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U-World > 7 > Flashcards

7 Flashcards

1
Q

Itching (severe), erythematous papules and excorations on extremities, axillia, nipples, or scrotum, type 4 hypersensitivity, often worse at night, scraping show mites ova and feces under LM

A

Scabies (sarcoptes scabiei mite)

Person-person spread

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2
Q

Candida Intertrigo

A

Fat people (or diabetics, steroid users) w/ plaques and erosions with satellite papules or pustles in axillia, genitals, finger/toe webs, other skin folds

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3
Q

Herpes (shignles) histo

A

multinucleated giant cells

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4
Q

SJS due to infection (post 1-3 weeks)

A

CMV! (or mycoplasma)

necrotic keratinocytes in the epidermis

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5
Q

Thyroid gland is formed from?

A

Outpouching (evagination) of the pharyngeal epithelium

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6
Q

Inappropriate apoptosis

A

DM1 (beta cells undergo pathologic apoptosis)

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7
Q

parafollicular C cells origin

A

ultimobranchial bodies (join thyroid via fusion)

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8
Q

True negatives (quick calculation)

A

specificity * (number of patients actually without disease)

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9
Q

False positives (quick)

A

(1-specificity)* (number of patients actually without the disease)

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10
Q

Net filtration pressure

A

(Pc-Pi) - (O(c) - O(i))

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11
Q

B-cell growth and isotype switching. Stimulates secretion of IgE (isotype switching). Stimulates TH0 (naive) T-helper cells into TH2 thus increasing TH2 subpopulation and the stimulus for humoral response

A

IL-4

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12
Q

Responsible for B-cell differentiation; stimulates IgA production and eosinophil activity. Important against parasitic infections

A

IL-5

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13
Q

Produced by macrophages. Activates TH0 (naive) into TH1 and TH2.

A

IL-1

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14
Q

First interleukin produced by T-cells after contact with antigen. Secreted by TH1 and stimulates CD4+, CD8+ and B-cells

A

IL-2

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15
Q

Produced by T-helper cells: stimulates growth and differentiation BM stem cells

A

IL-3

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16
Q

Produced by TH2. Inhibits synthesis of INF-gamma to decrease TH1.

A

IL-10

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17
Q

Released from Macs. Stimulates growth and development of TH1

A

IL-12

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18
Q

Enterocutaneous fistula

A

Crohn disease: Btw bowel and skin

Enteroenteric can also form btw bowel and another organ (bladder, vagina)

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19
Q

Children ages 5-14, ass. w/ Yersenia enterocolitica infection. Fever, RLQ pain, nausea and vomiting

A

Mesenteric Adenitis

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20
Q

Drug severe toxicity: Pulmonary edema, caused by rapid rise in volume that can also increase the overall hydrostatic pressure in the vasculature. Metabolic acidosis. and others.

A

Mannitol (avoid in CHF) or preexisting pulmonary edema

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21
Q

Bumetanide

A

Loop diuretic

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22
Q

Susceptibility to malignant hyperthermia is inherited as …

A

AD

Excess free Ca in cytoplasm–>stimulates ATP-dependent uptake by SR–>HEAT

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23
Q

Promotor sequences

  • TATA (Hogness)- 25 bp upstream
  • CAAT- 70-80 bp upstream of gene
A

directly bind general transcription factors and RNA pol II upstream of gene locus. Necessary for the initiation of transcription.

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24
Q

Bind activator proteins that facilitate bending of DNA to allow activator proteins to interact with general transcription factors and RNA pol II at the promotor

A

Enhancer sequences = INCREASE RATE of TRANSCRIPTION

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25
Q

Can be located upstream or downstream from the gene being transcribed. Or within introns of the gene being transcribed as well on separate chromosomes.

A

Enhancers

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26
Q

Similar to enhancers but decrease transcription rates by binding to repressors

A

Silencers

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27
Q

Intrapleural pressure at FRC

A

-5cm H20

Airway pressure is zero

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28
Q

Diuretic, natriuretic and vasodilation effects that antagonize RAAS

A

BNP

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29
Q

Metalloprotease that cleaves and inactivates endogenous peptides including BNP, glucagon, oxytocin, and bradykinnin

A

Neprilysin

can use neprilysin inhibitors to improve outcomes in patients with chronic systolic heart failure

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30
Q

Maturity-onset diabetes of the young

A

Heterozygous mutations of the glucokinase gene causing a decrease in beta cell metabolism of glucose, less ATP formation, diminished insulin secretion. Will see in pregnancy. Homozygous mutation = severe hyperglycemia and fetal growth retardation

