Rx_Random Set #8 Flashcards
Classic exam findings in osteoarthritis
- heberden’s nodes = swelling @ distal interphalangeal joints
- bouchard’s nodes = swelling @ proximal interphalangeal joints
Flucytosine: MOA + use
- antifungal agent used to treat systemic fungal infections
- MOA = pyrimidine antimetabolite: inhibits DNA syntehsis by conversion to fluorouracil which competes w/uracil
- selective for fungal cells bc enzymes required for entry and activation are found in low levels in mammalian cells
Cause of heriditary spherocytosis
- lack/mlfxn of RBC proteins spectrin or ankyrin
Mechanism/presentation of heriditary spherocytosis
- malfxn of spectrin/ankyrin ==> round sperocytes ==> prone to hemolysis, esp. @ spleen
- sx/signs
- jaundiced after viral illness
- FHx
- splenectomies
- Dx
- spherocytes on peripheral smear
- osmotic fragility test
Common histologic finding in squamous cell carcinoma of bladder
keratin pearls
Most common cause of squamous cell carcinoma of bladder (in world)
- helminth infection
- schistosoma haematobium ==> eggs @ bladder wall ==> chronic irritation ==> cancer
Final enzyme in purine salvage pathway
-
xanthine oxidase
- converts xanthine ==> uric acid
- inhibited by allopurinol (medication used to prevent gout attacks)
Presentation/mechanism of alkaptonuria
- AR disorder of homogentisic acid oxidase
- enzyme that helps degrade tyrosine
- ==> accumulation of homogetisic acid ==>
- cartilage (joint) damage + dark color
- heart valve damage
- formation of kidney stones
- excretion in urine ==> black urine
Brain abnormality associated with Patau syndrome
- holoprosencephaly
- commonly: midline forebrain structures affected
- optic tracts/bulbs
- corpus callosum
- pituitary
- hypothalamus
MOA of vasopressin @ V2 receptors
- V2 receptors located @ kidney collecting duct
- ADH/vasopressin ==> V2 ==> activation of adenylyl cyclase via Gs subunit ==> increased cAMP ==> insertion of aquaporin proteins @ apical membrane ==> increased urine concentration
Methotrexate: MOA, uses
- methotrexate = folic acid analog antimetabolite ==> inhibition of dihydrofolate reductase
- DHFR involved in synthesis of purines and some amino acids
- uses
- inflammatory conditions
- rheumatoid arthritis
- IBD
- chemotherapy
- breast carcinoma
- lung carcinoma
- ALL
- non-hodgkin’s lymphoma
- etc.
- inflammatory conditions
Cyclophosphamide: MOA, uses
- MOA: alkylating agent ==> adds alkyl group to DNA ==> interferes w/DNA synthesis
- Uses
- immunosuppressant
- SLE
- MS
- autoimmune hemolytic anemia
- **restricted use due to severe side effects
- chemotherapy
- breast carcinoma
- non-Hodgkin lymphoma
- ovarian carcinoma
- immunosuppressant
Hep A: viral type, transmission, presenation, tx
- ssRNA
- fecal-oral transmission
- esp. endemic areas w/contaminated water supply
- sx: jaundice, N/V, fever, abdominal pain, hepatomegaly
- tx: supportive care
Heart murmur in patient w/SLE ==> ?
- most-likely indicates Libman-Sacks endocarditis
- LSE = small vegetation of fibrin + inflammatory cells, often on both sides of valve leaflets
- rarely cause valvular complications or embolize
Common pathologic feature in lungs of smokers
- metaplasia of pseudostratified ==> stratified squamous eptihelium
Which of following types of epithelium not normally present in the lung, lines the bronchu shown in this image (hx: smoking)
A. pseudostratified columnar
B. simple squamous
C. stratified columnar
D. stratified squamous
E. transitional
D. stratified squamous
Treatment for depression w/safe cardiac profile
- Monoamine oxidase inhibitors
- e.g. phenelizine
Characteristics of WAGR syndrome
- presents in childhood
- Wilm’s tumor (kidney tumor)
- Aniridia (partial or complete lack of iris)
- genital anomolies
- mental disability
Presentation/mechanism of polyarteritis nodosa
- vasculitis of the small-medium arteries
- necrotizing immune complex formation
- non-specific sx from end-organ damage related to blood flow
- MSK, cutaneous, GI, cardiac, renal, neuro
- lung’s are spared
- often associated with Hepatitis B
Acarbose: MOA, use, SE
- MOA: alpha-glucosidase inhibitor ==> decrease hydrolysis and absorption of di/polysaccharides @ intestinal brush border
- ==> decreased postprandial hyperglycemia
- Use
- management of T2DM
- SE
- GI: abdominal cramps, diarrhea, flatulence
- contraindicated in poor liver fxn
Presentation of herniation of L5-S1 disc
- radiculopathy of S1 nerve root ==>
- decreased sensation @ post. leg + lateral foot
- diminished ankle jerk reflex
- weak plantarflexion of foot
- back pain radiating to leg
- positive straight leg test
Presentation of Vit D deficiency
- hypocalcemia
- secondary hyperparathyroidism
- hypophosphatemia
Peripheral smear and lab results in DIC
- Labs
- elevated prothrombin
- elevated partial thromboplastin time
- elevated D-dimer (=fibrin degradation products)
- Peripheral smear
- shicstocytes (“helmet” cells)
Presentation of indirect inguinal hernia
- most often = newborn male infants
- peritoneum passes through internal inguinal ring and enters scrotum
- ==> enlarged scrotum + pain
- covered by all three layers of fascia
