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
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
3
Q
Herpes (shignles) histo
A
multinucleated giant cells
4
Q
SJS due to infection (post 1-3 weeks)
A
CMV! (or mycoplasma)
necrotic keratinocytes in the epidermis
5
Q
Thyroid gland is formed from?
A
Outpouching (evagination) of the pharyngeal epithelium
6
Q
Inappropriate apoptosis
A
DM1 (beta cells undergo pathologic apoptosis)
7
Q
parafollicular C cells origin
A
ultimobranchial bodies (join thyroid via fusion)
8
Q
True negatives (quick calculation)
A
specificity * (number of patients actually without disease)
9
Q
False positives (quick)
A
(1-specificity)* (number of patients actually without the disease)
10
Q
Net filtration pressure
A
(Pc-Pi) - (O(c) - O(i))
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
12
Q
Responsible for B-cell differentiation; stimulates IgA production and eosinophil activity. Important against parasitic infections
A
IL-5
13
Q
Produced by macrophages. Activates TH0 (naive) into TH1 and TH2.
A
IL-1
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
15
Q
Produced by T-helper cells: stimulates growth and differentiation BM stem cells
A
IL-3
16
Q
Produced by TH2. Inhibits synthesis of INF-gamma to decrease TH1.
A
IL-10
17
Q
Released from Macs. Stimulates growth and development of TH1
A
IL-12
18
Q
Enterocutaneous fistula
A
Crohn disease: Btw bowel and skin
Enteroenteric can also form btw bowel and another organ (bladder, vagina)
19
Q
Children ages 5-14, ass. w/ Yersenia enterocolitica infection. Fever, RLQ pain, nausea and vomiting
A
Mesenteric Adenitis
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
21
Q
Bumetanide
A
Loop diuretic
22
Q
Susceptibility to malignant hyperthermia is inherited as …
A
AD
Excess free Ca in cytoplasm–>stimulates ATP-dependent uptake by SR–>HEAT
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.
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
25
Can be located upstream or downstream from the gene being transcribed. Or within introns of the gene being transcribed as well on separate chromosomes.
Enhancers
26
Similar to enhancers but decrease transcription rates by binding to repressors
Silencers
27
Intrapleural pressure at FRC
-5cm H20
Airway pressure is zero
28
Diuretic, natriuretic and vasodilation effects that antagonize RAAS
BNP
29
Metalloprotease that cleaves and inactivates endogenous peptides including BNP, glucagon, oxytocin, and bradykinnin
Neprilysin
| can use neprilysin inhibitors to improve outcomes in patients with chronic systolic heart failure
30
Maturity-onset diabetes of the young
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
31
Decreased exercise tolerance and muscle stiffness
LDH deficiencies
32
Lactic acidosis and fasting hypoglycemia
Infant with failure to thrive
Elevated pyruvate and alanine (possible)
pyruvate decarboxylase deficiencies
33
Carcinoid tumor (malignant transformations of neuroendocrine cells) possible locations:
GI (small intestine, rectum, appendix-->cause appendicitis if at base; if appendectomy will be found at tip)
Also Bronchopulmonary system
34
Light microscope: Uniformity in shape and size of cells that comprimse the islands. Eosinophilic cytoplasm and oval to round stippled nuclei
Carcinoid syndrome
35
EM carcinoid syndrome
Multiple dense-core granules seen in cytoplasm; contain vasoactive molecules (serotonin, bradykinin, histamine) or hormones (gastrin)
36
Location of meningiomas
dural reflections (falx cerebri, tentorium cerebelli)
37
Cheyne-Stroke breathing
Advanced congestive HF, stroke, brain tumors, TBI--> poor prognostic sign
38
Cyclic breathing pattern in which apnea is followed by gradual increase then decrease in tidal volumes until next apneic event
Cheyne-Stroke breathing
39
Deep and labored breathing pattern often associated with severe metabolic acidosis, especially diabetic ketoacidosis
Kussmaul breathing
40
Hypothyroidism can cause hypoventilation from respiratory muscle weakness (low tidal volume) and can develop obstructive sleep apnea due to development of
macroglossia (big tongue)
41
Treatment for PCOS
Weight loss
For those who do not want to be prego: Oral contraceptive pills
For those who want a baby: Clomiphene and letrozole
42
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
Clomiphene and letrozole
43
11-beta-hydroxylase inhibitor, blocks synthesis of cortisol
Metyrapone
44
Tissues that do not depend on insulin for glucose transport (diabetes related)
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
45
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?
