SGLT-2
(-flozin) decrease glucose absortption in PCT AE: glucosuria (candida), hyperkalemia, orthostatic hypotension, weight loss
meglitinides
(-inide) close K channels to cause Ca influx AE: disulfiram, weight gain, hypoglycemia
DPP-4
(-liptin) decreased glucagon and gastric emptying AE: increased satiety, infections
glitazones
(-zone) activate PPAR take several weeks to work AE: weight gain, MI, fractures, edema
echinocandins
-fungins inhibit B-glucan synthesis of cell walls uses: aspergillosis AE: GI upset, flushing
meningitis organisms by age
0-6mth (GEL): group B, E.coli, listeria 6-6yrs (SHiN): s. pneumo, HiB, neisseria, group B, enterovirus/coxsackie 6-60yrs: neisseria, s. pneumo, HSV2, enterovirus/coxsackie +60yrs (SHINGL): s. pneumo, HiB, neisseria, group B, listeria HIV: cryptococcus
Pompe disease
1,4 debranching deficiency cardiomegaly, weakness
Cori disease
1,6 debranching deficiency normal blood lactate levels fasting hypoglycemia, hyperlipidemia, hyperuricemia, hepatosplenomegaly
relative risk reduction formula
1-RR
hypersensitivity examples
1: anaphylaxis 2: graves, goodpasture, hemolytic reactions, rheumatic fever, myasthenia gravis 3: SLE, serum sickness, post-strep glomerulo 4: PPD, contact dermatitis, MS, DM1, organ rejection, hashimoto, GBS, RA
rib muscles
1: anterior scalene 2: posterior scalene 3-5: pectoralis minor 6-9: serratus anterior 10-11: latissimus dorsi 12: quadratus lumborum
tuberous sclerosis
1: chromosome 9 -- hamartin 2: chromosome 16 -- tuberin cardic rhabdo, ash leaf spots, renal angiomyolipomas
cranial nerve exits in skull
1: cribriform plate 2: optic canal 3, 4, V1, 6: superior orbital fissure V2: rotundum V3: ovale 7: stylomastoid or IAM 8: IAM 9, 10, 11: jugular 12: hypoglossal
warfarin
2, 7, 9, C, S given orally generalized skin necrosis give with heparin to avoid transient hypercoagulation
ANOVA
3 or more groups
Turner syndrome
45XO nonfunctioning ovaries (low estrogen, high FSH/LH) aorta coarctation, bicuspid aortic valve
Kleinfelter syndrome
47XXY low testosterone, high FSH/LH gynecomastia, hypogonadism, sterile
hemophilia
A: factor 8 B: factor 9 increased PTT joint bleeding and bruising
codominance
ABO blood groups
cross arm test
AC joint
anterior drawer sign
ACL tear
odds ratio formula
AD/BC
AD, AR, XD, XR inheritance patterns
AD: song AR: younger and more severe XD: daughters from fathers XR: sons from mothers
small cell lung cancer
AKA oat cell small dark cells hypocalcemia and SIADH
wide fixed S2
ASD
Menkes disease
ATP7A copper: low in brain/liver, high in gut/kidneys symptoms: kinky hair, hypotonia, cerebral aneurysms
insulinoma
B-cells tumor hypoglycemia, high C-peptides
staph aureus
B-hemolytic, heat stable virulence: protein A binds Fc-IgG to inhibit complement activation and phagocytosis causes: skin infections, organ abscesses, secondary pneumonia, endocarditis, septic arthritis, osteomyelitis MRSA: altered penicillin binding protein on mecA gene TSS: fever, vomiting, rash, liver failure (from tampons or nasal packing) food poisoning: meat, mayo, custard
incomplete penetrance
BRCA
BRCA chromosomes
BRCA1: 17 BRCA 2: 13
complement protein for cell migration
C3A mostly neutrophils
complement protein for opsonization
C3B
eculizumab
C5 complement paroxysmal nocturnal hemoglobinuria
axillary nerve
C5-C6 deltoid sensation to lateral arm
musculocutaneous nerve
C5-C7 bicep reflex sensation to lateral forearm forearm flexion and supination
median nerve
C5-T1 ape hand wrist flexion and thumb opposition sensation to thenar eminence
radial nerve
C5-T1 grip strength wrist drop extension of wrist and fingers
ulnar nerve
C8-T1 claw hand radial wrist deviation
Huntington's disease
CAG repeat chromosome 4 decreased ACh & GABA increased dopamine causes chorea in basal ganglia and caudate
