Card Set Information
most likely complication of digoxin
arrythmias due to hyperkalemia
Conditions that are polygenic
androgenic alopecia (baldness) with variable pentrance in males and females
type II DM
Side effects of a drug prescribed for bradycardia
acute closed angle glaucoma in elderly (increases IOP)
hyperthermia in infants
M3 antagonist ae.
Patient has a metabolic acidosis. How to predict if there's a compensatory respiratory alkalosis or not?
paCO2 = 1.5 x HCO3- + 8 (+/- 2)
if low, indicates compensatory respiratory alkalosis
if higher than predicted, indicates a problem of compensation = respiratory failure
replacement of G with C in the B-globin gene mRNA upstream from the AUG codon
Allergic bronchopulmonary aspergillosis
hx of bronchial asthma
high IgE levels (eosinophilia)
IgG antibodies against aspergillus
recurrent pulmonary infiltrates and proximal brochiectasis
hemorrhage into a prexisting pituitary adenoma
decreased ACTH = adrenocortical insufficiency = heart collapse
4 enzymes of gluconeogenesis
1. pyruvate carboxylase
: pyruvate --> OAA (mitochondria)
2. PEP carboxykinase
: OAA --> PEP (cytosol)
3. Fructose 1,6 bisphosphatase
: F1,6BP --> F6P (**RLS**) (cytosol)
4. glucose 6-phosphatase
: G6P --> glucose (ER)
ulcer location on the terminal sulcus 1 cm anterior to the foramen cecum. pain sensation by what nerve?
mandibular br. of the trigeminal nerve
how does squatting/tight hand grip help a kid with his cyanosis in tetralogy of fallot?
main concept is to increase afterload (due to pressure constriction)
because of afterload, pressure in the LV has to increase to overcome for the pump of blood flow out of heart
: pulmonic stenosis has a high pressure: blood goes from RV-LV via the VSD = cyanosis
: LV pressure increases, so blood goes from RV - pulmonary artery to get oxygenated in the lungs (helps with the cyanosis)
Piloglitazone binds to PPAR-gamma transcription regulator. What kind of receptor?
intracellular nuclear receptor
regulation of genes involved in lipid and glucose metabolism
Drugs with adverse effects of SLE are metabolized by what mechanism
slow acetylators = increased drug = greater risk for developing SLE
drugs that increase the sensitivity of insulin to tissues, and that increase insulin secretion
colonizing vs. invasive aspergillosis
colonizing: grows in old lung cavities: TB, emphysema, or sarcoidosis. Forms a fungus ball "aspergilloma"
invasive: infects lung tissues; opportunistic infections in immunosuppressed and neutropenic patients
pol gene mutations
env gene mutations
acquired resistance to RT and protease inhibitors
enable escape from host neutralizing antibodies
how do benzos and barbituates work at GABA receptors
allosteric binding to keep the GABA channels open
high : barbituates show direct gating of ion channels without the need of GABA
CGD has a defect in what enzyme
increased risk for catalase + organisms
Rapid acting anti-arrythmetic drug that causes adverse effects of: flushing, shortness of breath, chest burning (bronchospasm)
increases K efflux out of cells
patient dies of middle cerebral artery thrombosis and old renal infarcts. vitamin deficiency?
(presents like marfans except downward subluxation of lens)
how can plaques rupture to produce an MI
activation of metalloproteinases (activated macrophages contribute to collagen degradation)
what type of agar does H.influenza grow on?
enriched agar with factors V and X
N. gonorrhea grows on what type of agar?
vanco kills gram + organisms
gram (-) other than neisseria
fungi by nystatin
cells responsible for a type I HS reaction
mast cells (tissues)
contain Fc receptors for IgE and release histamine and heparin
adverse affects of verapamil
bradycardia --> AV block
Drug used to treat absence seizures and tonic-clonic seizures
phenytoin can treat TC seizures, but not absence.
carbamazepine treats TC seizures, but serious adverse effects
pathway of saphenous vein
starts at medial malleolus, drains on the medial aspect of leg.
joins the femoral vein in the femoral triangle, just inferior to the pubic tubercle
* not located in the popliteal fossa (for the popliteal artery (branch of femoral a.) and vein along with the tibial a.))
patient on INH therapy and develops fever, anorexia, and nausea one month later. damage?
transient increase in ALT, AST, and bilirubin
liver fx tests can return to baseline.
