weak spots Flashcards
what is winter’ formula?
PaCO2 = (1.5 *HCO3-) +8 +/-2
used to evaluate reps compensation when there is metabolic acidosi
PaCO2 > than predicted: concurrent resp acidosis
PaCO2 less than predicted: concurrent resp alkalosis.
name the retroperitoneal organs
SAD PUCKER
Suprarenal glands
Aorta and IVC
Duodenum (2nd and 3rd parts)
P-pancreas (except tail)
U- Ureters, bladder
C-ascending and descending colon
K- kidneys
E-esophagus lower 2/3
R-rectum lower 2/3
imaging in retroperitneum - use CT
what is moa of varenicline
partial agonist at AcH receptors (alpha 4, beta 2 receptor) and leads to partial stimulation of receptor —> reduced nicotine withdrawal + prevents nicotine from binding and inducing reward response (reduces withdrawal cravings and rewarding effects of nicotine)
what is the kozak sequence?
kozak sequence = gccRccAUGG where R = adenine or guanine
kozak sequences plays role in initation of translation.
mutation of 3 bases uspream(guannine replaced for cytosine) from start codon (AUG) assocaited with thalassemia intermedia
contets of Thayer martin media
what is it used to grow?
recall :VPN
chocolate agar with:
Vancomyocin - inhibit gram +
Polymyxin - inhibits gram - except Neisseria
Nyastatin to inhibit fungi
used to culture N. gonorrhea or N. meningitidis
fabry’s
defective enzyme:
accumulated substance
findings
enzyme: alpha galactosidase A
substance: ceramide trihexoside
finding: peripheral neuropathy, angiokeratomas, cardiovascular/renal disease
gaucher’s diseae
which enzyme
what accumulates
findings
MOST common
def of beta-glucocerebrosidease
accum: glucocerebroside
hepatosplenomegaly, aseptic necrosis of feymer, bone crises,
**macros that look like crumpled up tissue paper **
niemann pick picks the liver
which enzyme?
what accumulates
presentation
enzyme: spingomyelinase
accum: sphingomyelin
presentation: neurodegenration, **hepatosplenomegaly, cherry-red-spot on macula **
**foam cells **
tay sach’s
which enzyme
what accumlulates
enzyme: hexosaminidase A
accum: GM2 ganglioside
presen: cherry red spot on macula NO hepatosplenomegaly, progressive neuro degeneration, **lysosomes w/onion skin, developmental delay **
krabbe’s disease
which enzyme
what accum
presentation
enzyme: galactocerebrosidase
accum: galactocerebroside
present: peripheral neuropathy, developmetha delay, optic atrophy, globoid cells
metachromatic leukodystrophy
which enzyme
what accumulates?
eznyme: aryl sulfasase A
accum: cerebroside sulfate
presentation: **central and peripheral demyelination + ataxia+ dementia **
what are the two mucopolysacchridoses
hunter’s -XR w/no corneal clouding
hurler’s - AR
Hunter vs. HUrler
which enzymes def?
presentation?
what accumulates?
Hunter: def of alpha-L-iduronidase and presents with developmental delay, gargoylism, airway obstrution, corneal clouding, hepatosplenomegaly
Hurler: def of iduronate sulfatase + mild Hurler’s + aggressive behavior + no corneal clouding
accum for both: heparan and dermatan sulfate
what are 3 high potentcy typical antipsychotics
Try to Fly High
T-trifluoperazine
F - fluphenazine
H - haloperidol
what are 2 low potency antipsychotics?
Cheating Theives are Low
C-chlorpromazine
T-thioridazine
haloperizol + azines
typical antipsychotics
4 clinical uses of typical anti psychotics
schizophrenia (positive symptoms)
psycosis
acute mania
tourette
ADE of typical antipsychotics
- what are the extrapyramidal symptoms
- what are the endocrine ADEs
- what are the three receptors blocked here?
- extrapyramidal: 4hrs - acute dystonia (muscle spasm, stiffness, oculogyric crisis) , 4 day akathisia (restlessness), 4 wk bradykinesia(parkinsonianism), 4 mo tardive dyskinesia (stereotypical oral facial movememnts often irreversible)
- endocrine –>D2 receptor antagonism —>hyperprolactnemia—>galactorrhea
3 recepors: muscarinic - dry mouth, constipation. alpha 1- hypotension, histamine - sedation
what is neuroleptic malingant syndrome and how do you tx?
NMS = rigidity, myoglobinuria, autonomic instabilty, hyperpyrexia
tx: dantroline, D2 agonist (ie bromocriptine)
NMS - think FEVER
Fever
Encephalopathy
V-vitals unstable
E-elevated enzymes
R-rigidity of muscles
what are the 6 atypical antipsychotics
mnemonic: its atypical for old closets to **quietly **risper from **A to Z **
its atypical for old closets to quietly risper from A - Z. olazapine, clozapine, quietapine, risperidone, arirprirazole, ziprasidone
moa of all typical anti-psychotics
block dopamine D2 receptors –> increaed cAMP
ADE of olanzapine/clozapine
weight gain
ADE of clozapine
agranulocytosis + seizure(needs weekly WBC monitoring)
ade of ziprasidone
prolong QT syndrome
what blocks effects of adenosine
theophylline and caffeine
use of Mg2+ in arrhythmias
used in torsades de pointes and digoxin toxicity
how does adenosine work
incraseK+ out of cells —> cell hyperpolarization –> decrease Ica coming into cells. makes your heart stop!
photosensitivity drugs
SAT for phoot
Sulfonamides
amiodarone
tetracycle
which two class of anti-arrhymics predispose to torsades via incrased QT interval (ecompasses ventricular repolarization)?
class III (AIDS = amiodarone, ibutilide, dofelitide, sotalol (note amiodarone not assocaited w/torsades),
class IA(b/c have K+ blocking activity) = dqp = disopyramide, quinindine, procainamide (lupus like syndrome)
what causes increased tox for all class I drugs?
hyperkalemia
what is the equation for collapsing pressure?
P = 2T(surface tension)/r
principle - the smaller the radius, the larger the suface tension
what has a bright red central papule surrrounded by outwardly radiating vessels that blanch w/pressure and refill centrifugally on release due to dilataion of a central arteriole and its superfifical capillary network.
it is estrogen dependent
spider angiomas
cavernous hemangiomas(dilated vascular spaces with thin walled endothelial cells that presetn as soft, blue compressible masses up to a few cm in size) of the brain and viscera are associated with wihch condition?
von Hippel-Lindau disease
what are benign tumors made up of lympahtic cysts and lined by a thin endothelium that present at birth and are most commonly located on the neck and the lateral chest wall?
which 2 conditions are associated with tumors above?
cystic hygromas
turner syndrome
down syndrome
what are small, red cutaneous papules in aging adults that do not regress spontaneously and increased with age and light microscopy would show: proliferation of capillaries and post-cap venules in papillary dermis
cherry hemangiomas
polyuria
polydipsia
polyphagia accompanied by fatigue and weight loss in caucasian young man who is sexually active
type I diabetes
what mediates niacin cutaneous flusing and how can it be prevented?
how does capsaicin reduce pain
niacin flusing mediated by prostaglandings and reduce by giving aspirin
capsaicin reduces pain by decreasing levels of substance P in PNS
