Smart book Flashcards
1
Q
Which drug is used to help treat Hepatitis C and how does it work?
A
Ribivarin and it interferes with duplication of the viral genetic material
2
Q
Hypersensitivity reaction Type 2
A
CYTOTOXIC Humoral: IgG and IgM Complement activation & autoantibodies Cellular: NK, eosinophils, neutrophils, macrophages Examples: Autoimmune Hemolytic anemia
3
Q
What are the genetic and clinical presentation of Turner Syndrome
A
(45,X) loss of paternal X chromosome Lymphedema and Posterior Neck mass Short stature, heart problems, horseshoe kidney
4
Q
Normal values for pH pCO2 HCO3-
A
ph - 7.44 pCO2 - 40 HCO3 - 24
5
Q
Which mediator activates macrophages and promotes TH1 differentiation
A
TNF-gamma
6
Q
Hypersensitivity reactions Type 1
A
IMMEDIATE Humoral: IgE Cellular: Basophils and Mast Cells example: Anaphylaxis and AllergEEEEEz
7
Q
Symptoms of cocaine withdrawal
A
Acutely- increased appetite, severe depression (crash), hypersomnia, disturbing dreams
8
Q
Acute Hemolytic Transfusion reaction When donor blood has antibodies to recipient blood
A
Antibody type 2 hypersensitivity Compliment mediated cell lysis
9
Q
Sudden Dyspnea and calf sweeping should lead you to what
A
Pulmonary embolism
10
Q
What are some clinical findings of Polycystic kidney disease? And what birth defect can it lead to?
A
Renal insufficiency–> that leads to oligohydramnios which leads to Potters syndrome i.e. Flat facies, PULMONARY HYPOPLASIA, short limbs
11
Q
What does Dengue fever look like and what other fever is it related to?
A
Transmitted by mosquitos, travel to brazil Chikungunya fever: Fever with macular rash
12
Q
What is tPA (tissue plasminogen activation factor) used for and side effect
A
increases formation of plasmin which lyses clots (fibrin) rapid reperfusion
13
Q
Function of T-Tubules in muscle
A
Triggers the release of calcium Ensures coordination contraction of myofibrils
14
Q
Where are the actin filaments anchored on the sarcomere
A
On the Z-line (A)n (I)interesting (Z)oo, (M)ust (H)ave (M)mammals Actin in the I band attaches at Z line Myosin in the H band attaches at M line
15
Q
What is the majority cause of overdose deaths in the US
A
Opioids apparently
16
Q
Seal like Barking cough after URI. And what type of virus is it usually associated with
A
Coup (Laryngeotracheobronchiitis) Paravirus Family
17
Q
Where are Beta-1 receptors
A
Cardiac tissue Renal juxtaglomerular cells
18
Q
What do we give to combat Warfarin overdose
A
Vit K and Fresh Frozen Plasma
19
Q
What are the beta Lactase inhibitors and how do they work
A
Cluvulanate, Sulbactam, Tazobactam
20
Q
What type of drug is Setraline and a major side effect
A
Setraline is a SSRI (selective serotonin reuptake inhibitor) Commonly cause sexual dysfunction
21
Q
Tricyclic anti depressants (TCA) overdose
A
delirium, seizures, cardiac abnormalities caused by blockage of cardiac fast sodium channels widened QRS
22
Q
What do we give to combat Heparin overdose
A
Protamine
23
Q
What all is messed up in Cystic Firbrosis
A
Impaired function of the CFTR Reduces Cl- secretion and increases Na and H2O absorption
24
Q
What is used to treat TCA overdose, specifically the cardiac symptoms that come with the overdose and why
A
Sodium Bicarb is used because TCA overdose causes a widened QRS and blocks the fast sodium channels in the heart. Sodium Bicarb increases serum pH and extracellular Sodium
25
Whats a Hydatidiform mole and how do you treat it
Cystic Sweeling of cilli and proliferation of epithelium, Vaginal bleeding, uterine enlargement Tx-dilation with methotrexate and Monitor B-hCG
26
this organelle has its own DNA Small circular chromosome On EM it has a double membrane
Mitochondria
27
Hypersensitivity reaction Type 3
IMMUNE COMPLEX Humoral: Deposition of antigen-antibody complex Cellular: Neutrophils Examples: Serum Sickness, Lupus Nephritis
28
When a person has erosion of tooth enamel you should think
Bulimia
29
What vitamin is required for transamination and decarboxylation of amino acids
Vit. B6 Pyridoxine
30
How does ionizing radiation (gamma / X-rays) cause cell death in cancer treatment? 2 way
DNA double-strand breakage (single strand breaks are readily repaired) Free radical formation Malignant cells replicates so fast that that can't fix themselves
31
Immunofluorescence of Linear Deposits of IgG and C3 along the glomerular basement membrane is characteristic of what? And what is its histo show
Anti-glomerular basement membrane (Anti-gbm) disease Crescent formation
32
Relative Risk
RR=1 means no association between what you're comparing RR\>1 means exposure is associated with increased risk RR
33
Nephritic Syndrome
Inflammation, hypertension, cola-colored urine. Linear deposits of immunoglobulin Anti glomerular basement membrane Crescentic Formation
34
How does oseltamivir work and help with the flu
It is a neuramidase inhibitor So it prevents the release of the virus from infected cells
35
What does a scalene nerve block do and why
Causes ipsilateral diaphragm paralysis due to phrenic nerve roots
36
What do Organophosphates do and what symptoms do they cause
Ach stimulation by inhibiting Ach esterase salvation, lacrimation, diaphoresis, bradycarida
37
Contraindications of OCP's
Prior history of Thromboembolism or stroke estrogen dependent tumor women over 35 who smoke Hypertriglycerinemia Liver dz preggers
38
Amiodarone Type of blocker?