cataracts in patients with galactosemia
46
Regenerative source of ciliated cells in bronchioles
Club (clara) cells are nonciliated, secretory cells found predominately in the terminal portion of the bronchioles
47
Transmembranous efflux pumps confer resistance to antibiotics that require entry into the cell to function
Tetracyclines and macrolides
48
A salvage metabolic pathway can restore metabolic function that would otherwise inhibited by
Sulfamethoxazole or trimethoprim
49
Gly is necessary at every third position to ensure
compact coiling of collagen triple helix
50
Ehlers Danlos due to procollagen peptidase deficiency (impaired cleavage of terminal propeptides in EXTRACELLULAR space. Symptoms?
Joint laxity, hyperextensible skin and fragile tissue due to the formation of soluble collagen that does not properly crosslink
51
Acute allergic contact dermatitis (a form of eczematous dermatitis) Type 4 hypersensitivity. Characterized by?
Spongiosis (accumulation of edema fluid in intracellular spaces of the epidermis)
52
Thickening of stratum spinosum
acanthosis
53
Thickening of stratum corneum
hyperkeratosis
54
Premature keratinization of individual keratinocytes below strartum granulosom
Dyskeratosis congenita (AD) or squamous cell carcinoma sometimes
55
Hypergranulosis- increased thickness of stratum granulosum
Lichen planus
56
Mold with broad ribbonlike hyphae with rare sepations
Rhizopus
57
Attack rate (used in outbreak investigations)
Ratio of number of individuals who become ill divided by the number of individuals who are at risk of contraction that illness
58
Phenylketonuria (2 possible enzymes messed up) *seizures, retarded, abnormal pallor of catecholaminergic brain (lack of neuromelanin), hypopigmentation of skin hair eyes, body odor
Dihydropteridine reductase or phenylalanine hydroxylase
59
Burnt sugar smell in urine (diapers)
Maple syrup urine disease
60
Rare dysautonomia characterized by ptosis, orthostatic hypotension, hypoglycemia and hypothermia
Dopamine hydroxylase def. (dopa-->NE)
61
Hyperpigmentation and degenerative joint disease due to accumulation of homogentisic acid
Alkaptonuria (AR)
| Disorder of tyrosine degradation caused by deficiency in homogentisic acid oxidase
62
Albinism inheritance
AR (depressed or absent tyrosinase)
63
"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
Aortic Regurgitation
64
Bounding femoral and carotid pulses (abrupt distention and quick collapse)-->wide pulse pressure
Aortic regurg (water-hammer pulses)
65
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
Aortic regurgitation
66
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
Aortic stenosis
67
Arterial pulse, pulse pressure, and forward stroke volume changes in patients with chronic (compensated) mitral regurg
no change. normal.
68
Rubella spreads faster and does not darken or coalesce as compared to rash of
rubeola
69
Rare AR disorder of de novo pyrimidine synthesis: Physical and mental retardation, megaloblastic anemia, elevated urinary orotic acid levels
Hereditary orotic aciduria due to defect in uridine 5'monophosphate (UMP) synthase (polypeptide with two enzymatic domains)
70
Treatment of UMP synthase deficiency (orotic aciduria)
Uridine to bypass. Uridine converted to UMP via nucleoside kinases
71
TCA- Clomipramine
Role in TX of OCD
72
Fist anterior branch of aorta and its branches
Celiac trunk
- Left gastric
- Common hepatic
- Splenic arteries
73
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
Proper hepatic artery
74
IMA branches off abdominal aorta at the level of
L3
75
Supplies blood to pancreas and the intestine from the lower part of duodenum to the first 2/3 of transverse colon
SMA
76
Charcot-Leyden crystals contain
eosinophil membrane protein
77
Chronic eosinophilic bronchitis in asthmatics involves bronchial wall infiltration by numerous activated eosinophils, largely in response to IL-5 released by allergen activated
TH2 cells
78
Activates macrophages to promote adaptive immunity against intracellular pathogens
INF-gamma
79
CT is negative (10%) but you still suspect SAH...what do you do?
