8/13 Cleanup Flashcards
What are the components of an ovarian teratoma?
3 germ cell layers: ectoderm, endoderm, and mesoderm Benign most of the time
What is struma ovarii?
Thyroid tissue that is in a germ cell tumor
What is a dysgerminoma?
- Clear cytoplasm and central nuclei
- The female equivalent of a seminoma.
- Malignant and radiosensitive.
- Good prognosis; responds to radiotherapy
- LDH is elevated in the serum
What is an endodermal sinus tumor?
- Malignant tumor that mimics yolk sac; most common germ cell tumor in children
- AFP is marker
- Schiller duval bodies (look like glomeruli) are seen on histology
What is a choriocarcinoma?
- Malignant tumor of cytotrophoblasts and syncytiotrophoblasts
- Similar to placental tissue with no villi
- Small and hemorrhagic
- B-hcg positive which leads to thecal cysts of the ovary
What are the names of the germ cell tumors?
Teratoma
Dysgerminoma
Yolk sac
Choriocarcinoma
What are the names of the sex cord stroma tumors?
- Fibroma
- Granulosa cell
- Leydig sertoli
What is an ovarian fibroma? What is a major thing to look out for in a pt with ovarian fibromas?
- Benign tumor of fibroblasts
- Look out for Meigs syndrome: Ascites, pleural effusion
What are seen in leydig sertoli cell tumors?
- High androgen production
- Virilization (hair lip) and pseudohermaphroditism
What are the characteristics of a seminoma vs a nonseminoma?
- Seminomas - very responsive to radiotherapy and metastasize late (good prognosis)
- Nonseminomas - variable response to treatment and often metastasize early (bad)
What is a seminoma composed of?
- Large cells with clear cytoplasm and central nuclei that forms a homogeneous mass
- No hemorrhage or necrosis
- Marker: B hcg
- Good prognosis
What are the characteristics of a male embryonal carcinoma?
- Malignant tumor comprised of immature primitive cells that produce glands
- Aggressive tumor with early hematogenous spread
- CHemotherapy may result in differentiation into another type of germ cell tumor
What is a yolk sac tumor?
- Malignant tumor that resembles a yolk sac
- Shiller duval bodies
- AFP positive
What is a teratoma in a male? How is it different than one in a woman?
- Tumor composed of mature fetal tissue derived from two or three embryonic layers
- MALIGNANT IN MALES COMPARED TO NON MALIGNANT IN FEMALES
- AFP and b-hCG positive
What is a choriocarcinoma in males?
- Syncytriotrophoblases and cytotrophoblasts
- Spreads early via blood
- b-hCG is characteristically elevated; may lead to hyperthyroidism or gynecomastia
Compare acute and chronic prostatitis?
- Acute: Chlamydia and neisseria are common causes in young adults, E coli and pseudomonas are common in older adults.
- Prostate is tender and boggy on digital rectal exam
- Chronic: Dysuria with pelvic or low back pain
- Serum shows WBCs but are negative on culture
What are the characteristics of a thyroid adenoma?
- Common
- Benign
- Cold (non-functional)
- If funcitonal, causes hyperthyroidism
What are the characteristics of a papillary carcionma of the thyroid?
- Most common malignant thyroid cancer
- Radiation exposure
- Spreads lymphatically
- Excellent prognosis - slow growth
- Psammoma bodies “orphan annie nuclei”
What are the characteristics of a follicular carcinoma of the thyroid?
- Hematogenous spread to bone and lungs
- Can present hurthle cells too
- Micro: Delimited by fibrous capsule surrounding tighly packed follicles, trabeculae, or solid sheets of tumor cells that are often cuboidal with dark or pale staining nuclei with inconspicuous nucleoli
What are the characteristics of an anaplastic carcinoma?
- The worst
- Firm, bulky mass
- Early MTS to trachea and esophagus leading to dyspnea, dysphagia
- Bad prognosis, very aggressive
- Undifferentiated, anaplastic pleomorphic cells
What are the functions of the leukotrienes?