anti arrhythmic drug potassium channel blocker prolongs QT interval
39
Which enzyme is needed to catalyze Bile And lack of this enzyme presents what symptom
UGT Jaundice
40
Which type of cell releases IFN-g that recruits macrophages.
T helper (Th-1) lymphocyte
41
Tell me about Lesch-Nyhan syndrome
X-linked recessive Self mutilation Deficiency of Hypoxanthine-guanine phosphoribosyltransferase HGPRT
42
What does carbonic anhydrase do and what exchanger does it use
It converts CO2 to Bicarb Chloride channel
43
Noise induced hearing loss is caused by trauma to...
Sertocilliated hair cells of the ORGAN of CORTI
44
What is Porphyria Cutanea Tarda (PCT) and what is it caused
One of the most common disorders of porphyrin (heme) synthesis leads to severe photosensitivity (blisters) - late finding caused by a deficiency in Uroporphyrinogen decarboxylase (UROD)
45
Hereditary Hemochromatosis
Increased iron absorption Mutation of HFE gene Iron accumulation within tissues
46
What is Wiskott-aldrich syndrome
Triad of: eczema, Combined T lymphocyte and B lymphocyte disorder (recurrent infections) thrombocytopenia
47
Whats Choriocarcinoma
Malignant tumor of the uterus composed of abnormal proliferation of cytotrophoblasts and Synctiotrophoblasts
48
What is pyruvate kinase? and what does a deficiency in this cause
Enzyme that helps produce ATP it causes hemolytic anemia due to failure of glycolysis --\> can't maintain red blood cell structure ---\> spleen goes into over time and gets RED PULP HYPERPLASIA
49
Hypersensitivity reaction Type 4
DELAYED TYPE Humoral: None Cellular: T cells and Macrophages Example: Contact Dermatitis and TB skin test
50
When you see an infant is unable to pass meconium you should think \_\_\_\_\_\_\_\_\_. And what other defects are associated with this
Imperforate anus other congenital anomalies such as urorectal, urovesicular, urovaginal defects Urogenital Defects
51
Why can't IV-dopamine cross the BBB
Because the BBB is made up of tight junctions
52
Currant Sputum Jelly Alcholic
Klebsiella
53
What are some anticoags that are Xa inhibitors
RivaroXXXaban/ApiXXXaban
54
Potters Syndrome
Caused by Oligohyramnios (low amniotic fluid) Flattened facies, pulmonary hypoplasia, limb deformaties
55
HemiParesis with the arm being more affected in the leg is caused by a blockage of this artery
MCA
56
Large yeast with "broad-based" budding
Blastomyces Dermatitidis
57
What is Kleinfelters Syndrome associated with?
Bilateral gynecomastia, Small firm testis (47, XXY) Elevated FSH and LH
58
Varicella Ig Antibodies associated with
Varicella-zoster reactivation
59
Which plexus innervates the corpus cavernous to stimulate penile erection
Prostatic Plexus
60
Residual volume?
what is it and how
its the volume left in the lungs after max expiration
It is increased in COPD
61
Where are the anatomical locations of lungs, liver, and pluera in relationship to rib cage bones
62
what does cromolyn do?
It inhibits mast cell degranulation
63
What is cell mediated immunity driven by
what do they secrete
Th1 CD4 Tcells
IL-2, IFN-g
64
where are elastases contained?
