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Misc from UW


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What drugs have anticholinergic effects?
-atropine -TCAs -H1 blockers -atypical antipsychotics -antiparkinsonian meds
What is Chvostek's sign?
-twitching of ipsilateral facial muscles upon tapping facial nerve -indicates hypoCa
What is Trosseau's sign?
-carpal contractions provoked by inflating BP cuff>SBP for >3min -indicates hypoCa
Bones, stones, groans, and moans are signs of ______.
hyperPTH -painful bones -renal stones -abdominal groans -psychic moans
CD4 TH1 cells drive ______ and secrete _______.
-cell-mediated immunity -IL-2, IFNgamma
CD4 TH2 cells drive _______ and secrete ________.
-humoral immunity -IL-4, IL-5
Wiskott-Aldrich syndrome
-impaired function of both T and B cells -thrombocytopenic purpura -eczema -mainly IgM low
The ______ ______ nerve is the most commonly injured nerve of the leg. It can be damaged in fractures of the ________. Damage results in:
-common peroneal -head of the fibula -foot drop (loss of dorsiflexion and eversion), loss of sensation in dorsum of foot
In the female, ___ stimulates ____ to convert androgens to estradiol.
-FSH -granulosa cells
In the female, ___ stimulates ____ to convert XOL to androgens.
-LH -theca interna cells
Niemann-Pick disease
-sphingomyelinase deficiency -AR, Ashkenazi Jews -foamy histiocytes accumulate in liver, skin, spleen, CNS (--> neurological degeneration) -loss of prior motor skills -cherry red macular spot (as in Tay-Sachs) -hypotonia and blindness by age 1, death by age 3
In HbS, _______ replaces glutamate. In HbC, ________ replaces glutamate.
-valine (nonpolar) -lysine (+)
What diabetic meds cause hypoglycemia?
insulin and sulfonylurea
What diabetic med causes fluid retention and weight gain?
TZDs (pioglitazone, etc.)
What diabetic med causes lactic acidosis?
What diabetic med causes agranulocytosis?
What are some factors that precipitate isolated incidents of AF?
-binge alcohol consumption -increased sympathetic tone to the heart -pericarditis
What are some common inhibitors of cyt p450?
-azole antifungals -cimetidine -ciprofloxacin -erythromycin -grapefruit juice -ritonavir
What are some inducers of cyt p450?
-phenobarbital -phenytoin -rifampin
eczematous dermatitis
erythematous, papulovesicular, weeping, encrusted lesions that may evolve into thickened, scaly plaques; prone to bacterial superinfxn -allergic contact dermatitis -atopic dermatitis -photo-eczematous dermatitis -drug-induced eczematous dermatitis -primary irritant dermatitis
-epidermal accumulation of edematous fluid in intercellular spaces -edema can eventually form intraepithelial vesicles by tearing desmosomes apart -assoc with allergic contact dermatitis
-abnormal, premature keratinization -strongly eosinophilic -small, basophilic nuclear remnants -assoc with squamous cell carcinoma
-retention of nuclei in stratum corneum -normal only in mucous membranes
-granulation in stratum granulosum -assoc with lichen planus
LPL deficiency
-results in hyperchylomicronemia Presentation: -hyperlipidemia -pancreatitis (abd pain) -lipemia retinalis -eruptive skin xanthomas (yellow papules on extensor surfaces of extremities) -hepatosplenomegaly
familial hyperXOLemia
-tubular/tendon xanthomas -xanthelasmas -increased risk for premature CAD
-IV agent that dilates arteries and causes natriuresis -D1 receptor agonist
can cause hyperprolactinemia and amenorrhea
halothane hepatotoxicity
type 1: elevated LFTs, mild or no sx type 2: severe or fulminant hepatitis, eosinophilia,markedly elevated LFTs, prolonged PT
autoimmune d/o with inflammatory myopathy and cutaneous involvement -Gottron papules - on bony prominences of fingers -heliotrope rash - on upper eyelids and periorbital area -proximal muscle weakness -elevated CK -ANA(+) - nonspecific -anti-Jo1 Abs - specific
What are some symptoms of left-sided CHF?
dyspnea on exertion orthopnea paroxysmal noctural dyspnea
What are some symptoms of right-sided CHF?
hepatomegaly lower extremity edema
fibrous intimal thickening with endocardial plaques
heart disease resulting from CARCINOID SYNDROME -skin flushing -abdominal cramping -N/V -diarrhea due to secretion of 5-HT, kallikrein, BK, histamine, prostaglandins, tachykinins by carcinoid tumors
only statin that is NOT metabolized by CYP 3A4
only macrolide that does NOT inhibit CYP 3A4
formula for calculating respiratory compensation for metabolic acidosis
PaCO2 = 1.5(HCO3) + 8 +/- 2
niacin interactions
-potentiate effects of anti-hypertensives -inc insulin resistance --> inc need for diabetes meds -inc uric acid
medullary sponge kidney (MSK)
-common and benign congenital disorder -cystic dilations of medullary collecting ducts -Cx: kidney stones, hematuria, UTI
-purpuric rash on lower extremities -colicky abdominal pain -polyarthralgia
HSP male kids 3-11
use ____ to monitor unfractionated heparin
use ___ to monitor warfarin therapy
Vit K dependent clotting factors
-adult-onset asthma -eosinophilia -hx of allergy -mono or polyneuropathy -migratory or transient pulmonary infiltrates -paranasal sinus abnl's
Churg-Strauss syndrome
endocarditis after GU procedures
E. faecium growth in bile and 6.5% NaCl
endocarditis assoc w/ colonic malignancy
S. bovis growth in bile but NOT 6.5% NaCl
wrist drop
radial nerve damage
block plt ADP receptors needed for activation, aggregation, fibrin binding
migratory thrombophlebitis
CA of pancreas, colon, lung
amphotericin B
NEPHROTOXIC (dec GFR, toxic to tubular epi) --> anemia electrolyte abnl's hypoK hypoMg
-T wave flattening -ST depression -U waves -PVC, PAC
ECG changes in hypoK
Potter syndrome
oligohydramnios cause: renal agenesis effects: pulmonary hypoplasia, limb deformities, characteristic facies
What cells make IFNa and b? What about IFNg? What do IFNs do?
