u

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38
Q

Amygdalae mediates…

A

Fear, anxiety and aggression

Bilateral lesions→Kluver-Bucy Syndrome

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39
Q
  • Amide-based local anesthetic
  • CARDIOTOCITY→hypotension and arrhythmia risk if given IV
  • EPIDURAL
A

Bupivacaine

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40
Q
  • Ataxia of the limbs
  • You suck at finger-to-nose and heel-to-shin tests
  • Impaired rapid alternating movements
A

Damage to intermediate zone of cerebellar hemisphere

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41
Q

Bupivacaine

A
  • Amide-based local anesthetic
  • CARDIOTOCITY→hypotension and arrhythmia risk if given IV
  • EPIDURAL
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42
Q

Second degree heart block Mobitz type II

A

-Normal PR intervals with several nonconducted/dropped beats

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43
Q

Fentanyl: Drug type and ADRs

A
  • Opioid

- N/V, CONSTIPATION, RESPIRTATORY DEPRESSION, and coma

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44
Q
  • Gaseous anesthetic
  • Hepatotoxic
  • Malignant hyperthermia w/depolarizing paralytic (succinylcholine)
  • Decrease in cardiac output and blood pressure
A

Halothane

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45
Q

Ibuprofen

A
  • NSAID

- Gastric ulceration and renal failure (due to interaction with kidney autoregulation

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46
Q

Renal or hepatic impaired patient. Loading-dose is the SAME why? And lower maintenance dose why?

A

Loading dose dependent on VOLUME DISTRIBUTION, not excretion or metabolism
Maintenance dose should be lowered to account for less effective clearance

47
Q

How are Fluoroquinolones are excreted?

A

Renally

48
Q

Tertiary syphilis and the heart

A
  • Dilated aortic root and valve ring

- Linearly calcified, aneurysmal ACSENDING AORTA

49
Q

Most common malignancy of small intestine

A

Carcinoid syndrome

50
Q

Rheumatic fever can cause valvular

A

Mitral>aortic»tricuspid

51
Q

Whorled pattern of cell growth surrounding laminated areas of dystrophic calcification

A

Psammoma bodies

52
Q

Histology of Glioblastoma Multiforme

A

Pleomorphic tumor cells and central areas of necrosis and hemorrhage

53
Q
  • More in children
  • Usually Cerebellum
  • Foamy
  • High degree of vascularity
A

Hemangiomas

54
Q
  • S100 positive
  • Spindle cells
  • Usually localized to CNVIII
A

Schwannoma

55
Q

Meningioma

A

Seizure
Headache
Visual field deficit

56
Q

Fanconi anemia (FA) Inheritance

A

-AR

57
Q

Fanconi anemia (AR)

A
  • Bone marrow hypofunction→ Pancytopenia

- Bone problems at young age

58
Q

Increased chromosomal breakage in response to DNA-damaging agents (esp. cyclophosphamide) due to a defect in HOMOLOGOUS recombination DNA REPAIR-Fanconi’s syndrome

A

-Even worse when being treated for arthritis too

59
Q

Fanconi patients (AR) also at risk for…

A 
Myelodysplastic syndromes (5% of cases)
AML (acute myeloid leukemia) – 10% of cases
60
Q

Knockout mutation of ATM gene (what does gene encode?)

A
  • Ataxia-telangiectasia
  • Protein kinase that detects double-stranded DNA breaks
  • LOSS OF PURKINJE CELLS in the cerebellum and defective LYMPHOCYTE MATURATION and PROLIFERATION
61
Q
  • Ataxia-telangiectasia
  • Protein kinase that detects double-stranded DNA breaks
  • LOSS OF PURKINJE CELLS in the cerebellum and defective LYMPHOCYTE MATURATION and PROLIFERATION
A

Ataxia-telangiectasia

62
Q

Ataxia-telangiectasia

A
  • Ataxia
  • ELEVATED brown cutaneous lesions (secondary to chronic capillary dilation)
  • Extensor plantar responses
  • Distal sensory deficiencies
63
Q

