June 4th Flashcards by Kara Dickey

Leukocyte adhesion deficiency syndrome

Abnormal integrins = phagocytes unable to exit circulation

Delayed separation of umbilical cord

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Il-12 receptor deficiency predisposes you to

Mycobacterial and fungal infections

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Chronic mucocutaneous candidiasis defect and Tx

T cell dysfunction vs only candida albicans

Ketoconazole tx

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Pencillin to tx UTI

Amoxicillin

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Pencillin to tx Neonatal infection

Ampicillin + gentamicin

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Pencillin to tx syphilis

Penicillin G

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Pencillin to tx Pseudomonas

Piperacillin

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Antihistone Ab

drug induced lupus

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Gout + intellectual disability + lip biting

Lesch-Nyhan Syndrome

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Toxins of strep pyogenes?

Streptolysin O
Steptolysin S
Strep pygoengic exotoxinx ABC (Scarlet fever)

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Segment of renal tubule resorbs 67% of fluid and electrolytes filtered by glomerulus

Proximal convoluted tubule

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Segment of renal tubule site of secretion of organic anions and cations

Proximal convoluted tubule

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Segment of renal tubule always impermeable to water

Ascending thick loop of henle

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Segment of renal tubule permeable to water only in presence of ADH

Collecting tubule

Late distal tubule

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Segment of renal tubule site of Na/2Cl/K cotransporter

Thick ascending loop of henle

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Segment of renal tubule site of isotonic fluid resorb

Proximal convoluted tubule

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Segment of renal tubule responsible for diluting urine

Thick ascending loop of henle

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Segment of renal tubule only site where glucose and amino acids are resorbed

PCT

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Segment of renal tubule water reabsorption in loop of Henle

Thin descending loop of henle

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Bacteria that secrete exotoxins

ETEC 
Virbio
S.aureus 
Shigella 
Yersinia
Clostridium species

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Charcots Neuro Triad

Scanning speech
Intention tremor
Nystagmus and intranuclear opthalmoplegia
Dx of MS

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Subacute endocarditis organisms

Viridans strep (S.mutans)
Enterococci
S. epidermidis

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Increased survival and reduce mortality in CHF patients (3)

Beta blockers
ARB/ACE Inhibitor
Aldosterone antagonist

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Which loop diuretic is not a sulfa drug?

Ethacrynic acid

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What diuretic doesn't increase NaCl in urine?

Acetazolamide

What diuretics cause acidosis?

Acetazolamide (Carbonic anhydrase inhibitors) | K+ sparing

What diuretics cause alkalosis?

Loop diuretics and thiazides

What NT is depleted with MPTP exposure?

Dopamine | MPP destroys cells in substantia nigra

Involuntary flailing of one arm, where is the lesion?

Contralateral subthalamic nucleus = hemiballismus

Causes of High Anion Gap Metabolic Acidosis

``` MUDPILES Methanol Uremia DKA Propylene glycol Iron tablets/Isoniazid Lactic acidosis Ethylene glycol Salicylates (late) ```

Causes of Normal Anion Gap Metabolic Acidosis

``` RADS Renal tubular acidosis Acetazolamide Diarrhea Spironolactone ```

CSF Changes in Guillain-Barre

Albuminocytologic Dissociation High protein Normal cell count

Causes of Rash on Palms and Soles

Secondary Syphilis Rocky Mountain Spotted Fever Coxsackie A Kawaski = desquamation

Which glomerulonephritis is associated with Henoch Scholein Purpora?

IgA nephropathy

Can't see can't pee can't hear high C

Alport Syndrome

Defect in Alports

Mutation in collagen type 4 alpha 5 chain = COL4A5

Antibody titer in PSGN

Elevated anti-DNase B titers

SLE induced glomerulonephritis and micro

Diffuse Proliferative GN | Wire looping

Splitting of GBM

Alport Syndrome

Microscopic polyangitis marker

p-ANCA/MPO-ANCA

Granuolmatosis with polyangitisi maker

c-ANCA/ PR3-ANCA

IC deposits in mesangium

IgA nephropathy

Lumpy bumpy sub epithelial deposits

PSGN

Nerve damaged in fibular neck fracture

Common peroneal nerve = common fibular nerve

2 receptors opening SER with depolarization

Dihydropyridine | Ryanodine

Fx of Congenital Syphilis

Snuffles Saddle nose Saber shins Frontal bossing

Kimmelstiel Wilson lesions PAS+

Diabetic glomerulonephropathy

Apple green birefringence

Amyloidosis

Spike & dome appearance with sub epithelial deposits

Membranous nephropathy

Wilson's HepC SLE Colon CA Heavy metals

Membranous nephropathy

Hep B HepC Lupus Subacute bacterial endocarditis

Membranoproliferative glomerulonephritis

Multiple mesangial nodules

Diabetic glomerulonephropathy

Light micro shows segmental sclerosis and hyalinosis

Focal segmental glomerulosclerosis

Second generation cephalosporins

``` HENS PEcK H.flu Enterobacter Neisseria Serratia Proteus E.coli Klebsiella Gram + cocci ```

30S and 50S Inhibitors

AT 30S CCELL at 50S 30S= Aminoglycosides (Gentamicin) Tetracyclines ``` 50S= Chloramphenicol Clindamycin Erythromycin Linezolid Lincomycin Streptogramins ```

Diagnosis of depression

