6.20.16 Flashcards
how can you suppress peripheral chemoreceptors?
admin O2
calc: MAP
CO x TPR
common iliac veins become what?
IVC
severe HTN –> fibrinous necrosis of retinal arterioles –> manifestation on fundoscopy? why?
dot/flame-shaped hemorrhage
necrotic vessel –> bleed into nerve fiber layer
IL-12 receptor deficiency: tx
IFN-gamma
what is the major stimulator of respiration in healthy ppl?
PaCO2 (partial pressure of CO2 in arterial blood)
what N goes thru the obturator foramen?
obturator N
5a-reductase def: clinical presentation in M
M pseudohermaphroditism:
- feminized external genitalia –> masculinize at puberty
- small phallus w hypospadias
B-hCG: fx
signal to corpus luteum in ovary to continue producing progesterone
pulsus paradoxus: definition
inspire –> SBP –> decrease >10mmHg
what produces BNP?
ventricles when they are stretched –> ie CHF from systolic dysfx
temporal giant cell arteritis: type of inflamm?
granulomatous inflamm of media
Friedreich ataxia: most important clinical presentation? d/t what?
- progressive gait ataxia (degen of spinocerebellar tract)
- impaired joint & vibration sense (degen of post columns & dorsal root ganglia)
severe HTN: effect on retinal precapillary arterioles
disrupt endothelium –> plasma leak into arteriolar wall –> fibrinous necrosis
angiotensin II: effect
- systemic vasoconstrict –> increase BP
- eff art vasoconstrct –> increase GFR
- aldos –> increase renal Na resorb –> increase BP
acute asthma/COPD exacerbation: tx
B-adrenergic agonist
level of spine: common iliac veins become IVC?
L4
phosphodiesterase inh: effect
relax vasc smooth muscle – vasodilate
calc: CO
SV x HR
long-standing RA can cause what?
affect C spine –> vertebral malalignment (subluxation) at atlantoaxial jt
when would you use a IVC filter?
pt w DVT/PE w CI to anticoag
lung apices: location
extend above clavicle & 1st rib
porcelain gallbladder: pathophys
chronic inflamm –> dystrophic intramural calcium salt deposition
what is responsible for dev of internal M genitalia?
testosterone
bulimia nervosa vs anorexia nervosa
bulimia: normal body wt
anorexia: BMI
angiotensin II: direct effect on kidney
vasoconstrict eff art –> increase GFR
what vasculitides have granulomatous inflamm of the media?
- temporal giant cell arteritis
- Takayasu arteritis
gel electrophoresis: speed of Hb A, S, C movement
Hb A > S > C
when is B-hCG detectable in the urine?
14 days after fertilization
anal SCC: charact
ulcerative mass (>50% pt)
pulsus paradoxus: pathophys
inspire –> increase venous return –> increase vol in RH –> but constricted pericardial space –> RV can’t expand into pericardial space –> so IVS bow out into LV –> decrease LVEDV, SV –> decrease SBP during inspiration
HbC: pathophys
B globin chain –> missense mutation –> glutamate to lysine
VTE in preg: tx
LMWH (enoxaparin)
bulimia nervosa vs binge-eating disorder
bulimia: binge eat –> compensatory beh to prevent wt gain
binge eat: no compensatory beh
level of spine: renal V join IVC?
L1-2
intubation of pt w cervical subluxation: leads to?
acute compression of spinal cord, vertebral A
who is at increased risk for anal SCC?
HIV+ MSM
B-agonist for asthma/COPD exacerbation: MOA
increase intracell cAMP –> relax bronchial SM
increase PaCO2 –> effect?
stim central chemoreceptors –> increase pulm ventilation
what makes a naive T cell differentiate to a Th2 cell?
APC (not macrophage) –> IL-4
what drug decreases degradation of cGMP?
phosphodiesterase inh (sildenafil)
what produces B-hCG?
syncytiotrophoblast after implantation
BNP: effect
- vasodilate –> decrease preload
- diuresis
polyA tail: fx
protect mRNA from degradation in cyto
porcelain gallbladder: indicates?
chronic cholecystitis
cholesterol 7a-hydroxylase: what pathway?
bile acid syn –> rate limiting step
IL-12 receptor deficiency: at risk for what type of infections? why?
severe mycobacterial infect
can’t mount a strong cell-med granulomatous immune response
BNP, ANP: MOA
activate guanylate cyclase –> increase intracell cGMP
what is: pes cavus
high foot arches
ANP: effect
- vasodilate –> decrease preload
- diuresis
Friedreich ataxia: other (non-neuro) features?
