6.24.16 Flashcards
Tay Sachs dz: mode of inheritance
AR
mass in 3rd part of duodenum: may compromise?
SMA
caudal regression synd: charact
sacral agenesis:
- LE paralysis
- urinary incontinence
bacterial vaginosis: tx
- metronidazole
- clindamycin
what binds thyroid hormone?
thyroxine-binding globulin (TBG)
dx: mild intell disability, 47 chrom
Klinefelter synd
osteogenesis imperfecta: pathophys
defective syn of collagen I –> impaired bone matrix formation
femoral N injury: ssx
- weak quadriceps
- lose patellar reflex
- lose sensation: ant/med thigh, med leg
how do cells adhere to ECM?
integrin: bind fibronectin, collagen, laminin
Dx: proximal muscle pain, weak. Fatigue, wt gain. High CK
hypothyroid myopathy
Klinefelter synd: ssx
- tall
- small, firm testes
- azoospermia
- gynecomastia
- mild intell disability
S4: cause
decreased LV compliance
portal HTN: hemorrhoids –> d/t what vessel?
sup rectal V
sirolimus: MOA
cyto –> bind immunophilin FK-506 binding protein (FKBP) –> form complex –> bind & inh mTOR –> block IL-2 signal transduction –> prevent cell cycle progression –> prevent lymphocyte prolif
Dx: infant –> flaccid lower extremities, absent ankle reflexes bilat. Poorly dev lumbar spine & sacrum
caudal regression synd
chi square test: use
test assoc bw 2 categorical variables
increase estrogen –> increase TH –> effect on pt?
normal free TH ==> euthyroid
ID spinal level: fasciculus gracilis & cuneas
above T7: both
below: only gracilis
5-HT3 receptor ant: drug
ondansetron
selective estrogen receptor modulator: MOA
competitive inh estrogen binding to estrogen receptor
low hepcidin: effect?
- intestine –> increase absorb iron
- macrophage –> release iron
Dx: progressive proximal muscle weak & atrophy. No pain. Normal CK
glucocorticoid-induced myopathy
increase estrogen –> effect on thyroid hormone
estrogen –> increase TBG syn –> transient increase TSH –> increase TH syn –> increase total T4, total T3
Dx: shoulder, neck, pelvic girdle –> muscle pain & stiff. Worse in AM & with activity. Normal CK
polymyalgia rheumatica
net filtration pressure: calc
hydrostatic pressure gradient - oncotic pressure gradient
= (Pc-Pi) - (oc-oi)
caudal regression synd: RF
poorly ctrled maternal diabetes
prenatal screen for GBS: when?
35-37wks
ID spinal level: shape
as mv up –> more oval
acute viral hepatitis: histology
- “spotty necrosis”
- ballooning degen (hepatocyte swelling w wispy/clear cyto)
- Councilman bodies (eosinophilic apoptotic hepatocytes)
- mononuclear cell infiltrates
hepcidin: fx
central regulator of iron homeostasis
lat dorsi: fx
humerus:
- extend
- adduct
- med rotate
what is: dead space
air that is inhaled but has no role in gas exchange
vestibular nausea: tx
- antihist
- antichol
Dx: 8mo F –> normal dev –> now can’t sit, roll over. Macrocephaly. Bright red fovea centralis. Normal abd exam
Tay Sachs
ID spinal level: gray matter
as mv up –> decrease gray matter
tamoxifen: what is it? use?
SERM
trt estrogen receptor+ breast CA
femoral N injury: cause
- pelvic fracture
- compression from mass on iliopsoas, iliacus
muscle bx –> mid-size artery –> transmural inflamm w areas of homogeneous, eosinophilic arterial wall necrosis –> dx?
polyarteritis nodosa
acute synovitis, fever, leukocytosis –> next step in management?
synovial fluid analysis (R/O septic arthritis –> emergency!):
- xl analysis
- cell count
- Gram stain
- culture
tamoxifen: effect on breast
anti-estrogen
portal HTN: caput medusae –> d/t what vessel?
paraumbilical V
two sample t test: use
compre 2 group means
acute hep A: ssx
- prodrome: fever, malaise, anorexia, N/V, RUQ pain
- cholestasis: jaundice, pruritis, dark urine, clay stool
lat dorsi: N
thoracodorsal
Tay Sachs dz: key clinical features
- progressive neurodegen
- cherry red macula
what controls iron storage & release by other cells involved in iron homeostasis?
hepcidin
ID spinal level: ventral horn
Large:
- lower cervical
- lumbosacral
elevated creatine kinase: common causes
- hypothyroid
- autoimmune dz (polymyositis, dermatomyositis)
- muscular dystrophy
- med (HMG CoA reductase inh)
polyarteritis nodosa: charact
transmural inflamm w fibrinoid necrosis
calcineurin: fx
activate IL-2 –> T cell growth, prolif
calcineurin inh: use
immunosupp in transplant pts
polyarteritis nodosa: ssx
may affect almost any system –> ssx d/t ischemia of involved organs
how do you diagnose RA?
clinically
anti-cyclic citrullinated peptide Ab –> helpful for confirm
ID spinal level: white matter
as mv up –> increase white matter
anti-CCP –> dx?
