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3/29 - UW 31 Flashcards

1
Q

How does long term use of systemic steroids lead to osteoporosis?

A

Decreased synthesis of bone matrix
Inhibition of intestinal action of vit D
Increased PTH

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2
Q

What causes nipple inversion and skin retraction/dimpling in invasive breast carcinoma?

A

Invasion of the central region of the breast, and infiltration of the suspensory Cooper ligaments

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3
Q

What is “peau d’orange” in breast cancer?

A

Orange peel appearance, due to tumor blockage of the lymphatic drainage, causing lymphedema, pitting, and thickening of the skin

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4
Q

What is the difference in duration between acute stress disorder and PTSD?

A

Acute stress disorder: 3d - 1mo

PTSD: > 1mo

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5
Q

What are the most common organisms that cause necrotizing fasciitis?

A

Strep pyo
Staph aureus
C. perfringens

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6
Q

What organisms are positive for the PYR (like bacitracin) test?

A

Group A and D streptococcus

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7
Q

What enzyme and reaction does Methimazole inhibit?

A

Thyroid peroxidase, organification and coupling of iodotyrosines, to treat hypERthyroidism

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8
Q

What is the clinical presentation of primary biliary cirrhosis?

A

Early: Pruritus, esp severe at night

Fatigue is common. HSM and evidence of cholestasis (xanthelasma, pale stool)

Late: jaundice, steatorrhea, portal HTN, osteopenia

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9
Q

What disease presents as a Male with a long history of UC, with fatigue and a high alk phos?

A

Primary sclerosing cholangitis

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10
Q

What are the histologic findings of primary biliary cirrhosis?

A

Destruction of interlobular bile ducts by granulomatous inflammation (florid duct lesion) and heavy portal tract infiltrate of WBCs

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11
Q

What disease presents as an Older Female with weight loss, abd discomfort, jaundice, and epigastric mass?

A

Pancreatic cancer

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12
Q

What nerve can be damaged in a thyroidectomy?

A

Superior laryngeal, which innervates ONLY the cricothyroid muscle

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13
Q

Aside from the cricothyroid muscle, what nerve are the laryngeal muscles innervated by?

A

Recurrent laryngeal (also sensory innervation to the larynx below the vocal folds)

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14
Q

What nerves provide sensory innervation to the larynx above and below the vocal folds?

A

Above: Internal branch of the Superior laryngeal nerve

Below: Recurrent laryngeal

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15
Q

What IL are secreted by Th2 cells?

A

IL 4, 5, 10, 13

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16
Q

Which IL stimulates Th0 to differentiate into Th1? Th2?

A

Th1: IL-12 from macrophages
Th2: IL-4 from other APCs

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17
Q

In the absence of IL-12, what cytokine should be administered to make up for the lack of Th1 differentiation?

A

IFN-y, to activate macrophages

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18
Q

Clinical features of melanoma? (ABCDE)

A 
Asymmetry
Border irregularity
Color variation
Diameter > 6mm
Evolution in appearance
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19
Q

What is the embryological origin of melanocytes?

A

Neural crest

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20
Q

What are the derivatives of surface ectoderm?

A

Epidermis (and its appendages), mammary glands, lens of the eye, and the adenohypophysis

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21
Q

What are the derivatives of the neuroectoderm?

A

CNS, preganglionic autonomic neurons, retina, and posterior pituitary

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22
Q

What wrist bone is under the thumb?

A

Trapezium

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23
Q

What is the most common enzyme deficiency that causes CAH?

A

21 hydroxylase def

24
Q

What inheritance is CAH?

A

AR

25
Q

What are the sx of vit A def?

A

Night blindness, xeropthalmia, vulnerability to infx (esp measles)

26
Q

What are the sx of vit B1 (thiamine) def?

A

Infantile beriberi: cardiomegaly, tachycardia, cyanosis, dyspnea, vomiting

Adult dry beriberi: symmetrical peripheral neuropathy, esp in distal extremities
Adult wet beriberi: dry sx + cardiac involvement

Wernicke-Korsakoff in alcoholics

27
Q

What are the sx of vit B2 (riboflavin) def?