spinal tap---> xanthochromia (blood in CSF)
80
Recurrent brief attacks of sudden, severe, unilateral periorbital pain associated with ipsilateral rhinorrhea and watering of the eyes
Cluster headaches
81
Thunderclap headache
SAH
82
Adipose tissues composed of cells that contain one intracytoplasmic fat droplet
White adipose tissue
83
Posses several small intracytoplasmic fat vacuoles and considerably more mito (tan color)
brown adipose tissue (requires more capillaries than white adipose tissues)
84
ETC transport and phosphorylation are uncoupled. Protons pumped out are returned to matrix via _________ (uncoupling protein). No ATP is made. Energy released as heat
Mitochondrial membrane protein THERMOGENIN (seen in brown fat)
85
Progressive cough, dyspnea, orthopnea, and lower extremity edema. Tachycardia, tachypnea, accessory muscle use, bilateral crackles or wheezing (cardiac asthma)
ADHF
86
Always preceded by events such as sepsis, aspiration, pneumonia or trauma--> endothelial injury and fluid leakage from the capillaries
ARDS
87
Bilateral airspace opacification
ARDS
88
Diffuse reticular opacities typically associated with decreased lung volumes. Slowly progressive dyspnea and a non-productive cough
Idiopathic interstitial fibrosis
89
Atherosclerosis vessel involvment
Abdominal aorta>coronary>popliteal>ICAs>circle of willis
90
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
Ulnar nerve
91
Innervates flexor carpi ulnaris and medial portion of the flexor digitorum profundus
Ulnar nerver
92
- 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
Ulnar nerve
93
Wrist flexion/adduction, finger abduction/adduction and flexion of the fourth and fifth digits
Ulnar nerve
94
Loss of sensation over the lateral forearm and paralysis of forearm flexors at elbox
musculocutaneous nerve injury
95
Loss of sensation over the lateral up arm and deltoid weakness
Axillary nerve injury
96
Palmar sensory loss involving the majority of the first through third digits
median nerve
97
Weakness on wrist flexion/abduction, flexion of second and third fingers, flexion and opposition of the thumb
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
Loss of sensation over posterior arm and forearm, dorsolateral hand and dorsal thumb
radial nerve
99
Calcimimetic that allosterically activates the calcium-sensing receptor in the parathyroid gland, decreasing PTH release.
Cinacalcet is normally used for secondary hyperparathyroidism in dialysis patients
100
Glucocorticoids (prednisone) can worsen hypocalcemia by
decreasing the expression of vit. D receptor
101
Non-absorbable phosphate binding polymer that decreases absorption of phosphate in GI.
Sevelamer (used to treat hyperphosphatemia in dialysis patients)
102
Postoperative hypothyroidism (thyroidectomy) supplementation with _______ can be used to prevent post-op hypocalcemia
Oral calcium or Vit. D (calcitriol)
103
Test used to measure the amount of protein in body fluids (ex: measure insulin levels)
ELISA
104
Detect target mRNA in a sample to asses gene expression
Northern blot
105
Addition of ______ to the blood of a patient with hemophilia results in clotting
thrombin
106
Synthesized in liver, activated by endothelial injury, activates factor XI (intrinsic)
Factor XII (Hageman factor)
107
Most common pediatric malignancy
ALL (acute lymphoblastic leukemia)
108
Fever, fatigue, pallor, petechiae, and bleeding. LAD, HSM, and bone pain
ALL
109
Large anterior mediastinal mass that can compress great vessels causing SVC syndrome or esophagus (dysphagia) or trachea (dyspnea and stridor)
T-cell ALL (most commonly affects males in late childhood through young adulthood)
110
Both B-ALL and T-ALL are positive for
TdT (antigen of lymphocyte precursors)
111
Pre-B lymphoblasts (B-ALL) markers
CD10, CD19 and CD20
112
Pre-T lymphoblasts (T-ALL) markers
CD2, CD3, CD4, CD5, CD7, and CD8
113
AML M4 and M5
Arise from monocytic precursors
114
AML M6 arises from and typically affects
Erythroid precursors (elderly)
115
Which is more common: B-ALL or T-ALL
B-ALL (70-80%)
116
rare AML subtype arises from primitive megakaryoblasts and is associated with t(1;22) and DOWN SYNDROME in children
AML M7 subtype
117
Plane Xanthomas (linear lesions in skin folds)
Ass. w/ Primary biliary cirrhosis
118
Xanthelasma
soft eyelid or periorbital plaques with no associated abnormalities
119
small aggregates of dermal foam cells (benign macrophages packed with finely vaculated cytoplasm) that are present without inflammation or fibrosis
Xanthelasmas
Vs. Xanthomas do have inflammatory cells and fibrotic stroma
