Chlorpropamide 

MOA

Tx

SE

Chlorpropamide is sulfylurea (stimulates beta cells to secrete insulin)

Tx Type II DM

SE of SIADH (high urine Na but low serum Na)

Disulfiram like reaction 

Becks Triad?

Hypotension, muffled heart sounds, JVD

Indicates cardiac tamponade 

EKG -- electrical alteranans 

Walking pneumonia caused by?

CXR findings?

Mycoplasma pneumonia (#1), Leigonella, Chlamidia

CXR -- infiltrates in MULTIPLE lobes

Vs. lobar pneumonia (S. pneumo) -- involves only one lobe

Glucocerebrosidase 

(G - Gauchers, Glucocerebrosidase)

Hyperaldosteronism 

Labs - Hyper Na and Hypo K with low renin levels

Adrenal insufficiency 

Sx - hypo-Na, hyper-K, hyperpigmentation 

Cause of dandruff

Tx with selenium sulfide shampoo

Occurs soon after S2

Due to rapid venricular filling

Normal in pregnancy and children 

Tx endometriosis 

MOA -- inhibits LH and FSH release 

** SE -- hirtuism 

Since it is an aldosterone (androgen) agatonist

Men -- gynecomastia and testicular atrophy

Women -- amenorrhea 

Young woman -- Fibromuscular dysplasia

Old man -- atherosclerosis of renal artery

Dec. renal perfusion --> RAA activation 

Angiotensin II constricts efferent arteriole to maintain GFR

Aldosterone inc. Na/H20 reabsorption with K/H secretion

Indicative of defective corpus luteum (ovary)

At this point in the menstrual cycle -- corpus luteum should be producing all progesterone (responsible for maintaing endometrium for implantation)

*Known as luteal phase deficiency*

Colorado tick fever virus (reovirus -- DS RNA)

Bitten by tick in rocky mountains 

Present with flu like Sx + FEVER

Other reovirus -- Rotavirus (fatal diarrhea in children)

Listeria is cause of newborn meningitis 

(Other causes S. agalactiae, E. coli)

Tumbling motility

Associated with deli meats and dairy products 

Mutation in JAK2

Elevated RBC, WBC, platelets

Decreased EPO

*Pursitis after taking showers*

Selective COX2 Antagonist 

*Fewer GI SE than other NSAIDs*

*Risk thrombosis -- Stroke or MI*

Gastric ulcer blood type?

Duodenal ulcer blood type?

gAstric -- Type A

duOdenal -- Type O

"Take a snapshot of disease at a certain time"

Over represent chronic disease 

Under represent acute disease 

Phosphdiesterase-5-inhibitors -- Sildenafil 

Both increase cGMP --> vasodilation 

When combined, leads to life threatening hypotension

Endometrial hyperplasia is ______ ?

Risk factor 

Proliferation of the glands 

Associated with obesity 

Excess adipose tissue -- Inc. aromatase activity -- Excess estrogen

**Hyperplasia results from unopposed estrogen** 

Leads to myxedema coma

Sx - hypotension + hypo-respirations

Risk for pregnancy 

Why -- OCP are metabolized by P450

Benzodiazepine overdose

Sx

Tx

Sx - slurred speech, dec. respiratory rate, coma

Tx - flumazenil

Causes African Sleeping Sickness

Sx - daytime sleepiness, nightime insomnia, enlarged post. LN

Transmitted by the TseTse fly

Tx - suramin and melarsoprol

Prolactin inhibits GnRH --> decreased LH and FSH

*Hyper-prolactin can be caused by anti-psychotics (DA antagonists)

DA normally inhibits prolactin release 

Treating a patient in a way that ignores his/her interests but aims at promoting thier health

Example: giving blood to a Jehovah's witness

Crystal deposition in the kidneys

*Ethylene glycol OD --> oxalate crystal depositon in kidneys

POXVIRUS

Papules with central umbilication 

Imipenum (ertapenem, meropenem)

