stomatitis = painful mouth ulcers hepatotoxicity = hepatitis, fibrosis, cirrhosis myelosuppression ==\> increased infection risk B-cell lymphomas pulmonary fibrosis contraindicated in pregnancy

inhibits squalene oxidase ==\> inhibition of fungal wall formation use = dermatophytoses; e.g. tinea corporis

UWorld_4.3 Flashcards by Caitlin Heim

Pharmacokinetic characteristics of inhaled gases/anesthetics

onset of action correlates with blood solubility (blood/gas partition coeff.)
- high blood/gas = blood saturates slowly ==> slower equilibration w/brain & slower onset of action
- low blood/gas = blood saturates rapidly ==> faster equilibration w/braind and rapid onset of action
MAC = ~potency (inversely related)

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Resistance for circuits in parellel & series

[parallel] 1/R_T = 1/R₁ + 1/R₂ + 1/R₃ + ….
[series] R_T = R₁ + R₂ + R₃ + ….

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Hb actions @ lungs vs. peripheral tissues

@ lungs: increased O2 binding ==> release of CO2 and H+ = “Haldane effect”
@ periphery: high [CO2] & [H+] ==> O2 unloading

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Characteristics of Acute Intermittent Porphyria + tx

porphobilinogen deaminase deficiency
usually asymptomatic ==> acute abdominal pain + N/V + neuro sx + reddish-brown urine (or recurring ab pain)
tx =
- dextrose/glucose prep
- heme prep
- both ==I ALA synthase

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What are smelly sweat glands called?

apocrine glands

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Gram + rods that form “medusa” heads/serpentine ==> dx?

bacillus anthracis
pulmonary anthrax = woolsorters disease
- widening mediastinum (hemmorhagic mediastinitus)
virulence = antiphagocytic capsule w/D-glutamate instead of polysacc

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“Hot tub folliculitis”

self-limited P.aeuruginosa infection from hot tub/pools that do not have adequate chlorination
==> papulopustular rash w/oxidase-positive gram-neg rods

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Main energy source that drives gluconeogenesis

GTP: faciliates OAA ==> PEP by PEPCK
rxn that produces GTP = Succinyl CoA ==> Succinate

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Methotrexate SE

stomatitis = painful mouth ulcers
hepatotoxicity = hepatitis, fibrosis, cirrhosis
myelosuppression ==> increased infection risk
B-cell lymphomas
pulmonary fibrosis
contraindicated in pregnancy

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Encapsulated organisms

H. influenza
S. pneumo
N. meningitis
Salmonella

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Indirect vs. Direct vs. Femoral hernias

Indirect
- most common @ male infant
- enters inguinal ring
- lateral to inferior epigastric vessels
- due to persistent processus vaginalis & failure of closure of inguinal ring
Direct
- most common @ older men
- bulges through Hesselbach’s triangle
- medial to inferior epigastric vessels
- ==> external inguinal ring
- due to weakness in transversalis fascia
Femoral
- most common @ women
- potrudes through femoral ring
- medial to femoral vessels
- inferior to inguinal ligament

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Characteristics of acute pancreatitis

blockage ==> digestion of adipose by lipase
- calcium deposition + edema = acute interstitial
if inflammation continues ==> acute necrotic pancreatitis
- chalky white fat necrosis + hemorrhage
- activation of proteolytic enzymes

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Chronic lymphedema ==> increased risk for?

angiosarcoma

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Terbanifine: MOA

inhibits squalene oxidase ==> inhibition of fungal wall formation
use = dermatophytoses; e.g. tinea corporis

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branched-chain alpha ketoacid dehydrogenase coenzymes

coenzymes = “TLC For Newborn (w/MSUD)”
- Thiamine pyrophosphate
- Lipoate
- CoA
- FAD
- NAD
other enzymes w/same coenzymes
- pyruvate dehydrogenase
- alpha-ketoglutarate dehydrogenase

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Schilling test results

Administer parenteral B12 + oral radiolabeled B12
1. high urinary excretion = normal absorption <== low dietary intake
2. low urinary excretion = poor absorption
Administer parenteral B12 + oral radiolabeled B12 + IF
1. high urinary exretion = low IF is cause of poor absorption
2. low urinary excretion = poor absorption is due to pancreatic/bowel problem

Gram (+) bacteria w/polar granules staining w/aniline dyes ==> dx?

diptheria AB toxin = EF2 adp-ribosylation

Low vs. High frequency sound hearing @ inner ear

high freq = @ base of cochlea, near oval and round window
low freq = @ apex of cochlea, near helicotrrema

Ethambutol: MOA

inhbiits arabinosyl transferae ==> inhibition of carbohydrate polymerization necc. for synthesis of TB cell wall
not effective against non-TB bacteria

Intrafusal vs. golgi tendon organs @ muscles

GTOs responsd to m. tension ==> connect to inhibitory interneurons of anterior horn motor
- (sudden relax in elevated tension)
Intrafusal = responsd to passive strectch
- innervated by Ia and II sensory fibers
- DTRs

location of HMG-CoA

mitochondria of hepatocytes ==> cholesterol formation

Digoxin: MOA, use

==I Na-K-ATPase pump @ cardiac ventricular myocytes ==> Ca2+ accumulation ==> increased contractility
acts on vagus nerve ==> decreased AV node condution
2nd line in Afib w/RVR

Polycythemia vera association

JAK2 mutation = non-receptor tyrosine kinase

Characteristics of abetalipoproteinemia

defect in ApoB synthesis ==> inability to form chylomicrons & VLDL
==> fat accumulation @ epithelium of small intestine ==> foamy/clear appearace

Characteristics of contracture formation

* during wound healing: excessive MMP activity + myofibroblast accumulations @ wound margins ==\> contracture * produce deform @ wound/surround tissue * most often @ palms, soles, ant. thorax, serious burn sites

Common cause of congenital bilateral agenesis of vas deferens

Presentation of Reye synrome

* viral illness + tx with aspirin * hepatic dysfxn ==\> * vomiting + hepatomegaly * elevated ALT, AST, ammonia, bili, prolonged PT/PTTT * biopsy = microvesicular steatosis w/out necrosis or inflammation * encephalopathy = due to hyperammonia

CN IX fxn

* motor = stylopharyngeus * parasym * parotid gland secretion * sensory * post. 1/3 tongue * typamic membrane/eustachian tube * tonsillar region * upper pharynx * carotid body/sinus

PRPP synthase activation ==\> increased pathway activity and consequences?

* ==\> increased purine synthesis (+degredation) ==\> gout

Target in gout tx

* PMNs * via NSAIDs (COX inhibition) * or (if NSAIDs contraindicated) then Colchichine: MT inhibition

(Tetrahydrobiopterin) BH4 cofactor importance

* inc synthesis of tyrosine, DOPA, serotonin, NO * dihydrobiopterin reductase = enzyme that takes BH2 ==\> BH4 in order for enzymes in this pathway to fxn

Trousseau's syndrome + similar process in heart

* Trousseau = migratory thrombophlebitis * similar = nonbacterial thrombotic endocarditis \<==hypercoagulable state

Complication of tx of neonatal respiratory distress syndrome

* ==\> retinopathy due to retinal neovascularization

Cause of amennorhea in anorexia

* loss of pulsatile secretion of GnRH from hypothalamus

MEN 1 = MEN 2A = MEN 2B =

* MEN 1 = "3Ps" = parathyroid, pituitary, pancreas * MEN 2A = pheo, med carc thyroid, parathyroid * MEN 2B = pheo, med carc thyroid, oral and intestinal mucosal neuromas