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141
Medical
Graduate
04/04/2013

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Term
What are the short acting benzodiazepines
Definition
Alprazam
Triazolam
Oxazepam
Midazolam
Term
What are the longer acting benzodiazepines
Definition
Medium (estazolam, lorazepam, temazepam)

Long (chlordiazepoxide, dizepam, flurazepam)
Term
Categorize as SSRI, TCA< MAOI, NDRI, or SNRI

Nortriptyline, Selegiline, Bupropion Mritazapine, Fluvoxamine, Doxepin, Phenelzine, Fluoxtein, Comipramine, Imipramine, Amitriptyline, Nefazodone, Milnacipran, Despramine, Sertraline, Venlafaxine, Paroxetine, Tranycypromine, Duloxetine, Citalopram, Desvenlafaxine, Trazodone
Definition
SSRI: Fluoxetine, sertraline, paroxetine, citalopram, fluvoxamine

TCA: Nortriptyline, doxepin, clomipramine, imipramine, amitriptyline, desipramine

MAOI: Selegiline, phenelzine, tranylcypromine

NDRI: Bupropion

SNRI: Venlafaxine, duloxetine, desvenlafaxine, milnacipram, nefazodone

Tetracyclin: Mirtazapine, trazadone
Term
What is Hamm's test?
Definition
Old test used to diagnose Paroxysmal nocturnal hemoglobinuria. Acifidy blood to activate C'
Term
Which porphyria gives you hypertrichosis?
Definition
Porphyria cutanea tarda

(Other clinical signs include blistering cutaneous photosensitivity, tea-colored urine)
Term
Clinical symptoms of acute intermittent porphyria?
Definition
Painful abdomen
Port wine colored urine
Polyneuropathy
Psychological disturbances
Precipitated by drugs
Term
What is the ristocetin assay?
Definition
Used to test for aggregation of platelets in presence of vWF. Negative in von Willebrand's disease
Term
What is the mnemonic for TTP symptoms?
Definition
Nasty Fever Torched His Kidneys

Neutropenia, Fever, Thrombocytopenia, Hemolysis, Kidney Failure
Term
Which CD markers are positive in Reed Sternberg Cells?
Definition
CD15 and CD 30
Term
What is associated with intense itching after showering?
Definition
Polycythemia Vera
Term
What is Reye's Syndrome
Definition
Hepatoencephalopathy after giving aspirin to a child.

Mitochondria abnormalities, fatty liver, hypoglycermia, vomiting, hepatomegaly, coma.

Associated with viral infection (especially VZV and influenza B) treated with asprin.

Decreased beta oxidation by reversible inhibition of mitochondria enzyme.

Avoid aspirin in all children except those with Kawasaki disease.
Term
What does Cilostazol/Dipyridamol do?
Definition
Phosphodiesterase III inhibitor: increased cAMP in platelets, thus inhibiting platelet aggregation, vasodilators.

Used in intermittent claudication, coronary vasodilation, prevention of stroke or TIAs, angina prophylaxis
Term
Which antimetabolite inhibits DNA polymerase?
Definition
Cytyrabine (pyrimidine analog)
Term
Which antimetabolite is an adenosine analog? What is it used to treat?
Definition
Cladribine

resistant to degradation by adenosine deaminase
Term
What are the structures in the retroperitoneum?
Definition
A DUCK PEAR

Aorta and IVC, Duodenum (2nd and 3rd parts), Ureters, Colon (ascending and descending), Kidneys, Pancreas (except tail), Esophagus ( lower 2/3), Adrenal glands, Rectum (lower 2/3)
Term
What does the D-xylose test distinguish between?
Definition
GI mucosal damage from other causes of malabsorption
Term
What transporters are used to transport glucose, galactose, and fructose into the cell?
Definition
SGLT-1 transports glucose and galactose (Na+ dependent)

GLUT-5 transports fructose

All are transported into the blood via GLUT-2
Term
What is the rate limiting step of bile production?
Definition
Cholesterol 7alpha hydroxylase
Term
What are three salivary gland tumors?
Definition
Pleomorphic adenoma (composed of cartilage and epithelium, benign)

Warthrin's tumor (paipllary cystadenoma lymphomatosum, benign, has germinal centers)

Mucoepidermoid carcinoma (most common malignant tumor, mucinous and squamous components, painful mass because of involvement of facial nerve in parotid gland)
Term
What is the Leser-Trelat sign?
Definition
Seborrheic keratoses all over skin. Associated with gastric adenocarcinomas or malignancies of breast, lung, and urinary tract.
Term
What blood typie is associated with intestinal type gastric cancer?
Definition
type A blood.

