General 3 Flashcards
1
Q
describe a hyperacute graft rejections
A
antibody mediated type II HSN reaction
preformed IgG ab in the recipient that are directed against the host
2
Q
describe the different types of pleural effusions and thier mechanics
in decompensated heart failure, what happens
A
hydrostatic pressure increases and lymphatic flow increases to compensat,e, but can’t keep up so you get fluid backed up into lungs
vascular permability doens’t change neither does oncotic pressure
3
Q
which step in the CAC is thiamine dependent?
A
aKG to sCOa
aKG dehydrogenase complex is thiamine dependent
a KeG depends on THIAMINE (like an alcoholic depends on a KEG and needs THIAMINE)
4
Q
in newborns, juandice is commone becasue of what?
A
increased bilirubin production and enterhoepatic circulation but decreased conjugations
5
Q
restrictive cardiomyopathy due to amyloid deposition can cause what manifestations?
A
dialted left atrium from blow back of blood
thickened left ventricle and impaired relaxation
6
Q
Turner Moasicism (XO/XX) is a result of what time of mosaicism?
A
somatic mosaicism
7
Q
absence by itself gets treated with
absense with tonic clonic gets treated with?
A
ethosuxaminde
valporic acid
8
Q
bicornate uterus, messed up tubes and renal ageneisis sounds like
A
falure of lateral fusion of the paramesonephros
9
Q
What are the hormone levels in kleinfelters?
A
increased LH and FSH
increased estradiol (loss of feedback inhibtion)
low testosterone
10
Q
what is the most common risk factor for calcium stones in adults?
A
hypercalciuria (with normal serum ca)
11
Q
a bacterial infection is more likely when accompanied by pus and lymphadenopathy. what is causing the LAD
A
increased germinal centerrs (not paracortical)
12
Q
bronchophany is heard when?
can you feel crepitus with a PTX?
A
over more solid consolidations (not PTX)
yes
13
Q
what is the cause of sick sinus syndrome?
A
age related change in the right atrial wall at the SA node,
sinus pause and then a junctional beat with dropped p wave on eckg
14
Q
nitrates effect which vessel?
A
vens and cause venodilations
15
Q
in Conn syndrome (adrenal cortical adenoma), renin will be
in secondary hyperaldosteronism, renin will be
A
low
high
16
Q
know testosterone levels with age
A
total andd free decrease
SHBG increases
17
Q
what type of hernia is assox with Downs?
A
umbilical hernia, protursion worse with crying
caused by incomplete closure of umbilical ring/abdominal musculature
18
Q
what type of bacteria can cause nonpurulent cellulitis?
purlent cellulitis is caused by
A
beta hemolytic streptococci (includes strep pyogenes)
staph aurues
19
Q
randomizing groups causes what?
A
causes them to be balanced and fairly similar in qualities
20
Q
what should be expected in a young person with viral prodrome and now s/s of heart dailrue?
A
decompensated dilated cardiomyopathy from viral myocarditiis
21
Q
What are the s/s of s typhi
A
fever (woth pulse/fever dissoz)
rose spots, abominal pain, HSM, Gi bleed, perforation
get from food/water in developing country
replciates in macropahges (not the same as samonella )
22
Q
nitrates do what to LV?
A
reduce LV end diastolic pressure, reduce preload
increase peripheral vascular capacitance
decreases SVR
23
Q
femoral nck fractures are at risk of osteonecorsis due to what vessel?
A
medail femoral circumflex
24
Q
what drygs should be avoided in hypertrophic cardiomyopathy
A
there is an assox LVOT so any drug that decreases preload or SVR should be avoided
incldues dihidyro CCB, nitro/nitrates, and ACEi as well as diuretics
25
will shingles (VZV) have intranuclear inclusions
yes, Tzank
26
a1 antitrypsin def is asociaed with what acinar emphysema
PANacinar becaise A1 affects the whole lung
centroacinar assox with Cmoking (smoking)
27
what muscle attaches to the greater trochanter?
glut medi
28
what is more common in a complete mole, 46XX or 46Xy
46XX is more common in complete mole
29
pancytopenia with a dry tap think
its a TRAP
hairry cell leukemia
lymphocytes with hair like (cytoplasmic) prkoectinos
30
what will be seen on hist with rheumatic fever?
aschokoff
antichosw bodies
31
what increases in the amniotic fluid as gestational age increases?
phosphytidlcholine-used to make surfactant
sphingomyelin levels stay fairly constant
32
what is the mutation in hypertrophic cardiomyopathy?
what is the mutation in idiopathic dilated cardiomyopathy?
beta myosin heavy chain or miosin binding chain C
TTN gene, titin
33
how does epinephrine help prevent mast cell histamine release ?
