April 25 Flashcards
What is the most common cause of mitral stenosis and how does the murmur present?
Rheumatic fever
Low pitched, rumbling, mid-diastolic murmur heard best over the apex when the pt is laying in the left lateral decubitus position
AD syndrome featuring numerous hamartomas throughout GI tract, along with hyper pigmented mouth, lips, hands, genitalia. Also associated with increased risk of breast and GI cancers.
Peutz-Jeghers syndrome
What causes rectal bleeding in a 2 y/o with normal bowel sounds?
Meckel diverticulum –heterotopic mucosa can ulcerate and cause brisk but painless lower GI bleeding
What prokaryotic protein removes RNA primer and replaces it with DNA?
DNA polymerase I
Pt with marfanoid habitus and intellectual disability =
homocystinuria –usually results form cystathionine synthase mutation
Thrombosis and atherosclerosis
What makes heparin safe to use during pregnancy?
High water solubility –charged molecule
Myophosphoylase defects seen in McArdle disease causes failure of what?
Muscle glycogenolysis
What is the pathophys of exophthalmos seen with graves disease?
Increased Glycosaminoglycan deposition by orbital fibroblasts–increases osmotic muscle swelling–> muscle inflammation, and adipocyte count–> exophthalmos
Where is the location of stems cells for the intestinal mucosa?
Crypts of Lieberkuhn
The regenerative nodules seen in liver cirrhosis are composed of proliferating _________.
Hepatocytes
Cystic hygromas are most commonly associated with…
Chromosomal aneuploidy
Typically found on head and neck on left side
What would cause lactose intolerance in a middle aged women with Fhx of the dz?
Age dependent Decreased gene expression of lactase
Head and neck radiation causes increased risk of?
thyroid cancer
Fructose-2,6 BP regulates what?
Gluconeogenesis
Tetralogy of Fallot is characterized by cyanosis that worsens with…
Feeding
Crying
Exercise
Squat to improve blood flow–older children
APO B-48 is produced by…
Intestinal enterocytes
–which is a truncated form of APO B-100 which is produced by hepatocytes
What is the role of Probenecid when given with penicillin?
Inhibits secretion of penicillin–enhances efficacy of penicillin
Also used for gout–inhibits reabsorption of uric acid in PCT
What is the cause of cough syncope?
Increased intrathoracic pressure causing decreased venous return transiently decreasing CO and cerebral perfusion
Increased estrogen levels can be seen in pts with cirrhosis. What symptoms can this cause?
Spider angiomas--Characterized by central feeding arteriole surrounded by multiple smaller vessels that radiate outward Palmar erythema Gynecomastia Testicular atrophy Dupuyren's contractures Decreased body hair
What is the purpose of using paclitaxel in drug-eluting stents?
Decreases stent thrombosis by inhibiting intimal hyperplasia
–binds microtubules in M phase so that mitotic spindle cannot break down–causing cell cycle to remain in M phase –prevents microtubule breakdown
What causes an increase of glucose into skeletal muscle and adipose when insulin is released?
Insulin binds tyrosine kinase receptor on cell membrane–activation of PI3K pathways causes GLUT4 transporters to be translocated to the cell membrane of the skeletal muscle cells and adipocytes–leading to an increase in transport of Glucose into these cells
When insulin is depleted the GLUT4 is re-internalized via clathrin-coated pits
Lynch syndrome is caused by mutations in DNA mismatch repair genes that result in
Microsatellite instability
What are the 3 primary vesicles for the developing brain?
Forebrain–proencephalon–> Telncephalon/Diencephalon (secondary)
Midbrain–mesencephalon–> Mesencephalon
Hindbrain–Rhombencephalon–> Metencephalon/Myelencephalon
What are the structures perforating the diaphragm and at what levels?
I (IVC) ate (8) ten (10) eggs (esophagus) at (aorta) twelve (12)
T8–IVC
T10–esophagus and vagus–CN10
T12–Aorta (red), Thoracic duct (white), azygos vein (blue)
How does Von Gierke disease present and what enzyme is deficient?
Severe fasting hypoglycemia, increased glycogen in liver, increased blood lactate, increased TGs, increased uric acid (Gout), and hepatomegaly
Caused by Glucose-6-phosphatase deficiency–impairs release of free glucose generated through glycogenolysis and gluconeogenesis
Hypoglycemia does NOT improve with administration of fructose or galactose
What is vasogenic edema?
Infarction and/or neoplasm within the brain can destroy the endothelial cell tight junctions–> increased vascular leakage into the cerebral interstitium contributes to elevated intracranial pressure
What are causes of Nephrogenic DI?
Hereditary--ADH receptor mutaiton Hypercalcemia Hypokalemia Lithium Demeclocycline--ADH antagonist
