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Imhotep > RX Flash 253 > Flashcards

RX Flash 253 Flashcards

1
Q
  • Only output cell of the cerebellum (inhibitory)
  • Use gamma-aminobutyric acid (GABA)
  • Cerebellar atrophy can result from depletion of B1 (thiamine)→ seen in beriberi and Wernicke-Korsakoff
A

Purkinje Cells

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2
Q

I-Cell Disease (AR)

A
  • Results from failure to phosphorylate mannose residues onto mannose-6-phosphate at cis Golgi
  • Deficiency in N-actylglucosamine phosphotransfersase
  • Default exocytosis, rather than proper targeting to the lysosome
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3
Q
  • Hemolytic anemia
  • Leukopenia
  • Arthralgia (without joint deformity)
  • Skin rashes (malar or sun-exposed areas)
  • Renal disease
  • Libman-Sacks endocarditis
  • Neurologic symptoms
  • LAD (cervical, axillary and inguinal areas)
A

SLE symptoms

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4
Q

Anti-AChR antibodies

A

Myasthenia Gravis (worse near end of day or after exercise)

  • Present with diploplia or ptosis
  • 15% will have bulbar symptoms (dysarthria, dysphagia, and difficulty chewing)
  • Distal limb weakness (most common)
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5
Q

Anti-Scl70 antibodies

A
  • Diffuse systemic sclerosis or scleroderma (70%)
  • Features include: fibrotic changes in organs (GI, Lungs, Kidneys, and Heart)
  • Raynaud phenomenon (earliest symptom)
  • Perioral and jaw tightness (without swelling)
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6
Q

What is the most common inherited primary immune deficiency?

A

IgA deficiency

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7
Q

What is the most common subtype of kidney disease in SLE patient?

A
  • Diffuse proliferative glomerulonephritis (DPGN)
  • Type III hypersensitivity reaction
  • Immune complexes accumulate in the subendothelium and activate compliment
  • Characteristic wire looping appearance on electron microscopy
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8
Q

Treatment for DPGN (seen in lupus)

A
  • Cyclophosphamide (immunosuppressive agent)+ glucocorticoids (prednisone) for more severe lupus complications like DPGN
  • Reduces titer of autoantibodies
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9
Q

Molar pregnancy Triad?

A

-Triad: Hyperemesis, vaginal bleeding, and hyperthyroidism

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10
Q
  • Skin, bone, tendons, eyes, ears, and teeth
  • High tensile strength
  • Defective in Osteogenesis Imperfecta (AD)
A

Type I collagen

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11
Q

Hemolytic-uremic syndrome (HUS) triad

A

-Hemolytic anemia
-Thrombocytopenia
-Acute renal failure
Note: treating someone with E. Coli w/antibiotics is bad because increases HUS risk

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12
Q

Occurs when a cell takes up DNA from a donor cell

A

Transformation

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13
Q

Benign Prostatic Hyperplasia (BPH)

A
  • Nodular enlargement of the periurethral lobes that compress the urethra
  • Presents with increased urinary frequency, nocturia, and difficulty starting and stopping.
  • Can develop AUR (acute urinary retention): presents w/ sudden inability to pass urine and lower abdominal/Suprapubic pain. A FOLEY CATHETER relieves the obstruction and alleviates symptoms
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14
Q

-Onset of visual, auditory and tactile hallucinations 12-24 hours after consumption of last alcoholic drink

A

Alcoholic hallucinosis

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15
Q

Delirium tremens (DTs)

A
  • Begins 48-96 hours after the most recent drink
  • Lasts 1-5 days
  • Autonomic instability, hallucinations (visual or tactile), delirium, tachycardia, hypertension, fever, agitation or lethargy and diaphoresis
  • 5-20% mortality due to cardiac arrhythmias
  • Tx: Benzodiazepines, hydration and supportive car
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16
Q
  • Increased aldosterone secretion
  • Most common cause is an adrenal adenoma (w/lipid laden clear cells)
  • Failure to suppress aldosterone with salt loading
A

