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Smart book Flashcards

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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

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2
Q

Hypersensitivity reaction Type 2

A

CYTOTOXIC Humoral: IgG and IgM Complement activation & autoantibodies Cellular: NK, eosinophils, neutrophils, macrophages Examples: Autoimmune Hemolytic anemia

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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

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4
Q

Normal values for pH pCO2 HCO3-

A

ph - 7.44 pCO2 - 40 HCO3 - 24

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5
Q

Which mediator activates macrophages and promotes TH1 differentiation

A

TNF-gamma

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6
Q

Hypersensitivity reactions Type 1

A

IMMEDIATE Humoral: IgE Cellular: Basophils and Mast Cells example: Anaphylaxis and AllergEEEEEz

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7
Q

Symptoms of cocaine withdrawal

A

Acutely- increased appetite, severe depression (crash), hypersomnia, disturbing dreams

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8
Q

Acute Hemolytic Transfusion reaction When donor blood has antibodies to recipient blood

A

Antibody type 2 hypersensitivity Compliment mediated cell lysis

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9
Q

Sudden Dyspnea and calf sweeping should lead you to what

A

Pulmonary embolism

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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

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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

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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

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13
Q

Function of T-Tubules in muscle

A

Triggers the release of calcium Ensures coordination contraction of myofibrils

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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

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15
Q

What is the majority cause of overdose deaths in the US

A

Opioids apparently

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16
Q

Seal like Barking cough after URI. And what type of virus is it usually associated with

A

Coup (Laryngeotracheobronchiitis) Paravirus Family

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17
Q

Where are Beta-1 receptors

A

Cardiac tissue Renal juxtaglomerular cells

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18
Q

What do we give to combat Warfarin overdose

A

Vit K and Fresh Frozen Plasma

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19
Q

What are the beta Lactase inhibitors and how do they work

A

Cluvulanate, Sulbactam, Tazobactam

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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

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21
Q

Tricyclic anti depressants (TCA) overdose

A

delirium, seizures, cardiac abnormalities caused by blockage of cardiac fast sodium channels widened QRS

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22
Q

What do we give to combat Heparin overdose

A

Protamine

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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

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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

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25
Q

Whats a Hydatidiform mole and how do you treat it

A

Cystic Sweeling of cilli and proliferation of epithelium, Vaginal bleeding, uterine enlargement Tx-dilation with methotrexate and Monitor B-hCG

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26
Q

this organelle has its own DNA Small circular chromosome On EM it has a double membrane

A

Mitochondria

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27
Q

Hypersensitivity reaction Type 3

A

IMMUNE COMPLEX Humoral: Deposition of antigen-antibody complex Cellular: Neutrophils Examples: Serum Sickness, Lupus Nephritis

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28
Q

When a person has erosion of tooth enamel you should think

A

Bulimia

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29
Q

What vitamin is required for transamination and decarboxylation of amino acids

A

Vit. B6 Pyridoxine

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30
Q

How does ionizing radiation (gamma / X-rays) cause cell death in cancer treatment? 2 way

A

DNA double-strand breakage (single strand breaks are readily repaired) Free radical formation Malignant cells replicates so fast that that can’t fix themselves

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31
Q

Immunofluorescence of Linear Deposits of IgG and C3 along the glomerular basement membrane is characteristic of what? And what is its histo show

A

Anti-glomerular basement membrane (Anti-gbm) disease Crescent formation

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32
Q

Relative Risk

A

RR=1 means no association between what you’re comparing RR>1 means exposure is associated with increased risk RR

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33
Q

Nephritic Syndrome

A

Inflammation, hypertension, cola-colored urine. Linear deposits of immunoglobulin Anti glomerular basement membrane Crescentic Formation

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34
Q

How does oseltamivir work and help with the flu

A

It is a neuramidase inhibitor So it prevents the release of the virus from infected cells

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35
Q

What does a scalene nerve block do and why

A

Causes ipsilateral diaphragm paralysis due to phrenic nerve roots

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36
Q

What do Organophosphates do and what symptoms do they cause

A

Ach stimulation by inhibiting Ach esterase salvation, lacrimation, diaphoresis, bradycarida

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37
Q

Contraindications of OCP’s

A

Prior history of Thromboembolism or stroke estrogen dependent tumor women over 35 who smoke Hypertriglycerinemia Liver dz preggers

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38
Q

Amiodarone Type of blocker?

