UWorld Day Five Flashcards
dysphonia, dysphagia, diploplia - etiology
canned foods - Clostridium botilinum
MC lab value indication of kidney function
creatinine - the higher the creatinine, the lower the kidney function (GFR)
DKA urine:
pH
HCO3-
H2PO4- (from HPO4) and NH4 (from NH3)
(metabolic acidosis)
pH decreased - especially increased secretion in the distal tubules
HCO3 decreased - more is reabsorbed (as CO2 and H20 from H2CO3)
H2PO4 and NH4 are increased because it acts as a buffer to trap H+ in the urine so that it can be secreted
Why is brown fat brown and what is its function?
Color due to increased mitochondria and intracytoplasmic fat droplets. Function as heat generators in newborns by uncoupling oxphos with the protein thermogenin.
To test for hypothyroidism, do you test T3 and T4 or TSH?
TSH - the most sensitive marker
Describe the three steps of nucleotide excision repair, like after sunburn induced T-C pyrimidine dimers.
- Endonuclease nicking - removes damaged/crosslinked strand.
- DNA polymerase replaces removed bases.
- DNA ligase seals the gaps.
difference between synergistic effect and permissiveness of two hormones.
Synergy (additive effect) - coadmin results in sum of both max effects
Permissiveness is when one hormone allows the other to have its max effect
ACTH levels are suppressed (v. normal or elevated). What three potential causes?
- Adrenal adenoma (–> negative feedback on pituitary with increased adrenal output)
- Adrenal malignancy
- Exogenous GC malignancy
What does ACTH and cortisol suppression with high dose dexamethasone mean?
High dose dexamethasone suppression that DECREASES ACTH and CORTISOL indicates a pituitary adenoma (Cushing DISEASE - ACTH overproduction)
Two drugs that selectively cause coronary vasodilation should not be given under
adenosine and dypiramidole - exacerbate coronary steal
GFR = inulin = ___ in this transporter is blocked in the proximal tubule.
What is greater than filtered load (freely filtered and secreted into urine)
glucose (freely filtered, so if it can’t be taken back, then it is = to GFR)
PAH
MC type of kidney stone (also Crohn)
calcium oxalate (hypocitrauria) - “x” in middle
Kidney stone with urease + bug
ammonium magnesium phosphate (staghorn) - coffin lid
rhomboid kidney stone
urea
hexagon stone
Cysteine - “six”eine - hereditary with cysteine transporter (reabsorbing) in proximal tubule is defective
a person presents with a tremor that gets better with alcohol. Treat tremor with?
this is an essential tremor. MC movemnt disorder. hereditary
treat with propanolol
Nitroprusside toxicity is due to what? Treat?
cyanide (affects cytochrome c oxidase in ETC). treat with sulfer -
Difference between low dose and high dose epinerpherine (HR, systolic, diastolic BP)
Block low dose change in ___ how?
both: increase HR, increase systolic BP
low dose: decreases diastolic BP (beta 2) –> Block with B2 blocker
high dose: increases diastolic BP (alpha 1)
treat insomnia in elderly with what?
melatonin agonist - ramelteon (not benzo, antihistamine, or sedating antidepressant)
drug toxicity associated with hyperkalemia and vision chagnes
digoxin (inhibits Na/K/ATPase
doxazosin, prazosin, terazosin
alpha1 blockers
