3/25 - UWorld Flashcards
In endometrial hyperplasia, is the more hyperplasia of the glands or the stroma?
glands
What is the cause of endometrial hyperplasia?
Unopposed estrogen
Often occurs in post-menopausal women when there is not progesterone to stop the bleeding caused by estrogen
What is the linea alba, and what defect can it cause
Linea alba is a mildine band of fibrous tissue that usually closes off the umbilical ring
Incomplete closure can lead to umbilical hernia
What is the difference between an omphalocele and gastroschisis
Both are caused when, during development, abd contents undergo herniation followed by rotation of midgut; but then there is failure of gut to return to abd cavity
Omphalocele - midline herniation of abd contents within a sac
Gastroschisis - full thickness abd wall defect with fully exposed abd contents
Which inguinal hernia goes through both the deep (internal) inguinal ring AND superficial (external) ring
Indirect inguinal hernia
INdirect also goes through INternal (deep) ring
Which inguinal hernia is a result of failure of processus vaginalis to close?
Indirect inguinal hernia
Which inguinal hernia occurs medial to the inferior epigastric vessel?
Direct inguinal hernia
Which inguinal hernia is covered by all 3 layers of spermatic fascia?
Indirect inguinal hernia (follows the descent of the testes)
How do corticosteroids lead to neutrophilia (increased neutrophils)
Demargination of neutrophils leads to increased neutrophil count (even though neutrophils ability to fight infection is decreased)
What enzyme does Aspirin act on? Reversible for irreversible?
COX-1 and COX-2
Irreversibly inhibits via acetylation
What enzyme does Acetaminophen work on? Reversible or irreversible?
Reversibly inhibits COX enzymes
Acts mostly in the CNS so can be used as an analgesic but not anti-inflammatory (weak in the periphery)
What enzyme does glucocorticoids work on?
Inhibition of phospholipase A2 (preventing production of AA)
What is the mechanism of acton of Celecoxib
It is a selective COX-2 inhibitor
Provides anti-inflammatory effects without effecting platelet function (lower risk of bleeding)
What enzyme do NSAIDs work on? Reversible or irreversible?
Reversibly inhibit both COX-1 and COX-2
Where in the cell does fatty acid synthesis occur?
Cytoplasm
Where is the cell does breakdown of fatty acids occur?
Mitochondria
What is the mechanism that allows fatty acids from the cytosol to be transported to the mitochondria for breakdown?
Carnitine shuttle (needed because negatively charged fatty acids cannot cross the plasma membrane)
Carnitine acyl transferease
What molecule inhibits carnitine acyle transferase?
Malonyl CoA
What are the ToRCHeS infections?
Toxoplasmosis Rubella CMV HIV/HSV Syphilis
Where is the most common location of H. Pylori colonization
Antrum of the stomach (where there are the least amount of acid-secreting parietal cells)
Even if ulcers are in the duodenum, H. Pylori can only colonize areas of gastric metaplasia
Where is Secretin secreted from and what is it’s function?
Secreted from S cells of the duodenum in response to acidic chyme from the stomach
Stimulates pancreatic HCO3- secretion
Where is VIP produced and what is its function?
VIP is produced in the pancreas and stimulates intestinal water secretion, counteracts gastrin in the stomach, and promotes bicarb secretion from the pancreas
What are the symptoms of a VIPoma
WDHA syndrome:
Watery diarrhea, hypokalemia, achlorhydria
Do you get a respiratory or metabolic acidosis in DKA and why?
Metabolic
No insulin –> no glucose inside cells and no inhibition of fatty acid breakdown –> fatty acids break down to acidic ketone bodies –> bicarb binds to ketonic bodies to try to neutralize –> metabolic acidosis
