1
Q
What electrolytes does the low volume state have?
A
↑total Na, ↓serum Na (dilutional affect), ↓Cl, ↓K, ↓Ca2+(bound to Albumin)
2
Q
What pH does the low volume state have?
A
Alkalotic (except diarrhea, RTA Type II, and DKA) b/c Aldo dumps H+
3
Q
What pH do vomiters have?
A
Alkalotic b/c you vomit out H+;low volume state
4
Q
What pH does diarrhea have?
A
Acidosis b/c stool has bicarb from pancreas
5
Q
What happened if pulse ↑>10 on standing?
A
Hypovolemic shock
6
Q
What happened if pulse ↑<5 on standing?
A
Autonomic dysfunction
7
Q
What are the symptoms of a low energy state?
A
CNS: mental retardation, dementia; ↓activity
CV: heart failure, pericardial effusion
Muscle: weakness, SOB, vasodilation ,impotence, urinary retention, constipation
Rapidly Dividing Cells:
Skin: dry
Cuticles: brittle nails
Hair: alopecia
Bone marrow: suppressed
Vascular endothelium: breaks down; vasculitis
Lungs: infection, SOB
Kidney: PCT will feel the effect first
GI: N/V/D
Bladder: urinary retention
Sperm: decreased
Germ cells: predisposed to cancer
Breasts: atrophic
Endometrium: amenorrhea; atrophic
8
Q
What are the most common signs of the low energy state?
A
9
Q
What are the most common symptoms of the low energy state?
A
Weakness and SOB
10
Q
What are the most common infections of the low energy state?
A
UTI and respiratory infections
11
Q
What is the most common cause of death in the low energy state?
A
Heart failure
12
Q
Explain all restrictive lung diseases: Explain all obstructive lung diseases: Restrictive: interstitial problem (nonbacterial); ↓diffusion & perfusion Small stiff lungs (↓VC) Trouble breathing in => FEV1/ FVC: > 0.8 ABG: ↓pO2 => ↑RR
A
↓pCO2
13
Q
What symptoms does a “less likely to depolarize” state have? Nucleus turns into blobs “pick blobs”
A
14
Q
What is the humoral immune response? Nucleus fragments
A
15
Q
What is the cell-mediated immune response? Nucleus dissolves
A
16
Q
What is the central nervous system? Brain and spinal cord; oligodendrocytes Everything else; Schwann cells Automatic stuff
A
17
Q
What is the peripheral nervous system? Moving your muscles Rest-and-Digest => slows stuff down “DUMBBELS”: Diarrhea Urination Miosis “constrict” Bradycardia Bronchoconstrict Erection “point” Lacrimation Salivation
A
18
Q
What is the autonomic nervous system? Opposite of Parasympathetics: Constipation Urinary retention Mydriasis “eyes wide with fright” Tachycardia Bronchodilate Ejaculation “shoot” Xerophthalmia (dry eyes) Xerostomia (dry mouth)
A
19
Q
What is the somatic nervous system? Locus cerelues of the pns
A
20
Q
What is the sympathetic system? Fight-or-Flight => speeds stuff up How does the sympathetic system behave? Goes up in anxiety
A
21
Q
What happens to NE in anxiety and depression? Goes down in depression
A
22
Q
What is the parasympathetic system? Ventral tegmentum and SNc in the midbrain
A
23
Q
What happens to dopamine in Huntington’s
A
Parkinson’s
24
Q
What happens to serotonin in Parkinson’s
A
anxiety
25
How does the parasympathetic system behave? Basal nucleus of Meynert
26
Where is NE synthesized? Goes up in Parkinson’s Goes down in Alzheimer’s Goes down in Huntington’s Raphe Nucleus
27
Where is dopamine synthesized? Telencephalon -> Cerebral Hemispheres Diencephalon -> Thalamus
28
Where is serotonin synthesized? Metencephalon -> Pons and Cerebellum Myelencephalon-> Medulla
29
Where is ACh synthesized? Mesencephalon -> Midbrain HTN
bradycardia
30
What happens to ACh in Parkinson’s
Alzheimer’s
31
What does the forebrain or prosencephalon give rise to? Sacral pocket w/ meninges in it
32
What does the midbrain or mesencephalon give rise to? Sacral pocket w/ meninges and nerves in it
33
What does the hindbrain or rhombencephlaon give rise to? TB
34
What is Cushing's triad? Aura
photophobia
35
What is Budd-Chiari? Café au lait spots (hyperpigmentation) => peripheral nerve tumors
axillary freckle Type 1 "Von Recklinghausen's": Peripheral (Chr#17)
36
How is major depression diagnosed? need 5 "SIGE CAPS" >2wks Sleep disturbances: wake in early am Interest/Libido loss Guilt Energy loss Concentration loss Appetite loss Psychomotor agitation Suicide: hopelessness What is Autism? Repetitive movements
lack of verbal skills and bonding
37
What is Asperger's? Only in girls
↓head growth
38
What is Rett's? Develop normally for first 2 years
then behave autistic
39
What is Childhood Disintegrative Disorder? Kid talks sometimes Kid screams when Mom leaves
40
What is Selective Mutism? Aggressive
disregard for rules
41
What is Separation Anxiety Disorder? Low level sadness >2yr Dysthymia w/ hypomania
42
What is Conduct Disorder? Depression followed by dysthymia Depression and Mania (psychosis) Depression and Hypomania (no psychosis) Ideas switch subjects
incoherent Wanders off the point Digresses
43
What is Oppositional Defiant Disorder? Perfectionist
doesn't show feelings
44
What is Attention Deficit Hyperactivity Disorder? Prolonged pain not explained by physical causes Neuro manifestation of internal conflict
indifferent to disability Fake illness for monetary gain
45
What is Dysthymia? Prion induced
die within 1 year
46
What is Cyclothymia? ↓ACh in nucleus basalis of Meynert
bad ApoE
47
What is Double Depression? In substantia nigra
bradykinesia
48
What is Bipolar I? Think they have a different illness all the time (at least 4 organ systems)
49
What is Bipolar II? Think they have the same illness all the time
50
What are Loose associations? Mom makes child ill for gain
move a lot
51
What is Tangentiality? Can't recall important facts No past
travel to new place
52
What is Circumstanciality? Can you die during EtOH withdrawal? Can you die during opioid withdrawal? Have 5-10 alters
usually associated w/ incest "Out of body" experiences
53
How do you calculate SV? EDV – ESV = SV
54
How do you calculate CO? SV * HR = CO
55
What is normal CO? 5L/minute
56
How much of this CO goes to the brain
heart
57
How do you calculate CPP? MAP – ICP = CPP
58
What organs have resistance in series? Liver
