13 Flashcards
50% infectious dose (very high for salmonella) low for
shigella
campy
Very low for entamoeba histolytica and giardia (1-10 organisms)
3–>5 exonuclease activity of DNA pol. Mismatch repair during dna replication. Disease associated =
Heriditary nonpolposis colon cancer (AD)
80% get CRC
Associated with endometrial, skin, and ovarian cancers
MLH1, MSH2, MSH6 (microstallite instability)
Triad of arthritis, dermatitis and tenosynovitis in sexually active woman
N. gonorrhoeae
Secretory IgA (dimer joined by peptide j-chain) bind pili and other membrane proteins involved in bacterial adherence to mucosa
inhibiting mucosal colonization
IgA proteases (cleave a hing region leaving Fab and Fc fragments)
N. gonorrhoeae, N. meningitidis, step pneumo, H. flue
May cause reperfusion arrhythmia on arterial re-opening, usually benign
fibrinolytics (tPA)
Neuroprotective agent that may slow functional losses in AD
Vitamin E (alpha-tochopherol)
NMDA receptor antagonist. CNS NMDA- overstimulation by glutamate may contribute to AD symptoms thus this drug is used in AD treatment
Memantine
High concentration of serum ferritin are found in
Hemochromatosis
Hyperoxaluria is seen in Crohns disease. Causes
calcium oxalate RENAL stones due to increased absorption
Gallstones are due to decreased reabsorption of bile salts
Don’t confuse these two
Accelerated bone remodeling with eventual bony overgrowth. The disease is thought to be caused by gene mutation (affecting RANK, osteoprotegerin) that result in excessive RANK signaling and NF-kB activation—> osteoclast differentiation and activity.
Paget disease of the bone
ALAS is upregulated by what?
ALAS is downregulated by what?
Upregulated by CYP450 Inducers (antiepileptics, griseofulvin, rifampin, etc)
Downregulated by HEME AND GLUCOSE (dextrose)
Three mutations associated with early onset (
1) APP gene on chromosome 21
2) Presenilin 1 gene on chromosome 14
3) Presenilin 2 gene on chromosome 1
All promote production of A Beta-amyloid
Echocardiogram showing an aorta lying anterior to the pulmonary artery is diagnostic of
TGA (transposition of great arteries)
Failure of fetal aorticopulmonary septum to spiral normally during septation of the truncus arteriosus
ACE inhibitor cough due to increased
bradykinin, Substance P, prostoglandins
Bradykinin and substance P accumulation can cause inflammation and stimulate lung irritation
Immunochemistry of hydatidiform mole
p57 negative =
p57+ =
p57 negative= complete (due to absent maternal genome)
p57 positive = partial (due to maternal genome presence)
Hyperemesis gravidarum and formation of theca-lutein cysts in setting of molar pregnancy is due to?
Preeclampsia, anemia and hyperthyroidism can also be present in complete moles
Increased beta hCG secretion by proliferating trophoblast
Note: b-HCG stimulates ovarian growth leading to cysts
Decrease in SYSTOLIC pressure of > 10mm Hg with inspiration. MC seen in patients with severe asthma, COPD, constrictive pericarditis
Pulsus paradoxus
Medication induced muscle atrophy is most commonly seen with ___________. _________ can cause a similar condition too.
MC= chronic corticosteroid therapy
Chloroquine can also do this
Uveoscleral pathway- a small amount of AH can diffuse through the ciliary muscle and adjacent sclera
Prostaglandin agonist work on this pathway for tx of glaucoma
Diffusion through a trabecular network in Schlemm’s Canal (scleral venous sinus) and drains into EPISCLERA and CONJUCTIVAL VEINS
Trabecular outflow pathway (muscarinic agonists work here)
Progressive loss of ganglion cell axons, pale opitic disc and enlarged optic cup. Symptoms evolve over decades with progressive loss of peripheral visual fields
Open-angle glaucoma caused by increased secretion or decreased outflow of AH
Traumatic aortic rupture (rapid deceleration in car wreck)
Injury is to the aortic isthmus (tethered by ligamentum arteriosum and relatively fixed and immobile compared to adjacent distal aorta
Pneumobilia (air in biliary tract)
Gallstone illeus
Radiograph = dilated bowel loops with air-fluid levels and pneumobilia due to retrograde passage of intestinal gas through fistula
Overproduction of which cytokine is implicated in direct damage to podocytes (ex: minimal change disease)
IL-13
Renal veins join the IVC at what level?
Common iliac veins merge to become the IVC at the level of
Renal veins join IVC at L1/L2
Common iliac veins merge to become IVC at L4
IVC filters are placed in patients with DVT or PE who have
contraindications to antioagulation
S. gallolyticus endocarditis is unique in that most cases occur in patients without preexisting valvular abnormality
Check patient for colonic cancer (25% positive)
Nickel is a carcinogen and occupational exposure is associated with nasal and lung cancer. Nickel mining is also suggestive of
silica dust exposure
Thicken bronchial walls, lymphocytic infiltration, mucous glands enlargment, patchy squamous metaplasia of the bronchial mucosa
Chronic bronchitis (MC cause= smoking)
Major immune mechanisms against Giardia
CD4+ T-help cells and secretory IgA production
Chronic giardiasis? who are the players?
IgA deficiency, X-linked agammablobulinemia, CVID
Increase in pH effect on calcium
Hypocalcemia–> Increase affinity of albumin (anion) to bind Ca2++ (less H+ around to compete with it)
In decrease pH (acidosis) more H+ to bind Ca2+ which leads to more free calcium and hypercalcemia
