Mixed Block Notes 10 Flashcards by Ryan Lee

Adenosine MOA

AV node - slows conduction and decreases automaticity by hyperpolarizing cells

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Usefulness of Methacholine challenge

High sensitivity, Low specificity

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UG Sinus vs Wolffian Ducts in males

UG sinus = Bladder, urethra, prostate, bulbo’s; Wolffian = Epididymis, Ductus, Seminal vesicles

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In a healthy individual, airway resistance is smallest when

lungs are inflated - radial traction of pulmonary tissue on conducting airways

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Repetitive ischemia of cardiomyocytes or persistent hypoperfusion –>

Hibernation - Chronic but reversible loss of function

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Myocardial stunning

Less severe form of ischemia-induced reversible loss of contractile function than hibernation (from brief ischemic episodes)

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Long term lithium requires monitoring of

Thyroid and Renal function

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PCWP =

LA EDP, which should equal LVEDP

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Regulatory step for Pyrimidine synthesis

ATP, CO2, Glutamine –> Carbamoyl Phosphate

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Treatment of Orotic Aciduria

Can’t for UMP, so supplement with uridine (–> UMP)

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Presentation of Orotic Aciduria

Hypochromic megaloblastic anemia, Neuro, Growth

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Hydroxyurea inhibits

Ribonucleotide Reductase

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Leflunomide blocks formation of

Orotic Acid

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Peptide YY

Ileum and Colon –> ECL –> Inhibit gastrin-stimulated histamine release from ECL’s

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Bladder lymph drainage

Superior to External Iliac, Inferior to Internal

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Traction diverticula

Due to inflammatino and scarring –> True (eg mediastinal lymphadenitis, periesophageal scarring)

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Pathophys of aortic dissection from hypertension

Medial hypertrophy of aortic vasa vasorum –> Reduced BF for aortic media –> Medial degeneration

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PABA esters block

UVB (290-320)

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UV what is major cause of sunburn, photo-aging, and carcinogenesis

UVB

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Avobenzone

UVAI and UVAII

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Zinc Oxide sunscreen

UVB, UVAI, UVAII

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Stomatitis in treatment of RA

MTX (supplement folic acid)

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Serious potential AE of Hydroxychloroquine

Permanent retinal damage

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Lack of GC’s means response to what will be limited

Vasopressors

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Strong predisposing factor to Mallory Weiss

Hiatal hernia

Which MEN has marfanoid habitus

MEN2b

Which lung cancer is not surgically approached

Small cell

Primary mechanism of combination OCP's

Suppression of FSH, LH (no midcycle LH spike for ovulation); Secondary mechanism is blocking sperm and preventing implantation

Neuro-endocrine markers

Neuron-specific enolase, Chromagranin, Synaptophysin

Vimentin is used to dx

Sarcoma (mesenchymal origin)

Thrombin Time

Fibrinogen to Fibrin

Chronic HTN causes what microvascular changes in brain

Lipohyalinosis, Microatheroma

Lacunar infarct in Base of Pons

Ataxia-Hemiplegia; Dysarthria-Clumsy Hand syndrome

Lacunar infarct in Genu of Internal Capsule

Dysarthria-Clumsy Hand Syndrome

Initial presentation of Charcot Bouchard vs Lacunar Infarct

Charcot Bouchard would show hemorrhage on initial CT

First sign of puberty

Testicular and breast enlargement

What causes LV outflow obstruction in HCM

Abnormal systolic anterior motion of anterior leaflet of mitral valve toward hypertrophied IV septum

Garlic odor after poisoning

Arsenic --> Dimercaprol (which itself causes nephrotoxicity and HTN)

EDTA is used for

Lead and Mercury poisoning

Well-developed smooth ER

Steroid-producing cells (eg adrenals, gonads, liver); Detoxification

Most specific marker for dx of acute HepB

Anti-HBc IgM

All females with Mullerian defects should undergo

Renal ultrasound (coexisting urologic abnormality)

Relative speed of conduction in cardiac components

Purkinje > Atrial Muscle > Ventricular Muscle > AV node (Park At Ventura Avenue)

Why do cryptorchid testes not secrete Inhibit

Temperature degenerates seminiferous tubules selectively

Chronic gastritis with antral sparing vs antral-predominant

Autoimmune spares antrum; H pylori mostly affects antrum

Most common bening vascular tumors in adults

Cherry Hemangiomas (do not regress)

Superficial Hemangioma

Infantile, Capillary, Strawberry - Grow rapidly and regress

B1 is a cofactor for

Pyruvate DH, a-KG DH, Transketolase

QRS complex in exercise

Normally decr; If prolonged --> 1c anti-arrhythmic (use-dependent)

Use dependence of Class III anti-arrhythmics

Reverse use-dependence = Slower heart rate means more QT prolongation

Digoxin and K

Toxicity causes HyperK, but can be exacerbated by HypoK

Citrullination

Tissue inflammation --> Arginine enzymatically converted to citrulline

GABAa vs GABAb

A = Cl influx; B = GPCR (K efflux, decr Ca influx, inhibit AC)

Clinical manifestations of Chronic Interstitial Nephritis

(1) Modest elevation in creatinine; (2) Evidence of tubular dysfunction - polyuria, nocturia; (3) Fanconia syndrome - Aminoaciduria, Glycosuria, Hypophosphatemia, Hypouricemia

NSAID-associated chronic renal injury is morphologically characterized by

Papillary Necrosis; Chronic Interstitial Nephritis

Myelofibrosis

Atypical Megakaryocytic Hyperplasia --> Activate fibroblast prolifation

Myelodysplastic syndromes - BM bx

BM bx shows disordered differentiation affecting all non-lymphoid lineages, Ringed siderblasts, Megaloblastoid maturation

Myelophthisic anemia

Space-occupying lesion sof bone marrow - All lines affected (pancytopenia)

Most common causes of Myelophthisic anemia

Infiltration by met carcinomas w/ associated fibrosis; Also granulomas

Ergot Dopamine agonists

Bromocriptine, Pergolide

Non-ergo Dopamine agonists

Pramipexole, Ropinirole

CEA is a marker for

Colon, Pancreatic

CA-125

Maligant ovarian carcinoma

Congenital Long QT and Sensorineural deafness

Jervell and Lange-Nielsen (AR)

Congenital Long QT, pure cardiac

Romano-Ward

Virus with lipid solubule envelope are susceptible to

Diethyl Ether, Chloroform, 50% trichlorofluoroethane

Most common benign lung tumor

Hamartoma (Pulmonary chondroma) - Coin lesion

Lung lesion with alveolar growth pattern along alveolar septae without fascular or stromal invasion

Bronchioalveolar Carcinoma

Sporicidal compounds

Hydrogen Peroxide, Iodine (not alcohols or chlorhexidine, which disrupt membrane)

Chlorhexidine works by

Destabilizing cell membranes and coagulating intracellular constituents

Formaldehyde and Glutaraldehyde work by

Alkylating and cross-linking DNA and proteins

Matching is used to control

Confounding

Viruses that cleave one polyprotein via protease

+ss linear nonsegmented RNA viruses (eg echovirus)

BH4 is cofactor for synthesis of

Tyrosine, DOPA, Serotonin, NO