Week 1 Flashcards
What infections are associated with reactive arthritis?
Campylobacter, shigella, salmonella, yersinia, bordetella, chlamydia
What kind of study assesses for odds ratio? How is it calculated?
Case-control; ad/bc
At what sites in the CNS can an UMN lesion occur?
Internal capsule, precentral gyrus, midbrain, pons, medulla, cerebrospinal tracts
What is cladibrine?
It is a purine analog that is resistant to adenosine deaminase. It used for the treatment of hairy cell leukemia.
What infectious agents typically cause septic arthritis (3)? What is the drug of choice?
S. aureus, streptococcus, N. gonorrhoeae. Ceftriaxone
What is the first-line treatment for partial seizures?
Carbamazepine
What is the treatment for tonic-clonic seizures?
Phenytoin, carbamazepine, valproate
What is the first-line treatment for myoclonic seizures?
Valproate
What is the treatment for absent seizures?
Ethosuxamide followed by valproate
What microbe contains lecithinase? What does it cause?
Clostridium perfringes. It causes cell lysis (hemolysis), edema, and necrosis (gas gangrene)
What is the MOA of the diphtheria toxin? What does it cause? What other toxin is similar to diphtheria toxin?
It inhibits EF-2, preventing protein synthesis. It causes pseudomembrane pharyngitis, cervical LA, and severe myocarditis. P. aeruginosa’s exotoxin A is very similar.
What is unique about the murmurs of mitral valve prolapse and hypertrophic cardiomyopathy?
They do not increase with maneuvers that return blood to the heart and they do not diminish with maneuvers that decrease blood flow to the heart.
What is unique about the murmurs of VSD? What other murmurs share this feature?
It increases with the handgrip maneuver. This also occurs with the murmurs of aortic regurg and mitral regurg.
What is the MOA of daptomycin? What is its clinical use? For what infections is it ineffective?
It disrupts bacterial membranes by inserting channels in their membranes. It used for skin infections and bacteremia caused by MRSA. It is ineffective against gram (-) bugs.
What drugs induce P450?
Rifampin, phenobarbital, phenytoin
What drugs inhibit warfarin metabolism?
Amiodarone (inhibits P450), cimetidine, TMP/SMX, erythromycin
What drug slows AV node conduction by stimulating the vagus nerve?
Digoxin
What is a dangerous side effect of nitroprusside? What are the signs of this side effect? How can it be countered?
Nitroprusside can be metabolized to CN-, which presents w/ lactic acidosis and altered mental status. Countered with sodium thiosulfate
What are patients with Paget’s disease at risk of developing?
Osteosarcoma
Procainamide: what class?
Class Ia
Disopyramide: what class?
Class Ia
What class of antiarrhythmics are useful for ventricular arrhythmia and digoxin-induced arrhythmias?
Class Ib Na channel blockers
What antiarrhythmics significantly prolong the AV node refractory period making them contraindicated s/p MI?
Class Ic Na channel blockers
Flecainide: what class?
Class Ic Na channel blocker
Propafenone: what class?
Class Ic Na channel blocker
What drugs are useful for SVT that progress to ventricular fibrillation?
Class Ic Na channel blocker
Sotalol: what class?
Class III K channel blocker
Bretylium: what class?
Class III K channel blocker
What antiarrhythmics are useful for v-tach, v-flutter, and slowing ventricular rate in a fib and a flutter?
Class II β blockers
What drugs are useful for preventing nodal arrhythmias?
Class IV Ca channel blockers
What drug is useful for quickly abolishing SVT? How does it work?
Adenosine. It is a fast-acting drug that increases K efflux, hyperpolarizing the cell and decreasing Ca current
Name the intoxication: clammy skin, lethargy, constricted pupils, nausea, euphoria
Heroin
Name the intoxication: tachycardia, HTN, anxiety, tremor, hallucination, sweating, dry mouth
Amphetamine
Name the intoxication: tachycardia, HTN, tremors, twitching chest pain, irritability, delusion
Cocaine
Name the intoxication: detachment, vertigal nystagmus, ataxia, paranoia
Phencyclidine
Name the intoxication: bradycardia, decreased BP, confusion, sedation, mild amnesia, slurred speech
Benzodiazepine
Name the intoxication: tachycardia, dilated pupils, confusion, hallucination, disorientation, tremor
LSD
How is chronic granulomatous dz diagnosed?
Neutrophils are unable to reduce nitroblue tetrazolium
Where is the most common site of osteomyelitis? Why?
Metaphysis of long bone because of the rich vascular supply
Describe the effect of fibrates (Gemfibrozil).