rituximab
CD20 non-Hodgkin's lymphoma
daclizumab
CD25 MS
alemtuzamab
CD52 CLL
fragile X syndrome
CGG repeat large ears, long face, large testes
when are beta blockers contraindicated
CHF, asthma, COPD, diabetics, cocaine use
ocular cranial nerves and movements
CN III: levator, SR, MR, IR, IO CN IV trochlear: SO CN VI abducens: LR away from nose: SR up, IR down towards nose: IO up, SO down
obstructive lung disease
COPD, emphysema, asthma trouble exhaling decreased FEV, FEV/FVC, FVC increased TLC PEFR low increased compliance alveolar wall destruction
vancomycin
D-ala cell wall synthesis C.difficile and MRSA AE: nepro/ototoxic, red man syndrome
cetuximab
EGFR colon, throat cancer
Von Gierke's disease
G6P deficiency high blood lactate levels fasting hypoglycemia, hyperlipidemia, hyperuricemia, hepatosplenomegaly
Friedreich ataxia
GAA repeat frataxin defect increased Fe in cells, damaged mitochondria steppage gait, scoliosis, pes cavus, HCM
trastuzimab
HER2 breast cancer
roseola
HHV6/7 fever first then rash trunk to extremities
chromosome 4 disorders
Huntington, ADPKD2, achondroplasia
abciximab
IIa/IIIb glycoprotein on platelets CAD
ustekinumab
IL-12, IL-23 psoriasis
heart block poem
If the R is far from P, then you have a 1st degree. Longer, longer, longer drop, then you have a Weinkebach (Mobitz 1). If some Ps don't get through, then you have a Mobitz 2. If Ps and Qs don't agree, then you have a 3rd degree.
omalizumab
IgE allergies/asthma
classic complement pathway
IgG or IgM mediated C1 - C2B - C3B - C5B - MAC
vault hold finger placement
Index: greater wing of sphenoid Middle: preauricular portion of temporal bone Ring: mastoid process of temporal bone Pinky: squamous portion of occipital bone
CYP450 inducers
John's CRAP GPS: st. john's wort carbemazepine rifampin alcohol phenytoin griseofulvin phenobarbitone sulfonylureas
genitofemoral nerve
L1-L2 cremaster reflex sensation to medial thigh and scrotom/majora
lateral femoral cutaneous nerve
L2-L3 anterior lateral thigh sensation
obturator nerve
L2-L4 medial thigh sensation adduction
femoral nerve
L2-L4 patellar reflex medial leg sensation leg extension
common peroneal nerve
L4-S2 dorsiflexion and eversion lateral leg and dorsum sensation
sciatic nerve
L4-S3
tibial nerve
L4-S3 plantarflexion and inversion
inferior gluteal nerve
L5-S2 gluteus maximus trouble rising and climbing stairs
abnormal passive adduction
LCL tear
varus stress test
LCL tear
homonymous hemianopsia with macular sparing
MCA or PCA stroke (but not both) occipital lobe lesion
abnormal passive abduction
MCL tear
valgus stress test
MCL tear
medullary thyroid carcinoma
MEN2A and 2B calcitonin
heteroplasmy
MERFF (myoclonic epilepsy w/ ragged red fibers)
CYP 1A2
Metabolizes acetaminophen and diazepam
intermediate acting insulin
NPH
posterior draw sign
PCL tear
pleiotrophy
PKU
penicillinase sensitive penicillins
Penicillin G: strpe, neisseria, syphilis Amphicillin/amoxicillin: HHELPSS: H influ, H pylori, Ecoli, listeria, proteus, salmonella, shigella AE: hypersensitivity, hemolytic anemia, interstitial nephritis, pseudomembranous colitis
coxiella burnetii
Q-fever unpasteurized milk
denosumab
RANKL osteoporosis
MEN 2B
RET gene mucosal, medullary thyroid, pheochromocytoma (marfanoid harbitus)
MEN 2A
RET gene parathyroid, medullary thyroid, pheochromocytoma
palivizumab
RSV F-protein
heart sounds
S1: AV closure S2: aorta/pulmonary closure S3: CHF, dilated cardiomyopathy S4: AV opening (only heard in vent. hypertrophy)
CYP450 inhibitors
SICK QV AGE: sulfonamides isoniazid chloramphenicol ketoconazole quinidine valproate amiodarone grapefruit juice erythromycin
male fetal development
SRY gene causes testes development testes secrete testosterone wolfian ducts become sem. tubes, epidy, vas def testes secrete anti-mullerian for degeneration
