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Pharmacology > set 2 > Flashcards

set 2 Flashcards

1
Q

b cell surface antigens

A

cd 19, 20, 21, 40. 21 for ebv. b7. mhc11

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2
Q

macrophages antigens

A

cd14 (receptor for pamps, eg lps) cd40 ccr5 mhc2 b7(cd80/86) fc and c3b receptors (both enhance pahgocytosis)

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3
Q

brain mets

A

primary lung > breast > melanoma, colon, kidney

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4
Q

liver mets

A

colon >> stomach > pancreas liver and lung are the most common mets after lymphadenopathy

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5
Q

bone mets

A

prostate, breast > lung, thyroid, kidney bone mets more common then primary breast (mixed), lung lytic, thyroid lytic, kidney lytic, prostate is blastic predilection for the axial skeleton

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6
Q

cri du chat synrome

A

congential microdeltion of short arm of 5 (46xx or xy 5p-). findings: microcephaly, moderate to sever intellectual diability, high pitched crying/meowing, epicanthal folds, cardiac defects (vsd) u world partial denove mutation

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7
Q

fetal erythropoesis

A

yolk sac (3 8 weeks) liver (6 weeks - birth) spleen (10 - 28 weeks) bone marrow (18 weeks)

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8
Q

heme synthesis

A
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9
Q

acute intermittent porphyria

A

pophobilinogen deaminase (formerly called uroporphyrinogen 1 synthase) autosomal dominant

accumulation of porphobilinogen and ala

5 ps

painful abdomen

port wine urine (red initially -> brown)

polyneuropathy

psycholigic (anxiety, confusion, paranoia)

precipated by drugs (cyp p450 induce), alcohol, starvation

treat with glucose, heme which inhibit ala synthase

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10
Q

porphyria cutanea tarda

A

uroporphyrinogen decarboxylase

ad

uroporphyrin (tea color urine) accumulates

blistering cutaneous photosensitivty and hyperpigmentation

most common porphyria

exacerbted with alcohol consumption

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11
Q

lead treatment

A

dimercaprol and edta 1st line

succimer in kids

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12
Q

type 1 hyper chylomicronemia

A

ar

lipoproteinlipase or apolipoportein c 11

increase in chylomicrons, tg, cholesterol

pnacreatitis

eruptive/pruitic xanthomas

no increased risk for atherosclerosis

creamy layer in the super natant

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13
Q

type 2 famiilial hypercholesterolemia

A

AD

abesent or defective ldl receptor

IIa: ldl and cholesterol increased

IIb: ldl, cholesterol, vldl increased

heterzygots (1:500): have cholesterol = 300 mg/dl

homozygotes (very rare): 700+ mg/dl

accelerated atherosclerosis (may have mi before age 20), tendon (achilles) xanthomas, corneal arcus

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14
Q

type III dysbetalipoproteinemia

A

ar

defective apoe

increased chylomicrons and vldl (remants)

increased triglyceride and cholesterol

premature atherosclerosis, tuberoeruptive xanthomas

xanthoma striatum palmare

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15
Q

type IV hypertriglyceridemia

A

AD

hepatic overproduction of vldl

increased vldl and triglycerides

hypertriglyceridemia (> 1000 mg/dl) can cause acute pancreatitis

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16
Q

erb palsy (waiters tip)

A

traction on upper c5 - c6

infants delivery and adults tramua

deltoid, supraspinatus -> abduction (arm hangs by side)

infraspinatus -> lateral roation (arm medially rotated)

biceps brachii -> flexion, supination (arm extended and pronated)

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17
Q

klumpe palsy

A

traction on lower trunk (c8-t1)

infants - upward force on arm during delivery

adults trauma (grabbing tree)

intrinsic hand muscles: lumbricals, interossi, thenar, hypothenar

total claw: all lumbricals damaged

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18
Q

thoracic outlet obstruction

A

compression of lower trunk and subclavian vessels

caused by cervical rib or pancoast tumor

intrinsic muscle of hand: lumbricals, interosseia, thenar, hypothenar

atrophy of instrinsic hand mucles, iscehmia, pain, and edema due to vascular compression

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19
Q

il-1

A

Secreted by macs

casues fever, acute inflammation. activates endotehlium to express adhesion molecules. Induces chemokine section to recruit wbcs.

neutrophil/mac migration

increased in acute phase reactants

shock

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20
Q

il 6

A

secreted by macs

causes fever and stimulates proeuction of acute phase proteins in the liver.

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21
Q

il 8

A

secreted by macs

major chemotactic factor for neutrophils

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22
Q

il 12

A

induces differentiation of t cells into th1 cells. activate nk cells + cd8.

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23
Q

tnf a

A

secreted by macs

activates endothelium, causes wbc recruitment, vascular leak.

septic shock, fever

causes cachexia in malignancy

maintains granulomas in TB

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24
Q

il 2

A

secreted by all t cells

(mostly helper cells)

stimulates growth of helper, cytotoxic, and regulatory t cells, and nk cells

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25
Q

il 3

A

secreted by t cells

supports growth and differentiation of bone marrow stem cells. functions like gm-csf

increases hematopoesis

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26
Q

inf g

A

secreted from th1

secreted by nk and t cells in response to antigen or il 12 from macs. stimultated macs to kill phagocytosed pathogens. inhibits differentiation of th2

also activates nk cells to kill cirus infected cells. increases mhc expression and antigen presentation on all cells.