kidney
59
What organs have resistance in parallel? All the rest
60
What organ has the highest A-VO2 difference at rest? Heart
61
What organ has the highest A-VO2 difference after meal? Gut
62
What organ has the highest A-VO2 difference during a test? Kidney
63
What organ has the lowest A-VO2 difference? Ascending aorta (occurs in cystic medial necrosis
syphilis)
64
Where does Type A thoracic aortic dissection occur? Intima
media
65
Where does Type B thoracic aortic dissection occur? Arterioles
66
What layers does a true aortic aneurysm occur? Aorta
67
What layers does a pseudo aortic aneurysm occur? Capillaries Veins and venules 1) Volume: SV 2) Rate: HR 3) Resistence: TPR 220 – age (in years) Pain with exertion (atherosclerosis) Pain at rest (transient clots) Intermittent pain (coronary artery spasm) Stains Congo red
Echo Apple-green birefringence; deposition of proteins Fe deposit in organs => hyperpigmentation
68
What is pulse pressure? A murmur occurs in the heart A bruit occurs in blood vessels AR AS Dilated cardiomyopathy Idiopathic Hypertrophic Subaortic Stenosis A Fib PVC
69
What vessel has the thickest layer of smooth muscle? Right ventricle hypertrophy
70
What vessels have the most smooth muscle? IHSS Transposition of the great arteries
71
What vessels have the largest cross- sectional area? Return
72
What vessel has the highest compliance? AVM in lung
gut
73
What vessels have the highest capacitance? TR
MR
74
What are the three causes of HTN? AS
PS
75
What is your max heart rate? Aortic and pulmonic
76
What is Stable angina? TS or MS
77
What is Unstable angina? PDA or AVMs
78
What is Prinzmetal's angina? Pleuritis
79
What is Amyloidosis? Pericarditis
80
What is Hemochromatosis? A/P stenosis M/T stenosis Normal on inspiration (b/c pulmonic valve closes later) ↑O2
↑RV volume
81
What is Cardiac tamponade? Hepatomegaly Peripheral Edema Jugular venous distension
82
What is a Transudate? Pulmonary HTN => RV failure Pulmonary HTN => reverse L-R to R-L shunt
83
What is an Exudate? Aorticopulmonary septum did not spiral
84
What is the histology of the trachea? Top 1/3: Stratified Squamous Epithelium (Protect against abrasion) Middle 1/3: Mixture Lower 1/3: Tall Columnar Pseudo-stratified ciliated Epithelium
85
What are the muscles needed to breathe in? Innermost intercostals (contralateral chest wall) External Intercostals (ipsilateral chest wall) Diaphragm
86
What are the muscles needed to force air in? Scalenes SCM -sternocleidomastoid Trapezius Pectoralis Major/minor
87
What are the muscles needed to breathe out? Passive - recoil
88
What are the muscles needed to force air out? Internal/external oblique Rectus abdominus Transverse abdominus Quadratus lumborum
89
What is the difference between Carotid body: chemoreceptor a carotid body and a carotid Carotid sinus: baroreceptor Black "radiolucent" What color is air on an x-ray? Epiglottitis
90
What color is fluid/solid on x-ray? White "radiopaque" Croup What disease has a steeple sign on neck film? Bronchitis (chronic)
91
What disease has a thumb sign on neck film? Emphysema
92
What is a "blue bloater"? Aspergillosis
Strongyloides
93
What is a "pink puffer"? eosinophilia? Nitrofurantoin
Sulfonamides
94
What diseases have eosinophilia? Smoking
Radon
95
What drugs cause Middle of diaphragm
96
What are the risk factors pneumoconiosis (except anthracosis) for lung cancer? Gram – sepsis
PE) Obstructive Lung Dz
97
What diseases have hemoptysis? Bronchiectasis
bronchitis
98
Where is a Morgagni hernia? diarrhea)
99
What diseases have Restrictive Lung Dz (anxiety
pregnancy
100
What diseases have respiratory acidosis? Lungs hyperinflated with air
101
What diseases have metabolic Low Volume State (vomiting
diuretics
102
What diseases have metabolic Acid production (MUDPILES
RTA II
103
What disease has a corkscrew x-ray? Esophageal spasm Cancer What disease has an apple core xray? Intussusception
104
What disease has a stacked coin xray? Celiac sprue
105
What disease has a thumbprint x-ray? Toxic megacolon Volvulus What disease has an abrupt cutoff x- ray? Esophageal spasm
scleroderma
106
What disease has a barium clumping x- ray? Tear LES mucosa
chronic vomiters
107
What disease has a bird's beak x-ray? Achalasia What disease has a string sign x-ray? Pyloric stenosis What diseases have solid dysphagia? Schatzki's rings
stricture
108
What is Barrett's Esophagus? Metaplasia
↑AdenoCA risk Vomit blood everywhere
109
What are Esophageal Varices? Turns blue with crying
110
What is Mallory-Weiss? ↓LES pressure
111
What is Boerhaave's? ↑Peristalsis
112
What is Achalasia? Mass of hair or vegetables => antrum obstruction Upper GI bleed
anti-parietal cell Ab Upper GI bleed
113
What is Hirschprung's? ↓Peristalsis and ↑LES pressure Pyloric stenosis Intussusception
114
What is a Zenker's diverticulum? Spider angioma
palmar erythema
115
What is a Traction diverticulum? Bad Apo E (IDL/VLDL)
116
What is Plummer-Vinson syndrome? Bad Adipose LL (VLDL only)
117
What are Schatzki rings? Bad C2 (VLDL/CM) b/c C2 stimulates LL
118
What is a TE fistula? Unconjugated bilirubin
usually in infants
119
What is an Esophageal atresia w/ TE fistula? Glucoronyl transferase is saturated => stress unconjugated bilirubin
120
What is Conjugated bilirubin? Bad bilirubin storage => conjugated bilirubin Bad bilirubin excretion => black liver
121
What is Duodenal atresia? Bleed around umbilicus => hemorrhagic pancreatitis
122
What is Pyloric stenosis? Bleed into flank => hemorrhagic pancreatitis
123
How does Choanale atresia present? carbs
124
How is the Tetrology of Fallot presentation different? "WAGLA" WBC: >16K/μL (infection) Age: >55 (usually multiple illnesses) Glucose: >200 mg/dL (islet cells are fried) LDH: >350 IU/L (cell death) AST: >250 IU/L (cell death)
125
What makes Scleroderma unique? "BuCH was a SOB" BUN: ↑ >5mg/dL (↓renal blood flow) Ca: <8 mg/dL (saponification) Hct: drops >10% (bleed into pancreas) Sequester >6 L fluid => 3rd spacing pO2: <60mm Hg (fluid/protein leak → ARDS) Base deficit >4mEq/L (diarrhea => pancreatic enzymes are dead) Diarrhea