Macrophages
65
how do you prevent neonatal GBS sepsis
Intrapartum Antibiotics
| (ie penicillin)
66
What can Obstructive sleep apnea lead to?
Pulmonary hypertension ---\>Right sided heart failure
and systemic hypertension
67
whats sensitivity and specificity?
specificity: d/(d+b)
true negatives/total dz negatives
sensitivity: a/(a+c)
True positives/total dz positives
68
whats the Drug of choice for oralpharyngeal candidias?
Nystatin
69
how does elastin in the lungs work?
rubber-like properties are due to crosslinking involving **Lysine**
70
Whats aspergillus
fungus ball (colonizing)
71
What inheritence are mitochondrial dz's
and what do these dz's look like?
It has **Maternal** inheritance
"*Red Ragged"* muscle fibers because
abnormal mitochondria accumulate under the sarcolemma
72
What should you be worried about for the baby in premature delivery?
What tx usually helps this problem out?
**Neonatal respiratory distress syndrome**. Preme's sometimes have trouble with surfactant production
Maternal/fetal cortisol usually helps so you would want to give a type of cortisol ie **betamethasone/dexmethasone**
73
What are the foramens and which CN nerves run through each
74
What is the cellular changes down the stem of the bronchi
75
which pathway does Growth Hormone act on?
JAK STAT
76
in a study where you lose a disproportionate amount of follow up subjects between exposed and unexposed creates?
Attrition bias
a form of selection bias
77
Mutation in this gene cuases maturity-onset diabetes in the young women
**Glucokinase**
a glucose sensor in the beta cells of the pancreas
controls the rate of glucose entry into the glycolytic pathway
78
what is a scomata?
visual field defect that occurs due to pathologic processes incolving the **retina** or **optic nerve** that leads to altered vision surrounded by normal vision
79
What is Renal Blood flow equation
RBF= (PAH clearance)/(1-hematocrit)
80
which vein do esophageal varices flow into?
left gastric
81
what would you see in vibrio cholera stool?
purely toxin diarrhea so no leukocytes or RBC
Mucous and sloughed off eptihelia cells
82
What drug prevents cholesterol absorption at the brush border
Ezetimbe
83
When using anti cholinergics, whats a possible side effect/ contraindication involving the eyes?
Glaucoma
84
Whats ataxia-Telangectias
which gene mutation causes it? whats that gene responsible for?
Triad of Cerebellar ataxia, telangiectasis, and increased risk of pulmonary infections
"superficial blanching nests of capillaries"
**ATM** ataxia telan mutated
responsible for **DNA break Repair**
85
Whats angioedema?
what drug can lead to this? why
edema of tissues in the body, usually the lips, tongue, or eyelids
**ACE inhibitors** cause this. ACE inhibitors are responsible for **Bradykinin** breakdown so you end up with buildup that leads to Vascular permeability
86
Whats Primary carnitine deficiency look like?
what substance becomes deficient?
myopathy (high creatine levels), cardio myopathy, and hypoketotic hypoglycemia
## Footnote
**Acetoacetate**
87
What are the antibodies to in rheumatoid arthritis?
Antibodies to **Citrulinated Peptides**
88
what are the concentration levels as you go travel through the proximal tubule
89
Vasopression/ desmopression causes an increase in absorption of water and \_\_\_\_\_\_\_\_\_
Urea
90
whats the pancreas embryo story
You have a dorsal and ventral bud.
The dorsal forms the **tail**.
The ventral forms the **uncinate process, pancreatic head, and main pancreatic duct.**
91
how does Hep B help Hep D become infectious?
D must be coated by the coat of Hep B to be able to penetrate
92
Where would you find lyme disease aka borrelia?
what would you find on stain?
North East United states
Maltese cross, intraerythrocytic parasite
93
What happens to unabsorbed/excess copper?
what is absorbed copper used to form?
It is secreted into bile and excreted in the stool
ceruloplasmin
94
Which Interluekin (IL) plays a role in anti-inflamation
**IL-10**
95
What embryologic derivative is Rathke's pouch derived from?
rattle off any others you can think of
Surface ectoderm
96
whats a crossover study
what does it usually require to prevent error
When subjects are randomly allocated to 2 subsequent treatments AB/BA consecutively
-washout (no treatment) peroid between the different administrations
97
Most common cause of retinitis in HIV (+) patients
what would you treat it with
CMV
## Footnote
**Ganciclovir**
98
when you intentionally falsify/induce symptoms so that you can get the **sick role**
somatic symptom do/illness anxiety/conversion/malingering
Factitious disorder
99
What do patients require after total gastrectomy?
where is b12 absorbed
Because of no stomach, they can no longer produce Intrinsic factor (**IF**) from *parietal cells.*
So the patient requires B12 supplementation
-terminal ileum
100
When theres hyperpigmentation of the liver what should you think?
whats wrong that causes this to happen
Dubin Johnson and the curse of the black liver
-defective excretion of glucoronides
101
What do you give for PTSD
SSRI
102
how does cocaine intoxication cause its effects?
what else does cocaine intox lead to?
