SIM 2 Flashcards
What is metoclopramide used for? What is its MOA and contraindications?
Uses: gastroparesis and vomiting
MOA: D2 receptor antagonist
Contraindications: Parkinson’s disease
CMV retinitis occurs in
CMV infected HIV patients whose CD4 count is <50.
Treatment is Ganciclovir or Valganciclovir which are guanosine analogs and terminate chain elongation by inhibiting viral DNA polymerase.
Antibodies of Graves disease
anti-thyrotropin antibodies (bind TSH receptors and stimulate thyroid hormone release)
Proptosis and pre-tibial myxedema (skin thickening) are associated with
Graves disease due to accumulation of glycosaminoglycans (hyaluronic acid)
Clinical presentation/symptoms of pinealoma
hint: all eye-related
- upward gaze palsy (upward nystagmus)
- absence of pupillary light reflex
- convergence inability
Lymphatic malformation that can present as a soft, compressible mass that transilluminate and usually found on the left neck
Cystic Hygroma (aka. Lymphangioma)
Cystic Hygroma (aka. lymphangioma) is associated with what chromosomal aneuploidy?
Turner syndrome
Trisomy 13, 18, and 21
MOA of fluoroquinolone (-floxacin)
Inhibit topoisomerases that prevent supercoiling
- DNA gyrase (Topoisomerase II)
- Topoisomerase IV
Allergic contact dermatitis caused by toxicodendron species (poison ivy/oak) present as
erythematous rash with spots and streaks in exposed skin area during recent outdoor activity
How do you distinguish anemia (low Hb) caused by splenic sequestration crisis vs. aplastic crisis in sickle cell patient?
- splenic sequestration crisis: reticulocytosis (normal bone marrow)
- Aplastic crisis (Parvovirus B19): low reticulocyte (bone marrow is not functional)
Lactose intolerance that occur later in adulthood results from decreased
gene expression with age
Radiation exposure increases risk for kind of cancer?
Papillary thyroid carcinoma (arises from follicular cell)
Putamen and globus pallidus are collectively known as ____ and they form _____
lentiform nucleus; basal ganglia (movement)
internal capsule separate
caudate nucleus & thalamus from lentiform nucleus
a brain part that triggers conscious cravings (drugs)
Insula
Involuntary movements of mouth and tongue (lip puckering, smacking, and facial grimacing) due to long-term blockade of D2 receptors causing upregulation and supersensitivity of D2 receptors
Tardive Dyskinesia
What are the steps and enzymes in catecholamine synthesis?
- phenylalanine to tyrosine
- by phenylalanine hydroxylase - tyrosine to DOPA
- by tyrosine hydroxylase - DOPA to dopamine
- by AAAD (aromatic amino acid decarboxylase) - dopamine to NE
- by dopamine B-hydroxylase - NE to Epinepherine
- by PMNT
What enzyme converts tyrosine to melanin?
Tyrosinase
Orthostatic hypotension, ptosis, exercise intolerance, nasal congestion, and ejaculatory difficulties are impaired ______ activity caused by dopamine beta-hydroxylase deficiency
sympathetic adrenergic
What is expected CVP, Cardiac output, and SVR for a saddle PE?
- Answer as increase or decrease
CVP: increase
Cardiac output: decrease
SVR: increase
Reduced FEV1 (Forced expiratory volume in 1 second) is characteristic of
COPD
What lung measurements are increased in COPD?
- Residual volume (RV)
- Total Lung Capacity (TLC)
- Functional Residual Capacity (FRC = RV + ERV)
(oral vs. inactivated polio vaccine)
Killed vaccine so don’t have the ability to revert to active form
inactivated polio vaccine
(oral vs. inactivated polio vaccine)
attenuated live virus that can revert to virulent form and can cause vaccine-associated paralytic poliomyelitis
oral polio vaccine
What is the benefit of oral polio vaccines over inactivated vaccines?
OPV promotes IgA immunity in oropharynx and GI tract –> induce contact immunity
A set of symptoms (face and neck swelling, distended veins in upper trunk, tinnitus, dyspnea/cough, and HA) due to SVC obstruction is caused by ______ and is called _____
compression by tumor (ex. Pancoast); SVC syndrome
Nerve that travels spiral groove of humerus and controls all extensor muscles (elbow, wrist, and fingers) of upper limb below shoulder; it also provides sensory innervation to the posterior arm, forearm, and dorsal lateral hand
radial nerve
The only muscle that is spared during radial nerve damage
triceps brachii
Women who are heterozygous for an x-linked disorder can be more susceptible to displaying manifestations of disease
Skewed X inactivation
Describe Adenovirus characteristics
- No envelope (naked)
- ds DNA virus
- Cause URIs
How is poxvirus different from all other dsDNA viruses?
Replicate entirely in the cytoplasm of host cell instead of in the nucleus
RNA-dependent DNA polymerase is aka
reverse transcriptase
Viral infection that causes painful pharyngeal muscle spasms and dysphagia causing fear of water drinking (hydrophobia)
Rabies virus
- spread through animal bite
Histologic findings of rabies
eosionophillic neuronal cytoplasmic inclusions (Negri bodies)
Filtration Fraction Equation
FF = GFR/RPF
- RPF is renal plasma flow
Orthostatic hypotension (syncope and lightheadedness) that presents with drop in BP without compensatory increase in HR suggests
sympathetic failure of baroreceptor reflex
A skin disorder characterized by hyperkeratosis and epidermal hyperplasia
psoriasis
Describe pathophysiology of psoriasis
- Skin barrier disruption
- Activation of dendritic cells
- Differentiation of CD4 helper T cells
- Production of inflammatory cytokines
- Keratinocyte proliferation
Aminoglycosides MOA
bind 16S rRNA within 30s subunit of bacterial ribosome
First-line weight loss medication that inhibits intestinal lipase to reduce dietary fat absorption; has GI side effects (flatulence, diarrhea)
Orlistat
*brand name: Alli
Nephrotic syndrome is when proteinuria is
> 3.5 g/day
A nephropathy caused by immune-complex deposition in the subepithelial portion of glomerular capillary walls
Membranous nephropathy
Microscopy findings of membranous nephropathy
diffuse thickening of glomerular basement membrane
Silver stain findings of membranous nephropathy
immune-complex deposits that form spikes
Describe venous drainage of rectum ABOVE dentate line
superior rectal vein –> inferior mesenteric vein –> portal venous system
Describe venous drainage of rectum BELOW dentate line
inferior rectal vein –> internal iliac vein –> Caval system (IVC)
patients with xerosis (dry skin) have defects in permeability barrier of what skin layer?
stratum corneum
Enzymes of Glycolysis
- Insulin activates _____
- Glucagon activates _____
- Phosphofructokinase-2
2. Fructose-2,6-bisphosphatase
Hydrophobic/nonpolar amino acids
GLAM VIP PT
- Glycine
- Leucine
- Alanine
- Methionine
- Valine
- Isoleucine
- Phenylalanine
- Proline
- Tryptophan
A unique dural sinus that receives venous blood from both face veins and cerebral veins; Spread of infection of face via this sinus can cause gaze palsy and necrotic destruction of nasal turbinates
Cavernous Sinuses (lies on sella turcica behind optic chiasm)
A viral infection that causes fever and parotitis (swelling of parotid glands); childhood vaccination prevents this infection in developed countries
Mumps virus
A parasite infection that presents with abdominal pain and diarrhea; stool exam will show trophozoites with phagocytosed red blood cells
Entamoeba histolytica
