Wed jul 15 Flashcards
MOA of hydralazine?
anteriolar vasodilator
metoprolol MOA
cardioselective beta blocker - blocks B1
how long does it take for a drug metabolized by first order kinetics to reach steady state?
4-5 half lives
what murmur is heard with an ASD?
fixed splitting of S2
what murmur is heard with a VSD?
holosystolic murmur best heard at lower left sternal border
which drug is used to treat malignant hyperthermia?
dantrolene
MOA of dantrolene?
inhibits intracellular Ca release from the abnormal RYR receptor
what is the osmolarity of the fluid in the PCT?
Isotonic with plasma - about 300mOsm/L
in which part of the nephron is the fluid the most dilute?
DCT
how hypertenoic may urine become in the presence of ADH?
up to 1200 mOsm/L - mediated by ADH causing water reapsorption in the CD
which type of drugs follow the multicompartment model of distribution?
highly lipophilic drugs (such as propofol)
how will drug concentrations that follow the multicompartment model of distribution change over time?
Following a bolus dose the drug will first be high in the central compartment (blood) but rapidly spread to well-perfused organs (brain, heart, lungs). Over time the drug redistributes to less-well perfused organs such as skeletal muscle, fat, bone etc.
at which rib do the lungs end at the midclavicular line? Mixaxillary line? Paravertebral?
Midclavicular - 6th
Midaxillary - 8th
Paravertebral - 10th
Where should paracentesis be performed at the midclavicular line? Mixaxillary line? Paravertebral?
Midclavicular - below the 6th rib
Midaxillary - below the 8th rib
Paravertebral - below the 10th rib
atopic dermatitis is associated with loss of function mutations in…
filaggrin and other epidermal barrier proteins
mutations in what protein are responsible for epidermolysis bullosa simplex?
keratin genes
which pathogen causes linear ulcerations of hte esophagus?
CMV
which pathogen causes punched out ulcerations of hte esophagus?
HSV
what does the a wave in a JVP tracing represent?
atrial contraction
Under which condition will the a wave of a JVP tracing be absent?
atrial fibrillation
which specific mutation is responsible for sickle cell disease?
A point mutation on the beta globin gene that results in valine being replaced with glutamic acid
ingestion of pesticides/insecticides (possibly through contaminated water) may lead to which type of poisoning?
arsenic poisoning
which processes does arsenic poisoning disrupt?
binds to sulfhydryl groups on enzymes disrupting cellular respiration and gluconeogenesis
acute arsenic poisoning presentation?
garlic breath, vomiting, watery diarhea, QT prolongation
chronic arsenic poisoning presentation?
hyper/hypopigmentation, hyperkeratosis, stocking glove neuropathy
treatment of arsenic poisoning?
dimercaprol or DMSA
what chelating agent is used to treat iron overload?
deferoxamine
which cells produce anti-mullerian hormone?
sertoli cells
which cells produce testosterone?
leydig cells
which gene codes for testes determining factor?
SRY on Y chromosome
in the absence of the SRY gene, what will happen to gonads?
they will develop into ovaries
which subtype of ovarian cancer is associated with increased CA-125?
epithelial ovarian cancer
alpha fetoprotein may be increased with which types of cancer?
germ cell tumours of the ovaries and HCC
coffee bean nulcei and call-exner bodies are characteristic of which ovarian cancer?
Granulosa cell tumours (stroma - sex cord)
a mutatino of what may be implicatd in ALS?
copper-zinc superoxide dismustate 1 (SOD1)
what causes a right shift of the oxy-hemoglobin curve?
Increased H (decreased pH)
Increased 2,3BPG
Increased temperature
which enzyme is commonly deficient in homocystinuria?
cystathione beta-synthase
what is the cofactor for cystathione beta-synthase
B6
how does a transudative effusion compare to an exudative effusion?
it will have lower protein and lower LDH
fibrates MOA?
fibrates activate PPARalpha which decreases VLDL production and increase LPL activity (which hydrolyzes triglycerides in chylomicrons and VLDL to release FFA for storage or use by the cells)
how does cortisol exert its permissive effects on norepinephrine?
it upregulates alpha 1 receptors
treatment for scabies?
permethrin
CGG trinucleotide repeats are characteristic of which syndrome?
Fragile X syndrome
pathophys of lytic bone lesions seen in multiple myeloma?
Multiple myeloma directly stimulates osteoCLASTS by production RANKL and destroying OPG (decoy receptor) and also secrete cytokines that inhibit osteoblasts
