5 Flashcards
transtentorial/uncal herniation leads to ??
damages what nerve??
fixed and dilated pupil(ipsilateral)
CN III (oculomotor damage)
ipsilateral paralysis of oculomotor muscles, contra/ipsilat hemiparesis, contralat homonymous hemianopsia (possible)
ureteric bud gives rise to ??
collecting system: collecting tubules and ducts, major/minor calyces, renal pelvis, ureters
metanephric mesoderm gives rise to ??
glomeruli, Bowman’s space, proximal tubules, loop of Henle, distal convoluted tubules
(NOT collecting tubules- from ureteric bud)
H. pylori concentration is greatest where ??
in the pre pyloric area of the gastric antrum
stroke, intestinal and foot ischemia, renal infact, think ??
embolism, possibly from a-fib
milrinone and inamrinone are ??
PDE-3 inhibitors
increase IC cAMP–>Ca2+ influx–>^cardicac contractility
-also causes systemic vasodilation due to ^cAMP in vasc. smooth muscle (limited use in sev. hypotensive pts)
what must increase in Lesch-Nyhan syndrome??
de novo purine synthesis (PRPP amido transferase) to increase the lost bases
(HGPRT defect causes degradation of hypoxanthine and guanine–>uric acid)
“elfin” facies, supravalvular aortic stenosis, extroverted personality, think ??
Williams syndrome
think Will Ferrell in Elf
while the capsular polysaccharide of N. meningitides is an important virulence factor, ?? directly induces systemic inflammatory response, correlating with morbidity and mortality in meningitis/menigococcemia
LOS (menigococcal lipooligosaccharide)
what drug inhibits funny sodium channels, slowing depolarization of phase 4, slowing SA node firing (with no effect on cardiac contractility?)
Ivabradine
ovarian torsion typically involves ??
the infundibulopelvic ligament aka suspensory ligament of the ovary, resulting in decreased blood and neural supply to ovary
ataxia (spinocerebellar tract degeneration), loss of position and vibration sense (DC degen) and loss of deep tendon reflexes (peripheral nerve degen), think??
Friedrich ataxia and Vitamin E deficiency (free radical damage)
MM is sensitive to tx with ??
proteasome inhibitors such as bortezomib (boronic acid-containing dipeptide)
because the plasma cells are synthesizing large amounts of protein, so this inhibition–>apoptosis
most enveloped nucleocapsid viruses get their lipid bilayer by budding through the plasma membrane of the host cell except ??
herpesviruses (including CMV)- acquire envelope from host cell NUCLEAR membrane
most commonly deficient enzyme in B-oxidation of fatty acids
acyl-CoA dehydrogenase
If PaCO2 during metabolic acidosis is higher than predicted by Winter’s formula (??) consider a superimposed ??
respiratory acidosis (resp. failure) i.e. lungs are not hyperventilating enough to compensate for the metabolic acidosis
Winter’s formula: (1.5 x HCO3-) + 8 +/- 2
gastric ulcers can extend into ??
vs erosions ??
submucosal layer and muscularis propria
erosions do not fully penetrate the muscularis mucosa so do not reach the submucosa
colorectal, endometrial, ovarian cancer think ?? syndrome with ?? gene mutations
Lynch syndrome
MSH2, MLH1, MSH6, PMS2
the area of the brain demonstrating greatest degree of atrophy in Alzheimer’s disease??
hippocampus
poorly controlled maternal DM can lead to ?? in baby
caudal regression syndrome: sacral agenesis causing LE paralysis and urinary incontinence (also transposition of the great vessels)
hormones that share alpha subunits
hCG, TSH, LH, FSH
(also hCG and TSH have similar beta subunits) this can cause hyperthyroid-like presentation in pt w. germ cell tumor or gestational trophoblastic disease (^hCG)
how to calculate number needed to tx (NNT)
1/ARR
ARR=event rate in control group-event rate in tx group
migratory thrombophelbitis, think??
cancer (adenocarcinomas of pancreas, colon, lung) paraneoplastic syndrome–>hyper coagulability–>superficial venous thromboses (Trousseau syndrome)
the live attenuated oral polio vaccine (Sabin) produces a stronger ?? immune response then inactivated polio vaccine (Salk)
mucosal secretory IgA immune response (mucosal surfaces are directly stimulated by the antigen)