- B4 - neutrophil attraction and activation
- C4, D4, E4 - Vasoconstriction, bronchospasm, increased vascular permeability
What are the functions of COX products?
- I2,D2, E2 - vasodilation and increased vascular permeability
- E2 - also fever and pain
What are the effects of bradykinin?
Vasodilation
Vascular permeability
Pain
Define margination, rolling, and adhesion
- Margination - vasodilation leads to margination of cells from the center of the flow to the periphery
- Rolling - P and E selectin slow cells down to allow diapedesis to occur. These selectins are upgraded during inflammatory responses
- Adhesion - Firm adhesion leads to diapedesis
What are the contents of weibel palade bodies?
- P-selectin
- vWF
What are the two types of beta thalassemia?
- Minor - mildest form and is usually asymptomatic
- Major - more severe form and presents with severe anemia a few months after birth
What causes the crewcut appearance seen in beta thalassemia major?
- Unpaired alpha chains precpitate and damage the RBC membrane, resulting in ineffective erythropoiesis and extracascular hemolysis
- Because of this, there is expansion of hematopoiesis into the skull and facial bones leading to the classic crewcut appearance.
What type of anemia is thalassemia?
Microcytic, hypochromic RBCs
What is hemoglobin C? What is the mutation that causes it?
- AR mutation glutamic acid to lysine in the beta chain of hemoglobin
- Extravascular hemolysis
- HbC crystals seen in RBC smear
What is the body’s respnose to decreased LV contractility?
- Decreased cardiac output
- Increased renin angiotensin aldosterone activation
- Increased renal Na+ and H2O reabsorption
- Increased venous pressure
- Increased preload, increasd cardiac output
- Increased sympathetic activity leading to increased LV contractility
Define kussmaul sign?
- Increased JVP on inspiration instead of normal decreased
- Inspiration leads to negative intrathoracic pressure not transmitted to heart leading to impaired filling of the right ventricle
- Blood backs up into the vena cava leading to JVD
What conditions feature Kussmaul sign?
Constrictive pericarditis, restrictive cardiomyopathies, right atrial or ventricular tumors
What are the extraintestinal manifestations of Crohn?
Kidney stones (calcium oxalate), gallstones, possible ASCA antibodies
In terms of correcting sodium levels too fast, what happens if you increase sodium too fast vs decreasing sodium too fast
- Low to high: Pons will die
- High to low: Brain will blow (cerebral edema and herniation)
What pathway is responsible for the positive symptoms of psychosis?
Mesolimbic pathway (VTA to NA) has excess dopamine
What pathway is responsible for negative symptoms of psychosis?
Mesocortical pathway (VTA to cortex) has less dopaminergic action
What is the root cause of parkinsons?
Decreased dopamine in the nigrostriatal pathway (Substantia nigra to the striatum)
Congenital manifestations of rubella
“I (eye) heart ruby (rubella) earrings
- Cataracts (eye)
- Ear (deafness)
- Congenital heart disease (PDA)
- Blueberry muffin rash
What are the congenital symptoms of syphilis?
Often results in stillbirth, hydrops fetalis; if child survives, presents with facial abnormalities (saddle nose, notched teeth, short maxilla), saber shins, CN8 deafness
What occurs in appropriate absolute polycythemia
- Increased RBC mass
- Decreased O2 saturation
- Incresed EPO levels
- Lung disease, congenital heart disease, high altitude
What occurs in inappropriate absolute polycythemia
- Increased RBC mass
- Increased EPO mass
- Malignancy, hydronephrosis
- Caused by ectopic EPO secretion
What are the characteristics of polycythemia vera?
- Increased plasma volume
- Increased RBC mass
- Decreased EPO levels
- EPO decreased in PCV due to negative feedback suppressing renal EPO production
Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter applies to what?
Atropine poisoning (muscarinic antagonist)
What are the symptoms of cholinesterase inhibitor poisoning?
DUMBBeLSS mnemonic
What are the zones in liver tissue?