flushing
126
What makes Esophageal spasms unique? Familial polyposis w/ bone tumors
127
What makes Achalasia unique? Familial polyposis w/ brain tumors
128
What disease has a RUQ olive mass? 100% risk of colon cancer
APC defect => annual colonoscopy at 5y/o
129
What disease has a RLQ sausage mass? Hyperpigmented mucosa => dark gums/vagina w/hyperplastic polyps
130
What is a Bezoar? IBD w/ cobblestones
melena
131
What is Gastritis type A? IBD w/ pseudopolyps
hematochezia
132
What is Gastritis type B? Currant jelly stool
stacked coin appearance on enema
133
What is a Duodenal ulcer? Hurts
134
What is a Gastric ulcer? Intermittent severe cramps
135
What is a Sliding hiatal hernia? Alternating diarrhea/constipation
136
What is a Rolling hiatal hernia? Pain
137
What is Menetrier's disease? No pain
138
What defines Constipation? T. whippleii destroy GI tract
then spread causing malabsorption
139
What defines Diarrhea? Red
140
What is Osmotic diarrhea? Bilirubin
141
What is Secretory diarrhea? Clay-colored
142
What is Inflammatory diarrhea? Tea-colored
143
Which part of the nephron concentrates urine? (Membranoglomerulonephrits) Medulla The ureter passes under the uterine artery
and under the deferens. 60% total body water 40% ICF 20% ECF Flea-bitten kidney (blown capillaries) Azotemia + symptoms ↑BUN/Cr ↑Size of fenestrations => vasculitis Lost BM charge due to deposition on heparin sulfate => massive proteinuria and lipiduria Crescents Subepithelial
144
What is the course of the ureter? Tram-tracks (type II has low C3)
145
What is the 60/40/20 rule? Kids
fused foot processes
146
What is Goldblatt's kidney? "PMS in Salt Lake City"* Post-strep GN MPGN Type II SBE Serum sickness Lupus Cryoglobulinemia Dehydration Calcium phosphate Triple phosphate
147
What is Uremia? Uric acid
148
What is Azotemia? Wilm's tumor Juvenile rheumatoid arthritis Foreskin scarred at penis head (foreskin stuck smooshed up) Foreskin scarred at penis base (retraction of foreskin => strangulates penis)
149
What is Nephritic kidney disease? Cystine Oxalate Urgency leads to complete voiding (detrustor spasticity → small bladder vol) Weak pelvic floor muscles (estrogen effect) Runs down leg but can't complete empty of bladder Urethra
ejaculatory duct Ureters
150
What is Nephrotic kidney disease? Pyelonephritis (sepsis) Interstitial nephritis (allergies) Glomerulonephritis Nephrotic syndrome Chronic renal failure ATN ATN Normal sloughing Normal sloughing RPGN Creatinine (or inulin)
151
What is seen in RPGN (Rapidly Progressive Glomerulonephritis)? Secrete RPF goes down GFR goes up FF (GFR/RPF) goes up BUN (or PAH) Filter RPF goes down GFR goes down FF (GFR/RPF) stays unchanged
152
What is Post-Strep GN? GFR
153
What is Interstitial Nephritis? RPF
154
What is Lupus Nephritis? RPF stays unchanged GFR goes up FF (GFR/RPF) goes up
155
What is MGN? 100 mL/min RPF stays unchanged GFR goes down FF (GFR/RPF) goes down Low flow to kidney (BUN:Cr >20) Damage glomerulus (BUN:Cr <20) Obstruction (haven't peed in last 4 days) Reabsorb glucose
amino acids
156
What is a Neutrophil? The Phagocyte (has anti-microbials
most abundant) The Parasite Destroyer
157
What is an Eosinophil? Left shift => have infection
158
What is a Basophil? Bacterial infection
159
What is a Monocyte? TB: hemoptysis
night sweats EBV: teenager sick for a month Listeria: baby who is sick Salmonella: food RBC being destroyed peripherally
160
What is a Lymphocyte? Bone marrow not working right
161
What is a Platelet? (↓production) Different shapes
162
What is a Blast? Different sizes
163
What is a Band? 120 days
164
What does high WBC and high PMNs tell you? 7 days
165
What does high WBC and <5% blasts tell you? Low levels (usually due to virus or drugs)
166
What does high WBC and >5% blasts tell you? High levels
167
What does high WBC and bands tell you? High levels
168
What does high WBC and B cells tell you? Plasma: no RBC
169
What diseases have high eosinophils? "NAACP" Neoplasm (lymphoma) Allergy/ Asthma Addison’s disease (no cortisol → relative eosinophilia) Collagen vascular disease Parasites "STELS" What diseases have high Syphilis: chancre
rash
170
What do high retics (>1%) tell you? cherry-red lips
pinkish skin hue Non-competitive inhibitor of O2 on Hb =>
171
What do low retics tell you? almond breath Hb w/ Fe3+
172
What is Poikilocytosis? Sunlight => skin blisters w/ porphyrin deposits
Wood's
173
What is Anisocytosis? Homozygous HbS: (βGlu6 →Val) => vasoocclusion
necrosis
174
What is the RBC lifespan? Heterozygous HbS => painless hematuria
sickle with extreme hypoxia (can’t be a pilot
175
What is the platelet lifespan? (βGlu6→Lys)
still charged =>no sickling
176
What does –penia tell you? 1 deletion: Normal 2 deletions "trait": Microcytic anemia 3 deletions: Hemolytic anemia
Hb H=β4 4 deletions: Hydrops fetalis
177
What does –cytosis tell you? 1 deletion “β minor”: HbA2 and HbF 2 deletions "trait/intermedia/major": only HbA2 and HbF => hypoxia at 6 mo See w/ β thalassemia major (no HbA => excess RBC production); baby making blood from everywhere => frontal bossing
hepatosplenomegaly
178
What does –cythemia tell you? Thrombosis risk factors: 1) Turbulent blood flow "slow" 2) Hypercoaguable "sticky" 3) Vessel wall damage "escapes" Shortness of breath Clubbing of fingers/toes RBC destroyed in blood vv. → low haptoglobin (binds free floating RBC destroyed in spleen (problem w/ RBC membrane) => splenomegaly δ-ALA dehydratase Ferrochelatase
179
What is the difference between Serum: no RBC or fibrinogen plasma and serum? X2+ Fetal alcohol syndrome William's Pseudo-hypoparathyroidism
psoriatic arthritis Trisomy 13 Diamond-Blackfan Sickle cell disease
180
What is Chronic Granulomatous Disease? Vit B12 deficiency Folate deficiency Alcohol
181
What does MPO deficiency cause? G-6PD deficiency Cold autoimmune
182
