shit to learn Flashcards
Men, severe unilateral (orbital or periorbital pain) associated withipsilateral ANS sx (ptosis, miosis, lacrimation, conjunctival injection, rhinorrhea).
Cluster Ha
_____ dx w/ elevated LDH and decreased haptoglobin)
microangiopathic hemolytic anemia.
tx of torsades
magnesium
tx of unstable VT
amiodarone (causes QT prolongation)
tx of afib with rapid ventricular respone
diltizem
first line tx for unstable arrhythmias
epinepherine
Add what to TB regimen to reduce INH induced peripheral neuropathy.
What drug in regimen causes optic neuropathy/red-green colorblindness?
B6 - pyridoxine
ethanmbutol
E7 viral HPV protein binds to RB protein, preventing RB protein from interacting with ___?
What cyclin activates/phosphorylates RB?
E2F TF- in RB’s active/hypophosphorylated form, it binds E2F TF and prevents transcription of genes needed for DNA synthesis.
When CyclinD activates CD4.
Deposition of ___ in;
- AL amyloidosis
- Alzheimer
- PSGN
- dialysis-related amyloidosis
- AL amyloidosis - Ig light chain
- Alzheimer - Amyloid Precursor Protien
- PSGN - complement C3
- dialysis-related amyloidosis - Beta2-microglobulin
Gs pathway
Gs –(+)–> AC –(+)–> ATP to cAMP –(+)–> PKA
Gq pathway
Gq –(+)–> PLC –(+)–> PIP2 to DAG and IP3 –(+)–> PKC –(+)–> intracellular Ca
Vegan diet associated with what vitamin deficit and what results in megaloblastic anemia and demyelination causign peripheral neuropathy (DNA synthesis deficit).
Vit B12 (cyanocobalamin)
Deficiencies in __ Vit causes…
- pellagra
- beriberi
- DNA synthesis
- peripheral neuropathy w/o anemia.
- pellagra - B3
- beriberi - B1
- DNA synthesis - B9, B12
- peripheral neuropathy w/o anemia - B6
tx for trichomonas
metronidazole
tx for chlamydia
azithromycin
tx for Neisseria gono
azythromycin or doxycycline
doclizumab blocks ____ receptor
IL-2
antihep A IgM ab
acute hep A infxn
Hep B surface Ag and hep B core ab
acute hep B infxn
hep B sirface ag and anti-hep B core ab
chronic hep B infxn
anti-hep B core ab
recovered from hep B
hep B surface ab
vaccinated
heart sound heard with LVH
S4 (atrium pushing against stiff LV wall
fixed splitting of S2 heard with what defect?
atrial septal defect (dt L-to-R shunting delaying closure of Pulmonic valve)
Crescendo-decrescendo systolic ejection murmur
Aortic stenosis
heart sound associated with delay LV emptying, like in AS or LBBB
Paradoxical splitting of S2
Heart sound associated wiht increased filling pressures as seen in mitral regurgitation, CHF, dilated cardiomyopathy and L-to-R sunts.
S3 heart sound.
What is less than 4 consecutive days of elevated or irritable bood with at least 3 of: distractibility, engagement in irresponsible behavior, inflated self esteem or grandiosity, racing thughts or flight of ideas, increased goal-directed activity or psychomotor agitation, dcerased need for sleep, increased talkativeness or pressured speceh.
Bipolar, Type 2.
Type 1 is the presence of at least one manic episode (hypomania, but at least one week).
Tx of choice for CFH exacerbation.
IV loop diuretic (TaL)
Antibodies against ___ in bullous pemphigoid
hemidesmosomes
Deficeincy in what enzyme in inclusion cell disease.
N-acetylglucosaminyl-1-phosphotransferase.
Therefore unable to add mannose-6-phosphate tag.
Testicular tumor associated with painless, firm, testicular mass with elevated serum lactate dehydrogenase. Histo: uniform cells with abundant cellular cytoplasm with central nuclei and prominent nucleoli (fried egg).
seminoma
Tumor arising from cat-produceing sympathetic ganglion cells (anywhere along sympathetic chain, but adrenal gland most common). Elevated urine HVA and VMA . Hoer wright rosettes.
