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Imhotep > RX FLASH 256 > Flashcards

RX FLASH 256 Flashcards

1
Q
  • Seizures are rare
  • CD4 count less than 100
  • Delirium confusion
  • FND (focal neural defects)
  • Dementia
  • Retinitis can cause vision to be messed up
A

CMV encephalitis in HIV

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2
Q
  • HIV-pneumonia

- CD4 count

A

Pneumocystis jirovecii

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3
Q

Primary hypothyroidism

A
  • Thyroxine = DECREASED
  • TSH = INCREASED
  • Triiodothyronine resin uptake = DECREASED
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4
Q

Most common cause of Hypothyroidism in the USA

A

Hashimoto thyroiditis

  • Anti-thyroglobulin
  • Antithyroid peroxidase
  • Anti-TSH receptor antibodies
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5
Q

Histological findings of Hashimoto thyroiditis

A 
Lymphocytic infiltration and germinal center formation
HURTHLE CELLS (epithelial cells w/eosinophilic granular cytoplasm)
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6
Q

Subacute (de Quervain) thyroiditis

  • Mumps and Coxsackievirus
  • Flu-illness and a painful, tender thyroid
A

Focal destruction of normal thyroid tissue w/GRANULOMATOUS INFLAMMATION

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7
Q

Sheets of homogenous cells in an amyloid-containing stroma

A

Medullary Carcinoma
Originates from the C-cells of the thyroid
Produce calcitonin (tones down blood calcium)
Associated with MEN IIa and IIb

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8
Q

Replacement of normal thyroid tissue w/fibrosis

A

Riedel thyroiditis
Idiopathic w/ diffuse fibrosis
Mimics carcinoma

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9
Q

Isoproterenol

A
  • Non-selective AGONIST of beta-receptors
  • Vasodilation (B2)
  • Increased Inotropic/chronotopic (B1)
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10
Q
  • Hypernatremia
  • High serum osmolality > 290mOsm/L
  • Low urine osmolality
  • Low urine specific gravity
A

Diabetes Insipidus (DI)

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11
Q

-Preventing relapse and acute manic events

A

Lithium

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12
Q

Cause of TE fistula

A

-Tracheoesophageal septum fails to develop

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13
Q

Most common form of TE fistula

A
  • Blind upper esophagus with the lower esophagus having an anomalous connection to trachea
  • Polyhydramnios is seen in all TE fistulas
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14
Q

Double bubble sign

A
  • Duodenal atresia
  • Failure of duodenal recanalization
  • Polyhydramnios
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15
Q

Winged scapula

A

-Long thoracic Nerve (injury to axilla or breast surgery)

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16
Q

Axillary nerve damage

A

-Deltoid muscle fibers (middle fibers) = arm abduction

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17
Q

Axillary nerve damage can occur from=

A

Injury to surgical neck of humorous or anterior shoulder dislocation

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18
Q

Ulnar nerve damage

A
  • Injury to medial epicondyle of humerus
  • CLAW HAND
  • Ab/adduction weakness in fingers
  • Adduction of the thumb (Lucas says you MUST know this)→spared in C-tunnel
  • Extension of fingers
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19
Q

Median nerve damage

A
  • Supracondylar area of distal humerus

- Similar to C-Tunnel syndrome

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20
Q

Vitamin B12 neuropathy/Subacute combined degeneration of spinal cord

A
  • Demyelination of axons in the dorsal columns and spinocerebeller tracts (arm and leg ataxia)
  • Associated with pernicious anemia
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21
Q

Charcot-Marie-Tooth disease/ peroneal muscular atrophy

A
  • Loss of conscious proprioception (posterior columns)

- Lower motor neuron signs (anterior horn motor neurons)

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22
Q

Xp21 abnormality

A
  • DMD
  • Codes for dystrophin (myocyte-anchoring protein)
  • X-linked recessive
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23
Q
  • Excessive iron reabsorption

- Micronodular cirrhosis, pancreatic fibrosis, and bronze skin pigmentation

A

Hemochromatosis (AR)

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24
Q

G6PD inheritance

A

X-linked recessive

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25
Q

Physiologic Dead space (VD)

A

Vd= VT * [(PaCO2-PeCO2)/PaCO2]

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26
Q

Drug that can be used to prevent GVHD

A

Cyclosporine

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27
Q

Cyclosporine MOA

A
  • Inhibits T-lymphocyte activation (IL-2)

