3/22 - UW 17 Flashcards
What is digital clubbing caused by?
Hypoxic conditions: Heart or lung disease, IBD, hyperthyroidism, malabsorption
What kind of nuclear material is in the mitochondria?
mtDNA is a small, circular chromosome coding for 14 proteins and their associated rRNA and tRNA
What MRSA tx causes Red Man Syndrome and nephrotoxicity? MOA?
Vanc, blocks glycopeptide polymerization be binding to D-alanyl-D-alanine
What is Red Man Syndrome?
Due to vancomycin: flushing or rash on face, neck, torso due to nonspecific mast cell degranulation, NOT IgE-mediated
What MRSA tx causes myopathy and CPK elevation, that is inactivated by surfactant? MOA?
Daptomycin, depolarizes cellular membrane
What MRSA tx causes thrombocytopenia and optic neuritis, and increases risk for serotonin syndrome? MOA?
Linezolid, inhibits 50S subunit
What street drug causes nystagmus?
Phencyclindine (PCP)
What street drug causes chest pain and sz?
Cocaine
What street drug causes choreiform movements?
Meth
Cocaine MOA?
Blocks reuptake of DA, NE, 5HT in CNS
Phencyclidine (PCP) MOA?
Antagonizes NMDA rececptor
Acyclovir MOA?
Guanosine analog: first phosphorylated by viral thymidine kinase (rate limiting step) to monophosphate, then to active triphosphate form
Why are EBV and CMV less susceptible to acyclovir than HSV and VZV?
Different thymidine kinase limits ability to activate acyclovir by phosphorylation
Why is CMV more sensitive to ganciclovir than other herpesviruses?
Differences in viral DNA polymerase structure
What is the primary site of rRNA synthesis?
Nucleolus
What do RNA polymerase I, II, and III do?
RPI: rRNA
RPII: mRNA, snRNA, miRNA
RPIII: tRNA, 5S rRNA
What is the fxn of Secretin?
Pancreatic BICARB secretion
What is the effect of CCK on the gallbladder? What is it secreted by?
Contraction, secreted by duodenal and jejunal I cells
What is the fxn of Gastrin?
Secretion of gastric acid, and gastric motility
What is an antidepressant that doesn’t have sexual dysfunction side effects?
Bupropion
What CN carries motor innervation to the tongue?
Hypoglossal (CN XII), except the palatoglossus muscle (CN X)
What CNs carry general sensory from the tongue?
Anterior 2/3: mandibular branch of trigeminal (CN V3)
Posterior 1/3: glossopharyngial (CN IX)
Posterior part of tongue root: CN X
What CNs carry gustatory sensation from the tongue?
Anterior 2/3: chorda tympani of facial nerve (CN VII)
Posterior 1/3: glossopharyngeal (CN IX)
Posterior of tongue root: CN X
Jejunal ulcers is strongly suggestive of what neoplasm?
Gastrinomas: neuroendocrine tumors of the pancreas, peripancreatic tissue, or duodenum
Sx of VIPoma?
Intractable diarrhea, metabolic acidosis, hypokalemia
With gout, what accumulates in the synovial fluid and forms crystals?
Monosodium urate (uric acid salt)
With gout, levels of what increases in the serum?
Uric acid
What is lead time bias?
Bias in lead time (time between detection and outcome) due to different detection methods, without actual change in time to outcome
What is suggested with fatigue, bradycardia, weight fain, and slowed DTRs?
Hypothyroidism
What does the dexamethasone suppression test screen for?
Cushing’s syndrome (cortisol excess)
What substrates can be formed into propionyl CoA?
Isoleucine, valine, threonine, methionine
Cholesterol
Odd cahin fatty acids
What cofactor is necessary for the carboxylation of propionyl CoA to methylmalonyl CoA?
Biotin, cofactor for propionyl CoA carboxylase
What product of methylmalonyl CoA enters the TCA?
Succinyl CoA
What is the cofactor for isomerization of methylmalonyl CoA to succinyl CoA?
B12
A newborn with lethargy, emesis, hypotonia, AGMA, ketosis, and hypoglycemia is suggestive of what?
Propionyl acidemia
Phosphoinositol system?
Ligand ginds to Gq, activates PLC, hydrolyzing PIP2 into DAG and IP3. DAG stimulates PKC. IP3 increased intracellular Ca
What is visible 12-28 hours after ischemic inj to the brain?
Red neurons (eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance)
What is visible 3-6 hours after ischemic inj to the brain?
No visible changes
What is visible 3-5 days after ischemic inj to the brain?
Macrophage infiltration and phagocytosis
What is visible 1-3 days after ischemic inj to the brain?
Necrosis and neutrophilic infiltration
What is visible 1-2 weeks after ischemic inj to the brain?
Reactive gliosis and vascular proliferation = liquefactive necrosis
When does the glial cell form after ischemic inj to the brain?
Over 2 weeks later
When do you see macrophages after an ischemic inj to the brain?
3-5 days
What do you see neutrophils after an ischemic inj to the brain?
1-3 days
DKA is strongly associated with what fungal infection?
Mucor species
What is the most common cause of lacunar infarcts?
hypertensive arteriolosclerosis of small, penetrating arterioles
What lymph nodes does the prostate drain to?
Internal iliac nodes primarily, as well as external iliacs and sacral
What liver disease presents with severe, nocturnal pruritis?
Primary Biliary Cirrhosis
What is the pathogenesis of primary biliary cirrhosis?
Autoimmune destruction of intrahepatic bile ducts and cholestasis
Which cholesterol medication has a side effect of gouty arthritis?
Niacin
Niacin MOA?
Decreasing hepatic synthesis of triglycerides and VLDL. Also increase HDL by 25-30%
What medications increase serum uric acid levels?
Niacin, HCTZ, cyclosporing, pyrazinamide
Proopiomelanocortin (POMC) is the precursor for what endogenous peptides?
beta-endorphin, ACTH, MSH
What is the eponym for esophageal cells showing dysplasia at high risk of adenocarcinoma?
Barrett’s esophagus (intestinal type epithelium with goblet cells
What are the risk factors for esophageal squamous cell carcinoma?
Primary: alcohol and tobacco
Secondary: Plummer-Vinson syndrome, achalasia, corrosive strictures
What are the 3 components of a craniopharyngioma (arising from remnants of Rathke’s pouch)?
- solid (actual tumor cells)
- cystic (filled with machinery oil liquid)
- calcified
What are some sx of congenital hypothyroidism?
Jaundice, macroglossia, myxedema, lethargy, hypotonia, hoarse cry
Congenital hypothyroidism is associated with what cardiac abnormalities?
ASD, VSD