Primary hyperaldosteronism (Conn Syndrome)

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17
Q

Drainage of adrenal glands:

A 
Right= Right adrenal vein→ IVC
Left= Left adrenal vein→ Left renal vein→ IVC
Gonadal veins mirror this:
Right gonadal vein→ IVC
Left gonadal vein→ left renal vein→ IVC
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18
Q

Symptoms of Iodine deficiency include:

A

retardation and growth delay; bone age will appear less than patients actual age

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19
Q
  • Separates molecules based on sizes
  • Negatively charged DNA migrates in the electric field toward the positive end.
  • Small particles move far and fast
A

Gel electrophoresis

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20
Q

-Labeled antibodies are used to detect whether the serum contains antibodies against a specific antigen precoated on ELISA plate

A

ELISA

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21
Q

-RNA is separated by electrophoresis

A

Northern blot

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22
Q
  • Used to produce many copies of a segment of DNA
  • Two specific primers, deoxynucleotides and a heat stable polymerase
  • Solution is heated→DNA denatures→cooled→reannealing and synthesis
  • 20 cycles amplifies DNA more than a million times
A

PCR

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23
Q
  • Sound of alveoli opening and closing during respiration
  • Occurs in pneumonia (fine) and congestive heart failure (wet)
  • In addition to crackles, pneumonia (lobar) will have dullness to percussion (consolidation) and increased fremitus (consolidation)
A

Crackles

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24
Q

Decreased resonance to percussion, no breath sounds (over right lung usually) and decreased fremitus

A

Bronchial obstruction

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25
Q

Decreased fremitus and dullness to percussion

A

Pleural effusion

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26
Q

Hyperresonance to percussion and absent fremitus

A

Pneumothorax

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27
Q
  • Deficiency in homogentisic acid oxidase→ results in accumulation of homogentisic acid
  • Homogentisic acid is secreted in urine (turns urine black due to oxidation)
  • Asymptomatic until mid adulthood
  • Pigment and cartilage build up become visible and arthritic changes begin to manifest (often suffer from join pain)
  • Brownish-gray deposits in the sclerae and ears
  • Pigment also accumulates on heart valves and in kidney causing nephrolithiasis
  • Not life threatening but severely disabling
A

Alkaptonuria (AR)

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28
Q
  • Increase in urine and serum homocystine
  • Most common cause is deficiencies in cystathionine synthase
  • Mental retardation, optic lens dislocation, osteoporosis, and heart complications early in life
A

Homocystinuria (AR)

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29
Q

Nephrolithiasis and “staghorn” calculi

A

Cystinuria (AR)

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30
Q

Maple Syrup Urine disease/ Branched-Chain Ketoaciduria

A
  • Deficiency of branched-chain keto acid dehydrogenase (inability to break down branch chain amino acids)
  • Mental retardation, seizure disorder, and feeding problems early in life
  • I Love Vermont Maple Syrup
31
Q

Where is murmur of tricuspid valve endocarditis best heard?

A

Over the left fifth intercostal interface, just lateral of sternal boarder

32
Q

Refers to ability of a pathogen to establish infection
In the setting of accidental needle sticks the risk of being infected of the following is as follows:
Hepatitis B (30%)>Hepatitis C (10%)>HIV (0.3%- 0. 45%)

A

Infectivity

33
Q

Edwards Syndrome (Trisomy 18)

A

-47XY (trisomy 18)
-Mental retardation
-Rocker bottom feet
-Low-set ears
-Micrognathia (small jaw)
-Congenital heart disease
-Clenched hands with overlapping finger
-Prominent occiput
DO NOT LIVE PAST ONE YEAR

34
Q

Patau’s Syndrome (Trisomy 13)

A

-47 XY (trisomy 13)
-Severe intellectual disability
-Microopthalmia
-Microcephaly
-Cleft-lip/palate
-Abnormal forebrain structures
-Polydactyly
-Congenital heart disease
DO NOT LIVE PAT ONE YEAR

