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Mixed Block Notes 4 Flashcards

1
Q

Signs of Acute Tubular Necrossi

A

Oliguria, Muddy Brown Casts, Anion Gap Metabolic Acidosis

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2
Q

Signs of Aromatase Deficiency

A

Maternal virilization, High androgens, Low estrogen, Tall, Osteoporosis –> Girls have ambiguous genitalia, boys just tall and osteoporosis

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3
Q

Function of Red Nucleus

A

Motor control of Upper extremities

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4
Q

Skin biopsy in Dermatitis Herpetiformis shows

A

PMNs and fibrin at tips of dermal papilla = microabcesses; IgA deposits

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5
Q

Infant with malabsorption, failure to thrive, progressive ataxia, acanthocytes

A

Abetalipoproteinemia

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6
Q

Epinephrine stimulates B2 receptors in skeletal muscle to

A

Incr BF, Glycogenolysis, Lipolysis

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7
Q

Endocrine comorbidities with Down Syndrome

A

Hypothyroid, T1DM, Obesity

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8
Q

Rheumatology and Hematology comorbidities with Down Syndrome

A

Acute Leukemia, Atlantoaxial instability

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9
Q

are only found in Alzheimer’s dementia

A

Neurofibrillary Tangles

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10
Q

Lewy bodies

A

Round, eosinophilic, intracytoplasmic inclusions that contain neurofilaments of a-synuclein

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11
Q

Negri Bodies

A

Round eosinophilic inclusions seen in the cytoplasm of pyramidal hippocampal neurons and cerebellar purkinje cells

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12
Q

When does the metonephros begin to produce urine

A

8-10 wks

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13
Q

Most common cause of fetal hydronephrosis

A

Inadequate recanalization of the ureteropelvic junctions

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14
Q

Tumor that causes necrolytic migratory erythema

A

Glucagonoma

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15
Q

Manifestations of Somatostatinoma

A

DM, Steatorrhea, Cholelithiasis, Hypochlohydria

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16
Q

Order of sound /pressure waves in inner ear

A

Round window –> Scala Vestibuli –> Scala Tympani –> Basilar Membrane dilation

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17
Q

Brown pigment stones typically arise secondary to

A

Infection of the biliary tract –> Releases B-Glucoronidase –> Hydrolysis of bilirubin glucoronides –> incr amount of unconjugated bilirubin in bile

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18
Q

7a-Hydroxylase function

A

Convert cholesterol to bile acids (sufficient activity reduces likelihood of cholesterol stone formation)

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19
Q

Important to metabolism/levels of digoxin

A

Renal clearance mostly, Plasma protein binding and body mass somewhat; Not liver enzymes

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20
Q

Most common known viral cause of acute hemorrhagic cystitis in children (and males in particular)

A

Adenovirus (serotypes 11 and 21 of B subgroup)

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21
Q

Pathogenesis of Centriacinar Emphysema

A

Smoke –> Macrophages –> PMNs –> Proteases active, Antiproteases inactivated

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22
Q

Club/Clara cell function

A

Nonciliated, secretory cells in terminal respiratory epithelium –> Secrete protein, surfactant and help detoxify

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23
Q

Is S3 or S4 always pathologic in young patients

A

S4 always in younger, Not always in older

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24
Q

V/Q and Acid/Base consequences of PE

A

Redistribution of blood to unaffected –> V/Q mismatch –> Hypoxemia stimulates hyperventilation –> Respiratory Alkalosis

