Random II Flashcards
symptoms of fibrinous pericarditis
- pleuritic chest pain that decreases when sitting up
- pericardial friction rub (often triphasic)
- diffuse ST elevation
- pericardial effusion on echocardiogram
EKG findings for pericarditis
diffuse ST elevation
causes of fibrinous pericarditis
- viral
- SLE
- uremia
- post-MI
describe the two phases of diabetic retinopathy
early (non-proliferative)
- scattered retinal aneurysms
- dot and blot hemorrhages
- cotton wool spots
late (proliferative)
- new blood vessel formation
symptoms of diabetic retinopathy
painless vision loss
no redness, headache, focal weakness, or sensory loss
budesonide MOA and indications
glucocorticoid –> inhibits NFkB –> reduction in cytokines and inflammation
can be used in crohn’s disease
pulmonary AE of osmotic diuretic therapy (mannitol)
pulmonary edema
describe the path of aqueous humor flow
produced in ciliary epithelium –> posterior chamber –> anterior chamber –> trabecular meshwork –> either the canal of schlemm or the uvea and sclera
where do beta blockers work on the eye for glaucoma
on the ciliary epithelium (to decrease aqueous humor production)
what is the effect of prostaglandin agonists on aqueous humor flow
increases drainage into the uvea and sclera (increase outflow)
increases drainage into the uvea and sclera by decreases resistance of flow through uveoscleral pathway
MOA and indications for latanoprost and bimatoprost
prostaglandin agonists
increases drainage into the uvea and sclera by decreases resistance of flow through uveoscleral pathway
what Is the effect of M3 agonists on aqueous humor flow
increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabceular meshwork
what is the effect of alpha agonists on aqueous humor flow
decrease aqueous humor synthesis via vasoconstriction
what is the first line treatment for trigeminal neuralgia
carbamazepine
MOA carbamazepine
indications
blocks Na+ channels
trigeminal neuralgia, epilepsy, bipolar disorder
symptoms trigeminal neuralgia
repetitive, unilateral, shooting/shock like pain in the distribution of CN V
triggered by chewing, touching certain parts of face
sx of ebstein anomaly
apical displacement of tricuspid valve leaflets
decreased volume of right ventricle
atrialization of right ventricle
what causes ebstein anomaly
maternal lithium use in pregnancy
what layer is missing in a false diverticulum of the intestines
muscularis propria
what is peri-infarction pericarditis
a fibrinous or serofibrinous pericarditis that develops 2-4 days after a transmural MI
a reaction to the necrosis of the myocardium near the epicardial surface
what do homeobox genes usually code for
transcription factors
what is the treatment for enterococcus endocarditis
an aminoglycoside + cell wall synthesis inhibitor
adverse effects of aminoglycosides
hearing loss and tinnitus
what is wolf parkinson white
caused by an accessory conduction pathway causing preexcitation of the ventricles
(AV conduction that bypasses the AV node)
symptoms of benzo withdrawal
rebound anxiety
tremor
insomnia
sympathetic hyperactivity
seizures
where does the AV nodal artery arise from
the dominant coronary artery
right dominant: RCA
left dominant: LCX
codominant: both
symptoms of Meniere disease
- low frequency tinnitus
- vertigo
- sensorineural hearing loss
what causes Meniere disease
increase volume and pressure of endolymph in inner ear
thought to be due to defective resorption of endolymph
in fructokinase deficiency (essential fructosuria), what enzyme compensates by metabolizing fructose?