iliohypogastric nerve
T12-L1 suprapubic sensation
infliximab
TNF-a IBD
cranial techniques and what they are used for
V-spread: any suture dysfunction venous sinus: decrease dural sinus congestion parietal lift: squamous suture CV4: increase amplitude, breastfeeding (restrict flexion, enhance extension)
ventilation and perfusion
V/Q mismatch: anything causing hypoxemia high V/Q at top of lungs (high V, low Q) low V/Q at lower lungs (low V, high Q) all V: dead space all Q: shunting
bevacizumab
VEG-F colon cancer
pathological gaits
Waddling: Duchenne Trendelenburg: superior gluteal nerve (L4-S1) Steppage: common peroneal nerve (L4-S2) foot drop Truncal ataxia: wide based cerebellar gait (vermis lesion) Staggering: Friedreich ataxia Choreiform: Huntington
Hunter disease
X-linked recessive 2-iduronate sulfatase deficiency gargoylism, aggresion
attributable risk formula
[a/(a+b)]-[c/(c+d)]
relative risk formula
[a/(a+b)]/[c/(c+d)]
natalizumab
a-4 integrin MS, Chrons
glucagonoma
a-cells tumor dermatitis, diarrhea, DVT, declining weight, diabetes treat: octreotide
Fabry disease
a-galacosidase deficiency ceramide trihexose buildup angiokeratomas (skin spots), hypohidrosis, neuropathy
Hurler disease
a-iduronate sulfatase deficiency corneal clouding, gargoylism
a-glucosidase
acarbose, miglitol inhibits brush border glucose absorption AE: bloating, GI
insulin moa
activates tyrosine kinase increases glucose and TG storage increases K uptake in cells
subdural hematoma
alcoholics and elderly who fall crescent shaped bridging veins
osteoporosis with history of breast cancer
alendronate type of bisphosphonate inhibits osteoclast mediated resorption
cervical HVLA technique
always flex and only change one thing
50s binders
aminoglycosides (-micin) tigecycline tetracycline doxycycline
which antibiotics can cause a rash if given for a viral infection
amoxicillin ampicillin
myasthenia gravis
antibodies to postsynaptic ACh receptors symptoms: proximal muscle weakness, eye issues, dyspnea, dysphagia treat: pyridostigmine (AChE inhibitor)
Lambert-Eaton syndrome
antibodies to presynaptic Ca channels decreased ACh release associated with small cell lung cancer symptoms: proximal muscle weakness, dry mouth, constipation, impotence, hyporeflexia
TCA overdose
anticholinergic symptoms treat: sodium bicarb
macrolides
atypical pneumonia, chlamydia, pertussis AE: GI motility, prolonged QT, eosinophilia
meningitis treatment
bacterial: ceftriaxone + vancomycin pseudomonas: cefepime listeria: add ampicillin HIV: amphotericin + flucytosine HSV: acyclovir
benzos and barbiturates moa seizures
benzos: increase GABA frequency barbs: increase GABA duration
phenytoin
block sodium AE: zero order kinetics, fetal hydantoin
valproate
block sodium, increase GABA AE: anemia, hepatotoxic, spina bifida
beta blocker side effects
bradycardia, dyslipidemia, sexual dysfunction
common metastatic sites
breast: brain and bone prostate: bone lung: brain melanoma: brain colon: liver
sick sinus syndrome
bursts of tachy and bursts of brady
anticholinergic symptoms
can't see can't pee can't spit can't shit
Echinococcus
causes hydatid cysts in liver rupture causes anaphylaxis from ingesting eggs with dog feces intermediate host is sheep treat: albendazole
4th generation cephalosporin
cefepime pseudomonas
30s binders
chloramphenicol clindamycin linezolid macrolides (erythromycin, etc)
what malarial drugs are safe during pregnancy
chloroquine mefloquine (safe in 2-3 trimesters)
sulfonylureas
chlorpromadine, tolbutamide, glipizide, glyburide close K channels to cause Ca influx AE: disulfiram, weight gain, hypoglycemia
bile acid resins
cholestyramine, colestipol, colesevelam decreases LDL AE: GI upset, decrease absorption of fat vitamins
