UWorld_3.18 Flashcards
1
Q
Medications that cause fat redistribution
A
- glucocorticoids
- HAART
- fat from extremities ==> abdominal viscera and subcuatneous adipose tissues of the thorax, postererior neck, and supraclavicular region
2
Q
thiopental: moa, use
A
- 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
3
Q
Reason for measuring phospholipids in amniotic fluid
A
- 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
4
Q
Left testicular vein ==>
right testicular vein ==>
A
- left ==> left renal vein
- right ==> IVC
5
Q
Hyperammonemia in hepatic encephalopathy ==> biochemical consequences?
A
- depletion of alpha-ketoglutarate ==I kreb’s cycle
- excess ammonia also depletes glutamate (excitatory NT) ==> glutamine accumulation ==> astrocyte swelling and dysfxn
6
Q
Patient receives >5-6L of whole blood/RBCs over 24 hours ==>
A
- elevated levels of citrate (anticoagulant)
- citrate chelates calcium and magnesium ==> paresthesias
7
Q
Consequence of verapamil on cardiac pacemaker cells
A
- verapamil = ca-channel bloccker
- ==> slowed depolarization at phase 0 and end of phase 4
- “slow diastolic depolarization”
8
Q
Glucose transporters that are responsive to insulin
A
- ONLY GLUT 4 @ skeletal muscle and adipose tissue
9
Q
MS vs. MR murmur
A
- MS = opening snap + low-pitched, mid-diastolic rumbing murmur heard at apex
- MR = blwing, holosytolic murmur; heard at apez and radiates to axilla
10
Q
Lung cancer that cannot usually be treated with surgery
A
- small cell carcinoma
- most aggressive; usually distant mets @ discovery
- responsive to chemotherapy and radiation
11
Q
HLA class I =
HLA class II =
A
- 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
12
Q
Characteristics of serotonin syndrome
A
- 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
13
Q
Examples of serotonergic agents
A
- Anti-depressants
- monoamine oxidase inhibitors
- TCA
- SNRI
- analgesics
- tramadol
- anti-emetics
- 5-HT3 receptor antagonists (ondansetron)
- antibiotics
- linezolid = weak monoamine oxidase inhibitor
- neuropsych
- triptans
14
Q
Presentation and mechanism of normal pressure hydrocephalus
A
- elderly patients
- ==> ataxic gait, urinary incontinence, dementia
- sx due to distortion of periventricular white matter
15
Q
Regulations of mictrurition
A
- 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
