UWorld_3.31 Flashcards
Reason for methodone use
- used to help patients recover from heroin addiction
- very long half-life opioid agonist w/good oral bioavailablity
- prevents withdrawal sx while weaning off heroin
Gastroenteritis that can transfer between domestic animals and humans
- campylobacter
- acquired from domestic animals (cattle, chicken, dogs) or contaminated food
- ==> inflammatory diarrhea + ab pain + tenesmus
hidgut derivatives + blood supply
- transverse colon
- descending colon
- sigmoid colon
- rectum
- bs = inferior mesenteric artery
Major complication in subarachanoid hemorrhage + tx
- vasospasm can occur 4-12 days after ==> new onset sx
- Nimodipine = selective ca channel blocker usually prescribed to prevent
Shizoaffective disorder
- multiple psychotic episodes with concurrent major depressive/manic sx
- >2 weeks of psychosis (delusions, hallucinations) w/out mood sx
- mood sx present over majority of illness
Characteristics of Jervell and Lange-Nielson syndrome
- AR
- QT prolongation
- congenital neurosensory deafness
Consequence of Afib in LVH/aortic stenosis pt.
- afib ==> ineffective atrial contraction
- atrial contraction is important in ventricular filling of a noncompliant chamber
- innefective atrial contraction ==> sig. decreased preload ==> decreased CO
Common causes of myopathy with elevated CK
- inflammatory myopathy
- skin rash and inflammatory arthritis may also be present
- statin-induced
- hypothyroidism
- hypothyroid sx present
- myoedema = mounding of m. after percussion <== slow reabsorption of Ca from sarc. reticulum
Characteristics of germinomas
- most common tumor of pineal gland ==>
- B-hCG ==> prec. puberty in males
- obstructive hydrocephalus
- parinaud syndrome = paralysis of upward gaze
Common complication of bronchial asthma
- aspergillosis ==> transient recurrent pulm infiltrates ==> proximal bronchiectasis
PrP definition & consequences
- PrP = prion protein = alpha helix ==> beta pleated sheet = resistant to proteases ==> accumulation ==> spongiform transformation of gray matter
Ipratropium: MOA, use
- Muscarinic antagonist @ bronchial smooth m.
- less effective than B2 agonists
- enhance B2 agonists
- use in asthma
Theophylline: MOA, use
- MOA: inhibit phosphodiesterase ==> increased cAMP ==> bronchial sm. m. dilation
- use: asthma
Presentation of age-related macular degeneration (AMD) + Tx
- progressive ==> acute vision loss (usually)
- dry = subretinal drusden deposit or pigment changes
- wet = abnormal vessels, gray subretina, neovascularization
- dry ==> wet
- dry tx = antioxidant vitamins + zinc
- wet = anti-VEGF, laser therapy, phototherapy
Nicotinic receptors
- ligand-gated ion channels
- ACh binding ==> immediate influx of Ca2+ and Na+ and efflux of K+
Progressive dementia + cortical atropy ==> dx + tx
- dx = Alzheimer’s
- Tx
- Donepezil = cholinesterase inhibitor
- Vitamin E (antioxidant)
- Memantine = NMDA antagonist
Characteristics of cachexia
- lung mass that releases TNF-alpha ==> cachexia syndrome
- weight loss
- anemia
- anorexia
- wasting
H. pylori location?
prepyloric area of gastric antrum = greatest concentrations
Glucokinase fxn + deficiency consequences
- glucokinase = glucose sensor in pancreatic B-cells
- inactivation of glucokinase ==> mild hyperglycemia exacerbated by pregnancy
Acitinic keratosis presentation
- erythematous papules + white central scale
- rough, sandpaper like texture
Granulosa-theca cell tumors secrete…
estrogen
Biotin role in metabolism
- CO2 carrier on carboxylase enzymes
- pyruvate carboxylase
- ACoA carboyxlase
- propionyl carboxylase
- beta-methylacrotonyl carboxylase
- **all involved in carb and lipid metabolism
- in tissues that perform gluconeo gen, PC: pyruvate ==> OAA
- no gluconeogen ==> pyruvate ==> LA ==> metabolic acidosis
Clozapine: MOA, use, SE
- MOA: blocks D4 receptors
- use: refractory psychosis/schizophrenia
- SE
- agranulocytosis <== must monitor WBC count
- seizures
Total flow (w/in tube) =
Flow = cross sectional area x velocity = constant
Insulin types
- Basal/long-acting
- Glargine; Determir = once daily
- NPH = twice daily
- Short-acting/post-prandial
- Regular = best for IV
- Lispro, Aspart, Glulisine = peak @ 45 min - hour
- best for post-prand hyperglycemia
Common disinfectant mechanisms:
alcohols
chlorhexadine
hydrogen peroxide
iodine
- alcohols
- disruption of cell membranes
- denaturation of proteins
- chlorhexadine
- disruption of cell membranes
- coagulation of cytoplasm
- hydrogen peroxide
- free radicals
- sporocidal
- iodine
- halogenation of proteins & nucleic acids
- sporocidal
Consequences of placental aromatase deficiency
- inability to produce estrogens in placenta ==> excess androgens
- XX w/ambigous genitalia
- virilization of mother during preg.
Common sites of injury of ulnar nerve
- medial epicondyle of humerus
- near hook of hamate and pisiform bones of wrist
