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U-World > 9 > Flashcards

9 Flashcards

1
Q

Pernicious Anemia over time leads to

A

Chronic Atrophic Gastritis (autoimmune gastritis)

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2
Q

Histology of chronic atrophic gastritis?

A

Lymphocytic and plasma cell infiltrate (chronic)

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3
Q

Oxyntic (pale pink) found predominantly in upper grandular layer and secrete gastric acid and IF

A

Parietal cells

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4
Q

Deep aspect of gastric glands (lower grandular) what types of stomach cells are found and what do they synthesize/secrete?

A

chief cells- pepsinogen

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5
Q

Inhibits cellular oxidative phosphorylation by inhibiting Fe3+ in cytochrome c oxidase, lowering peripheral tissue oxygen consumption.

A

Cyanide poisoning

(PaO2, SaO2, and Capillary O2 remain at normal levels…however venous oxygen content sky rockets and the arterial venous oxygen gradient falls)

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6
Q

Reduced chest wall compliance–> hypoventilation of avleolar–>VQ mismatch–> Hypoxemia (low PaO2, low SaO2 and hypercapnia)

A

Obesity (FAT PEOPLE)

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7
Q

Partial pressure of oxygen dissolved in blood

A

PaO2

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8
Q

Oxygen saturation of Hb

A

SaO2

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9
Q

Oxygen content

A

Hb concentration

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10
Q

A form of bias: At least part of the exposure-disease relationship can be explained by another variable

A

Confounder/ Confounding

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11
Q

A form of bias: When subjects are selected for a study or from selective losses during follow up

A

selection bias

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12
Q

Travel (Africa and Haiti)

A

HIV rampant

Malaria (Africa)

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13
Q

Southwest USA

A

Coccidioides

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14
Q

Mississippi river valley

A

Blastomycosis

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15
Q

Ohio River Valley

A

Histoplasmosis

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16
Q

Contents of bee venum

A

Hyaluronidase and phospholipase–> Initiate IgE-mediated response

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17
Q

Rapidly progressive fever, severe sore throat, drooling and progressive airway obstruction

A

H.Flu

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18
Q

Histology of primary effusion lymphoma

A

large cells, big nuclei, prominent nucleoli

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19
Q

Classic Burkitt lymphoma histology

A

diffuse medium sized lymphocytes and a high proliferation index represented by high Ki-67 fraction (approaching 100%

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20
Q

Almost all CNS lymphomas and 1/2 of systemic B-cell lymphomas occurring in setting of HIV due to …

A

EBV

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21
Q

Formaldehyde and glutaraldehyde

A

Function by cross-linking and alkylating DNA and proteins

Used for hospital instruments that cannot withstand autoclave temps

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22
Q

Shortened ANAGEN (hair follicle growth) phase, with resulting follicular miniaturization

A 
Androgenetic alopecia (male-pattern hair loss)
Polygenic Inheritance
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23
Q

Oral isotretinoin used to treat severe acne MOA

A

Inhibits follicular epidermal keratinization in a manner similar to retinoids

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24
Q

Tx for androgenetic alopecia

A

5-alpha reductase inhibitors like finasteride

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25
Q

Autoimmune disorder that causes rapid onset patchy or diffuse hairloss

A

Alopecia areata (TX: intralesional glucocorticoids)

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26
Q

Pregnant woman (high levels of estrogen and progesterone) = what to hair?

A

Increased hair growth

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27
Q

Activation of specific CD4+ lymphocytes by APCs–> INF-gamma and IL-2 activation of macrophages and cytotoxic T lymphocytes.

A

TH1 response (ex: mycoplasma TB due to fact it is INTRACELLULAR)

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28
Q

Consist of epithelioid cells, T-lymphocytes, Langhans, multinucleated giant cells, fibroblasts and collagen

A

Caseating granulomas of TB

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29
Q

What activates CD8+ cells

A

Release of IFN-gamma and IL-2 from TH1 cells

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30
Q

Drug that causes side effect of anorgasmia in women?

A

SSRI

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31
Q

SSRI side effects

A 
#1 sexual dysfunction (make sure you ask patient about this)
Others: transient nausea (at start), risk of seizures (rare) and weight gain
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32
Q

Orthostatic Hypotension and urinary hesitancy ADR due to antagonism of cholinergic and alpha-adrenergic receptors

A

Urinary hesitancy

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33
Q

1) Regulator of Urea cycle

2) Rate limiting enzyme of urea cycle

A

N-acetylglutamate (the regulator) regulates the action of the rate limiting enzyme Carbamoyl phosphate synthetase (Bicarb + ammonia/NH3 +2ATP–> Carbamoyl phosphate)

Note: occurs in mitochondria

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34
Q

Chemokine responsible for:

  • Phagolysosome formation
  • Inducible nitric oxide synthase release
  • Development of granulomas and caseous necrosis
A

