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?
- metformin
- What diabetic med causes agranulocytosis?
- sulfonylurea
- 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
- spongiosis
- -epidermal accumulation of edematous fluid in intercellular spaces -edema can eventually form intraepithelial vesicles by tearing desmosomes apart -assoc with allergic contact dermatitis
- dyskeratosis
- -abnormal, premature keratinization -strongly eosinophilic -small, basophilic nuclear remnants -assoc with squamous cell carcinoma
- hyperparakeratosis
- -retention of nuclei in stratum corneum -normal only in mucous membranes
- hypergranulosis
- -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
- fenoldopam
- -IV agent that dilates arteries and causes natriuresis -D1 receptor agonist
- risperidone
- 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
- dermatomyositis
- 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
- pravastatin
- only macrolide that does NOT inhibit CYP 3A4
- azithromycin
- 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
- aPTT
- use ___ to monitor warfarin therapy
- PT
- Vit K dependent clotting factors
- II, VII, IX, X
- -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
- clopidogrel
- 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
- HNPCC
- 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
- kinesin
- microtubule-assoc, ATP-powered motor prot involved in anterograde transport of NT
- DIC vs. TTP-HUS
- 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
- niacin
- NE works at all adrenergic R's except
- B2
- diphenoxylate
- opiate anti-diarrheal, related to meperidine
- labetalol
- nonselective B blocker a1 blocker
- bilateral acoustic neuromas multiple meningiomas, gliomas, ependymomas of SC
- NF2
- 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
- CML
- 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)
- AML
- Inc circulating mature lymphoid cells
- CLL
- more than 20% lymphoblasts in blood or marrow
- ALL
- LN and /or soft tissue abnls
- Follicular lymphoma, Burkitt lymphoma, diffuse large B cell lymphoma