Block 1 Flashcards
Equation for TPR using MAP, right atrial pressure, and CO
TRP = (mean arterial pressure - right atrial pressure)/CO
In multiple myeloma, what do oyu see in the plasma cells due to an accumulation of immunoglobulin?
Russell bodies
In which disease do you see a “mosaic pattern of newly formed woven bone”
Paget’s disease
Paget’s disease puts patients at risk for what cancer?
osteosarcoma
How is the S3 sound best heard and why?
At apex with the bell while pt is in left lateral decubitus position and fully exhaled
Decreased volume in lungs brings the heart closer to the chest wall
What is JAK2?
A non-receptor tyrosine kinase associated with the erythropoietin receptor
In which disease is there mutations in JAK2 that cause constitutive kinase activation resulting in increased production of red blood cells
polycythemia vera
What is the Hawthorne effect?
It’s the tendency of study subjects to change their behavior as a result of their awareness that they are being studied
What is the Pygmalion effect?
Describes the fact that a researcher’s beliefs in the efficacy of treatment can potentially affect the outcome
Describe the shunting pathway seen in esophageal varices
Shunting of portal blood from left gastric vein to the esophageal vein (systemic)
What glands are unique to the duodenum and secrete alkaline mucous into ducts that track upward through the muscularis mucosae and into the crypts of Lieberkuhns and into the lumen?
Brunner’s glands
These lymphoid aggregates are specific to the ileum
Peyer’s patches
Peyer’s patches are specific to the ______.
Brunner’s glands are specific to the _______.
Peyer’s patches = ileum
Brunner’s glands = duodenum
Name 2 types of eukaryotic promoter regions
TATA/Hogness box
CAAT box
This promoter region is found 25 nucleotides upstream
TATA/Hogness box
This promoter region is found 70-80 bases upstream
CAAT box
Where are enhancers and repressors located relative to genes?
Upstream, downstream, near or far from genes –> variable locations
Langhans giant cells are formed from what?
Activated macrophages (epithelioid cells)
What is the ureteric bud a precursor for?
The caliceal system and ureters
When and from what does the adult kidney form?
It forms by the 5th to 6th week of gestation from the uteric bud (metanephric diverticulum)
What is the last segment of the fetal ureter to canalize?
Ureteropelvic junction
What is the most common site of obstruction in the kidney?
Ureteropelvic junction
In type-1 diabetes, what causes the destruction of beta cells?
Primarily through cell-mediated immunity (antibodies against islet antigens are detected)
Which are more common: duodenal ulcers or gastric ulcers?
Duodenal ulcers
Anterior duodenal ulcers result in what?
Perforation
Posterior wall ulcers results in what?
Hemorrhage of the gastroduodenal artery
What do you palpate when administering pudendal nerve blocks?
palpate ischial spines
What nerve is derived from S2-S4 and provides sensory innervation to the perineum and genitals as well as motor innveravtion to sphincter urethrae and the external anal sphincter?
pudendal nerve
MOA of ondansetron, granisetron, dolasetron?
5-HT3 receptor antagonists
Which drug class is highly effective in preventing chemo-induced vomiting and why?
5-HT3 receptor antagonists because they block vagus mediated nausea and vomiting and block serotonin in the chemoreceptor zone
What is the equation for flow?
Flow (Q) = (P1 - P2)/R
where R = (viscocity)(length of vessel)/r^4
What is the compensatory mechanism to increases in capillary fluid?
Increases in tissue lymphatic drainage that occurs due to increased interstitial fluid pressure
What vitamin serves as an essential cofactor for transaminases (reactions that typically occur between an amino acid and an a-keto acid)?
pyridoxal phosphate (vitamin B6)
What happens to bicarbonate in metabolic acidosis?
bicarbonate is completely reabsorbed from tubular fluid in acidotic states
What happens to urine during metabolic acidosis?
Urinary pH decreases due to increased excretion of free H+, NH4+, and H2PO4-
Where are intracranial schwannomas located and what nerves can they affect?
Most commonly located at the cerebellopontine angle, found between cerebellum and lateral pons
They can affect CNs 8, 7, 5
Describe the mechanism of acyclovir
Acyclovir is converted into acyclovir monophosphate via virus encoded thymidine kinase. The monophosphate is converted into acyclovir triphosphate which is incorporated into the viral DNA chain and DNA synthesis is terminated
Describe malassezia furfur
Hypo/hyperpigmented skin patches that become more visible with sun tan
What should you suspect if a patient from Central or South America presents with achalasia?
