7.2.16 Flashcards
Ehlers-Danlos: defining charact
- jt hypermobile
- hyperextensible, fragile skin
what colonic polyp can progress to adenoCA? what can’t?
neoplastic polyp:
- adenomatous –> villous more likely than tubular
- serrated
non-neoplastic polyp:
- hyperplastic
- hamartomatous
- inflamm
granulomatosis w polyangiitis (Wegener’s): histology
- crescents
- IF-
- elevated c-ANCA
hereditary spherocytosis: mode of inheritance
AD
A-fib –> most common site of thrombus?
LA appendage
what is: ALS
degen disorder of UMN & LMN of corticospinal tract –> ant motor horn, lat corticospinal tract
cofactor for methylmalonyl CoA mutase
vitB12
methylmalonic acidemia: how confirm dx?
elevated urine methylmalonic acid, propionic acid
prolonged burning substernal pain, ST elevation in leads I & V3-6 –> indicates?
anterolat LV infarct
inh gamma-aminolevulinate synthase –> leads to?
sideroblastic anemia (microcytic, hypochromic)
what is: Curling’s ulcer
stress-related mucosal dz: severe trauma, burn –> hypovol, hypotension –> local ischemia –> impair mucus protection –> ulcer
fasting glucose: value to dx DM
126
clopidogrel: MOA
platelet –> irrev block P2Y12 cmpt of ADP receptor –> prevent platelet aggregation
parvovirus B19: replicates in?
erythrocyte precursors in BM
what is: buspirone
nonbenzo anxiolytic –> trt GAD
methylmalonyl CoA mutase –> complete def –> ssx?
newborn:
- lethargy
- vomit
- tachypnea
what are signs of end organ damage?
- acute coronary synd
- encephalopathy
- pulm edema
- acute kidney injury
- intracranial, subarachnoid hemorrhage
- aortic dissection
- papilledema, retinal hemorrhage, exudate
how is Rb protein turned off?
prolif signal –> activate cyclin-dep kinase 4 (CDK4) –> hyperphos Rb
hypoxemia (low PaO2): cause
- alveolar hypovent
- vent-perfusion mismatch
- diffusion impair
- R–>L shunt
acute promyelocytic leukemia: pathophys
t(15;17) –> promyelocytic leukemia-retinoic acid receptor alpha (PML/RARa) fusion gene –> unable to signal for proper cell differentiation
amyotrophic lateral sclerosis (ALS): who?
middle age adults –> sporadic
what is: stress-related mucosal dz
severe physiologic stress –> shock, extensive burn, sepsis, severe trauma –> local ischemia –> gastric ulcer
mycoplasma pnemoniae –> hemolytic anemia –> pathophys?
shares antigen w human RBC –> cross-reacting IgM Ab (cold agglutinins) –> lyse RBC
what is: Hawthorne effect
observer effect –> study subj –> aware being studied –> change beh
what is: Janeway lesion
acute infective endocarditis –> septic embolization from valve vegetations –> nontender, macular, erythematous lesions –> usu palms/soles
granulomatosis w polyangiitis (Wegener’s): triad
- pulm ssx
- URT involvement
- RPGN
FOOSH –> can lead to?
dislocate lunate bone
what is: Eccentric hypertrophy
type of hypertrophy where the walls and chamber of a hollow organ undergo growth in which the overall size and volume are enlarged
what is: Cushing’s ulcer
stress-related mucosal dz: intracranial injury –> increase ICP –> direct stim vagus –> increase gastric acid secrete –> ulcer
lunate bone: location
more medial of the 2 carpal bones that articulate w radius
osteogenesis imperfecta: defining charact
- spont fracture
- bone & tooth malform
- blue sclera
how does isoniazid cause B6 def?
direct inh pyridoxine phosphokinase: cannot convert pyridoxine to active form
myasthenia gravis: pathophys
autoimmune –> NMJ –> postsyn terminal –> decrease fxal ACh receptors –> ACh can’t bind & open postsyn cation channels –> decrease end plate potential –> can’t reach threshold potential –> no AP
what is: Heinz body
Hb precipitate –> seen in G6PD def d/t oxidative stress
methylmalonic acidemia: cause
AR –> methylmalonyl CoA mutase
what is: transudate
ultrafiltrate of plasma caused by hemodynamic changes
hydroxylation of proline & lysine residues in collagen: fx? where?
max tensile strength
rER
clopidogrel: use
prevent CV events in CAD pts (as effective as ASA)
what is: Osler node
finger, toe –> painful, violaceous nodule
lat corticospinal tract degen –> ssx
UMN signs
acute promyelocytic leukemia: assoc dz
DIC
1g carb = how many Calories?