What is Chediak Higashi? Can you say that real fast 3 times in a row?... What organ can make RBCs if the long bones are damaged? Spherocytosis Tapeworms
vegans
183
What causes a shift to the right in the Hb curve? Diamond-Blackfan Aplastic anemia No RBCs
2-jointed thumbs Pancytopenia
184
How does CO poison Hb? Hb precipitates and sticks to cell membranes (G-6PD Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia
spleen trauma
185
How does Cyanide poison Hb? Baby w/ bleeding from skin and mucosa
big platelets (low GP1b) baby w/ bleeding from skin and mucosa (low GP2b3a) Umbilical stump bleeding (1st time baby has to stabilize a clot) Protein C can't break down Factor 5 => more clots Heavy menstrual bleeding Type 1 (AD): ↓VWF production Type 2 (AD): ↓VWF activity (+ Ristocetin aggregation test) Type 3 (AR): No VWF Defective Factor 8 (< 40% activity) => bleed into cavities (head
186
What is MetHb? >50 y/o males w/ lymphadenopathy
"soccer ball" nuclei
187
What is Acute Intermittent Porphyria? ↑Porphyrin
urine δ-ALA
188
What is Erythrocytic Protoporphyria? Porphyria cutanea tarda in a baby What is Sickle cell disease? Hct >60%
↓Epo
189
What is Sickle cell trait? Megakaryocytes
fibrotic marrow => teardrop cells
190
What is Hb C disease? Produce lots of Ab IgM
hyperviscous
191
What is α-thalassemia? ↑IgA
infiltration of bowel wall Kid w/ eczema
192
What is β-thalassemia? In serum You know you can use that blood
save it for specific pt Type it and wait Uses Ab to detect Ag "Fabulous" Uses Ag to detect Ab Have the A antigen Have no antigens
193
What is Cooley's anemia? 4 days to years later (T-cells
MP) > 7 days (Fibroblasts) Bone marrow transplants reject (TK
194
What is Virchow's triad? Measured PT/ Control PT
195
What is a Somatotrope? GH LH
FSH TSH ACTH PRL Cell membrane receptors
196
What is a Gonadotrope? Secretion into blood Secretion into non-blood Works on itself Works on its neighbor Cell is maintained => exocytosis Apex of the cell is secreted The whole cell is secreted "BRICKLE" Brain RBC Intestine Cardiac
Cornea Kidney Liver Exercising muscle Stimulates LH
197
What is a Thyrotrope? Nuclear membrane receptors "PET CAD" Note: thyroid hormone acts like a steroid Progesterone E2 Testosterone Cortisol Aldo Vit D
198
What is a Corticotrope? Inhibits PRL Inhibits GH Conserves water
vasoconstricts Milk letdown
199
What is a Lactotrope? Renin-Angiotensin
200
What receptors do protein hormones use? Androgens "sex"
201
What receptors do steroid hormones use? ACTH
CRH
202
What are the steroid hormones? Catecholamines
203
What does Endocrine mean? Preganglionic sympathetic fibers
204
What does Exocrine mean? High Aldo (tumor)
Captopril test makes it worse Inhibits Aldo
205
What is Autocrine? If the low-dose dexamethasone test suppresses
what does that tell you? If the low-dose dexamethasone test does not suppress
206
What is Paracrine? Cortisol: permissive under stress TSH: permissive under normal Gluconeogenesis
glycogenolysis Makes RBCs
207
What is Merocrine? Adrenal adenoma => Cortisol (call general surgeon) Small cell lung cancer => ACTH (call thoracic surgeon)
208
What is Apocrine? Stimulates parietal cells => IF
H+ Growth
209
What is Holocrine? Milk production Chews up bone Builds bone PTH
210
What organs do not require insulin? Parathyroid adenoma
211
What does GnRH do? Renal failure
212
What does GRH do? ↓Ca excretion
213
What does CRH do? Vit D deficiency Pepsin NE: Neurotransmitter Epi: Hormone PTH problem High Ca => hyperPTH Low Ca => hypoPTH Thyroidectomy
214
What does TRH do? G-protein defect
no Ca2+ problem
215
What does PRH do? Remove PTH → bone sucks in Ca2+ Secretion of bicarb
inhibit gastrin
216
What does DA do? Growth
differentiation Grave's
217
What does SS do? Horner's
218
What does ADH do? Exopthalmos
pretibial myxedema
219
What does oxytocin do? Antimicrosomal Ab = TPO Ab Hashimoto's Woody neck Reidel's struma Cretin Euthyroid sick syndrome Wolff-Chaikoff
220
What does GH do? Freaky features
hypothyroid Mom and Baby Low T3 syndrome Transient hypothyroidism Hyperthyroid adenoma Esophageal webs Makes external male genitalia Makes internal male genitalia Help T cells mature Inhibits secretin
221
What does TSH do? TSH β-HCG
222
What are 1st degree burns? Red (epidermis) Blisters (hypodermis) Painless neuropathy (dermis) "TRiCKSSS" Toxic Shock Syndrome Rocky mountain spotted fever Coxsackie A: Hand-Foot-Mouth disease Kawasaki Scarlet fever Staph Scaled Skin Syphilis
223
What are 2nd degree burns? Target lesions (viral
drugs)
224
What are 3rd degree burns? Stevens Johnson w/ skin sloughing Ab against desmosomes => circular immunofluorescence
in epidermis
225
What diseases have palm and sole rashes? Ab against hemidesmosomes => linear immunofluoresence
subepidermal
226
What is Erythema Multiforme? Polygonal pruritic purple papules Linear excoriation "burrows" in webs of fingers
toes
227
What is Stevens Johnson syndrome? Erythema Multiforme Major (mouth
eye
228
What is Pemphigus vulgaris? Males: back Females: leg Hutchison's freckle Superficial spreading: most common
flat brown Nodular: worst prognosis
229
What is Bullous Pemphigoid? Bowen's disease: SCC in situ on uncircumcised penis dorsum Verrucous carcinoma: wart on foot
230
What is Eczema? Pearly papules on upper face
palisading nuclei
231
What is Nummular dermatitis? Blush all the time
worse w/ stress/alcohol Painful black necrotic lesion
232
What is Spongiotic eczema? Warm red skin Painless black necrotic lesion Bedsore Blood clot in veins
associated w/ hypercoagulable state Shiny red
233
What is Lichenification? Gradual lizard skin "Heat rash": burning
itching papules on trunk Fleshy papules w/ central dimple
234
What is Pityriasis Rosea? Stevens Johnson syndrome (> 1 mucosal surface) Fat inflammation (painful red nodules on legs)
sarcoidosis Newborn benign rash (looks like flea bites w/ eosinophils)
235
Where is CK-MB found? Heart
236
