Mixed 7 Flashcards
What is cerebral amyloid angiopathy?
This condition is associated w/ Alzheimer’s dse and is the MCC of spontaneous lobar hemorrhage. It occurs when beta-amyloid deposits in the walls of cerebral blood vessels, making them weak and prone to rupture. They’re most commonly found in the occipital and parietal regions.
What is the emergent treatment for patients w/ acute coronary syndrome because of it’s capacity to decrease mortality?
Beta-blockers.
A patient is noted to have increased total T4 levels after taking OCPs. Why?
Inc. estrogen activity also raises the circulating TBG levels, causing a corresponding dec. T4 and T3. As such, there will be transient inc. thyroid hormone production until the added TBGs become saturated and the free T4 and T3 levels are restored.
A patient who underwent cervical lymph node dissection now has difficulty raising their arm above the horizontal plane. Which nerve was injured and what muscle was affected?
The spinal accessory nerve (CN 11) runs through the posterior triangle of the neck where it’s vulnerable to trauma or iatrogenic injury. This nerve innervates the SCM and Trapezius. SSx of trapezius weakness include shoulder droop, impaired abduction over horizontal plane, scapular winging.
What mutation is involved in Li-Fraumeni syndrome? What type of cancers does this disease include?
> AD mutation of TP53, w/c codes for the p53 tumor suppressor protein.
Leukemias, sarcomas; breast, brain, adrenal cortex.
Which cells do NK cells destroy?
NK cells recognize and kill cells w/ dec. MHC class I antigen, such as virus-infected cells or tumor cells. NK cells have perforins and granzymes that allow them to induce apoptosis of target cells.
Why does the use of arteriolar vasodilators (hydralazine) have compensatory tachycardia?
Arteriolar dilators lowers BP by dec. SVR. This triggers reflex sympathetic activation and stimulates RAAS, resulting in tachycardia and edema. This limits the drugs’ long-term efficacy.
Of all the antiarrhythmic drugs, w/c one has the lowest risk of causing Torsades de pointes?
Amiodarone is a class 3 antiarrhythmic that can lengthen cardiac AP, w/c manifests as QT prolongation but w/ a lower risk of torsades de pointes.
What cardiovascular side effects can result from using nondihydropyridine CCBs?
Verapamil blocks L-type Ca channels, thus dec. phase 0 depolarization and dec. conduction velocity through the SA/AV nodes. This can cause bradycardia and AV block.
*Contraindicated in CHF
Gerstmann syndrome involves damage to the angular gyrus of the dominant parietal lobe. How would this patient present?
> Agraphia (can’t write).
Acalculia (can’t do math).
Finger agnosia (can’t identify fingers on hand).
Left-right disorientation.
Why must you use caution when giving a diabetic patient beta-blockers like propanolol or nadolol?
In fasting state, NE/Epi stimulate B2 receptors to inc. hepatic gluconeogenesis. Nonselective B-blockers inhibit hepatic gluconeogenesis and lipolysis. They also inhibit NE/Epi-mediated reactions to hypoglycemia (tremulousness, palpitations, and anxiety). As such, diabetic patients have greater risk of hypoglycemia and dec. awareness of when they have hypoglycemia.
