UWorld_3.18 Flashcards
Medications that cause fat redistribution
- glucocorticoids
- HAART
- fat from extremities ==> abdominal viscera and subcuatneous adipose tissues of the thorax, postererior neck, and supraclavicular region
thiopental: moa, use
- lipid-soluble barbituate used as short-term anesthesia
- ==> brain ==> rapid redistribution to skeletal muscle and adipose tssue (w/in 5-10min)
- rapid redistribution allows for short term anesthia
Reason for measuring phospholipids in amniotic fluid
- helps asses fetal lung maturity
- phospholipids i.e. dipalmitoyl phosphatidylcholine (lecithin) = major component of pulmonary surfactant
- L (lecithin)/ S (sphingomyelin) ratio used tp asses maturity
- L/S > 2 = mature
Left testicular vein ==>
right testicular vein ==>
- left ==> left renal vein
- right ==> IVC
Hyperammonemia in hepatic encephalopathy ==> biochemical consequences?
- depletion of alpha-ketoglutarate ==I kreb’s cycle
- excess ammonia also depletes glutamate (excitatory NT) ==> glutamine accumulation ==> astrocyte swelling and dysfxn
Patient receives >5-6L of whole blood/RBCs over 24 hours ==>
- elevated levels of citrate (anticoagulant)
- citrate chelates calcium and magnesium ==> paresthesias
Consequence of verapamil on cardiac pacemaker cells
- verapamil = ca-channel bloccker
- ==> slowed depolarization at phase 0 and end of phase 4
- “slow diastolic depolarization”
Glucose transporters that are responsive to insulin
- ONLY GLUT 4 @ skeletal muscle and adipose tissue
MS vs. MR murmur
- MS = opening snap + low-pitched, mid-diastolic rumbing murmur heard at apex
- MR = blwing, holosytolic murmur; heard at apez and radiates to axilla
Lung cancer that cannot usually be treated with surgery
- small cell carcinoma
- most aggressive; usually distant mets @ discovery
- responsive to chemotherapy and radiation
HLA class I =
HLA class II =
- class I =
- HLA-A, HLA-B, HLA-C
- genes that code for MHC I receptors on all body cells
- class II =
- HLA-DR, HLA-DQ
- genes that code for MHC II receptors on immune cells
Characteristics of serotonin syndrome
- occurs when SSRIs are given in conjunction w/other serotonergic agens
- sx
- neuromuscular excitation: hyperreflexia, clonus, myoclonus, rigidity
- autonomic stimulation: hyperthermia, tachycardia, diaphoresis, tremor
- AMS
Examples of serotonergic agents
- Anti-depressants
- monoamine oxidase inhibitors
- TCA
- SNRI
- analgesics
- tramadol
- anti-emetics
- 5-HT3 receptor antagonists (ondansetron)
- antibiotics
- linezolid = weak monoamine oxidase inhibitor
- neuropsych
- triptans
Presentation and mechanism of normal pressure hydrocephalus
- elderly patients
- ==> ataxic gait, urinary incontinence, dementia
- sx due to distortion of periventricular white matter
Regulations of mictrurition
- sacral mictrution center = S2-S4 level and ==> bladder contraction
- parasym fibers travel from S2-S4 ventral white matter @ pelvic nerves to stimulate cholinergic receptors in bladder wall
- pontine micturition center = @ pontine reticular formation.
- coordinates relaxation of external urethral sphincter w/bladder contraction during voiding
- cerebral cortex = inhbits sacral micturition center
Tx tp prevent recurrences of genital herpes
- daily treatment with oral valacyclovir, acyclovir, or famciclovir ==> suppression of reactivation
Consequences of T. cruzi infection
- destroys myenteric plexus @:
- esophagus ==> achalasia
- intestines ==> megacolon
- ureters ==> megaureter
- dilated cardiomyopathy
abd pain and distention + fever + diarrhea + signs of shock + hx of IBD ==> dx?
- toxic megacolon <== dx via abdominal xray
Amphotericin B: MOA, SE
- MOA = binds ergosterol ==> pores ==> cell death
- SE
- renal toxicity
- ==> vasoconstrict ==> decreased GFR
- direct toxin to renal epithelial cells ==> ATN, renal tubular acidosis, and electrolyte distrubances
- **hypoK and hypoMg <== usually supplemented during tx
- ==> decreased EPO ==> normochromic, normocytic anemia
Water-soluble vit with significant body stores
Vit B12; can last years with absence in diet
Characteristics of follicular (non-hodgkin’s lymphoma)
- aggregates of packed follices that obscure normal lymph node architecture
- t(14;18) ==> overactive BCL-2 gene