Commonly on lesser curvature, looks like ulcer with raised margins, associated with H. pylori infection, dietary nitrosamines, achlorhydria, chronic gastritis.

Diffuse type stomach cancer is not associated with H. pylori. Appears with signet ring cells, stomach wall grossly thickened and leathery (linitis plastica)
Term
What is a Sister Mary Joseph's nodule
Definition
Subcuatneous periumbilical metastatis associated with intestinal type stomach cancer.

Krukenberg's tumor is associated with diffuse type.
Term
What is Menetrier's disease?
Definition
Gastric hypertrophy with protein loss, parietal cell atrophy, and increase in mucous cells. Precancerous. Rugae of stomach are so hypertrophied that they look brain gyri.
Term
Where are most diverticula found?
Definition
Sigmoid colon.

NB: False diverticulum include mucosa and submucosa. Zenker's diverticulum (in the esophagus) only involves mucosal.
Term
What tumor is associated with arsenic and polyvinyl chloride?
Definition
Angiosarcoma of the liver

Hepatic adenomas related to OCPS or steroid use.

Cavernous hemangiomas are common, benign liver tumor, typically occur at age 30-50. Biopsy contraindicated because risk of hemorrhage.
Term
How does lactulose help treat hepatic encephalopathy?
Definition
Gut flora degrades lactulose into lactic acid and acetic acid that promote nitrogen excretion as NH4+
Term
What tissues have GLUT1, 2, and 4?
Definition
GLUT 1: insulin independent; RBCs and brain tissue
GLUT 2: bidirectional; beta cells of pancreas, liver, kidney, small intestine
GLUT 4: insulin dependent, adipose tissue, skeletal muscle
Term
What adrenergic agonist increases insulin? Which one decreases insulin?
Definition
Beta2 agonists increase insulin release.

Alpha2 agonists decrease insulin release
Term
What oncogene is associated with neuroblastoma?
Definition
N-myc.
Term
What is Riedel's thyroiditis?
Definition
Thyroid replaced by fibrous tissue. Fixed, hard and painless goiter. Considered a manifestation of IgG-rlated systemic disease.
Term
What is the histologic appearance of subacute thyroiditis versus Hashimoto's thyroiditis?
Definition
Subacute thyroiditis: Mixed cellular infiltrate with occasional multinucleated giant cells.

Hashimoto's thyroiditis: Hurthle cells (pink) with lymphocytic infiltrate with germinal centers. Hashimoto's is associated with B cell lymphoma.
Term
What side effects of opioids do patients gain no tolerance to?
Definition
Miosis and constipation
Term
What is the mechanism of opioid drugs?
Definition
Act as agonists at opioid receptors to modulate synaptic transmission-- open K+ channels, close Ca2+ channels, leads to decrease in synaptic transmission. Inhibits release of ACh, NE, 5-HT, glutamate, substance P
Term
What are two partial mu agonists?
Definition
Butorphanol and Pentacozine.

May lead to withdrawal symptoms in patients dependent or toleratn to morphine/other opioids
Term
Which antiepileptic is contraindicated in porphyria?
Definition
Barbituates
Term
Which stage of sleep is decreased in benzodiazepine use?
Definition
REM
Term
What does poor blood solubility mean in terms of blood/gas partition coefficient?
Definition
Poor blood solubility means low blood/gas partition coefficients
Term
What does the MAC represent and how is it related to potency?
Definition
MAC is the minimal alveolar concentration at which 50% of the population is anesthetized. Varies with age.

Drugs with increased solubility in lipids have a higher potency. This is equal to 1/MAC.
Term
What receptor does ketamine block?
Definition
NMDA receptors
Term
What portion of the ion channel do local anesthetics bind to?
Definition
Local anesthetics block Na+ channels by binding to specific receptors on inner portion of channel. Preferentially bind to activated Na+ channels so most effective in rapidly iring neurons.

Tertiary amine local anesthetics (Lidocaine, mepivacain, bupivacaine) penetrate membrane in uncharged form, then bind to ion channels as charged form.

