4/1 - UW 38 Flashcards
How does herpes zoster present clinically?
Burning sensation/pain in a dermatome
How does herpes zoster present histologically?
Sample from a vesicle base reveals INTRAnuclear inclusions in keratinocytes and multinucleated giant cells (positive Tzank smear)
Pancreatic pseudocysts are formed by what tissue?
Granulation tissue (pancreatic enzymes induce inflammatory reaction in walls of surrounding organs)
How do the walls of cysts and pseudocysts differ?
True cyst: epithelial cells
Pseudocyst: granulation tissue
If reducing the dose of levodopa/carbidopa doesn’t help reduce neuro sx, what can be given?
Atypical antipsychotics (eg clozapine)
Which one is worse, CGD or Myeloperoxidase deficiency?
MPO def
With Niacin administration, medications for what comorbidities need to be adjusted?
Anti-HTN: need to decrease (compounding vasodilatory effects)
DM: need to increase (Niacin increases insulin resistance)
Gout: need to be careful (Niacin increases uricemia)
Which glomerular arteriole is constricted by Angiotensin II?
Efferent!
After how long is ischemic myocardial damage no longer reversible?
Over 30 min
What makes tPA a clot-specific thrombolytic?
Only binds plasminogen in the presence of fibrin
What 3 antithrombotic agents bind to plasminogen?
tPA, streptokinase, urokinase
Scopolamine MOA? Use?
Muscarinic antagonist (ie in the gut)
What part of the spinal cord is most affected by tabes dorsalis?
Dorsal roots and dorsal columns
What is a late stage urinary sx of BPH?
Overflow incontinence
What disease can cause glomerular sclerosis and hyalinosis?
Diabetic nephrosclerosis
What effect does cAMP have on platelet aggregation?
Decrease
What agents increase platelet cAMP? How?
Dipyridamole and Cilostazol increase platelet cAMP (decreasing aggregation) by decreasing phosphodiesterase (which breaks down cAMP)
Which platelet phosphodiesterase inhibitor is also a direct arterial vasodilator?
Cilostazol
When is argatroban used?
Treatment of heparin-induced thrombocytopenia. It is a direct thrombin inhibitor
What cells mediate the formation of noncaseating granulomas in Crohns disease?
Th1
For what cases of C. diff would you use each of the following: metronidazole, vancomycin, fidaxomicin?
Metronidazole: mild/moderate cases
Vancomycin: severe cases
Fidaxomicin: recurring cases
What is the clinical presentation of Polycythemia Vera?
Peptic ulceration (altered blood viscosity)
Itching (histamine release)
Gouty arthritis (increased cell turnover)
Moderate, reversible HTN (expanded blood volume)
What signaling pathway mediates Polycythemia Vera?
Mutation in JAK2 (non-receptor tyrosine kinase associated with EPO receptor), causing constant phosphorylation of STAT
What lymphoma is mediated by constitutive expression of a transcription factor?
Burkitt lymphoma (c-myc overexpression)
What type of tyrosine kinase is JAK2?
Non-receptor associated, linked to various myeloproliferative disorders (PV, essential thrombocythemia, primary myelofibrosis)
In which organs do Fluorinated anesthetics increase or decrease blood flow?
Increase: cerebral
Decrease: renal, hepatic
What monoclonal antibody is used in NHL against CD20?
Rituximab
What monoclonal ab to TNF-alpha is used in RA?
Infliximab (also used for ankylosing spondylitis and fistulizing Crohn’s disease)
How does imatinib treat CML?
Inhibitor of BCR-ABL tyrosine kinase
“Ground glass” cytoplasm is seen in what thyroid pathology?
Papillary carcinoma
What thyroid pathology is seen in MEN 2A and 2B?
Medullary thyroid cancer
In which glycogen storage disease do you see glycogen accumulation in lysosomal vacuoles?
Pompe disease, alpha-glucosidase
Which glycogen storage disease do you NOT see muscle involvement?
Von Gierke disease, glucose 6 phosphatase deficiency
What is the process of collagen synthesis?
In the ER:
- Signal sequence is removed
- Hyroxylation of proline and lysine (vit C dependent)
- Glycosylation of hydroxylysine
- Triple helix formation and secretion
Extracellular:
- Procollagen peptidases cleave into tropocollagen
- Covalent crosslinking by lysyl oxidase
What is the most likely cause of death due to rheumatic fever?
Severe myocarditis (causing cardiac dilation, MR, and HF)
At how many weeks gestation do lecithin levels start to rise?
32-33 weeks
What stimulates lung maturation?
Cortisol
How do oxytocin levels change during pregnancy?
They don’t. Oxytocin RECEPTORS increase in the myometrium later in pregnancy
End state chronic liver disease is characterized by what histology?
Cirrhosis: diffuse fibrosis with replace of normal lobular architecture by fibrous lined regenerative parenchymal nodules
In what hepatic pathology do you see dilation of sinusoids and perivenular hemorrhage?
Budd Chiari syndrome
In what hepatic pathology do you see granulomatous destruction of bile ducts?
Primary biliary cirrhosis
In what gender do you see PBC?
Women
How is Ras protein activated?
Binding to GTP
What does MAPK do?
Nuclear transcription factor