- Zone 1: periportal - affected by viral hepatitis, hit hardest by toxins
- Zone 2: intermediate - Hit by yellow fever
- Zone 3: Pericentral vein - hit by ischemia, P450, metabolic toxins, site of alcoholic hepatitis
How is glucose, galactose, and fructose absorbed in the small intestine?
- Fructose: GLUT5
- Galactose and glucose: SGLT1
- All: GLUT2
What are the characteristics of a pleomorphic adenoma?
Most common salivary tumor composed of chondromyxoid stroma and epithelium and recurs if incompletely excised or ruptured intraoperatively
What are mucoepidermoid carcinoma?
Most common malignant tumor, has mucinous and squamous components
What is a warthin tumor?
Benign cystic tumor with germinal centers typically found in smokers
What vitamins are malabsorbed in pancreatic insufficiency?
ADEK and B12
What is deficient in orotic aciduria?
- Orotic acid in urine
- Defect in UMP synthase
What is the presentation of orotic aciduria?
- Developmental delay and megaloblastic anemia refractory to folate and B12
- No hyperammonemia
- Increased orotic acid
What are the major causes of osteonecrosis?
- Corticosteroids
- Alcoholism
- SIckle cell disease
- Trauma
- the Bends
- Legg-Calve Perthes disease
- Gaucher disease
- Slipped capital femoral epiphysis
What is the trabecular outflow tract? What receptors are used to increase outflow through this tract?
- Drianage through the trabecular meshwork of the eye exiting through the canal of schlemm and into the episcleral vasculature
- M3 agonist increases outflow through this tract
What is the uveoscleral outflow tract? What receptors are utilized to increase outflow through this tract?
- Drainage into the uvea and sclera
- Increase with prostaglandin agonists
Where is aqueous humor produced? What receptors are present on this area?
- Ciliary body produces aqueous humor
- Beta blockers: decrease
- Alpha1 agonists decrease
- Carbonic anhydrase inhibitors decrease
What is the pathway involved in mediation of pupil dilation?
- Hypothalamus to ciliospinal center of Budge (C8-T2)
- Exit at T1 to superior cervical ganglion
- Plexus along internal carotid, through cavernous sinus, enters orbit as long ciliary nerve to pupillary dilator muscles
What are the features of lupus nephritis?
RASH OR PAIN
- Rash
- Arthritis
- Serositis
- Hematologic disorders (Leukopenia, thrombocytopenia, etc)
- Oral/nasopharyngeal ulcers
- Renal disease
- Photosensitivity
- ANA
- Immunologic disorder
- Neurologic disorders
What causes retinal vein occlusion?
compression of nearby arterial atherosclerosis causes hemorrhage and venous emngorgement
What causes central retinal artery occlusion?
Acute painless monocular vision loss caused by some kind of embolic source
Why is horner syndrome associated with lesion above T1?
T1 is where the nerve arises that travels along the carotid to sympathetically innervate the eye
What is WAGR complex?
Wilms tumor, Aniridia (absensce of iris), Genitourinary malformations, mental Retardation
What is Denys Drash
Wilms tumor, early onset nephrotic syndrome, male pseudohermaphroditism
Beckwith Weidemann
Wilms tumor, macroglossia, organomegaly, hemihyperplasia
What is the mnemonic for that the testes cells do generally during development?
- Leydig cells lead to Male differentiation
- Sertoli Cells Shut Down Female differentiation
What is the pathological appearance of primary sclerosing cholangitis?
Onion skinning of bile duct in sections leading to beading of intra and extrahepatic bile ducts on ERCP
What is the pathologic appearance of primary biliary cholangitis?
Autoimmune destruction leading to lymphocytic infiltrate and granulomas which destroy intralobular bile ducts
In AK53 mutation sequence of colorectal cancer, what does each mutation do?
- A: loss of APC gene leads to decreased adhesion and increased proliferation
- K: Loss of KRAS gene leads to unregular intracelluar signaling
- 53: Loss of P53 leads to loss of tumor suppression
Crohn disease is mediated by TH 1 or 2? What about UC?
