Term
Getting schizo right:
1) Hates people and is happy with it
2) Crazy lady on the street.
3) Schizophrenic but less that 6 months
4) Schizophrenic + bipolar/depressive mood |
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Definition
1) Schizoid
2) Schizotypal (Schizoid + magical thinking)
3) Schizophreniform
4) Schizoaffective |
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Term
| What is the one exception to accepting a gift? |
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Definition
one time thing w/ small or token value (e.g. cookies)
can't even accept gifts that are free to the patient, but still hold lots of value |
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Term
| Fever, urticaria, arthralgias, glomerulonephritis, lymphadenopathy, low C3 in a pt 5 days after starting a sulfa drug |
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Definition
serum sickness
you see low serum C3 b.c. immune complexes deplete complement components |
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Term
| what type of hypersensitivity is serum sickness? |
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Definition
| type 3: antibody-antigen complexes will deposit in vasculature, joints, & glomerulus (urticaria, arthralgias, glomerulonephritis); also get fever & lymphadenopathy |
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Term
Baby is born with sacral agenesis: lower extremity paralysis, & urinary incontinence. Can range from syrinomyelia to anal atresia
What is this called?
What is a risk factor? |
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Definition
Caudal regression syndrome
Diabetes |
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Term
| Etanercept predisposes to reactivation of this disease |
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Definition
| TB (TNF-alpha inhibitor messes up granulomatous encapsulation) |
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Term
| Piperacillin can be used against pseudomonas & bacteroides |
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Definition
true
Add a beta lactimase inhibitor to obviate resistance (e.g. tazobactam
it is effective against anaerobes (ceftriaxone, quinolones don't work against anaerobes) |
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Term
| Use this antibiotic against Chlamydia, Mycoplasma, H.flu, & Moraxala catarrhalis |
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Definition
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Term
| Can hepatocytes use ketone bodies for energy? |
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Definition
no!
They lack succinyl CoA-acetoacetate CoA transferase (thiophorase): enzyme that transfers an CoA unit onto acetoacetate from succinyl CoA |
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Term
| What headache meds can provoke Prinzemetals angina |
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Definition
Ergot (e.g. Ergonovine) & sumatriptin
can treat an episode of PA w/ nitrates & CCBs |
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Term
| Alk phos is elevated. What is the next step in management? |
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Definition
gGTP level (more specific for liver)
Alk Phos is produced in liver, bone, intestine, kidney, placenta, leukocytes, and some neoplasms |
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Term
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Definition
- general tissue injury (e.g. myocardial infarction)
- Hemolysis
- dx exudate from transudate (>0.6 normal (~200))
- tissue turnover (elevated in cancer)
- High levels in CNS w/ bacterial meningitis
- PCP pneumonia (in aids pt w/ respiratory Sx)
- |
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Term
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Definition
| protease on gut surface epithelium. Needed to activate trypsin, carboxypeptidase, elastase, & chymotrypsin. |
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Term
| Function of Acetyl-CoA carboxylase (ACC)? |
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Definition
- first step in fatty acid synthesis
- biotin-dependent
- found in liver & adipose |
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Term
| what part of fatty acid metabolism can be used for glucose production? what is the only organ that can use it? |
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Definition
Glycerol
Liver (through glycerol kinase: G --> G-3-P) |
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Term
| Fever, Headach, Lethargy, Light sensitivity, Painful extraocular movements are signs for? |
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Definition
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Term
| Defective in Dubin-Johnson? |
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Definition
| excretion of bilirubin glucuronides & other products (cMOAT defect, ATP-dependent enzyme) |
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Term
| Oral bioavailability of isosorbide dinitrite vs mononitrite? |
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Definition
dinitrate undergoes significant 1st pass metabolism
mononitrate is almost 100% bioavailable when taken orally |
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Term
Contraindications for Metformin?
How does Metformin produce lactic acidosis? |
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Definition
- Renal failure
- Hepatic failure
- CHF
- Alcoholism & sepsis
- Metformin hypersensitivity
Metformin increases glycolysis & inhibits gluconeogenesis, this combination increases lactic acid & inhibits the path for its metabolism (i.e. gluconeogenesis). All the contraindications are conditions that may precipitate the lactic acidosis (liver failure, CHF, alcoholism, sepsis) |
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Term
| Muromonab-CD3 (OKT3) MOA & use |
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Definition
anti-CD3
Used to treat acute rejection in pts w/ kidney, heart, or liver transplants. It inhibits activation of TCR (CD3 is needed for proper functioning) |
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Term
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Definition
CD31 (PECAM1) is a marker for vascular endothelium. Can be used to identify a vascular tumor (e.g. hepatic angiosarcoma)
Hepatic angiosarcoma risk factors include: polyvinyl chloride, thorotrast, & arsenic |
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Term
| Severe toxicity of osmotic diuresis (e.g. mannitol) |
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Definition
pulmonary edema
can also cause dilutional hyponatremia & metabolic acidosis, & hyperkalemia (contraindicated in CHF & preexisting pulmonary edema) |
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Term
| differentiate poststreptococcal glomerulonephritis from IgA nephropathy |
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Definition
PSCGN & IgA-N both follow an acute upper respiratory infection.
