April 4 Flashcards
What abx allow bacterial cells to be susceptible to osmotic stress causing them to burst?
B-lactam abx–penicillins, cephalosporins and vanco
What statistical test is used to determine whether there are any significant differences btw the means of 3 or more independent groups?
Analysis of variance (ANOVA)
What is the cause of the disease that presents with intellectual disability, post-pubertal macroorchidism, long face with a large jaw, large everted ears, autism, mitral valve prolapse and often hyper laxity of the joints in the hand?
Fragile X syndrome–due to loss-of-function mutation in the FMR1 gene on long arm of CH. X
Postop hypoparathyroidism with resultant hypocalcemia should be treated with what?
Oral Ca and Vit D –calcitriol– 1,25 D3
What is released from Sertoli cells that cause inhibition of FSH?
Inhibin B–which is negative feedback causing inhibitor of FSH
1 gram of protein yields ___ Cal of energy?
4
Carbs are the same and 9 Cal of energy per gram of fat
Long term glucocorticoid therapy causes an increase in what within the liver?
Gluconeogenesis and glycogenesis –contributes to hyperglycemia
Second generation antipychotics (atypical) have an increased risk of what and what should be monitored?
-pines–especially olanzapine and clozapine=increased risk of metabolic syndrome–weight gain, DM, hyperlipidemia
Monitor-lipid panal and glucose
What type of selection occur in the thymus that involves TCRs that bind with high affinity self antigen or self MHC class i or ii?
Negative selection–these cells that bind tightly are eliminated by apoptosis
Occurs in the medulla
Positive selection occurs 1st in the cortex
What translocation is present in 90% of follicular lymphomas and what does this cause?
t(14;18)—causes overexpresion of Bcl2–which inhibits apoptosis
Abnormal spasm or diminished relaxation of the cricopharyngeal muscles during swallowing (cricopharyngeal motor dysfunction) causes what?
Zenker diverticulum –pharyngoespohageal false diverticulum
What is seen with acute hepatotoxicity from inhaled anesthetics?
Elevated serum aminotransferase levels–due to massive hepatocellular injury
Prolonged PT–due to failure of hepatic synthetic function –deficiency of factor VII
Leukocytosis
Eosinophilia
What are the findings seen with congenital hypothyroidism (cretinism)?
Pot-pellied Pale Puffy-faced child with Protruding umbilicus Protuberant tongue Poor brain development
The 6 P’s
What is the 1st line treatment for arsenic poisoning which presents with abdominal pain, vomiting, severe watery diarrhea, delirium, and hypotension from dehydration–garlic odor can also be noted on pts breath?
Dimercaprol
Vitamin C is necessary for the hydroxylation of ____ and ____.
Proline and lysine in pro-collagen
Pt with lateral epicondylitis (tennis elbow) with have inflammation of what tendons, which can affect what muscles responsible for wrist extension?
Swollen extensor tendon–extensor carpi radialis brevis
What type of anemia results from B-thalassemia?
Microcytic, hypochromic anemia
What type of HSR is contact dermatitis?
Type IV HSR —mediated by T lymphocytes
Tissue damage and abscess formation is caused by what type of cells?
Macrophages and neutrophils–lysosomal enzyme release
What is inhibited with lead poisoning causing inhibition of heme synthesis?
d-ALA dehydratase
What is the purpose of a southwestern blot?
Identifies DNA-binding proteins–transcription factors, nucleases, histone–using labeled oligonucleotide probes
Bilateral wedge-shaped strips of necrosis seen in the cerebral convexity are indicative of what?
Hypoxic-ischemic encephalopathy
What enzyme is deficient in Niemann-Pick disease and how does it present?
Sphingomyelinase–buildup of sphingomyelin
AR disease that presents with progressive neurodegneration, heptosplenomegaly, foam cells (lipid-laden macrophages), and cherry-red spot on macula
When is pulmonary vascular resistance lowest?
