April 15 Flashcards
What embryologic structure forms the glomerulus through to distal convoluted tubule?
Metanephric mesenchyme (metanephric blastema)
What embryologic structure forms the ureter, pelvises, calyces, collecting ducts?
Metanephric diverticulum–Ureteric bud
What process provides a source of NADPH, occurs within the cytoplasm and what enzymes are used in this process?
HMP shunt–pentose phosphate pathway
Glucose-6-phosphate dehydrogenase and transketolase
Pt with DKA is going to have increased excretion of what 2 substance in the urine and what will decrease with the urine?
Increased NH4+ and H2PO4- –increased H+ secretion
Decreased pH and HCO3- excretion—bicarb will be resorbed at increased rate
Damage to the infraorbital nerve due to fracture of the orbital floor, which is composed of the zygomatic bone and maxilla, will cause what symptoms?
Numbness and paresthesia to the upper check, upper lip, and upper gingiva
Displacement of the orbital contents through the floor may cause enophthalmos, entrapment of the inferior rectus muscle impairing superior gaze.
Disorder involving recurrent unexpected panic attacks characterized by an abrupt surge of fear accompanied by physical and cognitive symptoms?
Panic disorder
Pt continuously worries about future attacks and restricts activity as a result
Pt received inject and shortly after walked with a limb where is right hip would drop when he lifted his right foot off the ground. Where was the shot administered?
Left superomedial quadrant of the buttock
Where does Isotyping of B-cells occur and what is required?
Germinal centers of lymph nodes
–requires interaction of CD40 with CD40L (CD154) expressed by activated T-cells
Pt presents with unilateral JVD and has lung cancer. Dx?
Right side Brachiocephalic vein obstruction–causing back-up into Jugular
What is the MOA of rasburicase and what is it used for?
Recombinant fricassee that catalyzes metabolism of uric acid to allantoin
Used for prevention and tx of tumor lysis syndrome–oncologic emergency that den develop from chemo causing rapid breakdown of cancer cells and high cell turnover
PE is associated with hypoxemia and ______ alkalosis.
Respiratory
What is the most important mediator of Giant cell (temporal) arteritis?
Production of IL-6 cytokine–cell mediated immunity
Epidermal accumulation of edematous fluid in intercellular spaces–seen with eczematous dermatitis?
Spongiosis
Collects data from group of people to assess frequency of disease at a particular point in time–What is happening at that point in time?
Cross-sectional study
Phenylalanine is a derivative of what?
tyrosine Dopa Dopamine NE Epi
Tryptophan is a derivative of what?
Niacin
Serotonin
Histidine is a derivative of what?
Histamine
Glycine is a derivative of what?
Heme
Glutamate is a derivative of what?
Glutamate
Arginine is a derivative of what?
Creatine
Urea
NO
What is essential in a pts diet who has homocystinuria and how does it present?
Cysteine
Commonly caused by cystathionine synthase deficiency which makes it cysteine is unable to be synthesized from homocysteine
Homocysteine builds up causing increased methionine
–prothrombotic causing premature thromboembolic events such as MI in young pt (like 12 y/o)
Trypsinogen is activated to trypsin by ________.
Duodenal enteropeptidase
–trypsin is essential for protein digestion and absorption
Injury to the supraspinatus muscle results in pain during what type of motion?
Abduction of the arm
What is the most reliable auscultatory finding indicating a high regurgitant volume and LV volume overload seen with mitral regurgitation?
Left sided S3 gallop
Holosystolic, high-pitched “blowing murmur”–loadest at apex and radiates toward axilla
What nerve innervates the extensors of the hand?
Radial nerve
What drug is used with pheochromocytoma to irreversibly inhibit a1 and a2?
Phenoxybenzamine–blocks action of NE
–reduces the arterial vasoconstriction caused by NE
Med used for DM2 that increases insulin sensitivity in peripheral tissue?
Glitazones/thiazolidinediones
-Pioglitazone and rosiglitazone
Binds to PPAR-g nuclear transcription regulator
–decreases insulin resistance
What is the function of c-MYC?
Transcription factor —transcription activator controlling cell proliferation, differentiation, and apoptosis
8;14 translocation seen with Burkitt lymphoma
What is the MOA of etanercept?
EtanerCEPT is a TNF decoy reCEPTor
Treatment with EPO-stimulating agents put pts at increased risk of developing what?
HTN and thromboembolic events
Intestinal atresia of the midgut–jejunum, ileum, proximal colon is due to ________ and presents with ______ and _____.
Vascular occlusion in utero
Bilious emesis
Abdominal distention
Associated with gastroschisis
Early onset Familial Alzheimer disease is associated with __, ___, ___ and sporadic Alzheimer disease is associated with _____
APP, Presenilin-1, Presenilin-2
ApoE4
ApoE2–> associated with decreased risk sporadic form
What is the 1st line tx for generalized anxiety disorder?
SSRIs–Fluoxetine, paroxetine, sertraline, citalopram
SNRIs– -lafaxine’s, duloxetine, -cipran’s
The splenic artery which originates from the celiac artery becomes blocked, what artery is most vulnerable due to its lack of anastomoses?
Short gastric arteries
What is hyperkeratosis?
increased thickness of stratum corneum
What is parakeratosis?
Hyperkeratosis with retention of nuclei in stratum corneum
—Hyperkeratosis is increased thickness of stratum corneum
What is actinic keratosis and what are the pts who have it at increased risk of developing?
Premalignant lesions caused by sun exposure
–small, rough, erythematous or brownish papules or plaques
Risk of SCC–proportional to degree of epithelial dysplasia
Male pt is on SSRI for depression but pissed because he has sexual dysfunction, what drug can be used so he’s not pissed?
Bupropion –increases NE and DA
What is decreased and what is increased causing aging signs of epidermal atrophy with flattening of rete ridges?
Decreased collagen fibril production
Increased degradation of collagen and elastin in the dermis
What type of reaction is involved in eosinophil killing of parasites?
Antibody-dependent cell-mediated cytotoxicity –when bound to parasite enzymes from cytoplasmic granules destroy parasite