Crohns is Th1 and UC is Th2
(Crohn’s is one word while UC is two words)
What is the importance of the submucosal layer of the gut wall?
Meissner’s plexus is here, responsible ofr secretion of fluid
Which layer of the gut wall is responsible for motility?
Muscularis externa
TRH, along with causing TSH release, also causes the release of what other hormone?
Prolactin
What is the difference between Mobitz type 1 and type 2?
Type II has dropped beats but no lengthening of the PR interval
Conduction rates
Purkinge then atria then ventricles then AV node PAVA
B1 stimulation of the heart causes what cellular change?
- B1 receptor stimulation leads to Ca2+ channel phosphorylation leading to increased Ca2+ entry
- increased active Ca2+ ATPase leading to increased Ca2+ storage in the sarcoplasmic reticulum
Men1
- Pituitary tumors
- Pancreatic endocrine tumors
- Parathyroid adenomas
Men2a
- Thyroid (medullary)
- Pheochromocytoma
- Parathyroids
Men2b
Medullary thyroid
Pheochromocytoma
Mucosal neuromas
Difference between direct and indirect inguinal hernias?
- Indirect goes through indirect and goes INto the scrotum
- Lateral to inferior epigastric vessels
- Direct goes through parietal peritoneum medial to inferior epigastric vesels but lateral to rectus abdominis
- Goes through external inguinal ring only
What is diamond blackfan anemia?
Rapid onset anemia within first year of life due to intrinsic defect in erythroid progenitor
What are the symptoms of diamond-blackfan anemia
Short stature, craniofacial abnormalities, and upper extremity malformations
What are the muscles responsible for arm abduction of different levels?
- Supraspinatous: 15 degrees
- Deltoid: 15-100 degrees
- Trapezius: Over 90 degrees
- Serratus anterior: over 100 degrees
What are the differences between the meyer loop and the dorsal optic radiation?
- Meyer loop - lower retina, goes around lateral ventricle
- Dorsal optic radiation - superior retina, goes through internal capsule
What is precontemplation
Not yet acknowledging the problem
What is contemplation
Acknowledging the problem but not wanting to make a change
What is preparation/determination?
Getting ready to change behaviors
What is action?
Changing behaviors
What causes acute interstitial nephritis?
- Diuretics (pee)
- Pain free (NSAIDS)
- Penicillins and cephalosporins
- Proton Pump inhibitors
- RifamPin
Mesonephric ducts are (female/male) while paramesonephric ducts are (male/female)
Meso: Male Parameso: Female
What are the characteristics of cryptogenic organizing mnemonia?
Inflammation of the bronchioles and surrounding structure. Can be secondary to chronic inflammatory diseases or medication side effects
Baroreceptors are increase their firing due to (increased/decreased) pressure
Increased
What is the order of events in the cushing reflex?
- Increased intracranial pressure constricts arterioles
- Cerebral ischemia occurs
- Increased pCO2 and decreased pH occur as result of ischemia
- Increased central reflex sympathetic stimulation leads to increased perfusion pressure (hypertension_
- Increased stretch
- Peripheral reflex baroreceptor induced bradycardia
What occurs when you massage the carotid?
- Increased pressure on carotid sinus
- Increased afferent baroreceptor firing triggers decreased AV node conduction speed and subsequent decreased HR
What triggers the chemoreceptors in the periphery?
- Carotid and aortic bodies are stimulated by decreased PO2, Increased PCO2, and decreased pH
What triggers chemoreceptors in the central areas?
- Changes in pH and PCO2 of brain interstitial fluid, which in turn are influenced by arterial CO2
- Do not directly respond to pO2
What is coronary steal syndrome?
Coronary stenosis causes maximally dilated vessels at baseline. Administration of vasodilators dilates normal vessels and shunts blood toward well-perfused areas, thereby diverting flow away from vessels that are stenosed and leading to ischemia in myocardium perfused by these vessels
What hormones are released from basophils?