Ataxia-telangiectasia

A
  • Ataxia-telangiectasia
  • Protein kinase that detects double-stranded DNA breaks
  • LOSS OF PURKINJE CELLS in the cerebellum and defective LYMPHOCYTE MATURATION and PROLIFERATION
64
Q

Ataxia-telangiectasia symptoms

A
  • Ataxia
  • ELEVATED brown cutaneous lesions (secondary to chronic capillary dilation)
  • Extensor plantar responses
  • Distal sensory deficiencies
65
Q

ITP (idiopathic thrombocytopenia purpura)

A
  • Commonly post viral exanthema or URI in a child

- Recover in 3-6 months usually

66
Q

All the glory to…

A

GOD

67
Q

Zeil-Neelsen stain

A

Acid Fast (ex: TB and leprosy)

68
Q

Giemsa stains

A
  • Borrelia
  • Plasmodium
  • Trypanosomes
  • Chlamydia
69
Q

India Ink

A

Cryptococcus neoformans

70
Q

Periodic acid-Schiff stain

A

-Carbohydrates (ex: glycogen)

71
Q

Bouchard nodes

A

Proximal interphalangeal joints (PIP)→ bony enlargement

-OA and RA

72
Q

Heberden Nodes

A
  • Distal interphalangeal joints (DIP) → bony enlargement

- SPARED in RA and present in OA

73
Q
  • Calcium pyrophosphate crystals
  • Positive birefringent
  • Knee (men over 50)
A

Pseudogout

74
Q

Subdural hematoma

A
  • Bridging veins
  • Crescent-shaped
  • Can cross suture lines but not falx cerebri or tentorium cerebeli
  • Slow progression and speech motor involvement possible
75
Q
  • BICONVEX disc on CT
  • Can cross falx but and tentorium but NOT suture lines (opposite of subdural)
  • Middle meningeal artery
A

Epidural hematoma

76
Q

When can pulsus paradoxus be seen?

A
  • Cardiac tamponade
  • Asthma
  • Croup
  • Obstructive sleep apnea
77
Q

All methotrexate uses:

A
  • RA (due to reduction of adenosine-mediated inflammatory changes)
  • Breast, head and neck, lung and choriocarcinoma
  • ALL and non-Hodgkin’s Lymphoma
  • Ectopic pregnancy, psoriasis, IBD
78
Q

Can tetracyclines be used in RA?

A
  • Yes in early stage

- Inhibit activity of metalloproteinase involved in joint destruction

79
Q

Cyclophosphamide (alkylating agent) uses:

A
  • Non-Hodgkin, breast and ovarian carcinomas

- Immunosuppressant: SLE, MS, autoimmune hemolytic anemia

80
Q

Probenecid (organic acid)

A

-Tx for chronic tophaceous gout or increasingly frequent gouty attacks

81
Q

X-linked defect affecting the methylation and expression of the FMR1 gene

A

-Fragile X syndrome

82
Q

Herpes Zoster (varicella-zoster)

A
  • Nasty nose

- Especially if immunosuppressed

83
Q

Is an inactive precursor that is activated by THYMIDINE KINASE when absorbed into infected cells→ forms GUANINE analog that results in chain termination

A

Acyclovir mechanism of action

84
Q

Mantle Cell lymphoma Translocation

A

t(11;14)

Overexpression of cyclin-D1

85
Q

-Broad, darkly staining malignant lymphoid cells in the MANTLE region surrounding residual reactive germinal centers

A

Mantle Cell histology

86
Q

PML/RAR-alpha hybrid protein

A
  • T(15;17)

- APL

87
Q

Treatment for acute pro-myelocytic leukemia

Forces differentiation of the leukemic cells into neutrophils, which have a short life span

A

All-trans retinoic acid

88
Q

Brodetella pertussis culture media

A

Bordet-Gengou medium

89
Q

Loffler’s Medium

A

Culture Corynebacterium diphtheriae

90
Q

Thayer-Martin medium

A

Culture Neisseria

91
Q

Pompe disease (Type II glycogen storage disease)

A
  • Pompe trashes the pump (heart)
  • Lysosomal alpha-1,4-glucosidase is absent
  • Necessary for hydrolysis of outer branches of glycogen
  • Glycogen deposited in myocardium
92
Q