A

anti arrhythmic drug potassium channel blocker prolongs QT interval

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39
Q

Which enzyme is needed to catalyze Bile And lack of this enzyme presents what symptom

A

UGT Jaundice

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40
Q

Which type of cell releases IFN-g that recruits macrophages.

A

T helper (Th-1) lymphocyte

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41
Q

Tell me about Lesch-Nyhan syndrome

A

X-linked recessive Self mutilation Deficiency of Hypoxanthine-guanine phosphoribosyltransferase HGPRT

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42
Q

What does carbonic anhydrase do and what exchanger does it use

A

It converts CO2 to Bicarb Chloride channel

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43
Q

Noise induced hearing loss is caused by trauma to…

A

Sertocilliated hair cells of the ORGAN of CORTI

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44
Q

What is Porphyria Cutanea Tarda (PCT) and what is it caused

A

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)

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45
Q

Hereditary Hemochromatosis

A

Increased iron absorption Mutation of HFE gene Iron accumulation within tissues

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46
Q

What is Wiskott-aldrich syndrome

A

Triad of: eczema, Combined T lymphocyte and B lymphocyte disorder (recurrent infections) thrombocytopenia

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47
Q

Whats Choriocarcinoma

A

Malignant tumor of the uterus composed of abnormal proliferation of cytotrophoblasts and Synctiotrophoblasts

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48
Q

What is pyruvate kinase? and what does a deficiency in this cause

A

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

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49
Q

Hypersensitivity reaction Type 4

A

DELAYED TYPE Humoral: None Cellular: T cells and Macrophages Example: Contact Dermatitis and TB skin test

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50
Q

When you see an infant is unable to pass meconium you should think _________. And what other defects are associated with this

A

Imperforate anus other congenital anomalies such as urorectal, urovesicular, urovaginal defects Urogenital Defects

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51
Q

Why can’t IV-dopamine cross the BBB

A

Because the BBB is made up of tight junctions

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52
Q

Currant Sputum Jelly Alcholic

A

Klebsiella

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53
Q

What are some anticoags that are Xa inhibitors

A

RivaroXXXaban/ApiXXXaban

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54
Q

Potters Syndrome

A

Caused by Oligohyramnios (low amniotic fluid) Flattened facies, pulmonary hypoplasia, limb deformaties

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55
Q

HemiParesis with the arm being more affected in the leg is caused by a blockage of this artery

A

MCA

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56
Q

Large yeast with “broad-based” budding

A

Blastomyces Dermatitidis

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57
Q

What is Kleinfelters Syndrome associated with?

A

Bilateral gynecomastia, Small firm testis (47, XXY) Elevated FSH and LH

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58
Q

Varicella Ig Antibodies associated with

A

Varicella-zoster reactivation

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59
Q

Which plexus innervates the corpus cavernous to stimulate penile erection

A

Prostatic Plexus

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60
Q

Residual volume?

what is it and how

A

its the volume left in the lungs after max expiration

It is increased in COPD

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61
Q

Where are the anatomical locations of lungs, liver, and pluera in relationship to rib cage bones

A
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62
Q

what does cromolyn do?

A

It inhibits mast cell degranulation

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63
Q

What is cell mediated immunity driven by

what do they secrete

A

Th1 CD4 Tcells

IL-2, IFN-g

64
Q

where are elastases contained?

A

Macrophages

65
Q

how do you prevent neonatal GBS sepsis

A

Intrapartum Antibiotics

(ie penicillin)

66
Q

What can Obstructive sleep apnea lead to?