B-Flat
- Basophils
- FSH
- LH
- ACTH
- TSH
Hemidesmosome connects what?
Keratin in basal cells to underlying basement membrane
What do desmosomes connect?
Intermediate filaments interact
Adherens junctions connect what?
Tight junction, forms belt connecting actin cytoskeletons of adjacent cells with CADherins
What are the jobs of the medial and lateral pterygoid muscles?
Medial is for munching and lateral is for lowering
What are the adverse effects of neonatal respiratory supplemental oxygen
RIB
- Retinopathy
- Intraventricular hemorrhage
- Bronchopulmonary dysplasia
What is CKMB used for?
Short term evaluation of myocardial infarction, but only lasts a short time
What is troponin used for
Long term confirmation of myocardial infarction
What is the function of endocannabinoids?
Act at cannabinoid receptors in hypothalamus and nucleus accumbens, two key areas for homeostatic and hedonic control of food intake, where it increases appetitie
Which receptors for ADH modulate osmolarity vs blood pressure?
- V2: Osmolarity
- V1: Blood pressure
When is GHRH levels increased?
- Exercise
- Sleep
- Puberty
- Hypoglycemia
What are some causes of hepatic adenoma?
Oral contraceptive or anabolic steroid use
Concerning features of hepatic adenoma
Rupture or regression
What is a greenstick fracture?
Incomplete fracture extending partway through the width of the bone
What is a torus fracture?
Buckle fracture of the cortex due to compression injury. Can be very subtle
What is the reason that seronegative spondyloarthropathy is called seronegative
No anti IgG rheumatoid factor
Destruction of the lateral hypothalamus leads to what
Lack of feelings of hunger meaning that the patient will rapidly lose weight
What is the mechanism of contraction alkalosis?
LOop diuretics and thiazides lead to increased AT2 which increases Na+/H+ exchange in the PCT leading to increased HCO3- reabsorption
What changes in the transition between bronchi and bronchioles?
Cartilage and goblet cells end when you transition from bronchi to bronhioles
What changes in the transition from terminal to respiratory bronchioles?
Terminal bronchioles have ciliated cuboidal cells compared to squamous cells in respiratory bronchioles
What is the function of TNF-alpha
Activates endothelium, causes WBC recruitment, vascular leak
Hepatitis B extrahepatic manifestations?
- Hematologic: Aplastic anemia
- Renal: Membranous GN
- Vascular: Polyarteritis nodosa
Hepatitis C extrahepatic manifestations
- Hematologic: Essential mixed cryoglobulinemia, increased B cell NHL, ITP, autoimmune hemolytic anemia
- Membranoproliferative GN
- Leukocytoclastic vasculitis
- Sporadic porphyrria cutanea tarda, lichen planus
- Increased diabetes risk
What are effects of insulin?
- Glucose tranasport into muscle and adipose
- Glycogen synthesis
- Triglyceride storage
- Sodium Retention
- Protein synthesis
- Cellular K+ uptake
- Decreased glucagon release
- Decreased lipolysis
What is the body’s response to SIADH
- Water retention leads to decreased aldosterone and increased ANP and BNP
- Because ANP and BNP are increased, extracelluar fluid volume is normalized, leading to euvolemia hyponatremia
What are the differences between cis and trans deletions in alpha thalassemia?
- Cis - deletion (both deletions on the same chromosome) common in asian populations
- Trans - deletion (on different chromosomes) common in african populations
Describe what happens in a leukoerythroblastic reaction
- Left shift - more immature cells are seen because of the need for more cells
- Band cells and metamyelocytes more common in response to infection or inflammation
What is the major cause of relative polycythemia?
Dehydration and burns
What are the jobs of each rotator cuff muscle?
- Supraspinatus - laterally abducts arm
- Infraspinatus - laterally rotates arm
- Teres minor - adducts and laterally rotates arm
- Subscapularies - medially rotates arm
What are the common injuries of each rotator cuff muscle?
