Random Flashcards
hypotension: what happens to baroreceptor firing, ANP, and SVR
decreased baroreceptors
decreased ANP
increased SVR
absent CD18 antigen on leukocytes is _____
leukocyte adhesion deficiency
recurrent infections w/o purulence is indicative of ______
leukocyte adhesion deficiency
late separation of umbilical cord might be indicative of what immunodeficiency
leukocyte adhesion deficiency
what lab finding is associated with leukocyte adhesion deficiency
persistent leukocytosis (since leukocytes can’t migrate out of blood vessels because no CD18)
symptoms of pancoast tumor
- shoulder pain
- horner’s syndrome
- upper limb paresthesia/weakness/areflexia
what ganglion is affected with a pancoast tumor
superior cervical ganglion
list DNA binding proteins
- transcription factors (myc, CREB)
- steroid hormones (progesterone, cortisol, aldosterone)
- thyroid hormone receptor
- fat soluble vitamin receptors
- DNA transcription and replication proteins
how does thymidylate synthase inhibition cause apoptosis
from folate deficiency or pharmacology
lack of thymidylate synthase increases ratio of dUMP to dTMP –> incorporation of uracil instead of thymidine –> apoptosis
function of ANP and BNP
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
what is sacubitril and how does it work
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
what does neprilysin do
a metalloprotease that breaks down ANP and BNP
naprilysin inhibitors like sacubitril prolong action of BNP and ANP to increase vasodilation and cause diuresis
how would an infection from the ear reach the brain?
spread to mastoid air cells then invasion of temporal lobe
function of Lipid A in E. coli
virulence factor that releases endogenous pyrogens (IL-1, prostaglandins) and inflammatory mediators (TNFa, interferon)
can cause septic shock
bortezumib MOA and clinical indication
proteasome inhibitor –> induces arrest at G2-M and cause apoptosis
used for myltiple myeloma and mantle cell lymphoma
what causes hereditary orotic aciduria
defect in UMP synthase in pyrmidine synthesis
what vitamin supplementation might be needed in a patient with measles
vitamin A
wide, fixed splitting of S2 in a child
ASD
what causes porphyria cutanea tarda
deficiency in uroporphyrinogen decarboxylase
symptoms of porphyria cutanea tarda
photosensitivity (vesicle and blister formation on sun-exposed areas, edema, pruritis, pain, erythema)
what metabolizes succinylcholine
plasma pseudocholinesterase
what causes pseudocholinesterase deficiency
what are the sx
genetic polymoprhism in the BCHE gene
prolonged muscle weakness after receiving succinylcholine (pseudocholinesterase metabolizes succhinylcholine)
MOA and side effects colchicine
prevents tubulin polymerization into microtubules
GI side effects (it also effects microtubules in the GI tract)
missense mutation coding for cystathione beta-synthase enzyme causes ______
homocystinuria
symptoms of homocystinuria
- lens dislocation
- intellectual defecits
- vascular thromboses
- marfanoid habitus
compare homocystinuria and marfan syndrome
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)
compare lung involvement in diffuse vs limited cutaneous systemic sclerosis
diffuse: interstitial lung dz
limited: pulmonary hypertension
early symptoms of diffuse systemic sclerosis
swelling of fingers and mild pruritis
diffuse skin thickening (extends proximal to wrist and may include trunk)
failure of neutrophils to turn blue on nitroblue tetrazolium testing indicates what
chronic granulomatous disease
how does changing CO2 levels help cerebral edema
lower the PaCO2 levels causes vasoconstriction –> reduces cerebral blood volume –> decreased ICP
why are neprilysin inhibitors and angiotensin II receptor blockers (sacubitril-valsartan) often prescribed together
neprilysin is responsible for inactivating angiotensin II, so inhibition of neprilysin causes increased angiotensin II, so you need an angiotensin II blocker as well
what cell types are involved in the immunologic reaction in sarcoidosis
cell mediated immunity driven by Th1 CD4 T helper cells
–> secrete IL-2 and IFN-y
what is the pathophysiology of high altitude pulmonary edema?
reduced partial pressure of O2 –> hypoxic pulmonary vasoconstriction –> increased pulmonary arterial pressure –> alveolar capillary membrane disruption –> patchy, bilateral pulmonary edema
how does the vascular endothelium synthesize nitric oxide
acetylcholine, bradykinin, serotonin, substance P, shear forces –> activation of endothelial nitric oxide synthase –> synthesizes nitric oxide from arginine, NADPH, and O2
does spina bifida occulta have polyhydramnios?
nope
what are the quadruple screen results for trisomy 21
low AFP, low estriol, high b-HCG, high inhibin A
virulence factors for listeria monocytogenes
listeriolysin O –> generates pores in phagosome membranes
actin based transcellular spread
antipsychotic induced parkinsonism is best treated with _____
anticholinergic agent (benztropine)
MOA and indications for dantrolene
direct-acting skeletal muscle relaxant
neuroleptic malignant syndrome
symptoms of pancreatic adenocarcinoma
- jaundice
- painless palpable gallbladder
- dark urine and pale stools
what is effect modification
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)
MOA triptans
stimulation of trigeminal serotonin receptors and inhibition of CGRP release from trigeminal neurons
what is pulsus paradoxus
what conditions is it seen in
loss of palpable pulse during inspiration
Pea COAT
- pericarditis
- croup
- obstructive sleep apnea
- asthma
- cardiac tamponade
sx of cardiac tamponade
- hypotension
- tachy
- jugular venous distention w/ clear lungs
- pulsus paradoxus
how to corticosteroids help an asthmatic pt already on beta agonists
corticosteroids potentiate the effects of beta-2-agonists by stimulate upregulation of beta-2 receptors in bronchial smooth muscle
flask shaped ulcers indicate what infection
E. histolytica
treatment for scabies
permethrin
compare type 1 and type 2 muscle fibers
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
why must PPIs be slowly tapered off
to prevent rebound gastric acid hypersecretion
SHORT term treatment for rheumatoid arthritis
glucocorticoids (prednisone) or NSAIDs
what is the pathophysiology of anemia in lead poisoning
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
symptoms of lead poisoning in children
developmental delay or regression, anemia, behavioral problems
Milrinone MOA
indications
PDE-3 enzyme inhibitor –> increases cAMP –> increases cardiac contractility and causes vasodilation
refratory heart failure due to LV systolic dysfunction
what receptor do antihistamines inhibit
H1
adverse effects of succinylcholine
- malignant hyperthermia
- severe hyperkalemia in patients with burns, myopathies, crush injuries, and denervation
- bradycardia or tachycardia
what chromosome is the amyloid precursor protein found on
21
what is kussmaul sign
what is it seen in
paradoxical rise in JVP during inspiration
constrictive pericarditis, restrictive cardiomyopathies, right HF, massive PE, right atrial or ventricular tumors
thick, fibrous tissue in the pericardial space is _____
constrictive pericarditis
compare constrictive and restrictive cardiomyopathies
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
causes of restrictive cardiomyopathy
Puppy LEASH
P: postradiation fibrosis L: loffler endocarditis E: endocardial fibroelastosis A: amyloidosis S: sarcoidosis H: hemochromatosis
what is trousseau syndrome
migratory superficial thrombophlebitis
presents as erythema and tenderness extending linearly on skin
associated with cancer