Cocaine, procain, tetracaine are esters.
Term
What order do you lose sensation with local anesthetics?
Definition
Pain, Temperature, Touch, Pressure
Term
What drugs are used to treat Huntington's disease?
Definition
Tetrabenazine and reserpine-- inhibit VMAT; limit dopamine vesicle packaging and release

Haloperidol-- dopamine receptor antagonist
Term
What signaling pathway is associated with holoprosencephaly?
Definition
Sonic Hedgehog
Term
At what pO2 does cerebral perfusion significantly increase?
At what PCO2 is cerebral blood flow no longer proportional to pCO2?
Definition
pO2 <50 mmHg

pCO2 >90mmHg
Term
What is a Charcot-Bouchard aneurysm?
Definition
Associated with chronic hypertension, affects small vessels (eg in basal ganglia, thalamus)
Term
What drug can you use to prevent vasospasm in subarachnoid hemorrhages?
Definition
Nimodipine (dihydropyridine Ca2+ channel blocker)
Term
What is the timeline of neuronal damage?
Definition
12-48 h: red neurons
24-72 h: necrosis and neutrophils
3-5 days: macrophages
1-2 weeks: reactive gliosis and vascular proliferation
>2 weeks: glial scar
Term
What are the symptoms of normal pressure hydrocephalus?
Definition
Wet, wobbly, and wacky.

Urinary incontinence, ataxia, and cognitive dysfunction
Term
What enzyme defect can cause ALS?
Definition
Superoxide dismutase
Term
What is usually the cause of death in patient with Friedreich's Ataxia?
Definition
Hypertrophic cardiomyophathy

AR trinucleotide repeat (GAA) in gene that encodes frataxin. Leads to impairment in mitochondrial functioning, staggering gait, frequent falling, nystagmus, dysarthria, pes cavus, hammer toes. Loss of spinocerebellar tracts. Presents in childhood as kyphosis.
Term
What does the dorsal motor nucleus do?
Definition
Sends autonomic (parasympathetic) fibers to heart, lungs, and upper GI.
Term
Where does the opthalmic arter go through? Where does the opthalmic vein go through?
Definition
Opthalmic artery: Optic canal

Opthalmic vein: Superior orbital fissure
Term
Where does the middle meningeal artery run through?
Definition
Foramen Spinosum
Term
What is Meniere's disease?
Definition
Peripheral vertigo with vertigo, tinnitus, and hearing loss.
Term
What TCA can be used for OCD?
Definition
Clomipramine
Term
What are the side effects of TCAs?
Definition
Cardiotoxicity, Convulsions, Coma

Also respiratory depression, hyperpyrexia
Term
Treatment for selected psychiatric conditions:

Anxiety
Definition
SSRIs, SNRIs, busprione
Term
Treatment for selected psychiatric conditions:

ADHD
Definition
Methylphenidate, amphetamines
Term
Treatment for selected psychiatric conditions:

Bipolar disorder
Definition
Mood stabilizers (lithium, carbamazepine, valproic acid), atypical antipsychotics
Term
Treatment for selected psychiatric conditions:

Bulimia
Definition
SSRIs
Term
Treatment for selected psychiatric conditions:

Depression
Definition
SSRIs, SNRIs, TCAs, mirtazapine (especially with insomnia)
Term
Treatment for selected psychiatric conditions:

OCD
Definition
SSRIs clomipramine
Term
Treatment for selected psychiatric conditions:

Panic disorder
Definition
SSRIs, venlafaxine, benzodiazepines
Term
Treatment for selected psychiatric conditions:

PTSD
Definition
SSRIs
Term
Treatment for selected psychiatric conditions:

Schizophrenia
Definition
Antipsychotics
Term
Treatment for selected psychiatric conditions:

Social phobias
Definition
SSRIs
Term
Treatment for selected psychiatric conditions:

Tourette's syndrome
Definition
Antipsychotics (haloperidol, risperidone)
Term
What is the treatment for narcolepsy?
Definition
Stimulants (amphetamines, modafenil)
Term
How do beta blockers help in thyrotoxicosis?
Definition
There is a decrease in the effect of sympathetic adrenergic impulses reaching the target organs and a decrease in the rate of peripheral conversion of T4 to T3.
Term
Which immunoglobulin cannot cross the placenta?
Definition
IgM
Term
What is Hartnup disease?
Definition
Hartnup disease can result in niacin deficient due to an excess loss of dietary tryptophan, resulting from defective intestinal and renal tubular absorption of that amino acid.
Term
What neurotransmitter does the opioid receptor stimulate?
Definition
Glutamate
Term
What is the most common cause of fetal hydronephrosis?
Definition
Inadequate recanalization of the ureteropelvic junction
Term
What does Fenoldopam do and what is it used for?
Definition
Dopamine D1 receptor agonist-- coronary, peripheral, renal and splanchnic vasodilation. Decreased BP and increase natriuresis.