- Supraspinatus - most common
- Infraspinatus - pitching injury
- Teres minor - not typically injured
- Subscapularis - not typically injured
In the spinothalamic tract, what do the lateral and anterior parts do??
- Anterior: Crude touch, pressure
- Lateral: Pain, temperature
Difference between simple and complex seizures?
- Simple partial - consciousness intact, motor sensory, autonomic, psychic
- Complex partial - impaired consciousness
COMPLEX MEANS IMPAIRED CONSCIOUSNESS
What is an absence seizure?
3 Hz spike and wave discharge leading to no postictal confusion and a blank stare
What is the difference between myoclonic and tonic clonic seizure?
- Myoclonic - muscle (myo) repetitive jerks (clonic)
- Tonic clonic - Alternation between stiffening (tone) and movement (clonus)
What is the definition of an atonic seizure?
Drop seizure in which the patient falls to the floor and appears to have fainted
Low K+ leads to
U waves, flattened T waves on ECG, arrythmias, muscle cramps, spasm, weakness
High K+ leads to
Wide QRS and peaked T waves on ECG, arrhythmias, muscle weakness
Low calcium leads to
Tetany, seizures, QT prolongation, twitching, spasm
High Mg2+ leads to
Decreased deep tendon reflexes, lethargy, bradycardia, hypotension, cardiac arrest, hypocalcemia
Low Mg2+ leads to
Tetany, torsades de pointes, hypokalemia, hypokalcemia
What are the symptoms of preecclampsia?
New onset hypertension with either proteinuria and end organ dysfunciton after week 20 of gestation caused by abnormal placental arteries and endothelial dyscunction, vasoconstriction and ischemia
What lobe do objects go into when the patient is laying down?
Posterior right upper
What are the functions of PDGF?
- Secreted by activated platelets and macrophages
- Induces vascular remodeling and smooth muscle cell migration
- Stimulates fibroblast growth for collagen synthesis
What are the cancers that spread hematogenously?
Four Carcinomas Route Hematogenously
- F: Follicular thyroid
- C: Choriocarcinoma
- R: Renal cell carcinoma
- H: Hepatocellular carcinoma
How does the foramen ovale form?
- Septum primum grows superiorly and inferiorly
- Septum segundum grows superiorly after
- Superior part of the septum segundum grows and fuses with septum primum
- Inferior part of septum primum closes hole of foramen secundum
What are the characteristics of primary closed angle glaucoma?
Enlargement or forward movement of lens against central iris leading to obstruction of normal aqueous flow through the pupil. Fluid builds up behind the iris, pushing the peripheral iris against cornea and impeding flow through trabecular meshwork
What are the characteristics of secondary closed angle glaucoma?
Hypoxia from retinal disease inducing vasoproliferation in the iris that closes the angle
What is the pathology that occurs with posterior urethral valves?
Membrane remnant in the posterior urethra in males leading to urethral obstruction. Can be diagnosed prenatally by hydronephrosis and dilated bladder on ultrasound
What are the major causes of low birth weight?
Caused by prematurity or intrauterine growth restriction
What are some conditions that are associated with low birth weight?
- Increased risk of sudden infant death syndrome and mortality
- Impaired thermoregulation and immune function
- Hypoglycemia
- Polycythemia
- Empaired emotional development
What does the HAVOCS mnemonic for menopause?
HAVOCS
- H: Hot flashes
- A + V: Atrophy of vagina
- O: Osteoporosis
- C: Coronary artery disease
- S: Sleep disturbances
Which breast tumors/pathology are found in the lactiferous sinus or major duct of the breast?
- Intraductal papilloma
- Abscess/mastitis
- Pagets disease
What are the pathologies that occur in the terminal duct lobular unit?
- Fibrocystic change
- DCIS
- LCIS
- Ductal carcinoma
- Lobular carcinoma
What breast pathologies are found in the stroma of the breast?
FIbroadenoma and phyllodes tumor
Derivatives of glycine
Porphyrin and heme
Derivatives of phenylalanine?