EPi binds to mast cells and inhibits degranulation and histamine release
34
add to last minute list
35
what is the treatement for recurrent HSV?
daily valcyclovir
36
what does a tzank test look like in HSV?
37
what type of cells are synpotphysin positive?
neurons, neuroectorderm and neuroendocrine
38
low fecal elastase will be seen when?
in pancreatic insuffiencicny/chronic oancreaitis
associated with exocrine pancreatic function
39
what common complication of subarachnoid hemorrhage occurs 3-12 days later and via what mechanism?
cerebral vascular vasospasm leading to ischemia and focal deficits
prevent with CCB increases vasodilation, reduces amount of ischemia and vsospasom
40
WPW conduction can be described as
AV conduction bypassing the AV node
or AV reentrant tachycardia type of SVT
41
what are the three Ds of botulism?
diplopia, dysphagia, dysphonia
alters the CMAP
9electrical activity of the muscles)
42
HBV can cause what in the liver
hepatocellular carcinoma (large yellowy lesions)
43
collagen binds to integrin via what connector?
fibronectin
44
what are some common withdrawal sx of amphetamines?
hyperphagia
hypersomnia
depression
45
countertransferance is what?
consists of a docs unconcious or concious reaction towrad a patient based on based personal experiences
46
what is the smear of a macrocytic anemia look like
due to imapaired dna synthesis
47
what is the function of TPO?
catalyzies the oxidation of iodine
iodination of thyroglobulin
coupling reactino between two iodinized tyrosineresidues
48
what nerve follows the spermatic cord and can be damaged during inguinal reapir leading to allodynia, burning and pain in the genitals and medial thigh?
ilioingional
49
differentiate HCM and normal physiologic adaptation to exercise
adaptation: eccentric hypertrophy wiht enlarged cavity and small amount of concentric hypertrophy with increased LV wall thicknes
HCM: concentric thickness withd decreased cavity space and poor blood supply
50
idk this
51
if someone has a mi and now they are bradycardic, what to do?
atropine to inccrease vagal tone and HR
52
in a PTX with low BP, is it becasue of pressure on the heart or pressure on the IVC?
pressure on the IVC decreasing return to the hrat
53
postprandial epigastric pain and food averson and weight loss is consistent with what in the setting of atherosclerosis?
chronic mesenteric ischeima
54
what is pierre robin sequence?
55
know trisomy 13
56
know the EMs
57
in hypovolemic states, what are the levels of these hormones:
vassopresin
NE
angII
endothelin 1
all increased
58
know henoch shonlein pupura
59
what are the s.s of hydrocephalus?
60
Hep D can't infect someone unless Hep B is there to do what?
coat the viral protein (like a trojan horse)
61
what kind of vaccine is the pnenuomoccaly?
polysacharide vacine (23)
or a conjugate vacine
62
what horome is eelvated in narcolepsy?
hypocretin 1 and 2 (orexin a and b)
63
how does prazole's work?
64
what are the two biggest risks for adenocarcinoma?
obesity and gerd
65
tips on AKI
low urine Na indicates to low FeNa
66
silicosis makes someome more at risk of TB ebcasuse of what?
impaired macrophage function
67
what classes of diabetes drugs causes hypoglymcea?
insulin secretagogues
- meglitindines
- sulfonurea
68
b12 def has elevated levels of what?
methymalonic acid and homocysteine
69
remember struvite/staghorn stones from protteus orklebsielia will have what pH in the urine?
high pH (like 8)
70
add to last minute list
71
wat is the timeline post MI for complications and what are they?
72
increasing estorgen increases waht thyroid homrone?