sickle cell
chromosome 11 glu to val mutation
wilms tumor
chromosome 11 hematuria, fever
MEN 1
chromosome 11 pituitary, pancreatic, parathyroid tumors
RB1
chromosome 13
wilson disease
chromosome 13 kayser-fleischer rings
Patau syndrome
chromosome 13 rocker bottom feet, cleft palate, midline defects
marfan's disease
chromosome 15 fibrillin defect MVP, upward lens subluxation, aortic dissections
Angelman syndrome
chromosome 15 maternal deletion happy puppet, sleepless
Prader-Willi Syndrome
chromosome 15 paternal deletion constant hunger, obesity
NF1
chromosome 17 neurofibromin -- inhibits RAS cafe au lait, wilms, pheochromocytoma, lisch nodules
Edward's syndrome
chromosome 18 rocker botton feet, overlapping fingers, micrognathia
NF2
chromosome 22 -- merlin bilateral schwannomas, ependymomas, juvenile cataracts
von hippel lindau
chromosome 3 hemangioma, renal cell carcinoma, angioblastoma
FAP
chromosome 5 APC gene 100+ GI polyps
cri-du-chat
chromosome 5 cat cry and VSD
hemochromotosis
chromosome 6 cirrhosis, diabetes, hyperpigmentation
cystic fibrosis
chromosome 7 absent vas deferens, greasy bulky stool
William's syndrome
chromosome 7 elfin face, extremely friendly, hypercalcemia, aortic stenosis
ascariasis
colicky pain in small instines
aspergillosis
common w/ chronic granulomatous disease has aflatoxin associated w/ hepatocellular carcinoma treat: voriconazole + caspofungin
subfalcine herniation
compresses ACA bitemporal hemianopia
isotonic exercises
concentric: towards you eccentric: away from you
granulosa cells
convert androgen to estrogen in resonse to FSH
epidural hematoma
convex ball does not cross suture lines has lucid intervals middle meningeal artery usually common with skull fractures
acid fast stool staining
cryptosporidium
lamotrigene
decrease Na and glutamate AE: steven johnson
G6PD deficiency
decreased NADPH Heinza bodies and bite cells avoid: fava beans, sulfa drugs, antimalarials back pain, hemoglobinuria
PCSK9 inhibitors
decreases LDL inactivates LDL receptor degradation to increase removal of LDL AE: myalgia, dementia, neurocog issues
ezetimibe
decreases LDL prevents cholesterol absorption at small intestine brush border AE: diarrhea, hepatotoxic
ethosuximide
decreases calcium AE: steven johnson
pramlintide
decreases glucagon and gastric emptying AE: increased satiety, hypoglycemia
von willebrand disease
defect in platelet plug formation/adhesion asymptomatic until injury increased PTT treat: desmopressin
somatostatinoma
delta-cells tumor lowers glucagon, insulin, gastrin, cholecystokinin symptoms: diabetes, steatorrhea, gallstones treat: octreotide
long acting insulin
determir glargine
DHT (dihydrotestosterone)
develops male external genitalia XY without DHT = internal male, external female
penicillinase resistant penicillins
diclo, nafcillin, oxacillin aureus except MRSA AE: hypersensitivity, interstitial nephritis
draw brachial plexus
draw brachial plexus
type III dyslipidemia
dysbetalipoproteinemia protein: ApoE increased: chylomicrons, VLDL remnants symptoms: CAD w/vasculitis, palmar xanthomas
estrogen types
estrone (E1)- post menopause estradiol (E2)- pre menopause estratriol (E3)- pregnancy
cholinergic symptoms
excess actylcholine DUMBELLS: diarrhea, urination, miosis, bradycardia, emesis, lacrimation, lethargy, salivation Nicotinic: dilated pupils, tachycardia Muscarinic: constricted pupils, bradycardia
polyhydraminos
excess amniotic fluid TE fistula, duodenal atresia, esophageal fistula maternal DM, hyperglycemic baby
GLP-1
exenatide, liraglutide decrease glucagon and gastric emptying AE: weight loss, pancreatitis
2nd generation cephalosporin
fa, fox, fur HENS PEcK: H influ, enterobacter, neisseria, serratia, proteus, Ecoli, klebsiella
