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1
Q

P450 inducers

A

Inducible Momma Barb Steals Phen-phen and refuses Greasy Carbs Chronically

Modafinil
Barbiturates
St John's Wort
Phenytoin
Rifampin
Griseofulvin
Carbamazepine
Chronic alcohol
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2
Q

P450 inhibitiors

A 
MAGIC RACKS in GQ
Macrolides
Amiodarone
GFJ
INH
Cimetidine
Ritonavir
Acute Alcohol
Ciprofloxacin
Ketoconazole
Sulfonamides  (TMP/SMX)
Gemfibrozil
Quinidine
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3
Q

Sulfa Drugs

A 
Popular FACTSSS
Probenecid
Furosemide
Acetazolamide
Celecoxib
Thiazides
Sulfonamide
Sulfasalazine
Sulfonylureas

Allergy = fever, UTI, pruritic rash, SJS, hemolysis, thrombocytopenia, agranulocytosis, urticaria

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4
Q

cAMP hormones

A

FLAT ChAMP

FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH

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5
Q

cGMP hormones

A

vasodilators: ANP, NO

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6
Q

IP3 hormones

A

GGGOAT

GnRH, GHRH, Gastrin, Oxytocin, ADH (V1), TRH

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7
Q

Steroid hormones

A

Vitamin D, EStrogen, Testosterone, T3/T4, Cortisol, Aldosterone, Progesterone

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8
Q

Intrinsic Tyrosine kinase hormones

A

MAP kinase –> Ras

Growth factors: Insulin, IGF-1, FGF, PDGF, EGF

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9
Q

Receptor -associated tyrosine kinase

A

JAK/STAT pathway

PIG: Prolactin, Immunomodulators (cytokines, IL-2,6,8, IFN), GH

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10
Q

Path vit D def

A

osteomalacia
failure to mineralize (Ca) osteoid matrix (made by osteoblasts)
increased deposition of unmineralized osteoid matrix around trabeculae

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11
Q

Path Paget dz

A

disorganized lamellar bone in mosaic pattern with cement lines

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12
Q

Path osteopetrosis (marble bone dz)

A

persistence of primary spongiosa in medullary cavity with no mature trabeculae. Osteoclastic dysfunction→ accumulation of woven bone and diffuse bone thickening

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13
Q

Bones in CKD

A

osteitis fibrosa cystica (from PTH)
osteomalacia (from lack of Vit D)
osteoporosis (from hypoCa)

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14
Q

path osteoporosis

A

leaching of calcium from bones slowly over time

trabecullar thinning with fewer interconnections

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15
Q

path hyperPTH

A

osteitis fibrosa cystica
Resorption of bone Ca → “burn out” → fibrosis and cysts
subperiosteal thinning → erosions and salt and pepper skull

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16
Q

Efficacy

A

Emax

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17
Q

Potency

A

dose requirement (ED50)

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18
Q

Drug-induced lupus

A

slow acetylators
Hydral
Procainamide
INH

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19
Q

Effect of competitive antagonist on dose-response curve

A

shifts curve to right (ED50 incr), without affecting Emax

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20
Q

effect of noncompetitive or irreversible antagonist on dose-response curbe

A

does not shift curve, reduces Emax

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21
Q

MEN syndromes

A

Men 1 – 3Ps. parathyroid, Pancreatic (ZES), pituitary adenoma (PRL, ACTH)
Men 2a 1M, 2 Ps: Medullary thyroid (calcitonin), pheo, parathyroid
Men 2b: 3Ms, 1 P: Medullary, Marfanoid, Mucosal neuromas, pheo

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22
Q

actions of TGFb

A
  1. arrest of cell cycle (tumor suppressor)
  2. promotes angiogenesis (allows mets to survive once they become resistant to it)
  3. stimulates fibroblasts to lay down ECM proteins (role in atherosclerosis and fibrosis
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23
Q

action of bradykinin

A

secreted by kidney when RAAS activated. constricts veins and dilates arterioles locally to incr renal perfusion

