UW 05-29-12

CN III - Oculomotor nerve
d/t/ ischemic damage

- Ptosis
- Eyes are "down & out" d/t CN IV and CN VI unaffected
(LR6SO4)3

Carcinoid tumors → 5HT oversecretion; asymptomatic until there are mets (b/c liver metabolizes 5HT):
- Flushing
- Asthma-esque (wheezing, dyspnea)
- Diarrhea
- Syncope (d/t low BP)

Long standing leads to RHFailure (d/t intimal thickening); MAO in the pulmonary vessels metabolizes 5HT so no LHFailure)

Systolic = Dilated (w/ S3)

Diastolic = Hypertrophic & Restrictive

Can invade either slightly damaged or completely intact valvular endothelium

- Surface adhesins allow it to bind to the endothelium
- Tissue factor is expressed and platelets & fibrin deposit (forming the vegetation)

- Staph aureus can then embolize and result in sepsis

Staph aureus = Mayo, dairy

Bacillus cereus = Starches (fried rice)

Common Peroneal = Most COMMON
(aka Fibular n. = Foot drop; D.E.F.)

Therefore you lose:
Motor = Dorsiflexion (Deep) & Eversion (superficial)
Sensory = Anterolateral leg, dorsal foot

ACTH secreting Pituitary Adenoma

Low Dose Dexa = Cortisol still elevated

HIGH DOSE = Cortisol drops (b/c you're able to suppress the ACTH release from pituitary)

Zidovudine (ZDV aka AZT)

Is a RT inhibitor (best to use @ 14 weeks of gestation and throughout pregnancy)

Reduces risk by 2/3 in HIV+ women not previously using ARV therapy

K+ Channel blockers (K IS BAD)
- Ibutilide
- Sotalol
- Bretylium
- Amiodarone
- Dofetilide

d/t B3 = Niacin deficiency d/t problems that affect the conversion from Tryptophan to Niacin
1) Hartnup Dz = ↓Trp absorption in gut
2) Carcinoid = ↓Trp metabolism (all of it gets turned into 5HT so none left for B3)
3) INH use = ↓B6 (needed to convert)

IL-10
TGF-ß

Elevated urine VMA (& Metanephrins)

Tx = Phenoxybenzamine (irreversible α-blocker)

It's a carcinoma in the apex of the lung that compresses the cervical sympathetic plexus and brachial plexus:
1) Cervical SANS Plexus → Horner's syndrome
2) Brachial plexus → Upper Extremity pain, weakness, ↓ reflexes, muscle atrophy

Direct thrombin inhibitor used in case of Heparin induced thrombocytopenia (HIT)

Others are the "-Rudin's" like Lepirudin and Bivalirudin

GGT = Gamma glutamyl transpeptidase

>10mmHg Systolic BP on inhalation

- d/t anything that restricts the expansion of the RV when it receives more venous return (during inspiration)
= tamponade, restritive cardiomyopathy, constrictive pericarditis, obstructive lung disease

RV squishes the LV, so it gets less diastolic filling and therefore generates less Systolic BP

Increased metabolism of EtOH leads to increased NADH

This causes a ↓ in ß-oxidation of FA's and a buildup of TG's

w/o normal flora, it proliferates and produces:
- Enterotoxin A = watery diarrhea
- Cytotoxin B = epithelial cell necrosis, fibrin deposition → pseudomembranous colitis

Tx = Metronidazole

1) Pyruvate Dehydrogenase (PDH) - w/o can't make Acetyl CoA (transfer acyl group to CoA) and therefore → Lactic Acidosis

2) α-Ketoglutarate Dehydrogenase - w/o it you can't make Succinyl-CoA and you get Maple Syrup Urine Dz

Both also need TPP (Thiamine, B1), FAD, and NAD+

ETEC Toxins:
- LT = Heat Labile ~ Cholera (Gs and ↑cAMP)
- ST = Heat Stable → ↑cGMP

Above the diaphragm = Clindamycin (Blocks 50S peptide bond formation; e.g. Lung Abscesses/Aspiration pneumonia)

Below the Diaphragm = Metronidazole (for ROS → damage bacterial DNA; e.g. C. diff and Bacteroides)

b/c it still binds to cholesterol (even if it prefers ergosterol)

1) Injection & Infusion:
- Thrombophlebitis
- Acute infusion rxn (fever, chills, hypotension, rigors)
2) RENAL:
- Nephrotoxicity (dose dependent → ↓GFR)
- Electrolyte problems (↓K+, ↓Mg2+)
- Anemia d/t ↓ EPO

Glucagon

Will increase HR and contractility independent of adrenergic (ß1) receptors

Glucagon has a Gs-GPCR → ↑cAMP

Propranolol (ß blocker, non-selective)

Patient usually self-medicates w/ EtOH; action worsens when holding certain postures (e.g. hodling a cup)

Nevirapine
Efavirenz
Delavirdine

Don't need to be phosphorylated
Aren't related to nucleosides

Follicular Lymphoma

d/t translocation (14;18) of bcl-2

1) AD = spherocytosis
2) XLR = G6PD

It's an Anti-IgE antibody used in cases of severe asthma

RF = DM, HTN, Smoking

Causes = lipohyalinosis, microatheromas

Primary ciliary dyskinesia d/t dynein defect (AR):
- male infertility (sperm immobility)
- situs inversus
- recurrent sinusitis
- bronchiectasis (dilation)

Envelope is hypervariable d/t lack of 3'-5' exonuclease activity of the RNA polylmerase

1) Hypothyroid (watch TSH)
2) Nephrogenic DI (watch BUN/Cr)
3) Teratogenic (Ebstein's anomaly)

There are 5 (3 -pines, 2 -idones, 1 -azole)

Clozapine = agranulocytosis, wt gain
Olanzapine = wt gain
Risperidone = Hyper PRL
Ziprasidone = Prolonged QT

t(15;17) of RARα (17) to the PML gene (15) → PML/RARα

Treatment w/ ATRA (all trans retinoic acid)