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3/29 - UW 32 Flashcards

1
Q

What sensory receptors detect muscle tension? Where?

A

Golgi tendon organs (GTO) at the junction of muscle and tendon

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2
Q

What sort of change is detected by Golgi tendon organs? What nerves innervate them?

A

Increases in tension, transmitted by group 1b sensory axons

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3
Q

What purpose does the Golgi tendon organ serve?

A

Negative feedback to the alpha motor neurons, turning off muscles when tension is too high, preventing damage

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4
Q

What are the fast and slow mechanoreceptors that mediate touch, proprioception, and vibration? What type of fibers innervate them?

A

Fast: Pacinian corpuscles
Slow: Ruffini’s end organs

Innervated by myelinated A-beta fibers

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5
Q

What is the condition that has decreased ability to repair DNA following UV damage? Its inheritance?

A

Xeroderma Pigmentosum (“dry, pigmented skin”), AR

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6
Q

How does retinoblastoma (Rb) gene suppress tumors?

A

Arrests cell cycle in G1, defect leads to retinoblastoma and osteosarcoma

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7
Q

How does ras protein suppress tumors?

A

G-protein that regulates signal transduction, cell division, apoptosis, cell adhesion

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8
Q

What type of DNA repair is impaired in Hereditary Nonpolyposis Colorectal Cancer (HNPCC or Lynch syndrome)?

A

DNA mismatch repair

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9
Q

CD14 is a surface marker for what cells?

A

Monocyte-macrophage lineage

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10
Q

What are the two factors that enhance diuresis by loop diuretics?

A
  1. Blocks Na-K-2Cl symporters, preventing reabsorption of Na, Cl, and water in the loop
  2. Stimulates renal prostaglandin release, which are vasodilatory, increasing RBF and GFR
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11
Q

What are the foregut structures? What vessel supplies them?

A

From esophagus to UPPER duodenum, including liver, gallbladder, and pancreas. Supplied by Celiac Trunk.

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12
Q

What are the embryologic midgut structures? What vessel supplies them?

A

From the LOWER duodenum to the PROXIMAL 2/3 of the transverse colon. Supplied by the SMA.

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13
Q

What are the hindgut structures? What vessel supplies them?

A

DISTAL 1/3 of transverse colon to the sigmoid colon. Supplied by the IMA

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14
Q

During which weeks of fetal development are the midgut structures outside the abdomen?

A

6th - 10th weeks

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15
Q

What is the toxin found in poisonous mushrooms? MOA?

A

Amatoxins are concentrated in hepatocytes, where they bind RNA polymerase II (mRNA synthesis)

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16
Q

What lung pathology is seen in Goodpasture syndrome?

A

Focal necrosis of alveolar walls and intra-alveolar hemorrhages, with hemoptysis

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17
Q

Does Churg-Strauss cause restrictive or obstructive pulmonary pathology?

A

Obstructive: severe asthma with bronchial wall thickening and eosinophilic infiltrates

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18
Q

What is the only RNA that contains thymidine? What is on its 3’ end?

A

tRNA, with CCA on the 3’ end

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19
Q

What are two causes of diastolic heart failure?

A

Impaired myocardial relaxation (eg from ischemia)

Increased intrinsic ventricular wall stiffness (eg from amyloid deposition)

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20
Q

Which branchial arch regresses completely?

A

5th

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21
Q

What are the structures derived from the 1st branchial arch?

A

(Associated with CN V)
Neural crest (bones): maxilla, zygoma, mandible, vomer, palatine, incus, malleus
Mesoderm (muscles): muscles of mastication, anterior digastric, mylohyoid, tensor tympani, tensor veli palatini

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22
Q

Muscular elements derived from any branchial arch are from what layer? Bony elements are from what cells?

A

Muscle: mesoderm
Bones: neural crest cells that migrate in

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23
Q

What are the structures derived from the 2nd branchial arch?

A

(Associated with CN VII)
Neural crest (bone): styloid, lesser horn of hyoid, stapes
Mesoderm (muscles): muscles of facial expression, stylohyoid, stapedius, posterior digastric

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24
Q

Which branchial arches form the cartilaginous structures of the larynx?

A

4th and 6th (5th arch regresses completely)

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25
Q

Why might the aortomesenteric angle (between the SMA and aorta) decrease?

A

Anything that decreases mesenteric fat, pronounced lordosis, or after surgical correction of scoliosis. This may occlude the transverse duodenum

26
Q

What are the levels of serum Ca and PTH in primary ostoporosis?

A

Both normal!

27
Q

What is the pathophys of Henoch-Schonlein purpura?

A

Ag exposure causes IgA immune complexes to deposit on vessel walls, causing inflammation, which manifests cutaneously as a leukocytoclastic vasculitis with palpable purpura (seen in ages 3-10)

28
Q

What syndrome is suggested by colon cancer at young age (<50) and FH of colon and other cancers? Inheritance?

A

Hereditary non-polyposis colon cancer (HNPCC) or Lynch syndrome, AD.

29
Q

What is the mutation that leads to cancer in HNPCC (Lynch syndrome)?

