14 Flashcards
Located in terminal bronchioles
Secret secretory protein that protects against inflammation and oxidative stress
Secrete surfactant component to prevent airway collapse
Club (Clara) cells
Shortened chromosome 22 and elongation of chromosome 9 on karyotype.
Even tho new fusion protein (BCR-ABL) is on 22…this is what karyotype of CML shows
host cell is coinfected with 2 viral strains and progeny virions contain unchanged parental genome from on strain and nucleocapsid (or envelope) proteins form the other. However because there is no change in underlying viral genomes (no genetic exchange), subsequent progeny revert back.
Phenotypic mixing
Thick capsule is seen as a clear zone on gram strain and also causes characteristic mucoid growth in culture. Usually upper lobes. Thick mucoid, blood-tinged sputum and lung tissue necrosis with early abscess formation
Klebsiella (gram-negative lactose-fermenting bacillus)
Patients with noncoronary atherosclerotic disease, DM, or CKD are at same risk of cardiovascular evens (MI or stroke) as
people with known coronary disease
Hyperosmolar coma- very high blood sugar without ketoacidosis
DM2
Causes of ________.
- Corn diets in developing countries due to (bound/unsoluble form)
- Carcinoid syndrome, prolonged INH therapy, Hartnup disease.
Pellagra (Niacin deficiency)
Precursor for NO, urea, ornithine and agmatine and is also necessary for formation of creatine
Arginine
precursor of pyrimidine
orotic acid
Carotene is a precursor for what?
Vitamin A
Formed through bile acid conjugation with amino acids glycine and taurine
Bile salts (increased solubility)
Enteropeptidase deficiency impairs both protein and fat absorption–> diarrhea, failure to thrive and hypoproteinemia (edema)
Trypsin involved in both protein and lipid digestion. Can’t be activated from trypsinogen–>trypsin.
Contaminated water (cruise ships, spas, hospitals, air-conditioned hotels)
High fever, cough, confusion, diarrhea
Facultatively Intracellular (shitty gram stain)
May see elevated transaminases too
Legionnaires' disease Risks -elderly -smokers -Immunocompromised -COPD -alcoholics
Selective media BCYE (buffered charcoal yeast extract)
Legionella
Precipitating factors for G6PD deficiency anemia
1) infections
2) Drugs- Dapsone, anti-malarials, sulfonamides
3) DKA
4) Favism (fava beans)
Diseases with red blood cell cytoskeleton abnormalities
Hereditary Spherocytosis, Heriditary elliptocytosis, hereditary Stomatocytosis
B12 neuro symptoms are due to?
abnormal myelin synthesis
Ascending dorsal columns and descending corticospinal tracts both fucked
Subacute COMBINED (ascending and descending) Degeneration
Anterior horn (flaccid paralysis, atrophy, fasciculation) and LATERAL CORTICOSPINAL (spasticity and hyperreflexia)
ALS
zinc-SOD mutation
Compression due to bone fragmentations or disc herniation. Complete loss of strength below level of injury with loss of pain and temp. but preserved vibratory senses
Anterior spinal artery syndrome
compression
Characterized by opening of L-type dihydropyridine-sensitive Ca++ channels and the closure of some K+
Phase 2: Plateau phase
Celiac trunk emerges from the aorta at what level?
T12/L1
C3-C5 nerve roots. Motor to diaphragm and carries pain fibers from the diaphragmatic and mediastinal pleura
Phrenic (pain worse with inspiration and referred to base of neck and over the shoulder)
Parietal pleura sensory by intercostal nerves and felt closer to source of pain
Tumor cells express neuroendocrine markers and contain neurosecretory granules in cytoplasm. Name some of the neuroendocrine markers for SCLC (most aggressive)
NCAM/CD56 Neuron specific enolase Chromogranin Synapophysin Some...neurofilaments
Non-small cell carcinoma markers
KRAS and EGFR
Expression of mucin
Vimentin
mesenchymal orgin–> sarcomas
Lithium-induced diabetes insipidus
antagonizing effect on the action of ADH on PRINCIPAL cells within the collecting duct
Fibrous cap of atherosclerotic plaque contains?
