Random Q set 2 Flashcards
Which enzyme can be defective & predispose a patient to diabetes, perhaps gestational diabetes?
glucokinase, b/c this is on pancreatic beta cells, & not in other tissues (hexokinase). Thus, it may not be able to sense that there is glucose there & that they should release insulin.
IV drug abuser is predisposed to staph aureus infective endocarditis, messed up tricuspid valve. What is a complication of this that could cause death?
throw blood clots to lungs. get hemorrhagic pulmonary infarcts.
What is Berkson’s bias?
selection bias when hospitalized patients are the control group
What is lead-time bias?
when you have a screening test, detect diseases much earlier than you would have normally
What is the Pygmalion effect?
researchers belief in the efficacy of the treatment may affect the outcome
What is the Hawthorne effect?
observer effect
study subjects change their behavior when they feel like they are being watched.
What are some examples of HIV drugs that require intracellular phosphorylation for activation?
nucleoside reverse transcriptase inhibitors (NRTIs)
zidovudine
zalcitabine
What are some examples of HIV drugs that do NOT require intracellular phosphorylation for activation?
non-nucleoside reverse transcriptase inhibitors (NNRTIs)
nevirapine
efavirenz
delavirdine
What is the MOA of ritonavir in HIV treatment?
inhibitor of HIV protease
MOA of enfuvirtide in HIV treatment?
inhibitor of HIV fusion
What are the common features of DOwn’s syndrome?
flat face flat nasal bridge up-slanting palpebral fissures epicanthal folds small mouth single palmar creases MR
Usu Down’s syndrome is caused by trisomy, 21. In rare cases, what genetic defect can cause it?
Robertsonian translocation & mosaicism.
How do CD8+ cells recognize foreign antigens?
With MHC 1 presenting cells.
What are MHC I proteins composed of?
heavy chain + beta 2 micro globulin
What are the different types of organ rejection?
hyperacute
acute (1-4 weeks), host CD8 cells against foreign MHCI
chronic
What is the treatment for acute organ rejection?
calcineurin inhibitors–cyclosporine, tacrolimus
corticosteroids
What is the significance of ERB-B2 sensitivity?
aka Her-2/neu, determines if the breast cancer will respond to trastuzumab treatment
What is the significance of ER/PR positivity in breast cancer?
determines whether the breast cancer will respond to tamoxifen
What are the main features of chronic bronchitis? What is its leading cause?
thick bronchial walls neutrophil infiltration mucous gland enlargement patchy squamous metaplasia **leading cause--smoking
Which part of the heart is closest to the esophagus? posterior to the esophagus @ the same place?
left atrium
descending aorta
Describe the conc’n of the tubular fluid in the kidney after the glomerulus.
PCT ~300 (isotonic w/ blood). Water & electrolytes are absorbed here.
Descending Limb –>1200 (only water reabsorbed)
Ascending Limb–>1200 b/c of ADH & water reabsorption
When do you usu see a Mallory Weiss tear?
a tear in the gastric mucosa near the gastroesophageal junction
tight lower esophageal sphincter
often caused by repetitive vomiting
vomiting produces metabolic alkalosis
What is cricopharyngeal motor dysfunction?
can’t relax your pharyngeal muscles when you’re swallowing
increased pressure–get a Zenker’s diverticulum
**get choking, coughing, dysphagia, aspiration
When you add carbidopa to levodopa…which symptoms can increase?
the peripheral symptoms are reduced, but the central symptoms, such as anxiety & agitation are increased.
How do you get osteomalacia from cholestasis?
can cause malabsorption & nutritional deficiencies of fat-soluble vitamins
Vit D deficiency=osteomalacia
What is the major virulence factor for strep pyogenes that is antiphagocytic & prevents complement activation?
Protein M
When IgA nephropathy includes abdominal pain & purpuric skin lesions what is it considered?
Henoch-Schonlein purpura
When you have metabolic alkalosis…which types are saline-responsive?
vomiting, loop diuretic use
lose water & chloride
**hyperaldosteronism can cause non-saline responsive metabolic alkalosis
What are some TCAs?
amitriptyline
imipramine
doxepin
clomipramine
What are possible negative side effects of TCAs?
anticholinergic effects, can cause urinary retention in patients with BPH
Mucopurulent cervicitis w/ cervical motion tenderness indicates what?
PID from N. gonorrhea or chlamydia
can cause scarring of fallopian tubes & infertility
Talk a little about beta oxidation & what it produces.
Beta oxidation in mitochondria.
carnitine transfers thru the mitochondrial membranes.
produces acetyl coa for tca & ketone bodies, including acetoacetate.
Tryptophan is a precursor to which substance?
serotonin
What is serotonin syndrome?
confusion agitation tremor tachycardia HTN clonus hyperreflexia hyperthermia diaphoresis
What can be used to treat serotonin syndrome?
cyproheptadine
antihistamine that has anti-serotnergic properties
Rate these in terms of sodium binding strength: 1A 1B 1C Antiarrhythmics.
1C>1A>1B
What is polycythemia vera?
clonal myeloproliferative disorder of pluripotent hematopoietic stem cells
increased RBC mass
increased plasma volume
decreased EPO level
JAK2 V617F mutation
**bone marrow has increased sensitivity to growth factors
What does it take to improve the opthalmic symptoms of hyperthyroidism?
high dose glucocorticoids
Glucagon should be used to treat patients who overdose on beta blockers. Why is this a good drug?
b/c it increases HR etc independent of adrenergic receptors
GPCR, activates adenylate cyclase, increases cAMP
What are the 2 most common causes of subaranchnoid hemorrhage & the “worst headache of my life”?
- ruptured aneurysms
2. AV malformation
Berry aneursym in the Circle of Willis are associated with which disease?
polycystic kidney disease
Which nerve can be damaged during bladder surgery? Which foramen does it pass thru? Which action is compromised?
obturator nerve
passes thru the obturator foramen
adduction of the thigh
When do you see air in the biliary tree?
when there is a fistula passing b/w the biliary tree & the small intestine
can develop this fistula from pressure from a large longstanding gallstone
*gallstone ileus-gallstone may pass into SI
If you see a calcified gallbladder what do you think?
porcelain gallbladder
puts patients at higher risk for gallbladder carcinoma
cholecystectomy recommended
What is the wobble phenomenon?
the fact that some tRNAs can bind multiple AA