A

Mutation in genes responsible for DNA mismatch repair

30
Q

What is the most common enteric parasite in the US? Route?

A

Giardia lamblia, by contaminated water

31
Q

How to treat Giardiasis?

A

Metronidazole

32
Q

What causes bacterial vaginosis? What causes chronic diarrhea from contaminated water? Tx for both?

A

Vaginosis: Gardnerella
Water: Giardia
Tx: Metronidazole

33
Q

Treatment for roundworms? MOA?

A

Mebendazole, acts on microtubules

34
Q

Treatment for tapeworms (Echinococcus)?

A

Albendazole

35
Q

What do you give Albendazole for?

A

Echinococcus (tapeworm), which causes hyatid cysts, which can cause anaphylactic shock

36
Q

What do you give Mebendazole for?

A

Round worm infx (Ancylostoma, Ascaris, Enterobius)

37
Q

What nitrate has the greatest PO bioavailability?

A

Isosorbide MONOnitrate (mono in your mouth bitch!)

38
Q

How is amyl nitrate administered?

A

Inhalation

39
Q

How is sodium nitroprusside administered? Use? Major toxicity?

A

IV (for hypertensive emergency, can cause cyanide toxicity)

40
Q

Dopamine is tricky! What receptors does it act on with different doses?

A

Low dose: D1 agonist in kidneys (and mesentery), increasing RBF, GFR, and Na excretion

Medium dose: add B1 agonist in the heart, increasing inotropy, pulse pressure, sBP (no change in dBP)

High dose: add a1 agonist in systemic vasculature, increasing vasoconstriction and afterload, decreasing CO

41
Q

What receptor does clozapine act on? What ADR is most concerning?

A

D4 (as opposed to D2 of traditional antipsychotics), so no DAergic side effects like pseudoparkinsonism, tardive dyskinesia, hyperprolactinemia.

Causes granulocytopenia, need to monitor CBC. Also seizures…!

42
Q

What disease commonly presents in women aged 20-40 with dypnea and exercise intolerance and a positive FH?

A

Familial Pulmonary Arterial Hypertension (PAH)

43
Q

What is the definitive tx for Pulmonary Arterial Hypertension?

A

Lung transplant

44
Q

What is an effective symptomatic tx for Pulmonary Arterial Hypertension?

A

Vasodilators, particularly Bosentan (endothelin-receptor antagonist)

45
Q

What type of thyroid neoplasm is seen in MEN 2A and 2B?

A

Medullary thyroid cancer

46
Q

What type of cells produce Medullary thyroid cancer? How do they appear histologically?

A

Parafollicular C (calcitonin) cells, appear uniform polygonal or spindle shaped cells with extracellular amyloid deposits that stain with Congo red

47
Q

In what type of thyroid cancer can you see follicular hyperplasia with tall cells forming intrafollicular projections?

A

Papillary thyroid cancer

48
Q

What are 2 causes of drug-induced body fat redistribution (Cushing syndrome or lipodystrophy)?

A

HAART (protease inhibitor) or glucocorticoids

49
Q

What are the unidirectional enzymes in glycolysis? (Cannot be reversed for gluconeogenesis)

A
  1. Hexokinase (glucokinase)
  2. Phosphofructokinase 1 (PFK-1)
  3. Pyruvate kinase
50
Q

High levels of Fructose-2,6-bisphosphate drives which reaction, glycolysis or gluconeogensis?

A

Glycolysis

51
Q

Conversion of F6P to F2,6P is driven by what enzyme? (Thereby promoting the PFK-1 mediated conversion of F6P to F1,6P)

A

PFK-2, driven by insulin!

52
Q

What are the lab findings of DIC?

A
  1. Prolonged PT, PTT, and bleeding time.
  2. Low platelets fibrinogen, factor V, and VIII
  3. Elevated D dimer (fibrin split product)
53
Q

Vegetations in bacterial endocarditis are composed of what cells?

A

Fibrin and platelet deposition at a site of bacterial colonization

54
Q

Where do hepatic adenomas typically arise? What drugs are they associated with?

A

Solitary mass in the right lobe, associated with oral contraceptives and anabolic steroids.

55
Q

Hepatic angiosarcomas are associated with what exposure?

A

Vinyl chloride, arsenic, or Thorotrast

Very aggressive!

56
Q

In addition to focal headache and craniofacial pain/claudication, what other sx can present with temporal arteritis?

A

Polymyalgia rheumatica (axial joint pain and morning stiffness)

Sudden vision loss…give prednisone stat!

57
Q

What is Ewing sarcoma?

A

Undifferentiated neoplasm of neuroectodermal cells, commonly in the long and flat bones of children and adolescents

58
Q

Where are neuroblastomas most commonly found?

A

Adrenals

59
Q

Oxalate crystals and acute onset renal failure are signs of what?

A

Ethylene glycol poisoning

60
Q

Phenelzine MOA?

A

MAOI, irreversibly binds MAO A and B

61
Q

Sertraline MOA?

A

SSRI

62
Q

Why is coadministration of Phenelzine and Sertraline contraindicated?

A

Coadministration of an MAOI and SSRI can cause Serotonin Syndrome

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