35
Q
  • Infects the small intestine, thereby causing lactose intolerance
  • Trophozoite form proliferates in intestine
  • Symptoms due to loss of brush border enzymes and progressive blunting of villi
A

Giardia lamblia

36
Q
  • Usually occurs do to folate or vitamin B12 deficiencies

- Alcoholism, liver disease, certain drugs (hydroxyurea and methotrexate)

A

Macrocytic anemia

37
Q
  • PIG-A GPI anchor mutation
  • Hemosiderin in urine
  • Triad: Coombs (-) hemolytic anemia, pancytopenia, and venous thrombosis
  • CD55/59 (-) RBCs
  • Tx: Eculizumab
A

Paroxysmal Nocturnal Hemoglobinuria (PNH)

38
Q

Fluconazole toxicity

A
  • Nausea, vomiting, abdominal pain, diarrhea

- Sever cases hepatotoxicity and hypokalemia

39
Q
  • Nevirapine, delavirdine, efavirenz

- ADR: Rash and Hepatitis

A

Nonnucleoside reverse transcriptase inhibitors

40
Q

Duodenal ulcer disease

A
  • Burning epigastric pain that occurs in absence of food
  • Gastroduodenal artery at risk for perforation
  • H.pylori = 90% (only 60% in gastric ulcers)
  • H.pylori can be test with sampling of exhaled air for presence of ammonia from cleaved urea (the urea breath test)
41
Q
  • Common cause of neonatal conjunctivitis

- 2-5 days after birth

A

Neisseria gonorrhoeae

42
Q
  • AD
  • Mismatch repair
  • Colorectal cancer (40-45 years old)
  • High risks for: endometrial, ovarian, urinary tract, small intestinal, stomach, and biliary cancer.
A

HNPCC (Lynch Syndrome)

43
Q

KISS and KICK until your SICK of SEX

A 
KISS= QISS= a1, a2, b1, b2
KICK= QIQ = M1, M2, M3
SICK= SIQ= D1, D2, H1
SEX= SQS (super qinky sex)= H2, V1, V2
44
Q
  • 5-14 days after birth

- Treat with oral and topical erythromycin to prevent → PNEUMONIA (most feared)

A

Chlamydial (inclusion) conjunctivitis

45
Q

17beta-Estradiol is synthesized in ovarian follicles Granulosa cells via aromatization of testosterone stimulated by what?

A

FSH

46
Q
  • Compression of median nerve
  • Often caused by synovitis.
  • Tinel’s sign (tingling along nerve with tapping)
A

Carpal Tunnel Syndrome

47
Q

What muscles does the median nerve (in hand) supply?

A

Three thenar muscles

48
Q

What are the actions of the thenar muscles? (Oaf)

A 
Oaf (a and f  are lower case because they are brevis)
-Oppose Abduct Flex
(Opponens Pollicis)
(Abductor pollicis brevis)
(Flexor pollicis brevis)
49
Q

Amiodarone ADRs (class III anti-arrhythmic)

A

Pulmonary fibrosis
Hepatotoxicity
Hypothyroidism

50
Q

What is somatization?

A

A process by which an individual uses his or her body or symptoms for a range of psychological purposes and gains

51
Q 
Manic episodes (periods of elevated or irritable mood that must last at least 1 week)
-May have depressive episodes or symptoms but this is NOT part of diagnostic criteria
A

Type 1 bipolar disorder

52
Q

What are the group B personality disorders? (WILD…with a genetic association with mood disorders and substance abuse)

A

1) Anti-social- conduct disorder if less than 18
2) Borderline—(Brandon Marshall)- Splitting is major defense mechanism (Tx: dialectical behavior therapy)
3) Histrionic (Maddie)
4) Narcissistic (Kanye West)

53
Q

What is another name for Kawasaki Disease?

