question log things that won't stick! Flashcards

1
Q

antibodies against polyribitol rbose phosphate(PRP) would most likely confer protection against _____

A

H influenze that caues epiglottitis

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2
Q

what are three mitochondrial disorders “red ragged fibers”

A

myoclonic epilepsy with ragged red fibers

leber optic neuropathy (blindess)

mitochondrial encephalopathy with stroke like episodes(ELAS)

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3
Q

burkitt lymphoma translocation

A

C-MYC (8;14)

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4
Q

FOLLICULAR LYMPHOMA TRANSLOCATION

A

T(14;18)

bcl-2 overexpression

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5
Q

what is elevated in neural tube defect?

A

AFP and acetylcholinesterase

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6
Q

what is fondaparinux?

A

synthetic factor 10a inhibitor

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7
Q

pentazocine

A

partial opiod agonist at mu receptors.

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8
Q

features of carcinoid syndrome from excess seretonin from carcinoid tumor?

A

bronchospasm,diarrhea, flushing of skin

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9
Q

what is pre-eclampsia?

what is HELLLP

A

pre-eclampsia = triad of HTN, proteinuria and edema and may progress to

HELLP(hemolytic anemia, elevated liver enzymes, low platelets). Eclampisa = pre-eclampisa + seizures.

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10
Q

rate limiting ezyme for bile acid syntehsis from cholesterol?

A

7-alpha hydroxylase

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11
Q

describe **single base excision **repair

A

single base excision repair corrects defects in single bases by 1. glycosylases - remove defective base pair and corresponding sugar-phosphate is cleaved and removed by endonuclease -->action of lyase. DNA pol replaces the missing nucleotides and ligase connects DNA strand.

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12
Q

what is the valsalva maneuver?

which musle important?

A

vasalva increases vagal tone and can be used to abolish paroxysmal supraventricular tachycarida.

Rectus abdominis = most important muscle in achieving intraabdominal and intrathoraci pressure of vasalva maneuver.

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13
Q

why do you need to space out MAO tx and SSRI tx?

A

Need to wait at least 14 days btw stopping an MAO inhibitor and giving an SSRI. Why? b/c need to regenerate MAO so that you don’t have too much seretonin running around—>increased risk of seretonin syndrome.

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14
Q

which condition?

infant presents with: flaccid lower extremeities, absent ankle reflexes bilaterally + x-ray showing poorly developed lumbar spine and sacrum

A

infant presents with: flaccid lower extremeities, absent ankle reflexes bilaterally + x-ray showing poorly developed lumbar spine and sacrum has caudal regresssion syndrome (sacral agenesis causing lower extremity paralysis and urinary incontinence) and is commonly associated with **poorly controlled maternal diabetes. **

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15
Q

what are the bones associated with the 1st pharyngeal arch(4)?

A

BONES + cartilage ASSOCIATED WITH ARCH 1:

Meckel’s cartilage: mandible, malleus, incuse, sphenomandibular ligament

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16
Q

classic location for anal fissure

A

anal fissure location: anal canal distal to dentate line posterior midline and associated with severe tearting pain when trying to pass bowel movement and other associations: low fiber diets and constipation.

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17
Q

oversuse: results in intracranial HTN, skin changes, hepatosplenomegaly.

A

vitamin A oversuse: results in intracranial HTN, skin changes, hepatosplenomegaly.

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18
Q

lithium-induced diabetes insipidus =

A

result of lithium antagonizing effect on action of vassopressin (ADH) on principal cells within collecting duct system.

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19
Q

labs of DIC

A

DIC: prolonged PTT and aPTT, thrombocytopenic migroangiopathic hemolytic anemia, low fibrinogen, elevated fibrin split products (D-dimer), low factor 5 and 8 levels.

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20
Q

____________binds to HIV envelope protein gp41 preventin fusion of of gp41 to CD4+ t-cell –> HIV can’t enter t-cell.

A

Enfurvitide binds to HIV envelope protein gp41 preventin fusion of of gp41 to CD4+ t-cell –> HIV can’t enter t-cell.