TBG which decreases free T4 and T3
this causes a decrease in TSH which in turns raises t4 and t3 again
73
prostacyclin (inhibits or excites) platelet aggregation
inhibits
74
th1 vs th2
75
left and right gonadal artery come off of what
aorta
only the veins do left renal for left gonadal
76
high altitude causes
resp alkalosis
renal H excretion decreases
77
bone mets
78
putamen hemoorhage is likely form what vessels?
lenticulostriate
79
what kind of regurgitation can occur after pacemaker placement
tricuspid valve regurg leading to right heart failure if it is severe enough
80
apiration pneumonititis (of gastric acid) leads to
aspiration pneumonia (of oropharygneal bacteria)
really acute onset, within hours, damage to alveoli
leads to weeks of pneumonia symptoms, foul smelling sputum, etc
81
febrile neutropenia occurs when neutrophils are less than what?
\<500
more suscpetible to aspergillus
82
patients with severe emphysema will have what acid base abnormality?
chronic respiratry acidosus with metabolic compensation
83
auer rods in APML have what chemical in them?
myeloperoxidase
84
isotype switching occurs where
in the germinal centers
85
in those with RA, rapid ETT intubmation can cause what problem?
cervical subluxation :(
86
cutaneous neurofibromas are derived from which cell?
neural crest (made up of mostly schwann cells)
87
what does a southwestern blot do?
substance detected: DNA binding protein
type of probe: dsDNA
(c-Jun and c-Fos are nucelar transcription factors that bind to DNA)
88
what protein assox with cr. 21 and down's syndrome is thought to speed up early onset demenita?
APP (amylpoid precurosr protein)
89
what is the initial management for transposition of the great arteries?
rostaglandin infusion to maintain PDA
atrial spetostomy to enlarge/maintain PFO
90
many african forms of malaria are chloriquine resistant. What is teh treatment
also what do the trophozites look like in ring form?
atorvoqoune-progunil
or artemisins
91
among e coli strains that cause neonatal meningitis, what is the likely virulence facotir?
K1 capsular antigen
92
lung infections with crytococcus neoformans is usually
in those with hiv, what other sx can be seen?
asymptomatic
meningoencphalitis and may have symptomatic lung infection
93
know the abx resistance mecahnisms
94
in status epilepticus, after the loreazepam, what is given?
what is the moa?
phenytoin or fosphenytoin
inhibits Na channels
95
MRSA specs
grows on oxacillin agar and has MECA gene which codes for PBP2a which has a low affinity for beta lactams, there fore oxaccilin, methicilin, and the cephalosporins, are NOT effective
96
normally, Low BP would mean high vasopressin to try to compensate, but in sepsis???
vasopressin is low
97
AAA is caused by
chronic transumural inflammation
(cystic medial necrosis-marfan's)
(focal initmal tear-aortic dissection)
98
muscarinic agonists will incresaes release of what?
NO
99
in vWF def, what are plt levels, PT and PTT?
all normal, but PTT can be prolonged
100
in graft versus host, is it the graft's T cells or B cells that cause the probel,
T cells
101
testes, glans penis and cutaneous portion of posterior calf drain into
scrote drains into
paraaortic nodes
superficial inguinal
102
neutropenic fever increases the risk of what infections
infection from your own flroa
103
PAH pathogenesis
smooth muscle hyperplasia in the vascularture
104
in Dubin Johnson syndrome, is the issue conjugation or excretion?
defect in excretion of bilirubin gluconurides
105
Pt's with MG are resistant/overly sensitive to depolarizing agents (rocuronium, vecuronium)?
Pt's with MG are resistnat/overly sensitive to nondepolarizing agents (succ)?
EXREMTLY senstiive
RESISTANT
106
pharmacokinetic equations
107
what's an aortic dissection look like?
wht is the most risky thing to cause it?
hypertension not smoking
108
3rd degree av blocks look like
why?
complete loss of QRS
degeneration of the AV node
109
multiple small nondestructive masses attached to the edges of the mitral valve leaflets
assox with underlying malignnancy NBTE
110
S4 is described as
Presystolic, late diastolic
assox with LV hypertrophy
111
global ischemia as visualized as several wedge shaped infartcts all over can be cuased by
hypotension
112
what is the cause of heritdary fructose intolerance, potentially fatal?
aldolase B deficiency
113
if it sounds like cobalamin def but he's alcoholic, what us it?
thiamine def/ (dry beri beri with cardio effects and neurpathy)
114
MCA occlusions sx?
contralateral hemisensory and hemiparesis loss over upper extrem and face
115
which E coli virulence factor caues sepsis?