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31
Q

Decreased exercise tolerance and muscle stiffness

A

LDH deficiencies

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32
Q

Lactic acidosis and fasting hypoglycemia
Infant with failure to thrive
Elevated pyruvate and alanine (possible)

A

pyruvate decarboxylase deficiencies

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33
Q

Carcinoid tumor (malignant transformations of neuroendocrine cells) possible locations:

A

GI (small intestine, rectum, appendix–>cause appendicitis if at base; if appendectomy will be found at tip)
Also Bronchopulmonary system

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34
Q

Light microscope: Uniformity in shape and size of cells that comprimse the islands. Eosinophilic cytoplasm and oval to round stippled nuclei

A

Carcinoid syndrome

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35
Q

EM carcinoid syndrome

A

Multiple dense-core granules seen in cytoplasm; contain vasoactive molecules (serotonin, bradykinin, histamine) or hormones (gastrin)

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36
Q

Location of meningiomas

A

dural reflections (falx cerebri, tentorium cerebelli)

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37
Q

Cheyne-Stroke breathing

A

Advanced congestive HF, stroke, brain tumors, TBI–> poor prognostic sign

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38
Q

Cyclic breathing pattern in which apnea is followed by gradual increase then decrease in tidal volumes until next apneic event

A

Cheyne-Stroke breathing

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39
Q

Deep and labored breathing pattern often associated with severe metabolic acidosis, especially diabetic ketoacidosis

A

Kussmaul breathing

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40
Q

Hypothyroidism can cause hypoventilation from respiratory muscle weakness (low tidal volume) and can develop obstructive sleep apnea due to development of

A

macroglossia (big tongue)

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41
Q

Treatment for PCOS

A

Weight loss
For those who do not want to be prego: Oral contraceptive pills
For those who want a baby: Clomiphene and letrozole

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42
Q

Selective estrogen receptor modulator that prevents negative feedback inhibition on hypothalamus and pituitary by circulating estrogen, resulting in increased FSH and LH and ovulation. Tx: for PCOS who want a baby

A

Clomiphene and letrozole

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43
Q

11-beta-hydroxylase inhibitor, blocks synthesis of cortisol

A

Metyrapone

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44
Q

Tissues that do not depend on insulin for glucose transport (diabetes related)

A

lens, peripheral nerves, blood vessels and kindeys (Aldose reductase converts glucose to sorbitol. sorbitol then converted to fructose. Sortbitol and fructose accumulation increases osmotic pressure. Water influxes. Lens= cataracts and Schwann cells= peripheral neuropathy

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45
Q

Aldose reductase converts galactose into galactitol. If level of galactose is increased such as in galactasemia…more galactitol is produced. This could lead to what?

A

cataracts in patients with galactosemia

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46
Q

Regenerative source of ciliated cells in bronchioles

A

Club (clara) cells are nonciliated, secretory cells found predominately in the terminal portion of the bronchioles

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47
Q

Transmembranous efflux pumps confer resistance to antibiotics that require entry into the cell to function

A

Tetracyclines and macrolides

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48
Q

A salvage metabolic pathway can restore metabolic function that would otherwise inhibited by

A

Sulfamethoxazole or trimethoprim

49
Q

Gly is necessary at every third position to ensure

A

compact coiling of collagen triple helix

50
Q

Ehlers Danlos due to procollagen peptidase deficiency (impaired cleavage of terminal propeptides in EXTRACELLULAR space. Symptoms?

A

Joint laxity, hyperextensible skin and fragile tissue due to the formation of soluble collagen that does not properly crosslink

51
Q

Acute allergic contact dermatitis (a form of eczematous dermatitis) Type 4 hypersensitivity. Characterized by?

A

Spongiosis (accumulation of edema fluid in intracellular spaces of the epidermis)

52
Q

Thickening of stratum spinosum

A

acanthosis

53
Q

Thickening of stratum corneum

A

hyperkeratosis

54
Q

Premature keratinization of individual keratinocytes below strartum granulosom

A

Dyskeratosis congenita (AD) or squamous cell carcinoma sometimes

55
Q

Hypergranulosis- increased thickness of stratum granulosum

A

Lichen planus

56
Q

Mold with broad ribbonlike hyphae with rare sepations

A

Rhizopus

57
Q

Attack rate (used in outbreak investigations)

A

Ratio of number of individuals who become ill divided by the number of individuals who are at risk of contraction that illness

58
Q

Phenylketonuria (2 possible enzymes messed up) *seizures, retarded, abnormal pallor of catecholaminergic brain (lack of neuromelanin), hypopigmentation of skin hair eyes, body odor

