2/20 Flashcards
IL-5
- who releases it?
- what does it do?
- Th2 cells
- Promotes differentiation of B cells.
- Enhances class switching to IgA.
- Stimulates growth/differentiation of eosinophils.
IL-3
Supports growth/differentiation of bone marrow stem cells.
-functions like GM-CSF
Genital tubercle
- glans penis, corpus cavernosum/spongiosum (via DHT)
- glans clitorus, vestibular bulbs (via E)
Urogenital folds
- ventral shaft of penis (urethra)
- labia minora
Lacioscrotal swelling
- scrotum
- labia majora
Hypocalcemia/parasthesias after a blood transfusion? How?
Citrate is an anti-coagulant thats mixed into blood transfusions prior to storage.
- Citrate can chelate calcium and cause hypocalcemia.
- usually after a massive transfusion.
Hyperkalemia after a blood transfusion? How?
RBCs may lyse in old blood units.
Partial central DI vs Complete central DI
- > 50% inc. in urine osm = complete
- <50% inc. in urine osm = partial
-measured 1 hr after DDAVP infusion.
Superficial inguinal nodes
- location
- what do they drain
- anterior thigh, right under inguinal ligament.
- drain nearly all cutaneous structures inferior to umbilicus including the external genitalia and the anus up to the pectinate line. Includes scrotum.
Deep inguinal nodes
- location
- what do they drain
- under fascia lata, on medial side of femoral vein.
- superficial inguinal nodes, deep lymphatic trunks along the femoral vessels, glans penis & clitoris.
Pergolide
- D2 agonist
- used in parkinsons.
Sulfonylureas
-mechanism
-close potassium channel in beta-cell => depolarizes cell
=> Ca influx => insulin release.
Glyburide, glipizine, glimepiride.
-sulfonylurea, 2nd gen.
Axial images (even CT scans)
- viewed from patients feet.
- so left side of image is pt’s right side.
Most common finding in PCA infarct?
-which CNs does PCA help supply?
- contralateral hemianopia often w/macular sparing.
- CN 3 & 4
Ischemic stroke affects which vessel the most often?
MCA
Glucagonoma
- necrolytic migratory erythema.
- hyperglycemia/DM
- GI Sxs
- normochromic normocytic anemia
Zinc deficiency
- delayed wound healing
- hypogonadism
- alopecia
- dysgeusia, anosmia
- acrodermatitis enteropathica
- may predispose to alcoholic cirrhosis.
inulin
Not resorbed & not secreted
~GFR
PAH
Filtered & actively secreted
~RPF
*not resorbed
creatinine
-Not resorbed & slightly secreted
-Kind of like inulin
~GFR
*overestimates GFR a tad b/c its slightly secreted.
Resorption of filtered water in the tubule
- 60% PCT
- 20% descending henle
- up to 20% collecting duct (via ADH) depending on hydration status.
Fructose intolerance
-do you get cataracts?
No
Urine distick
-detects which sugars?
Only glucose
-no fructose or galactose.
Interviewing technique: reflection
Physician repeats what the patient tells him.
Neurogenic bladder vs urinary retention
- Neurogenic bladder - you cant control your pee, so you give them a muscarinic antagonist so they dont pee themselves.
- Urinary retention following surgery - they cant pee, so you give them a muscarinic agonist so they can pee.
Oxybutynin
anti-muscarinic
-for urge incontinence.
Regression of notochord & thyroglossal duct
-what is this an example of?
atrophy
TCA
-block what receptors
- anti-alpha1
- anti-cholinergic
Anti-psychotics
-block what receptors
- anti-alpha1
- anti-muscarinic
- anti-histamine
tamsulosin
- alpha-1 blocker but specific for prostate.
- doesn’t affect vasculature.
TCAs = watch out when giving a pt w/BPH
-could further inc. their urinary retention.
SVC block vs brachiocephalic block
-SVC block would affect both sides whereas brachiocephalic affects 1.
Normal pCO2 levels?
Normal serum bicarb?
- 33-35 mmHg
- 22-28 mEq/L
Aspirin poisoning
-order of events
1) acute respiratory alkalosis b/c aspirin stimulates respiratory center to hyperventilate.
2) few hours later, metabolic acidosis.
* low bicarb due to metabolic acidosis, not renal comp for resp alkalosis. (renal comp takes at least a few days to kick in).
Where is juxtaglomerular apparatus?
Where is macula densa?
- afferent arteriole
- DCT
HIDA scan
-no radionuclide taken into gallbladder = blockage of cystic duct.
S-100
-marker for what?
- neural crest origin.
- melanoma, schwannoma, langerhan cell histiocytosis, neural tumors.
Which cranial nerve can schwannomas NOT arise from?
CN2 (covered by oligodendros).
karyorrhexis
nuclear fragmentation
Apop: DNA laddering
-how big are fragments?
180-bp fragments
How does radiation therapy kill cells?
Induces apoptosis via free radicals & ds breaks.
BAX, BAF, bcl-2
-anti or pro apoptosis?