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21
Q

when would you see eosinophils?

DNAACP

A

D-drugs

N-neoplastic

Allergic

Asthma

A-Addison’s disease and acute interstitial nephritis

Connective tissue disease- churg strauss

Parasites (invasive) - ascaris (loeffer)

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22
Q

role of IL-5

A

eosinophils and IgA

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23
Q

3 acute phase reactants secreted by macropphages

A

Il-1, IL-6, TNFalpha

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24
Q

what is the MOA of finasteride?

A

anti androgen that inhibits 5-alpha reductase which means testosterone not converted to DHT! + increases hair growth

ALSO CYPROTERONE HAS THIS SAME ACTION.

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25
Q

what does alpha-amantin, found in amanita phalloides (death cap mushrooms inhibit)?

A

inhibits RNA polymerase II which makes mRNA(massive) causes severe hepatotoxicity if ingested

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26
Q

What is treacher collins syndrome?

A

1st-arch neural crest fails to migrate—> no bones or cartilate = mandiblar hypoplasia, facial abnormaltities

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27
Q

only gram - w/out endotoxin

A

bacteriodes fragilis (strict anaerobe)

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28
Q

only gram + w/endotoxin?

A

listeria

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29
Q

Di George

Catch-22

A

C-cleft palate

A-abnormal facies

T-thymic aplasia

C-cardiac defects

H- hyocalcemia

22-chr 22q11 microdeletion

include: DiGeorge syndrome(thymic, parathryoid, caridc) and Velocardiofcial syndrome(palate, faical, and cardiac)

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30
Q

what is the defect in Job syndrome?

A

Th1 cells fail t produce IFN-gamma —>inability of neutrophls to respond to chemotactic stimuli

leads to FATED:

Coarse Facies, cold staph **Abscess, **retained primary **Teeth, Increased IgE, **Dermatologic issues (eczema)

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31
Q

withdrawal = tremors, agitation, anxiety, delirium, psychosis

seizures, **tachycardia, palpitations **

A

withdrawal for sedative substnaces ie: alcohol and benzodiazepines

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32
Q

withdrawal = N/V abdominal cramps, msucle aches

**dilated pupils, yawning, piloereection, lacrimation, hyperactive bowel sounds **

A

heroin

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33
Q

withdrawal: increased appetite, hypersomnia, **intense psychomotor retardation, severe derpession(“crash”) **

A

stimulant(cocain, amphetamines)

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34
Q

withdrawal symptoms: dysphoria, irritability, anxiety, **increased appetite **

A

nicotine

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35
Q

what are hirano bodies?

A

hirano bodies - eosinophilic rod like inclusions in hippocampus of alzheimers pt

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36
Q

tx for loa loa and Wucheria bancrofti

A

diethycarbamazine

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37
Q

tx for strongyloides and onchocera volvululus

A

ivermectin

38
Q

tx for diseases caused by trpanosomes eg chagas disease by T. cruzi

A

nifurtimox

39
Q

what is used to tx infections caused by Schistosoma, Clonorchis sinesis, and Paragonimus westermani

A

praziquantel

40
Q

DOC for enterobius vermicularis(pinworm)

how about in pregnant women?

A

Doc: bendazoles(mebendazole)

pyrantel pamoate for pregnant women

41
Q

vancomycin MOA

and 2 ADE

A

MOA: binds D-alanyl-alanine and blcoks glycopeptide polymerization

ADE: redman syndrome and nephrotoxicity

42
Q

MOA of daptomycin and 2 ADE and use

A

daptomycin: depolarization of the cellular membrane

ADE: myopathy and CPK elevation

inactivated by pulmonary surfactant

use: MRSA (gram + only) cannot be used to tx pneumonias bcinactivated by surfacant

43
Q

linezolid MOA

and 3 ADE

A

linezolin: inhibits bacterial protein synthesis by binding to 50S subunit

ADE: thrombocytopenia, optic neuritis, high risk for sereonin syndrome

44
Q

Sulfa Drugs

Popular FACTSSS

A

P-probenecid

F-furosemide

A-acetazolamide

C-celecoxib

T-thiazides

S-sulfasalzine

S-sulfonamide anitibiotics

S-sulfonylureas

45
Q

FFA and insulin resistance

A

FFA and serum trigs increase insulin resistance in overweight individuals, not homocystine. Note: high FFA +insulin resistance +betacell dysfunction = lipotoxicity.