PSCGN: takes weeks to develop. Reduced plasma C3. subepithelial "humps" (no mesangial involvement)
IgA-N: develops in days. normal plasma C3. Mesangial IgA deposits.
IgA-N can be associated w/ systemic symptoms --> Henoch-Schonlein purpura
-Skin: palpable purpura on dependent parts of body (arms, legs, buttocks)
- GI: abdominal pain, vomiting, bleeding, intussusception
- Renal: IgA nephropathy |
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Term
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Definition
secrete clara cell secretory protein (CCSP) --> inhibit neutrophil recruitment
(may also contribute to surfactant production or be precursors to goblet cells) |
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Term
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Definition
cholinomimetic (muscarinic agonist)
used for urinary retention |
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Term
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Definition
1) no intubation
2) no defibrillation
3) no IV drugs to treat terminal rhythm |
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Term
Name proteins for each phase:
- rolling
- tight binding
- diapedesis
- migration |
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Definition
- Endo=E&P selectings; Lymphocytes=sialyl-lewis X
- E=ICAM-1; L=LFA-1 ("integrins", CD18)
- E=PECAM-1; L=PECAM1
- E=C5a,IL8,LTB4,Kalikren (CILK); L=many (CD44, integrins, etc) |
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Term
| lost in leukocyte adhesion deficiency |
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Definition
|
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Term
| elevated angiotensin converting enzyme levels in serum is a marker for? |
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Definition
| granulomatous diseases (esp good for sarcoidosis) |
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Term
| major immune cell in sarcoidosis? |
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Definition
| CD4 (remember it's a granulomatous infection) |
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Term
| what 2 carpal bones articulate w/ the radius? |
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Definition
|
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Term
| what makes up the right heart boarder on PA chest film? |
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Definition
|
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Term
which nerve is responsible for foot dorsiflexion?
Which nerve supplies sensory innervation for dorsum of foot?
Which nerve everts the foot? |
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Definition
- deep fibular (also supplies sensory between 1st & 2nd toes)
- Superficial fibular
- Superficial fibular |
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Term
| Where is the aminoacid residue attached on the tRNA? |
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Definition
| 3' end (CCA terminal sequence) |
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Term
| Structures unique to tRNA |
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Definition
- Dihidroyuracil residues (D arm)
- anticodon arm (contains mRNA recognition sequence)
- Acceptor stem (5' & 3' ends H-bonded)
- CCA tail (3' end, binds amino acid)
- Pseudouridine residues (T-arm)
- only RNA to have thymidine (T-arm) |
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Term
Needed for wolffian duct maturation?
Needed for mullerian duct regression? |
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Definition
- Testosterone (from Leydig cells)
- MIF (from Sertoli cells) |
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Term
|
Definition
| used to detect capsule of cryptococcus (shows up red) |
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Term
| Rb is activated when hyper or hypophosphorylated? |
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Definition
hypophosphorylated (remember that CDKs promote cell cycle progression)
Rb prevents G1-S |
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Term
| EBV induced B-cell lymphoma is a risk factor for HIV pts? |
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Definition
| yes, reactivation (non-hodgkins) EBV-induced B-cell lymphoma results from decreased CD8+ cell sensitized to EBV (I don't get why) |
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Term
| Lung tumor that causes SVC syndrome? Horners? |
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Definition
- bronchogenic carcinoma (hilar mass)
- Pancoast tumor (superior sulcus) |
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Term
|
Definition
| doxycycline or penicillin-type antibiotics (e.g. ceftriaxone) |
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Term
| 2 bugs that cause non-gonococcal urethritis? |
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Definition
Chalmydia (#1) & Ureaplasma urealyticum; Treat w/ azithromycin (note: U.u can synthesize its own ATP)
(others: Mycoplasma & Trichomonas) |
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Term
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Definition
|
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Term
| describe MAP-kinase signaling pathway |
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Definition
- growth factors bind to receptor tyrosine kinase
- autophosphorylation
- SOS
- Activated RAS (G-protein)
- Activate RAF
- MAP KK --> MAP K |
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Term
Sustained involuntary contraction of muscles? Give 3 examples?
Sudden brief muscle contractions? |
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Definition
- Dystonia; Torticollis>Blepharospasm (also writers cramp)
- Myoclonus (hypnic jerks; commonly seen in epileptics or people w/ Creutzfeldt-Jakob) |
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Term
|
Definition
- muscle glycogenolysis (glycogen --> glucose-1-phosphate)
- clinically see decreased exercise tolerance, myoglobinuria, and muscle pain w/ physical activity |
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Term
| How to differentiate between acute stress disorder & PTSD |
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Definition
<4 weeks = ASD
>4weeks = PTSD
both consist of repeatedly reliving traumatic, life-threatening evens in the form of nightmares or flashbacks. Avoidance of things that remind pt of event. Loss of interest in activities & social detachment. |
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Term
2 classes of antiarrhythmics that prolong QT interval?