BAX & BAF = pro-apop
Bcl-2 = anti-apop (by inhibiting APAF)
*over-expression of bcl-2 = cancer
Fas-FasL interaction. Where do we see this?
-what happens when there are mutation in FAS?
- thymic medullary negative selection.
- Mutations in Fas increases numbers of circulating self-reacting lymphocytes due to failure of clonal deletion.
Whats the first sign of shock?
tachy
Distributive shock includes:
*distributive = high output
- septic
- neurogenic
- anaphylactic
PCWP (LA pressure) only inc. in which type of shock?
-cardiogenic shock. b/c of fluid backup.
Fibrinous inflammation
-acute infl: fibrinogen leaks out of permeable vessels and polymerizes to fibrin on surface of organ.
CD 14 on macros
TLR
Psammoma bodies
-dystrophic or metastatic calcification?
-dystrophic.
Metastatic calcification:
- in which tissues most often?
- why?
- Gastric, renal, lungs
- these tissues lose acid quickly. Alkaline environment favors deposition of calcium.
- ALP released by osteoblasts makes alkaline environment and then lays down bone.
Margination/Rolling
- endo: selectins/GlyCAM-1, CD34
- WBC: Sialyl-LewisX, L-selectin
Adhesion
- endo: CAMs (cell adhesion molecules)
- WBC: CD11/18 integrins (LFA-1, Mac-1), VLA-4 integrin
Diapedesis
- endo: PECAM-1 (CD-31)
- WBC: PECAM-1 (CD-31)
oxidative bust
first step w/NADPH oxidase.
-superoxide turns NBT blue
fibroblast growth factor
-whats it do?
angiogenesis
EGF
-how do these stimulate growth?
-tyrosine kinase activation
Decreased ESR found in:
Sickle cell, polycythemia, CHF.
Iron poisoning
-can lead to metabolic acidosis.
Primary amyloidosis
AL: Ig light chain
-plasma cell disorder/multiple myeloma
Secondary amyloidosis
AA: amyloid A
Dialysis amyloidosis
- build up of what?
- may present as what?
beta-2-microglobulin
-may present as carpal tunnel
G6PD A:B ratio
- hyperplasia
- neoplasia
- normal: 1:1
- hyperplasia: 1:1
- neoplasia: either A or B will be huge compared to the other. monoclonal prolif.
Barr Body
-Female: each cell in body inactivates an X chromosome (either one from mom or dad) randomly. So by chance alone it’ll be 1:1 ratio.
vimentin
-stains for which cancer
sarcomas
-vimentin = connective tissue IF.
dermatomyositis associated w/which cancer?
lung cancer
keratin
-marker for what
epithelial cells
Liver fluke (Clonorchis sinensis) -which cancer?
Cholangiocarcinoma
Schistosoma haematobium
-which cancer?
Bladder cancer (squamous cell)
Aflatoxins cause mutations in what?
p53 genes
which cancer has highest mortality rate among both men and women?
lung cancer
Neonatal HIV
- Sxs?
- prevention?
- oral thrush, severe lymphopenia, interstitial pneumonia.
- give mother zidovudine during pregnancy starting at 14 wks then to baby for six weeks post-partum.
Common cardinal veins
-whats derived from these?
-right common cardinal v. + right anterior cardinal v. = SVC.
What does truncus arteriosus give rise to?
asc. aorta & pulm. trunk
What are 3 groups that fetus’ veins fall into?
Vitelline, umbilical, Cardinal
Fate of vitelline veins?
form veins of portal system
Fate of umbilical veins?
degenerate
Fate of cardinal veins?
form veins of systemic circ.
What is the biggest factor in determinging coronary blood flow? Esp. during exercise.
Duration of diastole.
Capitation
- physicians paid a fixed amount per pt. not per service.
- so there is incentive to contain costs due to fixed budget allocated to them.
- strongly associated w/preventative care.
What are 2 primary contributors to serum ALP?
liver (including biliary system) and bone.
How do you test for cystinuria?
-how do u treat it?
Sodium nitroprusside test is positive. Detects urine cystine. Detects cystine’s sulfhydryl groups.
-treat: hydration & alkalinization of urine.
Sites on Ig for attachment
-complement attaches above where macros/neutros/b cells bind via Fc receptors.
Where is aortic regurg heard?
- left sternal border.
- 2/3rd rib space.
Papillary muscle defect results in what cardiac murmur?
-mitral valve regurg.
Osteomyelitis: most common location
- kids
- adults
- kids = metaphysis
- adults = epiphysis or vertebral body
sequestrum
dead piece of bone
Use of GGT (gamma glutamyl transpeptidase)?
distinguishing btwn bone or biliary system as the source of the elevated ALP.
- NOT found in bone disease.
- found primarily in hepatocytes and biliary epithelia.
Lacrimation, salivation, flushing (vasodilation), diaphoresis, miosis.
-too much what NT?
muscarinic cholinergic overstimulation.
-too much ACh.
