Mon Aug 3 Flashcards
what is the main mechanism that nitrates help treat angina?
Decreasing preload
presentation of chronic hypersensitivity pneumonitis?
- progressive cough, dyspnea, fatigue, leukocytosis
- hypoxemia that worsens with exertion
- diffuse reticular opacities
what will a lung biopsy of someone with hypersensitivity pneumonitis find?
- lymphocytic infiltrate
- poorly formed noncaseating granulomas
- interstitial fibrosis
timolol MOA for glaucoma
diminishes the secretion of aqueous humour by the ciliary epithelium
where is aqueous humour produced?
the epithelial cells of the ciliary body
what drugs increase the trabecular outflow of aqueous humour?
muscarinic agonists
what drugs increase the uveosceral outflow of aquous humour?
prostaglandin agonists
blood supply of basal ganglia?
lenticulostriate arteries
crescent shaped organism with central nucleus?
toxoplasmosis gondi
cardiac amyloid deposition may result in which type of cardiomyopathy?
restrictive
what happens to the ventricular walls with cardiac amyloid deposition?
they become uniformly thickened
cyclin dependant kinases control cell cycle progression between which stages?
G1 -> S
if cyclin dependent kinases are blocked, what protein has increased activity?
Rb protein -> cell cycle arrest and death
how to treat oral candida?
nystatin
which B protein is in chylomicrons?
ApoB-48
which B protein is found on VLDL?
ApoB-100
Chylomicrons are secreted from the…
small intestine
what is the function of microsomal triglyceride transfer protein?
Important during the synthesis of Apo-B containing lipoproteins- it acts as a chaperone protein for the proper folding of ApoB and participates in the transfer of lipids to newly formed chylomicrons and VLDL
which disease often results from a loss of function mutation of microsomal triglyceride transfer protein (MTP)?
abetalipoproteinemia
inheritance of abetalipoprotinemia?
AR
clinical presentation of abetalipoproteinemia?
- symptoms of malabsorption
- fat soluble vit deficiencies
- low plasma triglycerides and cholesterol
- absent VLDL, chylomicrons and ApoB from the blood
- abnormal red blood cells
- neurological symptoms
when does abetalipoproteinemia present?
first year of life
findings of a intestinal biopsy of someone with abetalipoproteinemia?
lipid accumulation in enterocytes
elevated serum levels of which substance contribute to insulin resistance?
free fatty acids
paraneoplastic sydromes may cause what compliction in the brain?
paraneoplastic cerebellar degeneration (autoimmune process)
patients with porcelain gallbladder have an increased risk of which cancer?
adenocarcinoma of the gallbladder
Fibrosing disease of the bile ducts, such as primary sclerosing cholangitis, or chronic liver fluke infection icnrease the risk of….
cholangiocarcinoma
patients with maple syrup urine disease should require supplementation of what?
thiamine - cofactor for branched-chain alpha ketoacid dehydrogenase
what breaks down ANP and BNP?
the metalloprotease ‘neprilysin’
effects of ANP and BNP?
- vasodilation
- increase GFR (dilate affarent, constrict efferent)
- decrease aldosterone production
transketolase is part of which pathway?
the pentose-phosphate pathway
where does the pentose-phosphate pathway occur?
cytosol
where is HMG-Coa located?
mitochondria
how do corticosteroids effect Beta-2 receptors?
they stimulate the upregulation of them in bronchial smooth muscle
blood findings in a leukemoid reaction?
- leukocytosis
- increased bands and early mature neutrophil precursors
- increased serum leukocyte alkaline phosphatase
- Dohle bodies
what are Dohle bodies?
Light blue peripheral granules in neutrophils - seen in a leukamoid reaction
are the cells produced in a leukamoid reaction immature?
no - they are mature cells
function of telomerase?
prevents chromosomal shortening
pathophys of fetal infection with parvovirus?
interruption of erythropoeisis leads to profound anemia and heart failure ->pleural effusions, pericardial effusions, and ascities.
Death from fetal hydrops.
what type of virus is parvovirus?
naked single stranded DNA
is estrogen decreased in PCOS?
No - it is increased and may lead to endometrial hyperplasia (androgens also increased, moreso)
why are the ovaries enlarged in PCOS?
They are undergoing increased activity
what ist he target of rituximab?
CD20 on B cells - used for lymphomas
metabolism of succinylcholine?
hydralized by PLASMA pseudocholinesterase
how do patients with pseudocholinesterase deficiency present?
extended paralysis (anesthesia) with the administration of succinylcholine, due to a diminished ability to hydrolyze succinylcholine in the plasma
how does modafinil effect CYP450s?
INDUCER
how does cyclophosphamide effect CYP450s?
INDUCER
how does amiodarone effect CYP450s?
inhibitor
how are pro-carcinogens activated in the body?
they are metabolized by CYP450 monooxygenase (microsomal monooxygenases)
patients with myasthenia gravis are often resistant to which type of neuromuscular blocking agents?
depolarizing agents
patients with myasthenia gravis are often more sensitive to which type of neuromuscular blocking agents?
non-depolarizing agents
what is vecuronium?
Nondepolarizing competitive antagonist of nicotinic acetylcholine receptors
what diet increases your risk for gastric adenocarcinoma?
High salt diet
Processed meats
filtration fraction =
GFR/RPF
why does filtration fraction increase in severe hypovolemia?
Although both the GFR and RPF decrease, the constriction of the efferent arteriole presevers some of the GFR, thus the RPF is relatively more decreased.
Since FF= GFR/RPF, FF increases.
why may someone with BPH have hematuria?
new friable blood vessels may form in the area of hyperplasia, leading to hematuria
