3/25 - UW 23 Flashcards
Lesion in what part of the brain would lead to a complete contralateral sensory loss?
Thalamic VPL and VPM nuclei
How big are lacunar infarcts?
Small, approx 5mm
What are two primary causes of lacunar infarcts?
Lipohyalinosis and Microatheromas
Oligodendrocyte apoptosis is characteristic of what pathology?
MS
What is the gross appearance of MS lesions?
Pink patches in white matter tracts, NOT cavities
In what organ does Renin act to convert Angiotensinogen to Angiotensin I?
Liver
What are the primary routes of HCV transmission?
Inoculation or Blood transfusions (not so much sexual)
Where is the IF-B12 complex absorbed?
Terminal ileum
How do OCP prevent pregnancy?
Suppression of FSH and LH secretion from anterior pituitary
What enzyme converts heme to biliverdin?
Heme oxygenase
How is bilirubin transported to the liver?
Bound to albumin
How is bilirubin (unconjugated) converted to bilirubin glucuronide (conjugated)?
By UGT (UDP glucuronyl transferase) in the liver
In what disease is UGT deficient in the liver?
Crigler-Najjar
What is the effect of 2,3-BPG on Hgb oxygen affinity?
Decrease, shifting curve to the right
What type of Hgb doesn’t bind to 2,3-BPG?
HbF
What kind of change in FSH levels are seen in menopause?
Increase, due to decreased estrogen inhibition
What are the major risk factors for esophageal squamous cell carcinoma?
Alcohol, tobacco, foods with N-nitroso compounds (e.g. betel nuts…?)
What are the major risk factors for esophageal adenocarcinoma?
Barrett’s esophagus, GERD, obesity, tobacco
Why would mannitol cause pulmonary edema?
Because it increases intravascular and intratubular volume. Increased IV volume increases hydrostatic pressure, which may leak into the lungs. I guess.
Aside from pulmonary edema, what are some other risks of mannitol over-treatment?
Interstitial volume depletion and hypernatremia, Plasma volume expansion and hyponatremia with metabolic acidosis and hyperkalemia
When would you see coagulative necrosis?
After ischemic injury, except in the brain
When and where do you see liquefactive necrosis?
Focal bacterial infx (with leukocyte involvement) and CNS infarcts
When do you see fat necrosis?
Acute pancreatitis, due to lipase release.
With what type of necrosis can you see saponification?
Fat necrosis, when lipase-digested fatty acids combine with calcium. In acute pancreatitis
When do you see caseous necrosis?
Tuberculous infx
Increased bleeding time with no other abnormalities suggests what disease?
von Willebrand’s disease
What clotting factor does DDAVP increase the production of? From where?
vWF, from endothelial cells
Association: DDAVP in bleeding problem…disease??
von Willebrand’s disease or hemophilia A
What clotting factor does vWF help to stabilize?
Factor VIII
What is contained in the lamellar bodies of type II pneumocytes?
Surfactant
What is alveolar atelectasis?
Collapse
HTN with low renin suggests what pathology?
Hyperaldosteronism
What electrolyte abnormalities are seen in hyperaldosteronism?
HypoK and metabolic alkalosis (due to loss of K and H from increased reabsorption of Na).
Why don’t you see hypernatremia in hyperaldosteronism?
Because of “aldosterone escape” wherein the increased Na and fluid retention causes a compensatory rise in ANP and hydrostatic natriuresis.
What cranial pathology is often seen in ADPKD?
Berry aneurysms in the Circle of Willis that can rupture, producing subarachnoid hemorrhages
Why would you see neck stiffness in Subarachnoid Hemorrhage?
Blood in the subarachnoid space is irritating to the meninges
What is the most common cause of post-MI hospital death?
Ventricular failure (cardiogenic shock)
What is the order of prevalence of atherosclerosis in arteries?
- Abdominal aorta
- Coronary arteries
- Popliteal
- Internal carotid (carotid sinus)
- Circle of Willis
How does ANP lower BP?
Peripheral vasodilation, natriuresis, diuresis
What is ANP’s action in the kidney?
Dilates afferent arterioles
Limits proximal tubule Na reabsorption
Inhibits Renin secretion
What is ANP’s action in the adrenals?
Restricts aldosterone secretion
What is ANP’s action in the blood vessels?
Arteriolar and venular vasodilation
Where does the conversion of vit D to 25(OH)D take place? What enzyme? What is another name for 25(OH)D?
In the liver by 25-hydroxylase.
Calcidiol
Where does the conversion of 25(OH)D to 1,25(OH)2D take place? What enzyme?
In the kidney by a1-hydroxylase
In what disease do you see hyperCa secondary to high serum calcitriol?
Sarcoidosis
