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my step1 > High Yield Concepts > Flashcards

High Yield Concepts Flashcards

1
Q

Ph at what the nonprotonated form(A- or B) = the protonated form(AH or BH+)

A

PK

(Acid dissosiation constant)

  • Protonated form are impermeable to membranes
  • Non protonated forms are permeable to membranes
    • give acid to trap a base(give Nh3CL to eliminate amphetamines,phenobarbital,methrotrexate)
    • give base to trap an acid(give Bicarb to eliminate salicilates)
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2
Q

phase 1 drug metabolism

what does it yields?

afected by what?

A

Phase 1 (redox and hydrolisis )

  • yield more hydrosoluble methabolites
  • geriatric patins lose phase I first
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3
Q

maximal effect a drug can produce

A

Efficacy

retaled to Vmax

efficacy is decresed by non competitive inhibitors

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4
Q

amount of drug needed for a given effect

A

Potency

competitive inhibitor decrese potency

Km =1/potency=1/afinity

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5
Q

Drugs that cause “Miopization” , blurred vision, inability to see far objects

A

Muscarinic drugs toxicity

  • treat with atropine and pralidoxime(regenerates ECHE if given early)
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6
Q

reversal of neuromuscular junction blockade=

myastenia gravis crisis treatment=

atropine overdose=

A

Neostigmine

Pyridostigmine

Physiostigmine

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7
Q
A
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8
Q

what does epinephrine and isoproterenol does to MAP:

A

epinephrine(a1ß1):increases MAP –>reflex bradycardia.

isoproterenol(ß1ß2):decrese in MAP –>reflex tachi.

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9
Q

drug used in cardiogeny shock because it increases blood renal flow

A

Dopamine

D1 receptor

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10
Q

ß that decrease mortality in post MI patients.

A

Bisoprolol

Carvidelol

Metroprolol

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11
Q

what b blockers should be avoided in ashtma?

A

non selective b blokers(N-Z)

nadolol

pindolol

propanolol

timolol

carvidelol(has some b2 blockade activiry)

labetalol

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12
Q

halos around light with with painful sudden vision loss

A

Acude closed narrow glaucoma

fix mid dilated pupil

BE CAREFUL:Halos arround lights are also communly seen in cataracts.

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13
Q

most common ligament injured feet invertion

A

the anterior fibular ligament.

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14
Q

thoracic outlet syndrome

A

klumpke palsy

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15
Q

problems related with erythema nodosum

A
  • inflammatory bowel disease
  • sarcoidosis
  • sufa drugs
  • malignant neoplasm
  • tuberculosis
  • B-hemolitic streptococci
  • coccidioidomycosis
  • histoplasmosis
  • leprosy
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16
Q

collagen synthesis hidroxilation syntesis=

collagen synthesis glycosilation deffect=

A

scurby

osteogenesis imperfecta

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17
Q

agraphia

alogia

acalculia

A

Gerstmann´s syndrome

damage to the visual association cortex.

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18
Q

neurololgical claudication(pain with prolonged by walking ,standing and relieved by rest and forward flexion of the vertebral column) relieved by siting and have negative leg raises bilaterally

A

Lumbar spinal stenosis

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19
Q

only gram + who has endotoxin

A

Listeria

  • gastroenteritis in healthy patients
  • meningitis,spontaneous abortous in neonates
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20
Q

only bacterial capsule not composed of polysaccharide

A

bacillus anthracis composed of D-Glutamate

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21
Q

with what cytokines these shocks states are related?

septic shock

anaphilactic shock

A

CAUSED BY ENDOTOXIN (Lipid A) of gram - and Listeria

  • septic shock=nitric oxide hypotention(from macrophages)
  • anaphilactic shock= C3a a part of the complement(releases histamine from mast cell)hypotention and edema
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22
Q

toxin that prevents the release of inhibitory (glycine and GABA) neurotransmitters from renshaw cells in spinal cord.

A

tetanospasmin

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23
Q

what toxin cause scarlet fever?