RA
glomerular cap hydrostatic pressure = 45
glomerular cap oncotic pressure = 27
bowman capsule hydrostatic pressure = 10
bowman capsule oncotic pressure = 2
what is net filtration pressure?
= (45-10) - (27-2)
= 10
why is alveolar ventilation lower than minute ventilation
dead space
sirolimus: use
immunosupp –> prevent transplant rejection
cardiac pacemaker cell: what is responsible for phase 4?
- close repolarizing K channel
- funny channel –> slow Na influx
- open T-type Ca channel
CYP450 effect on tamoxifen?
metab tamoxifen to active metabolite endoxifen
Niemann-Pick dz: clinical features
infant:
- HSM
- neuro regression
- cherry red spot
Klinefelter synd: pathophys
meiotic nondisjunction –> 47, XXY
analysis of variance (ANOVA): use
compare means of >2 grps
what is the most common liver malig?
metastasis from other primary site
what can be the 1st manifestation of hypothyroid?
hypothyroid myopathy –> elevated CK
RA: charact
- symm polyarthritis (MCP & PCP)
- morning stiff >30min
visceral nausea: cause
GI insult:
- gastroenteritis
- ctx
- gen anes
Dx: defective collagen I
osteogenesis imperfecta
CASE: various missionary trips –> liver bx –> spotty hepatocyte necrosis, inflamm cell infiltration –> dx?
acute hep A
what subst activates IL-2?
calcineurin
Dx: proximal muscle weak. Skin rash, inflamm arthritis. High CK
inflamm myopathy (polymyositis, dermatomyositis)
lateral horns of spinal cord: what level?
T1-L2
what lowers hepcidin?
- hypoxia
- increased erythropoiesis
osteogenesis imperfecta: clinical findings
- h/o fractures from minimal trauma
- blue sclera
- small, malformed teeth
adenosine: MOA
activate A1 receptors –> activate K channel –> increase K conductance –> membrane potential stay neg longer
why does antagonizing 5-HT3 receptor reduce N/V?
GI irritation –> increase mucosal serotonin release –> activate 5-HT3 receptors on vagal & spinal afferent N –> relay impulse to medullary vomiting center –> emesis
Dx: proximal muscle pain, weak. Started statin 2 mos ago. High CK
statin-induced myopathy
visceral nausea: tx
5-HT3 receptor ant
what is: minute ventilation
total vol of new air that enter resp pathways per minute
tamoxifen: effect on uterus
estrogen agonist effect –> endometrial hyperplasia –> CA
what increases hepcidin?
- high iron
- inflamm
IL-2: fx
- T cell activation, prolif
- NK, macrophage activity
- B cell growth
Niemann-Pick dz: def?
sphingomyelinase –> accum sphingomyelin
different drug efficacy & toxicity among indiv –> cause?
CYP450 polymorphism
Dx: 18mo M –> normal dev til 5mo –> now can’t sit, poor head ctrl. Large spleen, liver. Hypotonic. Red macula
Niemann-Pick dz
IL-2: produced by?
T cell
portal HTN: esophageal varices –> d/t what vessel?
L gastric V
differentiate: Tay Sachs vs Niemann-Pick
Tay Sachs: no HSM
what is: alveolar ventilation
vol of new air reaching the gas exchange areas per minute
metastasis to liver: CT
mult nodules
S4: assoc dz
- restrictive cardiomyopathy
- LV hypertrophy
polyarteritis nodosa: assoc dz
HBV
Listeria –> resistant to what abx? how?
cephalosporin
altered PBP
migraine w nausea: tx
dopamine ant
prolong phase 4 –> effect?
reduce rate of spontaneous depolarization –> decrease sinus rate, AV conduction –> decrease HR
total peripheral resistance of vessels arranged in parallel: calc
1/TPR = 1/R1 + 1/R2 + 1/R3 + …
thiazolidinedione: MOA
activate PPAR-gamma –> upreg GLUT4, adiponectin –> decrease insulin resistance
3rd part of duodenum: location
L3: across abd aorta & IVC
calcineurin inh: drugs
- cyclosporine
- tacrolimus
what subst prolong phase 4 of nodal tissue?
- Ach
- adenosine
synovitis: charact
- pain
- erythema
- swelling
- reduced ROM in jt
osteogenesis imperfecta: mode of inheritance
AD
Tay Sachs dz: pathophys
B-hexosaminidase A def –> accum GM2 ganglioside
ID spinal level: lat gray matter horns
thoracic & early lumbar
