usmle uworld and nbme Flashcards by Zena Saleh

drug that stimulates granulocyte colonies to increase WBC in neutropenic pts

filgrastim

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used to prevent bone marrow suppression while using methotrexate

leucovorin

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___ hyperstabilizes mictrotubule polymers while ____ inhibits microtubule polymers

paclitaxel, vincristine

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sign of pum htn

P2 higher than A2, normally aortic valve closes louder than pulmonic valve due to higher pressure. in this case it is reversed

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how do baroreceptors work

stretch receptors, will fire more when there is more fluid

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hemmorhagic shock pathophys

low blood volume causes decrease stretch on baroreceptors so low arterial barororeceptor firing rate, low arterial (afferent) baroreceptor firing rate activates efferent sympathetic firing which activates raas and causes vasoconstriction (increased tpr and systemic vascular resistance. capillaries in kidneys will want to reabsorp contents not filter

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place where pelvic free fluid goes to

pouch of douglas

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itchy butt, egg on tape test, fecal oral transmission

enterobius vermicularis, pin worm

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nematode that migrates from nose to mouth obstruction at iliocecal valve, biliary obstruction, intestinal performation, seen on stool microscopy

giant roundworm, ascaris lumbricoides

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larvae from soil that penetrates intestinal wall, seen in feces on microscopy

strongyloides (thread worm)

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larvae that causes microcytic anemia, serpiginous itchy rash, walking barefoot on beach, can be in intestine

ancylostoma (hookworm)

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sensitivity=

1- FN

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biphosphonates (alendronate, risedronate)

bind hydroxyapeatite on bone and inhibit osteoclast activity

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leflunomide

inhibit dihyrdooroate dehydrogenase, prevent pyramidine synthesis supressing T cell proliferation, used in RA

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salicycate Acid Base Finding

met acidosis and respiratory alkalosis, not compensatory respiratory alkalosis

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teriparatide

recombinant pth analog that increases osteoblastic activity, increases risk of osteosarcoma, dont give for paget give biphosphonate

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reason behind edema following injury

endothelial tight junctions become permeable so tha neutrophils and other immune immediators can travel to site of injury

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what are the “tingibly Body” macrophages on the “starry sky” histo of burkitts

phagocytosed apoptic cells

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transactivation of TAX gene leads to

Adult t cell lymphoma, caused by HTLV

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desmopressin moA

activates aquaporin channels through ADH. ADH increases cAMP

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hormones that work through non receptor tyrosine kinase

Insulin and the growth factors: IGF, FGF, PDgf, EGF

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nonreceptor tyrosine kinase hormones

prolactin, immunomodulators (IL2,6, IFN) Growth hormone Erythropoien thrombopoieten and JAK STAT

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cGMP

BNP, ANP, Nitric Oxide (EDRF)

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IP3

GnRH, Oxytocin, ADH, TRH, Histamine, Angiotensin II, Gastrin (GOAT HAG)

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Intracellular receptor Hormones

Progeserone, estrogen, testosterone, cortisol, aldosterone, t2 t4, vit D

fasting physiology timeline

glycogenolysis (6-24) gluconeogenesis (24)

chemotatic factor for neutrophils

C5a, leukotriene B4, lamin digest, platelet activating factor

mediastinal shift

tension pneumo

RSV properties

RNA virus, fusion protein entry, tx with palivisumab (blocks viral fusion)

Rhogam

binds and removes RhD antigens, preventing formation of maternal antibodies to RhD

fever, palmar erythema, lymphadenopathy after being treated with rabbit antithymocite IgG

