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Caleb's Step 1 > March 29 > Flashcards

March 29 Flashcards

1
Q

Anti arrhythmic that can cause 2nd degree AV block

A

diltiazem and verapamil

also cause constipation, bradycardia

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2
Q

Polycythemia vera

A

intense itching after hot shower, facial plethora (reddish complexion), splenomegaly

increased: RBCs, WBCs, Platelets

JAK2 mutation –>

JAK is an cytoplasmic receptor tyrosine kinase; EPO receptor signal transduction –> JAK2 –> clonal proliferation of myeloid cells

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3
Q

Cytoplasmic tyrosine kinase

A

aka non-receptor tyrosine kinase

JAK2/STAT

implicated in polycythemia vera, primary myelofibrosis, myeloproliferative disorders

prolactin, IL-2, IL-6, IFN, GH, EPO

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4
Q

Intrinsic receptor tyrosine kinases

A

receptors for insulin, insulin-like growth factor, and epidermal growth factor (EGFR)

think growth factors: IGF-1, FGF, PDGF, EGFR

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5
Q

Glucagonoma

A

rare pancreatic alpha cell tumor
causes DM and necrolytic migratory erythema

necrolytic migratory erythema - painful and pruritic rash @ face/groin/extremities

“crusting and scaling at the borders with central areas of brownish induration” + superficial necrolysis

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6
Q

VIPoma

A

WDHA

Watery Diarrhea Hypokalemia Achlorhydria

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7
Q

Dog Bite

A

Pasteurella multocida

gram negative cocobacillus

mouse smell on culture

mouse-like odor = indole+

cellulitits at site of bite

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8
Q

Fight Bite (human)

A

Eikenella corrodens

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9
Q

Cat Bite

A 
Pasteurella multocida (cellulitis) 
Bartonella henselae (lymphangitis)
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10
Q

Autosomal Dominant Polycystic Kidney Disease

A

85% due to mutation PKD1 @ Chr16
15% due to mutation PKD2 @ Chr4

associated with berry aneurysm (–> subarachnoid hemorrhage), mitral valve prolapse, hepatic cysts

tx: ACEi or ARB

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11
Q

most common cause of bacterial meningitis in adults

A

Strep pneumo

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12
Q

Transtentorial aka Uncal Herniation

A

ipsilateral mass lesion (hemorrhage or brain tumor) esp @ temporal lobe

first sign is impingement on CN III –> fixed dilated pupil (ipsilateral) + ptosis + down and out gaze

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13
Q

Hereditary Orotic Aciduria

A

defect in uridine 5’-monophosphate synthase –> elevated orotic acid levels - defect in pyrimidine synthesis

delayed developmental milestones and megaloblastic anemia

Uridine supplementation

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14
Q

Ligamentum Flavum

A

thickening can cause central spinal stenosis and compression of nerve roots –> pain/numbness/paresthesia

located between cord and spinus processes

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15
Q

posterior rostral pons at the lateral floor of the fourth ventricle

A

locus ceruleus

produces norepinephrine

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16
Q

Rifampin

A

inhibits DNA dependent RNA polymerase

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17
Q

hippocampus and cerebral arterioles with patchy red deposits that turn green under polarized light

A

Alzheimers

beta amyloid plaques

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18
Q

Crohns

A

mediated by Th1 –> granulomatous inflammation

hyperemic and edematous bowel, cobblestone appearance, non-caseating granuloma, transmural inflammatory infiltrate

risk of kidney stone due to hyperoxaluria

19
Q

Risk Factors for Nephrolithiasis

A 
Low fluids
Low Calcium
High Oxalate (spinach)
High ProteinHigh Sodium
High Fructose

Gout –> hyperuricosuria
Crohns –> hyperoxaluria
hyperPTH –> hypercalciuria

low urinary citrate (chronic metabolic acidosis like diarrhea)

20
Q

Myocardial hibernation

A

chronic myocardial ischemia causes decreased metabolic rate and function of myocardium

@ reperfusion/revascularization the hibernating myocardium improves contractility and LV function!

