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step 1 quick hits > weak spots > Flashcards

weak spots Flashcards

1
Q

what is winter’ formula?

A

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.

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2
Q

name the retroperitoneal organs

SAD PUCKER

A

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

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3
Q

what is moa of varenicline

A

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)

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4
Q

what is the kozak sequence?

A

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

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5
Q

contets of Thayer martin media

what is it used to grow?

recall :VPN

A

chocolate agar with:

Vancomyocin - inhibit gram +

Polymyxin - inhibits gram - except Neisseria

Nyastatin to inhibit fungi

used to culture N. gonorrhea or N. meningitidis

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6
Q

fabry’s

defective enzyme:

accumulated substance

findings

A

enzyme: alpha galactosidase A
substance: ceramide trihexoside
finding: peripheral neuropathy, angiokeratomas, cardiovascular/renal disease

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7
Q

gaucher’s diseae

which enzyme

what accumulates

findings

A

MOST common

def of beta-glucocerebrosidease

accum: glucocerebroside

hepatosplenomegaly, aseptic necrosis of feymer, bone crises,

**macros that look like crumpled up tissue paper **

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8
Q

niemann pick picks the liver

which enzyme?

what accumulates

presentation

A

enzyme: spingomyelinase
accum: sphingomyelin
presentation: neurodegenration, **hepatosplenomegaly, cherry-red-spot on macula **

**foam cells **

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9
Q

tay sach’s

which enzyme

what accumlulates

A

enzyme: hexosaminidase A
accum: GM2 ganglioside
presen: cherry red spot on macula NO hepatosplenomegaly, progressive neuro degeneration, **lysosomes w/onion skin, developmental delay **

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10
Q

krabbe’s disease

which enzyme

what accum

presentation

A

enzyme: galactocerebrosidase
accum: galactocerebroside
present: peripheral neuropathy, developmetha delay, optic atrophy, globoid cells

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11
Q

metachromatic leukodystrophy

which enzyme

what accumulates?

A

eznyme: aryl sulfasase A
accum: cerebroside sulfate
presentation: **central and peripheral demyelination + ataxia+ dementia **

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12
Q

what are the two mucopolysacchridoses

A

hunter’s -XR w/no corneal clouding

hurler’s - AR

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13
Q

Hunter vs. HUrler

which enzymes def?

presentation?

what accumulates?

A

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

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14
Q

what are 3 high potentcy typical antipsychotics

Try to Fly High

A

T-trifluoperazine

F - fluphenazine

H - haloperidol

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15
Q

what are 2 low potency antipsychotics?

Cheating Theives are Low

A

C-chlorpromazine

T-thioridazine

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16
Q

haloperizol + azines

A

typical antipsychotics

17
Q

4 clinical uses of typical anti psychotics

A

schizophrenia (positive symptoms)

psycosis

acute mania

tourette

18
Q

ADE of typical antipsychotics

  1. what are the extrapyramidal symptoms
  2. what are the endocrine ADEs
  3. what are the three receptors blocked here?
A
  1. 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)
  2. endocrine –>D2 receptor antagonism —>hyperprolactnemia—>galactorrhea

3 recepors: muscarinic - dry mouth, constipation. alpha 1- hypotension, histamine - sedation

19
Q

what is neuroleptic malingant syndrome and how do you tx?

A

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

20
Q

what are the 6 atypical antipsychotics

mnemonic: its atypical for old closets to **quietly **risper from **A to Z **

A

its atypical for old closets to quietly risper from A - Z. olazapine, clozapine, quietapine, risperidone, arirprirazole, ziprasidone

21
Q

moa of all typical anti-psychotics

A

block dopamine D2 receptors –> increaed cAMP

22
Q

ADE of olanzapine/clozapine

A

weight gain

23
Q

ADE of clozapine

A

agranulocytosis + seizure(needs weekly WBC monitoring)

24
Q

ade of ziprasidone

A

prolong QT syndrome

25
Q

what blocks effects of adenosine

A

theophylline and caffeine

26
Q

use of Mg2+ in arrhythmias

A

used in torsades de pointes and digoxin toxicity

27
Q

how does adenosine work

A

incraseK+ out of cells —> cell hyperpolarization –> decrease Ica coming into cells. makes your heart stop!

28
Q

photosensitivity drugs

A

SAT for phoot

Sulfonamides

amiodarone

tetracycle

29
Q

which two class of anti-arrhymics predispose to torsades via incrased QT interval (ecompasses ventricular repolarization)?

A

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)

30
Q

what causes increased tox for all class I drugs?

A

hyperkalemia

31
Q

what is the equation for collapsing pressure?

A

P = 2T(surface tension)/r

principle - the smaller the radius, the larger the suface tension

32
Q

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

A

spider angiomas

33
Q

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?

A

von Hippel-Lindau disease

34
Q

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?

A

cystic hygromas

turner syndrome

down syndrome

35
Q

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

A

cherry hemangiomas

36
Q

polyuria

polydipsia

polyphagia accompanied by fatigue and weight loss in caucasian young man who is sexually active

A

type I diabetes

37
Q

what mediates niacin cutaneous flusing and how can it be prevented?

how does capsaicin reduce pain

A

niacin flusing mediated by prostaglandings and reduce by giving aspirin

capsaicin reduces pain by decreasing levels of substance P in PNS

step 1 quick hits (15 decks)

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