Term
| How many calories per gram fat? |
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Definition
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Term
| How many calories per gram protein? |
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Definition
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Term
| How many calories per gram EtOH? |
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Definition
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Term
| How many calories per gram carbohydrate? |
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Definition
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Term
| where is the aorticopulmonary septum derived from? |
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Definition
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Term
Defective neural crest migration to truncal & bulbar ridges of trucus arteriosus & bulbous cordis is responsible for these 3 cyanotic heart diseases
(there are a total of 5 cyanotic heart diseases) |
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Definition
Tetrology of Fallot
Trucus arteriosus
Transposition of great vessels |
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Term
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Definition
alpha-1 agonist (vasoconstriction)
(can be used in nasal decongestants acutely, but if prolonged, will result in tachyphylaxis) |
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Term
| phenylephrine effect on cardiac function curve/venous return curve |
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Definition
| decrease cardiac output & venous return |
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Term
| What does an AV fistula do to the cardiac function/venous return curves? |
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Definition
Acutely: increases slope of both
Chronically: same as acute, but shifts venous return curve to the right b.c. of renal compensation, which increases vascular volume |
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Term
| NF1 gene location & inheritence |
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Definition
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Term
NF1 manifestations:
- Skin
- Eye
- Bones
- Tumors |
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Definition
- Cafe-au-lait spots (coast of california); axillary/inguinal freckles; neurofibromas (seen on skin & throughout body)
- Lisch nodules (asymptomatic pigmented hamartomas on iris)
- Sphenoid dysplasia; congenital pseudoarthrosis; scoliosis
- meningiomas (may cause neurological Sx of underlying area), gliomas, pheochromocytomas |
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Term
| what 2 cells have elastase? |
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Definition
| Macrophages & neutrophils (azurophil granules) |
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Term
| what decreases elastase action in lung? |
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Definition
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Term
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Definition
| they are non-cilliated cells in the respiratory epithelium. They secrete clara cell secretory protein (CCSP) which inhibits neutrophil recruitment & activation |
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Term
| major component of surfactant |
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Definition
dipalmatoyl phosphatidylcholine (aka lecithin) & Sphingomyelin
L/S ratio >2 indicates fetal lung maturity |
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Term
| pathogenesis of centri/panacinar emphysema |
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Definition
| neutrophils/macrophages secrete elastase --> overwhelms endogenous alpha-1 antitrypsin --> destruciton of lung parenchyma |
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Term
| what do TATA boxes bind & where is it located? |
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Definition
transcription factors & RNA pol II during initiation of transcription
it's usually about 25 bases upstream of beginning of coding region |
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Term
| where is a PDA murmur best heard? |
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Definition
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Term
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Definition
trochlear nerve palsy (trouble walking down stairs, & reading)
usually traumatic or idiopathic |
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Term
| median nerve courses between these 2 forearm muscles |
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Definition
| flexor digitorum superficialis & profundus (lesion = pope's blessing when making fist) |
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Term
| causes of injury of median nerve @ wrist? (3) |
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Definition
suicide attempts
carpal tunnel
trauma to anterior wrist |
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Term
| distal median nerve injury causes this deformity |
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Definition
| claw hand (2nd & 3rd fingers) |
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Term
| this nerve courses between biceps brachii & coracobrachialis |
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Definition
| musculocutaneous (lesion = inability to flex arm) |
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Term
| This nerve courses between flexor carpi ulnaris & flexor digitorum profundus |
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Definition
ulnar
(proximal lesion (i.e. medial epicondial) = paralysis of 4'th & 5'th digits; Disal lesion (i.e. in wrist, medial to hook of hamate) = intrinsic pope's blessing) |
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Term
| this nerve courses through supinator near head of radius |
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Definition
| radial (lesion = wristdrop) |
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Term
| what things push oxygen dissociation curve right? |
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Definition
- 2,3 DPG
- increased temperature
- decreased pH
(think tissue under stress) |
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Term
| what things push oxygen dissociation curve to left |
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Definition
- increase pH
- decreased T
- decreased 2,3 DPG |
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Term
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Definition