Neuroblastoma.
tx for AD.
Cholinesterase inhibitors to decrease ACh breakdown.
HACEK bugs (culture negative).
Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella).
Conjunctivitis, urethritis, arthritis
Reactive ARthritis - autoimmune rxn to prior infxn (often UTI).
___ poisoning: tinnitus, N/V, AMS, hyperthermia, mixed respiratory alkalosis-primary metabolic acidosis.
Salicylates.
cell that secretes hCG
syncytiotrophoblast
Tx for hyperprolactinemia (i,e, prolactinoma).
What drug could cause hyperprolactinemia?
cabergoline or bromocriptine - a dopamine agonist.
Risperidone could cause it bc it blocks dopamine-R.
Frequent otitis media, sinusitis, respiratory tract infxns. Increased risk for anaphylaxis in response to blood transfusions bc ____.
selective IgA deficiency
Increased risk for anaphylaxis in response to blood transfusions bc ____ anti-IgA ab in pt’s blood reaction IgA in transfused blood.
Deficiency in Tyrosine kinase causes _____.
What cell is lacking.
What inheritance.
Bruton agammaglobulinemia.
X-linked.
Cannot produce Ig (so no B-lymphocytes), so no anaphylactic reactions bc no IgE.
Recurrent severe diarrhea, infection, failure to thrive.
SCID - lack normal Ba nd T lymphocytes.
Pts with cirrhosis may develop gynecomastia, palmar erythema, and spider angiomata dt ___? Develop jaundice dt ___?
develop gynecomastia, palmar erythema, and spider angiomata dt increased estrogen levels? .
Develop jaundice dt portal hypertension.
t(8;14)
burkitt - younger with discrete mass.
t(11;14)
mantle cell lymphoma (a B-cell lymphoma)
t(12;21)
acute lymphoblastic leukemia (ALL). children. lymbphoblasts on peripheral smear.
t(14;18)
follucular lymphoma (B-cell lymphoma)
t(9;22)
chronic myelogenous leukemia (CML). BCR-ABL fusion gene (philadelphia chromosome)
marcus gunn pupil - describe it and what does it indicate?
decreased pupillary constriction in both eyes when light shone in affected eye, indicating demyelination of optic nerve (MS)
belomycin, methotrexate, and andamiodarone - what AE
pulmonary fibrosis
AE of
- 5-fluorouracil
- doxorubicin
- cytarabine
- amiodarone
- 5-fluorouracil - myelosuppression
- doxorubicin - dialted cardiomyopathy and myelosuppression
- cytarabine - pancytopenia
what produces crescendo-decresendo murmur?
AS
what produces opening snap, followed by late diastolic murmur?
MS
what produces midsystolic click followed by late systolic crescendo murmur
MVP
what produces holosystolic blowing murmur best hear at the tricuspid area (LLSB)
TR
what produces: radial pulse 70/min, reuglar and bounding and BP 130/50. Grade 2/6 diastolic decreascendo murmur at LSB.
AR - bounding pulse with wide pilse pressure
Muscle weakness, autonomic dysfunction, repetative contraction allows for temporary improvement of sx
What is it and MoA
Commonly associated secondarily to what?
Lambert Eaton Syndrome
MoA - antibodies against presynaptic Calcium channels.
temporary relief dt Ca accumulation
secondary to paraneoplastic syndrome dt Small Cell Lung Cancer.
Difference between Acute Stress Disorder and PTSD.
ASD 1mo after inciting event.
fever, abd pain, jaundice, AMS, hypotension
what is this dx and what labs should you see (ALP, GGT, Br)?
Cholangitis - reynold’s pentad
charcot’s triad is fever, abd pain, jaundice.
labs - elevated ALP, GGT, Br
lab with 95% specificity for RA
anti-citrullinated peptide Ab.
Associated ParvoB19 with what disease?
Sickle Cell Anemia - transient aplastic crisis
DoC for prostate cancers.
flutamide. competative inhibiotr of androgen receptor.
COPD - what happens to TLC, FEVq, FVC, FEV1/FVX?
flattening of diaphragm indicates ____?
