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Daily Flashcard Quizzes > 7/21 > Flashcards

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
Q

what should you think with a RBC containing blue on a Wright-Giemsa stain?

A

reticulocyte!

you’re staining ribosomal RNA precipitates

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26
Q

where is a blunt eye trauma most likely to herniate into

A

medial or inferior orbital walls, which would herniate into the MAXILLARY sinus

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27
Q

what is multiple myeloma as a generic term

A

plasma cell neoplasm

B-lymphocytes mature into plasma cells that synthesize abnormal/large amounts of monoclonal immunoglobulin

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28
Q

what type of cancer is at increased risk with aflatoxins

A

HCC

also associated with p53 mutation

29
Q

what are the TWO treatment options for gardnerella vaginosis

A

metronidazole or

clindamycin

30
Q

what does HPV preferentially attack

A

stratified squamous epithelium that lines areas undergoing frequent friction and abrasion:
true vocal cords
cervix
anus

31
Q

what is the initial insult of tertiary syphilis on the heart

A

vasa vasorum obliteration

this causes thoracic aortic aneurysm

32
Q

how does imprinting work

A

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
Q

what is a flame shaped hemorrhage on eye

A

likely 2/2 poorly controlled HTN

painless, unilateral visual disturbances

34
Q

what are all the buzzwords for what hypertensive retinitis looks like

A

flame-shaped hemorrhage

thickened arteriolar wall- “copper or silver wiring”

compression of associated veins- “AV nicking”

white foci of ischemia- “cotton-wool spots”

35
Q

what is the cherry red spot on eye a buzzword for

A

central retinal artery occlusion

most commonly 2/2 atherosclerosis, embolism, or vasculitis

36
Q

what causes optic disc cupping

A

closed-angle glaucoma

increased IOP form impaired aqueous humor drainage

37
Q

how does ionizing radiation work in treating cancers

A

cell death via 2 mechanisms:

dsDNA breaks

free radical formation

38
Q

what is the primary immune response to a new antigen

A

plasma cells that only produce IgM

39
Q

how does isotype switching occur

A

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
Q

what is the main immunoglobulin in the secondary immune response

A

IgG

41
Q

where is the site of T cell differentiation and maturation

A

Thymus!!!

42
Q

what part of the lymph node do T cells and dendritic cells reside

A

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
Q

what part of the lymph node do B cells proliferate

A

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
Q

what’s the predominate cell type in sarcoidosis granulomas

A

CD4 T cells!

you’ll see a “high CD4/CD8 ratio” in bronchoalveolar lavage fluid

45
Q

what regulates the different layers of the adrenal cortex

A 
ACTH:
Zona Fasciculata and 
Zona Reticularis,
making:
glucocorticoids (cortisol)
sex hormones

Angiotensin ii:
Zona Glomerulosa
making:
mineralocorticoids (Aldosterone)

46
Q

what are the 2 types of bone marrow blasts

A

lymphoblasts

myeloblasts

47
Q

what are markers for myeloblastic cells

A

peroxidase positive granules (Auer rods)

48
Q

what are makers for lymphoblastic cells

A

TdT+
PAS positive material

can be either a pre-B or a pre-T cell leukemia, depending on cell markers/immunotyping

49
Q

what are cell markers for precursor B cells

A

CD10 and CD19

double digits, just like B has 2 humps

50
Q

what are cell markers for precursor T cells

A

CD 1, CD2, CD5

single digits- just like T is stick-thin

51
Q

what are CMV and HSV treatments, respectively

A

CMV: gancyclovir

HSV: acyclovir

52
Q

what looks different with cerebellar vermis medial vs lateral descending lesions?

A

medial: truncal and gait ataxia
lateral: limb dysmetria

53
Q

describe rickets

A

Vitamin D deficiency

unmineralized osteoid matrix and epiphyseal cartilage, 2/2 low Calcium and PO4 needed to mineralize the matrix

54
Q

which lesion will give you bilateral loss of pain and temp

A

syringomyelia in the center of the spinal cord

55
Q

what does a horseshoe kidney get hooked on

A

IMA

56
Q

which drugs are preferentially processed by the liver for easier elimination

A

lipophilic
(high Vd
good CNS penetration)

57
Q

what is aspirin’s MOA

A

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
Q

what is acetaminophen’s MOA

A

reversibly inhibits COX enzyme, primarily in CNS

does not have anti-inflammatory properties due to its weak COX inhibition in peripheral tissues

59
Q

what is the MOA of diclofenac, indomethacin, and ibuprofen

A

NSAIDs that reversibly inhibit COX-1 and COX-2

60
Q

how would you be able to tell alcoholic vs nonalcoholic pancreatitis

A

alcoholic: macrocytic RBCs (poor nutrition)

61
Q

where will tumor lysis syndrome kidney stones ppt?

A

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
Q

what does Calcineurin do?

A

activates IL-2, which promotes growth and differentiation of T cells

63
Q

where is H pylori primarily colonize

A

gastric antrum or “pre-pyloric” area

64
Q

what is heteroplasmy

A

mixture of normal and mutated mtDNA causing variable expressivity in offspring

65
Q

what do macula lesions cause

A

CENTRAL SCOTOMAS

66
Q

what causes uniform uterus enlargement

A

adenomyosis-
“endometrial tissue in the myometrium” with normal-appearing endometrial tissue on biopsy

presents with menorrhagia and dysmenorrhea

67
Q

which HAART drug is contraindicated in HLA-B*57:01 pts

A

Abacavir`

68
Q

what is pathology of Guillan Barre syndrome?

A

“endoneural inflammatory infiltrate”

it’s an acute demyelinating peripheral neuropathy

69
Q

what are the genital lesions called in each phase of syphilis

A

primary: chancre
secondary: condylomata lata
tertiary: gumma

Daily Flashcard Quizzes (21 decks)

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