Results in inc. seizure incidence

Ab against heparin-platelet factor 4

Tx Direct thrombin inhibitors 

Bivalirudin, lepirudin, dibigatran

Deficienct factor VIII

Commonly presents with hemarthrosis 

Scabies presentation 

Tx

Burrowing and pursitis (most commonly in between fingers)

Tx with Permethrin cream from neck down

Indicates hyperthyroidism (low TSH)

Most commnoly a follicular adenoma 

*Carcinoma of they thyroid -- cold nodule

Achalasia Dx

Tx

Dx with Manometry (reveals inc. LES tone)

Tx pneumatic (balloon) dilation 

Clomiphene

MOA

Tx

SE

Estrogen agonist --> increased LH and FSH

Used for ovulation induction in polycystic ovary syndrome

SE - hot flashes, enlarged ovaries 

GnRH agonist --> decreased levels of FSH and LH

*This decreases estrogen levels*

Tx Uterine leiomyoma, endometriosis, prostate cancer 

Due to defective androgen receptor 

PTs are genotypic males (XY) but phenotypically females

Present with female genitalia and blind vaginal pouch

Decreases function of vWF

Elevated bleeding time and PTT (vWF stabalizes factor VII)

Tx - desmopressin (ADH analog)

SE - hypo-natremia 

Gonadal dysgenesis

(important to know both names for boards)

Streak ovaries, broad chest, webbed neck

Risk co-arctation of aorta and horseshoe kidney

DA receptor antagonists 

Examples

SE

Metoclopramide (diabetic gastroparesis)

Anti-psychotics

SE - Inc. prolactin release 

Peroneal nerve injury 

Levels

Where

Sx

L4-S2

Fracture of fibular neck

Sx - foot drop, loss of eversion, dorsiflexion

MOBILE, painless mass

Responsive to estrogen so may change during menstrual cycle, pregnancy, etc. 

Causes Q fever

Associated with animals 

Causes atypical pneumonia and hepatitis 

INTRACELLAR G - bacteria 

Anti-androgen used in prostate cancer

SE - gynecomastia, impotence, galactorrhea 

Prophylaxis for meningitis 

Eradicates organisma from where?

Rifampin and ciprofloxacin

Eradicates organisms from nasopharynx

Onchocerca volvulus 

Present with blindness and thickened/hyperpigmented skin

Transmitted by blackflies

Diethylcarbazine

*Presents with worm in eye*

pH ↑ 

HCO3 ↑ 

Compensate by HYPO-ventilation (results in ↑  pCO2)

Due to diuretics (furosemide/thiazide), vomitting

OBSTRUCTIVE lung disease 

Cant blow air out --> inc. volume in the lungs 

↓ FEV1/FVC

Almond shaped eyes

Hyper-phagia --> obesity

OCP

Benefit 

Risk

Decreased risk of ovarian cancer

Increased risk of thromboembolism 

Sporotrichosis (Caused by Sporothrix)

Presentaiton 

Tx

Lesion after being pricked by a thorn

Tx Itraconazole (because it is local)

Sleep Walking 

Occurs when?

Tx?

Stage 3 or 4

Tx:

TCAs (inhibit 5HT and NE reuptake)

Benzodiazepines (inc. frequency of GABA)

Both these reduce time spent in stage 3/4

Most common site for subarachnoid hemorrhage

Men?

Women?

Men - anterior communicating artery

Women - posterior communicating artery 

Elevated glucagon

Low AA (because they are shunted to gluconeogenesis)

Nectrotizing migratory erythema (*HIGH YIELD*)

Epididymitis DOC

Under 35

Over 35

Young - ceftriaxone (Neisseria)

Old - Fluorquinolones (E.coli)

Draculanus mediensus

Sx

Transmission

Tx

Worm coming out of an ulcer

Transmitted by contaminated water

Tx with Niridazole

Alpha agonists:

Oxymetazoline

Pseudoephedrine

Phenylephrine

Meningitis in the summer months

Preceeded by influenza like illness

'Bruise like lesions' found on almost 100% of East Asain born babies 

Will regress sponataneously