hexokinase
converts dietary fructose to fructose-6-phosphate
hemorrhage occurring in neonates after vacuum delivery is most often located where
between periosteum and galea aponeurosis
subgaleal hemorrhage
what is acute intermittent porphyria
autosomal dominant disease with porphobilinogen deaminase deficiency
causes accumulation of porphobilinogen and ALA
symptoms of acute intermittent porphyria
5 Ps
- painful abdomen
- port wine colored pee
- polyneuropathy
- psychological disturbances
- precipitated by drugs (cytochrome P450 inducers)
what is the management for acute intermittent porphyria
infusion of hemin –> downregulates hepatic aminolevulinate (ALA) synthase
effects of secretin
increase bicarbonate secretion
decrease gastric acid secretion
increase bile secretion
effects of cholecystokinin
increase pancreatic secretion
increase gallbladder contraction
decrease gastric emptying
increase sphincter of Oddi relaxation
effects of somatostatin
decrease gastric acid and pepsinogen
decrease pancreatic and small intestine secretions
decrease gallbladder contraction
decrease insulin and glucagon
exocrine and endocrine effects of GIP (glucose dependent insulinotropic peptide)
exocrine: decrease gastric H+ secretion
endocrine: increase insulin release
what antimicrobial also stimulates motilin
erythromycin
what is phenotypic mixing
occurs with simultaneous infection of a cell with 2 viruses
progeny virions will contain unchanged parental genome from one strain and nucleocapsid proteins from the other strain
subsequent progeny will revert to having original parent type
ring enhancing lesions with mass effect in HIV patient:
- what are the ddx
toxoplasmosis
primary central nervous system lymphoma
sx west nile virus
fever, headache
rash
meningitis, encephalitis, flaccid paralysis
parkinsonian sx (rigidity, bradykinesia, tremor)
what is the mecA gene, and what does it mean for bacteria that have it
encodes for penicillin-binding protein 2a
allows for resistance to beta lactam antibiotics (penicillins and cephalosporins)
compare immune response to superficial and disseminated candidiasis
superficial: T cells
disseminated: neutrophils
what is stasis dermatitis
erythema, induration, fibrosis, and deposition of hemosiderin in lower extremities of patients with venous insufficiency
(prolonged standing, pregnancy, obesity)
active RAS is bound to _____
GTP
what is parinaud syndrome
pineal gland mass
what are the sx of parinaud syndrome
limited upward gaze with a downward gaze preference
bilateral eyelid retraction
light-near dissociation (pupils that react to accommodation but not to light)
MOA vecuronium and rocuronium
competitive antagonists of nicotinic acetylcholine receptors
MOA succinylcholine
competitive agonists of nicotinic acetylcholine receptors –> persistent depolarization –> desensitization of motor end plate
sx of neuroblastoma
nonrhythmic conjugate eye movements and involuntary jerking movements of trunk and limbs (opsoclonus-myoclonus syndrome)
firm abdominal mass (most often involving adrenal gland)
periorbital ecchymoses
lab findings in neuroblastoma
elevated catecholamine metabolites (due to neural crest origin)
what expression indicates poor prognosis in neuroblastoma
N-myc amplification
what is the effect of B blockers on ECG
they prolong the PR
what is intermittent claudication
muscle pain with exercise that remits with rest
smoking is important risk factor
usually due to atherosclerosis of large arteries
causes of concentric left ventricular hypertrophy
pressure overload
- chronic HTN
- aortic stenosis
causes of eccentric left ventricular hypertrophy
volume overload
- aortic or mitral regurgitation
- ischemic heart disease
- dilated cardiomyopathy
sx of Gaucher disease
- anemia
- abd distension due to hepatosplenomegaly
- pancytopenia
- bone pain due to bone marrow invasion/inflammation
what is eisenmenger syndrome
uncorrected left to right shunt –> increases pulmonary blood flow –> pathologic remodeling of vasculature –> pulmonary arterial HTN
what is congenital torticollis
child born with sternocleidomastoid injury and fibrosis
usually due to birth trauma or malposition of head in utero
head tilted toward affected side chin pointed away
why does propofol have a rapid onset and rapid recovery
propofol is rapidly cleared from plasma and preferentially distributed to organs receiving high blood flow (brain)
over time, propofol is redistributed to organs receiving less blood flow (fat, muscle tissue) causing rapid termination of drug action (since the brain is the site of action)
cromolyn and nedocromil MOA
inhibits mast cell degranulation and prevents release of preformed chemical mediators
what is the mutation in maturity onset diabetes of the young (MODY)
glucokinase mutation
why can supplemental oxygen in the setting of COPD cause decreased respiratory rate
due to reduction in peripheral chemoreceptor stimulation
what are the primary sites for sensing PaO2 and thus are stimulated by hypoxemia
peripheral chemoreceptors in carotid and aortic bodies
a lesion affecting both the spinothalamic tract and the dorsal column medial lemniscus tract is most likely located:
in the ventral posterior thalamus
both tracts cross through the VPL
how can crohn’s disease cause easy bleeding
crohn’s disease affects terminal ileum –> loss of bile acid resorption –> fat malaborption –> deficiencies in fat-soluble vitamins (including vitamin K) –> loss of vitamin K dependent coagulation factors
affect of glucocorticoids on adipose tissue
lipolysis
altered fat distribution
affect of glucocorticoids on adrenal cortex
atrophy
affect of glucocorticoids on bone
osteoporosis
affect of glucocorticoids on liver
increased gluconeogensis and glycogenesis
affect of glucocorticoids on skeletal muscle
atrophy
affect of glucocorticoids on skin
thinning
stria
impaired wound healing
where does heme synthesis occur in the cell
mitochondria
spontaneous cases of Clostridium septicum indicates what underlying pathology
colonic malignancy
it creates a portal of entry for the bacteria
46,XY newborn with hypospadias and small phallus, testes developed but in the inguinal area, testosterone normal
what is the enzyme deficiency
5a-reductase
it converts T to DHT
initial stages of diabetic nephropathy have what changes in GFR
increased GFR