1st generation cephalosporin
faz, phalex PEcK: proteus, Ecoli, klebsiella
malaria infection pathway
female anopheles injects sporozoite (infective) merozoites spread through body (pathogenic)
Still's technique
first toward ease then towards restriction (indirect then direct)
diphyllobothrium latum
fish tapeworm causes B12 deficiency treat: praziquantel
tonsillar herniation
flaccid paralysis unconsciousness
Dengue
flavivirus (enveloped +ssRNA) symptoms: high fever, easy bruising/bleeding, pain in joint/back/back of eyes treat: acetominophen
serotonin syndrome
from SSRIs or linezolid hyperreflexia treat: cryptoheptadine (H1 and serotonin blocker)
locked-in syndrome
from basilar arteries can only do vertical eye movement and blink
sporotrichosis
from rose gardens treat: itraconazole (14-demethylase ergosterol synthesis inhibition)
neuroleptic malignant syndrome
from typical antipsychotics rigidity
Trichinella
from undercooked pork or bear larva enters blood and encysts in muscle symptoms: fever, N/V, periorbital edema treat: bendazoles
Krabbe disease
galactocerebrosidase deficiency globoid cells, optic atrophy, neuropathy
which STD can change pH
gardnerella treat: metro or clindamycin
fibrates
gemfibrozil, -fibrate decreases triglycerides activates PPAR to induce HDL synthesis AE: myopathy, gallstones
rubella
german measles togavirus associated with PDA symptoms: fever, lymphadenopathy, blueberry muffin, rash of face that spread centrifugally to trunk and extremities
Gaucher disease
glucocerebrosidase deficiency AVN, hepatosplenomegaly, osteoporosis
McArdles disease
glycogen phosphorylase deficiency symptoms: hypoglycemia and muscle cramps with exertion, myoglobinuria
prevotella
gram negative anaerobic rod pneumonia in alcoholics nosocomial decubitus ulcers
follicular thyroid carcinoma
hematogenous spread caricinoma = invades capsule adenoma = contained in capsule
brown sequard syndrome
hemisection of spinal cord ipsilateral: corticospinal tract UMN ipsilateral: dorsal column (proprio, fine touch) contra: 3 segments down LST (pain, temp)
pinpointed pupils
heroin or opiate overdose treat: naloxone
isometric exercises
holding a weight still
locus heterogeneity
homocysteinuria MEN2B marfanoid habitus
uncal herniation
homonymous hemianopia CN3 palsy ipsilateral body weakness
anticipation
huntington
Conn syndrome
hyperaldosteronism hypernatremia, hypokalemia, HTN
type II dyslipidemia
hypercholesterolemia proteins: LDL receptors, ApoB increased: LDL symptoms: CAD, tendon xanthomas
type I dyslipidemia
hyperchylomicronemia protein: lipo lipase, ApoC increased: chylomicrons symptoms: pancreatitis, skin xanthomas
protein C and S deficiency
hypercoagulability
Cushing's syndrome
hypercortisolism
cephalosporin AEs
hypersensitivity, disulfiram, vitamin K deficiency
type IV dyslipidemia
hypertriglyceridemia protein: Apo A-V increased: VLDL symptoms: obesity, diabetes
insulin AEs
hypoglycemia lipodystrophy hypersensitivity
carbamazepine
increase Na refractory AE: steven johnson, SIADH
causes of edema (starling forces)
increased capillary pressure increased capillary permeability increased interstitial oncotic pressure decreased plasma proteins
niacin
increases HDL AE: flushing
azoles
inhibit ergosterol synthesis (14-demethylase) AE: gynecomastia, liver dysfunction from P450 inhibition Uses: less serious systemic mycosis and candida mucor/rhizopus: isavuconazole aspergillis: voriconazole
flucytosine
inhibits 5-fluorouracil DNA synthesis uses: cryptococcus AE: bone marrow suppression
tetanus
inhibits GABA and glycine
metformin
inhibits mGPD AE: weight loss, B12 deficiency, lactic acidosis, GI
griseofulvin
inhibits microtubules uses: dermatophytes AE: teratogenic, carcinogenic, disulfiram, induce P450/warfarin metabolism
