General Principles Flashcards
What are the histological characteristics of apoptosis?
Cell with hyperchromatic, fragmented nuclei and small, discrete blebs containing cytoplasm and nuclear fragments
What is amyloidosis?
Liver produces serum amyloid-assoc protein in response to systemic inflammation (like in RA)
How does amyloidosis appear on histology?
Stains red w Congo red and exhibits apple-green birefringence upon polarization
What are histological characteristics of psammoma bodies? And what are they associated with?
laminated, concentric, calcific spherules
Papillary carcinoma of thyroid Serous papillary cystadenocarcinoma of ovary a Meningioma Malignant Mesothelioma o m a
What is the clinical triad for hypertrophic osteoarthropathy (HOA)?
clubbing of the digits,
periostitis of the long (tubular) bones,
arthritis
What imaging can be used to help diagnose hypertrophic osteoarthropathy (HOA)?
CHEST X-RAY bc HOA is assoc w thoracic malignancy: bronchogenic carcinoma, lung cancer, mesothelioma, etc.
What is Sturge-Weber syndrome?
port-wine Stain Tram-track calcifications Unilateral Retardation Glaucoma/Gnaq gene Epilepsy
Which mycs are assoc w which diseases?
N-myc = neuroblastoma L-myc = small cell carcinoma of the lung C-myc = Burkitt Lymphoma
Under which conditions would Central inappropriate ADH secretion occur?
head trauma or intracranial neoplasm
Which cell is responsible for wound contracture?
myofibroblasts
Which diseases are assoc with the following amyloid types:
AA, AF, AL, ACal, AB
AA = acute phase rxn (inflamm) AF = familial + old Fogies AL = light chains + lymphoma ACal = Calcitonin AB = Alzheimers ATTR = cardiac + old Fogies Beta-2 = long term hemodialysis
What are symptom is likely to present with cardiac amyloidosis?
proteinuria
What disease should be suspected in woman 15-45 who presents with non-specific arthralgias, fatigue, and malaise?
Systemic lupus erythematosus
What type of genetic abnormality causes Tay-Sachs?
Frameshift mutation
What stain is used for hemochromatosis?
Prussian blue
What is desmoplasia?
Excessive fibrous tissue formation in stroma surrounding a tumor
What is the predisposition to Lynch Syndrome (hereditary nonpolyposis colorectal cancer (HNPCC))?
mutation in DNA mismatch repair
What are the hallmarks of Lynch Syndrome ( hereditary nonpolyposis colorectal cancer (HNPCC))?
3-2-1 rule: 3 relatives with Lynch syndrome– associated cancers across 2 generations, 1 of whom must be diagnosed before age 50 years.
What are the hallmarks of salicylate poisoning?
Early resp alkalosis (high pH, low pCO2, norm bicarb) –> mixed metabolic acidosis-resp alkalosis
What are the hallmarks of acetaminophen poisoning?
irreversible liver fail; metabolic acidosis (not resp alk)
What are the hallmarks of hydrochlorothiazide poisoning?
metabolic alkalosis (w resp comp) + hyper GLUC
- Glycemia
- Lipidemia
- Uricemia
- Calcemia
Familial breast cancer and ovarian cancer abnormality in tumor suppressor gene is on which chromosome?
17q
What are the causes of metabolic acidosis w normal anion gap?
HARD-ASS: Hyperalimentation Addison disease Renal tubular acidosis Diarrhea - Acetazolamide Spironolactone Saline infusion
What are the causes of metabolic acidosis w increased anion gap?
MUDPILES: Methanol (formic acid) Uremia Diabetic ketoacidosis Propylene glycol Iron tablets or Isoniazid Lactic acidosis Ethylene glycol (oxalic acid) Salicylates (late)
When does one calculcate anion gap?
To find cause of metabolic acidosis?
What is the most common cause of metabolic acidosis w normal anion gap?
loss of bicarb thru diarrhea
What is contraction alkalosis?
Loss of ECF vol from brisk diuresis leads to increased conc of bicarb
-loop diuretics cause salt and water to be lost but bicarb retained
What immunological factors mediate septic shock?
TNF from macros
Hyperventilation and feeling of faintness indicates a decrease in what?
