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31 Cards in this Set
- Front
- Back
- 3rd side (hint)
CYP450 inducer |
Chronic alcohol use St. john's wort Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine |
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CYP450 substrates |
Anti-epileptics Theophylline Warfarin OCPs |
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CYP450 inhibitor |
Acute alcohol abuse Ritonavir Amiodarone Cimetidine Ketoconazole Sulfonamides INH Grapefruit juice Quinidine Macrolides(except azithromycin) |
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Acute rejection |
usually<6months
exposures to donor antigen induces humoral/cellular activation of naive immune cells
lymphocytic interstitial infiltrate & endothelitis |
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von Willebrand disease |
Autosomal dominant
• intrinsic pathway coagulation defect → functional factor VIII deficiency → prolonged BT/PTT • Normal PT/platelet count • defect in platelet-to-vWF adhesion
• Dx. ristocetin cofactor assay • Tx. desmopressin |
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HELLP syndrome |
Hemolysis Elevated Liver enzymes Low Platelets
• severe preeclampisa • nausea, vomiting, RUQ pain • blood smear : schistocytes
Tx. immediate delivery |
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Osteogenesis inperfecta |
• Genetic bone disorder • mutation of type I collagen • macrocephaly with poor skull mineralization • shortened extremities • misshaped long bone • multiple fracture during birth • blue sclerae d/t translucency of the connective tissue • conductive hearing loss • dental imperfections d/t lack of dentin |
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Osteogenesis imperfecta |
• Genetic bone disorder • mutation of type I collagen • macrocephaly with poor skull mineralization • shortened extremities • misshaped long bone • multiple fracture during birth • blue sclerae d/t translucency of the connective tissue • conductive hearing loss • dental imperfections d/t lack of dentin |
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Chronic rejection |
• months to years • CD 4+ T cells respond to recipient APCs presenting donor peptides, including allegeneic MHC • proliferation of vascular smooth muscle and parenchymal fibrosis • affects small airway → bronchiolitis obliterans |
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Lipid lowering agent |
Back (Definition) |
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Fibrates |
• gemfibrozil, clofibrate, bezafibrate, fenofibrat • lowering TG > LDL • activate PPAR-a → decreased hepatic VLDL, increase LPL activity → ↑ TG clearance
• S/E : myopathy ( ↑ risk with statin) cholesterol gallstone (↑ with cholestyramine) |
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SLE |
• gradual symptom onset • malar or discoid rash • joint, renal, serosal &/or neurologic involvement
• anemia(spherocytosis, coomb test (+)), leukopenia, thrombocytopenia • ANA(+), anti-dsDNA(+), anti-Sm(+) • low C3 &C4 • increased immune complexes |
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Sarcoidosis |
• Young adults, African Americans
• Constitutional symptoms • cough, dyspnea & chest pain • Extrapulmonary findings - skin lesions - anterior/posterior uveitis - Lofgren syndrome
• bilateral hilar adenopathy • pulmonary reticular infiltrates
• Hypercalcemia/hypercalciuria (d/t 1a-hydroxylase mediated vitamin D activation in macrophage) • elevated serum ACE level
• noncaseating granuloma |
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cholinesterase inhibitor poisoning |
• organophosphates(irreversible cholinesterase inhibitor) • insecticides, farmer Hx.
• activation muscarinic effect Diarrhea Urination Miosis Bronchospasm(wheezing) Bradycardia Excitation of skeletal m.&CNS Lacrimation Sweating Salivation
Tx. atropine + pralidoxime (atropine-competitive, pralidoxime-regenerates AchE) |
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Atropine poisoning (Gardener's mydriasis) |
• Jimson Weed poisoning
Hot as a hare (temperature ↑) Dry as a bobe (dry mouth) Red as a beet (flushing) Blind as a bat (mydriasis, acute angle-closure glaucoma) Mad as a hatter (disorientation)
Tx. Physostigmine |
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Atropine poisoning (Gardener's mydriasis) |
• Jimson Weed poisoning
Hot as a hare (temperature ↑) Dry as a bobe (dry mouth) Red as a beet (flushing) Blind as a bat (cycloplegia, mydriasis, acute angle-closure glaucoma) Mad as a hatter (disorientation, hallucination, delirium)
Tx. Physostigmine |
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Atropine poisoning (Gardener's mydriasis) |
• Jimson Weed poisoning
Hot as a hare (temperature ↑) Dry as a bobe (dry mouth) Red as a beet (flushing) Blind as a bat (cycloplegia, mydriasis, acute angle-closure glaucoma) Mad as a hatter (disorientation, hallucination, delirium) the bowel and bladder lose their tone, and the heart runs alone
Tx. Physostigmine |
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Multiple Endocrine Neoplasia |