- Renal toxicity

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28
Q

Mycophenolate mofetil ADRs

A
  • N/V, nausea, vomiting, abdominal pain,

- LEUKOPENIA and ANEMIA

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29
Q
  • Converted to mycophenolic acid in gut
  • Potent, reversible, noncompetitive inhibitor of IMP dehydrogenase
  • Inhibit de novo PURINE synthesis
A

Mycophenolate mofetil

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30
Q

Muromonab-CD3 ADR

A
  • Anaphylactoid reactions

- CNS (seizure and headache)

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31
Q
  • Immunosuppressant after organ transplant
  • Binds CD3
  • Blocks access of the antigen recognition site (disrupts t-cell functioning)
A

Muromonab-CD3

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32
Q
  • Monoclonal antibody that acts against an interleukin IL-2 receptor antagonist
  • T-cells cannot proliferate if their receptor is blocked
  • GI is main adverse effect
A

Daclizumab

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33
Q
  • Pro-drug that is converted to 6MP
  • NUCLEOTIDE analog
  • IMMUNOSPPRESSIVE
  • ADR: BONE MARROW SUPPRESSION
A

Azathioprine

Used in RA, UC, etc

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34
Q

Risedronate and alendronate

A
  • Bisphosphonates
  • Treats metastatic bone diseases (multiple myeloma) and osteoporosis
  • Reduce activating of osteoclasts
  • ARD: GI and Hypocalcemia
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35
Q
  • Cough
  • Angioedema
  • Proteinuria
  • TASTE CHANGES
  • RASH
  • HYPERKALEMIA
A

ACE Inhibitor ADR

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36
Q

Vinca Alkaloids

A
  • Vinblastine and Vincristine
  • Testicular carcinoma
  • Hodgkin
  • Non-Hodgkin
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37
Q

Criteria for Chronic Bronchitis

A
  • Productive cough lasting at least 3 months a year for at least 2 consecutive years
  • Decreased FEV1 and FEV1: FVC
  • Hypotrophy of mucus glands
  • Monocytes and CD8+ T-cells
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38
Q

Reid index

A

Ratio of gland depth to the total thickness of bronchial wall
Normal:

39
Q

Chronic Bronchitis Biopsy

A
  • CD8+ T-cells and monocytes
  • Squamous cell metaplasia and fibrosis
  • Narrowing of bronchioles by mucus plugs
40
Q

-Infiltration of eosinophils and CD4+ and Th2 lymphocytes

A

Asthma Histo

41
Q

-Rare glucagon-secreting tumor that can cause hyperglycemia, diarrhea and weight loss

A

Glucagonoma

42
Q

What rash is Glucagonoma associated with?

A
  • Necrolytic migratory erythema

- Painful, pruritic, erythematous papules that blister, erode and crust over

43
Q
  • Present w/ fasting HYPOglycemia
  • Diaphoresis, palpitations, tremulousness, behavior changes and confusion
  • Can be mistaken for neuro disorder
  • Weight gain
A

Insulinomas

44
Q

Adenocarcinoma of the pancreatic tail rash

A
  • Migratory thrombophlebitis (Trousseau Syndrome)

- Extremities become red and tender

45
Q

Aschoff Body

A
  • Focal area of interstitial/perivascular inflammation characterized by fragmented collagen
  • Mononuclear cells (Antischkow)—can be seen in normal myocardium
  • Multinucleated giant cells (Aschoff)
46
Q
  • Rare endocrine tumors
  • Arise from pancreatic islets
  • Chronic profuse, watery diarrhea
  • Can cause hyperglycemia and a pancreatic mass on CT
A

VIPomas

47
Q
  • Central area of necrosis w/ macrophages

- Surrounded by lymphocytes and plasma cells

A

Caseating granuloma

48
Q

Foam cells

A
  • Present in atherosclerosis plaques

- Lipid-laden macrophages

49
Q

Marfan’s (AD) Findings I still didn’t know…

A
  • Arm span exceeding height (ratio>1.05)
  • Reduced upper-to-low body segment ratio
  • Arachnodactyly
  • Scoliosis greater than 20 degrees
  • Dural Ectasia
  • Aortic involvement (dilation of root→regurgitation)
50
Q