terbinafine
inhibits squalene epoxidase uses: nail, hair, skin dermatophytes AE: GI upset, hepatotoxic, taste disturbance
heparin
injection site necrosis
mefloquine
kills malaria cysts in liver
cavitary lung lesions
klebsiella pneumonia think nursing homes and alcoholics makes it easier to get TB
O'Brien test
labrum tear
muscle used to open jaw
lateral pterygoid
dapsone
leprosy pneumocystis prophylaxis AE: G6PD, agranulocytosis
rapid acting insulins
lispro aspart glulisine
acetaminophen overdose
liver failure symptoms treat: N-acetyl-cysteine
paired t-test
looking for mean difference
Addison's disease
low cortisol and aldosterone (dark skin, low BP, thin, hypotension, hypoglycemia)
bird beak sign
lower sphincter of esophagus cannot relax lost innervation seen in Chagas
Wuchereria
lymphatic filariasis elephantiasis worms in lymph nodes from mosquito treat: diethylcarbamazine
papillary thyroid carcinoma
lymphatic spread psmomma bodies
drugs that cause prolonged QT
macrolides class 1a, 1c, III
theca cells
make androgen in response to LH
lectin complement pathway
mannose mediated C1 like - C4B - C3B - C5B- MAC
variable expressivity
marfan NF1
rubeola
measles symptoms: fever, cough, coryza, koplik spots rash from head downward treat: vitamin A
counterstrain for elbow epicondyles
medial: flex, adduct, pronate lateral: extend, supinate
malaria prophylaxis
mefloquine, atovaquone, doxycycline
most common cancers in men and women
men: prostate, lung women: breast, lung mortality men: lung, prostate mortality women: lung, breast
McMurray test
meniscus tear (LIME: lateral meniscus-int rotation, medial meniscus-ext rotation)
aspirin overdose
metabolic acidosis treat: sodium bicarb
CYP 2D6
metabolizes cardiovascular drugs
CYP 2E1
metabolizes ethanol
CYP 2C9
metabolizes warfarin
abortion medications
mifepristone: blocks progesteron misoprostol: inhibits gastric acid E1
rheumatic fever heart problems
mitral stenosis from strep pyogenes
CYP 3A4
most common
candida treatment
mouth: nystatin (tears ergosterol) blood: amphotericin (tears ergosterol) vagina: metro or topical azoles pregnant: topical azoles
atypical pneumonia
mycoplasma, legionella, chlamydia usually both lungs interstitial infiltrates everywhere
visual field defects and lesion locations
nerve: complete loss in same eye chiasm: bitemporal hemi tract: opposite homo hemi parietal radiations: inferior quad temporal radiations: superior quad
female fetal development
no SRY gene causes ovary development no testosterone causes wolfian degeneration no testosterone allows mullerian to develop
melanomas
nodular: deep and worst prognosis basal cell: upper lip and higher, less aggresive, pearly and telangiectasia squamous cell: lower lip, ulcer looking, keratin pearls
most common lung cancer in non-smokers
non-small cell lung cancer (adenocarcinoma)
growth charts
normal velocity = parallel to curve = no worries
subarachnoid hematoma
on bottom of brain follows tracts from AVM or aneurysm CSF is yellow (xanthrochromic) worst headache of my life associated wtih PKD
extra pyramidal symptoms
parkinsonism: tardive dyskinesia, dystonia, akathisia treat: benzotropine (anticholinergic) or beta blocker
PIGA mutation
paroxysmal noctural hemoglobinuria complement mediated hemolysis CD55/59
enterobius vermicularis
pinworms scotch tape test nocturnal anal itching
Malassezia
pityriasis or tinea versicolor hypo or hyperpigmentation shagetti and meatball microscopy common after sun exposure treat: selenium sulfide
restrictive lung disease
pneumonia, fibrosis, sarcoidosis trouble inhaling normal or slightly decreased FEV decreased FVC normal or high FEV/FVC decreased TLC PEFR normal
nosocomial pneumonia
pseudomonas usually from ventilators
drugs to avoid in G6PD