MEN 1(3P) - Primary hyperPTH (hyperCa) - Pituitary tumor (prolactin, visual defects) - Pancreatic tumors (gastrinomas)
MEN 2A (2P) - MTC (calcitonin) - Pheochromocytoma - Parathyroid hyoerplasia
MEN 2B (1P) - MTC (calcitonin) - Pheochromocytoma - Mucosal neuromas/marfanoid habitus |
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lacunar infarct |
• pure motor hemiparesis - posterior limb of the internal capsule or basal pons • pure sensory stroke - ventroposterolateral or ventroposteromedial thalamus • ataxia-hemiplegia syndrome - posterior limb of the internal capsule or basal pons • dysarthria-clumsy hand syndrome - genu of the internal capsule or basal pons |
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RA |
• pain, swelling & morning stiffness in multiple joints • small joints(PIP, MCP, MTP); spares DIP joints • systemic symptoms (fever, wt. loss, anemia) • Cervical spine involvement : subluxation, cord compression
• (+)RF, anti-CCP antibodies • CRP & ESR correlate with disease activity • x-ray: soft tissue swelling, joint space narrowing, bony erosions |
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Digoxin toxicity |
• cardiac : life- threatening arrhythmia
• Gi : anorexia, N/V, abdominal pain
• Neurologic : fatigue, confusion, weakness, color vision alternation
predisposing factor : renal failure, hypokalemia, verapamil, amiodarone, quinidine |
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CREST syndrome |
Calcinosis Raynaud's phenomenon Esophageal dysmotility Sclerodctyly Telangiectasias
Anti-centromere antibodies Anti-Scl-70 antibodies(anti-DNA topoisomerase I antibody) |
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Chediak-Higashi syndrome |
• AR • Defect in lysosomal trafficking regulator gene(LYST) • Microtubule dysfunction in phagosome-lysosome fusion
• recurrent pyogenic infections bu staphylococci and streptococci, partial albinism, peripheral neuropathy, progressive neurodegeneration, infiltrative lymphohistocytosis
• Giant granules in granulocytes and platelets • pancytopenia • mild coagulation defects |
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Oogenesis |
1st oocytes • begin meiosis I during fetal life • before menarche : arrested in meiosis I prophase I until ovulation.
2nd oocytes • meiosis II is arrested in metaphase II until fertilization
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Tricyclic antidepressant(TCA) |
• Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, dexepin, amoxapine
Action/side effect • Inhibiton of presynaptic neurotransmitter reuptake / tremor, insomnia
• blockade of cardiac fast sodium channel / conduction defect(cause of death), arrythmias, hypotension
•antagonism of centeal and peripheral muscarinic Ach receptor / hyperthermia, flushing, dilated pupils, intestinal ileus, urinary retention, sinus tachycardia
• antagonism of peripheral a1 adrenergic receptor / peripheral vasodilation(orthostatic hypotension)
• antagonism of histamine(H1) receptor / sedation |
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CSF flow |
ependymal cells of choroid plexus → lateral ventricle → foramina of Monro → 3rd ventricle → cerebral aqueduct of Sylvius → 4th ventricle → Foramen of Luschka/Magendie → subarachnoid space(arachnoid granulation) → dural venous sinus |
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Calcium metabolism |
PTH •↑ bone resorption •↑ renal reabsorption of calcium & ↓ reabsorption of phosphate •↑ conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D
Vitamin D •↑ Intestinal absorption of calcium & phosphate •↑ Renal reabsorption of calcium & phosphate •↓ Parathyroid hormone secretion •↑ Mineralization of bone
Calcitonin •↓ Bone resorption •↓ Renal calcium reabsorption |
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High anion gap metaboic acidosis |
AG=Na-(Cl+HCO3) (N:8-12mEq/L)
MUDPILES Methanol(formic acid) Uremia DKA Propylene glycol Iron tablet/Isoniazid Lactic acidosis Ethylene glycol(oxalic acid) Salicylates(late) |
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Amiodarone |
• class III antiarrhythmics • potassium channel block(slowing phase 3) • ↑ AP duration, ERP, QT interval
• lipophilic • Toxicity ⭐️ - pulmonary fibrosis - hepatotoxicitu(fatty change) - hypo/hyperthyroidism 👉TSH check!!!! - acts as hapten(corneal deposition, blue/gray skin deposits resulting in photosensitivity) - neurologic effects - constipation - bradycardia, heart block, HF
• leas risk of torsades de pointes |
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Gaucher disease |
most common AR
Hepatosplenomegaly Pancytopenia Osteoporosis Aseptic necrosis of femur Bone crises Gaucher cells(lipid laden macrophage resembling crumpled tissue paper)
Glucocerebrosidase deficiency |
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Heroin(opioid) withdrawal |
sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nauea, stomach cramps, diarrhea(flu-like symptoms)
Tx. - long term support - methadone, buprenorphine |
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