Where is CK-MM found? Brain All blood in gut and skeletal mm. have ran out of ATP Distal weakness + fasiculations Proximal weakness + pain Actin Myosin A band Cardiac muscle: Z line Skeletal muscle: A-I junction Dystrophin frameshift
Gower sign
237
What is Slipped Capital Femoral Epiphysis? Middle age male w/ fasiculations
descending paralysis
238
What is Rheumatoid Factor? An IgM against IgG Fc Gout crystals + giant cells Big toe inflammation from gout Calcinoss Raynaud’s Esophageal dysmotility Sclerodactyly Telangiectasia
239
What are Tophi? Anti-centromere Ab Scleroderma Takayasu's RA SLE Low platelets
240
What is Podagra? Weak shoulders
temporal arteritis Meet 4 criteria: "DOPAMIN RASH" Discoid rash Oral ulcers Photosensitivity Arthritis Malar rash Immunologic disorder: Anti-ds DNA
241
What is CREST syndrome? Tight skin
fibrosis Pulseless Asian women
242
What does the Seminal Vesicle give to sperm? Food (fructose) and clothes (semen) Bicarbonate (neutralize lactobacilli) "The prostate HAZ it" Hyaluronidase Acid phosphatase Zn used to peel semen off Sperm release enzymes to eat corona radiata Wall formed after 1 sperm enters (to prevent polyspermy) the egg Adrenal gland and testicles Testicles (at puberty) External genitalia problem; does not match genotype Internal genitalia problem => has both sexes’ genatalia Impossible b/c the default is female XX with low 21-OHase => high testosterone
243
What do the Bulbourethral = Cowper's glands secrete? XY with no MIF XY that has low 17-OHase => low testosterone
244
What does the Prostate secrete? Hairy Man-like see in female child
245
What is the Capacitation reaction? Bad DHT receptor → XY w/ blind pouch vagina Precocious sexual development
polyostotic fibrous dysplasia "whorls of CT"
246
What is the Acrosomal reaction? Luteal stage (has secretory endothelium) E1: Estrone (made by fat)
247
What is the Crystalization reaction? E2: Estradiol (made by ovaries) E3: Estriol (made by placenta) Pregnancy
liver failure
248
Where does Testosterone come from? Placenta previa
249
Where does DHT come from? Endometrial cancer
250
What is a Pseudohermaphrodite? Endometriosis until proven otherwise
251
What is a True Hermaphrodite? PG-F causes painful menstrual cramps (teenagers miss school/work) Painful cyclical heavy menstrual bleeding => "powder burns
chocolate cysts" due to ectopic endometrial tissue Scant bleeding at ovulation
252
What is a Female Hermaphrodite? Heavy menstrual bleeding Benign uterus SM tumor Submucosal type => bleeding Subserosal type => pain Bleeding or spotting in between periods Pain at ovulation Treponema pallidum (spirochete) ds DNA virus ds DNA virus Obligate intracellular parasite Gram – diplococcus H. ducreyi Chlamydia trachomatis
253
What is a Female Pseudohermaphrodite? C. granulomatosis Chlamydia or GC Flat fleshy warts
ulcerate
254
What is a Male Hermaphrodite? Paper-like vulva
itching
255
What is a Male Pseudohermaphrodite? "TORCHS" Toxoplasma: multiple ringenhancing lesions
cat urine
256
What is Hirsuitism? Rash and ulcer around nipple
breast cancer Cells line up single file
257
What is Virulization? Nipple bleeding Worst prognosis breast cancer Vagina cancer
ball of grapes appearance
258
What is Testicular Feminization = Androgen Insensitivity What is McCune-Albright? Ovarian CA spread to umbilicus Pleural effusion
ovarian fibroma
259
Why do pregnant women get anemia? Dilutional effect; RBC rises 30% but volume rises 50% 1st Degree: Skin 2nd Degree: Muscle 3rd Degree: Anus 4th Degree: Rectum Cheesy baby skin Green baby poop Endometrial slough 500mL 1L Diet Insulin Egg split into perfect halves "monochorionic" Multiple eggs fertilized by different sperm Weight gain and enlarged ovaries after clomiphene use Baby Mom => GnRH
CRH
260
What are the degrees of vaginal lacerations? Placenta Maintains corpus luteum
sensitizes TSHr => act hyperthyroid (to ↑BMR) Placenta
261
What is Vernix? Doubles every 2 days until 10 wks (when placenta is fully formed) Regulates fetal intravascular volume
262
What is Meconium? Blocks insulin receptors => sugar stays high (baby's stocking up on stuff needed for the journey)
263
What is Lochia? Inhibits FSH => no menstruation Milk ejection
baby ejection Decreases immune rejection of baby
264
What is normal blood loss during a vaginal delivery? Week 16
265
What is normal blood loss during a C- section? Oligohydramnios (cord compression)
266
How do you treat A1 Gestational DM? Polyhydramnios (DM)
267
How do you treat A2 Gestational DM? Estrogen crystallizes on slide
268
What are identical twins? Shows presence of amniotic fluid
269
What are fraternal twins? Fetal limb defects
270
What is Ovarian Hyperstimulation Syndrome? Abortion (2% risk)
271
Who makes the Trophoblast? >8
272
Who makes the Cytotrophoblast? "Test the Baby
MAN!" Tones of the heart Breathing Movement: BPD
273
Who makes the Syncitotrophoblast? Platypelloid
android
274
When does implantation occur? 9 months from last menses →add 1 wk
275
When is β-HCG found in urine? B/c it does not start from ovulation date
276
What is the function of Estrogen? Add x days if cycle is x longer
277
What is the function of Progesterone? 1lb/wk
278
What makes progesterone <10wk gestation? 3rd trimester b/c PG-F in semen may cause
279
What makes progesterone >10wk gestation? uterine contractions 1) Feel fundus
280
What is the function of β-HCG? 2) Feel baby's back 3) Feel pelvic inlet 4) Feel baby's head Up to full dilation 1) Latent Phase (<20h): Contractions →4 cm cervical dilation Active Phase (<12h): 4-10 cm cervical dilation (1cm/ hr) Full dilation → delivery Station 0: Baby above pelvic rim (most uteri are anteverted) 1. Engage 2. Descend 3. Flex head 4. Internal rotation 5. Extend head 6. Externally rotate 7. Expulsion: LOA most common presentation Delivery of placenta (due to PG-F) Blood gush →cord lengthens →fundus firms
281
What makes β-HCG? Can you try vaginal delivery on a woman who has had a Classic Horizontal C/S previously? Can you try vaginal delivery on a woman who has had a Low Transverse C/S previously?