``` 5/9 Sx for >2 weeks including anhedonia or depressed mood "SIG E CAPS" Sleep disturbance Interest lost Guilt worthlessness Concentration loss Psychomotor retardation/agitation Suicidal ideation ```

WAGR Complex

Wilms tumor Aniridia GU malformations Retardation (motor/intellectual)

Risk fx for transitional cell CA

Smoking Cyclophosphamide Aniline dye exposure

Red cell casts

Acute glomerulonephritis

Waxy casts

Chronic renal failure, decreased urine flow

Fatty cast

Nephrotic syndrome

Granular cast

Chronic renal disease

Hyaline casts

MC cast due to concentrated urine

enzyme matches amino acids to tRNA

Aminoacyl tRNA synthetase

SE of Lithium

``` Tremor Nephrogenic DI Ebstein anomaly Arrythmias Hypothyroid Polyuria ```

Pinpoint pupils, nausea, vomiting, seizures

Opioid OD

Rebound anxiety, tremors, seizures, life threatening

Withdrawal from alcohol, barbs and bentos

Headache anxiety depression weight gain

Withdrawal from nicotine and caffeine

Classic features of drug induced interstitial nephritis

Fever Rash Eosinophilia Azotemia

Drugs causing drug induced interstitial nephritis

``` NSAIDs TMP-SMX Furosemide Ciprofloxacin Cimetidine Allopurinol PPI's Indinavir Mesalamine ```

Metabolic panel findings in renal failure

increased K decreased Ca Increased BUN/Cr

Infant equivalent of depression

Reactive attachment disorder

3rd aortic arch derivative

common carotid and proximal internal carotid

4th aortic arch derivative

``` Left = aortic arch Right = Proximal right subclavian a. ```

6th aortic arch derivative

Proximal part of pulmonary aa. and ductus arteriosus

APGAR score

``` 10 point scale Apperance Pulse Grimace Activity Respiration Each receives 0-2 points >7 good 4-6 assist and stimulate ```

MCC of neonatal meningitis and pneumonia and Tx

``` Men = Group B strep E.coli listeria Pneumo = GBS and E.coli Tx = Ampicilin and Gentamicin ```

Low birth weight and complications

Rolls over Laugh & squealing Hands together

3 months

``` Sit up unassisted Single syllables Transfer a cube Self - feed Stranger anxiety begins ```

6 months

Crawling Object permanence Stranger anxiety

9 months

Stranger anxiety ages

Starts 6 months ends at 12 months

Separation anxiety age

12-15 months

Stand & walk 1-3 words Block in cup Drinks from cup

12 months

Walk backward & run 6 words 2 cube tower Fork and spoon

15 months

Climb stairs & kick ball Combine words 4 cube tower Brush teeth with help

18 months

Jump up Half understandable with 2-3 word sentences 6 cube tower wash/dry hands

2 yr

``` Jump forward & ride tricycle Understandable Copy circle/dash Bowl of cereal Brush teeth Dress Board games ```

3 yr

Toilet training age

2-3yrs

Gender identity

2-3yrs

Hop on one foot Copy + sign and draw stick figure Button clothes

4 yr

``` Tie shoes Identify colors and coins Count to 5 Copies square and triangle Magical thinking ```

5 yr

Logical thinking | if & then consequences

6 yr

Female breast development

10.5 yrs

Female growth spurt

12 yrs

Female menarche

13 yrs

Male stage 2 enlargement of testes

12 yrs

Male growth spurt

14-15

Zoonotic bacteria causing recurrent infections due to variable surface antigens

Borrelia recurrentis

Brown Sequard Syndrome

Ipsilateral loss of pain/temp/sensation at the level of the lesion Contralateral loss of pain/temp 2-3 levels below lesion Ipsilateral dorsal column (PVT) loss below lesion Ipsilateral UMN signs below lesion LMN signs (flaccid paralysis)

Lesion causing hemiballismus

Lesion to subthalmic nucleus of substantia nigra

Retroperitoneal Structures

``` "A DUCK PEAR" Adrenals Duodenum (2nd,3rd,4th) Ureters Colon (descending/ascending) Kidneys Pancreas Esophagus Aorta Rectum ```

Gibbs free energy equation

^G=^H-T^S | ^=delta

Rate limiting step in gluconeogenesis

Fructose 1,6 bisphosphatase

Irreversible enzymes of gluconeogenesis

Pyruvate carboxylase + biotin PEP carboxykinase Fructose 1,6 bisphosphosphatase Glucose 6 phosphatase

Rate limiting enzyme of glycolysis

Phosphofructokinase-1

Deficiency of this enzyme in glycoslysis is most common and causes what Sx

Pyruvate kinase | Hemolytic anemia

Three enzymes to know in glycolysis

Hexokinase/Glucokinase Phosphofructokinase-1 Pyruvate kinase