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Ramlonie
| Question | Answer |
|---|---|
| Digoxin toxicity Symptoms | - life threatening arithymyes -anorexia -nausea -vomiting -abdominal pain -fatigue confusion weakeness -***color vision disturbance |
| Selective estrogen receptor modulators (SERMs) | *TAMOXIFEN AND RALOXIFENE |
| MOA of slective estrogen receptor modulators? | -Competetive inhibitors of estrogen binding -Mixed agonist/antagonist action |
| SERMs indications | - prevention of breast cancer in high risk patients -Tamoxifen=adjunct treatment of Brest cancer -Raloxofene= post menopausal osteoporosis |
| SERMs adverse effects | -hot flashes.--venous thromboembolism -*ENDOMETRIAL HYPERPLASIA and carcinoma ( tamoxifen only) |
| Tamoxifen on Lipids? | Favorable effect --> decreases in total Lipids and LDL cholesterol. No change i HDL. Serum triglycerides may increase |
| Liver cirrhosis patient with Gynomastia arises from? | HYPERESTERONISM due to = increased adernal production of androtestenedione with aromatization To ---> estrone and eventual conversion of estradiol. |
| ESTRADIOL function | INDUCES SEX HORMONE-BINDIG GLOBULIN PRODUCTION---in the liver, uterus and testes |
| HYPERRSTRENISM manfestation in Cirrosis | *** SPIDER ANGIOMATA *** -> estrogen effects also on artiorloes -> also seen in Pregnanc |
| What are Spider Angiomata? | -skin/subcutaneous vascular lesion consisting of a central arteriole surrounded by many vessels that BLANCH ON COMPRESSION Due to -> estrogen effects also on artiorloes -> also seen in Pregnancy |
| accumulation Of AMMONIA seen in? | LIVER CIRRHOSIS |
| Hyperammonia in Cirrosis SYMPTOMS | * Altered Mental status * Malodorous, seet, feculent Breath |
| Filtration Fraction equals?? | FF= GFR/RPF |
| Para-aminohippuric acid equals | Renal Plasma Flow ( RPF) *PAH Is mostly secretreted |
| GFR calculated using? | Inulin and Creatinine (freely filtered) |
| Lymph drainage of *SCROTUM* | Superficial Inguinal nodes |
| Superficial Inguinal Lymph nodes Drain ? | - Anus BELOW the dentate -cutaneous lymph from umbilicus to feet |
| Testes Lymph drainage? | Para-aoric --(retropretoneal lymph nodes) |
| Glans penis and superfical nodes --> lymph drain to? | Deep Inguinal Nodes |
| COMMON ILIAC NODES lymph drainage? | Internal and External Iliac Nodes -->external ilaic recieve lymph from the Deep Inguinal Lymph Nodes |
| Inferior Mesenteric Arteries (IMA) drain what structures? | 1. Branches of IMA Such as Left colic, sigmoid, and SUPERIOR RECTAL ARTERIES = Descending and Sigmoid colon -Upper part of Rectum & their EFFERENTS DRAIN INTO pre-aortic nodes |
| UPPER Limb and Breast lymph Drainage? | Infraclavicular Lymph Nodes |
| Great Saphaneous Vein PATHWAY | Orginates from= medial aspect of Leg--> courses anterior to the meduak malleolus --> then travels to the medial aspect of LEG and THIGH |
| Great Saphenous Vein drains into? | FEMORAL VEIN , In the femoral triangle near *** InferilLateral to the Pubic Tubercle ** |
| DNA supercoil accumulation | Topoisomers reduce DNA supercoiling by nickig the DBA strands |
| Double-strand DNA break Repair seen in? | Exposure to Ionizing RADIATION |
| Impaired Mismatch Repair seen in? | * Hereditary nonpolyposis Colorectal cancer Repair of Mismatch BASES occurs in the normal genome during DNA replication. |
| What supplies Arterial blood to the Liver ? | CELIAC TRUNK -also supplies, spleen, stomach, abdominal esophagus, and parts of duodenum. |
| Increased Cells in COPD? | 1. Neutrophils 2. Macrophages 3. CD-8 T lymphocytes |
| 1. Neutrophils& Macrophages &CD-8 T lymphocytes Release what to causing damage in COPD? | *Proteases --> neutrophil Elasttase, MMP9--> leading to Mucus Hypersecretion in bronchi and Alveioli Destruction. |
| ACUTE Choleysistis Diagnosis | failed Gallbladder visualization on radionuclide Bilary scan |
| DISTENDED duadenum on upper GI series | Gallstone ILEUS (small bowel obstruction) |
| ULTRASOUND of Acute Choleysistis = | gallbladder wall thickening-- -Pericholeystic Fluid ** MURPHY SIGN + post |
| New-onset Odynophagia( hurt to eat) and Chronic GI Reflux disease suggests what? | ULCER formation |
| INFECTIOUS Esophagitis caused by what Bugs? | CMV, Candida, and Herpes simplex virus |
| Esophageal Stricture | *Dysphagia to solid food -Esophageal obstruction - |
| Barretts Metaplasia | -Malignant transformation->>due to chronic complication of GERD - weight loss and Dysphagia |
| Prostate cancer spreads to Bone how? | -through PROSTATIC venous plexus --> Vertebral venkus plexus ---> Lumbrosacr Spine |
| T-tubles | **Ensures Coordinated Contraction of the Myofibrils -depolarization signals to the Sarcoplasmic Reticulum -trigger release of Calcium |
| No T-tubles in Muscle fibers leads to= | Uncoordinated contraction if Myofibrils |
| NO Troponin C and Myocin in Muscle fibe leads to= | NO Conteaction jn response to Intracellular Ca |
| MYASTHENIA GRAVIS | Autoantibodies to Acetochioline receptors in NMJ => Poor contractile force generation on Repeated Stimulation |
| McArdle Disease | -glycogen storage diease type 4 due to defdxt in ***Myophisphorylase ->Impaired energy production during muscle contraction--> lWeakness And Cramping during Excersize -> failure of Muscle glycogen Breakdown due |
| KRAS moa | Proto-onco gene thats encodes GTP-Bindig Protein involved in division via transduction of extracellular signals --> Epidermal Growth factor Receptors(EGFR) |
| KRAS mutation | -increased cell proliferation , that is *RESISTANT TO ANTI-EGFR MEDS (cetuximab and panitumumab) ** metastatic COLON cancer |
| Platelet-Derived Growth factor | *forms new blood vessels ** proliferation of Fibroblasts and smooth muscle cells ****BINDS TO Receptor Tyrosine kinase ** Mutation leads to =over-expression and uncontrolled Angiogenesis |
| Vascular endothelial Growth factor (VEGF) | -angiogensis -LYMPH VESSEL devlopments *mutation leads to VEGG promotes Growth and metastasis of Cancers |
| Old lady or Giatric Patients with -->Isolated systolic Hypertension and diastolic blood pressure normal (<90) is DUE to | Age related Aortic Stiffening --> decreased in complince of the Aorta and major peripheral arteries. |
| Pneumococcal Conjugate Vaccine | Strongly immunogenic ðð¾ because of both B and T-cell Recruiment--> they provide long lastjng antibid Titers vs he ðpolySsachride Vacine |
| Pneumococcal Polysaashride vaccineðð¾ | Poorly immunogenic in infants due to their Relatively Immature Humoral Antibody resppnse ðð¾ |
| HYPOVENTILATION | Low PaCO2 with NORMAL A-a gradient |
| Mallory-weiss syndrome | Increased intraluminal gastric pressure due to -> ***Retching, Vomiting, other abdominal Straining |
Created by:
Ramzdjama
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