3/27 - UW 29 Flashcards
What is the function of bcl-2?
Inhibits apoptosis of tumor cells
Mutations of genes responsible for DNA mismatch repair lead to what neoplasm?
Lynch syndrome: hereditary nonpolyposis colon cancer
How does NAC treat acetaminophen toxicity?
Donates sulfhydryl groups to enhance SULFATION elimination (non-toxic)
Reacts with NAPQI as a substitute for glutathione
What is the product of the toxic P450 oxidation elimination of acetaminophen?
NAPQI, usually metabolized by hepatic glutathione into nontoxic compounds.
What should be administered to improve the cardiovascular manifestations of tricyclic antidepressants?
Sodium bicarb
In a migraine, what vasoactive neuropeptides are released by trigeminal afferents that innervate the meninges?
Sustance P and calcitonin gene-related peptide (CGRP)
Leads to neurogenic inflammation due to vasodilation and plasma protein extravasation
“-triptans” MOA?
5HT agonists
How do triptans treat migraines?
Inhibit repease of substance P and CGRP, promoting vasoconstriction and blocking pain pathways
Abortive therapy
What are some prophylactic migraine meds?
Beta blockers
Antidepressants (amitriptyline, venlafaxine)
Anticonvulsants (Valproate, topiramate)
What are the two most common causes of SCID?
- X linked SCID
2. Adenosine deaminase deficiency
Why does adenosine deaminase deficiency cause SCID?
Adenosine accumulation is toxic to lymphocytes
What is the function of xanthine oxidase?
Enzyme in formation of uric acid from hypoxanthing and xanthine.
Essential for final step of purine degradation
What is the xanthine oxidase inhibitor called? What is it used for?
Allopurinol, to decrease uric acid formation in gout
How does pneumoconiosis (interstitial lung fibrosis secondary to inhalation of inorganic dust) arise?
Alveolar macrophages which phagocytose particles are activated to release cytokines and growth factors. These cause inflammation/injury/fibrosis.
Which DNA polymerase is primarily responsible for synthesis of daughter DNA strands?
DNA polymerase III
What are two etiologies for disease of the posterior column of the spinal cord?
Syphilis (tabes dorsalis) and vit B12 def
What are some sx of vagus nerve damage?
Hoarseness
Dysphagia
Abnormal GI motility
Tachycardia
What type of ventricular adaptation is seen in pressure overload?
Concentric hypertrophy, from parallel deposition of new sarcomeres, reducing chamber size
What type of ventricular adaptation is seen in volume overload?
Eccentric hypertophy, from chamber dilation due to increased volume, and in series deposition of new sarcomeres
How does renal disease relate to bones???
VITAMIN D COME ON!!!
What are all the B vitamins?
B1: Thiamine B2: Riboflavin B3: Niacin B4: DOESN'T EXIST B5: Pantothenic acid B6: Pyridoxine B7: Biotin B9: Folic acid B12: Cobalamin
What are the downstream products and uses for Riboflavin (B2)?
Riboflavin (phosphorylated to) flavin mononucleotide FMN (phosphorylated to) flavin adenine dinucleotide FAD.
FMN and FAD are cofactors for flavoproteins, enzymes for redox reactions
FAD, and thus riboflavin, is necessary for what TCA enzyme?
Succinate dehydrogenase, converts succinate to fumarate
What is the pathogenesis of alcohol-induced hepatic steatosis?
Decrease in free fatty acid oxidation secondary to excess NADH production by alcohol dehydrogenase and aldehyde dehydrogenase
What two HBV antigens correlate well with viral replication?
HBcAg
HBeAg
What does the tibial nerve do?
Calf muscles motor, and plantar foot sensory.
What effect do statins and bile acid binding resins have on cholesterol synthesis?
Statins: decrease (inhibit HMG CoA
Bile acid binding resins: increase (reduced bile recycling, need new bile!)
What is thiopental?
Short acting barbiturate used for general anesthesia, as a GABA agonist
Why does thiopental only work briefly?
Highly lipid soluble, so it goes to brain within 1min. Then quickly redistributes into skeletal muscle and adipose with 5-10 min.
Terbinafine MOA?
Allylamines class, inhibits ergosterol SYNTHESIS by inhibiting squalene epoxidase
What antifungal blocks squalene epoxidase? What does that do?
Terbinafine, blocks ergosterol synthesis
What antifungals bind to ergosterol?
Polyenes (anphotericin B and nystatin)
What antifungal blocks cell wall synthesis? What is the component it blocks?
Caspofungin blocks synthesis of B-D-glucan, cell wall component of Candida and Aspergillus
Caspofungin MOA?
Blocks fungal cell wall synthesis by blocking synthesis of B-D-glucan
Griseofulvin MOA?
Binds to microtubules and disrupts fungal mitotic spindle, preventing mitosis
What is the only group of fungi for which Griseofulvin is effective? Why?
Dermatophytes only, because it accumulates in skin
What is the antifungal that prevents mitosis by binding to tubulin?
Griseofulvin, for dermatophytes
Flucytosine MOA?
Antifungal URACIL analog that is transformed into 5-fluorouracilin in the cell
What antifungal inhibits protein synthesis?
Flucytosine
How is fetal lung maturity measured via amniocentesis?
Level of phophatidylcholine (i.e. lecithin) is a major component of surfactant
What do you measure in the amniotic fluid to check fro NTD?
AFP
What are you checking for when you measure amniotic fluid bilirubin?
Erythroblastosis fetalis
Enlargement and proliferation of what cells is seen in a gliosis in the brain?
Astrocytes, which resorb the necrotic tissue after a stroke
Leukocytoclastic vasculitis is characterized be what pathology of the small vessels?
Segmental fibrinoid necrosis
Lesions of Microscopic polyangiitis are histologically similar to what?
Polyarteritis nodosa (segmental fibrinoid necrosis)
What arteries are often affected in Thromboangiitis obliterans?
Tibial and radial arteries
What type of lymphoma is marked by remissions and recurrences?
Follicular lymphoma (from follicular B cells)
How does Follicular lymphoma present?
Painless lymph node enlargement or abdominal discomfort from a mass
What lymphoma can form Pautrier microabscesses in the dermis and epidermis?
Mycosis fungoides (cutaneous T cell lymphoma)
What drug blocks the rate limiting step of catecholamine synthesis? What is that step?
Metyrosine blocks tyrosine hydroxylase
Is p53 a tumor suppressor or oncogene?
Tumor suppressor
When and how does p53 regulate cell proliferation?
During G1, it detects abnormalities and prevents progression.