TLC increases, but all others decrease.
flattening of diaphragm indicates hyperinflation.
multinulceated giant cells - think ___ virus
Herpes
koilocytes, think what virus?
HPV
What AE does methotrexate, doxorubicin, and cisplatin have?
What drug prevents this AE?
myelosuppression
leucovorin prevents this by being folinic acid (give to pts receiving HD MTX treatment).
Give ___ to pats receiving cylcophosphamide or ifosfamide to prevent hemorrhagic cystitis.
Give ___ to pts receiving doxorubicin to prevent cardiotoxicity.
Mesna
Dexrazoxane
CSF studies showing:
- elevated opening pressure, low glucose, elevated protein, elevated leukocyte with neutrophilic predominance
- normal opening pressure, normal glucose, elevated protein, elevated leukocyte with lymphocytic predominance
- elevated opening pressure, low glucose, elevated protein, elevated leukocyte with lymphocytic predominance
- bacterial meningitis
- viral meningitis
- fungal meningitis
What drug:
- lowers LDL cholesterol, but no effect on HDL cholesterol and TG levels.
- Fibrate most effective at lowering TG levels.
- decreases LDL cholesterold, increases HDL cholesterol, decreases TG levels
- HMGCoA reductase inhibitor.
- decreases LDL, slight increase HDL, increased TG
Ezetimibe gembibrozil niacin simvastatin chollestyramine
Dx of hirschspring diseae
rectal biopsy to demonstrate absence of ganglion cells in tissue in rectum (failure of migration of neural crest cells to distal colon).
intellectual disability, seizure, facial angiofibromas.
what carcinoma increased risk?
Tuberous sclerosis
increased risk of renall cell carcinoma and subependymal astrocytomas.
constriction of pupils - drug
opioid
secretin affects what?
what about somatostatin?
pancratic stimulation to release bicarbonate.
v. somatostatin which is produced by the pancreas to inhibit pancreatic fluid sercertion
testes drain to what lymph nodes first.
paraaortic.
red man syndrome dt what drug
vancomycin.
contact dermatitis/poison ivy is what HSR?
type 4 - CMI, activation fo sensitized T lymphocytes.
Stevens-Johnson syndrome due to what drug?
TMP-SMX
What breast cancer presents with uniform infiltrating breast stroma in a single file? Loss of expression of what?
invasive lobular carcinoma
loss of e-cadherin
what vitamin is involved in hydroxylation of proline and lysine residues in collagen synthesis?
vitamin C
damage to dorsal column and dorsal roots. decreased sensation and proprioception (sensory ataxia, lancinating pains, absent LE reflexes, pupils accomodate, but dont react)
tabes dorsalis
cocaine use in at term female
abruptio placentae
destruction of what hypothalamic nucleus leads to uncontrolled appetite and obesity?
ventromedial.
CRACK AMIGOS - most importatn P450 inhibitors
cyprofloxacin, ritonavir, amiodarone, cimetidine, ketoconazole, acute alcohol use, macrolides, grapefruit juice, omeprazole, sulfonamides
kidney develop:
what gives rise to the colleting system of the kidney (collectung tubules, ducts, calyces, renal pelvis, ureters)
v.
glomeruli/bowman’s space, proximal tubules, Distal tubules?
ureteric bud
metanephric mesoderm (blastema)
Main blood-gas changes during aerobic excericise.
Arterials dont change much.
Venous CO2 increases, O2 decreases, and pH decreases.
what bug is pyrrolidonyl-arylamidase postive (PYR)
strep pyogenes
What type of viruses reassort? How are their progeny different than ones who recombine?
segmented.
Ressortment (i.e. genetic shift of influenza A) results in progeny with characterisitc of both parents (like humans). Recombination results in characteristics that neither of the parents have.
Inactivated or killed vaccine (cellualr and humoral) Live attenuated vaccine (humoral) Nonattenuated viral vaccin Conjugate vaccines Toxoid vaccines Component vaccines
Inactivated - Rabies, Influenza (injection), Polio (Salk), hepatitis A (
Live attenuated - all others. (generate MHC1 Tc cells)
Nonattenuated - adenovirus
Conjugate - Strep pneumo, N. meningitis, H. influenza
Toxoid - DTaP
Component vaccines - HBV
