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misc Flashcards

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
Q

skeletal muscle excitation- contraction coupling

A

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

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26
Q

cardiac muscle E-C coupling

A

L type channel –> Calcium influx –> binding to RyR2 (Ca-dependent Ca release) –> troponin C

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27
Q

Smooth muscle E-C coupling

A

L type channel –> Ca influx –> RyR (Ca-dependent Ca release) –> calmodulin –> Myosin LC kinase –> myosin phosphorylation –> actin binding –> muscle contraction

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28
Q

pemphigus vulgaris vs bulous pemphigoid

A

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
Q

anorexia vs bulimia

A

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
Q

grehlin

A

“hunger hormone”
secreted when stomach is empty –> arcuate nuc of hypothal –> incr hunger
also incr gastric acid, motility to prepare for a meal

31
Q

leptin

A

“satiety hormone”
secreted by adipose –> arcuate nuc of hypothal –> decr hunger
decr sensitivity in obesity

32
Q

UC vs Crohn’s

A

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
Q

alpha subunit hormones

A

FSH, hCG, LH, TSH

34
Q

17 deficiency

A

incr mineralcorticoids, decr cortisol and sex hormones

35
Q

21 deficiency

A

decr mineralcorticoids (may not show), decr cortisol, incr sex hormones. INCR 17-hydroxyprogesterone

36
Q

11 deficiency

A

decr aldo but incr 11-deoxycorticosterone can –> hypermineralism
decr cortisol and incr sex hormones

37
Q

puberty order girls

A

telarche –> pubarche –> menarche

38
Q

porphyria cutanea tarda

A 
uroporphyrinogen decarboxylase def
accumulate uroporphyrin (tea colored urine)
Blistering cutaneous photosensitivity
39
Q

AIP

A

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
Q

Lead poisoning

A

inhibit ferrochelatase and ALA dehydratase (containe Zn). Accumulate protophorphyrin, d-ALA.
Microcytic anemia, GI/renal dz, headache, memory loss, demyelination

41
Q

Cavernous sinus nerves

A

III, IV, V1, V2, VI, and postaganglionic sympathetics in route to orbit

42
Q

action of PGs on kidney

A

dilate afferent arteriole

FF constant but RPF, GFR up

43
Q

action of ATII on kidney

A

constrict efferent arteriole (RPF, GFR down but FF incr)

44
Q

retroperitoneal organs

A 
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
Q

Meniere’s

A

defective absorption of endolymph

Triad: vertigo, tinnitus, hearing loss

46
Q

path temporal and takayasu’s

A

granulomatous inflammation
Takayasu’s: younger asian women
Temporal: older women

47
Q

PAN

A 
Young adults
HBV positive in 30%
Segmental, transmural fibrinoid necrosis
spares lungs (PAs)
Tx steroids, cyclophosphamide
48
Q

Path buerger’s

A

segmental thrombosing vasculitis extending into vessels/nerves

49
Q

microscopic polyangiitis

A 
necrotizing vasculitis.
pauci-immune RPGN
Type III hypersensitivity. Abx.
p-ANCA
cyclophosphamide, corticosteroids.
50
Q

calcium oxalate/calcium phosphate

A 
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
Q

Struvite stones

A

(Mag ammonium sulfate or triple phosphate)
radiopaque
Rectangular prism (coffin lids)
urease forming organisms (Proteus, staph, klebsiella)
Staghorn
Alkaline environments

52
Q

Urate stones

A

RAdiolucent**
Yellow or red-brown, diamond or rhombus
high protein, low fluid, Lesch-Nyhan, leukemia
Tx: alkalinization of urine

53
Q

Cystine stones

A 
Radiopaque
Flat, yellow, hexagonal
Cystinuria (AR)
form in acidic pH
tx: alkalinization of urine
54
Q

VIPomas

A

WDHA

watery diarrhea, hypokalemia, achlorhydria

55
Q

stool findings watery diarrhea

A

no fecal leuks, no RBCs

56
Q

stool findings inflammatory diarrhea

A

PMNs +/- RBCs

57
Q

Stool findings in salmonella Typhi

A

Monos

58
Q

live attenuated vaccines

A

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
Q

Killed vaccines

A

SalK = Killed
RIP Always
Rabies, Influenza (injected), Polio (Salk), HAV

60
Q

drugs causing incr lithium levels

A

ACEi, HCTZ, NSAIDS

not loops

61
Q

Clinical trial phases

A

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
Q

congenital parvo

A

hydrops fetalis

63
Q

congenital GBS, lysteria, E coli

A

meningitis

64
Q

Congenital rubella

A

PDA (or PA hypoplasia), cataracts, excephalopathy, deafness, +/- “blueberry muffin” rash

65
Q

Congenital CMV

A

Chorioretinitis, petechial “blueberry muffin” rash, HSM, jaundice

66
Q

Congenital HIV

A

recurrent infections, diarrhea

67
Q

Congenintal HSV-2

A

encephalitis, herpetic lesions

68
Q

congenital syphillis

A

usually stillbirth, hydrops. Saddle nose, short maxilla, notched teeth, saver shins, CN 8 deafness.

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