4/3 - UW 42 Flashcards
What is congenital torticolis?
SCM injury and fibrosis by 2-4 weeks of age, due to either in utero malpositioning (from macrosomia or oligohydramnios) or birth trauma
What maternal pathology can cause asymmetric intrauterine growth restriction (normal head size, reduced abd circ)?
Maternal HTN
What molecules act by tyrosine kinase activating receptors?
Insulin Growth factors (EGF, TGF-b, VEGF)
What is the host defense reaction against mycobacteria?
Mycobacteria are intra-macrophage; Macrophages release IL-12, stimulating Th1 and NK cells to release IFN-y, which activates JAK-STAT in the macrophage
What mediates chronic renal allograft rejection?
Low grade cellular and humoral immune responses against alloantigens
Poor intestinal absorption of cystine suggests what other pathology?
Cystine excretion in feces and urine (along with ornithine, lysine, and arginine; all dibasic AAs).
What AA insolubility causes kidney stones?
Cystine
Which catecholamine is primarily produced in the adrenals?
Epinephrine
What is another name for dihydroxyphenylalanine?
Dopa, produced by tyrosine hydroxylase
What enzyme converts dopa to dopamine?
Dopa decarboxylase
What enzyme converts dopamine to NE?
dopamine beta-hydroxylase
What enzyme converts NE to epinephrine?
PNMT
What hormone increases PNMT expression?
Cortisol (which is very high in the venous drainage of adrenal cortex, which travels through adrenal medulla to stimulate Epi synthesis)
What disease is the result of valine substituting for glutamic acid?
Sickle cell, at 6th codon of beta globulin
What disease is the result of a phenylalanine deletion (deltaF508)?
CF
What mediates phase 4 in cardiac pacemaker cells?
Na channels, but then Ca channels towards the end, which is how CCB can slow heart rate
What intracellular and extracellular K levels are seen in DKA?
Intracellular: decreased
Extracellular: increased
How does insulin affect K movement?
Insulin causes cellular uptake of K
How does estrogen affect thyroid hormone levels?
Increases in total T4, with normal thyroid function
Why does total T4 increase with estrogen?
Estrogen decreases catabolism of TBG
What therapy would reduce recurrence of genital herpes?
Daily oral “-cyclovir”
What do you give lamivudine for?
HIV, NRTI
What are probenecid and allopurinol used for?
CHRONIC FUCKING GOUT YOU MOTHERFUCKER
What you do you give for ACUTE gout???
NSAIDs or COLCHICINE
Colchincine MOA?
Binds intracellular protein tubulin, preventing polymerization into microtubules, impairing leukocyte migration and phagocytosis, reducing inflammation in gouty arthritis.
What gout medication causes diarrhea?
Colchicine
Why don’t you give probenecid or allopurinol for acute gout?
They can precipitate release of stored uric acid
What hepatitis virus is HEV similar to?
HAV (unenveloped, ssRNA, fecal-oral)
Damage to what part of the spinal cord mediates the muscular effects of poliovirus?
Damage to anterior horn lower motor neuron cell bodies
What can actinic keratoses progress to?
Squamous cell carcinoma
RUQ pain after mu opioid use indicates what?
Biliary colic due to contraction of smooth muscle cells in the sphincter of Oddi
What is the opioid of choice for biliary and pancreatic pain?
Meperidine, due to less constriction of sphincter of Oddi
Where are mu opioid metabolized?
Liver
How do mu opioids mediate vasodilation?
Histamine release, also causing itching
What bowel symptoms do mu opioids usually cause?
Constimpation by slowing gut motility
What is mu opioid effect on parietal cells?
Decrease acid secretion
What symptom can you see with combined aminoglycosides and loop diuretics?
Ototoxicity
What are 1st gen antihistamines?
Hydroxyzin, promethazine, chlorpheniramine, diphenhydramine
What are the major side effects of 1st gen antihistamines?
Anti-muscarinic, -serotonergic (appetite stimulation), -alpha adrenergic (postural dizziness), can cross BBB (sedation, cognitive deficits)
What generation antihistamine is fexofenadine?
Second (less antimuscarinic, antiserotonergic, antialpha adrenergic properties)
What type of anterior mediastinal mass do patients with Myasthenia Gravis present with?
Thymoma or Thymic hyperplasia
What structures are derived from the 3rd pharyngeal pouch?
Thymus
Inferior parathyroid glands
What is the purpose of Edrophonium (Tensilon test) in myasthenia gravis?
A short acting AChE-I that can test if more AChE-I is needed normally
What are the most common side effects of verapamil?
Constipation and gingival hyperplasia (more rarely: bradycardia, heart block)
What is VHL?
AD mutation on chromosome 3 characterized by:
- capillary hemagioblastomas in retina/cerebellum
- congenital cysts/neoplasms in kidney, liver, pancreas
What is Von Recklinghausen’s disease?
NF-1: PERIPHERAL nervous system tumors (neurofibromas, optic nerve gliomas, Lisch nodules in the iris, cafe au lait spots)
What is NF-2?
AD, CENTRAL nervous system tumors: bilateral CN VIII schwannomas, multiple meningiomas
What is tuberous sclerosis?
AD, CNS hamartomas, kidney/liver/pancreatic cysts, cutaneous angiofibromas. SEIZURES!
What is Osler-Weber-Rendu syndrome?
Hereditary hemorrhagic telangiectasia, AD, rupture of telangiectasias may cause epistaxis, GI bleeding, or hematuria
What is the skin lesion in tertiary syphilis called?
Gumma
What stage of syphilis has a chancre?
Primary
