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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
Q

3 NNRTI’s

A

Nevirapine, Efavirenz, Delavirdine

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26
Q

MOA of Enfuvirtide

A

Prevent fusion by binding gp41

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27
Q

Most concerning AE of NNRTI’s

A

Hepatic Failure with Encephalopathy

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28
Q

Holoprosencephaly is associated with

A

Trisomy 13 and 18, Fetal Alcohol Syndrome

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29
Q

Deformation vs Malformation

A

Deformation occurs due to extrinsic mechanical force; Malformation is a primary defect in cells or tissues that form an organ

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30
Q

“Disruption”

A

Secondary breakdown of a previously normal tissue or structure

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31
Q

Aldolase function

A

A/B/C metabolize F-1,6-BP to G3P and DHAP; Aldose B also metabolizes F-1-P to Glyceraldehyde and DHAP

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32
Q

Tx Aldolase B deficiency by

A

Eliminating dietary fructose (sucrose)

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33
Q

Sucrose

A

Fructose + Glucose

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34
Q

Lactose

A

Galactose + Glucose

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35
Q

Maltose

A

Glucose + Glucose

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36
Q

For patients with stiff lungs, work of breathing is minimized when

A

RR is high, TV is low

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37
Q

For patients with high airflow resistance, work of breathing is minimized when

A

RR is low, TV is high

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38
Q

LPS/LOS cause sepsis by induction of systemic inflammatory response characterized by

A

TNFa, IL-1b, IL-6, IL-8 (much of which is formed after interaction with TLR-4)

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39
Q

Osteoporosis is defined as

A

Bone density >2.5 SD below mean for peak young adult bone density

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40
Q

Risk factors for Osteoporotic Fractures

A

White/Hispanic/Asian, Hx, Decr activity, Low body weight, Excessive alcohol or tobacco, Premature menopause

41
Q

How do GC’s incr bone loss

A

(1) Decr GI absorption of Ca, (2) Inhibit collagen synthesis, (3) Decr GnRH, (4) Incr urinary Ca loss

42
Q

Side effects of Statins

A

Myotoxicity, Hepatotoxicity (discontinue if LFT’s >3x normal)

43
Q

CYP Inducers

A

Chronic Alcohol, St Johns wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine

44
Q

CYP substrates

A

Anti-epileptics, Theophylline, Warfarin, OCPs

45
Q

CYP inhibitors

A

Acute Alcohol, Ritonavir, Amiodarone, Cimetidine, Ketoconazole, Sulfonamides, Isoniazid, Grapefruit, Quinidine, Macrolides (ex azithromycin)

46
Q

Acanthosis

A

Incr thickness of stratum spinosum (psoriasis commonly associated with acanthosis)

47
Q

Spongiosis

A

Intercellular epidermal edema –> incr space b/t cells (eg eczematous dermatitis)

48
Q

Dyskeratosis

A

Premature keratinization of individual keratinocytes (eg SCC)

49
Q

First line for isolated systolic HTN in non diabetics

A

Thiazides and DHP CCBs

50
Q

HTN drug that can lead to flushing and peripheral edema

A

Amlodipine

51
Q

First line for essential HTN in general public

52
Q

Most frequent AE’s w/ Verapamil

A

Constipation, Gingival hyperplasia

53
Q

Drugs that cause Gingival Hyperplasia

A

Phenytoin, CCBs, Cyclosporine

54
Q

MOA of Clomiphene

A

SERM that prevents negative feedback inhibition on hypothalamus (used in PCOS)

55
Q

Diseases that cause myocardial fibrosis

A

Dermatomyositis, Muscular Dystrophy, Sarcoidosis, Scleroderma

56
Q

Why doesnt Anti-HepC IgG confer immunity?

A

RNA polymerase errors –> Varied antigenic structure

57
Q

AE’s of Amphotericin B

A

Infusion reaction, Thrombophlebitis, Nephrotoxicity, HypoMg/HypoK, Anemia (suppressed EPO)

58
Q

BH4 is a cofactor for synthesis of

A

Tyrosine, DOPA, Serotonin, Prolactin, NO

59
Q

Cardiac morphology changes with aging

A

(1) Decr LV chamber size; (2) Sigmoid IV septum; (3) Incr interstitial CT; (4) Lipofuscin accumulation

60
Q

Murmur of VSD

A

Loud holosystolic murmur over left sternal border 3-4 intercostal space (smaller = louder)