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24
Q

BNP and ANP pathways

A

increase cGMP –> vasodilation. Also cause natruresis

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25
skeletal muscle excitation- contraction coupling
depolarization --> opening of L-type Ca Channels --> direct opening through physical interaction of RyR1 Ca channels on SR --> release of Ca --> Troponin C NO extracellular Ca flux. no effect of CCBs
26
cardiac muscle E-C coupling
L type channel --> Calcium influx --> binding to RyR2 (Ca-dependent Ca release) --> troponin C
27
Smooth muscle E-C coupling
L type channel --> Ca influx --> RyR (Ca-dependent Ca release) --> calmodulin --> Myosin LC kinase --> myosin phosphorylation --> actin binding --> muscle contraction
28
pemphigus vulgaris vs bulous pemphigoid
PV -- desmosome Abs (desmoglein 1). flaccid bullae, mucosal membranes, +sloughing and new bullae nikolsky. Analogous to SSSS! BP -- hemidesmosome Abs. intact bullae, no mucosal involvement. "Bullow" epidermis! (basement membrane)
29
anorexia vs bulimia
BN: binging and compensatory behaviors (don’t have to be purging per se) self-worth influenced by weight maintain BMI, don’t get malnutrition Anorexia can have purging behaviors, difference is that they lose weight and have malnutrition.***
30
grehlin
"hunger hormone" secreted when stomach is empty --> arcuate nuc of hypothal --> incr hunger also incr gastric acid, motility to prepare for a meal
31
leptin
"satiety hormone" secreted by adipose --> arcuate nuc of hypothal --> decr hunger decr sensitivity in obesity
32
UC vs Crohn's
UC -- mucosa and Submucosa, crypt abscess, pseudopolyps, loss of haustra (lead pipe sign on imaging). Toxic megacolon, carcinoma after >10 years. PSC, p-ANCA. smoking protective Crohn’s -- full thickness, fissures, lymphoid aggregates and granulomas, skip lesions, cobblestone mucosa, creeping fat, strictures (string sign), malabsorption, Ca oxalate nephrolithiasis, fistula, carcinoma (if colonic dz), ankylosing spondylitis, sacroiliitis, migratory polyarthritis, erythema nodosum, uveitis, incr risk with smoking.
33
alpha subunit hormones
FSH, hCG, LH, TSH
34
17 deficiency
incr mineralcorticoids, decr cortisol and sex hormones
35
21 deficiency
decr mineralcorticoids (may not show), decr cortisol, incr sex hormones. INCR 17-hydroxyprogesterone
36
11 deficiency
decr aldo but incr 11-deoxycorticosterone can --> hypermineralism decr cortisol and incr sex hormones
37
puberty order girls
telarche --> pubarche --> menarche
38
porphyria cutanea tarda
``` uroporphyrinogen decarboxylase def accumulate uroporphyrin (tea colored urine) Blistering cutaneous photosensitivity ```
39
AIP
def in porphobilinogen deaminase accumulate porphobilinogen, d-ALA, urophorphyrin (urine) Abd pain, port wine colored urine, polyneuropathy, psych, precipitated by drugs Tx: glucose, heme, inhibit d-ALA synthase
40
Lead poisoning
inhibit ferrochelatase and ALA dehydratase (containe Zn). Accumulate protophorphyrin, d-ALA. Microcytic anemia, GI/renal dz, headache, memory loss, demyelination
41
Cavernous sinus nerves
III, IV, V1, V2, VI, and postaganglionic sympathetics in route to orbit
42
action of PGs on kidney
dilate afferent arteriole | FF constant but RPF, GFR up
43
action of ATII on kidney
constrict efferent arteriole (RPF, GFR down but FF incr)
44
retroperitoneal organs
``` SAD PUCKER Suprarenal (adrenals) Aorta/IVC Duodenum (second and third segments) Pancrease (head, neck, body) Ureters Colon (ascending and descending) Kidneys Esophagus (lower 2/3s) Rectum (upper 2/3s) ```
45
Meniere's
defective absorption of endolymph | Triad: vertigo, tinnitus, hearing loss
46
path temporal and takayasu's
granulomatous inflammation Takayasu's: younger asian women Temporal: older women
47
PAN
``` Young adults HBV positive in 30% Segmental, transmural fibrinoid necrosis spares lungs (PAs) Tx steroids, cyclophosphamide ```
48
Path buerger's
segmental thrombosing vasculitis extending into vessels/nerves
49
microscopic polyangiitis
``` necrotizing vasculitis. pauci-immune RPGN Type III hypersensitivity. Abx. p-ANCA cyclophosphamide, corticosteroids. ```
50
calcium oxalate/calcium phosphate
``` most common. Radiopaque Colorless octahedron crohn's -> bile acid malabsorption --> calcium binds to lipids instead of oxalate --> incr oxalate absorption --> stones Also ethylene glycol or Vit C abuse Tx: thiazides and citrate ```
51
Struvite stones
(Mag ammonium sulfate or triple phosphate) radiopaque Rectangular prism (coffin lids) urease forming organisms (Proteus, staph, klebsiella) Staghorn Alkaline environments
52
Urate stones
RAdiolucent** Yellow or red-brown, diamond or rhombus high protein, low fluid, Lesch-Nyhan, leukemia Tx: alkalinization of urine
53
Cystine stones
``` Radiopaque Flat, yellow, hexagonal Cystinuria (AR) form in acidic pH tx: alkalinization of urine ```
54
VIPomas
WDHA | watery diarrhea, hypokalemia, achlorhydria
55
stool findings watery diarrhea
no fecal leuks, no RBCs
56
stool findings inflammatory diarrhea
PMNs +/- RBCs
57
Stool findings in salmonella Typhi
Monos
58
live attenuated vaccines
Live! one night only! see small yellow chickens get vaccinated with Sabin's and MMR! it's incredible Smallpox, yellow fever, chickenpox, Sabin's polio, MMR, Influenza (inhaled
59
Killed vaccines
SalK = Killed RIP Always Rabies, Influenza (injected), Polio (Salk), HAV
60
drugs causing incr lithium levels
ACEi, HCTZ, NSAIDS | not loops
61
Clinical trial phases
Preclinical -- Testing of drug in non-human subjects Phase 0 -- small doses; pharmacodynamic and pharmacokinetics (often skipped) Phase I -- healthy volunteers, dose-ranging. 20-100 pt Phase II -- patients. efficacy/safety (100-300pt) does it have an effect? Phase III -- 1000-2000 pts. quantify efficacy, effectiveness, safety Phase IV -- postmarket surveillance
62
congenital parvo
hydrops fetalis
63
congenital GBS, lysteria, E coli
meningitis
64
Congenital rubella
PDA (or PA hypoplasia), cataracts, excephalopathy, deafness, +/- "blueberry muffin" rash
65
Congenital CMV
Chorioretinitis, petechial "blueberry muffin" rash, HSM, jaundice
66
Congenital HIV
recurrent infections, diarrhea
67
Congenintal HSV-2
encephalitis, herpetic lesions
68
congenital syphillis
usually stillbirth, hydrops. Saddle nose, short maxilla, notched teeth, saver shins, CN 8 deafness.

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