tues aug 12 Flashcards

1
Q

what stimulates the translocation of GLUT4 to the surface of muscle cells?

A
  1. Insulin

2. muscle contraction

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2
Q

how does regular exercise effect muscle glucose uptake?

A

Muscle contraction stimulates GLUT4 to move to the cell membrane to uptake glucose. With regular exercise, there is greater expression of GLUT4 leading to increased skeletal muscle glucose uptake at any level of insulin.

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3
Q

what are the TWO watershed areas of the colon?

A
  • splenic flexure

- rectosigmoid junction

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4
Q

which arteries supply the rectosigmoid junction?

A

-here, the inferior mesenteric sigmoid arteries and superior rectal arteries anastomose

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5
Q

what is the composition of the H influenza type B capsule?

A

polyribosylribitol phosphate (PRP)

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6
Q

how does the PRP capsule of H influenza prevent phagocytosis?

A

Binds to factor H in the blood, a circulating regulator protein that NORMALLY prevents complement deposition on host cells

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7
Q

list lights criteria for an exudative pleural effusion?

A
Pleural fluid protein/serum protein> 0.5
OR
Pleural LDL/serumLDH > 0.6
OR
Pleural LDL > 2/3 the upper limit of normal for serum LDL
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8
Q

what causes an exudative pleural effusion?

A

inflammation secondary to infection, malignany, or rheumatologic disease

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9
Q

if you have an inflammatory pleural effusion what would you expect the glucose to be?

A

decreased

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10
Q

what are aprepitant and fosaprepitant?

A

NK1 receptor antagonists useful for treating chemo-induced vomiting

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11
Q

what is neprilysin?

A

a metalloprotease that cleaves ANP and BNP

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12
Q

how do neprilysin inhibitors help treat heart failure?

A

-they prevent the cleavage and thus increase ANP and BNP which initiate diureses

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13
Q

In heart failure, why do you have to combine neprilysin in inhibitors with an ATII blocker?

A

Because neprilysin also cleaves/inactivates angiotensin II, so if neprilysin is blocked there will be increased angiotensin II so you must block this

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14
Q

histopathology of thrombiitis obliterans (beurgers diseaes)?

A
  • inflammatory intraluminal thrombi with vessel wall sparing

- extension into contiguous veins & nerves

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15
Q

how does pufferfish cause poisoning?

A

-binds to Na channels inhibiting Na influx and preventing action potential conduction

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16
Q

what toxin is in pufferfish?

A

tetrodotoxin

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17
Q

name two stimulant laxatives?

A

bisacodyl and senna

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18
Q

docusate MOA

A

its a surfactant laxitive - decreases stool surface tension allowing water to enter

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19
Q

what kind of mutation causes duchennes muscular dystrophy?

A

frameshift

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20
Q

what kind of mutation causes beckers muscular dystrophy?

A

non-frameshift

21
Q

MEN have problems with PSA pneumonic?

A

meningiomas = psammoma bodies, spindle cells and from arachnoic matter

22
Q

which cranial nerve is covered by oligodendrocytes instead of schwan cells?

A

CN II

23
Q

which brain tumour is S100 + ?

A

schwannomas

24
Q

listeria has intrinsic resistance to..

A

third gen cephalosporins

25
Q

how may cornybacterium diptheria get the toxoid?

A

via infection with a lysogenic bacteriophage - it inserts the tox gene into the genome and now the bacteria can produce AB exotoxin (diptheria toxin)

26
Q

fenoldapam MOA?

A

D1 agonist - increases intracellular camp, leading to vasodilation, including renal vasodilation and increased renal blood flow leading to natureisis

27
Q

hydralazine MOA?

A

direct arteriolar vasodilator - causes reflex tachycardia so is not often used for hypertensive emergency

28
Q

how does leuprolide effect GnRH levels?

A

constant infusion will eventually lead to a downregulation of receptors and thus decrease LH/FSH- useful for cancer.
However int he first week it causes a SURGE so should be given with an androgen receptor blocker initially.

29
Q

which type of kidney stones is associated with hypocitraturia?

A

calcium oxalate

30
Q

what will be seen on neuroimaging of a patient with huntingtons?

A

enlargement of the frontal horns and lateral sinus’s (due to atrophy of the caudate and putamen)

31
Q

does coadministration of epinephrine with lidocaine alter the duration of action?

A

yes, it increases the duration of anesthesia at the site

32
Q

how are ergot derivatives used regarding migraines?

A

migraine ABORTION

33
Q

name the drugs that can be used for migraine PROPHYLAXIS

A

Beta blockers
TCAs
Anticonvulsants - topiramate and valproate

34
Q

topiramate MOA?

A
  • inactivation of Na channels

- also allosterically binds GABA-A

35
Q

are SSRIs used for migraine prophylaxis?

A

NO - TCAs are, or venlafaxine

36
Q

problems with Meyers loop causes…

A

pie in the sky

37
Q

if someone is presenting with a pure SENSORY stroke where did it likely occur?

A

thalamus

38
Q

ventral posterior lateral nucleus (of the thalamus) receives info from…

A

the spinothalamic tract and dorsal columns

39
Q

ventral posterior medial nucleus (of the thalamus) receives info from…

A

the trigeminal and gustatory pathways

40
Q

is S pyogenes PYR positive?

A

yes

41
Q

what is PYR?

A

Pyrrolidonyl arylamidase (PYR)

42
Q

long term use of nsaids may result in…

A

chronic interstitial nephritis

43
Q

which nerve supplies sensation to the upper medial arm?

A

intercostobrachial nerve

44
Q

formula for specificity?

A

true negatives / (true negatives + false positives)

45
Q

what causes a ganglion cyst?

A

mucoid degeneration of periarticular tissue, leading to outpouching of connective tissue

46
Q

do lipomas transilluminate?

A

no

47
Q

do ganglion cysts transilluminate?

A

yes

48
Q

if a patient has low literacy how should you improve communication?

A

provide visual aids (illustrations, videos) to help with understanding