21
Q

Fluphenazine

A

DA antagonist

treatment for Tourette syndrome

tics are often temporarily suppressible and often preceded by an urge to make movement/noise

extrapyramidal side fx

22
Q

Diverticula

True vs False
Traction vs Pulsion

A

True = all layers Mucosa-Submucosa-Muscularis-Serosa (Meckel’s)

False = Psuedo - no muscularis (Zenker’s)

Pulsion are caused by increased intraluminal pressure @straining for BM

Most adult diverticulum are false and pulsion

23
Q

TB treatment that must be activated by mycobacterial catalase peroxidase

A

INH

activated by intracellular catalase peroxidase - mechanism of resistance

24
Q

Halothane hepatitis

A

acute hepatitis post-op due to halogenated inhaled anesthetics like desflurane

elevated AST, ALT and bilirubin + centrilobular necrosis

25
Q

D-alanine-D-alanine

A

structurally similar to penicillin

what vancomycin binds to

26
Q

Ree-Sternberg cells

A

CD15+ and CD30+

Hodgkin lymphoma

peak in 20y/os and 60y/os

B-cell lymphoma

associated with EBV infection

27
Q

Opioid OD

A

miosis, decreased RR, decreased HR, decreased BP, decreased bowel sounds

give naloxone

28
Q

“watershed” area of kidney

A

proximal tubules

ischemia –> acute tubular necrosis (increased serum Cr and BUN but normal ratio)

straight portion of proximal tubule and thick ascending limb of Henle are most susceptible to hypoxia b/c they have active (ATP) transport of ions = increased O2 demands

29
Q

Muddy brown casts

A

Acute Tubular Necrosis (most often due to cardiogenic shock)

30
Q

Erosion vs Ulcer

A

Erosion stays in mucosa and muscularis mucosa

ulcers go deeper: mucosa-muscularis mucosa-submucosa and even muscularis propria

31
Q

Placental abruption

A

seperation of placenta from uterus while baby is still in utero –> DIC

DIC of pregnancy mediated by tissue factor (from placental injury) –> activation of coag cascade

32
Q

Familial hypocalciruic hypercalcemia

A

autosomal dominant disorder to Calcium-sensing receptors (which are transmembrane GPCR) - high serum calcium required to activate defective calcium sensors - raised set point of calcium induced regulation (inhibition) of PTH

33
Q

Fenoldopam

A

D1 agonist

for HTN crisis

vasodilator (esp at coronary, pheripheral, renal, splanchnic)

promotes natriuresis

34
Q

NNRTIs

A

Efavirenz
Nevirapine (CYP inducer)
Delavirdine

35
Q

Integrase Inhibitors

A

-TEGRAVIRs

Dolutegravir
Elvitegravir

36
Q

Penetration Inhibitors

A

Enfuviritide

binds GP41

37
Q

Attachment Inhibitors

A

Maraviroc

binds CCR5

38
Q

Hormone Sensitive Lipase

A

converts TG

  • -> glycerol –> gluconeogenesis –> glucose
  • -> free fatty acid –> lipolysis –> ketones
39
Q

Aortic Dissection

A

severe retrosternal chest pain that radiates to the back

inciting event: tear in aortic intima

HTN is primary risk factor

HTN ==> medial hypertrophy –> reduced blood flow –> medial degeneration –> aortic enlargement and increased wall stiffness –> increased wall stress –> tear –> dissection

40
Q

Paroxysmal nocturnal hemoglobinuria

A

mutated PIGA gene –> decreased GPI –> decreased surface proteins:

CD55 = DAF (decay accelerating factor)
CD59 = MAC inhibitory protein

without these you get too much complement-mediated hemolysis

symp: hemolytic anemia, hemoglobinuria, thrombosis (hepatic, portal cerebral veins), pancytopenia

hemosiderosis - iron deposition in the kidney due to chromic hemolysis –> PCT dysfunction

41
Q

Schiller-Duval body

A

yolk sac tumors

resemble glomeruli

42
Q

congenital hypothyroidism

A

generally due to thyroid dysgenesis (agenesis, hypoplasia, ectopy)

symp: lethargy, poor feeding, constipation, hypotonia, umbilical hernia, protruding tongue, large fontanelle

43
Q

Hemochromatosis

A

Autosomal recessive, abnormally high iron uptake

liver disease, hepatomegaly, abd pain, hyperpigmentation

“bronze diabetes” = DM, pigment cirrhosis, and hepatomegaly

Caleb's Step 1 (16 decks)

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