USMLE secrets Flashcards
digitalis moa, tox, treatment?
tox: diarrhea, vomiting, increased PR interval, arrythmias, blurry yellow vision (cholinergic effects); stop dig, give potassium/mg/Fab fragments; lidocaine for arrhythmia
things causing eosinophilia?
helminths, asthma, allergic disorders, AIN, hodgkins lymphoma
drugs ass with AIN?
penicillins, cephalosporins, sulfonamides, NSAIDs, PPIs
ADPKD vs ARPKD
ARPKD presents in infancy and is always associated with liver abnormalities: hepatic cysts, congenital hepatic fibrosis/organ dysfunction
VHL
bilateral kidney cysts, AD, mutiple types of neoplasms and hamartomas; hemangioblastomas of CNS and retina, pheos, pancreatic tumors, renal cysts predispose to RCC
tuberous sclerosis
AD, multiple cysts and tumors in kidney with CNS tuber formation + skin lesions, subungual/periungual fibromas, astrocytoms, renal angiolipomas, retinal hamartomas, cardiac rhabdomyomas
drugs that case oto and nephrotoxicity
loop diuretics, vancomycin, cisplatin, aminoglycosides
struvite vs uric vs cystine stones ppt at high/low pH?
struvite ppt at High pH; uric ppt at low PH; cystine at low pH
which stones can be seen on xray?
calcium stones; cystine/uric acid stones are organic and cannot be seen on x-ray
stones in Crohn’s
gall stones and kidney stones–calcium oxalate
CYP450 inhibitors
cimetidine, macrolides, azoles, isoniazid, sulfonamides, grapefruit juice, protease inhibitors, ciprofloxacin
CYP450 inducers
barbiturates, quinidine, rifampin, phenytoin, griseofulvin, carbamazepine, st john’s wort, chronic alcohol use
treatment for Gilbert or Crigler najjar Type 2?
phenobarbital–increases UDP glucoronyltransferase activity
treatment for Dubin johnsons?
avoid estrogens
treatment for crigler najjar type 1?
phototherapy bridge to liver transplant
treatment for rotor syndrome?
no treatment
diseases that hepB makes you susceptible to?
liver disease/HCC; glomerulonephritis (Ab-Ag deposition in glomerulus); polyarteritis nodosa; HepD infection
HCC mets to where?
lungs, adrenals, regional lymph nodes
HCC paraneoplastic syndromes?
IGF-1–>constitutional hypoglycemia; EPO; PTHrP
substances that signal through cAMP
FLAT P + HCG: FSH, LH, ACTH, TSH, PTH, hCG, CRH, glucagon
substances that signal through cGMP
NO, ANP (vasodilators)
substances that signal through IP3 (Gq)
GnRH, GHRH, oxytocin, TRH
substances that signal through steroid receptors
Estrogen, testosterone, glucocorticoids, vitD, aldosteron, progesterone, T3/T4
substances that signal through tyrosine kinases
insulin, growth factors, GH, prolactin
tuberoinfundibular stalk disruption by head trauma?
all anterior pituitary hormones decreased because lose hypothalamic stimulus, except prolactin which increases because dopamine (via hypothalamus) is no longer inhibiting prolactin
licorice inhibits…and can cause?
inhibits 11B-HSD, enzyme converts cortisol–cortisone–>hypertension and pseudohyperaldosteronism–>metabolic alkalosis
POMC cleavage gives…which hormones?
ACTH and MSH in the anterior pituitary
neisseria meningitis–>adrenal?
Waterhouse Freidrichson: adrenal hemorrhage, septicemia, DIC, petechial rash
neural crest derived cells:
chromaffin cells, parafollicular thyroid cells, Schwann cells, ANS, dorsal root and celiac ganglia, melanocytes, cranial nerves, pia/arachnoid, odontoblasts, skull bones, aorticopulmonary system
neural crest derived tumors?
pheo and neuroblastoma, medullary thyroid (parafollicular)
methimazole vs PTU
both inhibit thyroperoxidase (organification) centrally, only PTU inhibits T4 to T3 conversion peripherally via inhibtion of 5-hydroiodoinase (something like that)
meds that can cause hypothyroidism
amiodarone and lithium
drugs that induce uterine contractions
alkaloids (ergonovine), triptans, synthetic prostaglandins
X-linked immunodeficiencies?
Missing WBCS: hyper IgM syndrome, Wiscott-Aldrich syndrome, Bruton’s aggama..; chronic granulamatous disease, SCID;