It causes increase of sympathetics by **blocking reuptake of monoamines** (NE, dopamine, serotonin)
its a vasoconstrictor so MI via vasospams, *mucosal atrophy*, and nasal septal perforation
103
when do you see the effects of a carcinoid tumor?
what cell type are these tumors derived from
Only when it mets to the liver. becasue its usally formed in the intestine, where its products get metabolized. but if its in the liver, it bypasses degredatoin
-neuroendocrine
104
with strep pyogenes, what virulence factor inhibits phagolysis and compliment activation
Protein M
105
which substance has the fastest rate of metabolism in the glycolytic pathway and why
dietary Fructose is rapidly metabolized becasue it bypasses the *major rate limiting step* of glycolysis which is PFK-1
106
What does ciliac dz look like on biopsy?
how does it present
Crypt hypoplasia, villous atrophy, and lymphocyte penetration
-presents as abdominal pain and weight loss. @ 6-24 months
107
Type 2 diabetes has elevated ______ levels which contribute to insulin resistence by imparing uptake
**free fatty acids**
108
Superior vena Cava syndrome but only one sided leads you to think...
theres a blockage in the **Brachiocephalic vein**
109
which nerve provides cutaneous sensation to the **external** auditory canal
what about everywhere else?
-Auricular branch of the **Vagus**
**-**mandibular of Trigeminal
110
when you see an organsims producing **dextrans** you should think..
Strep Viridans
Dental carries and Endocartis/Heart valve problems
111
How do conjugated vaccines usually work?
Protein conjugation causes a T-cell immune response that leads to long term immunity through production of memory cells
112
What does creutzfield Jakob present like?
Rapid dementia and myoclonic jerks
uniform vacoules in the brain
113
What causes turner syndrome (45,X0)
Paternal Meiotic Nondisjunction
causes a complete or partial loss of X chromosome
114
Sensitivity vs specificity
**Specificity** is a measure of a tests ability to rule a person **negative**
115
Eukaryotic DNA Replication fork
| (image)
116
Cholesterol gall stone formation. How do you prevent it?
**Bile acids** and phospholipids are in charge of making cholesterol more soluble (so it doesnt crystalize)
Non surgical tx usually involves *Supplemental Bile Acid*
117
Difference between HSV and syphillis
how do you test for HSV
HSV has **multiple painful** ulcers
-Tzank smear or PCR
118
What is Carcinoembryonic antigen (CEA) used for?
Its helpful in detecting residual disease and recurrances of cancer
119
C. Tetani produces the exotoxin *Tetanospasmin.* How does it work?
how does the vaccine work?
- prevents release of inhibitory neurotransmitters ie Gaba and glycine.
- its a toxoid vaccine so it triggers the production of **anti toxin antibodies**
120
what are the antibodies to in Pemphis Vulgaris and Bullous Pemphigoid?
PV- antibodies to desmosomes
BP-antibodies to hemidesmosomes
121
What are the drugs used to treat TB and their side effects?
RIPE
122
When is ß-HCG first detected in serum during a completed fertilizaiton and implantion menstrual cyle?
6-7 days after **fertilization**
123
Stem cells of the lungs?
Type II pneumocytes
124
How does Niacin (nicotinic acid) get obtained?
whats niacin used for?
What does a deficiency cause?
Niacin can be synthesized endogenously from **Tryptophan**.
- its an essential part of Nicotinamide adenine dinucleotide (NAD)
- Pellegra: (rough skin) 3D's Dermititis, Diarrhea, Dementia
125
What happens to Tcells that bind to self MHC or self antigens?
they go through **Negative Selection** and apoptosis
126
Contralater Homonymous Hemanopsia
where is the lesion
Optic Tract
127
Whats the difference between Bipolar I and bipolar 2
Bipolar I has **manic episodes**
Bipolar II has **Hypomanic episodes**
128
What are the most common cancers in women
most mortalitity
Breast\>lung\>colon
lung\>breast\>colon
129
What nerve is messed up in sciatica? (lower back pain)
**S1**
130
Whats the best way to analyze if a gene is being expressed?
and which blot test should you use?
you should test **mRNA**
**Northern** Blot Test
131
How do beta blockers treat glacouma?