A

Cheilosis, stomatitis, glossitis, dermatitis, corneal vascularization, ariboflavinosis

28
Q

What are the sx of vit B6 (pyridoxine) def?

A

Cheilosis, glossitis, dermatitis, peripheral neuropathy

29
Q

Def of what vit causes pellagra?

A

Niacin

30
Q

What are the sx of infant hydrocephalus?

A

Macrocephaly, irritability, poor feeding, muscle hypertonicity and hyperreflexia (UMN damage)

31
Q

Tinnitus, vertigo, and hearing loss are sx of acoustic neuroma, from what neoplasm? Where is it located?

A

Schwannomas in the cerebellopontine angle (attached to CN VIII)

32
Q

In what genetic abnormality do you see bilateral acoustic neuromas? Inheritance?

A

Neufofibromatosis (NF) type 2 (fewer cutaneous manifestations than NF-1), AD

33
Q

Which neurofibromatosis type is more CNS involvement?

A

NF-2 (tumor suppressor gene for Merlin protein), on Chr 22 (Bilateral acoustic…22 looks like ears…)

34
Q

What gene mutation causes renal cysts, renal cell carcinoma, and hemangioblastoma of the cerebellum and retina?

A

VHL on chr3

35
Q

What virus is Burkitt’s lymphoma strongly associated with?

A

EBV

36
Q

What does c-myc encode for? What chromosome is it on, and what neoplasm can its translocation cause?

A

Protein for transcription activation, on chromosome 8

t(8;14) causes Burkitt’s lymphoma

37
Q

What does cyclin D1 do? Chromosome? Translocation causes what neoplasm?

A

Promotor of G1 to S phase, on chromosome 11

t(11;14) causes mantle cell lymphoma

38
Q

What is the function of the BRCA genes?

A

Code for DNA repair enzymes

39
Q

What to give for trigeminal neuralgia?

A

Carbamazepine

40
Q

Why should carbamazepine be used with care (i.e. what does it cause)?

A

Aplastic anemia

41
Q

Which “part” of triglyceride breakdown goes to the liver? First enzyme?

A

TG into glycerol and FA in adipose (by Lipase)

GLYCEROL goes to liver, converted to Glycerol 3-phosphate by glycerol kinase

42
Q

Where is COX2 expressed?

A

Sites of inflammation

43
Q

Where is COX1 expressed?

A

Constitutively expressed in platelets and GI tract

44
Q

Which abortifactant is an anti-progestin?

A

Mifepristone

45
Q

What drugs inhibit formation of progesterone from pregnenolone?

A

“-ostane” drugs
Epostane
Trilostane

46
Q

What enzyme converts pregnenolone to progesterone?

A

3-beta-hydroxysteroid dehydrogenase

47
Q

Which abortifactant is a prostaglandin agonist? Why does it work?

A

Misoprostol, because prostaglandins induce uterine contraction and cervical dilation. Used with Mifepristone.

48
Q

What is the only type of renal calculi that is radioLUCENT?

A

Uric acid

49
Q

What organism causes Magnesium ammonium phosphate calculi?

A

Proteus (form struvite, staghorn calculi)

50
Q

Why is digoxin used for AF with RVR?

A

Increases parasympathetic tone from vagus, decreasing AV conduction

51
Q

In addition to increasing parasympathetic tone on the AV node, what is the other main effect of digoxin?

A

Increased ventricular contractility by blocking Na-K-ATPase on myocytes, increasing intracellular Ca

52
Q

What type of mitochondrial damage is associated with irreversibly myocardial injury?

A

Vacuoles or phospholipid containing amorphous densities (permanent inability to generate ATP). Simple mitochondrial swelling can be reversible.

53
Q

What are 2 selective COX2 inhibitors and when would you want to use them?

A

Celecoxib and Rofecoxib, when you wnat to reduce risk of bleeding and GI ulceration

54
Q

What is the difference between dystonia and myoclonus?

A

Dystonia: sustained muscle contraction
Myoclonus: sudden, brief, sometimes severe muscle contraction

55
Q

A lesion in what part of the CNS will cause hemiballism?

A

Contralateral subthalamic nucleus

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