A

Mucocutaneous Node Disease

54
Q

Azathioprine

A
  • RA

- Anti-rheumatic drug (disease-modifying)

55
Q

What are the TNF-alpha inhibitors?

A
  • Etanercept (RA, psoriasis, ankylosing spondylitis)

- Infliximab, adalimumab (above + IBD)

56
Q

Exacerbate tuberculosis by antagonizing TNF

A
  • TNF plays important role in granuloma formation and stabilization
  • TNF-alpha inhibitors (Etanercept, Infliximab, Adalimumab)
57
Q

Risedronate

A
  • Bisphosphonate

- Used in prevention and treatment of osteoporosis

58
Q

What drugs are ligands for PPAR-alpha (a receptor that regulations the transcription of genes involved in lipid metabolism)?

A
  • Fibrates (ex: Gemfibrozil)
  • Increased expression of lipoprotein lipase on endothelial cells→ increased clearance of triglyceride rich lipoproteins
  • Fatty acid uptake and breakdown by beta-oxidation
  • 35-50% decreases in triglycerides
59
Q

Broca’s (expressive) aphasia

A
  • Difficulty enunciating words
  • Can understand both written and verbal language
  • Frustration because they know they have a defect (Unlike Wernicke’s aka Receptive)
  • LEFT MIDDLE CEREBRAL ARTERY
60
Q

Achondroplasia

A
  • FGR-3 mutation

- Abnormal endochondral ossification

61
Q
  • Mimics the appearance of PML, but…
  • ENHANCING PERIVENTRICULAR WHITE MATTER LSEIONS IN CORTICAL AND SUBEPENDYMAL REGIONS
  • Histology: EOSINOPHILIC inclusions in both cytoplasm and the nucleus
A

CMV encephalitis

62
Q

Toxoplasmosis lesions in brain are usually located where?

A
  • Corticomedullary junction
  • Tx = sulfadiazine/pyrimethamine or trimethoprime/sulfamethoxazole
  • Multiple enhancing lesions on MRI
63
Q

Acute Intermittent Porphyria (AIP)

A
  • Lack of porphobilinogen deaminase

- Build up of aminolevulinate and porphobilinogen lead to symptoms

64
Q

Acute Intermittent Porphyria (AIP) symptoms

A

-ABDOMINAL PAIN, neuropathy, high sympathetic tone, muscle weakness, and neuropsychiatric disturbances (seizures, paranoia, depression, and anxiety)

65
Q

The mandibular division the trigeminal nerve exits the skull via…

A

Foramen Ovale (V3)

66
Q 
V1= Superior orbital fissure
V2= Rotundum
V3= Ovale
A

Foramina of the trigeminal nerve divisions: Standing Room Only (SRO)

67
Q

Common symptoms of craniopharygiomas

A
  • Early morning headaches and N/V (increased ICP)
  • ENDOCRINE dysfunction
  • Increased thirst and urination due to diabetes insipidus (pituitary-stalk dysfunction 10-20%)
  • Stunted growth (decrease growth hormone)
  • Visual disturbances
  • Tx: surgery or radiation
68
Q

Where are ependymomas located and what can they cause?

A

Fourth ventricle and hydrocephalus

69
Q

Cisplatin Side Effects:

A
  • Nephrotoxicity (hydrate to prevent kidney damage)

- Acoustic nerve damage

70
Q

Nephrotoxic Chemotherapy agents

A
  • Streptomycin
  • Cisplatin
  • The nitrosoureas
  • Methotrexate
  • Mithramycin
  • Cyclophosphamide
71
Q

5-FU ADRs

A
  • Emesis
  • Myelosuppression
  • Alopecia
72
Q

Doxorubicin ADRs

A
  • Cardiotoxicity
  • Myelosuppression
  • Alopecia
  • GI
73
Q

Etoposide ADRs

A
  • Myelosuppression
  • GI distress
  • Alopecia
  • OVARIAN FAILURE

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