HTN, hypernatremia, hypokalemic alkalosis
- muscle weakness from hypokalemia
- parasthesias from hypokalemic alkalosis |
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Term
| hemolytic anemia, hypercoagulable state, and decreased blood counts |
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Definition
paroxysmal nocturnal hemoglobinuria (PNH)
Caused by loss of PIG-A, that codes for glycosylphosphatidylinositol (GPI) anchor for CD55 & CD59, which inactivate complement. |
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Term
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Definition
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Term
| common cause of death in paroxysmal nocturnal hemoglobinuria |
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Definition
| fatal thrombosis (inculding Budd-Chiari) |
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Term
| which class of antiarrhythmics preferentially affect ischemic or depolarized purkinje & ventricular tissue? |
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Definition
Class IB (Lidocaine, Mexilctine, Tocainide)
useful in acute ventricular arrhythmias (esp post-MI) and digitalis-induced arrhythmias & for treatment of Torsades (decrease QT) |
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Term
| Class IA antiarrhythmics SE |
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Definition
quinidine, procainamide, disopyramide
increase QT interval --> exacerbate ventricular arrhythmias/torsades (don't give in MI); thrombocytopenia
quinidine = cinconism
procainamide = drug-induced lupus |
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Term
| class IC antiarrhytmics SE |
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Definition
| significantly prolongs refractory period in AV node; proarrhythmic, especially post MI |
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Term
| digoxin can be used for this arrhythmia |
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Definition
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Term
| adenosine can be used for this arrhythmia |
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Definition
| acute Tx of paroxysmal suprventricular tachycardia |
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Term
| arrhythmia verapamil is used for |
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Definition
| atrial tachyarryhtmias (class IV, slows AV node conduction) |
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Term
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Definition
| sudden decrease in drug response (phenylephrine used for rhinorrhea for a few days straight --> rebound congestion) |
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Term
| Which histone protein lays outside main core? |
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Definition
| H1, important for packing the histone structure: 2x(H2A, H2B, H3, H4) |
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Term
| mental retardation, multiple thrombotic events of large & small vessels (especially in brain), marfan habitus (lens ectopia, elongated limbs, arachnodactyly, and scoliosis) |
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Definition
| homocystinuria (defect of methionine metabolism, caused by cystathionine synthetase deficiency) |
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Term
| failure to thrive, photosensitivity, ataxia, tryptophan in urine |
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Definition
| hartnup disease (can mimic pellagra; remember that tryptophan is needed for de-novo synthesis of NAD+) |
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Term
| >30% of plasma cells in bone marrow? |
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Definition
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Term
| median age of diagnosing multiple myeloma |
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Definition
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Term
| what do you see in the urine in multiple myeloma |
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Definition
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Term
| symptoms of multiple myeloma |
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Definition
1) normocytic, normochromic anemia (from hematopoiesis suppression of neoplastic cells)
2) "punched out" bone lesions associated w/ pain (increased osteoclastic activity from IL1 & IL6 production by neoplastic cells)
3) Hypercalcemia from increased bone destruction & renal failure (fatigue, confusion, constipation)
4) AL amyloid (light chains/bence-jones protein); increased ESR; Amyloidosis can deposit in heart, tongue, & CNS
5) Renal failure: metastatic calcifications |
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Term
| AL amyloidosis is associated with? |
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Definition
multiple myeloma & other monoclonal plasma cell dyscrasias
forms deposits in kidneys (bence-jones), heart, tongue, & CNS |
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Term
| Things that mycobacterium have the prevent phagosome-lysosome fusion |
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Definition
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Term
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Definition
found in mycobacterium, it bridges mycolic acids together (causing the bacteria to grow in cords)
Possession of cord factor is associated w/ virulence, it is responsible for inactivating neutrophils, damaging mitochondria, & inducing release of TNF |
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Term
| what is necessary for mycobacterium virulence? |
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Definition
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Term
These things are associated with?:
antibiotic use (suppress normal flora)
contraceptive use
corticosteroid therapy
uncontrolled diabetes
immunosuppression |
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Definition
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Term
| what drug can cause acquired angioedema? |
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Definition
ACE inhibitors (prevent breakdown of bradykinin)
They are contraindicated in hereditary angioedema |
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Term
| 15 y.o. w/ a Hx of periodic, sudden arrhythmic jerky movements (jumps) |
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Definition
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Term
| 1st line for myoclonic seizures |
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Definition
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Term