Serem Sickness, type III hypersensitivity

Causes of serum sickness

foreing proteings, IgG, drugs (haptens, penicillin,) infections such as HepB

zoonotic infx in New mexico with necrotic lesions that drain blood, swollen infected lymph nodes or buboes

yersinia, similar presentation to fransicella but in midwest, tx both with aminoglycosides

external rotation of shoulder

teres minor and infraspinatus

which artery supplies parathyroid gland

inferior thyroid artery, branch of thryocervical trunk which branches from subclavian artery

superior thyroid artery branches off the

external carotid, runs along the superior laryngeal nerve

Ca Oxalate stone tx in patients with increased Ca in urine

thiazide diuretics, work on NaCl symporter to increase Ca reabsorption which causes hyperCa and decrease Ca urine

old person with blisters in areas of flexion, friction, do not break easily

pemphigus bullous, hemidesmisomes, break in basement membrane and keratinocytes

mec A- positivity in bacteria

bacteria is methicillin resistant, tx with vanc

genetic polymorphism

variation of alleles in a locus. variation in mutation of nucleotide that does not cause change the amino acid at the locus ex marfans

Type I and II pneumocytes during lung damage

any lung damage will cause depleion of type 1 pneumocytes since they make up 97% of lung surface. type II will proliferate in response to type I depletion.

malonyl coA

stimulates fatty acid synthesis, inhibits fatty acid degradation and beta oxidation

hexokinase vs glucokinase

converts glucose to G6P in tissues, used when glucose concentrations are low; glucokinase converts glucose to G6P in liver when glucose concentrations are hight

Glycolysis activators

AMP, fructose 2,6 biphosphate activate PFK1; fed state: increase insulin, decrease cAMP, decrease protein kinsase A, decrease FBPase 2, increase PFK2 which increase fructose 2,6 BP which activates PFK1

Gluconeogenesis regulating enzyme

fructose 1,6 BP (1,6 NOT 2,6)

glycolysis regulating enzyme

PFK1

Gluconeogenesis activators

ATP, Citrate; fating state: incease glucagon, increase cAMP, Incr protein kinase, Increase FBPase 2, decrease PFK2

FBPase 2

glycolysis/gluconeogenesis off/on switch. Increase FBPase 2 favors gluconeogenesis; Decrease FBPase 2 causes increase PFK 2 favors glycolysis

Fructose 2,6 biphosphate

increases glycolysis, decreases gluconeogenesis

TCA activators

Pyruvate dehydrogenase, ADP, citrate synthase, alpha keto glutarate dehydrogenase, isocitrate dehydrogenase

TCA inhibitors

ATP, Acetyl CoA, NADH, Succinly Coa

Alpha Keto Gluturate Dehydrogenase fxn & cofactors

converts alpha keto glutarate to Succinyl CoA in TCA; cofactors: B1, B2, B3, B5, lipoic acid

naegleria fowleri

CNS protozoa, swimmers get, travels through nose, olfactory nerve, will see amoebas in CSF, ruffs worst nightmare

CNS protozoa

toxo (meat & cat liter), naegleria fowleri (swimming), trypanosma brucei (african sleeping sickness, tsetse fly)

protozoa that causes hepatosplen, pancytopenia, and skin ulcers, macrophage contain amastigotes

leishmania, sandfly

old person with RLL pneumonia

think of aspiration pneumonia

contralateral weakness and loss of proprioception, ipsilateral tongue deviation

medial medullay syndrome, Anterior spinal artery

pain and temp contralateral body, ipsilateal face, ipsilateral horner, ipsilateral ataxia, dysphagia, hoarseness, gag

lateral medullary

laterally medullay CN

9,10,11,12

facial nucleus defect, paralysis of face, pain and temp contralateral body, ipsilateral face, ipsilateral deafness, ipsilateral horner

lateral pontine, AICA

pelvic frracture can damage ___ urethra

membranous, fluid leaks in retropubic space

straddle injury, blood in scrotum

bulbar spongy injury

odds ratio greater than 1 and 95% confidence interval has a range greater than 1

statistically significant results

irritation, abnormal insertion of patellor tendon

osgood schlatter dx

BK virus

cold like sx, occurs in kidney transplant pts who are on too much immunosuppressant

double hit mutation is needed in _______ diseases

autosomal recessive;

usmle uworld and nbme Flashcards

(66 cards)