A

ESCARLE FEVER(S.pyogenes type A)

  • erithrogenic toxin
  • pyrogenic toxin
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24
Q

caracteristics of MacConkey agar

A
  • bile salt and cristal viollet=>gran + inhibition
  • lactose
  • nuetral red

Lactose fermenters turn red:

  • FAST
    • Klebsiella
    • E.colli
    • enterobacter
  • SLOW:
    • citrobacter
    • serratia
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25
Q

catalase positive bacteria

A

PLACESS

  • Pseudomonas
  • Listeria
  • Aspergillus
  • Candida
  • E.coli
  • S.aireus
  • Serratia

people with chronic granulomatous disease (NADPH oxidase deficiency)have current infections with these bugs

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26
Q

obligated anaerobes

A

clostridium

bacteroides

actinomices

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27
Q

major virulence factor of S.pyogenes

A

M PROTEIN

  • (-) phagocytosis
  • (-) the activation of complement
  • enhance bacterial attachment

antibodies against M protein cause rheumatic fever

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28
Q

toxins that produces scalded skin syndrome

A
  • exfoliative toxin
  • epidermolitic toxin
  • enterotoxin
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29
Q

neutrophil chemotaxis

A

IL-8

C5a

LB4

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30
Q

elevated ESR

A
  • polymyalgia reuhmatica
  • temporal arteritis
  • disease activity in RA and SLE
  • infection
  • inflamation
  • malignacy
31
Q

CD16=

CD14=

CD56=

CD55 AND CD59=

A

CD16=Binds Fc of IgG in macrophages and NK

CD14=macrophages it binds to LPS

CD56=unique marque for BK

CD55 AND CD59=DAF

32
Q

likelyhood that alpha error(false positive) is present

A

p value

33
Q

who do you increase statistical power

A

↑power and ↓ ß by:

  • ↑ sample size
  • ↑ expected effect size(how big the think you are looking for)
  • ↑precision of measurement
34
Q

confidence interval between 2 variables includes 0

A

there is no significant difference and H0 is not rejected

35
Q

if odds ratio includes 1?

A

H0 is not rejected

36
Q

Aztreonam

A

for gram - rods when px its allergyc to amynoglycosides

37
Q

MRSA and VRSA oral medication

A

Linezolid

works on 50s fraction of the ribosome

38
Q

sulfa drugs

A

Popular FACTSSS

  • Probenecid
  • furosemide
  • acetazolamide
  • celecoxib
  • thiazide
  • sulfonamide antibodies
  • sulfasalazina
  • sulfanylureas
39
Q

serotoninergic syndrome

A

triptans

linezolid

ondansetron

tramadol

antidepresans

40
Q

P 450 substrates

  • *A**lways, Always, Always,
  • *A**lways Think When
  • *S**tarting Others
A
  • anti-epileptics
  • antidepressants
  • antipsychotics
  • anesthetics
  • theophylline
  • warfarin
  • statins
  • OCPs
41
Q

P-450 inducers

Guinness,Coronas, and PBRs induce CHRONIC ALCOHOLISM

A

They decrese p450 substrate concentration in plasma

  • Griseofulvin
  • Carbamazepine
  • Phenytoin
  • Barbitures
  • Rifampin
  • chronic alcohol
  • modafinil
  • st.jhons wort
  • nevirapine
    *
42
Q

P-450 inhibitors

CRACK AMIGOS

A

They increse P-450 substrates(eg.warfarin) concentration in plasma

  • cipro
  • ritonavir
  • amiodarone
  • cimetidine
  • ketokonazol
  • alcute alcohol
  • macrolides
  • INH
  • Grape juice/gemfibrozil
  • omeprazol
  • sulfa
43
Q

trematodes realate to

  • squamos cell carcinoma of the bladder=
  • cholangiocarcinoma=
A

-squamos cell carcinoma of the bladder=

  • Schistosoma haematobium

-cholangiocarcinoma=

  • clonorchis sinensis(from undercooked fish)
44
Q

paracite causing B12 deficiency

A

diphyllobotrium latum(cestode)

raw fresh water fish

45
Q

paracite that causes hydatidi cyst

A

echinococus granulosus(cestodo)

ingestion of eggs from dogs

46
Q

cause of S3 sound

A
  • Dilated Cardiomyopathy
  • CHF
  • Mitral regurgitation
  • Left to right shunt
  • normal in children and pregnancy
47
Q

cause of s4 sound

A

ATRIAL KICK

  • hypertrophic cardiomyopathy
  • aortic stenosis
  • chronic HTN with LVH
  • after MI
48
Q

drugs causing torsades

A

Some Risky Meds Can Prolong QT:Soltalol

  • Sotalol
  • Risperidona
  • Macrolides
  • Chroloquine
  • Protease inhibitors
  • Quinidine
  • Thiazides
49
Q

5 deadly cause of chest pain

A
  • Aortic dissection
  • unstable angina
  • myocardial infarction
  • tension pneumotorax
  • pulmonary embolus
50
Q

causes of pulsus paradoxus

A

Droop pressure >10mmhg during inspiration

  • asthma
  • caridac tamponade(electrical alternance in EKG)
  • obstructive sleep apnea
  • croup
51
Q

kussmaul sign

A

decrease of capacitiy of the right ventricle

increase JVP on inspioration instead of a normal decrease.