| loss of upper extremity pain & temperature sensation, upper LMN signs &/or lower UMN signs & scoliosis |
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Definition
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Term
| what does H.flu need to grow? |
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Definition
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Term
| H.flu serotype that is the worst. What is unique about it's capsule |
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Definition
| type b; has ribose rather than hexose as carbohydrate portion of capsule |
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Term
| high AFP levels in amniotic fluid (4 causes) |
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Definition
| NTDs, omphalocele, gastroschisis, multiple gestation |
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Term
| Triple test and what it can tell you |
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Definition
AFP, Estriol, beta-hCG
NTD: high AFP, normal everything else
Down syndrome: Low Estriol & AFP, high beta-hCG
Edwards: low everything |
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Term
| what is the chemical part of N-acetyl cysteine that makes it an antioxident? |
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Definition
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Term
| anthracycline chemo agents MOA |
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Definition
generates free radicles (related to it's cardiotoxicity profile)
noncovalently intercalates in DNA --> breaks in DNA --> decreased replication |
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Term
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Definition
| dilated cardiomyopathy (cumulative effect): presents with Sx of left & right ventricular CHF |
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Term
| things that can cause restrictive cardiomyopathy |
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Definition
hemochromatosis, amyloidosis, sarcoidosis, radiation
others: endocardial fibroelastosis (congenital) & Loffler's syndrome (fibrosis w/ eosinophilia) |
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Term
| mutation in beta-myosin heavy chain |
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Definition
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Term
| reactivation of TB with this DMARD |
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Definition
TNF-alpha inhibitors (infliximab, etanercept, adalimumab)
- pts must get a PPD prior to starting this biologic
- also more susceptible to fungi & atypical mycobacteria |
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Term
| Second-line Tx for PCP, leishmaniasis, & trypanosome brucei (sleeping sickness) |
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Definition
pentamidine
PCP = TMP-SMX
T.brucei = Suramin
Leismania = Sodium sibogluconate (pentavalent antimony) |
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Term
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Definition
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Term
| Tx for ascariasis, trichuriasis, hookworm, pinworm |
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Definition
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Term
| Vector & Tx for onchocerciasis |
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Definition
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Term
| used to Tx Giardia, E.histolytica, T.vaginalis |
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Definition
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Term
| needed for P.vivax & P.ovale |
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Definition
| Primaquine (to kill latent liver schizonts) |
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Term
tumor seen @ lung periphery, stains for:
neuron specific enolase, chromogranin, and synaptophysin; neurofilaments |
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Definition
Oat-cell carcinoma
(note that these cells can express neuron-like things because they are considered to be "neuroendocrine" in origine) |
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Term
| Lung cancer w/ EGF receptors, mucin, & surfactant associated proteins |
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Definition
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Term
| See vimentin in these types of cancers |
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Definition
sarcomas
(vimentin is an intermediate filament found in mesenchymal) |
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Term
| 55 y.o. person w/ headaches, facial pain, jaw claudication, & visual loss |
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Definition
| giant cell arteritis (granulomatous inflammation of arteries, especially temporal artery) |
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Term
| most common cause of claudication |
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Definition
| atherosclerotic plaques of larger arteries |
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Term
| what does valsalva do to preload? |
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Definition
decreases it, this will increase HOCM & decrease aortic stenosis
HOCM is increased b.c. it further decreases the size of the outflow tract |
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Term
| what does handgrip maneuver do? |
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Definition
| increases afterload: this will decrease HOCM & Aortic stenosis murmurs |
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Term
| holosystolic murmur that's increased w/ handgrip |
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Definition
VSD
MR & MP will also be increased) |
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Term
| obese woman taking fibrates: What 3 things are contributing to gallstone formation |
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Definition
1) high cholesterol
2) estrogen increases HMG-CoA reductase
3) Fibrates inhibit 7-alpha hyroxylase --> unable to convert cholesterol to bile acids
(MOA of fibrates: upregulate LDL receptor --> increase TG clearance; they are very effective at decreasing triglyceride levels) |
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Term
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Definition
antiemetic by 2 mechanisms:
1) block vagus-mediated nausea & vomiting
2) block serotonin in CTZ (area postrema)
1) block 5HT3 receptors in GI tract on Vagus nerve
2) block 5HT3 receptors in CTZ & solitary nucleus |
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