quinidine isoniazid sulfa drugs aspirin/NSAIDs quinolones nitrofurantoin
anaplastic thyroid carcinoma
rapid onset older people large neck
leptospirosis
rat urine hemorrhagic jaundice
short acting insulin
regular
strep. bovis
related to colon cancer
onchocerca volvulus
river blindess black fly
typical pneumonia
s. pneumo, influenza, aureus secondary usually one lung consolidations in lungs treat: ampicillin, azithromycin, ceftriaxone
Leischmaniasis
sandflies skin sores, dyspnea
hilar lymphadenopathy
sarcoidosis tuberculosis
cryptococcus
seen with India ink (halo and red capsule) latex agglutination test gray matter with soap bubble lesions soil and pigeon droppings
dexamethasone suppression test
should decrease cortisol levels if levels stay high = Cushings
most common lung cancer in smokers
squamous cell carcinoma causes hypercalcemia
HMG-CoA reductase inhibitors
statins lowers LDL decrease mortality in CAD patients AE: hepatotoxic, myopathy
central herniation
sunset eyes dilated & fixed pupils
alternative complement pathway
surface mediated C3 - C3B + Bb - C3B - C5B - MAC
benzo overdose
symptoms: confusion, bradycardia, resp distress, ataxia, slurred speech, hypotension, red eyes treat: flumazenil
5th generation cephalosporin
taroline MRSA
nystatin
tears ergosterol uses: candida topical use only
amphotericin B
tears ergosterol uses: systemic mycoses and mucor AE: fever/chills, phlebitis, anemia, hypotension, nephrotoxic
Wallenberg test
tests for vertebral artery insufficiency
Chikungunya
togavirus (enveloped, +ssRNA) can co-infect with Dengue symptoms: high fever, intense joint pain, rash treat: acetominophen
oligohydraminos
too little amniotic fluid bladder obstruction PCKD potter syndrome: pulmonary hypoplasia, oligo, twisted facies, extremity deformities, renal agenesis
tamoxifen
treats ER+ breast cancer binds estrogen decreases breast cancer risk increases endometrial cancer risk
syphilis heart problems
tree bark appearance of aorta
3rd generation cephalosporin
tria, tax, pod, taz crosses BBB (lyme disease, meningitis)
heart problems in IV drugs users
tricuspid valve issue from aureus or viridans
Necator americanus
type of ancylostomas hookworms subcutaneous transmission from barefeet serpiginous rash cause iron deficiency anemia treat: bendazoles (microtubulin) or pyrantel pamoate (depolarizing neuromuscular block)
carbonic anhydrase inhibitors
types: acetazolamide uses: altitude sickness, glaucoma, metabolic alkalosis moa: decrease Na reabsorption area: PCT AE: acidosis, hypokalemia
loop diuretics
types: furosemide, ethacrynic acid, bumetanide uses: edema, HTN, hypercalcemia moa: prevents Na/K/Cl transporter area: thich ascending loop AE: ototoxic, hypokalemia, hypomagnesium, gout, metabolic alkalosis, interstitial nephritis
potassium sparing diuretics
types: spironolactone, amilioride, triamterene uses: hyperaldosteronism moa: decrease Na reabsorption, decrease K excretion area: DCT and collecting duct AE: hyperkalemia, gynecomastia
5a-reductase deficiency
unable to make DHT male internal, ambiguous external really high testosterone levels during puberty
brucella
undulant fever from unpasteurized dairy treat: doxycycline, streptomycin, or cipro
dilated pupils
upper overdose (cocaine, meth, PCP, LSD) treat: benzos treat cocaine: benzo and labetalol
thiazide diuretics
uses: HTN, osteoporosis, CHF moa: inhibits Na/Cl reabsorption area: DCT AE: hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, hyponatremia, hypokalemia
seizure medications and uses
valproate: first line for general seizures phenytoin: prophylaxis/reoccurrence ethosuximide: absence seizures carbamazepine: trigeminal neuralgia lamotrigene: seizures & bipolar benzos/barbiturates: stop active seizure
rickettsia
vasculatis with rash