Subendothelial collagen and glycosaminoglycans
Gomori Trichome stain
mitochondrial myopathies
Red ragged fibers
abnormal mitochondria accumulate under the sarcolemma of muscle fibers (irregular shape and size/enlarged)
Scant inflammatory cells and interstitial fibrosis
Chronic rejection (months to years)
Chronic rejection is a process mediated by what?
Host T lymphocytes and B-lymphocytes as well as antibodies
Perivascular infiltrate with abundant eosinophils in the setting of a new drug therapy is a hisopathologic presentation of
Hypersensitivity myocarditis
In rare cases, cardiac rejection is due to anti-donor host Abs and cases of humoral rejection, diagnosed with
direct immunofluorescense
Dense infiltrate of mononuclear cells usually composed primary of T-lymphocytes.
Acute rejection cellular rejection mediated by host T-lymphocytes sensitization against graft (foreign MHC)
Indicator of the severity of mitral stenosis?
The S2 opening snap interval = diastolic time interval btw the closure of the aortic valve (A2) and the abrupt halting of leaflet motion during opening of a stenotic mitral valve (opening snap)
Fomepizol
inhibits alcohol dehydrogenase
_______ is an antidote for methanol or ethylene glycol poisoning
Fomepizol
A microtuble associated, ATP-powered motor protein that facilitates the anterograde transport of neurotransmitter-containing secretory vesicle down axons to synaptic terminals
Kinesin
Diplopia and dysphagia= nicotinic blockade
Muscarinic Blockade= dry mouth
Diplopia, dysphagia, dysphonia= 3 Ds
Normal conduction velocity but decreased CMAP (compound muscle action potential)…Repetitive nerve stimulation leaves to facilitation of CMAP
BOTULISM
lol OMG
Descending paralysis starting from cranial nerves
Absent reflexes and progressive symmetric weakness (typically starting in lower extremities)
Guillain-Barre Syndrome
- muscle weakness, fasciculations, paralysis via depolarizing blockade
- CNS = lethargy and seizures
- Muscarinic overstimulation (miosis, bradycardia, increased lacrimation and salivation
Poisoning due organophosphates (AChEsterase inhibitors) used in insecticides.
Inhibition of sodium influx into nerve ending
Symptoms: weakness, paresthesias (face, extremities), loss of reflexes and sometimes severe hypotension. Conscious although paralyzed.
Tetrodotoxin poisoning
baseline erythrocyte transketolase activity is low but increases after addition of thiamine pyrophosphate
Diagnosis of thiamine (B1) deficiency
Cofactor for pyruvate dehydrogenase, alpha ketoglutarate dehydrogenase, branched chain alpha ketoacid dehydrogenase and transketolase
Thiamine (B1)
Used in case-control studies in order to control confounding.
Matching (age, race, etc)
MOE (malignant otitis externa) serious infection of ear seen in elderly diabetic patients)
Exquisite ear pain and drainage, granulation tissue is often seen within the ear canal
Pseudomonas aeruginosa
Inhaled allergens (animal dander) should be avoided in
asthma patients
First sign of uncal (transtentorial herniation) is a fixed and dilated pupil on the side of the lesion
due to occulomotor nerve compression
Isolated right-sided varicoceles
IVC occlusion by a malignant tumor or thrombus
Maltese cross appearance under polarized light (free fat and oval fat bodies)
Lipiduria (increased lipoprotein synthesis)
Tesamorelin
GHRH analog
Used to treat HIV- associated lipodystrophy
Hypothyroid—>hyperprolactinemia
Due to increased TRH which increases prolactin release
how does octreotide cause secondary HYPOthyroidism
Inhibits TSH release (somatostatin/GHIH analog)
Prolactin is structurally homologous to
GH and human placental lactogen
Chest wall injury can actually cause
hyperprolactinemia (inhibition of DOPA via ANS)
Renal failure can increase it too via decreased excretion
Breast suckling inhibits dopa release leading to
increased prolactin
starvation and sleep deprivation effect on leptin
decreases it
sleep deprivation and prader willi effect on ghrelin (makes you hungry)
increases it (acts on LATERAL hypothalmus) makes you grow laterally
Anastrozole and exemestane
aromatase inhibitors
Androstenedione–> estrone
Testosterone–> Estradiol
Glycyrrhetic acid
inhibits cortisol—>cortisone
Decrease in CORTISOL does what to ACTH
increases it due to lack of negative feedback