-many euk cells -T cells and NK cells -stimulate production of antiviral proteins that interfere with viral protein synthesis
hypersensitivity of DNA to cross-linking agents
Fanconi anemia
hypersensitivity of DNA to UV light
xeroderma pigmentosum -premature skin aging -inc susceptibility to skin CA
defect of mismatch repair enzymes
general chromosomal instability
Bloom syndrome
cerebellar atrophy oculocutaneous telangiectasia immunodeficiency - repeated sinopulmonary infxns inc risk of CA
ataxia-telangiectasia AR defect in DNA repair DNA is hypersensitive to ionizing radiation
calcified cystic tumors with cholesterol crystals
craniopharyngioma stratified squamous epi keratin pearls
Rathke's pouch
evagination of ectoderm that lines fetal oral cavity forms adenohypophysis (neuroectoderm forms neurohypophysis)
MVP displaced lens aortic root dilation aortic dissection
Marfan syndrome also ADPKD, berry aneurysms
short stature, shield chest, webbed neck lymphedema CV malformations: coarctation of aorta, bicuspid aortic valve, aortic dissection streak ovaries
Turner syndrome
____ causes aortic aneurysms. ______ causes aortic dissection. ______ causes vaso vasorum obliteration.
-atherosclerosis -HTN -syphilis
RFs for osteoporosis
-smoking -menopause -Caucasian race -low body weight -alcohol use -little physical activity -glucocorticoids
common cx of gram(-) sepsis
DIC -elevated PTT and PT -dec fibrinogen -inc D-dimers
microtubule-assoc, ATP-powered motor prot involved in anterograde transport of NT
DIC: -pts bleed -coagulation cascade activated -prolonged PTT and PT -dec fibrinogen TTP-HUS -pts do not bleed -only plts activated -nl PTT, PT -nl fibrinogen other sx: -fever -thrombocytopenia -microangiopathic hemolytic anemia -CNS sx in adults (HUS) -renal failure in kids (HUS)
vWF dz
inherited results in factor VIII deficiency, prolonged PTT
paroxysmal nocturnal hemoglobinuria
C' mediated hemolytic anemia with thrombocytopenia and leukocytopenia
gray vaginal discharge and clue cells (squamous epi cells covered with smaller cells)
Gardnerella vaginosis tx: oral metronidazole
2 toxins that ADP-ribosylate EF2
P. aeruginosa exotoxin A diphtheria toxin (pharyngitis with exudates - upper respiratory tract illness characterized by sore throat, low fever, and an adherent membrane (a pseudomembrane) on the tonsils, pharynx, and/or nasal cavity)
granulosa-theca cell tumor
-5% of all ovarian tumors -classified as sex-cord-stromal tumors -postmenopausal women -mostly granulosa cells --> secrete estrogen --> precocious puberty, FCC, endometrial hyperplasia, endometrial carcinoma
ash-leaf patches renal angiomyolipomas cortical tubers subependymal hamartomas facial angiofibromas cardiac rhabdomyomas
tuberous sclerosis AD
cerebellar hemangiomas liver cysts high risk of renal cell carcinoma
Von Hippel-Lindau
most common side effect of oral glucocorticoids (e.g. flunisolide)
oral candidiasis systemic effects at higher doses: inc IOP cataracts bone loss, growth retardation suppression of HPA
treat high LDL
statins, then ezetimibe
treat high TG
fibrates, then niacin
treat low HDL
NE works at all adrenergic R's except
opiate anti-diarrheal, related to meperidine
nonselective B blocker a1 blocker
bilateral acoustic neuromas multiple meningiomas, gliomas, ependymomas of SC
Candida albicans in immunosuppressed pts
R-sided endocarditis renal abscess pneumonia esophagitis
Malassezia furfur Microsporium canis
cutaneous mycoses
facial and periorbital pain headache purulent nasal discharge
mucormycosis Mucor, Rhizopus, Absidia
alpha glucosidase inhibitors
acarbose, miglitol take with meals
Dementia, dermatitis, diarrhea
Niacin deficiency – pellagra
Thiamine (Vit B1) deficiency
nfantile beriberi – 2-3 months; cardiomegaly, tachycardia, dyspnea, cyanosis, vomiting Dry beriberi – symmetrical peripheral neuropathy with sensory and motor impairments, esp of distal extremities Wet beriberi – neuropathy AND cardiac sx – cardiomegaly, cardiomyopathy, CHF, peripheral edema, tachycardia also Wernicke-Korsakoff syndrome in alcoholics
Arginase makes ____ and _____ from arginine.
urea and ornithine
Philadelphia chromosome 9:22 Leukocyte count >50,000 Complete spectrum of granulocytic cells w/ more PMNs and myelocytes <10% blasts Low PMN alkaline phosphatase
overexuberant WBC response a/w leukocytosis >50,000 due to bacterial infxn, malignancy, etc. Left shift Nl or elevated PMN alkaline phosphatase
Leukomoid rxn
Inc myeloblasts (more than 20% of nucleated cells)
Inc circulating mature lymphoid cells
more than 20% lymphoblasts in blood or marrow
LN and /or soft tissue abnls
Follicular lymphoma, Burkitt lymphoma, diffuse large B cell lymphoma

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