INF-gamma

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35
Q

Air-fluid level (CT) in lower lobe of right lung

A

Pulm. abscess due tissue damage and resultant abscess formation caused by lysosomal content released by macs and neutrophils

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36
Q

Stimulates natural kill cells to destroy

Responsible for T-helper cell secretion of IFN-gamma

A

IL-12

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37
Q

Blood flow equation

A

Flow (Q) = [(P1-P2)*r^4]/nL

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38
Q

Genetic code is degenerate

A

more than 1 codon can code for a pair of amino acids

also called wobble

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39
Q

Genetic Transition

A

purine–> purine

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40
Q

Genetic transversion

A

purine–> pyrimidine

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41
Q

Brachial plexus controls all motor activity in the upper extremity except for …

A 
Trapezius muscle (innervated by CN XI)
Actions? fucking cant copy and paste
42
Q

Interscalene nerve block

A

regional anesthesia technique for procedures involving shoulder and upper arm. Administer in scalene triangle: affects brachial plexus roots and trunks

43
Q

ipsilateral diaphragmatic paralysis (roots of phrenic- C3 to C5) pass through interscalene sheath

A

Interscalene nerve block

Avoid in patients with chronic lung disease or phrenic nerve dysfunction

44
Q 
Omohyoid muscle
Origin
Insertion 
Action 
Innervation
A

Origin: upper scapular border and travels along the front of the neck
Inserts: hyoid bone
Action: ?
Innervation: C1-C3 ansa cervicalis (cervical plexus branches)

45
Q

Superficial neck muscle covering the clavicle and sternocleidomastoid before inserting around mandible. Innervation ?

A

Cervical branch of facial nerve

46
Q

Superficial neck muscle controlling neck flexion and head rotation that is innervated by the accessory nerve (XI)

A

STERNOCLEIDOMASTOID

47
Q

Howell-Jolly Bodies (splenectomy)

A

DNA

48
Q

Pappenheimer bodies (sideroblastic anemia)

A

Iron

49
Q

Abnormal Eosin-5-maleimide Test

A

Hereditary Spherocytosis

50
Q

Increased osmotic fragility on acidified glycerol lysis test

A

Hereditary spherocytosis

51
Q

When do you use colchicine for ACUTE gout ?

A

Mild to moderate renal failure, peptic ulcers, or other

52
Q

Where are uric acid crystal located in the nephron?

A

Distal tubules and collecting ducts due to low pH (acid environment)
Thus to prevent tumor lysis syndrome: Urine alkalinization and hydration (throw some allopurinol in there too)

53
Q

Overflow incontinence is due to? (involuntary and continuous leakage when bladder is full and have incomplete emptying)

A

Impaired detrusor contractility (DM1 autonomic neuropathy) or bladder outlet obstruction (tumor obstructing urethra)

Watch out for them UTIs too!

54
Q

Test to confirm inadequate bladder emptying?

A

PVR (post-void residual testing with ultrasound or cath)

55
Q

Urge incontinence (sudden desire to urinate)

A

NPH or spinal cord lesion–>inhibition of of detrusor contraction (urge incontinence)

56
Q

Aedes mosquito transmit both Dengue Fever and Chikungunya fever

A

simultaneous outbreaks in subtropical regions (south asia, pacific islands, caribbean, americas)

Prevent w/ bed nets, window screens, and insect spray

57
Q

Febrile, flu-like, prominent polyarthralgia/arthritis (hands wrists and ankles), with diffuse macular rash

A

Chikungunya fever

58
Q

How is typhoid fever (salmonella) acquired?

A

Contaminated food or water (areas with poor sanitation)

59
Q

Duodenal ulcers on anterior wall

A

perforation

60
Q

Duodenal ulcers on posterior wall

A

Hemorrhage (gastroduodenal artery)

61
Q

Carbolfuchshin acid-fast stain results:

Red vs Blue

A

Red: mycobacteria (norcardia-ish)
Blue: non-acid fast

62
Q

Mycobacterium cell membrane and wall most similar to

A

gram positive (weakly positive on gram stain)

63
Q

N-actylmuramic acid and N-actylglucosamine

A

saccharides that combine with an amino acid chain to form the peptidoglycan layer in both gram positive and gram negative cell wall

64
Q

Serves as antigenic determinant for organism identification in lab and an antigenic target for human immune system. Linked to peptidoglycan cell wall of Gram positive but not gram negative

A

Teichoic acid

65
Q

Component of outer cell envelope of gram-neg bacteria

A

LPS

66
Q

Inheritance pattern in which one parent must also affected in order for child to have disorder

A

AD

67
Q

Only _______ is able to bind to both antithrombin III and thrombin to allow antithrombin to inactivate thrombin

A

LMWH

68
Q

A dihyropyridine calcium channal blocker commonly used as monotherapy or in combo to treat HTN. ADRs = HA, flushing, dizziness, and PERIPHERAL EDEMA

A

Amlodipine

69
Q

Decreased forced expiratory volume in 1 sec (FEV1) and decreased peak expiratory flow rate

A

Asthma…If normal us methacholine challenge to diagnose

70
Q

Cardiogenic shock and evidence of watershed necorsis

A

hypoxic-ischemic encephalopathy

71
Q

most vulnerable to ischemic injury and affected first

A 
Pyramidal cells (hippocampus)
Purkinje cells (cerebellum)
72
Q

Profound ischemia (cerebral)

A

necrosis of areas supplied by distal-most branches of cerebral arteries (watershed infarction)

73
Q

Cortical watershed infarcts typically appear how?