Tyrosine which can be converted to DOPA which can be converted to Dopamine then NE then Epinephrine
Glutamate derivatives
GABA and glutathione
Arginine derivatives
Creatine, urea, nitric oxide
Tryptophan derivatives
Niacin and serotonin
What is the pathogenesis of cystic fibrosis?
Misfolded protein leads to retention of Cl- channels in the RER causing decreased Cl- and H2) secretion leading to increased intracellular Cl- and compensatory Na+ reabsorption via epithelial Na+ and abnormally thick mucus secreted into the lungs and GI tract
How does cystic fibrosis effect membrane potential?
Makes membrane potential more negative
Whaat is the function of ouabain?
Inhibition of the ATPase by binding to the K+ site
Major genetic connections are present between osteosarcoma and what other tumor?
Retinoblastoma or pagets disease
Albinism leads to what potential pathology?
- Squamous cell carcinoma
- Basal cell carcinoma
- Melanoma
Large cell lung carcinoma that stains positive for what identifying factors?
- TTF-1 - adeno
- P40 (squamous)
- Chromogranin (Neuroendocrine)
What is the criteria for acute rheumatic fever?
- Migratory polyarthritis
- Pancarditis
- Subcutaneous nodules
- Erythema marginatum
- Sydenham chorea - involuntary muscle movements
What is erythema marginatum?
annular, nonprutiritc rash with erythematous borders, commonly involving trunk and limbs
What causes rheumatic fever?
Cross reactivity with bacterial M protein
What situations will ESR be elevated?
- Anemias
- Infections
- Inflammation
- Cancer
- Renal disease
- Pregnancy
What conditions lead to decreased ESR
- Sickle cell anemia
- Polycythemia
- HF
- Microcytosis
- Hypogibrinogenemia
What occurs in the proliferative stage of wound healing?
Deposition of granulation tissue and type III collagen, angiogenesis, epithelial cell proliferation, dissolution of clots, and wound contraction
What occurs in the remodeling stage of wound healing
Fibroblasts deposit type I collagen and replace type III collagen leading to increased tensile strength of tissue
Most (carcinomas/sarcomas) spread hematogenously
Sarcomas
What parameters are changed by rapid squatting?
- Increased venous return
- Increased preload
- Increased afterload
Why does renal failure result in inhibited GnRH?
Prolactin is eliminated renally and therefore is increased which inhibits GnRH release
What are the characteristics of a neuroblastoma
- Most common tumor of adenal medulla in children
- CAN CROSS THE MIDLINE
- Usually in children
What is the histological appearance of a neuroblastoma
Homer-Wright rosettes
How do neuroblastomas stain?
Bombesin and NSE +
Motilin
- Source:
- Action:
- Regulation:
- Source: small intestine cells
- Action: MMC production
- Regulation: Increased in fasting state
VIP
- Source:
- Action:
- Regulation:
- Source: Parasympathetic ganglia in sphincters, gallbladder, small intestine
- Action: Increased intestinal water and electrolyte secretion, increased relaxation of intestinal smooth muscle and sphincters
- Regulation: Increased by distation and vagal stimulation, decreased by adrenergic input
What are the actions of CCK
- Increased pancreatic secretion
- Gallbladder contraction
- Decreased gastric emptying
- Increased sphincter of Oddi relaxation
Glucose dependent insulinotropic peptide action
- Exocrine: decrease gastric H+ secretion
- Endocrine: Increased insulin release
Define pseudofolliculitis barbae?
“Razor bumps” Foreign body inflammatory facial skin disorder characterized by firm hyperpigmented papules and pustules that are painful and pruritic located on cheeks jawline and neck
What are the main reasons for acanthosis nigricans
insulin resistance from diabetes, obesity, cushing syndrome, or some kind of visceral malignancy like a gastric adenocarcinoma
What autonomic responses are responsible for the male sexual response?
POINT SQUEEZE SHOOT
- Parasympathetic - erection
- Sympathetic (hypogastric nerve) - emmission
- Somatic (pudendal) - ejaculation