Trypanosoma cruzi
Mutations in which genes are responsible for emergence of HIV protease variants that are resistant to standard protease inhibitors?
Pol genes of HIV
Neutropenia is seen in about 1% of patients on this drug and typically presents with fever and mouth ulcers. Name this drug
ticlodipine
1st and 2nd most common causes of SCID
Most commonly X-linked
2nd most common = adenosine deaminase
Describe adenosine’s cause of SCID
adenosine accumulation is toxic to lymphocytes and leads to widespread death of both T and B lymphocytes
All Burkitt’s lymphoma are associated with what genetic abnormality?
c-myc translocation on chromosome 8
t(8;14) involves…
the heavy chain gene locus
t(8;22) involves…
the lambda light chain gene locus
t(2;8) involves…
the kappa light chain gene locus
what is phenazopyridine?
an analgesic with special properties that can provide pain relief in the GU tract
where do carcinoid tumors commonly metastasize to?
the liver
malignant skin tumor that forms “pearly papules” on sun-exposed skin, palisading of the basal cell-like nuclei at the edge of clusters of cells penetrating into the dermis
basal cell carcinoma
bengin, hyperplastic cells that have a basaloid appearance, pseudo-horn cyst formations, in which small cystic spaces with keratin formation are seen in the epidermis
seborrheic keratoses
what are Roth spots?
fundoscopic lesions/areas of retinal ischemia commonly due to emboli from bacterial endocarditis
1-cm, waxy, flesh colored lesions with a rolled edge, telangiectasias, and central ulceration
nodular basal cell carcinoma
what happens if you adminster epinephrine after administration of an alpha-receptor antagonist like phentolamine?
there’s only beta stimulation, so you get increased vasodilation
what are ICAM-1 and LFA-1 necessary for?
diapedesis (passage of cells through intact walls of the capillaries
this tumor has pale-staining, rod-shaped inclusions known as crystal of Reinke and may produce androgens or estrogens
Leydig (interstitial) cell tumor
what is the inability to recognize despite adequate sensation?
agnosia
describe the visual ventral pathway/stream
the “what” pathway, projects to temporo-occipital association cortex
describe the visual dorsal pathway/stream
the “where” pathway, projects to pparieto-occipital association cortex
what is a Baker cyst?
popliteal cyst
from what vein does a hemorrhoid below the dentate line come from? is it painful?
below the dentate line:
PAINFUL
variscosities in the inferior rectal vein
inferior rectal vein –> pudendal vein –> internal iliac –> IVC
from what vein does a hemorrhoid avove the dentate line come from?
above the dentate line:
NO PAIN
variscosities in the superior rectal vein
superior rectal vein –> inferior mesenteric vein –> portal system
which selective COX-2 inhibitor can be used in pts with a history of ulcers?
celecoxib
patients with iron or vitamin B12/folate deficiency anemia may have falsely high levels of what?
falsely high levels of HbA1c (seen with low red cell turnover)
what type of epithelium covers the esophagus?
nonkeratinized, stratified, squamous epithelium
describe the musculature of the esophagus
upper 1/3: skeletal
middle 1/3: skeletal/smooth
lower 1/3: smooth
X-linked condition characterized by thrombocytopenia, immunodeficiency, and eczema (TIE).
platelets are small, have a shortened half-life, and are deficient in CD43.
serum IgM decreased, serum IgE increased
mutation in WASP gene
Wiskott-Aldrich syndrome
this drug is good at treating aspiration pneumonia in alcoholics, lung abscesses, and oral infections, as well as anaerobic infections above the diaphragm
clindamycin
name three big side effects of carbamazepine
bone marrow suppression (agranulocytosis)
hepatotoxicity
may cause SIADH
what is Ebstein’s anomaly?
characterized by apical displacement of tricuspid valve leaflets, decreased volume of the righ ventrical, atrialization of the right ventricle
what is rituximab?
a monoclonal antibody used in lymphoma immunotherapy that specifically targets the CD20 surface immunoglobulin
most common neurological complication of VZV infection?
localized dermatomal pain that persists for more than one month after a zoster eruption
what does lithium therapy do to kidneys?
reduces the ability of the kidneys to concentrate urine primarily by antagonizing the action of ADH in collecting tubules and ducts
what are calcipotriene, calcitriol, and tacalcitol and what are they used for?
topical vitamin D analogs, frequently used to treat psoriasis, they inhibit keratinocyte proliferation and have shown to inhibit T cell proliferation
what heart abnormalities are associated with Turner syndrome (45, XO)?
aortic coarctation, bicuspid aortic valve