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25
3 NNRTI's
Nevirapine, Efavirenz, Delavirdine
26
MOA of Enfuvirtide
Prevent fusion by binding gp41
27
Most concerning AE of NNRTI's
Hepatic Failure with Encephalopathy
28
Holoprosencephaly is associated with
Trisomy 13 and 18, Fetal Alcohol Syndrome
29
Deformation vs Malformation
Deformation occurs due to extrinsic mechanical force; Malformation is a primary defect in cells or tissues that form an organ
30
"Disruption"
Secondary breakdown of a previously normal tissue or structure
31
Aldolase function
A/B/C metabolize F-1,6-BP to G3P and DHAP; Aldose B also metabolizes F-1-P to Glyceraldehyde and DHAP
32
Tx Aldolase B deficiency by
Eliminating dietary fructose (sucrose)
33
Sucrose
Fructose + Glucose
34
Lactose
Galactose + Glucose
35
Maltose
Glucose + Glucose
36
For patients with stiff lungs, work of breathing is minimized when
RR is high, TV is low
37
For patients with high airflow resistance, work of breathing is minimized when
RR is low, TV is high
38
LPS/LOS cause sepsis by induction of systemic inflammatory response characterized by
TNFa, IL-1b, IL-6, IL-8 (much of which is formed after interaction with TLR-4)
39
Osteoporosis is defined as
Bone density \>2.5 SD below mean for peak young adult bone density
40
Risk factors for Osteoporotic Fractures
White/Hispanic/Asian, Hx, Decr activity, Low body weight, Excessive alcohol or tobacco, Premature menopause
41
How do GC's incr bone loss
(1) Decr GI absorption of Ca, (2) Inhibit collagen synthesis, (3) Decr GnRH, (4) Incr urinary Ca loss
42
Side effects of Statins
Myotoxicity, Hepatotoxicity (discontinue if LFT's \>3x normal)
43
CYP Inducers
Chronic Alcohol, St Johns wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine
44
CYP substrates
Anti-epileptics, Theophylline, Warfarin, OCPs
45
CYP inhibitors
Acute Alcohol, Ritonavir, Amiodarone, Cimetidine, Ketoconazole, Sulfonamides, Isoniazid, Grapefruit, Quinidine, Macrolides (ex azithromycin)
46
Acanthosis
Incr thickness of stratum spinosum (psoriasis commonly associated with acanthosis)
47
Spongiosis
Intercellular epidermal edema --\> incr space b/t cells (eg eczematous dermatitis)
48
Dyskeratosis
Premature keratinization of individual keratinocytes (eg SCC)
49
First line for isolated systolic HTN in non diabetics
Thiazides and DHP CCBs
50
HTN drug that can lead to flushing and peripheral edema
Amlodipine
51
First line for essential HTN in general public
HCTZ
52
Most frequent AE's w/ Verapamil
Constipation, Gingival hyperplasia
53
Drugs that cause Gingival Hyperplasia
Phenytoin, CCBs, Cyclosporine
54
MOA of Clomiphene
SERM that prevents negative feedback inhibition on hypothalamus (used in PCOS)
55
Diseases that cause myocardial fibrosis
Dermatomyositis, Muscular Dystrophy, Sarcoidosis, Scleroderma
56
Why doesnt Anti-HepC IgG confer immunity?
RNA polymerase errors --\> Varied antigenic structure
57
AE's of Amphotericin B
Infusion reaction, Thrombophlebitis, Nephrotoxicity, HypoMg/HypoK, Anemia (suppressed EPO)
58
BH4 is a cofactor for synthesis of
Tyrosine, DOPA, Serotonin, Prolactin, NO
59
Cardiac morphology changes with aging
(1) Decr LV chamber size; (2) Sigmoid IV septum; (3) Incr interstitial CT; (4) Lipofuscin accumulation
60
Murmur of VSD
Loud holosystolic murmur over left sternal border 3-4 intercostal space (smaller = louder)
61
Phenylethanolamine N-methyltransferase
NE to Epi
62
Systemic sclerosis is thought to be due to activation of what cell type
CD4
63
A strict vegetarian diet can cause a deficiency of
B12
64
Free wall rupture occurs how long after MI
3-7 days
65
Triad of muffled heart sounds, elevated JVP, profound hypotension indicate
Pericardial Tamponade
66
How does GI bleed precipitate Hepatic Encephalopathy
Incr nitrogen delivery to gut in form of hemoglobin --\> converted to ammonia and enters bloods stream
67
Molecules that act thru nuclear receptors
TH, Retinoids, PPAR, Fatty Acids
68
Spirochetes are universally sensitive to
Penicillin (gram nevative peptidoglycan cell wall)
69
Xeroderma Pigmentosa is defect in
DNA excision repair
70
DNA mismatch repair defect
Lynch syndrome
71
Why doesn't Ceftriaxone work on Chlamydia
Cell wall lacks peptidoglycan (Ureaplasma lacks cell wall alltogether)
72
Phentolamine MOA
Alpha 1 and 2 blocker (no BB effects)
73
Dose-dependent effects of Epinephrine
Increases systolic, Increases HR, and either increases or decreases diastolic dependending on dose (a1 at high, or B2 at low)
74
Kappa opioid receptors mediate
Miosis
75
Hexamethonium MOA
Potent nicotinic receptor antagonist
76
Defect in keratins 5 and 14
Epidermolysis Bullosa Simplex
77
Characteristic Triad of Ataxia Telangiectasia
Those + Incr risk of sinopulmonary infections (IgA deficiency)
78
ATM gene is responsible for
DNA break repair (hypersensitive to x ray radiation)
79
Why does lead cause hypochromic anemia
Inhibits mitochondrial iron transport
80
Bare Lymphocyte Syndrome
Absent MHC II --\> T and B cell deficiency
81
Features of Lesch-Nyhan
Hyperuricemia, Gout, Pissed off, Retardation, dysTonia
82
AICA block
Facial droop means AICA's pooped
83
Process of Base Excision Repair
Abnormal Base --\> Glycosylase removes --\> Endonuclease and Lyase cleave 5 and 3' --\> DNA polymerase and ligase
84
Pyrophosphate analog that doesn't require phosphorylation
Foscarnet
85
Properties of Type 1 muscle fibers
Slow = Aerobic, High myoglobin and mitochondria
86
Side chain cleavage enzyme in adrenals
Cholesterol --\> Pregnenalone
87
Pulmonary Stretch Receptors
C fibers in lungs and airways that regulate degree of distension (Hering-Breuer reflex)
88
Infant with Air in bowel wall, Abdominal distension, and Bloody stools
Necrotizing Enterocolitis
89
N-acetylmuramic acid and N-acetylglucosamine
Saccharides that combine with AA chain to form peptidoglycan cell wall
90
Tay Sachs findings
Cherry Red Macula, Neurodegeneration, Developmental delay, Onion Skin Lysosomes, No HSM (vs Niemann-Pick)
91
Niemann-Pick findings
Cherry Red Macula, Neurodegeneration, Foam Cells, HSM
92
Important genes altered by PPARg
Adiponectin, FA transport, Insulin receptor, Glut-4
93
DOC for Complex Partial Seizures
Carbamazepine
94
PTH effects on bone cells
Incr RANKL and M-CSF production by osteoblasts; Decr OPG
95
MOA of Pergolide
D2 agonist
96
Isoniazid vitamin deficiency
B6 --\> Peripheral neuropathy (GABA def)
97
4 phases of lobar pneumonia
Congestions (first 24hr) --\> Red Hepatization (2-3d) --\> Gray Hepatization (4-6d) --\> Resolution
98
Microscopic appearance in Congestion --\> Red --\> Gray Hepatization
Vascular Dilatation, Mostly bacteria --\> RBCs, PMNs, Fibrin --\> Disintegrated RBCs, PMNs and Fibrin
99
MTB virulence factor allowing for intracellular proliferation
Sulfatide

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