46
Q

kid w/imperforate anus on 1st day

A

patient with imperforate anus. Manifests during first days of life by inability to pass meconium, alt. meconium may dishcarhge from urethra or vagina if fistula is present. Pt w/imperforate ansum may have other conditions ie: VACTERL: vertebral defects, anal atreasia, cardiac anomalies, TE fisutla, esophageal atreasia, renal anomalies, limb anomalies.

47
Q

hormones of ant pit?

A

FLAT PiG:

FSH

LH

ACTH

TSH

PROLACTIN

GH

48
Q

ACIDOPHILS ON ANTERIOR PITUITARY

A

GH, prolactin

49
Q

Basophils of anterior pituitary

A

Basophilic cells: FSH. LH, ACTH, TSH

50
Q

4 hormones that share an alpha subunit?

A

TSH, LH, FSH, hCG

51
Q

what are the catabolic effects of glucagon

A

glycogenolysis

gluconeogenesis

lipolysis

ketone production

52
Q

3 molecules derived from POMC that are stimulated by CRH?

A

ACTH, melanocyte stimulating hormone, beta-endorphin

53
Q

somatostatin inhibits which two hormones?

A

GH, TSH

54
Q

TRH stimulates release of which two hormones?

A

TSH

prolactin

55
Q

what inibits GH secretion (2)?

A

glucose

somatostatin

56
Q

actions of cortisol BBIG

5 ways it is anti-inflammaootry

its affect on glucose

A
  1. maintain BP by upreg of alpha 2 receptor on arterioles (increases sensitivyt of NE and EPi)
  2. decrease bone formation
  3. Anti-inflammatory: 5 ways
    a. inhibits production of leukotrienes + prostaglandins
    b. inhibit leukocyte adhesion —->neutrophilia
    c. block histamine release from mast cells
    d. reduce eosinophils
    e. blocks IL-2 production
57
Q

cortisol effect on glucose and gluconeogensis?

A

increases insulin resistance

increases gluconeogenesis, lipolysis, proteolysis and _inhibits fibroblasts(causes striae) _

58
Q

how does PTH stimulate osteoclasts?

A

incrases M-CSF and RANK-L in osteoblasts —>osteoclast stimulation

59
Q

how does very very low Mg2+ affect PTH?

A

low Mg2+ –> increased PTH secretion

very very low Mg2+ –> decreased PTH secretion

60
Q

4 common causes of decreased Mg2+

A

diarrhea

aminoglycosides

diuretics

alcohol abuse

61
Q

hormones that use cAMP

FLAT ChAMP

A

FLAT ChAMP

FSH, LH, ACTH, TSH, CRH, hCG, ADH(V2receptor), MSH, PTH, calcitonin, GHRH, **glucagon **

62
Q

which hormones use cGMP (think vasodilators)?

A

ANP

Nitric oxide(EDRF)

63
Q

which hormones use IP3?

GGOAT

A

GGOAT

GnRH

GHRH

Oxytocin and ADH(V1)-both post pit hormones

TRH, histamine H1, _angiotenstin II, gastrin _

64
Q

angiotensin II uses which signalling pathway?

A

IP3

65
Q

which hormones use a steroid receptor?

VETTT CAP

A

VETTT CAP

V-vitamin D, E-estrogen, T-testosterone, TT-t3 + t4, C-cortisol, A-aldosterone, P-progesterone

66
Q

which hormone use intrinsic tyrosine kinases?

