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Maddy - First Aid > Random > Flashcards

Random Flashcards

1
Q

hypotension: what happens to baroreceptor firing, ANP, and SVR

A

decreased baroreceptors

decreased ANP

increased SVR

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2
Q

absent CD18 antigen on leukocytes is _____

A

leukocyte adhesion deficiency

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3
Q

recurrent infections w/o purulence is indicative of ______

A

leukocyte adhesion deficiency

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4
Q

late separation of umbilical cord might be indicative of what immunodeficiency

A

leukocyte adhesion deficiency

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5
Q

what lab finding is associated with leukocyte adhesion deficiency

A

persistent leukocytosis (since leukocytes can’t migrate out of blood vessels because no CD18)

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6
Q

symptoms of pancoast tumor

A
  • shoulder pain
  • horner’s syndrome
  • upper limb paresthesia/weakness/areflexia
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7
Q

what ganglion is affected with a pancoast tumor

A

superior cervical ganglion

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8
Q

list DNA binding proteins

A
  • transcription factors (myc, CREB)
  • steroid hormones (progesterone, cortisol, aldosterone)
  • thyroid hormone receptor
  • fat soluble vitamin receptors
  • DNA transcription and replication proteins
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9
Q

how does thymidylate synthase inhibition cause apoptosis

from folate deficiency or pharmacology

A

lack of thymidylate synthase increases ratio of dUMP to dTMP –> incorporation of uracil instead of thymidine –> apoptosis

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10
Q

function of ANP and BNP

A

secreted in response to volume overload in atria and ventricles

bind to natriuretic peptide receptors to activate guanylate cyclase to form cGMP –> diuresis and peripheral vasodilation to help alleviate volume overload

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11
Q

what is sacubitril and how does it work

A

neprilysin inhibitor

prevents degradation of natriuretic peptides, angiotensin II, and substance P –> increases vasodilation and decreases ECF volume

used in combo with valsartan to treat heart failure

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12
Q

what does neprilysin do

A

a metalloprotease that breaks down ANP and BNP

naprilysin inhibitors like sacubitril prolong action of BNP and ANP to increase vasodilation and cause diuresis

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13
Q

how would an infection from the ear reach the brain?

A

spread to mastoid air cells then invasion of temporal lobe

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14
Q

function of Lipid A in E. coli

A

virulence factor that releases endogenous pyrogens (IL-1, prostaglandins) and inflammatory mediators (TNFa, interferon)

can cause septic shock

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15
Q

bortezumib MOA and clinical indication

A

proteasome inhibitor –> induces arrest at G2-M and cause apoptosis

used for myltiple myeloma and mantle cell lymphoma

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16
Q

what causes hereditary orotic aciduria

A

defect in UMP synthase in pyrmidine synthesis

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17
Q

what vitamin supplementation might be needed in a patient with measles

A

vitamin A

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18
Q

wide, fixed splitting of S2 in a child

A

ASD

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19
Q

what causes porphyria cutanea tarda

A

deficiency in uroporphyrinogen decarboxylase

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20
Q

symptoms of porphyria cutanea tarda

A

photosensitivity (vesicle and blister formation on sun-exposed areas, edema, pruritis, pain, erythema)

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21
Q

what metabolizes succinylcholine

A

plasma pseudocholinesterase

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22
Q

what causes pseudocholinesterase deficiency

what are the sx

A

genetic polymoprhism in the BCHE gene

prolonged muscle weakness after receiving succinylcholine (pseudocholinesterase metabolizes succhinylcholine)

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23
Q

MOA and side effects colchicine

A

prevents tubulin polymerization into microtubules

GI side effects (it also effects microtubules in the GI tract)

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24
Q

missense mutation coding for cystathione beta-synthase enzyme causes ______

A

homocystinuria

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25
Q

symptoms of homocystinuria

A
  • lens dislocation
  • intellectual defecits
  • vascular thromboses
  • marfanoid habitus
26
Q

compare homocystinuria and marfan syndrome

A

homocystinuria:

  • marfan habitus
  • lens dislocation (DOWNWARD AND INWARD)
  • vascular thromboses
  • INTELLECTUAL DISABILITY

marfan:

  • cystic medial necrosis of aorta, aortic root aneurysm, rupture or dissection
  • subluxation of lens (UPWARD AND OUTWARD)
27
Q

compare lung involvement in diffuse vs limited cutaneous systemic sclerosis

A

diffuse: interstitial lung dz
limited: pulmonary hypertension

28
Q

early symptoms of diffuse systemic sclerosis

A

swelling of fingers and mild pruritis

diffuse skin thickening (extends proximal to wrist and may include trunk)

29
Q

failure of neutrophils to turn blue on nitroblue tetrazolium testing indicates what

A

chronic granulomatous disease

30
Q

how does changing CO2 levels help cerebral edema

A

lower the PaCO2 levels causes vasoconstriction –> reduces cerebral blood volume –> decreased ICP

31
Q

why are neprilysin inhibitors and angiotensin II receptor blockers (sacubitril-valsartan) often prescribed together

A

neprilysin is responsible for inactivating angiotensin II, so inhibition of neprilysin causes increased angiotensin II, so you need an angiotensin II blocker as well

32
Q

what cell types are involved in the immunologic reaction in sarcoidosis

A

cell mediated immunity driven by Th1 CD4 T helper cells

–> secrete IL-2 and IFN-y

33
Q

what is the pathophysiology of high altitude pulmonary edema?