A

Pulmonary hypertension —>Right sided heart failure

and systemic hypertension

67
Q

whats sensitivity and specificity?

A

specificity: d/(d+b)

true negatives/total dz negatives

sensitivity: a/(a+c)

True positives/total dz positives

68
Q

whats the Drug of choice for oralpharyngeal candidias?

A

Nystatin

69
Q

how does elastin in the lungs work?

A

rubber-like properties are due to crosslinking involving Lysine

70
Q

Whats aspergillus

A

fungus ball (colonizing)

71
Q

What inheritence are mitochondrial dz’s

and what do these dz’s look like?

A

It has Maternal inheritance

“Red Ragged” muscle fibers because

abnormal mitochondria accumulate under the sarcolemma

72
Q

What should you be worried about for the baby in premature delivery?

What tx usually helps this problem out?

A

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
Q

What are the foramens and which CN nerves run through each

A
74
Q

What is the cellular changes down the stem of the bronchi

A
75
Q

which pathway does Growth Hormone act on?

A

JAK STAT

76
Q

in a study where you lose a disproportionate amount of follow up subjects between exposed and unexposed creates?

A

Attrition bias

a form of selection bias

77
Q

Mutation in this gene cuases maturity-onset diabetes in the young women

A

Glucokinase

a glucose sensor in the beta cells of the pancreas

controls the rate of glucose entry into the glycolytic pathway

78
Q

what is a scomata?

A

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
Q

What is Renal Blood flow equation

A

RBF= (PAH clearance)/(1-hematocrit)

80
Q

which vein do esophageal varices flow into?

A

left gastric

81
Q

what would you see in vibrio cholera stool?

A

purely toxin diarrhea so no leukocytes or RBC

Mucous and sloughed off eptihelia cells

82
Q

What drug prevents cholesterol absorption at the brush border

A

Ezetimbe

83
Q

When using anti cholinergics, whats a possible side effect/ contraindication involving the eyes?

A

Glaucoma

84
Q

Whats ataxia-Telangectias

which gene mutation causes it? whats that gene responsible for?

A

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
Q

Whats angioedema?

what drug can lead to this? why

A

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
Q

Whats Primary carnitine deficiency look like?

what substance becomes deficient?

A

myopathy (high creatine levels), cardio myopathy, and hypoketotic hypoglycemia

Acetoacetate

87
Q

What are the antibodies to in rheumatoid arthritis?

A

Antibodies to Citrulinated Peptides

88
Q

what are the concentration levels as you go travel through the proximal tubule

A
89
Q

Vasopression/ desmopression causes an increase in absorption of water and _________

A

Urea

90
Q

whats the pancreas embryo story

A

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
Q

how does Hep B help Hep D become infectious?

A

D must be coated by the coat of Hep B to be able to penetrate

92
Q

Where would you find lyme disease aka borrelia?

what would you find on stain?

A

North East United states

Maltese cross, intraerythrocytic parasite

93
Q

What happens to unabsorbed/excess copper?

what is absorbed copper used to form?

A

It is secreted into bile and excreted in the stool

ceruloplasmin

94
Q

Which Interluekin (IL) plays a role in anti-inflamation

A

IL-10

95
Q

What embryologic derivative is Rathke’s pouch derived from?

rattle off any others you can think of

A

Surface ectoderm

96
Q

whats a crossover study

what does it usually require to prevent error

A

When subjects are randomly allocated to 2 subsequent treatments AB/BA consecutively

-washout (no treatment) peroid between the different administrations

97
Q

Most common cause of retinitis in HIV (+) patients

what would you treat it with

A

CMV

Ganciclovir

98
Q

when you intentionally falsify/induce symptoms so that you can get the sick role

somatic symptom do/illness anxiety/conversion/malingering

A

Factitious disorder

99
Q

What do patients require after total gastrectomy?

where is b12 absorbed

A

Because of no stomach, they can no longer produce Intrinsic factor (IF) from parietal cells.