Lipid A
116
in left dominnat ciruclation, the PDA origiantes from
LCx
gives off AV nodal
117
how does pleural fluid move?
in thru intercostal vessels out thru parietal plural lymphatic vessels
118
in Bells palsy, is the forehead affected?
yes (peripheral nerve lesion, lmn)
opposite in stroke
119
spastic bladder and bladder hypertonia is common in
MS patients after getting an UMN lesion
120
is capillary wedge pressure normal in ARDS?
yes
121
can aortic dissections cause tamponade?
yes
122
where do most cardiac myxomas oringate?
left atrium
123
respiration curve for normal vs copd
124
metolazone is what drug class?
thiazide
can help potentiate loop diuretics and increase Na delivery to the DCT
125
what endogenous hormone is similar to opioids
ACTH-idk y UW is confusing me
derived from POMC, like b-endorphin and MSH
126
Edwards syndrome
127
where is uric acid most lilely to precipitate in the kidneys?
in the CD due to low pH
128
what drug can be used in hypertensive emergency?
Fendolopam (d1r agonist)
leads to renal vasodilation, incresaed perfusion and natrieuresis
129
the median nerve travels between which landmarks
humeral and ulnar heads of the pronator teres m
130
a hard mass with high cholesterol causing SBO, what could it be?
obstructing gll stone (gallstone ileus)
can find pnuemobilia
131
what is teh cause of black gallstones?
supersaturation of bilirubin due to increased bilirubin prodcution or altered enterohepatic circulation
132
what does cryptococcal encephalitis look like?
133
what is the lung function in an obese person with restrictive lung dz (due to the obesitY)
FEV1, FVC, ERV and TLC are all decreased
RV normal
134
someones got hypoparathyroidism from iatrogenic remocal, what is the treatment
calcitriol
(cincacelt is for 2nd hyperparathyroidism)
135
whats a weird thing about ankylosing spondyltiis?
restricrted chest movement/expansion
136
in DIC, Protein C, fibrinogen and VII are all
depleted bc they are all being used to make and break clots
137
what are the PTH levels in mulriple myeloma?
PTH is decreased
urinary Ca in increased (due to low OTH)
1, 25 vit D is decreased (due to low PTH)
PTHRP is normla
138
hypoketotic hypoglycemia with sz is
MCAD def
medium chain acylcoa dehydrogenase def.
139
mmuscle weaknes,s hypoketotic hypoglycemia, cardiomyopathy and elevated muscle triglycerides (no sZ) is what?
rimary carnitine def.
140
arteriolar vasodilaters can cause what side effect?
na and fliud retention
141
this is hy?
142
which of these is a tumor suppresor gene?
p53, lof would mean cancer
143
a common side effect of penicillimine is
neprhotic syndrome due to membranous nephropathy
144
PAY attnetion to clues about situs inversus eps if it sounds like CF because its acually
kartagner syndrome with defective dynein arm
145
146
if a COPDer gets a drop in RR after O2 supplementatioln, why?
a rapid rise in PaO2 which reduces peripheral chemoreceptor stimulation (which is the carotid body)
147
PV loop for exercise
148
PV loop for digoxin or increased afterload/increased contractiliy
149
calcified nodules in lungs ln and spleen
histoplasmosis
150
minimal change diseases causes plamsa oncotic pressure to increase or decerased?
decrease
151
wrinkles in aging is assox with a decrese in
collagen fibril production
152
busrelein is a what?
give with biculatamide why?
GNRH analogue that continualsiy pulses to decrease GnRH receptor, lowering LH and androgen production
to block the acticity of the angrogens on the tumor cell (if there is an initial increasE)
153
DNa polymerase 1 functions to (3-5' activity)
removes mismatch base pairs
154
know
155
HSV can cause what ss/
test how
ulcers and painful inguinopathy
tzank and PCR
156
157
tubular necrosis will have what findings?
intersitlay nephritis
ischemia, red casts, not pyruria
drugs, wbc
158
intention to treat analyisis includes all pts even those that are
noncompliant
159
what is the process of gluconeogenesis ?