282
How fast should β-HCG rise? Doppler
scalp electrode Tocodynamics
283
What is the function of AFP? Acidemia Ischemia to placenta => HTN (>140/90) Delivery
284
What is the function of HPL? Hepatic injury causing: Hemolysis Elevated Liver enzymes Low Platelets HTN + seizures H/A
changes in vision
285
What is the function of Inhibin? Placenta invades into myometrium Placenta perforates through myometrium Severe pain
premature separation of placenta Fetal vessels insert between chorion and amnion Tearing sensation
286
What are the newborn screening tests? "Please Check BBefore Going HHome"* PKU Congenital adrenal hyperplasia Biotinidase
β-thalassemia Galactosemia Hypothyroidism
287
What is an average IQ? EtOH
Fragile X
288
What are the most common causes of mental retardation in the US? Measles German measles Test at 1 and 5min (normal>7) Appearance (color) Pulse Grimace Activity Respiration Clear discharge due to silver nitrate
289
What is Rubeola also known as? Gonorrhea => purulent discharge
290
What is Rubella also known as? Chlamydia
291
What is the APGAR test? Chromosomal abnormality or TORCHS Herpes Sepsis
ABO incompatibility
292
What is the most common eye infection the first day of life? Bleeding under bone (blood not cross suture lines) White pearls on hard palate Blocked duct
293
What is the most common eye infection the first week of life? Hypothyroidism
Down's
294
What is the most common eye infection the second week of life? Medial nasal prominence did not fuse
295
What is the most common eye infection the third week of life? Maxillary shelves did not fuse
296
What are the causes of Hyperbilirubinemia? Cataracts
297
What is the cause of symmetrically small babies? Retinoblastoma
298
What is the cause of asymmetrically small babies? covered by peritoneum Abdominal wall defect
off-center
299
What is the cause of large babies? Kidney "Wilm's" tumor
hemihypertrophy
300
What is Milia? Adrenal medulla tumor
hypsarrthymia
301
What is Nevus Flammeus? Too much amniotic fluid
baby can't swallow NM problem: Werdnig-Hoffman
302
What is Seborrheic Dermatitis? Too little amniotic fluid
baby can't pee Abd muscle problem: Prune Belly Renal agenesis: Potter’s syndrome Erythema infectiosum "slapped cheeks"
303
What are Hemangiomas? Trunk rash
lymphadenopathy behind ears
304
What are Mongolian spots?
305
What is Erythema Toxicum? Multiple ecchymoses Retinal hemorrhage Epidural/Subdural hemorrhage Spiral fractures (twisted) Multiple fractures in different healing stages Osteogenesis imperfecta Bleeding disorders Fifth disease Mongolian spots
306
What is the most common intracellular buffer? Protein Bicarbonate A molecule with one negative and one positive end The pH at which there is no net charge PFK-1 Pyruvate carboxylase G-6PD Glycogen synthase Glycogen phosphorylase AcCoA carboxylase CAT-1 HMG CoA reductase
307
What is the most common extracellular buffer? HMG CoA synthase
308
What is a Zwitterion? "ABC" AcetylCoA production β-oxidation Citric acid cycle "EFGH" ER Fatty acid synthesis Glycolysis HMP shunt "HUG" Heme synthesis Urea cycle Gluconeogenesis Creates an isomer Creates an epimer
which differs around 1 chiral carbon Moves sidechain from one carbon to another (intrachain) Moves sidechain from one substrate to another (interchain) Phosphorylates using ATP Phosphorylates using Pi Forms C-C bonds (w/ ATP and biotin) using CO2 Consumes 2 substrates equally Consumes 2 substrates
309
What is the Isoelectric Point? PRPP synthase Asp transcarbamoylase Isocitrate dehydrogenase CPS-I δ-ALA synthase
310
What is the rate limiting enzyme in Glycolysis? Constant drug percentage metabolism over time
depends on drug Max effect regardless of dose (lower w/ non-competitive antagonist) Vmax Amount of drug needed to produce effect (lower w/ comp antagonist) Km Concentration of drug that binds 50% of receptors Concentration of drug that produces 50% of maximal response Fights for active site
311
What is the rate limiting enzyme in Gluconeogenesis? Gaucher's
Hurler's Hexosaminidase A deficiency => blindness
312
What is the rate limiting enzyme in the HMP shunt? Carboxylation
313
What is the rate limiting enzyme in Glycogenesis? A
G C
314
What is the rate limiting enzyme in Glycogenolysis? Nucleotides All other reactions Heterochromatin = tightly coiled Euchromatin = loose (10nm fibers)
315
What is the rate limiting enzyme in FA synthesis? "PVT TIM HALL" Phe Val Trp Thr Ile Met His Arg Linolenic
316
What is the rate limiting enzyme in β- oxidation? Asp
Glu
317
What is the rate limiting enzyme in Cholesterol synthesis? Lys
Arg
318
What is the rate limiting enzyme in Ketogenosis? Cys
Met
319
What is the rate limiting enzyme in Purine synthesis? Ser
Thr
320
What is the rate limiting enzyme in Pyrimidine synthesis? Asn
Gln
321
What is the rate limiting enzyme in TCA cycle? Gly
322
What is the rate limiting enzyme in Urea cycle? Asn
Gln
323
What is the rate limiting enzyme in Heme synthesis? Phe
Tyr
324
What are the catabolic pathways that create energy? Pro
325
What are the anabolic pathways that store energy? Left of any amino acid on the carboxy terminal Right of N terminus
326
What are the anabolic + catabolic pathways? Right of Met
327
What does an Isomerase do? Right of Cys
Met
328
What does an Epimerase do? Right of Gly
Ala
329
What does a Mutase do? Arg
Lys
330
What does a Transferase do? Phe
Tyr
331
What does a Kinase do? Inhibits trypsin from getting loose
332
What does a Phosphorylase do? No Phe → Tyr (via Phe Hydroxylase): Nutrasweet sensitivity
mental retardation
333
What does a Carboxylase do? Defective metabolism of branched aa (Leu
Iso
334
What does a Synthase do? Cystine
Ornithine
335
What does a Synthetase do? Niacin deficiency: Dermatitis
Diarrhea
336
What does a Phosphatase do? Malabsorption
big belly (ascites)
337