- hypertrophic cardiomyopathy
- skeletal abnormalities –> kyphoscoliosis, pes cavus
- DM
pulsus paradoxus: often seen in?
- cardiac tamponade
- constrictive pericarditis
- severe asthma, COPD
Friedreich ataxia: onset
childhood, adolescence
brain natriuretic peptide: use
lab test –> determine if pt is suffering from CHF exacerbation
typical cause of injury to obturator N?
compression –> ie pelvic trauma, surg, tumor
what stimulates peripheral chemoreceptors?
hypoxemia
preg increases risk for what vasc disorder?
venous thromboembolic dz
how does HCV have such high genetic variability?
- RNApol –> no proofreading 3’–>5’ exonuclease
- envelope glycoprotein seq –> hypervariable region –> prone to freq genetic mutation
when is B-hCG detectable in the serum?
8 days after fertilization
what makes a naive T cell differentiate to a Th1 cell?
APC –> macrophage –> IL-12, IFN-gamma
IL-12: fx
stimulate differentiation of naive T helper cells to TH1
Friedreich ataxia: #1 COD
hypertrophic cardiomyopathy
what does BNP act with?
ANP
penetrating wound –> just above clavicle, bw midclavicular & lat sternal lines –> leads to?
(tension) pneumothorax/hemothorax
what produces ANP?
atria when they are stretched
5a-reductase: rxn
testosterone –> dihydrotestosterone
COPD: what is the important contributor to the resp drive?
hypoxemia (PaO2, low oxygen in blood)
inspiration: effect on blood flow
increase systemic venous return –> increase R heart vol
what is the result of the JAK-STAT pathway?
IGF-1 gene transcription
Huntington dz: pathophys
loss of neurons in caudate nucleus & putamen
MDD: duration for dx
> 2wk
what endogenous subst use the JAK-STAT pathway?
- growth hormone
- cytokines (IFN)
- hematopoietic growth factors (erythropoietin, G-CSF)
what pts have a blunted response to PaCO2?
COPD
peripheral chemoreceptors: location?
carotid & aortic bodies
esophageal SCC: histology
- solid nests of neoplastic squamous cells –> abundant eosinophilic cyto & distinct borders
- areas of keratinization (keratin pearls)
- intercell bridges
esophageal SCC: presentation
- progressive solid & eventually liq dysphagia
- wt loss
what endogenous subst has the same MOA as ANP & BNP?
nitric oxide
dev milestone: 2yo –> lang
- 50+ word vocab
- 2-word phrases
Friedreich ataxia: mode of inheritance
AR
Huntington dz: clinical manifestation
- progressive demential
- choreiform movements
how does preg increase risk of venous thromboembolic dz?
- increase venous stasis
- endothelial injury (during delivery)
- hypercoag
Th1: fx
- activate macrophages & cytotoxic T cells
- mediate delayed type HSN
SJS/TEN: ssx
flu-like ssx –> widespread mucocut epidermal necrosis
obturator N injury: ssx
- weak thigh adduct
- distal medial thigh –> sensory loss
porcelain gallbladder: at risk for?
gallbladder adenocarcinoma
location: temporal giant cell arteritis vs Takayasu arteritis
temporal giant cell arteritis: more distal carotid artery branch involvement
Takayasu arteritis: aorta & proximal aortic arterial branch involvement
who?: temporal giant cell arteritis vs Takayasu arteritis
temporal giant cell arteritis: >50yo
Takayasu arteritis:
what inh chol 7a-hydroxylase?
fibrates (fenofibrate, gemfibrozil)
Th2: fx
- activate B cells
- promote class switching
when does implantation occur?
6-7 days after fertilization at the earliest
diffuse atherosclerosis may cause?
bilat renal artery stenosis
what is responsible for dev of external M genitalia?
dihydrotestosterone
what senses PaO2?
peripheral chemoreceptors
