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7/21 Flashcards

1
Q

describe the rationale behind the special sweat test for CF

A

in epithelia, impaired CF transmembrane conductance regulator protein reduces the luminal chloride secretion

this increases Na and H2O absorption

results in dehydrated mucus and a
more negative nasal transepithelial potential difference

this negative finding can dx CF

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2
Q

what is the major adaptive immune mechanism for Influenza virus?

A

a HUMORAL response with antibodies against HEMAGGLUTININ is generally the most important source of protection

they block virus binding to host cells

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3
Q

what is the RER’s primary role

A

synthesis of cell membrane proteins

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4
Q

what is the primary mechanism of calcium efflux from cardiac cells prior to relaxation

A

Na/Ca exchange pump and

SR Ca-ATPase pump

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5
Q

what is calmodulin useful for

A

Ca-binding messenger protein that is present in all cells, but it is important for excitation-contraction coupling in SM cells, which lack troponin

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6
Q

what is pleiotrophy

A

one gene mutation having multiple phenotypic manifestations

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7
Q

what’s the pathogenesis of centriacinar emphysema

A

oxidative injury to respiratory bronchioles and
activation of resident alveolar macrophages

inflammatory recruitment of neutrophils into the airspace

activated macrophages and neutrophils release proteases that degrade EC matrix, and generate free radicals

acinar wall destruction and irreversible airspace dilation distal to terminal bronchioles

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8
Q

what presents with recurrent infections, candidiasis, failure to thrive, diarrhea, low gamma globulin levels, and absent thymic shadow

A

SCID

combined T and B cell dysfunction

pt has low/absent CD3+ T cells and hypogammaglobulinemia

since there’s severe T cell deficiency, you’ll likely have an absent thymic shadow

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9
Q

what is Etoposide’s MOA

A

chemotherapeutic agent that inhibits sealing activity of topoisomerase II

causes chromosomal breaks to accumulate in dividing cells

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10
Q

what does topoisomerase 1 do

A

induces single strand DNA breaks to relieve negative supercoiling during replication

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11
Q

what causes cleft lip

A

failure to fuse the maxillary prominence and inter maxillary segment

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12
Q

what causes holoprosencephaly

A

failure of medial nasal prominence to fuse and form the inter maxillary segment

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13
Q

where do MEN disorders arise from embryologically

A

neural crest tissue

medullary thyroid cancer w/ parafollicular C cells
Pheochromocytoma from adrenal medulla

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14
Q

what forms a glial scar in the CNS several weeks after an infarct

A

cystic cavity filled with dense fibers formed by ASTROCYTES

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15
Q

what are hamartomas composed of

A

disorganized cartilage, fibrous tissue, and adipose tissue

AKA coin lesion

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16
Q

what is Flutamide’s MOA

A

androgen receptor antagonist

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17
Q

what is leuprolide’s MOA

A

long-acting GnRH agonist

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18
Q

what is weird about leuprolide dosing

A

it’s a GnRH analog that will cause a transient increase in LH and testosterone when you first start treatment, since the body is first seeing a GnRH spike

prescribe with anti-androgens to avoid this initial spike/worsening of symptoms

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19
Q

what is finasteride’s MOA

A

5-alpha-reductase inhibitor

it prevents conversion of testosterone to DHT in peripheral tissues

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20
Q

what brain area is damaged in Huntington

A

Caudate nucleus

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21
Q

what brain area is damaged in Parkinson

A

substantia nigra

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22
Q

what brain area causes myoclonus

A

nucleus ambiguous

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23
Q

what brain area causes hemiballism

A

sub thalamic nucleus

usually 2/2 lacunar infants and HTN near the sub thalamic nucleus

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24
Q

what should you be extra careful of with a baby born with CF

A

Vitamin K deficiency-
necessary for carboxylation and functionality of coagulation factors