A

reduced partial pressure of O2 –> hypoxic pulmonary vasoconstriction –> increased pulmonary arterial pressure –> alveolar capillary membrane disruption –> patchy, bilateral pulmonary edema

34
Q

how does the vascular endothelium synthesize nitric oxide

A

acetylcholine, bradykinin, serotonin, substance P, shear forces –> activation of endothelial nitric oxide synthase –> synthesizes nitric oxide from arginine, NADPH, and O2

35
Q

does spina bifida occulta have polyhydramnios?

A

nope

36
Q

what are the quadruple screen results for trisomy 21

A

low AFP, low estriol, high b-HCG, high inhibin A

37
Q

virulence factors for listeria monocytogenes

A

listeriolysin O –> generates pores in phagosome membranes

actin based transcellular spread

38
Q

antipsychotic induced parkinsonism is best treated with _____

A

anticholinergic agent (benztropine)

39
Q

MOA and indications for dantrolene

A

direct-acting skeletal muscle relaxant

neuroleptic malignant syndrome

40
Q

symptoms of pancreatic adenocarcinoma

A
  • jaundice
  • painless palpable gallbladder
  • dark urine and pale stools
41
Q

what is effect modification

A

when the effect of an exposure on an outcome is modified by another variable

(association between estrogen receptor and risk of DVT in smokers compared to nonsmokers)

42
Q

MOA triptans

A

stimulation of trigeminal serotonin receptors and inhibition of CGRP release from trigeminal neurons

43
Q

what is pulsus paradoxus

what conditions is it seen in

A

loss of palpable pulse during inspiration

Pea COAT

  • pericarditis
  • croup
  • obstructive sleep apnea
  • asthma
  • cardiac tamponade
44
Q

sx of cardiac tamponade

A
  • hypotension
  • tachy
  • jugular venous distention w/ clear lungs
  • pulsus paradoxus
45
Q

how to corticosteroids help an asthmatic pt already on beta agonists

A

corticosteroids potentiate the effects of beta-2-agonists by stimulate upregulation of beta-2 receptors in bronchial smooth muscle

46
Q

flask shaped ulcers indicate what infection

A

E. histolytica

47
Q

treatment for scabies

A

permethrin

48
Q

compare type 1 and type 2 muscle fibers

A

type 1: actions requiring low-level sustained force (postural maintenance)

  • high myoglobin
  • more mitochondria

type 2: rapid forceful pulses of movement
- less myoglobin and mitochondria

49
Q

why must PPIs be slowly tapered off

A

to prevent rebound gastric acid hypersecretion

50
Q

SHORT term treatment for rheumatoid arthritis

A

glucocorticoids (prednisone) or NSAIDs

51
Q

what is the pathophysiology of anemia in lead poisoning

A

lead poisoning –> inhibition of ferrochelatase and ALA dehydratase in the heme synthesis pathway –> protoporphyrin IX can’t combine with iron –> it incorporates a zinc ion instead –> elevated zinc protoporphyrin levels

52
Q

symptoms of lead poisoning in children

A

developmental delay or regression, anemia, behavioral problems

53
Q

Milrinone MOA

indications

A

PDE-3 enzyme inhibitor –> increases cAMP –> increases cardiac contractility and causes vasodilation

refratory heart failure due to LV systolic dysfunction

54
Q

what receptor do antihistamines inhibit

A

H1

55
Q

adverse effects of succinylcholine

A
  • malignant hyperthermia
  • severe hyperkalemia in patients with burns, myopathies, crush injuries, and denervation
  • bradycardia or tachycardia
56
Q

what chromosome is the amyloid precursor protein found on

A

21

57
Q

what is kussmaul sign

what is it seen in

A

paradoxical rise in JVP during inspiration

constrictive pericarditis, restrictive cardiomyopathies, right HF, massive PE, right atrial or ventricular tumors

58
Q

thick, fibrous tissue in the pericardial space is _____

A

constrictive pericarditis

59
Q

compare constrictive and restrictive cardiomyopathies

A

both: reduced compliance
constrictive: due to external pericardial constraint (fibrosis on outside of heart)
restrictive: due to abnormal elastic properties of myocardium and/or intercellular matrix

60
Q

causes of restrictive cardiomyopathy

A

Puppy LEASH

P: postradiation fibrosis
L: loffler endocarditis
E: endocardial fibroelastosis
A: amyloidosis
S: sarcoidosis
H: hemochromatosis
61
Q

what is trousseau syndrome

A

migratory superficial thrombophlebitis

presents as erythema and tenderness extending linearly on skin

associated with cancer

Maddy - First Aid (23 decks)

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