So the patient requires B12 supplementation

-terminal ileum

100
Q

When theres hyperpigmentation of the liver what should you think?

whats wrong that causes this to happen

A

Dubin Johnson and the curse of the black liver

-defective excretion of glucoronides

101
Q

What do you give for PTSD

A

SSRI

102
Q

how does cocaine intoxication cause its effects?

what else does cocaine intox lead to?

A

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
Q

when do you see the effects of a carcinoid tumor?

what cell type are these tumors derived from

A

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
Q

with strep pyogenes, what virulence factor inhibits phagolysis and compliment activation

A

Protein M

105
Q

which substance has the fastest rate of metabolism in the glycolytic pathway and why

A

dietary Fructose is rapidly metabolized becasue it bypasses the major rate limiting step of glycolysis which is PFK-1

106
Q

What does ciliac dz look like on biopsy?

how does it present

A

Crypt hypoplasia, villous atrophy, and lymphocyte penetration

-presents as abdominal pain and weight loss. @ 6-24 months

107
Q

Type 2 diabetes has elevated ______ levels which contribute to insulin resistence by imparing uptake

A

free fatty acids

108
Q

Superior vena Cava syndrome but only one sided leads you to think…

A

theres a blockage in the Brachiocephalic vein

109
Q

which nerve provides cutaneous sensation to the external auditory canal

what about everywhere else?

A

-Auricular branch of the Vagus

-mandibular of Trigeminal

110
Q

when you see an organsims producing dextrans you should think..

A

Strep Viridans

Dental carries and Endocartis/Heart valve problems

111
Q

How do conjugated vaccines usually work?

A

Protein conjugation causes a T-cell immune response that leads to long term immunity through production of memory cells

112
Q

What does creutzfield Jakob present like?

A

Rapid dementia and myoclonic jerks

uniform vacoules in the brain

113
Q

What causes turner syndrome (45,X0)

A

Paternal Meiotic Nondisjunction

causes a complete or partial loss of X chromosome

114
Q

Sensitivity vs specificity

A

Specificity is a measure of a tests ability to rule a person negative

115
Q

Eukaryotic DNA Replication fork

(image)

A
116
Q

Cholesterol gall stone formation. How do you prevent it?

A

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
Q

Difference between HSV and syphillis

how do you test for HSV

A

HSV has multiple painful ulcers

-Tzank smear or PCR

118
Q

What is Carcinoembryonic antigen (CEA) used for?

A

Its helpful in detecting residual disease and recurrances of cancer

119
Q

C. Tetani produces the exotoxin Tetanospasmin. How does it work?

how does the vaccine work?

A
  • prevents release of inhibitory neurotransmitters ie Gaba and glycine.
  • its a toxoid vaccine so it triggers the production of anti toxin antibodies
120
Q

what are the antibodies to in Pemphis Vulgaris and Bullous Pemphigoid?

A

PV- antibodies to desmosomes

BP-antibodies to hemidesmosomes

121
Q

What are the drugs used to treat TB and their side effects?

A

RIPE

122
Q

When is ß-HCG first detected in serum during a completed fertilizaiton and implantion menstrual cyle?

A

6-7 days after fertilization

123
Q

Stem cells of the lungs?

A

Type II pneumocytes

124
Q

How does Niacin (nicotinic acid) get obtained?

whats niacin used for?

What does a deficiency cause?

A

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
Q

What happens to Tcells that bind to self MHC or self antigens?

A

they go through Negative Selection and apoptosis

126
Q

Contralater Homonymous Hemanopsia

where is the lesion

A

Optic Tract

127
Q

Whats the difference between Bipolar I and bipolar 2

A

Bipolar I has manic episodes

Bipolar II has Hypomanic episodes

128
Q

What are the most common cancers in women

most mortalitity

A

Breast>lung>colon

lung>breast>colon

129
Q

What nerve is messed up in sciatica? (lower back pain)

A

S1

130
Q

Whats the best way to analyze if a gene is being expressed?

and which blot test should you use?