A

Dihydropteridine reductase or phenylalanine hydroxylase

59
Q

Burnt sugar smell in urine (diapers)

A

Maple syrup urine disease

60
Q

Rare dysautonomia characterized by ptosis, orthostatic hypotension, hypoglycemia and hypothermia

A

Dopamine hydroxylase def. (dopa–>NE)

61
Q

Hyperpigmentation and degenerative joint disease due to accumulation of homogentisic acid

A

Alkaptonuria (AR)

Disorder of tyrosine degradation caused by deficiency in homogentisic acid oxidase

62
Q

Albinism inheritance

A

AR (depressed or absent tyrosinase)

63
Q

“Blowing diastolic decrescendo murmur best heard at the left sternal boarder in the 3rd and fourth intercostal space. The precordial impulse is hyperdynamic and displaced laterally and downward

A

Aortic Regurgitation

64
Q

Bounding femoral and carotid pulses (abrupt distention and quick collapse)–>wide pulse pressure

A

Aortic regurg (water-hammer pulses)

65
Q

Head bobbing with cartotid pulsations (de Musset sign) due to transfer of momentum from the large LV strove volume to head and neck. Systolic pulsations also heard in other organs (liver, spleen, retina) and finger tips

A

Aortic regurgitation

66
Q

Small pulse amplitude (pulsus parvus) with a delayed peak and slower upstroke of the arterial pulse (pulsus tardus) due to diminished stroke volume and prolonged ejection time

A

Aortic stenosis

67
Q

Arterial pulse, pulse pressure, and forward stroke volume changes in patients with chronic (compensated) mitral regurg

A

no change. normal.

68
Q

Rubella spreads faster and does not darken or coalesce as compared to rash of

A

rubeola

69
Q

Rare AR disorder of de novo pyrimidine synthesis: Physical and mental retardation, megaloblastic anemia, elevated urinary orotic acid levels

A

Hereditary orotic aciduria due to defect in uridine 5’monophosphate (UMP) synthase (polypeptide with two enzymatic domains)

70
Q

Treatment of UMP synthase deficiency (orotic aciduria)

A

Uridine to bypass. Uridine converted to UMP via nucleoside kinases

71
Q

TCA- Clomipramine

A

Role in TX of OCD

72
Q

Fist anterior branch of aorta and its branches

A

Celiac trunk

  • Left gastric
  • Common hepatic
  • Splenic arteries
73
Q

Runs with the portal vein and common bile duct to form portal triad in the liver. Forms the arterial blood supply to the liver and perfuses right hepatic lobe mass

A

Proper hepatic artery

74
Q

IMA branches off abdominal aorta at the level of

A

L3

75
Q

Supplies blood to pancreas and the intestine from the lower part of duodenum to the first 2/3 of transverse colon

A

SMA

76
Q

Charcot-Leyden crystals contain

A

eosinophil membrane protein

77
Q

Chronic eosinophilic bronchitis in asthmatics involves bronchial wall infiltration by numerous activated eosinophils, largely in response to IL-5 released by allergen activated

A

TH2 cells

78
Q

Activates macrophages to promote adaptive immunity against intracellular pathogens

A

INF-gamma

79
Q

CT is negative (10%) but you still suspect SAH…what do you do?

A

spinal tap—> xanthochromia (blood in CSF)

80
Q

Recurrent brief attacks of sudden, severe, unilateral periorbital pain associated with ipsilateral rhinorrhea and watering of the eyes

A

Cluster headaches

81
Q

Thunderclap headache

A

SAH

82
Q

Adipose tissues composed of cells that contain one intracytoplasmic fat droplet

A

White adipose tissue

83
Q

Posses several small intracytoplasmic fat vacuoles and considerably more mito (tan color)

A

brown adipose tissue (requires more capillaries than white adipose tissues)

84
Q

ETC transport and phosphorylation are uncoupled. Protons pumped out are returned to matrix via _________ (uncoupling protein). No ATP is made. Energy released as heat

A

Mitochondrial membrane protein THERMOGENIN (seen in brown fat)

85
Q

Progressive cough, dyspnea, orthopnea, and lower extremity edema. Tachycardia, tachypnea, accessory muscle use, bilateral crackles or wheezing (cardiac asthma)

A

ADHF

86
Q

Always preceded by events such as sepsis, aspiration, pneumonia or trauma–> endothelial injury and fluid leakage from the capillaries

