Term
What type of study measures exposure & outcome simultaneously? |
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Definition
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Term
PaCO2 = 1.5x[HCO3] + 8 (+/- 2) |
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Definition
Winter's formula
If Respiratory compensation isn't adequate in metabolic acidosis (e.g. DKA), then you must worry about respiratory depression |
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Term
AML with DIC? What is the translocation? |
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Definition
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Term
How does viridans group strep cause bacterial endocarditis? |
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Definition
It synthesizes dextran mesh from sucrose (same mechanism that it adheres to teeth & causes carries) which adheres to fibrin in a fibrin clot
Thus, S.viridans requires endothelial damage to cause endocarditis. Previous damage to the valves will lead to collagen exposure --> fibrin adherence --> viridans attachment. This is a major concern in pts with valvular damage that undergo dental procedures |
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Term
What additional drug would you put someone with CHF on besides HCTZ & an aspirin |
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Definition
beta blocker (esp carvedilol) --> has been shown to significantly reduce mortality & increase event-free survival.
Beta blockers are recommended for all cases of compensated heart failure, and even in some cases of decompensated. This is a switch in dogma, which used to say B-blockers were contraindicated in CHF)
The drugs that have been proven are carvedilol > metoprolol~bisoprolol. B-blockers w/ intrinsic sympathomimmetic activity (e.g. acebutolol & pindolol) should be AVOIDED. |
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Term
Charcot marie tooth disease etiology? Presentation? |
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Definition
Mutation in genes responsible for the synthesis of myelin (e.g. duplication of PRPP2 --> demyelination); Inherited in an AD fashion
Usually presents as a common fibular (peroneal) palsy (e.g. foot drop). Pts have a high arch, lack of muscle, & claw toes. Normal lifespan is typical (not totally debilitating) |
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Term
What are the mediators of acid secretions in each phase? 1) cephalic (increase secretion) 2) Gastric (increase secretion) 3) Intestinal (Decrease secretion) |
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Definition
1) Vagal-mediated 2) food & stomach distension --> gastrin release --> histamine 3) Peptide YY (inhibits histamine secretion from enterochromaffin cells), Secretin, somatostatin, GIP
CCK decreases stomach emptying, not acid |
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Term
major risk factor in bupropion? what population is especially susceptible? |
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Definition
seizures; bulimics (but everyone is, just bulimics are esp @ risk for whatever reason)
Drugs with significant seizure risk: - Bupropion - INH (if given without B6) - Imipenem |
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Term
common SE of these three drugs: - Bupropion - INH (given without B6) - Imipenem |
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Definition
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Term
What sugar completely bypasses the PFK1 step (rate-limiting step of glycolysis)? |
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Definition
fructose-1-phosphate
aldolase B takes F1P & produces DHAP & Glyceraldehyde (liver only. Other tissues just put a phosphate on it, which is dangerous in its own regard b.c. it can deplete Pi, and cause unregulated glycolysis & lactic acidosis in liver & muscle) |
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Term
impaired intestinal absorption of lysine, arginine, ornithine, & cystine. What is a major concern? |
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Definition
Renal stones (cystine stones) |
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Term
Hib vaccine includes toxoid/surface antigen to induce what part of the immune response? |
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Definition
Ig class switching & memory B-cell production. Also causes T-cell response (cell mediated) |
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Term
slowly expanding, retroperitoneal hematoma after trauma? |
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Definition
pancreatic damage
damage to abdominal aorta would create a rapidly-expanding retroperitoneal bleed |
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Term
L-cystine supplementation of charcoal-yeast extract agar |
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Definition
L.pneumonia
beware water-based cooling systems |
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Term
2 HIV "entry inhibitor" and their MOA |
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Definition
Enfuvirtide: binds Gp41 --> prevents viral penetration (fusion)
Maraviroc: binds CCR5 --> prevents interaction w/ Gp120 --> inhibits viral attachment |
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Term
best way to increase HDL? |
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Definition
niacin (diet & exercise are good, but not the best): decreases liver VLDL secretion & adipose lipolysis |
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Term
The peptidoglycan coat of a G(+) bacteria protects it against osmotic stress. What type of antibiotic would cause a G(+) bacteria to explode when incubated in a hypotonic solution |
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Definition
Beta-lactam antibiotic (e.g. penicillin, cephalosporin) |
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Term
why is thiopental so short acting? |
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Definition
after equilibrium with the brain, it is rapidly redistributed to the skeletal muscle |
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Term
Hemostatic disorder in person who is uremic? |
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Definition
Qualitative platelet disorder. PT, aPTT and platelet counts are all normal |
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Term
Skin disorder associated w/ sarcoidosis |
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Definition
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Term
recurrent pulmonary infections with bilateral absence of vas deferens |
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Definition
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Term
retardation, hypopigmntation (including substatia nigra/basal ganglia), & mousy odor |
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Definition
phenylketonuria; caused by phenylalanine hydroxylase or dihydrobiopterin reductase |
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Term
Endocrine disorder with fatigue, weight gain, & elevated CK |
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Definition
hypothyroidism (mostly CK-MM)
other causes of elevated CK: - statins - autoimmune (poly/dermatomyositis) - muscular dystrophies (duchenne) |
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Term
vasculitis associated w/ polymyalgia rheumatica
PR = bilateral stiffness of shoulder & pelvic girdle, fever, weight loss, & increased ESR |
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Definition
temporal arteritis (giant cell arteritis) |
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Term
PEG is what type of laxative? |
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Definition
osmotic laxitive (similar to lactase deficiency); Mg-containing laxatives are also osmotic |
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Term
Dialysis pt has tingling in her first 3 fingers |
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Definition
carpal tunnel syndrome associated w/ dialysis-associated amyloidosis
other causes of carpal tunnel: - repetitive motions - hypothyroidism - diabetes mellitus - rheumatoid arthritis - dialysis-associated amyloidosis (beta2-microglobulin) |
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