160
how is uv damage repaired?
thimidine dimers are repaired with nucleotide excision repair
this is the process of endonuclease nicking of damaged DNA strands
161
in this question stem, the patient had been in an MVA and had a laparatomy for bleeding. You were supposed to assume what?
now he's septic with strep pneumo, and dies. Why?
that he had a splenic lac that rquired removal
unable to clear systemic bacteria due to asplenia. asplenics should be vaccinated from encapsulated bacteria including strep pneumo, h flu, n menitigittsi
162
benzo overdose elads to what metabolic derangement?
acute respiratoruy acidosis from hypoventiliation
A-a gradient will be normal
163
what is systemic mastocytosis\>
mast cell proliferation all over
leads to pruritis, hypotension, urticaria and excessive gastric acid secretion
164
monoclonal ab can cause what side effect 7-10 days later?
serum sickness, with rash, fibrotic necrosis and neutrophilic infiltration of the bv
type 3 hsn which will decrese C3 levels ab-ag complex deposition and complement activation
165
thiaizides do what to Ca?
increase Ca reabsoprtion
| (loops increase urinary Ca excretion)
166
pertussis is g+ or g -?
g-!!
167
paradoxical emboli usually occur thru which type of shunt?
if no abn is seen on echo, what is it?
what manual test can help prove a PFO?
r-l shunt
PFO
release phase of valsalva
168
in a pt with exertional dyspnea and cough with lymphocytes predominant BAL, what is the issue?
hypersensitivity pneumonitis
169
how does HLA genetics work?
1/4 chance of being an identical match with a sibling
170
PPIs inhbit absorption of
increase absorption of
Ca, Iron, Mg, and B12
dietary fats in those taking pancreatic enzymes
171
what are the s/s pf TTP?
pathogenesis?
hemolytic anemia with elevated LDH and decreased hatpglobin, schistocytes on smear
increased bleeding time with normal PT/PTT
may have renal failure, fever, neuro
acquired or hereditary defect in ADAMS13 level leading to uncleaved vWf mutlimers which causes PLT trapping and activation
172
damage where will cause a contralateral pure sensory deficit storke?
ventral posterior thalamus (may have gait issues if senory loss is severe enough)
173
if you think they have sicke cell and they are sick with no hints as to what it could be, what are the go tos?
h flu, strep pneumo, n menigitis
174
biliary atresia manifests with what symptoms?
dark urine
acholic stools
elevated direct bilirubin, elevated GGt
175
pt's with renal function so severely decreased that htey need dialysis could manifest with what bleeding disorder?
qualitative plt disorder due to acumulation of uremic toxins leading to prolonged bleeding time with no change in PT/PTT or PLT
(uremic plt dysfunction)
176
DEFECT IN UMP syntehtase leasd to
orotic aciduria
elevated urinary ortoic acid
megaloblastic anemia
physicla and mental retardation
suplpment with uridine
177
what does myeloblastic leukemia look like?
178
family hx of colon and endometrial/ovarian cancer think what gene mutation (had it right first and changed it!!)
MSH1, 6, MLH2, PMS2
179
divertica can bleed and cause painless hematochezia due to what?
disruption of the vasa recta
180
middle aged women with granulomatous destruction of intralobar bile ducts
primary biliary colangitis (PBC-women)
181
what is the major virulence factor of H flu?
polysaccharide capsule amde of PRP (polyribsotyle phosphate) that inbitits phagocytosis and complement by binding to factor H
182
what two electrolyte abnormalities can cause vacular calcifications?
hypercalcemia and or hyperphosphatemia
other things: inflammation, atherosclerosis
183
focal sz with impaired awareness and olfactory hallucinations or GI distress usually oritingate where?
mesial temporal region: hippocampus, amygdala, parahippocampal gyrus
often due to hippocampal sclerosis from febriel sz in childhod
184
what is the most specific ab for Graves?
thyroptropin (TSH) receptor antbiody
thyroglobulin ab are less specific and more for hypo than hyper
185
signet ring carcinoma (type of gastric adenomacarcinoma) can look like this
186
What might a plasma cell neoplasm look like?
