fri jul 17 Flashcards
why may hypotension occur with opioid overdose?
opioids can induce histamine release from mast cells
which of the class I antiarythmics are useful for both atrial and ventricular arythmias?
Class IA and class IC
what will be seen on histology of psoriasis?
parakeratosis, hyperkeratosis, epidermal hyperplasia
where in the cell is vit C found?
RER
what causes the intracellular Ca rise in cells experiencing transient ischemia?
When there is ischemia the cells will undergo anearobic metabolism. This cannot maintain adequate ATP levels and thus ATPases, including NaKATPase and the CaATPase of the sarcoplasmic reticulum fail, leading to increases Na and Ca and cellular swelling.
what is the weakest point of the posterior urethra?
the membranous portion
where is the posterior urethra located?
above the bulb of the penis
what is pioglitazone?
a thiazolidinediones
MOA of thiazolidinediones
activate PPARgamma and effect transcription of genes - > decreased insulin resistance
S/E of thiazolidinediones
fluid retention due to increased Na reabsorption in the kidneys and increased vascular permeability of adipocytes
what will be seen on wet mount of CSF of someone with Naegleria fowleri?
motile protozoa
how do thiazides help treat diabetes insipidus?
Thiazides paradoxically reduce renal water loss by inducing a mild volume depletion that increases Na and water reabsorption in the PCT
what adverse effects are you worried about in a patient on long-term EPO?
Thomboembolism
Hypertension
A patient is on long-term EPO, are they are risk for iron depletion or overload?
Iron depletion -iron will be used in the production of new RBCs -should be monitored during treatment
what tissue does the spleen derive from?
mesoderm of the dorsal mesentary (NOT the foregut)
what is chlorthalidone?
a thiazide diuretic
what is loeffler syndrome?
eosinophilic invasion of the lungs due to parasitic infection
does endometriosis cause irregular uterine enlargment?
no
what is meant by ‘splinting’ to defecate?
It is the manual movement of an obstruction (uterine fibroids) in order to defecate. ex. a women may insert her fingers into her vagina to move the fibroid
presentation of igA nephropathy?
recurrent gross hematuria that occurs suddenly, 5-7 days within a upper respiratory infection
when igA nephropathy is accompanied by extrarenal symptoms, its known as…
Henoch-Schonlein purpura
which two structures cause left ventricular outflow obstruction in hypertrophic cardiomyopathy?
the interventricular septum and mitral valve
where is the SA node located?
junction of the right atria and SVC opening
what is the underlying mechanism of zenker diverticulum formation?
spasm or diminished relaxation of the cricopharyngeal muscles eventually leading to formation of a diverticulum through killians triangle
A biopsy with spindle cells with cytologic atypia, blood vessel proliferation and extravasated RBCs is characteristic of….
kaposi sarcoma
if a patient with organophosphate poisoning is treated with atropine, what symptoms will persist?
the symptoms caused by blockage of nicotinic receptors (muscle weakness) - must also give pralidoxime
pathophys of the formation of a complete mole
90% of cases are from a single sperm fusing an ovum that has no maternal chromosomes, with the genetic material being duplicated to form either XX or YY.
Can also form from two sperms fertilizing an empty ovum.
excessive consumption of dietary nitrites can promote..
the deamination of cytosine, adenosine and guanine to form uracil, hypoxanthine and xanthine, respectively
List the steps in base excision repair
- glycosylase recognizes and cleaves the abnormal base leaving an apurinic site
- endonucleus cleaves the 5’ end
- lyase completes the extraction by cleaving the 3’sugar-phosphate
- DNA polymerase fills the gap
- ligase seals the nick
what CD molecules are expressed by NK cells?
CD16 or CD56
are NK cells present in athymic patients?
yes - they dont require the thymus for maturation
what activates NK cells?
IFNgamma and IL12
which cells are responsible for killing cells that have downregulated their MHCI?
NK cells
what are the lab findings that may suggest bulimia?
hypokalemia and metabolic acidosis
what may be found on physical exam of a patient with bulimia?
- Hypotension, tachycardia
- dental erosin, carries
- dorsal hand calluses
- parotid gland swelling
what is latanoprost?
a topical prostaglandin agonist used to treat open angle glaucoma
MOA of latanoprost
prostaglandin agonist - > increased uveoscleral outflow
how do muscarinic agonists effect the eye ?
the increase trabecular outflow - used for open angle glaucoma
how do Beta blockers effect the eye?
decrease aqueous humor production - used for open angle glaucoma
how do alpha agonists effect the eye?
inhibit aqueous humour production through vasoconstriction -used for open angle glaucoma
how do carbonic anyhydrase inhibitors effect the eye?
Decrease formation of bicarb in the ciliary body leading to decreased Na and fluid transport and subsequently decreased production of aqueous humour - used for open angle glaucoma
what metabolic disturbance arises with hypovolemia?
metabolic acidosis due to increased anearobic metabolism leading to lactic acidosis production
diagnosis of M. avium?
Blood cultures - my takes weeks to grow
Bone marrow biopsy-granulomata composed of foamy epitheliod cells and multinucleated Langhans cells- intracellular acid fast bacteria
what are specific symptoms for GRAVES hyperthyroidism?
pretibial myxedema and graves opthalmology
what causes pretibial myxedema in graves disease?
the thyrotropin receptor antibodies also bind to the TSH receptor on fibroblasts, adipocytes and other tissues leading to excess production of glycosaminoglycans and adiopogenesis
Rotavirus pathophys
it invades the epithlium in the duodenum and proximal jejunum - leads to villous blunting and loss of absorbative capacity, proliferation of secretory crypt cells and reduced brush border enzymes