Cerebral blood flow
Which substance is affected as a consequence of iodine def (cretinism)?
growth hormone
Describe the effect ECF osmolarity has on ICF vol.
Decrease ECF osm = expansion of ICF
Increase ECF osm = decrease ICF vol
How does one calculate interstitial fluid vol?
= ECF vol (inulin) - plasma vol (RIS Albumin)
Which factors cause a RIGHT shift in O2-Hb dissoc curve?
Right shift—ACE BATs right handed: Acid CO2 Exercise 2,3-BPG Altitude Temperature
Right shift = decreased affinity of Hb for O2
Which anti-histamine has minimal sedative effects and low anti-cholinergic effects?
Fexofenadine
Which drug is used to treat CML (bcr-abl[9;22]) and has side effects of fluid retention and edema?
Imatinib
Which immunosuppressant inhibits purine synthesis and interacts w allopurinol?
Azathioprine
What drug is associated with “gray baby” syndrome?
Chloramphenicol
What drug(s) is associated with fetal teeth issues?
tetracyclines
What drug is associated with fetal kernicterus?
TMP-SMX
What drug(s) is associated with fetal MSK issues?
fluoroquinolones
What drug(s) is associated with fetal ototoxicity?
Kanamycin, streptomycin
What drug is associated with fetal cleft palate?
clarithromycin
What drug is used for tinea corporis?
clotrimazole
What side effect of Metformin leads to increased anion gap?
Lactic acidosis
What is efficacy of a drug?
the ability of a drug to produce the desired effect
What is the MOA and indication for mycophenolate mofetil?
Inhibits purine synthesis (G) to prevent organ rejection
Which drug is used to treat AML by inhibiting DNA polymerase and causes leukopenia and anemia?
Cytarabine
Which antibiotic combos can be used to treat acute cholecystitis?
Cefo/metro
piper/tazo
amp/sulfba
meropenem
What equation can be used to determine half life?
t/2 = (0.7 x Vd)/CL
What is the earliest symptoms for salicylate intox?
tinnitus
Which drugs are P450 inducers?
Chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs
Chronic alcohol use St. John’s wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine
Which drugs are P450 substrates?
Always Think Wet Octopussy
Anti-epileptics
Theophylline
Warfarin
OCPs
Which drugs are P450 inhibitors?
AAA RACKS IN GQ Magazine
Acute alcohol abuse Ritonavir Amiodarone Cimetidine Ketoconazole Sulfonamides Isoniazid (INH) Grapefruit juice Quinidine Macrolides (except azithromycin)
Which drugs prevents organ rejection by preventing IL-2 via Calcineurin/cyclophilin w side effect of nephrotox?
cyclosporine
Whats the key difference between OD on stimulants v anti-cholinergics?
Stimulants = diaphoresis (sweating) anti-cholingergics = dry
What are the effects of anti-cholinergic toxicity?
“red as a beet, dry as a bone, mad as a hatter, blind as a bat and hot as a hare”
What kind of receptors or glutamate receptors?
ligand-gated and voltage-gated cation channel
What is the general guideline for steady-state plasma conc of a drug?
50% in 1 half-life
75% in 2 half-lives
87.5% in 3 half-lives
Which drug attacks guanine to cause DNA crosslinking, thereby causing hemorrhagic cystitis?
cyclophosphamide
Which anti-depressant can cause priapism?
Trazodone
Daclizumab is used for renal transplants via what MOA?
Monoclonal antibodies that block IL-2R.
What is serum sickness and its hallmarks?
Type III hypersensitivity in which antibodies to foreign proteins are produced
Keys: Fever, urticaria, arthralgia, proteinuria, lymphadenopathy occur 5–10 days
Tx for serum sickness?
antihistamine + corticosteroids
Which second messenger do ANP receptors stimulate?
Guanylyl cyclase (cGMP)
Where should primers be positioned for PCR?
3’ end on both strands of the DNA sequence of interest
Thiamine (B1) is a cofactor for which 4 enzymes?
BAT-P!
Branched-chain ketoacid dehydrogenase
Alpha-ketoglutarate dehydrogenase
Transketolase
Pyruvate dehydrogenase