What is the typical incidence of rare things? 1-3% 10% 50% 90% Structural problem
50% chance of passing it on Enzyme deficiency
338
What is the typical incidence with 1 risk factor? "Lesch-Nyhan went Hunting For Pirates and Gold Cookies"* LeschNyhan (HGPRT def.): self mutilitation
gout
339
What is the typical incidence with 2 risk factors? (X
O): web neck
340
What is the typical incidence with 3 risk factors? ↓testosterone
341
What does Autosomal Dominant usually indicate? (47
XXX): normal female w/ two Barr bodies (47
342
What does Autosomal Recessive usually indicate? Patau's
polydactyly
343
What are the X-linked Recessive deficiencies? pee problem
holoprosencephaly Edward's
344
Where did X-linked Recessive diseases come from? Down's
simian crease
345
What are the X-linked Dominant diseases? macroglossia
Mongolian slant of eyes
346
Where did X-linked Dominant diseases come from? Dystrophy
Friedreich's Ataxia "Happy puppet syndrome"
347
What are the Mitochondrial diseases? Leber's = atrophy of optic nerve Leigh's = subacute necrotizing encephalomyelopathy Mom → all kids Where did Mitochondrial diseases come from? Hyperphagia
hypogonadism
348
Why do we stop CPR after 20-30min? The brain has irreversible cell injury The body has irreversible cell injury Why do we only have 6hrs to use tPA? Anosmia
small testes Regress to infantile state Decreased organ or tissue size Cell wraps itself w/ dense fibrous tissue Lose contact inhibition (cells crawl on each other) Increased cell number Increased cell size Change from one adult cell type to another New growth Well circumscribed
349
What cancers have psammoma bodies? Papillary (thyroid) Serous (ovary) Adenocarcinoma (ovary) Meningioma Mesothelioma
350
What cancer has CA-125? Ovarian Pancreatic Melanoma Breast Prostate Colon
Pancreatic Liver
351
How do you know it's an anaerobe? Gas
bad odor <10 epithelial cells and >25 leukocytes per low power field Staph aureus (attacks healthy valves)
352
What makes an adequate sputum sample? Need at least 2 "SPECC": Subcutaneous nodules Polyarthritis Erythema Marginatum (red margins) Chorea (Sydenham's) Carditis (MS > AS > TS) "MAT"
353
What bug causes Acute Bacterial Endocarditis? Neisseria Strep viridans (attacks damaged valves)
354
What bug causes Subacute Bacterial Endocarditis? H. influenza Neisseria catt.
355
How do you diagnose Rheumatic Fever? bronchitis "simple HE"
356
What are the only Gram – diplococci? H. influenza E. coli "CLUMsy"
357
What is the only Gram + diplococci? Strep pneumo "Don't TeLL Chaga" Diptheria Typhoid fever (Salmonella typhii) Legionella Lyme disease Chagas disease (Whipple's) Strep pneumo. What are the IgA protease bugs? Chlamydia Legionella Ureaplasma Mycoplasma
358
What do the IgA protease bugs Sinusitis
otitis media
359
What are the simple Gram – bugs? "Some Killers Have Pretty Nice Capsules" Salmonella Klebsiella H. influenza B Pseudomonas Neisseria Citrobacter Strep pneumo "Urease PPUNCH" Proteus Pseudomonas Ureoplasma Nocardia Cryptococcus H. Pylori "STELS" Syphilis TB EBV Listeria Salmonella
360
What are the atypical (no cell wall) bacteria? Cholera: stimulates Gs E. coli: stimulates Gs
361
What is the only Gram + endotoxin? Listeria What bugs cause heart block infections? Klebsiella Pseudomonas
362
What are the Gram – exotoxins? Bartonella henselae Pasturella multocida Toxoplasmosis
363
What are the spore forming Gram + bacteria? Lyme disease – bull's eye lesion Babesiosis – hemolytic anemia Ehrlichyosis – puncture near eye Day 1-3: Staph aureus – lots of O2 Day 4-7: Strep viridans – no enzymes Day >7: Anaerobes – PMNs DM Cystic fibrosis pts Burn pts Neutropenic pts
364
What bugs cause walking pneumonia? TB Sarcoidosis Syphilis Histiocytosis X The -ellas Sickle cell: AAs G-6PD: Mediterraneans Entamoeba histolytica Citrobacter Osler-Weber-Rendu "NASSA" Necator americanus Ancylstoma duodenale Schistosomiasis Strongyloides Ascaris lumbricoides Pulmonary eosinophilia
365
What causes Cryoglobulinemia? Pulmonary Infiltrate w/ Eosinophilia
366
What are the Silver Stainers? Group B Strep E. coli Listeria >2mo: Strep pneumo 10-21y/o: N. meningitidis
367
What bacteria cause diarrhea <8hrs after introduction? T cell/MP → non-bacterial Normal glucose →viral Gone before pt has symptoms (2 mo)
368
What are the Gram – capsules? Past infection
369
What is the Gram + capsule? Low transmissibility
370
What are the Urease + bugs? IgM
371
What bugs cause Monocytosis? IgG
372
What are the Big Mama Anaerobes? Bacteroides fragilis Strep. bovis C. melanagosepticus Pertussis: inhibits Gi What bugs disrupt G proteins? Pregnant women
Asians
373
What bacteria cause UTIs E. coli Proteus and prostatitis? endocarditis
styes
374
What bug is associated w/ cat scratch? "LINES"
ASO
375
What bug is associated w/ cat saliva? Central lines
VP shunts
376
What bug is associated w/ cat pee? Acne
progesterone => propionic acid
377
What bug is associated w/ cat caca? Toxacara cati What diseases are caused by the Ixodes Tick? Swollen eyeball w/ pus
378
What bugs cause hospital abscesses? Cat/dog saliva => cellulitis w/ lymphadenitis Female UTIs
honeymooner's cystitis Ulcers at rabbit or deer tick bite site (Tx: Streptomycin) Otitis externa
379
What kind of patients does Staph and Pseudomonas like to attack? Painful mouth ulcers
gum pus
380
What diseases have granulomas? Subacute bacterial endocarditis
green pigment Cold agglutinin test
381
What diseases provide malaria protection? Rheumatic fever
strain 12 => PSGN
382
What bug causes multiple liver abscesses? Pharyngitis Chinese letters
gray pseudomembrane
383
What bug causes multiple cerebral abscesses? Staccato coughing
elementary and reticulate bodies
384
What has multiple lung aneurysms? Bullous myringitis
ground-glass CXR
385
What bugs cause Loeffler syndrome? AC ducts
silver stains lung
386
What is the symptom of Loeffler syndrome? Canned food
