Fever vs heat stroke in children
-fever is treated with supportive care
above what temperature, oxidative phosphorylation ceases and ATP becomes rapidly depleted, leading to end organ damage?
108 F
dantrolene
skeletal muscle relaxant used to treat malignant hyperthermia
arches and associated cranial nerves
-common carotid artery is from arch 3
-true aorta arch is arch 4 relationship between flow and radius
flow is correlated to radius to the size 4th
lymph vessels & nodes of male genitalia
-testis drain to para-aortic -glans penis and superficial node stains to deep inguinal nodes
-scrotum drains to superficial inguinal nodes Horner syndrome
-Sympathetic lesion marked by miosis, ptosis and anhidrosis; often unilateral
Bells palsy
-temporary paralysis of the seventh cranial nerve that causes paralysis only on the affected side of the face
-cannot close the eye lid -increased sensitivity to found ( hyperacusis) Neurofibromatosis type 1
- you get cafe-au-lait spots!
- also get neurofibromas
-have lisch nodules in iris --> sign!
-body abnormalities: pseudoarthrosis
Bilirubin metabolism
-macrophage uses heme oxygen erase to turn heme to biliverdin ( green in color) -biliverdin reductase then takes it to unconjugated bilirubin which is yellow in color -bilirubin glucoronyl transferense is. needed to conjugated bilirubin in the liver Acute intermittent porphyria
-most common is seen in porphobilinogen deaminase ( PBG) porphyria cutanea tarda
-most common porphyria
-caused by Uroporphyrinogen decarboxylase
Phenylketonuria
-Excess phenylalanine metabolites contribute to the hypopogmentation involving the skin, hair, eyes, and catecholaminergic brain nuclei
Maple Syrup Urine Disease
is caused by a defect in alpha keto acid dehydrogenase, leading to an inability to degrade branched amino acids (isoleucine, leucine, and valine). This illness classically results in poor feeding and dystonia as well asthe maple syrup scent ( burnt sugar) in the patients urine after first couple days of life.
metformin
-MOA: inhibits mitochondrial glycerophosphate DH and complex 1 and up regulates AMP-activated protein kinase -renal clearance --> needs to measure creatine level first -AE: diarrhea and lactic acidosis increased conjugated bilirubin happens when?
-hepatobiliary disease: cirrhosis or hepatitis
rheumatoid arthritis MOA