UWorld_3.26 Flashcards
Initial test for hypothyroidism
-TSH levels <== more sensitive than T4/T3 levels
Major signal trasnduction systems
- MAP-kinase 2. PIP3K/Akt/mTOR 3. cAMP 4. Inositol phospholipid 5. JAK/STAT
Characteristics of PIP3K/Akt/mTOR pathway
-important in cell growth and proliferation -tyrosine kinase receptor autophosphorylates ==> PIP3K converts PIP2=>PIP3 ==> Akt activation ==> mTOR = trxn factor -PTEN inhibits mTOR activation: tumor suppressor that removes phosphate from PIP3
Characteristics of thalamic stroke
-complete sensory loss on contralateral side of body -no motor deficits -loss of proprioception ==> difficulty ambulating
Cause of lacunar infarcts
-lipohylanosis or atherosclerosis w/in penetrating vessels to deep brain structure
Medium for growing Neisseria
-Thayer-Martin VCN (vanc/colistin/nystatin) agar = selective medium for Neisseria
Neuronal cells vulnerable to global ischemia
- hippocampus 2. purkinje cells of cerebellum
Gram + cocci that produces yellow pigment
S. aureus (aureus = gold)
Characteristics of digoxin toxicity
-nonspecific GI = N/V, abdominal pain, anorexia -neurologic = fatigue, confusion, weakness, sometimes: color vision changes -most serious complication = arrhythmias
Drugs not to use with partially occluded coronary arteries
-coronary artery vasodilators -vasodilation of unoccluded arteries ==> reduced blood flow through collaterals to ischemic areas ==> worsening ischemia
Virus: nonenveloped w/ssDNA
parvoviridae = parvovirus B19 ==> 1. erythema infectiousum (5th disease) 2. aplastic crisis in sickle cell 3. hydrops fetalis @ <20wks gestation
Location to perform thoracocentesis
-between ribs 5-7 @ midclavicular (on upper border) -between ribs 7-9 @ midaxillary (on upper border)
Location of intercostal neurovascular bundle
in subcostal groove @ lower border of rib
Which of these drugs would cause bradycardia: -Nifedipine -Captopril -Verapamil -Isosorbide nitrate -Prazosin
-verapamil only -all others act peripherally
Drugs with negative chronotropic effects @ heart
-B-blockers -non-dihydropyridine Ca-channel blockser (verapamil, diltiazem) -cardiac glycosides (digoxin) -Amiodarone and sotalol -Cholinergic agonists (pilocarpine, rivastigmine)
Drug effect of sildanefil is similar to what naturally occuring hormones/mechanisms
- NO 2. ANP all ==> increased cGMP
Vegetation composition in bacterial endocarditis
fibrin & platelet deposition at sites of bacterial invasion due to exposure of TF
Presentation of Kawasaki’s
-child w/ 1. fever 2. lymphadenopathy 3. bilateral conjuctivitis 4. cutaneous involvement -palate/tongue erythema -edema/erythema @ palms/soles = fingertip desquamation -general rash: extremities ==> trunk
Renal consequence associated with Chron’s
-oxalate kidney stones -oxalate normally bound by calcium, but crohn’s ==> decreased Ca2+ absorption ==> oxalate precipitation
Biopsy in paget disease of bone
mosaic pattern of lamellar bone
Embryo: -deformation -malformation -disruption -sequence
-deform = change in fetal structure due to mechanical forces; e.g. clubbed feet, hip dislocation due to breach position -malform = primary defect/intrinsic abnormality; e.g. holoprosencephaly, congenital heart defect -disruption = disruption of previously normal tissue; e.g. amnio rupture ==> limb damage -sequence = key single problem ==> number of abnormalities; e.g. oligohydramnios/potter
DDAVP: moa, use
-vasopressin analog -little affect @ V1 receptors ==> no vasoconstriction -use: 1. central DI 2. bleeding control: induces release of procoag proteins (e.g. vWF) and stabilized factor VIII (Hemo A)
Substances that induce angiogenesis
-VEGF -FGF (fibroblast)