4
methylmalonic acidemia: lab findings
- hyperammonemia
- ketotic hypoglycemia
- metab acid
vitC def: ssx
- bleeding gums
- ecchymosis, petechiae
- impaired wound heal
cardiogenic acute pulm edema: histology
increased infiltration of plasma H2O & electrolytes into lung interstitium & alveoli
hemophilia: classic manifestation
- hemarthrosis
- delayed, prolong bleeding following minor trauma, surg
- intramusc hemorrhage
what is: retinoblastoma (Rb) protein
regulator of G1–>S phase transition:
- hypophos –> active –> bind E2F transcription factor –> inh gene transciption necess for G1–>S transition
- hyperphos –> inactive –> release E2F
Ehlers-Danlos: mutation
collagen type V
extensor carpi radialis brevis: fx
wrist extend
mild hemophilia A: tx? MOA?
desmopressin (DDAVP):
- increase circulating levels of factor VIII
- stim vWF secretion
what is: exudate
extravasation of plasma, plasma protein, circulating lymphocytes –> seen in inflamm states
G6PD def: mode of inheritance
XR
1g protein = how many Calories?
4
mycoplasma pnemoniae –> what dz?
- walking pneumonia
- tracheobronchitis
gallbladder hypomotility: features
- postprandial RUQ discomfort
- CCK stim –> slow/incomplete gallbladder emptying
- biliary stasis –> gallbladder continue to actively absorb H2O from bile –> bile concentration –> bile precipitate –> biliary sludge –> risk for stone formation, bile duct obstruct
bacterial endocarditis –> types of lesions? cause?
embolization of septic vegetations:
- Janeway lesion
- Osler node
- splinter hemorrhage
- Roth spots
1g fat = how many Calories?
9
what is pyridoxine needed for?
heme syn: cofactor for gamma-aminolevulinate synthase –> rate limiting step
highly lipophilic anesthetic drug: mult-compartment model of distribution? results in?
IV admin:
1) high [] in central cmpt (plasma)
2) rapidly dist to well-vascularized peripheral cmpt –> brain, liver, kidney, lungs, heart
3) re-dist over time –> poorly vascularized peripheral cmpt –> skeletal muscle, fat, bone
short DOA
methylmalonic acidemia: pathophys
normally: catabolism of aa –> propionyl CoA –> methylmalonyl CoA –> succinyl CoA –> enter TCA
cannot convert methylmalonyl CoA to succinyl CoA –> methylmalonic acid, propionic acid buildup:
- metab acid
- inh gluconeogenesis –> hypoglycemia
- inh urea cycle –> hyperammonia
when should you suspect dilated cardiomyopathy caused by viral myocarditis?
progressive onset of HF in setting of recent viral infect
ant motor horn degen –> ssx
LMN signs
ankylosing spondylitis: ssx
- axial jt –> stiff & fuse (ankylosis)
- inflamm at tendon insertion to bone (enthesitis)
- limited chest expansion –> hypovent: involvement of thoracic spine, costovertebral/costosternal jx
what is: HTN emergency
severe HTN (>180/120) + end organ damage
buspirone: charact
- slow onset of axn
- no muscle relaxant, anticonvulsant properties
- no risk of dependence
aortic dissection: #1 RF
HTN
anterolat LV infarct: comp
- LV fail
- cardiogenic acute pulm edema
- pulm venous HTN (congestion)
- transudate of plasma into lung interstitium & alveoli
how does viral myocarditis lead to dilated cardiomyopathy?
myocardial inflamm –> heart chambers –> dilate & enlrg (eccentric hypertrophy) –> decrease V contractility (systolic dysfx)
lat epicondylitis: cause? ssx?
overuse extensor carpi radialis brevis –> angiofibroblastic tendinosis at its origin on lat epicondyle
what is: biotin
vitB7
what is normal partial pressure of O2 in alveoli?
104
name the opsonins
- IgG
- C3b
acute promyelocytic leukemia: tx? MOA?
all-trans-retinoic acid (ATRA) –> stim differentiation of myeloblasts to mature granulocytes