5

A

Insulin, IGF-1, FGF, PDGF, EGF

(map kinase pathway)

think growth factors

67
Q

which hormones use receptor associated tyrosine kinase? (PIG)

A

prolactin

**immunomodulators(cytokines IL-2, IL-6, IL-8, IFN), GH **

**JAK/STAT pathway **

**thik acidophiles and cytokines **

68
Q

four functions of thyroid hormones?

4 B’s?

A

Brain maturation

Bone growth

Beta-adrenergic effects

basal metabolic rate increaed

69
Q

which enzyme converts T4 to active T3 in peripheral tissues? in

A

5’-deiodinase

70
Q

what is the wolff-chaikoff effect?

A

excess iodine temporarily inhibitds thyroid peroxidase –> decreased iodine organificaition —> decreased T3 and T4 production

71
Q

which thyroid drug inibits both peroxidase and 5’ deiodinase?

which one inhibits peroxidase only?

A

5’ deiodinase and peroxidase inibitor = propylthiouracil

only peroxidase = methimazole.

72
Q

what inhibits iodine uptake into cells (2 things here)

A

anions: perchlorate, pertechnetate

73
Q

5 Ps of pheochromocytoma

A

Pressure (elevated BP - give irreversible alpha blocker phenoxybenzamine b4 removing tumor)

Pain (headache)

Perspiraiton

palpitations(tachycardia - tx w/ beta blockers)

pallor

74
Q

rules of 10% for pheochromocytoma

A

10% malignant

10% bilateral

10% extraadrenal

10% calcify

10% kids

75
Q

4-characteristics of adrenal medulla neuroblastomas?

A

N-myc

bombesin

neurofilament stain

homer wright pseudorossettes

76
Q

what is Jod-Basedow phenomemon?

A

thryotoxicosis if a pt w/iodine def goiter is made iodine replete

77
Q

what is a stress induced catecholamine surge leading to deathy by arrhytmhmia?

A

thryoid storm

78
Q

what is osteitis fibrosa cystica

A

cystic bone spaces filled with brown fibrous tissue (bone pain) “stones, bones, and groans”

79
Q

what is renal osteodystrophy

A

bone lesions due to secondary or tertiary hyperparathyroidsm due in turn to renal disease

80
Q

casues of primary, secondary, tertiary hyperaparthyoidims

A

primary - adenoma in parathyoid glands (**hypercalcemia, **increaed PTH, alkphos, ad cAMP in urine)

secondary - renal disease - **hypocalcemia, alk phos,and increased PTH **

tertiary - refractory (autonomous) hyperparathyroidism resulting from chronic renal disease increased PTH and Ca2+

81
Q

what is pseudohyporathryodisim?

A

end organ resistance to PTH

albrights hereditary osteodystrphy

autosomal dominant kidney unresponsiveness to PTH

hypocalcemia, short 4th/5th ditigs/ short stature

82
Q

which 4 drugs can cause SIADH?

A

cyclophosphamide

psychotropics(SSRIs, TCAs, haloperidol)

sulfonylureas

83
Q

3 drugs to tx SIADH?

A

conivaptan

tolvaptan

demeclocylince

IV saline

84
Q

what is the most common tumor of appenxdix?

A

carcinoid syndrome (1/3 metastisize, 1/3 present w/2nd malignancy, 1/3 mutliple)

85
Q

zollinger ellis on syndrome?

what does stomach show?

which MEN syndrome?

A

gastrin secreting tumor of pancrease of duodenum

stomach shows rugal thickening w/acid hypersecretion

may be associated with MEN type 1

86
Q
A
87
Q

what is Wermer syndrome?

A

MEN 1

88
Q

what is sipple sydndrome?

A

MEN2A

89
Q

endoneural inflammatory infiltrate found in pt w/ascending paralysis after a febrile illness

A

guillan barre

90
Q

what are dadrocytes

A

tear drop cells seen in primary myelofibrosis