AD
15
Fibrillin (component of microfibrils)
Microfibrils are critical in: Elastin of aorta, suspensory ligaments of lens of eye, and other connective tissue

A

Marfan’s Chromosome

51
Q

Treatment of hemochromatosis

A

Regular phlebotomy

DEFEROXAMINE (iron-chelating agent)

52
Q
  • Deficiency of a biliary cooper-excreting ATPase
  • Hepatic cooper accumulation and toxicity
  • Ceruloplasmin decreased
A

Wilson disease (AR)

53
Q

-Decreased TIBC (indirect measure of serum transferrin)
Note- Transferrin (binds iron in blood) is down-regulated in iron overload b/c decreased need for iron absorption
-FERRITIN VERY HIGH (iron storage)

A

Hemochromatosis “Bronze diabetes”

54
Q

Where is ferritin (iron storage) found?

A

-Liver and erythroid cell line

55
Q

Ion: Ca2+ (increased inward current)
Physiologic Effect: Conduction velocity
Site of action: AV node

A

Dromotropy

56
Q

Ca2+
Contractility
Cardiac myocytes (site of action)

A

Inotropy

57
Q

Na+ Ca2+
Heart rate
Site of action= SA node

A

Chronotropy

58
Q

In contrast to Wegner’s granulomatosis, which vasculitis has the lungs spared?

A

PAN (polyarteritis nodosa)

59
Q
  • Spares lungs
  • Different stages inflammation coexist in different vessels
  • Bead of pearls
  • HepB Ag-Antibody
A

Polyarteritis nodosa “Buzz phrases”

60
Q

PAN skin rash?

A

Livedo reticularis: ulcerations and a purplish discoloration

In addition: anemia, CPR increased, neutrophilic leukocytosis

61
Q
  • Necrotizing vasculitis that affects small vessels
  • All vessels are typically at the same stage of inflammation
  • MPO-ANCA (P-ANCA)
  • Lung and kidney most common affected
A

Microscopic polyangiitis

62
Q

Microscopic polyangiitis

A
  • Necrotizing vasculitis that affects small vessels
  • All vessels are typically at the same stage of inflammation
  • MPO-ANCA (P-ANCA)
  • Lung and kidney most common affected
63
Q
  • Tx for sickle cell
  • Also for decreasing burden of high WBC counts in acute leukemia and CML
  • Anti-metabolite that works in S phase
  • MYELOSUPPRESSION= ADR
A

Hydroxyurea

64
Q

At least two of the following symptoms must be present at least 6 months

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Catatonic behavior
  • Negative symptoms (flat affect, lack of motivation, poverty of speech)
A

Diagnosis of schizophrenia requires what?

65
Q

Besides CML what else does Imantinib treat?

A

Gastrointestinal STROMAL tumors

66
Q

Must have for at least one month

  • Non-bizarre delusions that are not attributable to another psychiatric condition
  • Does not impair normal life
A

Delusion Disorder Criteria

67
Q

What are the negative symptoms of schizo?

A
  • Flat affect
  • Lack of motivation
  • Poverty of speech
68
Q

Schizo in populations

A

Affects 1%

69
Q

Presence of at least one of the following for AT LEAST A DAY but LESS THAN A MONTH:

  • Hallucinations
  • Delusions
  • Disorganized speech
  • Grossly disorganized behavior
A

Brief psychotic disorder

70
Q

History of hypotonia, stretchy skin, and abnormal joints

A
  • Ehlers-Danlos syndrome (defect in collagen synthesis)

- Normal intelligence and meet milestones

71
Q

-Reduces surface tension by disrupting INTERMOLECULAR FORCES (hydrogen bonds) of alveoli

A

Surfactant

72
Q
  • Manifest in newborns as muscle hypotonia and joint laxity
  • May be present at birth or manifest later
  • Respiratory complications and recurrent joint dislocations
  • Hyperextensible skin and typically velvety, pale and translucent with poor wound healing
  • Vascular fragility w/spontaneous rupture
A

Kyphoscoliosis form of Ehlers-Danlos

73
Q

Kyphoscoliosis form of Ehlers-Danlos defect

A

Most common= Lysyl hydroxylase (enzyme that cross-links collagen fibrils)

74
Q

Pompe disease

A

Type II glycogen storage disease

75
Q
  • Lysosomal alpha-1-4-glucosidase→cardiomegaly, hepatomegaly and skeletal myopathy
  • Die of respiratory failure by 2 years of age
A

