uWorld 43 Flashcards
whats in rat poison
BRADIFACOUM (SUPERWARFARIN) a long acting 4-hydroxycoumarin derivative
depletes vitamin K clotting factors resulting in a coagulopathy similar to WARFARIN tox
use FRESH FROZEN PLASMA if emergency situation or vitamin K (if just the coagulation tests are fucked but no symptoms)
what is CRYOPRECIPITATE
obtained from fresh frozen plasma
contains factors VIII, XIIII, vWF, and fibrinogen
what accounts for dyspnea in left sided heart failure
DECREASED LUNG COMPLINACE (from fluid accumulation)
left ventricular contractility significantly decreases, reducing left ventricular output
resulting HIGH END-DIASTOLIC PRESSURE imparts diastolic return of blood TRANSUDATION of FLUID from the pulmonary capillaries into the lung interstitial
presence of fluid in the pulmonary intertisitium causes distortion (swelling) of affected tissue increasing resistance of movement (DECREASING LUNG COMPLIANCE)
as a result, the negative pressure generated during normal inspiratory effort is not sufficient to adequately distended the lungs, resulting in poor gas exchange and shortness of breath
what are some causes of decreased lung compliance
left sided heart failure
pulmonary fibrosis
insufficient surfactant
what enteric bacteria release AB5 toxins that activate electrolyte transport
Campy
Vibrio
what mediates cholesterol uptake
ENDOCYTOSIS via LDL receptor
GLUT transporters are examples of what
carrier mediated transport (FACILITATED DIFFUSION)
GLUT-4 is INSULIN SENSITIVE for UPTAKE of glucose found in SKELETAL MUSCLE and ADIPOCYTES
GLUT-2 facilitates export of glucose FROM the LIVER, SMALL INTESTINES, KIDNEYS into circulation
sickle cell causes what changes in hemoglobin
acidic glutamic acids (glu) residue at 6th position on beta-globing chain is replaced by NONPOLAR (neutral charge) VALINE (val) residue
leads to alteration of the region on the beta-globing SURFACE that interacts with a complementary site on another Hb molecule
the HYDROPHOBIC INTERACTIONS that occur cause aggregation of the Hb molecules (under anoxic conditions)
tertiary structure changed on surface
what happens in HbC
glutamic acids replaced by BASIC POLAR (positively charged) LYSINE
presence of lys causes HbC to have decreased mobility on electrophoresis
what is Familial Hypocalciuric hypercalcemia (FHH)
AD disorder due to defective CALCIUM SENSING by PARATHYROID and RENAL TUBULES
prevents PTH from being SUPRESSED in response to an INCREASE in CALCIUM
results in HYPERCALCEMIA with NORMAL-to-HIGH serum PTH levels
HYPOCALCIURIA due to impaired renal calcium sensing
what is seen in secondary hyperparathyroidism
chronic renal failure or vitamin D deficiency
hypocalcemia and elevated PTH
what is seen primary hyperparathyroidism
increased calcium and PTH
tetrahydropterin is needed for synthesis of what neurotransmitter
SEROTONIN (tryptophan hydroxylase needs it)
also Dopa, Norepi, and Epi (cuz phenylalanine hydroxylase and tyrosine hydroxylase needs it)
tetrahydropterin defieiceny causes what
disrupted neuronal and glial development (high phenylalanine development)
neurologic deterioration (low serotonin and other neurotransmitters)
developmental delay, hypotonia, dystonia, and seizures
low phenylalanine diet and BH4 supplementation
how is glutamate made
glutamine from glutaminase
how is GABA made
via glutamate decarboxylase
what patients are predisposed to priapism
sickle cell
multiple myeloma
how does trazodone work
serotonin modulator (antagonizes receptors and and inhibits reuptake)
alpha 1 blocker
H1 blocker
what causes mallory weiss tears
increased intraluminal gastric pressure due to retching, vomiting, or other abdominal straining
medicare is offered to whom
patients 65 or older who have worked and paid into the system
younger peeps with disabilities, end-stage renal disease, or ALS