honey
387
What is PIE syndrome? Black eschar
woolsorter's lung disease
388
What diseases have PIE syndrome? Aspergillus
Loeffler's
389
What are the CSF lab PMNs →bacteria values for Meningitis? Colon cancer; black pigment
390
What does the Hep B Core Ag tell you? Raw hamburger
ADP ribosylates Gs
391
What does the Core Ab tell you? Traveler's => rice-water diarrhea Hemorrhagic => renal failure Inflammatory => loose stool Pathogenic => newborn diarrhea Alcoholics
currant jelly sputum
392
Which cytokine do macrophages produce? IL-1
393
Which cytokines do TH cells stimulate? Everything other than IL-1 Supraclavicular Epitrochlear (above elbow) Inguinal TK (killer) or TS (suppressor) cell; responds to MHC-1 (self) All except RBCs and platelets
394
Which enlarged lymph nodes are most likely malignant? TH (helper) cell; responds to MHC-2 (non- self) Cell-mediated
395
Who ae the CD8 cells? IFN-gamma
396
Which of your cells express MHC-1? IL-4
IL-5
397
Who are the CD4 cells? Humoral Bacterial infection Kids w/ B cells don't differentiate into plasma cells => low Ab
398
What type of immunity does TH1 provide? Multiple osteolytic lesions
IgG
399
What do Th1 cells secrete? Recurrent encapsulated infections
400
What do Th2 cells secrete? Transfusion anaphylaxis
mucous membrane infections Fried egg/sunburst appearance
401
What type of immunity does TH2 provide? Low IgA
neuro problems
402
What do B cell deficiency patients die of? High IgM
low all other Ab
403
What is Common Variable Hypogammaglobulinemia? Viral infection
CMV
404
What is Bruton's Agammaglobulinemia? Young adults w/ defective Tyr kinase => no Ab
X-linked Redheaded females
405
What is Multiple Myeloma? albicans
chronic fatigue
406
What is Heavy Chain Disease? No thymus
frayed long bones
407
What is Selective IgG2 Deficiency? Low IgM
low platelets
408
What is Selective IgA Deficiency? IgA disease 2 weeks after URI
409
What is Hairy Cell Leukemia? IgA disease associated with deafness & cataracts
410
What is Ataxia Telangiectasia? Ankylosing Spondylitis Inflammatory Bowel Disease Reactive Arthritis (Reiter’s Syndrome)
411
What is Hyper IgM syndrome? Hay Fever SLE Goodpasture Syndrome
412
What is Grave's disease? Graves Disease
413
What is SLE? SLE
414
What do T cell deficiency patients die of? DM1
415
What is DiGeorge Syndrome? Hashimotos
416
What is the Mean? Average Middle value Most frequent value People that have the disease w/ + test People that don't have the disease w/ test
417
What is the Median? Probability of having a disease w/ + test
418
What is the Mode? Probability of not having a disease if have a negative test New cases (rate per unit time) Total cases (at one time) Diseased are x times more likely to see risk factor 95% sure it lies within the interval Risk of getting disease w/ known exposure Number Needed to Treat to change 1 life Random chance that you will be wrong 1 time out of 20 Nothing’s happening Probability of detecting a true intervention P value error
false negative "too optimistic" Power error
419
What does pain radiating to the jaw indicate? MI or pericarditis
420
What does pain radiating to the left shoulder indicate? Bend neck
see knee flexion => meningitis Purple vagina => pregnancy
421
What does pain radiating to the scapula indicate? MI or spleen rupture Gall bladder problems Pericarditis Ureter stones or osteoarthritis of hip Rebound tenderness => peritonitis Cervical motion tenderness => PID Tap facial nerve => muscle spasm Palpable gall bladder => cancer (pancreatic) Dorsiflex wrist causes pain => lateral epicondylitis "tennis elbow" Bleeding around umbilicus => hemorrhagic pancreatitis Scaly patches on MCP
PIP joints => dermatomyositis
422
What drugs act as haptens on platelets? Aspirin Heparin Quinidine
423
What drugs act as haptens on RBCs? "PAD PACS" Penicillamine α-MeDopa Dapsone PTU Antimalarials Cephalosporins Sulfa drugs "ABCV" AZT Benzene Chloramphenicol Vinblastine
424
What drugs wipe out the bone marrow? Carbaqmazapine Clozapine Ticlopidine
425
What drugs wipe out granulocytes?
426
What drugs cause pulmonary fibrosis? Busulfan Bleomycin Amiodarone Tocainide Methotrexate ACE-I and Nitrates Stabilizes: mast cells/endothelium Inhibits: MP migration/ PLA Kills: T cells/eosinophils Mental side effects Pain relief ACEI Celocoxib Loop diuretics Thiazides Sulfonylureas Sulfonamides Lispro Regular Asparte NPH Lente Glargine Ultralente "HIPPPE" Hydralizine INH Procainamide Phenytoin Penicillamine Ethosuximide Anti-histone Ab PGE2 – ripens cervix Oxytocin – increase contractions Pitocin – increase contractions Hydration (stop ADH=oxytocin) MgSO4 – decrease contractions Terbutaline – decrease contractions Ritodrine – ↑edema; decrease contractions
427
What drugs dilate veins and arteries? Water soluble drugs Fat soluble drugs N-acetylcysteine Flumazenil Glucagon Calcium Chloride + Glucagon 100% O2 Penicillamine Amyl Nitrite EtOH
Fomepizole Deferoxamine Aminocaproic acid Protamine sulfate Sodium polystyrene sulfonate Methylene blue Atropine + Pralidoxime Naloxone Succimer Charcoal or bicarbonate Bicarbonate (prevent arrhythmias) Esmolol Vit K "RIPS" Rifampin INH Prednisone Statins Metronidazole Cephalosporins Procarbazine Metronidazole Clarithromycin Lithium
428
What are the anti-inflammatory actions of steroids? "Brand New Potient" Bacitracin Neomycin Polymyxin D Azithromycin "Try to fix the fox with floxs" Ceftriaxone Cefixeme Cefoxitin
429
What do opioid mu receptors cause? MRSA Staph. epidermidis Enterococcus
430
What do opioid kappa receptors cause? Quinine – tinnitus Mefloquine – good liver penetration Primaquine – prevents relapse
high bug resistance Chloraquine – kills RBCs
431
What drugs have sulfur in them? You have been empowered… You now have the eyes of physio!
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