A

BILATERAL wedge-shaped strips of necrosis over cerebral convexity

Severe carotid artery stenosis may = UNILATERAL

74
Q

Cardiac embolism

A

MULTIPLE infarcts within different major vascular territories (eg. middle and anterior cerebral arteries)

75
Q

Charcot-bouchard aneurysm rupture usually causes hemorrhage involving

A

Deep brain structures (basal ganglia, cerebellar nuclei, thalamus, pons)

76
Q

HA, Vomiting, confusion—>coma/death–>autopsy shows brain EDEMA and PETECHIAL HEMORRHAGES throughout gray and white matter

A

Hypertensive ENCEPHALOPATHY

77
Q

Saccular aneurysm rupture

A

Subarachnoid hemmorrhage

78
Q

Cerebral amyloid angiopathy (AB40)

A

deposition of amyloid. Results in lobar hemorrhages (occipital, parietal) esp. in elderly

79
Q

Hirano bodies

A

elongated, eosinophilic, ACTIN-containing bodies found in pyramidal neurons of hippocampus

80
Q

Chromosomal rearrangement that creates a fusion gene btw EML4 (echinoderm microtuble-associated protein like 4) and ALK (anaplastic lymphoma kinase). Results in constitutive active tyrosine kinase that causes malignancy

A

NSCLC

81
Q

Most common cause of glomerulonephritis

A

IgA nephropathy (Berger Disease)

82
Q

Painless hematuria within 5-7 days of URI in older child or young adult

A

IgA nephropathy

83
Q

Renal Biopsy of IgA nephropathy

A

Nonspecific mesangial hypercellularity and mesangial IgA deposits

84
Q

IgA nephropathy with extrarenal symptoms (ab pain, arthralgias, purpuric skin lesions)

A

HSP

85
Q

Primary and secondary amyloidosis. Most frequent organ involved?

A

Kidney

86
Q

Basket weave appearance (lamellated BM w/ irregular thinning and thickening)

A

Alport syndrome (renal failure by 40 - eyes and ears involved)

87
Q

Disorder of type IV collagen that typically causes microscopic hematuria. Only abnormality is a thin basement membrane

A

Thin basement membrane disease

88
Q

The immune reaction to M.tuberculosis is ______ cell-mediated

A

TH1

89
Q

Name four risk factors for TB reactivation

A

1) HIV
2) Infliximab/ etanercept
3) calcineurin inhibitors (cyclosporine)
4) Chronic corticosteroid users

90
Q

Classic extrapulmonary sites of TB?

A

Basal meninges (tuberculous meningitis), psoas muscle (psoas absecess), lumbar spine (Pott disease), serous membranes such as pericardium and pleura.

91
Q

Idiosyncratic aplastic anemia

A

not dose dependent

92
Q

Absorbed by upper dermis and contribute to sunburn and increased risk of malignancy

A

UVB wavelengths

93
Q

Penetrate deeper in into the skin and cause photoaging

A

UVA wavelengths

94
Q

How does UVA cause photoaging?

A

Produce reactive oxygen species, which cause upregulation inflammatory cell-surface receptors an nuclear TFs. This leads to decreased collagen fibril production and upregulation of matrix metalloproteinases

95
Q

Photoaging (wrinkling)

A

Epidermal atrophy with flattening of rete ridges.
Decreased collagen fibril production and increased degradation of collagen and elastin in the dermis.
Also increased cross-linking

96
Q

Alzheimers disease brain atrophy is most pronounced where?

A

Temporoparietal lobes and HIPPOCAMPUS

Hippocampal atrophy is evident even in early stages of disease and can be detected with and MRI

97
Q

HA, memory loss, cerebrospinal fluid VDLR+, and pleocytosis

A

Neurosyphilis

98
Q

Valvar lesion in late (tertiary) syphilis

A

gumma

99
Q

Valvar lesion in primary syphilis

A

chancre

100
Q

Secondary syphilis (bactermic stage that develops 5-10 weeks after chancre resolution)

A

Presents with diffuse macular rash (palms and soles included)
CONDYLOMATA LATA

101
Q

Warfarin initiation ( first factors to fall)

A

FACTOR VII (also called?) and protein C

102
Q

Warfarin skin necrosis Tx

A

Fresh frozen plasma to replenish protein C and get the hell off warfarin

U-World (16 decks)

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