187
Resistant to change when Protein c is added, probably means what?
Factor V leiden mutation
188
mitral regurgitaiton on a catheterization tracing
189
brown stones are formed by what?
b-gluconurnidase from bacteria (e coli) or helminths {(c. sinesis)
functions to increase amount of unconjugated bilirubin
can also happen in hemolytic anemia
190
describes the findings and treatment of arsenic poisoning?
garlic smell, watery diarrhea, QT prlongation
from pesticides, wells, wood
treat with dimercaperol, DMSA
191
during trauma with hemorrhage, why is glucose elevated?
increased hepatic glucose production, increased gluconeogensis
increased release of cytosol and cytokines, catecholamines
also happens in sepsis and hypoxia
192
decrease in HGb and increase in bilirubin after drug treatment what might be?
drug induced immune mediated hemolytic anemia
193
EPO stimulating agents like erythropoeitin, darbepoietin alfa, have what side effect?
wirsen hypertension
194
this is a proto oncogene? (more likely to be acticated in cancer genes)
these are antioncogenes (more likel to be inactivated in cancer genes)
KRAS
APC, BRCA, TP53, RB
195
what class of antiarhtymics blocks K efflux
amiodaraone, sotoolol, dofetilidie
class III
196
treatment of HCV with DAAs (sofosbuvir and ledipavir) what is the MOA?
inhibit viral genome replciation and assembly
197
what does clear cell carcinoma of the kidney look like gorrly?
where does it originate from?
usually the PCT
198
what is hypertrophic osteoarthropathy?
painful bone growth, arthropathy, clubbing fingers, enlarged peristeuim in the setting of adenocarcinoma
199
exertional heat stroke can trigger what terrifying bleeding/clotting condition
DIC
alos apparently you can be sweating during heat storke lol
200
in liver cirrhosis causing ascites, what is the volume, urine Na and ADH?
total body volume is increased
ADH is increased
urine Na is low
201
does your diastolic bp change during exercise
apparently not (unchanged or a slight decrease)
but systolic p and pp do increase
202
what does the maltese cross look like on babesios?
203
in chronic aortic regurgitation, the compensatory eccentric cardiohypertrophy leads to what mechanism to maintain CO?
increased stroke volume
204
renal artery stenosis causing prerenal azotemia is suspected when what drug has been started?
Prerenal azotemia can also occur after starting pt on what
ACEi
diuretic
205
what drugs can cause drug-induced lupus?
hydralazine
procainimide
isonizid
minicylcine
quininide
206
treating triglyceride induced panceatits with insulin triggers what receptors?
upregulating lipoprotein lipase which hydrolyzes TGD into chylomicrons and VLDL
reduces HSL to supress the release of fatty acids
207
knwo tha pathays
208
what is the pathogeneis of hydradenitis supperativa
obstruction of folliculopilosebacious units
209
what is teh pathogensis of calcific aortic valve disease
differentiation of valve fibroblasts into osteoblast-like cells
usually due to atherosclerosis and endothelial cell dysfunction
210
what nreves will be injured in anterlateral displacement of the humerus ?
anteromedial
radial n
median n
211
what section is the CAAT in?
promoter
212
what is an imporant electorlyte when determing the cause of metabolic alkalaosis?
cl
213
what deposits will you see in medullary tho=yoid cancer?
amyloid! in nests or sheets of polygonal or spindle shapes
214
in facial nerve palsy/injury, what happens to tears?
decreased tear oroduction
215
wht is the most benign common liver tumor?
whats it look like?
cavernous hemangioma
216
where does PTH help decrease the reabsorption of Ph/
in the PCT
217
elastin is so bendy ebcause of
lysin interchain cross linking
218
what is synthesized in the RER ribosomes
integral proteins, membrane proteins
cytsol proteins-free ribosomes
219
prior to starting SLGT1 inhibitors, what must be checked?
