5/16 Flashcards
risk of myopathy is enhanced when statins taken with….
gemfibrozil- reduces hepatic clearance of statins
also niacin and ezetimibe but to lesser extent
pathway of nesseria meningitidus from entry to meninges
inhaled–> nasopharnyx–> blood –> choroid plexus –> meninges
when you look at horizontal cut on CT, are you looking at it from above or below
below
arteries of less curvature of stomach (top) and greater curvature (bottom)
lesser- left and right gastric arteries
greater- left and right gastroepiploic arteries
infarct of medial pons at level of middle cerebellar pedunce
affect CST- contralateral hemiparesis, Babinski
affect CBT- contralateral facial palsy
affect corticopontine fibers- contralateral dysmetria and dysdiachokinesia
trigeminal nerve arises through there
which myotoms for biceps reflex
C5-C6
which proteins does RER make
secretory proteins
integral membrane proteins
proteins within ER, golgi, and lysosomes
lynch syndrome gene
aut dom- defect mismatch repair
MSH2, MLH1- encode for MutS and MutL
what drug can help prevent cerebral vasospasm and death after subarachnoid hemorrhage
CCBs (nimodipine)
3 mitochondrial diseases
- leber herditary optic neuropathy
- myoclonic epilepsy with ragged red fibers
- mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS)
which drug prolongs QT interval without risk of torsades
amiodarone
which cells release proteases in emphysema
neutrophils and macrophages
DOC for acute decompensated heart failure
diuretics
Mc Murray test
pain popping on external rotation –> medial meniscus tear
pain popping on internal rotation –> lateral meniscus tear
areas to injure radial nerve
- midshaft fracture of humerus
- compress axilla (crutches or sleeping with arm over chair)
radial injury presentation
wrist drop
loss of elbow, wrist, finger extension
decrease grip strength
lose sensation over posterior arm/forearm and dorsal hand
L3-L4 radiculopathy
weakeness of knee extension
decreased patellar reflex
L4-L5 radiculopathy
weak dorsiflexion
difficulty in heel-walking
L5-S1 radiculopathy
weak plantarflexion
decreased achilles reflex
difficulty toe walking
causes of osteonecrosis
Corticosteroids
Alcoholism
Sickle cell disease
tramau
The bends
Legg-Calve- perthes disease
Gauchers
Slipped capital femoral epiphysis
CAST Bent LEGS
giant cell tumor
20-40 years old
epiphyseal end of long bones- knee
locally aggressive, benign
soap bubble on x-ray
multinucleated giant cells
mixed connective tissue disease
features of SLE, sclerosis, polymyositis
anti-U1 RNP
which disease is endomysial inflammation and which perimysial inflamm?
endomysial- polymyositis
perimysial- dermatomyositis
which layer does staph scalded syndrome affect?
stratum granulosum
erythema multiforme
macules, papules, vesicles, target lesions
assocations: infections (mycoplasma, HSV) drugs (Sulfa, beta-lactams, phenytoin) cancer autoimmune
McCune-Albright syn
GNAS mutation –> const. AC
cafe-au-lait endocrine abnl (precocious puberty, thryoid) fibrous dysplasia (multiple osteolytic lesions)
congenital hypothyroidism
infants develop constipation, hypotonia, macroglossia, umbilical hernia, large anterior fontanelle
patellar fracture
from blow to anterior patella
swelling, tenderness, inability to extend knee against gravity
thoracic outlet syndrome
compress lower trunk of brachial plexus in scalene triangle
upper extremity weakness, tingling, numbness
scaphoid fractures at risk for
avascular necrosis `
which muscle in greater sciatic foramen
piriformis
merocrine exocrine glands
cells release watery secretory product via exocytosis
salivary, eccrine, apocrine
apocrine exocrine glands
release membrane bound vesicles with secretory product
mammary glands
holocrine exocrine glands
release entire contents of cells via cell lysis
sebaceous glands
lambert-eaton myasthenic syndrome symptoms
proximal muscle weakness
CN involved
autonomic disturbances
most have malignancy (small cell lung cancer)
Ehlers-danlos enzyme defect
procollagen peptidase- cleaves terminal propeptides from procollagen in extracellular space
potency of anesthetic determined by
minimum alveolar concentration (indirect relationship)
structures of neural crest
melanocytes odontoblasts tracheal cartilage enterochromaffin cells laryngeal cartilage
Parafollicular cells of thyroid
adrenal medulla
schwann cells
spiral membrane
MOTEL PASS
location of locus ceruleus
posterior rostral pons near lateral floor of 4th ventricle
tPA transient side effect
reperfusion arrythmia
how does alcohol lead to hypoglycemia
metabolism of ethanol reduces NAD+ to NADH–> inhibits gluconeogenesis
systemic mastocytosis
mast cell proliferation- KIT mutations –> excessive histamine
hypotension, pruritis, excess gastric acid secretion, inactivates pancreas and intestinal enzymes (diarrhea)
hereditary pum hypertension hits
1st hit- BMPR2- aut dom- smooth muscle cell proliferation
2nd hit- (infection, drugs, ion defects) - activates the disease- vasoconstriction
krukenberg tumor morphology
increased mucin production
signet ring- nuclei pushed to periphery
ataxia telengctasia gene and symptoms
ATM- DNA break repair from radiation
ataxia, telengctasia, recurrent resp infections
how to treat mild vs severe hypoglycemia in DM1 patient
mild- fast-acting carbs (juice, glucose tablets
severe- intramuscular glucagon
shapes of urine stones
calcium oxalate- octahedron (square with X)
Calcium phosphate- elongated, wedge shaped
Mg ammonium phosphate- rectangular prisms or struvite
uric acid- rhomboid
cystine- flat yellow hexagonal
how does chronic diarrhea lead to uric acid stones
lose HCO3–> increase excretion of H+ to compensate –> acidic environment in urine –> increase conversion of urate (soluble) to uric acid (insoluble)
c-myc function
transcription activator
what should be the next lab after elevated alk phos?
gamma-glutamyl transpeptidase
determines if elevated alk phosphate is due to hepatic/gall baldder cause or bone
will be elevated in hepatic cause
