3/18b Flashcards
What areas of the respiratory tract are lined with pseudostratified, columnar, mucus-secreting epithelium?
Nose, paranasal sinuses, nasopharynx, most of the larynx, and the tracheobronchial tree
What areas of the repiratory tract are lined with stratified squamous epithelium?
Oropharynx, laryngopharynx, anterior epiglottis, upper half of the posterior epiglottis, and the true vocal cords
Where are the piriform recesses of the oropharynx? What do they cover?
Small cavities on either side of the laryngeal orifice through which food pass around the airway. Food can get lodged there. They cover the internal laryngeal nerve.
Which laryngeal nerves carry motor fivers to the vocal cord muscles?
Recurrent and external laryngeal nerves
Which laryngeal nerve carries only sensory and autonomic fibers?
Internal laryngeal nerve (mediates cough reflex
What nerve mediates the gag reflex?
Glossopharyngeal nerve (CN9)
What nerve mediates the cough reflex?
Internal laryngeal nerve, a branch of the superior laryngeal nerve, off of the vagus.
What is a common cause of outpatient hypocalcemia?
HypoPTH
What is the mechanism for the microangiopathy and nephropathy seen in chronic DM?
Glycosylation products, that accumulate and cross link with collagen in blood vessel walls and interstitial tissues
What is the mechanism for the cataracts and peripheral neuropathy seen in chronic DM?
Glucose converted to sorbitol by aldose reductase. Sorbitol converted to fructose, which increases osmotic pressure. Osmotic injury to lens fiber cells and Schwann cells.
What type of inheritance is Friedreich ataxia?
AR
Where is the mutation located in Friedreich ataxia?
Chromosome 9
What disease causes gait ataxia, kyphoscoliosis, foot abnormalities, hypertrophic cardiomyopathy, and sometimes DM?
Friedreich ataxia
Airflow obstruction in COPD results from what two causes?
- anatomic narrowing of the bronchi
2. decreased lung elasticity from destruction of interalveolar walls
What is the embryological process that leads to tetralogy of fallot, truncus arteriosus, and transposition of the great vessels?
Abnormal migration of neural crest cells
Collagen degradation by what enzyme increases risk of atherosclerotic plaque rupture?
Metalloproteinases
What cells secrete metalloproteinases?
Macrophages
What does prolyl 4-hydroxylase do?
Hydroxylation of proline on procollagen chains, a step in the formation of a stable collagen triple helix
What does lysyl oxidase do?
Conversion of collagen amino terminus from LYSINE to ALDEHYDE, stabilizing it.
How does the liver take up indirect bilirubin?
Passively with an organic anion transporting polypeptide (OATP)
How does the liver secrete direct bilirubin?
Actively by MRP2
What happens when MRP2 in the liver is inhibited?
Conjugated bilirubin leaks out of basolateral OATP into the blood, causing hyperbilirubinemia and bilirubinuria
What organism causes scabies?
Sarcoptes scabiei mite
How does scabies present?
Rapidly spreading, pruritic rash with erythematous papules and excoriations on the exremities
What type of infection is suggested by intensely pruritic rash on the flexor surfaces of the wrist, lateral surfaces of the fingers, and finger webs?
Scabies infection by Sarcoptes scabiei
What type of immune response causes the rash seen in scabies?
Type IV delayed hypersensitivity
What type of infection would show multinucleated giant cells on skin sampling?
Shingles, which present as painful vesicles in dermatomal distribution
What type of infection would show molluscum bodies?
Molluscum contagiosum, presenting with single or multiple lesions (smooth, 2-6mm, white/skin colored, firm)
Typically does not involve pals and soles
How does Candida intertrigo present?
Erythematous plaques and erosions with satellite papules or pustules in the axillae, genital areas, web spaces, and skin folds.
Where, and in what stage of life is physiological carcinoembryonic antigen (CEA) found?
In the embryonic pancreas, liver, and intestine
Minute amounts in healthy adults
What is the CEA used for?
Not for dx, just for monitoring colorectal cancer recurrence
Mucosal neuromas and Marfanoid habitus are signs of which MEN syndrome?
MEN 2b, along with medullary carcinoma of the thyroid and pheochromocytoma
Biotin is involved in the reactions of which enzymes?
acetyl-CoA carboxylase (ACC), pyruvate carboxylase (PC), propionyl carboxylase (PCC), and beta-methylcrotonyl CoA carboxylase (MCC)
What are the anti-inflammatory cytokines?
TGF-b and IL-10
Which cells release TNF-a?
T cells and monocytes, inducing nf-kB
What are the two SERMs?
Raloxifene and Tamoxifen
What effect does milrinone have on vascular smooth muscle?
Vasodilation
Milrinone MOA?
Phosphodiesterase isoenzyme 3 inhibitor, preventing the metabolism of cAMP. Increased cAMP levels means increased Ca release from the sarcoplasmic reticulum, increasing cardiac contractility.
MIs in what location is associated with bradycardia? Why?
Inferior MIs often lead to bradycardia because it is usually the result of a R coronary artery blockage, which supplies the SA and AV nodes
What is the treatment of choice for early (<6wk gestational age) ectopic preg?
Methotrexate
Methotrexate MOA?
Competitive, irreversible inhibitor of dihydrofolate reductase
Why might you give fatty acid oxidation inhibitors for chronic stable angina?
Fatty acid oxidation requires more oxygen per ATP than glucose oxidation or glycolysis. Reducing it will reduce oxygen demand in stable angina.
What class of drugs end in “-pril”
ACE inhibitors
What is a common cause of Hemolytic-Uremic Syndrome?
Following diarrheal illness by Shiga toxin, from EHEC O157:H7 or Shigella dysenteriae
In what syndrome can you see fibrous intimal thickening with endocardial plaques in the R heart?
Carcinoid syndrome
The 5-HT and bradykinin released by the carcinoid tumor target the right heart because they are inactivated by the lungs
Where do you find serotonergic neurons in the brain?
Raphe nuclei
What NT is released by the raphe nuclei?
Serotonin
What role do the neurons from the raphe nuclei play?
Sleep-wake cycle, level of arousal. Lesions can lead to insomnia and depression
What NT is released by the nucleus ceruleus?
NE, in the dorsal pons
What NT is released by the substantia nigra? What disease is it associated with?
DA, Parkinson’s
Lesions in what lobe of the brain produce contralateral superior quadrantanopia?
Temporal lobe
What lab test involves mixing patient serum with cardiolipin, lecithin, and cholesterol?
RPR, for the spirochete T. pallidum (sylphilis)
