UWorld 1 & 2 Flashcards
What affect does estrogen have on HMG-CoA reductase?
Upregulates
Why do pregnant women present more with gallstones?
Estrogen upregulates HMG-CoA reductase, reusling in bile to become supersaturated with cholesterol
What effect does progesterone have on bile acid secretion and gallbladder emptying?
Progesterone reduces bile acid secretion and slows gallbladder emptying
What is used to treat patients with recurrent calcium-based nephrolithiasis?
Thiazide diuretics - increase Ca reabsorption
What drug can be used to treat narcolepsy?
Modafinil
How do you calculate maintenance dose?
(Steady state plasma concentration x clearance) / bioavailability fraction
What is the MOA of ribavirin?
Interfering with the duplication of viral genetic material - it is a nucleoside antimetabolite
Adrenal crisis requires what for immediate treatment?
Fluid resuscitation and glucocorticoid supplementation (hydrocortisone or dexamethasone)
What is a patients greatest risk from dying following complications for acute rheumatic fever?
Pancarditis
DRESS syndrome is seen in what drugs? What timeframe does it present at?
Presents 2-8 weeks after exposure; egs: phenytoin, carbamazepine, allopurinol, sulfonamides, antibiotics (minocycline, vanco)
How does DRESS present
2-8 wks after exposure - fever generalized lymphadenopathy, facial edema, diffuse morbilliform skin rash; labs show eosinophilia
Drug induced antineutrophil cytoplasmic antibodies associated vasculitis presents with what drugs?
Commonly medications for hyperthyroidism (PTU, methimazole) and hydralazine
How does drug induced antineutrophil cytoplasmic antibodies associated vasculitis present?
Constitutional symptoms, arthralgias/arthritis, cutaneous vasculitis
What is mixed cryoglobulinemia?
Small to medium vessel vasculitis caused by circulating immunoglobulin-complement complexes that precipitate on refigeration
What is mixed cryoglobulinemia associated with?
Chronic inflammatory states - SLE, HCV
How does mixed cryoglobulinemia present?
Systemic findings and palpable purpura in the lower extremities due to cutaneous vasculitis
What are the sertoli cells responsible for and where are they found?
Found in the testes; responsible for producing anti-mullerian hormone which causes mullerian duct involution; they also produced androgen-binding protein which concentrates testosterone in the seminiferous tubules to enable spermatogenesis
What do the Leydig cells do and what are they responsible for?
Secrete testosterone and stimulate the Wolffian duct to develop into internal male reproductive organs (epididymides, vas deferens, ejaculatory ducts, seminal vesicles)
What forms the external male reproductive organs? What hormone is responsible?
Genital tuberlce, urogenital folds and labioscrotal swelling; dihydrotestosterone
What is septic abortion?
Abortion resulting in retained products of conception
How does septic abortion present?
Fever, chills, lower abd pain and blood or purulent discharge; boggy, tender uterus with dilated cervix. Pelvic US: retained products of conception, increased vascularity, echogenic material in cavity, thick endometrial stripe
What microorganisms are responsible for septic abortion?
S aureus is very common; others: gram neg bacilli (E coli) and GBS
What is Asherman syndrome?
Long term complication from septic abortion - adhesions in uterine cavity that can lead to secondary amenorrhea and infertility
What organisms are resistant to cephalosporins?
L monocytogenes, MRSA, enterococci, atypicals (mycoplasma and chlamydia)