At functional residual capacity –which is end of normal expiration
Fracture of the left 12th rib is most likely to damage what organ?
Left kidney
What is defective in Xeroderma pigmentosum?
Nucleotide excision repair–prevents repair of pyrimidine dimers because of UV light exposure
Pyrimidine dimers are formed in DNA as a result of UV exposure —these cannot be fixed by nucleotide excision repair in pt with XP
What is produced by the placenta to maintain a PDA?
Prostaglandin E2 –indomethacin can be given to close–PGE2 inhibitor
What stains can be used to stain for Cryptococcus neoformans?
India ink stain
Mucicarmine stain
What 2 things can decrease the concentration of stone forming ingredients (Ca, phosphate, oxalate salts)?
High fluid intake
High urine citrate concentration–binds free Ca (ionized)–preventing precipitation and facilitating its excretion
Potassium citrate can be prescribed to prevent stone formation
What diuretic can cause hypercalcemia and which one can cause renal stones?
Thiazides–hypercalcemia–decrease excretion of Ca
Loops–increased excretion of Ca–stones
Diseases caused by ‘exotoxin’ release by S. aureus–
Toxic shock syndrome
Staph scalded syndrome
gastroenteritis
What is the DOC for bulimia nervosa?
SSRI–Fluoxetine
Why is hypokalemia seen with loops and thiazides?
Increased renin and aldosterone–increased K+ secretion
–can cause EKG changes and muscle pain
What are the common associations with psoriasis?
Psoriatic arthritis
Nail pitting
Uveitis
What are the most characteristic signs of marijuana intoxication?
Conjunctival injection
tachycardia
increased appetite
dry mouth
Widening the pressure-volume loop to the left results in…
Increased contractility
- -increased SV
- -increased EF
- -Decreased ESV
Widening the pressure-volume loop to the right results in…
Increased preload
–increased SV
Narrowing the pressure-volume loop and increasing LV pressure results in?
Increased after load
- -increased aortic pressure
- -decreased stroke volume
- -increased ESV
What are the causes of Vit A deficiency and how does it present?
Biliary obstruction
Exocrine pancreatic insufficiency
Small bowel resection
Night blindness
Dry, scaly skin
Corneal degeneration
What does Metyrapone stimulation test block and what does it cause if pt has intact hypothalamic-pituitary axis?
Blocks last step of cortisol synthesis (11-deoxycortisol–>cortisol)
Decreased cortisol will increase ACTH, 11-deoxycortisol and urinary 17-hydroxycorticosteroid levels
Primary adrenal insufficiency–increased ACTH but decreased 11-deoxycortisol
secondary/tertiary –Both ACTH and 11-deoxycortisol remain decreased after test –Pituitary/hypothalamic disease
Pulmonary-capillary wedge pressure is an indirect measure of what?
Left atrial pressure
What are the common inducers of CYP-450?
Phenytoin Phenobarbital Rifampin Griseofulvin Carbamazepine
What are the common inhibitors of CYP-450?
Ritonavir Cimetidine Ciprofloxacin -Azoles Isoniazid Grapefruit juice Macrolides--except azithromycin
What makes up the hindgut and what artery supplies it?
Distal 1/3 of transverse colon to upper portion of rectum
Supplied by IMA
What cells cause fatty streaks in the aorta that can be seen as early as the second decade?
Macrophages–foams cells in the intima that can eventually progress to atherosclerotic plaques
Isoproterenol has what effects?
B1=B2
Causing increased contractility and decreased vascular resistance by smooth muscle relaxation (B2)
Increased CO, HR, PP
Decreased MAP
“Red neurons” characterized by intense eosinophilic staining of the cytoplasm + Nissl substance disappears indicates damage that occur when?
within the last 12-24hrs
There are fast and slow _______ for liver metabolism of drugs?
Acetylators
In males, incomplete closure of the urethral (urogenital) folds results in?
Hypospadias–abnormal opening of the urethra proximal to the glans on the ventral surface
