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83 Cards in this Set
- Front
- Back
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Location of most tubular injuly in ischemic ATN
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Straight portion of proximal tubule + medullary thick ascending limb
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Main serum abnormality in initiation phase of ATN
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BUN and creatinine increased
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Main serum abnormalities in maintenance phase of ATN
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Progressive BUN and creatinine increase, hyperkalemia, acidosis
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Main serum abnormalities in recovery phase of ATN
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BUN and creatinine progress toward normal, hypokalemia
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Casts seen in ischemic ATN
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Hyaline and granular
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Vertebral level of kidneys
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T12-L3, right slightly lower
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Side of kidneys paranephric fat is on, and its relationship to renal fascia
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Posterior; superficial
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Vertebral level of kidney hilum
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L1 or 2
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Lymphatic drainage of kidney
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Lumbar nodes at renal artery origin
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Layer of fat under renal fascia
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Perinephric
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Structure immediately anterior to right renal artery near midline
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IVC
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Which renal vein is longer?
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Left
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Most common causes (not the organism, the cause) of UTI in women
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Pregnancy, sex
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Minimum number of colonies to diagnose UTI instead of just contamination
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10^5
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Enzyme blocked by TMP
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Dihydrofolate reductase
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Enzyme blocked by SMX
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Dihydropteroate Synthase
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Toxicity of TMP-SMX
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Stevens-Johnson, myelosuppresion, mydriasis, agranulocytosis, liver damage
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Difference of floroquinolone mechanism in gram + vs gram -
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Gram +: Topoisomerase IV inhibitor, Gram - : DNA gyrase inhibitor
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More potent: cipro or levofloxacin?
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Levofloxacin (especially in gram +)
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Possible EKG abnormality with floroquinolones. Why?
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Prlonged QTc; blockage of potassium current
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Mechanism of disorientation in SIADH?
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Osmotic shift of water into brain cells
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Main nuclei where ADH is formed
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Supraoptic
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Method of feedback of ADH secretion
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Stretch and baro receptors
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Function of Vasopressin 1 vs 2 receptors
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1 = vasoconstriction, 2 = water absorption
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Mechanism of muscle weakness in SIADH
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Hyponatremia
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Two markers signifying a tumor is of neuro-endocrine origin
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Chromogranin, neuron-specific enolase
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Vitamin (not D) whose deficiency can cause osteoporosis
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Vitamin C
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Three cytokines that increase RANKL activity post-menopausal osteoporosis
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IL1, IL6, TNF
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Ligand causing differentiation of macrophages into oscteoclasts
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RANKL
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Heaviest site of GI calcium absorption
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Duodenum
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Mechanism by which Vit D increases calcium absorption in the gut
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Increases production of calcium binding protein in intestinal epithelium
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Effect of vitamin D on phosphate levels
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Increased
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Effect of PTH on Mg excretion
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Decreased
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First line tx for Paget's disease
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Bisphosphonate, calcitonin
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SERM used for postmenopausal osteoporosis
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Raloxifene
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Reason bisphosphonate users are instructed to drink water and remain upright following a dose
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Reduce risk of erosive esophagitis
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This drug is used to inhibit bone resorption and comes in a nasal spray
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Salmon calcitonin
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What form of vitamin D should you give someone with kidney failure? Why?
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Calcitriol. This is an active form. Precursors can't be converted
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Vitamin D analog that can lower PTH and much less likely to precipitate hypercalcemia
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Paricalcitol
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MOA of cinaclet
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Activates calcium-sensing receptor in parathyroid cells to decrease PTH synthesis
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Mechanism by which osteoprotegerin decrease bone resorption
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Acts as a decoy receptor for RANKL, thereby decreasing osteocyte production
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Paget's disease: more common in men or women?
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Men
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Distal radius fracture in an eldery person: more likely Paget's or osteoporosis?
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Osteoporosis
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Three common locations of Paget's fractures
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Pelvis, skull, femur
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What is seen at the center of a rheumatoid nodule?
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Fibrinoid necrosis
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WBC's seen in a tophus
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Macrophages, lymphocytes, giant cells
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Shape of pseudogout crystals
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Rectangular/rhomboid
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Two initial substrates that lead to uric acid production
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GMP and AMP
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Function of hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
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Purine salvage pathway. Converts hypoxanthine to IMP and guanine to GMP. Decreases net uric acid
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Disease where HGPRT is deficient and its symptoms
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Lesch-Nyhan. Hyperurecemia, retardation, self-mutilation, sometimes gout
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Inheitence of Lesch-Nyhan
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X-linked
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Two modifiable risk factors for gout
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Alcohol and obesity
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Cytokine released when monosodium urate crystals are phagocytized
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Leukotriene B4
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Visceral organ sometimes affected in gout and problems caused
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Kidney - can lead to stone formation, fibrosis, UTI, and even renal failure
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Shape of neisseria gonorrhoeae
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Cocci
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Types of nerve fibers transmitting pain
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A-delta and C fibers
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Where is CRP produced?
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Liver
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Generation of ceftriaxone
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3rd
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Advantage of 3rd gen over 1st gen cephalosporins
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Broading spectrum of action (particularly against gram neg), some able to cross BBB
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Substrate of COX
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Arachidonic acid
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Gout drug that pregnant women should not use
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Colchicine
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What time of day does cortisol peak?
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The morning
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Effect of ACTH on total cholesterol
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Decreased (cortisol production requires cholesterol)
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GI consequence of Cushing's
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Can induce peptic ulcers
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Usefullness of ketoconazole in Cushing's
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Reduces all steroid production
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Reason for hirsutism in Cushing's
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Increase DHEA
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Dexamethasone + this drug is a very effect antiemesis treatment for chemotherapy
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Granisetron
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Hormone, other than cortisol, which ACTH plays a roll in regulating
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DHEA
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Alternate name for somatomedin C
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IGF-1
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Since GH fluctuates thorought the day, this is a better serum marker
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IGF-1
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Timing and source of S3 heart sound
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Middle third of diastole, caused by oscillation of blood between walls of ventricles
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Cause of S4 heart sound
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Atrial contraction forcing blood against a stiff ventricular wall
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Mechanism of cataract formation in diabetics
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Sorbital accumulation and subsequent osmotic damage
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Mechanism of neovascularization in diabetic retinopathy
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Microcirculation problems --> Ischemia --> VEGF --> Neovascularization
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Outermost and innermost layer of Bruch's membrane?
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Choriocapillary layer and pigmented retinal epithelium
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Innermost layer of cornea, underlies endothelium
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Descemet's membrane
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Aceullular structure underlying basement membrane of cornea
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Bowman's membrane
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Blood supply of retinal receptor layer
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Choriocapillary layer
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Retinal layer where rod and cone cell bodies are found
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Outer nuclear layer
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Most external layer of retina
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Retinal pigmented epithelium
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Two factors seen on sliding scale for insulin dose
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Blood glucose and patient's weight
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Effect of hyperkalemia of EKG
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Tall T waves
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MOA of sodium polystyrene sulfonate
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Binds to potassium in intenstines and decreases absorption
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