QBank notes: 2/25/2010 [48]

Carcinoid syndrome of heart: flushing, nausea/vomiting, diarrhea, TIPS -- tricuspid insufficiency pulmonary stenosis, if carcinoid tumor is in liver. If in lung, can cause left heart problems. Due to serotonin causing fibrosis of endocardium.

Putamen is brave, it's on outside; pallidum pales in comparison, it hides on the inside.

Caudate is a C-shaped nucleus comprising part of the lateral wall of the lateral ventricle.

Salicylate poisoning: You get both metabolic acidosis and respiratory alkalosis. The respiratory alkalosis is due to a direct stimulation of the respiratory center in the medulla. The metabolic acidosis is due to interference with the Krebs cycle, causing reversion to anaerobic glycolysis, which produces lactic acidosis. This gives metabolic acidosis with high-anion gap, due to depletion of bicarbonate. (Anion gap = [Na+ plus K+] - [HCO3- plus Cl-]).

Common causes of high-anion gap metabolic acidosis: lactic acidosis (i.e. metformin, INH, alcohol), ketoacidosis (Type I diabetes -- no insulin, alcohol).

Common causes of normal-anion gap metabolic acidosis: GI or renal loss of bicarbonate, acetazolamide.

Acetaminophen poisoning: liver failure, given N-acetylcysteine. Also nausea, vomiting, abdominal pain.

Carbon monoxide: hypoxemia, cherry-red lips.

Acute mercury poisoning: necrosis of renal tubules, GI epithelium. Chronic mercury poisoning: CNS atrophy, gingivitis, gastritis, renal tubular changes.

Lead poisoning (chronic): neuropathy, abdominal pain, anemia with basophilic stippling.

Potter's syndrome: Babies who can't Pee in utero develop Potter's. Caused by malformation of uretic buds, so bilateral renal agenesis. Face and limb deformities, hypoplastic lung. Oligohydramnios.

Molluscum contagiosum: caused by poxvirus (dsDNA), replicates in cytoplasmic in inclusion bodies, causes umbilicated papules, transmitted by sexual or nonsexual contact (wrestling); chronic infection in HIV positive patients.

Tuberoglomerular feedback. Furosemide doesn't cause afferent arteriole constrict because although it increase osmotic diuresis, it inhibits the same NKCC transporter that's on the macula densa cells of the distal tubule.

Mast cells: cytoplasmic granules with "scroll-like" content.

Terazosin: Treats both benign prostatic hyperplasia and hypertension in one fell swoop.

Celiac sprue involves the proximal small bowel; at this point the gliadin has not yet been digested.

Cimetidine: P450 inhibitor (increases warfarin), antiandrogenic effects, crosses blood brain barrier (confusion, dizziness, headaches), along with ranitidine decreases renal excretion of creatinine.