mon jul 21 Flashcards
who does medicare cover?
- patients over 65
- young persons with disabilities
- patients with end stage renal disease
- patients with ALS
which cytokine plays an important role in giant cell arteritis severity?
IL-6 (correlates with disease severity)
what is tocilizumab?
Monoclonal antibody against IL6 useful in treating giant cell arteritis
how does a bacteria infection of the biliary tract lead to brown pigment stones?
infection leads to release of beta-glucoronidase by injured hepatocytes and bacteria. This enzyme hydrolyzes biliary glucuronidases leading to increased unconjugated bilirubin
what causes hereditary hemochromatosis?
AR disorder due to increased intestinal absorption of iron
what causes wilsons disease?
AR disorder with a defective ATP7B gene which results in the liver being unable to transport the copper into bile or onto ceruloplasmin
esmolol MOA
selective B1 blocker
what is isoproterenol?
a B1 and B2 AGONIST
capsaicin MOA for treating pain
causes a build up of intracellular Ca leading to nociceptive nerve fiber dysfunction.
Also depletes substance P
What is substance P?
polypeptide neurotransmitter involved in transmission of pain signals
what is zolpidem?
a non-benzo hypnotic that works by binding GABA-A
what is the difference in presentation between serotonin syndrome and neuroleptic malignant syndrome?
Neuroleptic malignant syndrome –diffuse lead pipe rigidity and hyporeflexia
Serotonin syndrome – Clonus and hyperreflexia
presentation of west nile virus?
West Nile fever - fever, headache, rash.
Neuroinvasive: meningitis, encephalitis, acute Asymmetrical flaccid paralysis
Parkinsonian symptoms
ACUTE asymmetric flaccid paralysis is suggestive of..
west nile virus
how do diagnos west nile virus?
CSF with anti-WNV antibodies
osteosarcoma is associated with mutations in which genes?
RB1
TP53
RB1 mutations are associated with which cancers?
osteosarcoma, melanoma, retinoblastoma and sarcomas
what are the components of LPS?
O antigen, core polysaccharide, Lipid A
which part of LPS is responsible for causing sepsis?
Lipid A - toxic to mammalian cells -causes release of endogenous pyrogens
the activity of pyruvate carboxylase is increased by what substance?
acetyl-coa
how does PCP intoxication present?
may present with psychotic symptoms and violent behaviour, NOTABLY with nystagmus
Presentation of goodpastures syndrome?
rapidly progressive glomerulonephritis (edema, hematura, hypertension, acute renal failure) and alveolar hemorhage (shortness of breath, hemorrhage)
why is pregnancy associated with constipation?
the increased progesterone is associated with decrased colonic smooth muscle, and prevents the release of motilin
how do alcohol agents (isopropranol and ethanol) disenfect surfaces?
disrupt cell membranes and denature proteins
