General 5 Flashcards
is bone marrow fibrosis normal with increased age?
no, but it does become hypocellular and decrease in mass, more fat
what happens when you give a COPDer oxygen?
vasodilation occurs and shunts blood away from well-ventilated areas and increases physiologic dead space, increasing VQ mismatch
are femoral hernias above or below the ingional lig?
BELOW because they are near the FEMOR
5 a reductase inhibiotrs, like finasteride, have wht side effects?
what is the MOA?
gynecomastia and decreased libido
decrease dihydrotestosterone synthesis
how does simultaneous use of aceteminophen and ethanol decrease hepatoxicity by tylenol?
through competitive inhbition by CYP P450 2E1, ethanol can decrease metabolism of NAPQI and therefore decrease NAPQI concentrations
what is the mechanism of tylenol induced hepatotoxicity?
depleted glutathione, build up of NAPQI
NAPQI binds with mitochondira
leads to oxidative hepatocellular injury
post-MI, what is a common occurance?
how can this be attenuated (avoided)
LV dilation driven by angiotensin II
ACEi
what is the MOA of penicilliminie?
increases urinary excretion of Cu
what happens to children exposed to second hand smoke?
mucocilliary dysfunction
imparied phagocytosis of alveolar macrophage
immune and inflam cell recruitment
what are teh associated syndromes for small cell lung carcinoma?
SIADH
Cushing
Lamber Eaton
know galactose metabolism deficiency
notable that galactose-1-phosphate uridyl transferase makes babies more at risk for e coli sepsis
injury to the membranous urethra (posterior urethra) is assox with what findings?
anterior (spongy) urethral injury is assoxi with
pelvic fracture
blood at meatus
high riding boggy prostate
straddle injury
flu vaccine neutralizes __
HA
inhibits viral entry into cells
in hirshprungs, would a biopsy of the narrow submucsa portion or dilated portion show absence of neurons
narrow portion of the submucosa has an absence of ganglion celsl
(absence of myenteric and aurbacuh)
in unilateral renal artery stenosis, what is the pathology of the stenotic kdiney?
and the normal kidney?
tubular atrophy, interstitial ischemia, glomerular crowding,
arteriolar thickening due to hyaline or hyperplastic arteriolarsclerosis
non caseating granulomas in the GI tract may indicate
Crhons
Cd55 defienciny-what will you find in the kidney?
hemosiderosis due to chronic RBC breakdown and iron depostion
wht is the brain pathology for cerebral palsy?
periventricular leukomalacia or necrosis
what has the fastest rate of metabolism in the glycolytic pathway?
fructose 1 phostphate because it bypasses PFK1, the rate limiting enzyme
what are neurophysins?
carrier proteins for ADH and oxytocin
mutation in them could cause DI
S4?
blood FOURced against a stiff ventricle
could mean diastolic dysfunction from LVH
is the bladder extraperitoneal?
yes
what is thyroglobulin?
large protein that carries around tyrosine to help make thyroid hormone. if you take exogenous thyroid homrone, thyroglobulin will be low, because no need to make your own TH
add to list
GPCRs help do what?
cellular binding/anchoring
what drug class is prefered for RLS?
D2 agonists, like ropinerole, pramipexole
systemic scleroderma risk?
lung intersitial fibrosis
sclerosis and skin thickening of the limbs and trunk
someone was on an abx and warfarin, and now the inr is super high. why?
abx can decrease intestinal flora which are required to make vitamin K and with depleted K, inr can shoot up
metronidazole, flouroquinolones, macrolides
what is a lung complication of CREST
pulmonary hypertension
a monoclonal lymphocytic proliferation in the LN is strongly suggestive of
malignancy
lymphocytic pleocytosis with elevated protein in CSF, lower extremity asymetric flaccid paralysis, parkonson’s like sx all could mean
west nile virus
if theyre talking about a squamous cell cancer in the tongue/oropharynx, make sure to think about
HPV! RB or TP53
what does mitral stenosis look like
gastric bypass can cause what?
this depletes what?
but increases what?
SIBO
most vitamins, B12, D, A, E
but increases K and Folate
most cholesterol gallstones are due to what?
incraased cholesterol syhnthsis, gallbladder hypomotility, increased Ca or mucin, or decreased bile acid synthesis/recirculation
decreaed bile acid synthesis happens with fibrate use (pt in this stem not on a fibrate) and recirculation issues happen with spinal cord injury, pregnancy or fasting, which did not apply in that stem
K excretion
know this ugh
what hormones work the same as sildeniafi?
ANP and BNP
activate gunayl cyclase and increase conversion of 5’ triphosphate to cGMP
B blockers do what to renin
decrease renin reelase from the GJ cells
neuropathys
pleitropy is
lots of phenotyoe manifestations from one genetic aberation
which nucleus is assox with taste?
nucleus solitarious
facial, glossopharyngeal and vagus all bring taste to that area
pay attention to these labs if you think its ATN
FENA >2
BUN:CRT 10:1 or more
will have muddy brown casts and elevated spec gravity
what is first line for treating hyperkalemia with EKG changs?
calcium gluconate
what is gold standard for carpal tunnel diagnosis?
EMG/nerve conduction
what common drugs can cause AV block?
digoxin
CCB
BB
(doxirubicin causes Dilated cardiomyopathy)
maintain ductus arteriosus with what
prostaglandin analogues
PROSTaglandanins to PROP the DA open
posterior sacral positions and treatments
what are the s/s of anterior spinal cord syndrome?
anterior spinal artery compromise
bilateral motor and temp/pain sensory deficits
intact vibratory/pinpont sensation due to preserved DCML
whats another drug besides clozapine that can cause agranulocytosis?
mirtazipine or carbemaziepibe, methimazole, colchicine, PTU, dapsone, ticlopidine
clozapine can also cause somnolence, myocarditis, Sz
metofrmin-lactivc acidosis in kidney damage, GI upset
lithium-NDI, tremor, hypothyroid, hyperPTH, ebsteins anomaly
valproic acid-elevated LFTs, thrombocytopenia (bleeding), Neural tube defect