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27
Q

il 4

A

from th2 cells

induces differentiation of t cells into th2 cells. promotes growth of b cells. enhances class switching to ige and igg.

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28
Q

il 5

A

promotes growth and differentiation of bcells. enhances class switching to iga. stimulates growth and differentiation of eosinophils.

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29
Q

il 10

A

attenuates inflammatory response. decreases expression of mhc II and th1 cytokines (il2 and inf g). inhibits activated macs and dendritic cells. also secreted by t regs. some enhancement of th2. decrease th1 differentiation and increase th2.

tgf b and il 10 both attenuated the immune response

30
Q

dilated cardiomyopathy

A

most common cardiomyopathy

idiopathic or familial (usuallu AD)

ABCCCD

alcohol use, wet beri beri, coxsackie B viral myocarditis, chronic cocaine use, chagas disease, doxorubicin

hemochromatosis (k says late), sarcoidosis, peripartum.

findings: hf, s3, systolic regurgitant murmur, dilated heart on CXR

treatment:

na restriction, ace inhibitors, b blockers, diuretics, digoxin, ICD, heart transplant

Takotsubo cardiomyopathy

“broken heart syndrome”

ventricular apical balloning likely due to increased sympathetics (stressful situations)

eg death of love one, break up, chronic anxiety

temporary muscular weakening

can cause acute hf, arrythymia, ventricular rupture

those that survive prognosis is excellent

31
Q

Hypertrophic (obstructive cardiomyopathy)

A

70 % familial

myosin binding protein c, b myosin heavy chain

findings: s4, systolic murmur, can see mitral regurgitation.

treatment:

cessation of high intesenity exercise, beta blockers or non dihydropyridine ca channel blockers (relieve obstruction)

icd if patient at high risk

crescendo decrescendo stysloic murmu like aortic stenosis

32
Q

restrictive/infiltrative cardiomyopathy

A

Puppy LEASH

post radiation fibrosis, loffler syndrome, endocardial fibroelastosis (thick fibroelastic tissue in the endocardium of young children, amylodosis, sarcoidosis, hemochromatosis (although dilated cardiomyopathy is more common).

low voltage ekg depsite thick myocardium (especially in amyloid).

loffler syndrome: endomyocadrial fibrosis with prominent eosinophillic infiltrate.

presents as CHF

33
Q

axillary roots

A

c5 -c6

34
Q

musculocutaneous roots

A

c5-c7

35
Q

radial roots

A

c5-t1

36
Q

median roots

A

c5-t1

37
Q

ulnar

A

c8-t1

38
Q

reccurent branch of the median nerve roots

A

c5-t1

39
Q

arm abduction

A

supraspinatus 0-15

deltoid 15-100

traps > 90

serratus anterior > 100

40
Q

men 1

A

wermers

pituitary (prolactin or gh)

mutatin of men1 gene (codes for menin a tumor supressor gene on 11)

41
Q

men 2a/2b

A

sipple syndrome

usually thyroid caner presents first

asssocaited with ret mutation (codes for receptor tyrosine kinase) in cells of neualcrest origin

men 2b also ret mutation

42
Q

right atrial pressre

A

<5

43
Q

right ventricular pressure

A

25/5

44
Q

puomary artery pressure

A

25/10

45
Q

PCWP pressure

A

4-12

46
Q

left ventricular pressure

A

130/10

47
Q

aortic pressure

A

130/90

48
Q

mitral valve prolapse

A

late systolic crescendo.

most frequent valvular lesion

loudest just before s2

most of the time incidental

predispose to infective endocarditis

can be caused by rheumatic fever, chordae rupture

can cause arrythymia or mitral regurgitation

mxomatoud degeneration - primary or secodnary to marfan/ehlers

49
Q

aoritc area

A

Systolic:

aortic stenosis

flow murmur (eq physiologic murmur)

aortic valve sclerosis

50
Q

erb’s point

A

diastolic:

aoritc and pulmonic regurg

Systolic:

Hypertrophic cardiomyopathy

51
Q

pulmonic area

A

systolic:

pulmonic stenosis

flow murmur

52
Q

tricuspid area

A

holosystolic murmur:

tricuspid regurgitation

VSD

Diastolic:

tricuspid stenosis

ASD from increased flow across tricuspid valve

53
Q

mitral area (apex)

A

holosystolic murmur

mitral regurgitation

systolic murmur

mitral valve prolapes

diastoliic:

mitral stenosis

54
Q

mitral/tricuspid regurgitation

A

holosystolic high pitched blowing murmur

mitral - radiates to axilla

MR often due to iscehmic heart disease (post mi), MVP, LV dilation (CHF)

TR commonly due to RV dilation

Rheumatic fever or infecetive endocarditis can cause either MR or TR

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Pharmacology (33 decks)

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