ECG of infant shows short PR intervals and LARGE QRS complexes evidencing biventricular hypertrophy

A
  • Pompe Disease
  • By six month of life child experiences developmental delay, feeding problems, and eventually heart failure
  • Cardiomegaly on CXR
  • Skeletal muscle and liver affected
93
Q

Fabry disease

A
  • Lysosomal storage disease

- Alpha-galactosidase A deficiency

94
Q

Alpha-galactosidase A deficiency what disease and what accumulates

A
  • Fabry disease

- Ceramide trihexoside → peripheral neuropathies of hands and feet, angiokeratomas, and cardiovascular and renal disease

95
Q

Gaucher disease (Lysosomal storage disease)

A
  • Beta-GLUCOCEREBROSIDASE deficiency
  • HSM
  • Aseptic necrosis of femur
  • Bone crises
  • GAUCHER CELLS
96
Q
  • Lysosomal storage disease

- Alpha-galactosidase A deficiency

A

Fabry disease

97
Q

Pioglitazone (thiazolidinone)

A
  • Sensitize skeletal muscle and liver to insulin→ increasing uptake of glucose
  • Binds and activates PPAR nuclear regulators→increase insulin receptors
98
Q
  • Long-acting synthetic insulin

- Continuous baseline level of insulin in blood

A

Glargine

99
Q
  • Sensitize skeletal muscle and liver to insulin→ increasing uptake of glucose
  • Binds and activates PPAR nuclear regulators→increase insulin receptors
A

Pioglitazone (thiazolidinone)

100
Q

Acarbose

A
  • Alpha-glucosidase inhibitor

- Acts on intestinal brush boarder to decrease absorption of starches and other polysaccharides

101
Q

-Closes K+ channels expressed in the cell membrane of pancreatic acinar beta cells→cellular depolarization→calcium influx→triggers release of insulin

A

Glipizide (sulfonylurea)

102
Q

Metformin

A
  • Oral hypoglycemic agent
  • Inhibits HEPATIC gluconeogenesis
  • Decreased blood glucose levels
  • Increase skeletal muscle GLUT4 membrane translocation
103
Q

Paget disease of bone

A
  • Mosaic pattern (accelerated bone turnover/formation and resorption)
  • Pain, skeletal deformities and fractures
  • Associated with: secondary osteosarcoma and fibrosarcoma
104
Q
  • Alpha-glucosidase inhibitor

- Acts on intestinal brush boarder to decrease absorption of starches and other polysaccharides

A

Acarbose

105
Q

Bronchiolitis from infection: RSV vs. Mycoplasma pneumonia

A

RSV 5 years of age

106
Q

Treatment of prostate cancer with a drug that requires careful monitoring, as it will first INCREASE hormone production before therapeutically decreasing hormone production

A

Leuprolide (inhibits LH and FSH release)

107
Q

CRH (Corticotropin-releasing hormone)

A

-Stimulates (+)→ POMC gene→Production of ACTH and MSH (melanocyte-stimulating hormone)

108
Q

Leuprolide ADRs

A
  • Impotence

- Hot flashes

109
Q

Aminoglutethimide: Use and MOA

A
  • Treat metastatic breast cancer
  • Inhibits synthesis of estrogens from cholesterol
  • Shrinks tumor in ESTROGEN-DEPENDENT breast cancer
110
Q

5-FU ADRs

A
  • Alopecia
  • PHOTOSENSITVITY
  • Myelosuppression
  • N/V
  • Diarrhea
111
Q
  • Treat metastatic breast cancer
  • Inhibits synthesis of estrogens from cholesterol
  • Shrinks tumor in ESTROGEN-DEPENDENT breast cancer
A

Aminoglutethimide: Use and MOA

112
Q

What is responsible for feedback inhibition of GHRH?

A

Somatostatin

113
Q

5-FU myelosuppression reversal

A
  • THYMIDINE supplementation

- Bypass block to continue DNA synthesis

114
Q

Aminoglutethimide: ADR

A
  • Depression

- Maculopapular rash

Imhotep (11 decks)

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