A

you should test mRNA

Northern Blot Test

131
Q

How do beta blockers treat glacouma?

A

They decrease the secretion of aqueous humor by the Ciliary epithelium

132
Q

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?

A

T-Test

-ANOVA (analysis of variance)

133
Q

Whats methemoglobin?

A

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
Q

Tell me about Trisomy 18 (Edward’s syndrome)

what genetic malformation causes it? whos fault?

physical symptoms

-heart,gi, renal probs?

A
  • meiotic nondisjunction (maternal age over 35)
  • low set ears, rocker bottom feet, hypertonia, clenched hands with overlapping fingers
  • VSD, merkels divurticulum, horsehoe kidney
135
Q

whats Fabry dz

what enzyme does it lack? which build up does this laead to?

A

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
Q

EQUATIONS

Total Filtration rate = ?

how would you find excretion rate?

A

TFR= (Inulin clearance) x [plasma substance A]

excretion rate = (Total filtration rate) - (reabsorption rate)

137
Q

Which enzyme deficiency can lead to SCID (severe combined immuno deficiency)?

what does that enzyme do?

A

Adenosine Deaminase

-it eliminates excess adenosine within cells

138
Q

when prescribing a benzo, what all should you tell the patient to avoid?

A

alcohol, barbituates, neuroleptics, 1st gen antihistamines

-pretty much anything that can cause more sedation

139
Q

Stomach vasculature

look at anastomoses (short gastric off splenich etc)

A
140
Q

Mechanisms of Bacterial gene transfer

Transformation, conjugation, transduction?

A

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
Q

nulliparity, early menarch, and obesity in females lead to an increase in _________ cancer

A

Endometrial

142
Q

what anatomical structure can get affected in a baby who has a mother with HPV

A

HPV loves to infect stratified squamous epithelium

which can be found in the true vocal cords

143
Q

spike and dome apperance on immunoflourescence

A

Membranous Glomerulonephropathy

(Nephrotic syndrome)

144
Q

What nerves innervate the carotid baroreceptors?

aoritc arch baro?

A

Glossopharyngeal

vagus

145
Q

what physiologic responses contribute to symptoms of heart failure

A

Sympathetic Nervous symptoms, Renin-angiotensin, ADH

146
Q

which vessel has the least amount of oxygen in it compared to the highly oxygenated aorta?

A

coronary sinuses

147
Q

What is orthostatic hypotension

which blockade causes this?

A

drop in blood pressure on standing from the supine postion. Causes pooling of blood in veins below the heart

Alpha blockers

148
Q

which mutation is associated with hypertrophic cardiomyopathy (leading to sudden cardiac death)?

A

mutation in the B-myosin heavy chain

149
Q

what is a cause of an S3 heart murmur

where is it best heard?

A

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
Q

Whats diastolic HF characterized by?

A
  • normal ejection fraction (since systole works fine)
  • normal end diastolic volumes/increased ED pressure
  • decreased ventricular compliance (cant dialate well)
151
Q

whats pulmonary arterial hypertension (familial type/gene mutation)

why does it happen

A

HTN in the pulmonary artery

inactivation of BMPR2 gene - causes vascular smooth muscle proliferation

152
Q

when do you use a chi square test?

A

used to test the association of 2 variables with 2 different outcomes.

2x2 tabe

153
Q

Orthopnea?

which HF is it assocaited with

A

cant breathe when laying flat

LEFT SIDED HF

154
Q

CT of the heart

whats derived from the embyro cardinal veins

A

Superior venacava

155
Q

How do nitrates work

what should you avoid using when taking nitrates?

A

they Incr. cGMP w/ smooth muscle relaxation

-Erectile dysfunction drugs (Sildenifil)

156
Q

What drug do you use in coronary heart dz when aspirin cant be tolerated?

A

Clopidigrel

157
Q

which class of Anti HTN drugs cause peripheral edema?

A

CCB’s (-dipines or verapamil/diltiazem)

Amlodipine

Brain Gainz (30 decks)

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