thurs aug 14 Flashcards
what is somatic symptom disorder?
excessive anxiety and preoccupation with at least one unexplained symptom
presentation of beri beri?
Peripheral neuropathy of distal extremities with both sensory and motor deficits. If ‘wet beri beri’ there is also cardiac involvement such as high output congestive heart failure
what is phenelyzine?
MAOI
MAO inhibitors are particually useful for…
atypical depression
what are the characteristics of atypical depression?
MDD along with mood reactivity, leaden paralysis, rejection sensitivity, increased sleep and appetite
what is meant by mood reactivity in atypical depression?
mood improves in response to positive events
what pressures are seen in the right atrium?
0-5
what pressures are seen in the right ventricle?
systolic 25, diastolic 0-5
what pressures are seen in the pulmonary artery?
systolic 25, diastolic 10
what pressures are seen in the left atrium?
8-10
what pressures are seen in the left ventricle?
120 systolic, 0-8 diastolic
what is defective in ehlers danlos syndrome?
collagen synthesis
what is hemoglobin A2?
alpha 2 delta 2
do iron supplements help patients with thalasemmias?
no
is DNA replication in patients with beta thalasemia normal?
yes - it is not until the dna is transcribed into mRNA that hemoglobin production becomes abnormal
pathogenesis of beta thalasemia mutations?
the DNA mutations lead to problems with transcription, processing and translation of beta globin mRNA. Most commonly the mtuations cause abberant splicing or premature termination during translation
what is the most common pathogen causing septic abortion?
staph aureus
do patients with bacterial vaginosis (gardnerella vaginallis) present with fever and uterine tenderness?
NO - just smelly discharge
does the discharge in septic abortion smell?
yes
name two examples of LOW potency first gen antipsychotics?
chlorpromazine, thioridazine
name two examples of HIGH potency first gen antipsychotics?
haloperidol
fluphenazine
what type of antipsychotic is fluphenazine?
first generation, high potency
side effects of first gen low potency antipsychotics?
sedation (antihistamine)
- anticholinergic side effects
- orthostatic hypotension (alpha 1 blockage)
first gen high potency antiphsychotics have increased risk for what side effects?
extrapyramindal side effects such as rigidity, akathisia, parkinsoniasm, acute dystonia
what is pthirus pubis?
pubic louse
treatment of pthirus pubis (pubic lice)?
topical permethrin
pyridoxine deficiency affects which step of heme synthesis?
ALAS - B6 is needed for this step
treatment of campylobacter jejuni?
self limited
where does the middle meningeal artery branch from?
the maxillary artery and enters the skull through foramen spinosum
where does the opthalmic artery come from?
the internal carotid artery
how can you treat symptoms of carcinoid syndrome?
ocreotide
ocreotide MOA
analog of somatostatin with longer half life. Acts on somatostatin receptors and inhibits hormone secretion
most common cause of parotitis?
S aureus
how do patients with polyarteritis nodosa usually present?
weeks to months of nonspecific constitutional symptoms (weight loss, fatigue, etc.) and signs of tissue ischemia in kidneys, GI tract, peripheral nerves and or skin.
does polyarteritis nodosa have ANCA or ANA?
no
what does polyarteritis nodosa associated with?
hepatitis B and C
what should be monitored in patients on azoles?
LFTs
MOA of patiromer?
exchanges calcium for potassium in the intestines, leading to fecal excretion of potassium
use of patiromer?
chronic hyperkalemia (not acute since it takes a few hours to act)
ethosuximade MOA
blocks thalamic T type Ca channels
opioid receptors are which type of receptor?
g protein
which two locations do opioids act?
presynaptic neuron AND postsynaptic
opioids MOA?
On the presynaptic neuron they inhibit calcium influx (thus decreasing secretion of NTs)
On the postsynaptic neuron they increase K eflux, leading to hyperpolarization
a stroke of the lenticulostriate artery will present with?
pure motor symptoms (contralateral paralysis)
which areas do the lenticulostriate arteries supply?
striatum and internal capsule (stroke here is purely motor)
which part of the brainstem does the ASA supply?
medial medulla
presentatin of ASA stroke? (medial medullary syndrome)
- contralateral paralysis (loss of lateral corticospinal tracts)
- contralateral loss of proprioception (due to loss of medial lemniscus)
- ipsilateral hypoglossal dysfunction (CNXII)
where does the PICA supply?
the lateral medulla
what cranial nerves are found in the lateral medulla?
9,10,11
where does the AICA supply?
the lateral pons
which cranial nerves are found in the lateral pons?
5,7,8
which artery supplies the medial pons?
basilar
stroke of the basilar artery results in…
locked in syndrome
diffuse axonal injury MRI will show multiple lesions affecting where?
white matter tracts
what are charcot-bouchard microaneurysms associated with?
chronic hypertension
histological findings of parkinsons disease?
intracellular eosinophilic inclusions of alpha synuclein (lewy bodies)
NT changes in huntingtons disease?
decreased GABA, decreased Ach, increased dopamine
gross findings in huntingtons disease?
atrophy of the caudate and putamen with ex vacuo ventriculomegaly
gross findings of parkinsons disease?
depigmentation of substantia nigra pars compacta
histologic findings of alzheimers disease?
beta amyloid and intracellular hyperphosphorylated tau protein (neurofibrillary tangles)
gross findings of alzheimers disease?
widespread cortical atrophy
-narrowing of gyri and widening of sulci
which two neurodegenerative disorders have alpha synuclein inclusions?
parkinsons and lew body dementia
presentation of frontotemporal dementia?
dementia with early changes in personality and behaviour or aphasia. may have movement disorders as well
what is lewy body dementia?
visual hallucinations, fluctuating dementia, REM sleep disorder and parkinsonism
presentation of lead toxicity in a childhood?
Developmental delay or language regression, and anemia
which enzymes does lead inhibit?
ferrochelatase and ALA dehydratase
which antidepressant is associated with priapism?
trazadone
what is zolpidem?
nonbenzo hypnotic
name two substances important for angiogenesis?
VEGF
FGF
does EGF (epidermal growth factor) play an important role in angiogenesis?
no
FF =
GFR / RPF
what is hydrocephalus ex vacuo?
enlargement of the ventricles due to cortical volume loss
