6.10.16 Flashcards
glucose 6-phosphate deH def: pathophys
1) pentose phosphate pathway: G6PD –> NADPH
2) reduce glutathione
3) glutathione peroxidase: H2O2 –> H2O
no NADPH –> oxidative damage
G6PD def: ssx
- hemolytic anemia
- jaundice
Heinz bodies: what is, assoc dz
oxidized Hb conglomerates
G6PD def
what is: bite cells
splenic macrophage –> bite away Heinz bodies in RBC
glutathione reductase: rxn
oxidized glutathione + NADPH –> reduced glutathione + NADP
glutathione reductase def: similar to what dz?
G6PD def
methacholine challenge: use
detect degree of bronchial hyperactivity –> R/O asthma
carpal tunnel synd: motor deficit
- weak thumb abduct, opposition
- thenar atrophy
MHC Class I: struct
heavy chain + B2-microglobulin
base excision repair: process
1) glycosylase: remv defective base
2) endonuclease & lyase: remv empty sugar-phosphate site
3) DNApol: replace missing nucleotide
4) ligase: seal nick
inflamm leukocyte accumulation: steps
1) margination
2) rolling
3) activation
4) tight adhesion & crawling
5) transmigration
what is: PCAM-1
protein on intercell jxs of endothelial cells –> neutrophil integrins bind PCAM-1 to transmigrate out of vasc to tissue
thyrotoxicosis –> tx –> BB: MOA
1) decrease effect of sympathetic adrenergic impulses on target organs
2) decrease rate of peripheral conversion of T4 to T3
what is: VIPoma
pancreatic islet cell tumor –> hypersecrete vasoactive intestinal peptide
VIPoma: causes what synd?
WDHA synd (pancreatic cholera):
- watery diarrhea
- hypoK
- achlorhydria
VIP: axn
1) increase intestinal Cl- loss into stool
2) excess loss of accompanying water, Na, K
3) inh gastric acid secretion
VIPoma: tx
somatostatin: inh VIP secretion
what produces holosytolic murmurs?
- mitral regurg
- tricuspid regurg
- VSD
How do you differentiate bw the holosystolic murmurs?
- MR: radiate to axilla
- TR: murmur increase w inspiration
- VSD: loud, accompanied by thrill
what happens to blood flow during inspiration?
- intrathoracic pressure drop –> more blood return to R heart
- increase pulm vessel capacity –> decrease LV venous return
what is the center of the airway pressure-vol curve?
fxal residual capacity: resting state where airway pressure equals 0
what is: fxal residual capacity
vol of air remaining in lungs after passive expiration
what is the intrapleural pressure at fxal residual capacity?
-5cm H2O
IVC: formed by what? where?
union of R & L common iliac veins at L4-5
renal A & V: located at what level of spinal cord?
L1
IVC: drains what?
- LE
- portal system
- abd, pelvic viscera
how does CSF exit the 4th ventricle?
thru:
- lat foramina of Luschka
- median foramen of Magendie
injury to what N causes Trendelenburg sign?
sup gluteal N
sup gluteal N injury: affects what muscles?
- gluteus medius
- gluteus minimus
- tensor fascia lata
sup gluteal N injury: pts present with what type of gait?
gluteus medius gait: lean toward ipsilat side when walking to stabilize pelvis
gastric adenocarcinoma: variants?
1) intestinal-type
2) diffuse
how was intestinal-type gastric adenoCA present?
- solid mass that project into stomach lumen
- lrg, irreg ulcer w heaped up margins
diffuse gastric adenoCA: hallmarks
- signet cells
- linitis plastica
serotonin is a derivative of what aa?
tryptophan
serotonin synd: ssx
- confuse
- agitate
- tremor
- tachycardia
- HTN
- clonus
- hyperreflexia
- hyperthermia
- diaphoresis
serotonin synd: tx
cyproheptadine: antihist w anti-serotonin properties
what is: Kehr sign
referred pain to shoulder d/t phrenic N irritation (C3-5)
SLE: CV manifestations
- accelerated atherosclerosis
- small vessel necrotizing vasculitis
- pericarditis
- Libman-Sacks endocarditis
Libman-Sacks endocarditis: hallmark
small, sterile vegetations on both sides of valve
SLE: renal manifestations
diffuse prolif glomerulonephritis
diffuse prolix glomerulonephritis: hallmark
diffuse thickening of glomerular capillary walls –> light microscopy –> “wire-loop” structures
acute interstitial pancreatitis: gross appearance
- focal areas of fat necrosis
- Ca2+ deposition
- interstitial edema
necrotizing (hemorrhagic) pancreatitis: gross appearance
- chalky-white areas of fat necrosis
- interspersed hemorrhage
Kaposi sarcoma: bx findings
- spindle cells
- neovascularization
- extravasated RBC