Pompe disease deficiency

76
Q
  • Osteoclast cannot appropriately reabsorb bone → form of osteoporosis
  • Multiple fractures
  • HSM from extramedullary hematopoiesis
A

Deficiency of carbonic anhydrase II

77
Q

Neurofibromin

A

Tumor suppressor gene = inactivated in NF1

  • Remember skeletal abnormalities also seen
  • AD
78
Q
  • COL5A1 or COL5A2 mutations
  • Type V collagen defect
  • Large and small joint hypermobility
  • Widen scars
  • Hyperextensible and fragile skin
  • MOLLUSCUM PEUDOTUMORS
  • Hernias
A

EDS (Ehlers-Danlos Syndrome): Classic Subtype

79
Q

EDS (Ehlers-Danlos Syndrome): Arthrochalsia subtype

A
  • COL1A1 or COL1A2 mutations (type I collagen defect)
  • Joint hypermobility
  • CONGENITAL HIP DISLOCATION
  • RECURRENT DISLOCATIONS/SUBLUXATIONS
80
Q
  • Unknown pathogenesis
  • Large and small join hypermobility
  • AUTONOMIC INSTABILITY
  • DELAYED GASTRIC EMPTYING
  • IBS
A

EDS (Ehlers-Danlos Syndrome): Hypermobility subtype

81
Q

EDS (Ehlers-Danlos Syndrome): Dermatosparaxis subtype

A

-ADAMTS2 mutation (procollagen)

82
Q
  • COL3A1 mutations (type III procollagen defect
  • SMALL JOINT hypermobility
  • Thin translucent skin
  • THIN FACE
  • Easy bruising
  • Arterial, uterine and intestinal rupture
A

EDS (Ehlers-Danlos Syndrome): Vascular Subtype

83
Q

EDS (Ehlers-Danlos Syndrome): Kyphoscoliosis subtype

A
  • PLOD1 mutation (Lysyl hydroxylase deficiency
  • Joint hypermobility
  • CONGENITAL HYPOTONIA
  • SCOLIOSIS
  • Fragile sclera
  • Retinal detachment
  • Glaucoma
  • Medium-sized arterial rupture
84
Q
  • COL1A1 or COL1A2 mutations (type I collagen defect)
  • Joint hypermobility
  • CONGENITAL HIP DISLOCATION
  • RECURRENT DISLOCATIONS/SUBLUXATIONS
A

EDS (Ehlers-Danlos Syndrome): Arthrochalsia subtype

85
Q

EDS (Ehlers-Danlos Syndrome): Hypermobility subtype

A
  • Unknown pathogenesis
  • Large and small join hypermobility
  • AUTONOMIC INSTABILITY
  • DELAYED GASTRIC EMPTYING
  • IBS
86
Q

EDS (Ehlers-Danlos Syndrome): Vascular Subtype

A
  • COL3A1 mutations (type III procollagen defect
  • SMALL JOINT hypermobility
  • Thin translucent skin
  • THIN FACE
  • Easy bruising
  • Arterial, uterine and intestinal rupture
87
Q
  • PLOD1 mutation (Lysyl hydroxylase deficiency
  • Joint hypermobility
  • CONGENITAL HYPOTONIA
  • SCOLIOSIS
  • Fragile sclera
  • Retinal detachment
  • Glaucoma
  • Medium-sized arterial rupture
A

EDS (Ehlers-Danlos Syndrome): Kyphoscoliosis subtype

88
Q

-ADAMTS2 mutation (procollagen)

A

EDS (Ehlers-Danlos Syndrome): Dermatosparaxis subtype

89
Q

Langhans giant cells

A

-Granulomatous lung diseases (ex: TB)

90
Q

LangERhans Cells

A

-Seen specifically in pulmonary Langerhans cell histiocytosis

91
Q

Birbeck Granules

A
  • Seen in histolytic cells that are closely related to Langerhans’ cells of skin
  • Tennis racket cytoplasmic inclusions
92
Q

Intra-arterial thrombus with RBC extravasation on histology

A

Pulmonary embolism

93
Q

Marked intra-alveolar fibrin and cellular debris (microscopic)

A

ARDS

94
Q

Thick-walled spherules containing endospores with surrounding inflammatory cells

A

-Coccidoidomycosis

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