Mixed Blocks Notes 7 Flashcards
Treatment of Restless Leg Syndrome
(1) Limit alcohol, nicotine, caffeine; (2) Dopamine Agonists (eg pramipexole)
Restless Leg is common in those with
Iron Deficiency, CKD, Diabetes
Treatment of Cataplexy
Muscarinic Antagonists (narcolepsy)
When does the neural tube form
Third week of fetal life
When do the neuropores close
Week Four = Anterior on day 25, Posterior on day 27
Tensilon Test
Tx of MG pt with Edrophonium (short acting AChEsterase inhibitor); Lack of improvement = cholinergic crisis
What mediates rapid decrease in myocardial calcium before relaxation
Na/Ca pump sarcolemmal pump; and Ca-ATPase
Major immune mechanism against Giardia
CD4 and IgA
RUQ pain after opiate
Biliary colic from contraction of SM cells in sphincter of oddi
Mu opioid effects on Histamine, Parietal Cells
Increase histamine (don’t use in hypotension); Decr parietal gastric acid secretion
Non-caseating granulomas - Crohn’s or Ulcerative colitis
Crohn’s
Unidirectional enzymes in glycolysis
Gluco/Hexokinase, PFK-1, Pyruvate Kinase
F-2,6-BP activates what?
PFK1 = Glycolysis
Insulin vs Glucagon effects on PFK1
Insulin –> PFK2 –> F-2,6-BP –> PFK-1 = Glycolysis; Glucagon inactivates PFK-2 via phosphorylation
What causes myocardial swelling with ischemia?
No ATP to pump Na (Na/K) or Ca (Ca-ATPase) out
Mechanism of nitrites in cyanide poisoning
Oxidized iron to Fe3+, which binds and sequesters cyanide, preventing it from binding cytochrome a-a3
What is used beside nitrites in cyanide poisoining
Thiosulfate –> Sulfate binds cyanide
Most common cause of aPTT prolongation
Lupus anticoagulants
Common findings in PCA stroke
(1) Contralateral hemianopia; (2) Contralateral parasthesias and numbness [thalamus]
Cranial Nerves supplied by PCA
III and IV
Why gallstones in Crohn’s
Can’t resorb bile acids in terminal ileum
Rate limiting step in catecholamine synthesis? What blocks this?
Tyrosine Hydroxylase - Metyrosine
What maintains cardiac output in acute/subacute aortic regurgitation
HR temporarily, but mainly increased LV preload
Carbamazepine adverse effects
(1) BM suppression; (2) Hepatotoxic; (3) SIADH
Drugs that cause SIADH
Carbamazepine, Cyclophosphamide, SSRI’s
Allergic contact dermatitis is due to
Antigen presentation by Langerhans cell –> CD4 response
Acanthosis
Incr in spinosum (think psoriasis)
Hypergranulosis
Excessive granulation of s granulosum (think lichen planus)
Max and min pressures in RV, Pulmonary Artery
4-25 in RV; 9-25 in PA
Treatment of PSGN
Loop diuretics and Vasodilators to relieve edema and hypertension
Most important prognostic indicator in PSGN
Age
Osteoporosis tends to affect what bone
Trabecular - Vertebral bodies, Neck of femure
what is characteristic of hyperparathyroidism
Subperiosteal resorption with cystic degeneration
Vit D bone loss is characterized by
Excessive unmineralized osteoid
Osteopetrosis is characterized by
Persistance of primary, unmineralized spongiosa in medullary canals
Drugs that cause seizures
I BItE my tongue - INH, Buproprion, Imipenem, Enflurane
Most common sites of intracranial hemorrhage
Deep brain = Basal ganglia, Cerebellar nuclei, Thalamus, Pons
Cerebral amyloid angiopathy tends to occur in what areas
Lobar/cortical parenchyma
Findings with Pulmonary Silicosis
Nodular densities and eggshell calcifications
Pulmonar berylliosis findings
Resembles sarcoidosis (nodular infiltrates, enlarged lymph nodes, non-caseating granulomas), but is not strongly associated with pleural plaques or effusions
Findings in coal worker’s pneumoconiosis
Multiple discrete nodules most prominent in upper lung zones
X ray of hypersensitivity pneumonitis due to inhalation of organic dust
Diffuse nodular interstitial infiltrates
Granulomatous destruction of liver bile ducts
Primary biliary cirrhosis
Intrahepatic hydatid cysts
Echinococcus
Mechanism of gingival hyperplasia with phenytoin
PDGF
Phenytoin toxicity mainly effects
Cerebellum and vestibular system –> Ataxia, Nystagmus
Systolic ejection murmur that increases with standing? Decreases with standing?
Hypertrophic CM - increases; Valvular aortic stenosis - decreases
Wide splitting of S1 accentuated by inspiration
Delayed closure of tricuspid = Complete right bundle branch block or tricuspid stenosis
Carboxylation of glutamate residues
Vitamin K
Erythropoeisis and peripheral blood smeal in Acute Intermittent Porphyria
Erythropoeisis and peripheral blood smear normal
Opiates used for diarrhea
Loperamide, Diphenoxylate
Pathogens most responsible for post-flu pneumonia
Pneumococcus, S aureus, H flu
Mycobacterium kanasaii symptoms
Pulmonary tuberculosis-like symptoms
High intracellular NADH in setting of hypoglycemia
Fuel other than glucose is being metabolized
High NADH/NAD+ ratio
Pyruvate to lactate and OAA to malate => Inhibits gluconeogenesis
What antibody is rarely seen in drug-induced Lupus
Anti-dsDNA (look for anti-histone)
Range for microalbuminuria
30-300 ug/mg creatinine
MOA of Adenosine in Supraventricular Tachy
Slows conduction thru AV node by hyperpolarizing the nodal pacemaker and conducting cells
All inhalational anesthetics, except what, are respiratory depressants
NO
Inhalational anesthetics preferred in pts with asthma
Halothane, Sevofluorane - Bronchodilation properties
Inhalational anesthetic effects on hepatic, renal, and cerebral BF
Decr hepatic; Incr cerebral; Decr GFR and RPF
Main side effects of bile acid binding resins
HyperTG (incr VLDL and TG synthesis), GI upset, Malabsorption, Gallstones
First line treatment of hypertriglyceridemia
Fibrates - decr hepatic synthesis
Clinical manifestations of schistosomiasis result from
Th2-mediated granulomatous response directed against eggs (with eos and mac’s)
Periportal Pipestem Fibrosis
Hepatic schistosomiasis
Echinococcus reservoir
Dog
Diphyllobothrium latum comes from
Freshwater fish
2,3-BPG only binds to
Deoxyhemoglobin
Why doesn’t HbF bind 2,3-BPG as well
Serine residues instead of histidine
HbC
Glutamic acid –> Lysine = Mild, chronic hemolytic anemia
Directly responsible for intimal thickening in athersclerosis
Smooth muscle cells (NOT FIBROBLASTS)
Treatment with Menotropin and hCG
Menotropin is human menopausal gonadotropin and acts like FSH; hCG acts like LH surge
Hepatolenticular degeneration
(GP and Putamen) Wilson’s disease –> Wing-beating tremor, Psychosis