ADH and aldosterone work on what segments of the collecting duct
: medullary (water reabsorption)
: cortical (sodium reabsorption)
Top 2 causes of meningitis > 60 y.o.
cholestasis can cause intestinal malabsorption and nutritional deficiences of?
fat soluble vitamins
ureter crosses over the common iliac a. and then passes in what direction to the external and internal iliacs
lateral to the internal iliac
medial to the external iliac
(ureters enter medial to the ovarian vessels before entering the true pelvis)
how do patients who receive blood tranfusions develop parasthesias?
citrate is added to stored blood
citrate chelates calcium and magnesium
mast cell degranulation releases what substances?
uridine supplementation for orotic aciduria inhibits what enzyme?
adverse affects of theophylline
abdominal pain, vomiting, seizures
blocks the affects of adenosine (short-acting vasodilator)
patient presents with weight loss, hemoptysis, and cough. Has pulmonary infiltrate in the
and area of
. what stage of TB?
reactivation of an old infection
patient has a calcified granuloma in the lower lung with hilar lymphadenopathy. stage of TB?
ghon focus = granuloma
ghon complex = granuloma + lymphatic spread
meningococcal pili are responsible for what disease mechanism?
epithelial attachment to the nasopharynx --> invasion and disease
composition of RCC
glycogen and lipids
associated problems with hydrocephalus in fetuses
stretching of the periventricular tracts = UMN lesions
: hypertonicity and hyper-reflexia
mechanism of relaxation to decreases Ca+2 levels in a muscle
Ca+2 efflux from cytoplasm
use of Ca+2 ATPase (needs ATP) and Ca+2/Na+ exchanger (doesn't need ATP)
which enzyme has a RT activity and adds TTAGGG repeats to the 3' ends of the chromosome
find them in cancer cells and stem cells
Effect of a main exposure on an outcome is modified by another variable and is not a bias
e.g. asbetos exposure on lung cancer, affected by smoking
not due a flaw in the design or analysis of the study
Prescribe a B-blocker to a patient. Result on RAAS system?
decreases renin release, decreases aldosterone
no renal sodium and water retention
histology of adrenal medulla
chromaffin cells with basophilic cytoplasm
post-ganglionic sympathetic neurons from neural crest cells
complications of SLE anti-coagulants (indicated by prolonged PTT and false VDRL)
anti-phospholipid Ab syndrome
- hypercoagulability (venous and arterial thrombosis)
- repeated miscarriages (2nd and 3rd trimesters)
low T cell count associated with Candida
low neutrophil count associated with Candida
low T cell
: local infections (oral thrush, candidiasis, vulvovaginitis)
low neutrophil count
: systemic infections (hematogenous spread - liver and kidney abscesses, candidemia)
Strep pneumo undergoes what mechanism to become virulent if the strains are originally not virulent - conjugation, transformation, or transduction?
(uptake from the environment)
conjugation occurs with E.coli mostly
what structures drain to the superficial inguinal lymph nodes?
umbilicus down to the feet, including anus upto the dentate line
posterior calf drains to popliteal lymph nodes
prostate drains to internal iliac
superior portion of bladder to ext iliac, and inferior portion of bladder to the internal iliac
lipofuscin granules in organs due to aging is due to what mechanism
product of free radical injury and lipid peroxidation
enzyme that produces the green colour in bruises
heme oxygenase (converts heme to biliverdin)
HIV polyprotein cleavage is mediated by what enzyme?
if two studies have the same relative risk, but differ in statistical significance, what is a likely problem?
sample size (due to power of the study)
: hence, there's no flaw in the study design
drug that provokes Prinzmetal's angina (coronary vasospasm)
ergonovine (agonist at alpha and 5HT receptors)
how do alcoholics develop megaloblastic anemia
folate deficiency - impairs DNA synthesis
sx of a glucagonoma?
necrolytic erythema (erythematous rash over the lower extremities especially groin area)
imperforated anus (failure to pass meconium) can present with what other defect
urinary tract defects (renal genesis, epispadias, etc.)
a boy jumps from a tree and catches a branch while falling and then swings his arm and jumps to the ground. what nerve injured?
lower trunk of brachial plexus
ovarian vessels run in what ligament
chronic mitral regurg patients develop what complications
LA dilation (increased compliance) --> atrial fib and mural thromboembolism
acute rejection after a lung transplant affects what part of the lung?
pulmonary and bronchial circulation/vasculature
chronic rejection after a lung transplant affects what part of a lung?
n.b. airways walls and pleura are not affected
Strep viridans binds to damaged valves, which are identified by?
fibrin-platelet aggregates deposited at sites of endothelial trauma
transient MI causes heart cells to increase in size due to what mechanism?
blood flow cannot meet heart demands, move from aerobic to anaerobic metabolism
no ATP therefore, pumps cannot work (Na/K and Na/Ca)
accumulation of Na and Ca that draws water in and causes cell and mitochondrial swelling
contraction stops as SR cannot take up the Ca+2
most common benign liver tumor
biopsy is C/I because it can cause fatal hemorrhage
resistance against cephalosporins
change in protein structure
less sensitive to B-lactamases (like penicillins)
tx for serotonin syndrome
anti-histamine (H1) with non-specific serotonin antagonist effects
purine analog that achieves high  because of its resistance to degradation by adenosine deaminase
tx for hairy cell leukemia
what determines if a plaque will cause ischemic myocardial injury to that vessel?
rate of progression
: could develop collaterals that could prevent myocardial necrosis
: thin fibrous cap, rich lipid core, and active inflammation would all decrease plaque stability
In hereditary spherocytosis, is MCHC increased of decreased
mild dehydration of the RBC