UW4 Flashcards
Disulfuram like reactions
Metronidazole, griseofulvin, procarbazine, tobutamide, chlorpropamide
What is dectected in chronic Hep B infections?
Persistent HBsAg and HBV DNA
what can cause a widened QRS?
Left or Right bundle branch block, fasicular blocks, pacemakers
What can prolong the PR interval?
things that slow AV conduction like beta blockers
High peaking left ventricular pressure and decreased aortic pressure ( increased pulse pressure)
Aortic regurgitation
Iatrogenic injury during hip surgery
Superior gluteal nerve (hip drop, Trendelenburg sign)
knee buckling and loss of patellar reflex. Loss of sensation to skin of anterior thigh and medial leg
Femoral nerve (flexion of the thigh)
Difficulty rising from seated position and climbing stairs
Inferior gluteal nerve (gluteus maximus)
Hyperosmotic volume contraction
Seen in diabetes insipidus. Loss of free water causes increase in free water and volume contraction
How would acute GI hemorrhage affect osmolarity and ICF
Isotonic loss of ECF and no change in ICF. Isoosmotic volume contraction
How would adrenal insufficiency affect ECF and ICF?
Hypertonic loss of NaCl. Lose salt. Low osmolarity of ECF would cause water to shift into ICF
How would hypertonic saline infusion change osmolarity and volume?
Hypertonic volume expansion. High osmolarity of ECF would shift water into ICF
how would primary polydipsia affect osmolarity and volume?
Volume expansion in both ICF and ECF and decreased osmolarity
What is synaptophysin a marker for?
Neurons (transmembrane glycoprotein foundin presynaptic vesicles of neurons)
GFAP stain
Astrocytomas (Gliblastoma multiforme, oligodendroglioma, ependymoma, peripheral neral sheath tumor). Neoplasms of glial origin
When do you hear an S3?
CHF. Immediately after S2 during passive ventricular filling (blood rushing into a partially filled ventricle or stiff ventricle)
How do ACE inhibitors affect GFR?
ACEi decrease ANG II to cause vasodilation of the efferent arteriole leading to increase in RBF and thus decrease filtration
AICA aneurysm can compress which nerves
Compresses the facial and vestibulocochlear neves
unilateral headache, eye pain, diplopia, dilated nonreactive pupil, pstosis, down and out eye
Aneurysm compressing the occulomotor nerve (PCA and superior cerebellar arteries)
Puffy face, dyspnea, facial swelling, dilated vessels
SVC syndrome (lung cancer, Hodgkin lymphoma)
Cushings, SIADH
Small cell lung cancer
Hypercalcemia with lung cancer
Squamous Cell (PTHrP)
Dullness to percussion and diminished breath sounds over affected area
Pleural effusion
Distended neck veins, distant heart sounds, pulsus pardoxus
Pericardial effusion
Shoulder pain, Horner’s syndrome
Pancoast tumor (superior sulcus tumors)
What substances utilize the JAK/Stat pathway?
cytokines, growth hormone, prolactin, IL-2
What substances utilize the MAP kinase pathway?
Growth factors, EGF, PDGE, FGF
What is the mechanism of leptin?
Produced in proprotion to the amount stored. Inhibits production of neuropeptide Y to decreas appetite and stimulates alpha MSH (increase satiety) Mutaiton leads to obesity
granulomatous destruction of bile ducts
Florid duct lesions of Primary biliary sclerosis
Homeless man with fever, abdomina pain, jaundice
acute cholangitis
History of ulcerative cholitis with high alkaline phosphatase
Primary sclerosing cholangitis
older female with weight loss, abdominal discomfort, epigastric mass
Pancreatic cancer
history of pruritis, fatigue with new onset pale stool and xanthelasma
Primiary biliary sclerosis
Most common cancer in women
Breast, lung, colon
Cancer mortality rates
Lung, breast, colon
Mechanism of flucytosine
Nucleotide analog that inhibits RNA synthesis. Used with Amphotericin B for Cryptococcal meningitis
Mechanism of Caspfungin
blocks synthesis of glucan component of fungal cell wall. Used for Candida and Aspergillus
Mechanism of amphotericin B and nystatin
Bind ergosterol molecules in fungal cel membranes to cause lysis
Mechanism of azoles
Inhibits ergosterol synthesis
Tachyphylaxis
Vasoconstriction by a-adrenergic agonist decline in efficacy after a few days of use due to negative feedback. Results in vasodilation and exacerbation of nasal congestion symptoms
Rebound rhinorrhea
Nasal congestion WITHOUT cough, sneezing or post nasal drop. Associaed with use of topical decongestants for more than 3 days
Prevent NSAID induced ulcers
Misoprostol, prostaglandin E1 analog
HDL levels
> 40 Men and >50 women
V-fib younger than 30
Hypertrophic cardiomyopathy
Congenital icuspid aortic valve is associated with what defect later in life?
Accelerated onset of calcific aortic stenosis
Pancreatic pancer risk factors
Tobacco, obesity
gastric cancer risk factors
Dietary nitrates, alcohol, tobacco, H. pylori
Liver cancer risk
Hep B and C, cirrhosis, Hemochromotosis, aflatoxin
Colorectal cancer risk
HNPCC, IBD, obesity, charred or fried foods
Renal cancer risk
Tobacco, obesity, hypertension
Bladder cancer
Tobacco, occupational exposures ( rubber, dyes, textiles, leather)
Breast Cancer risk
early menarche, late menopause, nulliparity, BRCA mutations
Prostate cancer risk
Increasing age, African American
Cryptorchid tests, no axillary or public hair, no penis or scrotum, no uterus or ovaries. Breast development
Androgen insensitivity syndrome
Recurrent infections with diffuse granuloma formation.
Chronic granulomatous disease. Deficiency in NADPH oxidase
Elevated PT and PTT. Decreased fibrinogen, elevated fibrin degradation products and D-dimer
DIC
Fever, acute renal failure, thrombocytopenia and microangiopathic hemolytic anemia
HUS TTP. Usually do not bleed. Only platelets are activated. Normal PT and PTT. Normal Fibrinogen
When does GVHD develop?
1 week after transplantation