  • constrictive pericarditis
  • restrictive cardiomyopathies
  • right atrial or ventricular tumors
52
Q

live vaccines

A

Do not to give inmunocompromize patients and close contects

  • smallpox
  • chickenpox
  • yellow fiver
  • sabrin(polio)
  • MMR(can be give a patien with HIV buy not with AIDS)
  • intranasal influenza
53
Q

egg vacciones

A

flu vaccine

yellow vaccione

MMR(does not induces allergy)

54
Q

features of anaplastic cells

A
  • high nucleous to cytoplasm ratio
  • prominent nucloli
  • nuclear chromatin clumping
  • many mitotic figures
55
Q

epithelial tumor normally they spread through lympnoces, but someones do not, what epithelial tumor do not spread by lymph nodes?

A

carcinomas that spread hemotogenously(normally it would be by lymph node)

  • HCC
  • RCC
  • Follicular Thyroid
  • Choriocarcinoma
56
Q

drug induce lupus

A

anti histone antibodies

SHIP

  • sulfa drugs
  • hydralazine
  • INH
  • procainamida
  • phenytoin
57
Q

essentia aminoacids

A

PVT TIM HaLL

  • Phenylalanine
  • Valine
  • tryptophan
  • Threonine
  • Isoleucine
  • Methionine
  • Histidine
  • Leucine
  • Lysine
58
Q

golgi modified aminoacids=

nuclear signaling aminoacids=

collagen aminoacids=

A

golgi modified aminoacids=

  • seria
  • asparagina
  • threonina

nuclear signaling aminoacids=

  • Lisina
  • arginina
  • prolina

collagen aminoacids=

  • glycina
  • prolina
  • lysina
59
Q

drugs with anticholinergic activity

AVOID IN ELDERLY

A

1 generation antihistamines

low potencia antipsychotics

TCAs

amantadine

antimuscairinics

60
Q

X linked diseases

A
61
Q

autosomal recessive

A
  • cystic fibrosis(chromosome 7)CFTR gene
  • BLOOD:
    • Sickle cell anemia
    • Thalassemias
  • METALS:
    • hemochromatosis
    • wilsons
    • albinism
    • ARPKD
    • glycogen storage disease
    • mucopolysaccharidoses(excep hunter syndrome)
    • sphingolipidoses(except fabry´s)
    • kartagener syndrome
    • phenylketonuria
62
Q

Autosomic Dominant

A
  • VHL(chromosome 3)
  • Huntington´s(chromosome 4)CAG trinucleotides
  • FAP(APC gen 5)
  • ADPKD(chromosome 16)PKD1 gene
  • NF-1(chromosome 17)NF1 gene
  • NF-2(chromosome 22)NF2 gene
  • familial hypercholesterolemia
  • Osler-Weber-Rendu(hereditary hemorrhagic telangiectasia)
  • Hereditary spherocytosis
  • Marfan
  • MEN
  • Tuberous Sclerosis
63
Q

Nuclear signaling AA and Histones

A

Arginine

Lysine

64
Q

purine synthesis

A

Glysine

Aspartate

Glutamine

65
Q

Nuclear signal

A

Lysina

Arginine

Proline

66
Q

collagen synthesis AA

A

glycine

Proline

Lysine

67
Q

Branched AA

A

Isoleucine

Leucine

Valine

68
Q

Ketogenic AA

A

Tx for Pyruvate dehydrogenase defienciency

Leucine

Lysine

69
Q

Essential AA

A

PVT TiM HaLL

  • phenylalanine
  • Valine
  • Threonine
  • Tryptophan
  • Methionine
  • Histidine
  • Leucine
  • Lysine
70
Q

Acidic AA

A

Aspartate

Glutamate

71
Q

B1 (thiamine) is needed for?

A

alpha-ketoglutarate dehydrogenase

Pyruvate dehydrogenase

transketolase

branched-chain ketoacid dehydrogenase

72
Q

B6(piridoxyne) is needed for?

A
  • Transamination(AST and ALT)
  • Neurotrasmiter synthesis:
    • 5HT
    • dopamine
    • norepinephrine
    • epinephrine
  • cystathionine syntethase(cofactor)
  • heme synthesis(ALA synthase cofactor)
  • Niacine
  • histamine
    *
73
Q

Hydrophobic AA(in transmembrane proteins)

A

Valine,Isoleucine,alanine.methionine and phenylalanine

74
Q
A

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