neonates are at risk of bleeding and seizures

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25
what should you think with a RBC containing blue on a Wright-Giemsa stain?
reticulocyte! | you're staining ribosomal RNA precipitates
26
where is a blunt eye trauma most likely to herniate into
medial or inferior orbital walls, which would herniate into the MAXILLARY sinus
27
what is multiple myeloma as a generic term
plasma cell neoplasm B-lymphocytes mature into plasma cells that synthesize abnormal/large amounts of monoclonal immunoglobulin
28
what type of cancer is at increased risk with aflatoxins
HCC also associated with p53 mutation
29
what are the TWO treatment options for gardnerella vaginosis
metronidazole or | clindamycin
30
what does HPV preferentially attack
stratified squamous epithelium that lines areas undergoing frequent friction and abrasion: true vocal cords cervix anus
31
what is the initial insult of tertiary syphilis on the heart
vasa vasorum obliteration this causes thoracic aortic aneurysm
32
how does imprinting work
DNA methylation, an epigenetic process where genes can be silenced by attaching methyl groups to cytosine residues in the DNA molecule may use "SAM" as the methyl group donor
33
what is a flame shaped hemorrhage on eye
likely 2/2 poorly controlled HTN painless, unilateral visual disturbances
34
what are all the buzzwords for what hypertensive retinitis looks like
flame-shaped hemorrhage thickened arteriolar wall- "copper or silver wiring" compression of associated veins- "AV nicking" white foci of ischemia- "cotton-wool spots"
35
what is the cherry red spot on eye a buzzword for
central retinal artery occlusion most commonly 2/2 atherosclerosis, embolism, or vasculitis
36
what causes optic disc cupping
closed-angle glaucoma increased IOP form impaired aqueous humor drainage
37
how does ionizing radiation work in treating cancers
cell death via 2 mechanisms: dsDNA breaks free radical formation
38
what is the primary immune response to a new antigen
plasma cells that only produce IgM
39
how does isotype switching occur
occurs after the primary IgM immune response. happens in the germinal centers of lymph nodes, and requires interaction of CD40 receptor on B cells with the CD40 ligand expressed by activated T cells
40
what is the main immunoglobulin in the secondary immune response
IgG
41
where is the site of T cell differentiation and maturation
Thymus!!!
42
what part of the lymph node do T cells and dendritic cells reside
paracortex the paracortex becomes enlarged during proliferation of T cells during an adaptive cellular immune response (viral infection), but may be small/absent in an athymic pt because they don't have mature T cells coming from the thymus
43
what part of the lymph node do B cells proliferate
follicles in the cortex primary follicles: dense and dormant secondary follicles: pale germinal centers with proliferating B cells and follicular dendritic cells in agammaglobulinemia, pts do not have germinal centers or primary lymphoid follicles because they don't have B cells
44
what's the predominate cell type in sarcoidosis granulomas
CD4 T cells! you'll see a "high CD4/CD8 ratio" in bronchoalveolar lavage fluid
45
what regulates the different layers of the adrenal cortex
``` ACTH: Zona Fasciculata and Zona Reticularis, making: glucocorticoids (cortisol) sex hormones ``` Angiotensin ii: Zona Glomerulosa making: mineralocorticoids (Aldosterone)
46
what are the 2 types of bone marrow blasts
lymphoblasts myeloblasts
47
what are markers for myeloblastic cells
peroxidase positive granules (Auer rods)
48
what are makers for lymphoblastic cells
TdT+ PAS positive material can be either a pre-B or a pre-T cell leukemia, depending on cell markers/immunotyping
49
what are cell markers for precursor B cells
CD10 and CD19 | double digits, just like B has 2 humps
50
what are cell markers for precursor T cells
CD 1, CD2, CD5 | single digits- just like T is stick-thin
51
what are CMV and HSV treatments, respectively
CMV: gancyclovir HSV: acyclovir
52
what looks different with cerebellar vermis medial vs lateral descending lesions?
medial: truncal and gait ataxia lateral: limb dysmetria
53
describe rickets
Vitamin D deficiency unmineralized osteoid matrix and epiphyseal cartilage, 2/2 low Calcium and PO4 needed to mineralize the matrix
54
which lesion will give you bilateral loss of pain and temp
syringomyelia in the center of the spinal cord
55
what does a horseshoe kidney get hooked on
IMA
56
which drugs are preferentially processed by the liver for easier elimination
lipophilic (high Vd good CNS penetration)
57
what is aspirin's MOA
an NSAID that irreversibly inhibits COX-1 and COX-2 via acetylation prevents conversation of arachidonic acid to prostaglandins, prostacyclin, and thromboxane COX-1 acetylation inhibits thromboxane A2 in platelets (antithrombotic) COX-2 acetylation inhibits prostaglandins production in inflammatory cells (anti-inflamm, antipyretic, and analgesic)
58
what is acetaminophen's MOA
reversibly inhibits COX enzyme, primarily in CNS does not have anti-inflammatory properties due to its weak COX inhibition in peripheral tissues
59
what is the MOA of diclofenac, indomethacin, and ibuprofen
NSAIDs that reversibly inhibit COX-1 and COX-2
60
how would you be able to tell alcoholic vs nonalcoholic pancreatitis
alcoholic: macrocytic RBCs (poor nutrition)
61
where will tumor lysis syndrome kidney stones ppt?
they'll ppt in the distal tubules and collecting ducts because of the low pH prevent tumor lysis syndrome w/ alkalinizing the urine and adequate hydration
62
what does Calcineurin do?
activates IL-2, which promotes growth and differentiation of T cells
63
where is H pylori primarily colonize
gastric antrum or "pre-pyloric" area
64
what is heteroplasmy
mixture of normal and mutated mtDNA causing variable expressivity in offspring
65
what do macula lesions cause
CENTRAL SCOTOMAS
66
what causes uniform uterus enlargement
adenomyosis- "endometrial tissue in the myometrium" with normal-appearing endometrial tissue on biopsy presents with menorrhagia and dysmenorrhea
67
which HAART drug is contraindicated in HLA-B*57:01 pts
Abacavir`
68
what is pathology of Guillan Barre syndrome?
"endoneural inflammatory infiltrate" it's an acute demyelinating peripheral neuropathy
69
what are the genital lesions called in each phase of syphilis
primary: chancre secondary: condylomata lata tertiary: gumma

Daily Flashcard Quizzes (21 decks)

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