which drug doesn't increase risk of torsades? |
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Definition
- Class IA & Class III
- Amiodarone (class III) does not increase the incidence of torsades (but all other IA & III drugs do) |
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Term
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Definition
Triad: (seronegative) arthritis, urethritis, conjunctivitis
can also see:
- Keratoderma Blennorrhagicum (vesicles on hands/feet)
- Balantitis (head of penis rash)
- Sacroiliitis |
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Term
| how do you isolate the supraspinatus? |
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Definition
abduct arms to 90 degrees, Flex 30 degrees, Turn thumbs down
apply pressure in this position |
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Term
| what rotator cuff muscle internally rotates? |
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Definition
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Term
| constipation, dry skin, hair loss, weight gain, low HR |
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Definition
Hypothyroidism
remember that hypothyroidism is a SE of Lithium (also teratogenic & causes ebsteins anomaly) |
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Term
Match these drugs as either universal p450 inhibitors or inducers:
- Rifampin
- Amiodarone
- TMP-SMX
- Phenobarbital
- Phenytoin
- Cimetidine |
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Definition
inducers: Phenobarbitol, Phenytoin, Rifampin
Inhibitors: Cimetidine, TMP-SMX, Amiodarone |
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Term
| Categorize metabolic alkalosis: |
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Definition
1) saline responsive
2) saline resistant
1: 2 causes
(1-a) Loss of hydrogen ions (vomiting/NG suction) --> concurrent loss of Cl- --> low serum Cl --> low urine Cl
(1-b) Diuretic usage --> contraction alkalosis w/ increased urine Cl
2: 1 cause
(2-a) Conn syndrome --> tons of aldosterone --> NaHCO3 resorbed w/ subsequent losses of KCl --> high urine Cl
URINE Cl:
- decreased (<10mEq/L) w/ 1-a (i.e. vomiting)
- increased (>20mEw/L) w/ 1-b & 2 (i.e. diuretics & Conn) |
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Term
| What type of people are susceptible to drug-induced lupus? |
|
Definition
slow acetylators
DIL (anti-histone antibodies) is linked to drugs that are metabolized through acetylation in the liver |
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Term
Name the disease associated w/ each translocation:
- t(8;14)
- t(9;22)
- t(11;14)
- del13q
- t(15;17) |
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Definition
- Burkitt's (c-myc next to Ig heavy chain)
- Philadelphia chromosome (bcr-abl)
- Mantle cell lymphoma (activated cyclin D)
- CLL
- APL (PML/RAR-alpha --> Tx w/ VitA) |
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Term
Genes associated w/ early onset Alzheimers?
Late onset? |
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Definition
- APP (trisomy 21), presenilin1 (Chr14), presenilin 2 (Chr1)
- ApoE4
(aside: presenilin is a component of gamma-secretase, an enzyme responsible for the cleavage of ABeta) |
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Term
|
Definition
| AFP & acetylcholinesterase |
|
|
Term
| Rabies vaccine is what type of vaccine? |
|
Definition
| beta-propiolactone killed vaccine |
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|
Term
| spaghetti & meatballs KOH prep |
|
Definition
malassezia furfur (pityriasis versicolor)
hyper/hypopigmentation esp after sun exposure |
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Term
| first line tx of toxo in AIDS pts |
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Definition
| pyramethamine-sulfadiazine |
|
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Term
| other thing that can cause ring-enhancing lesions in AIDS pt (first is toxo) |
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Definition
CNS lymphoma (e.g. B-cell lymphoma from latent EBV)
other causes of REL: cancers (glioblastoma multiforme), mets, abscesses |
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Term
| Stages of Paget's disease: |
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Definition
1) initial osteoclastic-driven osteolytic stage
2) mixed osteoclastic-osteoblastic ending in predominantly osteoblastic activity
3) burn out, osteosclerotic phase
The etiology has to do w/ a hypersensitive RANKL signaling (NF-kB) in osteoclasts |
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Term
| 2 hyperlipidemia drugs that increase risk of gallstones |
|
Definition
1) bile-acid binding resins (cholestyramine, colestipol, colesevelam)
2) Fibrates (e.g. Gemfibrozil) |
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Term
| What drug do you add to the normal CHF regimine (ACEIs, dig, diuretic) to significantly increase survival? |
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Definition
| spironolactone (b.c. it decreases aldosterone effect of cardiac remodeling) |
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Term
| Chronic rejection of lung looks like this |
|
Definition
| Bronchiolitis obliterans: lymphocytic infiltrate --> necrosis of bronchiolar walls --> fibropurulent exudate & granulomas in bronchioli --> replaced by scar --> lumen obliteration |
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Term
| Risk factors for pancreatic cancer? |
|
Definition
- Age (65-75)
- Smoking (most important environmental RF)
- Diabetes
- Chronic pancreatitis (20+ years w/ disease)
- MEN1, hereditary pancreatitis, HNPCC, FAP |
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Term
|
Definition
| hereditary pancreatitis (trypsinogen gene) |
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|
Term
fatigability (from anemia)
constipation (from hypercalcemia)
bone pain (common in back & ribs)
renal failure |
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Definition
|
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Term
| don't give this cardiac drug w/ COPD or asthma |
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Definition
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