Used in malignant hypertension treatment (along with nitroprusside, nicardipine, clevidipine, labetalol)
Term
What are hypertension drugs that are safe in pregnant women?
Definition
Hypertensive Moms Love Nifedifine

Hydralazine, Methyl-dopa, Labetolol, Nifedipine
Term
What is Minoxidil and what are its SE?
Definition
Hypertension drug that opens K+ channels

Toxicities: hypertrichosis, hypotension, fluid retention, reflex tachycardia
Term
What beta blockers are contraindciated in angina?
Definition
Pindolol and acebutolol

Partial beta agonists
Term
Which beta blocker can cause dyslipidemia?
Definition
Metoprolol

Treat with glucagon
Term
Which beta blocker can exacerbate vasospasm in Prinzmetal's angina?
Definition
Propanolol
Term
Why does amiodarone have class I, II, III, and IV effects of antiarrhythmics?
Definition
Alters lipid membrane
Term
What is the mechanism of adenosine?
Definition
Takes K+ out of the cell

Drug of choice for diagnosing/abolishing supraventricular tachycardia. Effects blocked by theophylline and caffeine
Term
What gene is implicated in primary pulmonary hypertension?
Definition
BMPR2
Term
What is the classic triad for pulmonary emboli?
Definition
hypoxemia, neurologic abnormalities, and petechial rash
Term
What is the initial damage in ARDS caused by?
Definition
Neutrophilic substances that are toxic to alveolar wall, activates coagulation cascade and oxygen free radicals.
Term
Which lung cancer is chromogranin positive?
Definition
Bronchial carcinoid tumor
Term
What is transudate?
Definition
decreased protein content. due to CHF, nephrotic syndrome, or hepatic cirrhosis.

exudate has high protein content, cloudy, due to malignancy, pneumonia, collagen vascular disease, trauma
Term
What is the mechanism of action of beclomethasone and fluticasone?
Definition
Inactivates NF-kB, the transcription factor that induces that production of TNF-a
Term
What therapy is especially good for aspiring induced asthma?
Definition
Montelukast, zafirlukast (leukotriene receptor blockers)
Term
What's the mechanism of Bosentan?
Definition
Used to treat pulmonary arterial hypertension Competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance.
Term
What is the mechanism of Dextromethorphan?
Definition
Antitussive, antagonizes NMDA glutamate receptors. Synthetic codeine analog.
Term
Location and function: Gastrin
Definition
G cells (antrum of stomach)

Increases gastric H+ secretion, increases growth of gastric mucosa, increases gastric motility
Term
Location and function: Cholecystokinin
Definition
I cells of duodenum and jejunum

Increases pancreatic secretion, gallbladder contraction, spinchter of Oddi relaxation.

Decreases gastric emptying
Term
Location and function: Secretin
Definition
S cells (duodenum)

increases pancreatic HCO3 secretion and bile secretion

decreases gastric acid secretion
Term
Location and function: Somatostatin
Definition
D cells of pancreatic islets and GI mucosa

Decreases: gastric acid and pepsinogen secretion, pancreatic and small intestine fluid secretion, gallbladder contraction, insulin and glucagon releases
Term
Location and function: GIP
Definition
K cells (duodenum and jejunum)

Exocrine: decreases gastric H+ secretion
Endocrine: increases insulin release
Term
Location and function: VIP
Definition
Parasympathetic ganglis in sphincters, gallbladder, small intestine

Increases: intestinal water and electrolyte secretion, relaxation of intestinal smooth muscle and sphincters
Term
Location and function: Motilin
Definition
Small intestine

Produces MMCs
Term
Location and function: Intrinsic Factor
Definition
Parietal cells (stomach)

Vitamin B12 binding protein
Term
Location and function: Gastric acid
Definition
Parietal cells of stomach

decreases stomach pH
Term
Location and function: Pepsin
Definition
Chief cells of the stomach

Protein digestion
Term
Location and function: HCO3
Definition
Mucosal cells of stomach, duodenum, salivary glands, pancreas and Brunner's glands of duodenum