61
Q

Phenylethanolamine N-methyltransferase

62
Q

Systemic sclerosis is thought to be due to activation of what cell type

63
Q

A strict vegetarian diet can cause a deficiency of

64
Q

Free wall rupture occurs how long after MI

65
Q

Triad of muffled heart sounds, elevated JVP, profound hypotension indicate

A

Pericardial Tamponade

66
Q

How does GI bleed precipitate Hepatic Encephalopathy

A

Incr nitrogen delivery to gut in form of hemoglobin –> converted to ammonia and enters bloods stream

67
Q

Molecules that act thru nuclear receptors

A

TH, Retinoids, PPAR, Fatty Acids

68
Q

Spirochetes are universally sensitive to

A

Penicillin (gram nevative peptidoglycan cell wall)

69
Q

Xeroderma Pigmentosa is defect in

A

DNA excision repair

70
Q

DNA mismatch repair defect

A

Lynch syndrome

71
Q

Why doesn’t Ceftriaxone work on Chlamydia

A

Cell wall lacks peptidoglycan (Ureaplasma lacks cell wall alltogether)

72
Q

Phentolamine MOA

A

Alpha 1 and 2 blocker (no BB effects)

73
Q

Dose-dependent effects of Epinephrine

A

Increases systolic, Increases HR, and either increases or decreases diastolic dependending on dose (a1 at high, or B2 at low)

74
Q

Kappa opioid receptors mediate

75
Q

Hexamethonium MOA

A

Potent nicotinic receptor antagonist

76
Q

Defect in keratins 5 and 14

A

Epidermolysis Bullosa Simplex

77
Q

Characteristic Triad of Ataxia Telangiectasia

A

Those + Incr risk of sinopulmonary infections (IgA deficiency)

78
Q

ATM gene is responsible for

A

DNA break repair (hypersensitive to x ray radiation)

79
Q

Why does lead cause hypochromic anemia

A

Inhibits mitochondrial iron transport

80
Q

Bare Lymphocyte Syndrome

A

Absent MHC II –> T and B cell deficiency

81
Q

Features of Lesch-Nyhan

A

Hyperuricemia, Gout, Pissed off, Retardation, dysTonia

82
Q

AICA block

A

Facial droop means AICA’s pooped

83
Q

Process of Base Excision Repair

A

Abnormal Base –> Glycosylase removes –> Endonuclease and Lyase cleave 5 and 3’ –> DNA polymerase and ligase

84
Q

Pyrophosphate analog that doesn’t require phosphorylation

85
Q

Properties of Type 1 muscle fibers

A

Slow = Aerobic, High myoglobin and mitochondria

86
Q

Side chain cleavage enzyme in adrenals

A

Cholesterol –> Pregnenalone

87
Q

Pulmonary Stretch Receptors

A

C fibers in lungs and airways that regulate degree of distension (Hering-Breuer reflex)

88
Q

Infant with Air in bowel wall, Abdominal distension, and Bloody stools

A

Necrotizing Enterocolitis

89
Q

N-acetylmuramic acid and N-acetylglucosamine

A

Saccharides that combine with AA chain to form peptidoglycan cell wall

90
Q

Tay Sachs findings

A

Cherry Red Macula, Neurodegeneration, Developmental delay, Onion Skin Lysosomes, No HSM (vs Niemann-Pick)

91
Q

Niemann-Pick findings

A

Cherry Red Macula, Neurodegeneration, Foam Cells, HSM

92
Q

Important genes altered by PPARg

A

Adiponectin, FA transport, Insulin receptor, Glut-4

93
Q

DOC for Complex Partial Seizures

A

Carbamazepine

94
Q

PTH effects on bone cells

A

Incr RANKL and M-CSF production by osteoblasts; Decr OPG

95
Q

MOA of Pergolide

A

D2 agonist

96
Q

Isoniazid vitamin deficiency

A

B6 –> Peripheral neuropathy (GABA def)

97
Q

4 phases of lobar pneumonia

A

Congestions (first 24hr) –> Red Hepatization (2-3d) –> Gray Hepatization (4-6d) –> Resolution

98
Q

Microscopic appearance in Congestion –> Red –> Gray Hepatization

A

Vascular Dilatation, Mostly bacteria –> RBCs, PMNs, Fibrin –> Disintegrated RBCs, PMNs and Fibrin

99
Q

MTB virulence factor allowing for intracellular proliferation

Uworld (16 decks)

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