March 14 Flashcards
myoglobin
causes kidney injury in the setting of rhabdomyolysis
CK is a marker of rhabdo
Vitamin E Deficiency
posterior column and spinocerebellar tract demyelination
anticoag that causes thrombocytopenia
heparin (can be used in PE)
staghorn canaliculus
struvite stone aka ammonium magnesium phosphate
radio-opaque
caused by urease positive bugs: proteus, klebsiella, staph saprophyticus
pemphigus vulgaris
autoantibodies against desmosomglian (component of desmosomes)
epidermal acantholysis resulting in flaccid intraepidermal bulla
hypochromic RBCs
iron deficiency due to GI blood loss
Pelvic Splanchnic Nerve
rectum motility
internal urethral sphincter
erections
‘beads on a string’ appearance of artery
fibromuscular dysplasia
polyarteritis nodosa
primary hypertension
results of portal HTN (like in alcoholics)
caput medusae
esophageal varicies
anal-rectal varicies (hemmorhoids)
spider angioma
gynecomastia
Leprosy
Mycobacterium leprae
acid fast bacillus
likes cool temperatures
glove and stocking loss of sensation
tx: dapsone, rifampin clofazimine
TNF-alpha
fever and hypotension (vascular leak), WBC recruitment
cachexia in malignancy
secreted by macrophages in response to Lipid A of endotoxin
Physical Exam findings of pleural effusion
decreased breath sounds
dullness to percussion
decreased tactile fremitus
fluid between the pleural layers
tx: thoracentesis
pneumothorax
decreased tactile fremitus
hyper resonance
diminished breath sounds
trachea deviates away
air in the pleural space
hCG causes gynecomastia by
binding to testicle and causing estradiol production
LH stimulates
Leydig cells to produce testosterone
FSH stimulates
sertoli cells for spermatogenesis
secrete androgen binding protein and MIF
Development at 10 months
pincer grasp
pull to stand
object permanence (9mo)
myxoma
left atria
multiple syncopal episodes
throw clots
Porphyria cutanea tarda
defective heme synthesis
photosensitivity –> blisters
most common porphyria
Where does gluconeogenesis occur?
liver, kidney and intestinal epithelium
Loratadine
second gen antihistamine (H1 blocker)
for allergies, less sedation (decreased CNA penetration)
H2 blockers
Cimetidine (inhibitor CYP) also ranitidine (Zantac), famotidine, nizatidine
H2 block for decreased H+ secretion
peptic ulcer disease
Neural Tube Defects
occur at 4th week
increased AFP and AChE in amniotic fluid
associated with low Folate intake
Osteogenesis Imperfecta
problem forming triple helix of COLLAGEN -
most common form due to decreased production of normal collagen
Leukocyte Adhesion Deficiency
defect in LFA-1 integrin (CD18)
impaired migration and chemotaxis
umbilical cord doesnt seperate for 30 days
persistent leukocytosis without infection
COLD abscesses (no inflammation nor pus formation)
Molluscum contagiosum
Poxvirus (dsDNA linear and enveloped)
flesh colored papules, transferred by fomites
ARD of Ibutilide
Torsades de pointes
Class III antiarrhythmic - increase QT, prolonged phase 3
tx: atrial fibrillation
1-3 Days post MI
fibrinous pericarditis (pericardial rub)
coagulative necrosis
inflammation with neutrophils
3-14 Days post MI
Free wall rupture –> tamponade
papillary muscle rupture –> mitral regurg
pseudoaneurysm
macrophages then granulation tissue at margins
Complication of cocaine abuse
dissecting aneurysm (–> aortic valve insufficiency –> diastolic murmur)
cyclophosphamide
Alkylating agent for solid tumors and leukemias/lymphomas
inhibits DNA replication
ARD: hemorrhagic cystitis - give mesna
cyclosporine
Calcineurin inhibitor
blocks T-cell activation by preventing IL-2 transcription
tx: transplant rejection P - psoriasis A - ankylosing spondylitis I - IBD R - rheumatoid and reactive arthritis
Nephrotoxic
Rosacea
@FACE: erythematous papules and pustules
facial flushing with alcohol or heat
Pityriasis rosea
christmas tree distribution on trunk
Peutz-Jeghers Syndrome
Autosomal Dominant
multiple GI hamartomas
hyperpigmented mouth, lips, hands, genitals
increased breast and GI cancers
Turcot Syndrome
FAP + malignant CNS tumor
Turcot = Turban (not chill)
Gardner Syndrome
FAP + osseous and soft tissue tumors
too many teeth (possibly impacted)
EBV associated cancers
nasopharyngeal carcinoma
Burkitt lymphoma
infects B-cells via CD21
Right MLF Lesion
affects right eye - inability to track and affected eye gets nystagmus
MS patients
C5-C9 deficiency
recurrent systemic Neisseria bacteremia
inability to assemble MAC complex, which protects against gram negative bugs
Winter Formula
1.5(HCO3) +/- 8 = Predicted PCo2 ) (+/-2)
if observed is in range of predicted, then its a pure metabolic derangement
if measured is greater than predicted then there is respiratory acidosis
if measured is less than predicted its respiratory alkalosis
Haemophilus influenza type B vaccine
given at 2 months
converts T-independent antigens to T-dependent forms = Conjugate Vaccine
conjugated to diptheria toxin
NA<120
SIADH
urine osmol»_space;» plasma
Na way down
Schizoid
distant
voluntary social withdrawal
constricted affect
‘recluse’
Avoidant
desire relationships but scared of rejection
Antisocial
sociopath
don’t play by societal norms
sulfasalazine
treatment for colitits - combo antibacterial antiinflammatory
for UC and Crohns colitis
Heparin
potentiates antithrombin III
ARD = thrombocytopenia
monitoring = PTT
CYP inhibitors
CRACK AMIGOS in GQ
Cimitidine
Ritonavir (protease inhibitor)
Amiodarone (Class III)
Ciprofloxacin (Fluoroquinolone - DNA gyrase
Ketaconazole (and other azoles - inhibit ergosterol synth)
Acute Alcohol #inhibitions Macrolides Isoniazid Grapefruit Juice Omeprazole Sulfonamides
Gemfibrizil
Quinidine
CYP Inducers
Bull Shit CRAP GPS
Barbituates St. J wort Carbamazipine Rifampin Alcohol Phenytoin Griseofulvin Phenobarbitol Sulfonylurea
IBD treatment
TNF-alpha antibodies
infliximab
adalimumab
Sarcoidosis
African American Females
non-caseating granuloma bilateral hilar adenopathy increased ACE in serum increased CD4:CD8 increased 1-alpha-hydroxylase --> increased 1,25-dihydroxycholecalciferol --> increased calcium
tx: steroids
enterococcus faecalis/fecium
non-hemolytic
catalase negative
gram positive cocci in pairs and chains
grows in 6.5% NaCl
grows in Bile
often vanc resistant
endocarditis, UTI, biliary tree infection
tx: linezolid