Neutralizes acid
Term
What is the genetic abnormality that primarily affects hemochromotasis?
Definition
HFE is on the short arm of chromosome 6 and encodes for a molecule that affects iron absorption from the GI tract.
Term
How is copper excreted from the body?
Definition
Absorbed copper is used to form ceruloplasmin. Senescent ceruloplasmin and unabsorbed copper are secreted into bile and excreted into stool.
Term
Why do Klinefelter patients get gynecomastia?
Definition
Increased plasma FSH
Term
After a blood transfusion, why may a patient present with hypocalcemia?
Definition
Patients who receive more than one body blood volume of whole blood (5-6 liters) may develop elevated plasma levels of citrate, which would chelate calcium and magnesium and cause paresthesias.
Term
How long does cardiomyocyte contractility last after onset of total ischemia?
Definition
60 secs. After 30 minutes of total ischemia, ischemic injury is irreversible.
Term
What causes decrease in renin with beta blockers?
Definition
Beta-1 receptor blockade on JGA cells.
Term
What are the non-selective alpha and beta blockers?
Definition
Carvedilol and labetolol
Term
What are the partial beta agonists?
Definition
Pindolol, Acebutolol
Term
What disease is associated with HLA-A3?
Definition
Hemochromotosis
Term
What disease is associated with HLA-B27?
Definition
PAIR
Psoriatic arthritis, Ankylosing Spondylitis, Inflammatory Bowel Disease, Reiter's Syndrome
Term
What disease is associated with HLA-DR2/DQ8?
Definition
Celiac disease
Term
What disease is associated with HLA-DR2
Definition
Multiple Sclerosis, hay fever, SLE, Goodpasture's
Term
What disease is associated with HLA-DR3
Definition
DM type 1, Grave's Disease
Term
What disease is associated with HLA-DR4
Definition
Rheumatoid Arthritis,DM type 1
Term
What disease is associated with HLA-DR5
Definition
Pernicious anemia, Hashimoto's thyroiditis
Term
Which immunosuppressant has a SE of being neurotoxic?
Definition
Tacrolimus (FK506)
Term
Which immunsuppressant inhibits mTOR by binding to FK binding protein?
Definition
Sirolimus (rapamycin)
Term
What immunosuppressant is a guanine nucleotide inhibitor?
Definition
Mycophenolate.

Inhibits inosine monophosphate dehdrationase
Term
What is aldesleukin and what is its clinical use?
Definition
Interleukin 2 recombinant

RCC, metastatic melanoma
Term
What is Oprelvekin and what is its clinical use?
Definition
Recombinant IL-11

Thrombocytopenia
Term
What are four causes of renal papillary necrosis?
Definition
1. Sickle Cell Disease
2. Acute Pyelonephritis
3. Diabetes Mellitis
4. Drugs (Phenacetin)
Term
What are the toxicities of furosemide?
Definition
OH DANG

Ototoxicity, hypokalemia, dehydration, allergy, nephritis (interstitial), gout
Term
What are the toxicities of HCTZ?
Definition
GLUC

Hyperglycemia, hyperlipidemia, hyper uricemia, hypercalcemia, sulfa allergy
Term
What kind of autoantibodies are Anti-Ro and Anti-La?
Definition
Anti-ribonucleotide antibodies found in Sjogrens Syndrome
Term
What kind of tumors have "palisading nuclei"?
Definition
Basal Cell Carcinoma
Term
What type of inflammatory cell is also found in bullous pemphigoid?
Definition
Eosinophils
Term
What diseases are erythema nodosum associated with?
Definition
Sarcoidosis, coccidioidomycosis, histoplasmosis, TB, streptococcal infections, leprosy, Crohn's disease
Term
What type of T cells is polymyositis associated with?
Definition
CD8 T cells, endomysial inflammation, most often involves shoulders.
Term
What type of T cells is dermatomyositis associated with?
Definition
CD4 cells, increased risk of occult malignancy. Perimysial inflammation and atrophy.
Term
What is vemurafenib?
Definition
A BRAF kinase inhibitor, may be useful in melanoma treatment.
Term
What is Meig's syndrome?
Definition
Triad of fibroma, hydrothorax, and ascites.
Term
What affects girls <4 years old and presents as spindle shaped tumor cells that are desmin positive in the vagina?
Definition
Sarcoma botryoides.
Term
Which ovarian germ cell tumor has early hemotagenous spread to lungs?
Definition
Choriocarcinoma.
Term
What penile pathology presents with inflammation of the glans penis?
Definition
Balanitis
Term
What penile pathology presents with bent penis due to acquired fibrous tissue formation?
Definition
Peyronie's disease
Term
What penile pathology presents with grey crusty solitary plaque on genitals with a risk of squamous cell carcinoma?
Definition
Bowen disease

Bowenoid papulosis-- multiple pauplar lesions which do not become invasive.
Term
What penile pathology leads to red velvety plaque usually involving the glans penis?
Definition
Erythroplasia of Queyrat
Term
What are two aromatase inhibitors?
Definition
Anastrozole/ exemestane
Term
What is tamusolin?
Definition
alpha 1 anagonist used to treat BPH by inhibiting smooth muscle contraction.
Term
What are two indications for danazol?
Definition
Partial androgen agonist used for endometriosis and hereditary angioedema.
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