A

ARDS

87
Q

Bilateral airspace opacification

A

ARDS

88
Q

Diffuse reticular opacities typically associated with decreased lung volumes. Slowly progressive dyspnea and a non-productive cough

A

Idiopathic interstitial fibrosis

89
Q

Atherosclerosis vessel involvment

A

Abdominal aorta>coronary>popliteal>ICAs>circle of willis

90
Q

C8-T1 medial cord branch–>courses posteriomedially in the upper arm–>passes posterior to the medial epicondyle of the the humerus to enter anterior compartment of arm

A

Ulnar nerve

91
Q

Innervates flexor carpi ulnaris and medial portion of the flexor digitorum profundus

A

Ulnar nerver

92
Q
  • Passes between the hook of the hamate and the pisiform bone with Guyon’s canal.
  • Provides sensation over medial 1/2 digits and hypothenar eminence deep motor branch
  • Deep motor branch that supplies intrinsic muscles of hand
A

Ulnar nerve

93
Q

Wrist flexion/adduction, finger abduction/adduction and flexion of the fourth and fifth digits

A

Ulnar nerve

94
Q

Loss of sensation over the lateral forearm and paralysis of forearm flexors at elbox

A

musculocutaneous nerve injury

95
Q

Loss of sensation over the lateral up arm and deltoid weakness

A

Axillary nerve injury

96
Q

Palmar sensory loss involving the majority of the first through third digits

A

median nerve

97
Q

Weakness on wrist flexion/abduction, flexion of second and third fingers, flexion and opposition of the thumb

A

Median nerve.
Preachers hand when try to make fist due weakness of the thenar and flexor digitorum profundus muscles of second and third digits

98
Q

Loss of sensation over posterior arm and forearm, dorsolateral hand and dorsal thumb

A

radial nerve

99
Q

Calcimimetic that allosterically activates the calcium-sensing receptor in the parathyroid gland, decreasing PTH release.

A

Cinacalcet is normally used for secondary hyperparathyroidism in dialysis patients

100
Q

Glucocorticoids (prednisone) can worsen hypocalcemia by

A

decreasing the expression of vit. D receptor

101
Q

Non-absorbable phosphate binding polymer that decreases absorption of phosphate in GI.

A

Sevelamer (used to treat hyperphosphatemia in dialysis patients)

102
Q

Postoperative hypothyroidism (thyroidectomy) supplementation with _______ can be used to prevent post-op hypocalcemia

A

Oral calcium or Vit. D (calcitriol)

103
Q

Test used to measure the amount of protein in body fluids (ex: measure insulin levels)

A

ELISA

104
Q

Detect target mRNA in a sample to asses gene expression

A

Northern blot

105
Q

Addition of ______ to the blood of a patient with hemophilia results in clotting

A

thrombin

106
Q

Synthesized in liver, activated by endothelial injury, activates factor XI (intrinsic)

A

Factor XII (Hageman factor)

107
Q

Most common pediatric malignancy

A

ALL (acute lymphoblastic leukemia)

108
Q

Fever, fatigue, pallor, petechiae, and bleeding. LAD, HSM, and bone pain

A

ALL

109
Q

Large anterior mediastinal mass that can compress great vessels causing SVC syndrome or esophagus (dysphagia) or trachea (dyspnea and stridor)

A

T-cell ALL (most commonly affects males in late childhood through young adulthood)

110
Q

Both B-ALL and T-ALL are positive for

A

TdT (antigen of lymphocyte precursors)

111
Q

Pre-B lymphoblasts (B-ALL) markers

A

CD10, CD19 and CD20

112
Q

Pre-T lymphoblasts (T-ALL) markers

A

CD2, CD3, CD4, CD5, CD7, and CD8

113
Q

AML M4 and M5

A

Arise from monocytic precursors

114
Q

AML M6 arises from and typically affects

A

Erythroid precursors (elderly)

115
Q

Which is more common: B-ALL or T-ALL

A

B-ALL (70-80%)

116
Q

rare AML subtype arises from primitive megakaryoblasts and is associated with t(1;22) and DOWN SYNDROME in children

A

AML M7 subtype

117
Q

Plane Xanthomas (linear lesions in skin folds)

A

Ass. w/ Primary biliary cirrhosis

118
Q

Xanthelasma

A

soft eyelid or periorbital plaques with no associated abnormalities

119
Q

small aggregates of dermal foam cells (benign macrophages packed with finely vaculated cytoplasm) that are present without inflammation or fibrosis

A

Xanthelasmas

Vs. Xanthomas do have inflammatory cells and fibrotic stroma

U-World (16 decks)

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