UWorld_3.15 Flashcards
Characteristics of G6PD Pathway
- G6PD: G6P == …. ===> ribulose-5-P + 2 NADPH
- NADPH ==> oxidative processes
- FA, cholesterol
- steroid synth
- drug metabolism
- ribulose-5-p ==> nonox processes
- glycolytic
- aromatic aa synth
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HIV+ w/800 T cells + pneumo ==> causative agent?
s. pneumo
PCP common @ < 200 T cells
Mycoplasma pneumo ==> dx?
atypical pneumo
Characteristics of drugs w/various volume of distribution
- low Vd = 3-5 L
- highly bound
- charged
- hydrophillic
- high molecular weight
- Vd = 14-16L = plasma + interstitial fluid
- small molecular weight
- hydrophillic
- Vd = 41L = highest distribution
- lipophillic (or hdyro)
- uncharged
Where is the majority of water reabsorbed at nephron?
- proximal tubule, regardless of patient hydration status
Implications of folate deficiency
- thymidilate synthase: 5,10-MEtetrahydrafolate + dUMP ==> dihydrofolate + dTMP (deoxythymidine monophosphate)
- folate deficiency ==> megaloblastic anemia and promotes erythrocyte apoptosis
- supplementing with thymidine would decrease erythro apoptosis
Most potent cerebral vasodilator [blood gas]
pCO2
Aorta anterior and to the right of pulmonary artery ==> dx + embryologic cause?
- dx = transposition of the great arteries (vessels)
- due to failure of aorticopulmonary septum to spiral normally during septation of the truncus arteriosus
Embryology:
- fail of proliferation ==>
- fail of obliteration ==>
- fail of migration ==>
- fail of apoptosis ==>
- fail of fusion ==>
- prolif ==> fibular aplasia
- obliteration ==> branchial cyst
- migration ==> hirschsprung
- apoptosis ==> overactive/autoreactive B/T cells ==> apoptosis
- fusion ==> hypospadia
Factors used in the ddx of metabolic alkalosis
- urine chloride
- patient volume status
- low urine chloride ==>
- vomiting/ng aspiration
- prior diuretic use
- high urine chloride + hypo/euvolemia ==>
- current diuretic use
- barter or gittelman syndrome
- high urine chloride + hypervolemia ==>
- excess mineralocorticoids:
- Cushings
- ectopic ACTH
- primary hyperaldo
- excess mineralocorticoids:
Isoniazid: MOA
- antimycobacterial
- inhibits mycolic acid synthesis
Cell structure of mycobacteria that lead to acid-fastness
mycolic acids (loss of myc acid ==> loss of acid-fast)
Buspirone: MOA/properties, use
- MOA: partial 5HTA1 agonist
- no muscle relaxant
- no anti-seizure
- little hypnosis/hallucinatory
- Use:
- anxiety
- esp. @ previous abusers of anxiolytics
- less addiction potential vs. benzos
Consequences of Vit A abuse
- ==> acute, chronic, teratogenic
- acute = N/V
- vertigo
- blurred vision
- chronic
- alpecia
- skin changes, dry skin
- hepatomegaly
- intracranial HTN (pseudotumor cerebri) ==> papilledema
- vision difficulties
- teratogenic
- abortive
- microcephaly
- cardiac abnormalities
Beck’s triad =
- hypotension
- JVD
- distant/muffled heart sounds
- ==> cardiac tamponade
Recent viral illness + thyrotoxicosis, thyroid tenderness, reduced radioactive iodine uptake, elevated ESR ==> dx + histo features
- subacute thyroiditis
- mixed, cellular infiltrate w/occasional multi-nucleated giant cells
a1 receptors location + effect + drugs (agonists)
- pupil sphincter ==> mydriasis (dilation)
- bladder ==> sphincter contraction
- peripheral blood vessels ==> increased SBP
- agonists
- norepi
- epi
- phenylephrine
- methoxamine
beta-1 receptor locations + effects + agonist drugs
- heart ==> increased HR, contractility
- agonsits
- epinephrine
- dobutamine
- dopamine
- isoproteronol
beta-2 receptor locations + effects + agonist drugs
- bronchi ==> bronchodilation
- uterus ==> relaxation
- skeletal muscle bood vessels ==> vasodilation
- agonist drugs
- isproteronal
- terbutaline
- ritodrine
unsteady gait, tremor + elevated transaminase + low ceruloplasmin ==> dx + tx?
- dx = wilsons disease = excess copper @ liver, brain, eye
- tx = penicillamine
- chelation agent