Upregulates lipoprotein lipase, which increases triglyceride clearance
What drugs increase risk of myopathy when taken with statins and increase the risk of gallstone when taken with acid-binding resins?
Fibrates (Gemfibrozil)
How is theophylline intoxication treated?
Gastric lavage, activated charcoal, β blockers for arrhythmia, and benzos/barbs for seizures
What are the normal gas partial pressures for inspired air, tracheal air, alveolar air, and venous blood?
Inspired air: PO2 = 160
Tracheal air: PO2 = 150
Alveolar air: PO2 = 104; PCO2 = 40
Venous blood: PO2 = 40, PCO2 = 45
When the content of alveolar air matches the content of tracheal air, what does it represent?
Perfusion deficit
When the content of alveolar air matches the content of venous blood, what does it represent?
Ventilation deficit
What drugs can cause pancreatitis?
Sulfasalazine, azathioprine, furosemide, valproate
What infections can cause pancreatitis?
Mumps, EBV, VZV, coxsackie, TB, mycoplasma
PAH clearance is used to estimate what?
Renal plasma flow
Inulin clearance is used to estimate what?
GFR
What is a normal filtration fraction?
About 20 percent
What is the quad screen for trisomy 18?
Decreased αFP, decreased βHCG, decreased estriol, normal inhibin A
What is the quad screen for trisomy 13?
Normal αFP, βHCG, estriol, and inhibin A
This drug is a 5HT1α agonist used for anxiety that requires 2-3 weeks to be effective. What are its advantages?
Buspirone. It is not associated with addiction, sedation, or tolerance.
What is the standard treatment for urethritis?
Ceftriaxone to cover gonorrhea; azithromycine or doxycycline to cover chlamydia
What are the S/S of serotonin syndrome?
Neuromuscular: rigidity, myoclonus, hyperreflexia
Autonomic: diaphoresis, flushing, tachycardia, hyperthermia
CNS: confusion and agitation
What drugs can cause serotonin syndrome (8)?
SSRIs, SNRIs, TCAs, MAOIs, tramadol, ondansetron, linezolid, triptans
What are the actions of thiamine?
Cofactor for pyruvate DH, αKG-DH, transketolase, branched-chain AA DH
What is the purpose of pyridoxine?
Decarboxylation reactions, transamination, glycogen phosphorylase and synthesis of cystathionine, histamine, GABA, heme, and niacin
Describe the presentation of rubella.
Fever, LA (postauricular and occipital), mild flu-like illness followed by rash that spreads from forehead to face to torso to extremities (lasts 3 days)
Name the class: tranylcypromine
MAOI
Name the class: isocarboxazid
MAOI
Name the class: phenelzine
MAOI
What drugs are antiandrogenic? What are their MOAs?
Finasteride (5α reductase inhibitor), flutamide (steroid receptor antagonist), ketoconazole (inhibits desmolase), spironolactone (blocks steroid binding)
What is the quad screen results for a fetus with Down syndrome?
Decreased αFP, increased βHCG, decreased estriol, increased inhibin A
A lacunar infarct of the VPL or VPM causes what?
Pure sensory loss
A lacunar infarct of the base of the pons causes what?
ataxia-hemiplegia syndrome or dysarthria-clumsy hand syndrome
A lacunar infarct of the posterior limb of the internal capsule causes what?
Hemiparesis
A lacunar infarct of the of the internal capsule causes what?
Dysarthria-clumsy hand syndrome.
What grows on Thayer-Martin VCN agar?
N. gonorrhoeae
What is the function of DNA polymerase I?
Prokaryotic. Degrades RNA primer (5’ to 3’ exonuclease) and fills in the gap with DNA. Proofreads w/ 3’ to 5’ exonuclease.
What is the function of DNA polymerase III?
Prokaryotic. Elongates 5’ to 3’. Proofreads each added nucleotide with 3’ to 5’ exonuclease.
What is the function of DNA polymerase α?
It synthesizes the RNA primer.
What is the function of DNA polymerase δ?
Catalyzes DNA elongation, and proofreads 5’ to 3’.
What is the function of DNA polymerase ε?
It fills in the gaps on lagging strand and proofreads 5’ to 3’.
What are the distinguishing features of pseudomonas aeruginosa?
Motile, aerobic, gram (-) rod, oxidase (+), lactose non-fermenter, produces procyanin, produces endotoxin and exotoxin A
What antibiotics are effective against pseudomonas (6)?
Aminoglycosides, antipseudomonal penicillins, 3rd gen cephs, imipenem, aztreonam, quinolones
What can be used to treat Alzheimer’s?
ACh agonists (donepezil), NMDA antagonists (memantine), neuroprotective antioxidants (vit. E)
