3/20 - UW 15 Flashcards
What prevents C. diff from infecting healthy people?
Intestinal biomass…so much good bacteria!
What are the two possible cancers that cause blue lesions under the nail?
Glomus tumor (glomangioma)
Subungual melanoma
What the hell is a glomus body?
Small, encapsulated neurovascular organs in the dermis of the nail bed, pads of digits, and ears. For thermoregulation.
What is the prototypical triple helix polypeptide?
Collagen
What role does Proline play in the collagen structure?
Introduces bends into the chain
What are the three most common AA in collagen?
- Glycine (every third residue)
- Proline
- Lysine
What non-foregut organ is supplied by a foregut artery?
Spleen (by the splenic art. off the celiac trunk)
What enzyme is missing in Crigler-Najjar syndrome?
UGT, which catalyzes bile glucuronidation into conjugated bilirubin
What is kernicterus caused by Crigler-Najjar?
Severe jaundice and neurologic impairment
What process is impaired in Dubin-Johnson syndrome?
Active transport of conjugated bilirubin into bile ducts
What does the liver look like in Dubin-Johnson?
Darkly pigmented
What syndrome is similar to Dubin-Johnson, with impaired bilirubin secretion into bile ducts?
Rotor syndrome
In addition to histamine, what enzyme is released by mast cells in anaphylaxis?
Tryptase
In what cells can you find myeloperoxidase?
Neutrophils
What is increased 5-hydroxyindoleacetic acid (5-HIAA) associated with?
Serotonin breakdown, particularly in carcinoid syndrome
How does IgE cause mast cell degranulation?
Cross linking
What movement of the lung does “compliance” describe?
The ability to stretch during inhalation
What is a common topical treatment for psoriasis? MOA?
Vit D analogs (calcipotriene, calcitriol, tacalcitol), activating nuclear transcription factor that inhibits keratinocyte proliferation and stimulates kertatinocyte differentiation
Cyclosporine MOA?
Inhibits calcineurin, inhibiting NFAT from transcribing IL-2, which activate T cells
What does Etanercept inhibit?
TNF-a
What does Methotrexate inhibit?
DHF reductase
Fever, pharyngitis, general LAD in a young adult = ???
MONO!
What is the primary viral cause of infectious mononucleosis? What neoplasms is it associated with?
EBV, Hodgkins and non-Hodgkin’s lymphomas, nasopharyngeal carcinoma, Burkitt’s lymphoma
What virus is associated with anal carcinoma?
HPV
What is carnitine used for?
Transport of fatty acids into the mitochondria
What is a common cause for Zenker diverticulum?
Increased intraluminal oropharyngeal pressure causes herniation through posterior hypopharynx, due to cricopharyngeal muscle dysfunction
What abx binds to cell wall glycoproteins? Where?
Vancomycin, terminal D-alanine residues
What abx binds to PBPs?
Penicillin and cephalosporins. Like transpeptidases.
What abx binds to DNA gyrase?
Fluoroquinolones
What type of ALL is more likely to present with mediastinal mass?
T-ALL
Blast cells in the peripheral blood suggests what type of neoplasm?
Acute lymphoblastic leukemia
What are the cell surface markers for B cell ALL?
CD10, 19, 20
What are the cell surface markers for T cell ALL?
CD2-8
What marker do all ALLs have?
TdT?
What cells produce androgen binding protein in the seminiferous tubules?
Sertoli cells
What chemotherapeutic agents cause hemorrhagic cystitis?
Cyclophosphamide or its analogs (e.g. ifosfamide)
How does cyclophosphamide cause hemorrhagic cystitis?
It’s renally metabolized into acrolein, which is toxic to uroepithelial cells, causing cell death and necrosis
When might you use N-actylcysteine (NAC)?
Acetaminophen overdose, or as a mucolytic or reno-protective agent
What is Leucovorin (aka folinic acid) used for?
Methotrexate overdose
When might you use Filgrastim? MOA?
Stimulate proliferation and differentiation of granulocytes (i.e. post-chemotherapy). As a G-CSF analog.
When might you give Dexrazoxane? MOA?
Iron chelating agent used for anthracycline (e.g. doxorubicin)-induced cardiotoxicity
Amifostine MOA?
Cytoprotective free-radical scavenging agent to decrease nephrotoxicity from some chemotherapeutic agents
What is hydrocephalus ex vacuo?
Compensatory ventricular expansion due to brain atrophy; no increase in ICP
What is pseudotumor cerebri?
Idiopathic intracranial HTN, with normal CSF content and normal neuroimaging
What is lissencephaly?
Congenital absence of gyri
What to give for drug-induced parkinsonism?
Antimuscarinic (trihexyphenidyl, benztropine), NOT dopamine drugs
Characteristic side effects of marjiuana intoxication?
Conjunctival injection, tachycardia, increased appetite, dry mouth
What type of headache produces facial flushing, nasal congestion, lacrimation, pupillary changes?
Cluster
What type of headache is band-like (bilateral)?
Tension
Describe a migraine headache
F > M, often with FH
Unilateral, pulsatile/throbbing
Auras, photophobia and phonophobia, nausea
Describe a cluster headache
M > F, no FH
Excruciating, sharp pain located behind one eye
Sweating, facial flushing, nasal congestion, lacrimation, pupillary changes
Describe a tension headache
F > M, no FH
Often due to stress, with a band like, bilateral distribution
Dull, tight persistent pain with muscle tenderness of the head/neck/shoulders