They decrease the secretion of aqueous humor by the **Ciliary epithelium**
132
What is used to compare the difference of _means_ between _two_ groups? (biotsat)
Whats used to compare the difference of _means_ between _more than two_ groups?
**T-Test**
**-ANOVA** (analysis of variance)
133
Whats methemoglobin?
When Heme (Fe2) gets oxidized to its ferric state *methemoglobin* (Fe3+) by **nitrite poisoning**
Methemoglobin doesnt bind oxygen well
\*in this type of poisoning, the **partial pressure of O2** is **unchanged**
134
Tell me about **Trisomy 18 (Edward's syndrome)**
what genetic malformation causes it? whos fault?
physical symptoms
-heart,gi, renal probs?
- meiotic nondisjunction (maternal age over 35)
- low set ears, **rocker bottom feet**, hypertonia, **clenched hands with overlapping fingers**
- VSD, merkels divurticulum, horsehoe kidney
135
whats Fabry dz
what enzyme does it lack? which build up does this laead to?
lysosomal storage dz!
Triad of Peripheral neuropaty, angiokeratomas, and hypohidrosis
late stage= renal failure/ CV dz
-lacks **a-galactosidase A**. leads to build up of **globotriaosylceramide**
136
EQUATIONS
Total Filtration rate = ?
how would you find excretion rate?
TFR= (Inulin clearance) x [plasma substance A]
excretion rate = (Total filtration rate) - (reabsorption rate)
137
Which enzyme deficiency can lead to SCID (severe combined immuno deficiency)?
what does that enzyme do?
**Adenosine Deaminase**
**-**it eliminates excess adenosine within cells
138
when prescribing a benzo, what all should you tell the patient to avoid?
alcohol, barbituates, neuroleptics, 1st gen antihistamines
-pretty much anything that can cause more sedation
139
Stomach vasculature
look at anastomoses (short gastric off splenich etc)
140
Mechanisms of Bacterial gene transfer
Transformation, conjugation, transduction?
Transformation: Direct uptake of naked DNA
Conjugation: one way transfer of chromosonal DNA (f factor & sex pilus)
Transduction: Transfer of DNA from one bacteria to another by means of bacteriophage
141
nulliparity, early menarch, and obesity in females lead to an increase in _________ cancer
Endometrial
142
what anatomical structure can get affected in a baby who has a mother with HPV
HPV loves to infect **stratified squamous epithelium**
which can be found in the **true vocal cords**
143
spike and dome apperance on immunoflourescence
Membranous Glomerulonephropathy
| (Nephrotic syndrome)
144
What nerves innervate the carotid baroreceptors?
aoritc arch baro?
Glossopharyngeal
vagus
145
what physiologic responses contribute to symptoms of heart failure
Sympathetic Nervous symptoms, Renin-angiotensin, ADH
146
which vessel has the least amount of oxygen in it compared to the highly oxygenated aorta?
coronary sinuses
147
What is orthostatic hypotension
which blockade causes this?
drop in blood pressure on standing from the supine postion. Causes pooling of blood in veins below the heart
## Footnote
**Alpha blockers**
148
which _mutation_ is associated with hypertrophic cardiomyopathy (leading to sudden cardiac death)?
mutation in the **B-myosin heavy chain**
149
what is a cause of an **S3** heart murmur
where is it best heard?
Associated with **increased-left ventricular systolic volume**
(blood left over in LV)
rapid ventricular refilling
-over the APEX in left decibutis postion at **end expiration**
150
Whats **diastolic HF** characterized by?
- normal ejection fraction (since systole works fine)
- normal end diastolic volumes/**increased ED pressure**
- decreased ventricular compliance (cant dialate well)
151
whats _pulmonary arterial hypertension_ (familial type/gene mutation)
why does it happen
HTN in the pulmonary artery
inactivation of **BMPR2 gene** - causes *vascular smooth muscle proliferation*
152
when do you use a **chi square test?**
used to test the association of 2 variables with 2 different outcomes.
## Footnote
**2x2 tabe**
153
Orthopnea?
which HF is it assocaited with
cant breathe when laying flat
## Footnote
**LEFT SIDED HF**
154
CT of the heart
whats derived from the embyro cardinal veins
Superior venacava
155
How do **nitrates** work
what should you avoid using when taking nitrates?
they **Incr. cGMP** w/ smooth muscle relaxation
-Erectile dysfunction drugs (*Sildenifil)*
156
What drug do you use in coronary heart dz when *aspirin* cant be tolerated?
**Clopidigrel**
157
which class of Anti HTN drugs cause peripheral edema?
CCB's (-dipines or verapamil/diltiazem)
## Footnote
**Amlodipine**