CRT, as an estimate of GFR since the efficacy of the drug depends on it
220
describe pemphigus vulgaris
erosions of the skin and mucosa with painful flaccid bullae
worse with rubbing-Nikolsky sign
ab against desmoglein
221
natural history of diabetic glomerulopathy
222
what does tenofovir inudced renal injury look like
AKI (elevated crt, water retention) and or
PCT dysfunction phosphatirua, glucosirua, proteinuria
223
nice lil review
224
what must be supplmented in phenylektonuria?
tyrosine
can't turn phen into tyr
225
more biochem shite
226
what do kemmelstiel-wilson noduels look like?
aka nodular sclerosis
in diabetics
227
what are the stool contents in vibrio diarhea?
some mucus and no erythrocytes or leukocytes
228
trigeminal neuralgia is treated with
what is the MOA
carbemazipine
blocks Na current on many levels
229
what hormone can stimulate prolactin
TRH
230
tell me about an S3
sudden stop of blood thru the left ventricle
normal in youths, pathological after 40
may indicate mitral regrug, aortic regurg, dilated cardiomio
occasionally present in pregnancy or thyrotoxicosis
suggests eccentric hypertrophy
231
heart failure can cause pleural effusion taht is (transudative or exudative) in nature?
transudative
low protein, low LDH
232
hemodynamic changes in mitral regurg
233
what are some s/s of PDA?
clubbing and cyanosis of the LE
decrease in postductal o2 saturation
starts as L-R shunt but can turn into L-R shunt via eisenger
234
how do EGFR ab help in cancer therapy?
they are selective for the cancer cells only so only the ccner cells take up the durg
235
whsat type of kidney disease is seen in rhabdo?
what in the urine
acute tubular necrosis
granular casts
236
elastase are in neurophils and what else
macrophages (alveolar)
237
pancreatic tumors (like ZE syndrome) are found in what MEN?
what else should be checked for?
MEN 1
1' hyperparathyroidism (assx nephrocalcinosis)
pituitary tumors (vision changes, prolacin levels)
238
struma ovarri is from what tpye of cell
germ cell! (germy struma ovarii)
carries thyroid tissue derived from endoderm
239
child with mediastinal mast and lots of blast cells?
ptobably T-aLL
240
blunt aortic injury usually occurs where?
at the aortic isthmnus
241
what is a complication of viral pericarditis?
pericardial effusion
tachycardia, electrical alternans, dyspnea, low voltage qrs
242
type A dissections normall occur near the
type B dissections normally occur nea the
sinotubular junction
left subclavian a
243
a lung infection and we are told that the cell mediators are Th1, INFy and IL2
waht is the most likly pathogen?
legionelle
intracelular, requires cell mediated immunity
244
in atrial fibrillation, what sets the pace of ventricular depolarization?
th AV node refractory period
245
where does malaria lie dormant?
in the liver
246
an arrangement in which a payor pays a fixed predetermined fee per pt for all required medical services is termed
capitation
payment structure underlying HMOs
247
ETOH based cleansers kill how?
disrupt the lipid bilayer
248
Pt's who receive total parenteral nutrition are at risk of gallstones because
those with ileum resections are at increased risk becasue
lack of CCK secretion resulting in biliary stasis
there is disruption in the enterohepatic circulation of bile acids leading to inadequate solubilization of biliary cholesterol and formation of cholesterol chrystals
249
what is more likkely to cause cataracts, prednisone or hydroxychloroquine?
predinsome
250
what is the MOA of PCKS9 inhibitor evolucomab
decreases LDL R degredation by lysosomes
251
what cells are resonsible for the findings in systemic sclerosis?
vascular endothelial cells
T cells
derma fibroblasts
252
MSUD patients may benefit from supplementation of waht
thiamine
required cofactros for branched a chain a ketoacid dehydrogenase: thimaine, lipoate CoA, FAD, NAD
(tender loving care for nancy)
253
what intracellular component will be increwased after exposure to phospholipase c?
Ca (part of the DAG pathway)
254
what two factors help make blood vessels
VEGF
FGF
255
what is the mode?
most frequently observed number in a dataset
256
in LV eccentric hypertrophy and heart failure, what will the EF be?
what will the compliance be?
EF decreases
compliance increases
257
digoxin slows AV node conduction by
increasing parasympathetic tone
but can't really do that during exercise
258
what does the marrow look like in aplastic anemia
fibrsos and fat
