Block 3 Flashcards
Foramen rotondum transmits >
Foramen ovale transmits>
Optic canal transmits>
- Foramen rotundum transmits V2 (maxillary branch of CN V)
- foramen ovale transmits V3 (mandibular nerve)
- optic canal transmits optic nerve CN II
In case of Vit D excess (compensation)
Cycle shift towards 24,25 dihydroxycholecalciferol instead of 1,25 . This leads to inactive form of vitamin D
Cough in ACEI cause:
ACE normally degrades bradykinin and substance P. Inhibition of ACE leads to elevated bradykinin and substance P levels –> nonproductive cough
Intrapartum ampicillin is given in
- universal prenatal screening for group B streptococci colonization in vagina and rectum is recommended at 35-37 weeks of gestation.
- in women who culture positive for GBS or in women who have had infant infected with GBS before intrapartum antibiotic prophylaxis is indicated.
MAC (minimal anesthetic concentration)
This term is used in inhaled anesthetics, is defined as the concentration of inhaled anesthetic at which 50% of the patients do not respond to surgical stimulus.
- the more lipid soluble the anesthetic the lower the MAC and the greater the potency.
Carcinoid tumor treatment
Octerotide for symptomatic patients, surgery for liver metastases
Organophosphate intoxication signs and symptoms
DUMBELS
- Diarrhea, diaphoresis
- Urination
- Miosis
- Bronchospasm and Bradycardia
- Emesis
- Lacrimation
- Salivation
Chronic bronchitis effect on airways and mucus
- airway inflammation
- mucus hypersecretion
Effect of solubility on the onset of gas anesthetic
Poorly soluble gas = low blood/gas coefficient
Highly soluble gas = high blood/gas coefficient
- the speed at which the blood becomes saturated depends on the solubility of the gas in the blood. Highly soluble anesthetics dissolve easily and requires larger amounts before blood becomes saturated.
-
Symptoms of advanced aortic stenosis include
Syncope, angina, dizziness or heart failure
Carcinoid syndrome features
Clinical:
Skin: flushing, telengectasis
GI: watery dirrhea,cramping
Pulmonary : bronchospasm, dyspnea, wheezing
Cardiac: valvular fibrous plaques ( right> left)
Diagnosis:
Elevated 24 hrs urinary excertion 5-HIAA , CT/MRI of abdomen and pelvis to localize tumor
White reflex in the eye indicates ->
Retinoblastoma
Acute HIV presentation
Rash, lymphadenopathy, fever , and painful oral ulcers on tongue.
Cavernous hemangioma
- Vascular malformation, involves the deeper tissues of the body such as liver and brain.
- gross exam: “mulberry-like” appearance due to their purple vascular clusters.
- Histologically: they are composed of abnormal, dilated blood vessels with a thin adventitia lacking elastic fibers and smooth muscle.
- reduced structural support gives them a tendency to leak causing recurrent hemorrhage.
Medications associated with osteoporotic fracture
- Anti convulsant that induce CYP450 (phenobarbital,phenytoin, carbamazepine) . (Increase VIT D catabolism)
- aromatase inhibitors and medroxyprogesterone ( decrease Estrogen)
- GnRh agonist (decrease testosterone and estrogen)
- glucocorticoids, unfractioned heparin and thazolidineiones (decrease bone formation)
Acne pathophysiology and association
Cause are:
1. Follicular epidermal hyper proliferation
2. Excessive sebum production
3. Inflammation
4. Propionibacterium acnes
Drugs: methyltestosterone, lithium and HER-1 receptor blocker
Pneumonia with non-productive cough
M.pneumoniae
Hyper-acute rejection occurs within
- Minutes of transplantation. Performed antibodies against ABO or HLA are the cause.
- Graft blood vessel spasm and diffuse intravascular coagulation with ischemia.’
Cataracts in diabetes
- sorbitol accumulation increase cellular osmotic and oxidative stress
- contribute to diabetic retinopathy, neuropathy and nephropathy.
- in lens cells the increased stress leads to development of hydropic lens fibers that degenerate eventually resulting in lens opacification and cataract formation
How are NK cells activated
By interferon gamma and IL-12
What is frameshift mutation
Frameshift mutation are caused by deletion or insertion of any number of nucleotides that are not multiples of 3. This leads to the formation of entirely different protein as all amino acids after the affected area are pushed and changed .
Pralidoxime
Anti cholinergic that can be given in the early course of organophosphate intoxication. can act on muscarinic and nicotinic receptors
Alanine to pyruvate , enzyme and requirement
Enzyme is alanine transaminase (ALT)
And requirement are vitamin B6
Perforins and granzymes mechanism of action.
Perfoirn produce a hole in the target cell membrane and granzyme induce target cell apoptosis
Oculomotor nerve palsy, along with worse headache of my life
- posterior communicating cerberal artery saccular(berry) aneurysm.
- pcca is between MCA and PCA(image)
Single sarcomere is between ?
Two Z lines
Saccular aneurysm
Berry aneurysm
Farmers and agricultural workers are exposed to
Oraganophosphate intoxication –> excessive amounts of pesticides
Legionella diagnosis
- sputum diagnosis is unreliable –> many neutrophils and no colonies, since unique lipopolysachharides chain on outer membrane inhibits gram staining
- diagnosis is most commonly made by testing for legionella antigen in urine.
Vitamin B5 pantothenic acid
Essential for CoA
B6 is required for
ALT and AST, heme ,NE and epinephrine, dopamine, GABA, niacni , histamine, serotonin, , glycogen synthesis.
Rates of onset and recovery after inhaled anesthesia depends on;
Blood-gas ratio:
- The more soluble the anesthetics in blood- the slower the anesthesia.
- anesthetics with high blood/gas ratio are associated with slow onset
- anesthetics with high blood/gas ratio are associated with slow recovery
- low blood/gas ratio = faster onset and recovery.
Aldose reductase function
- Glucose –> sorbitol
2. Galactose –> galactitol
COPD signs
Wheezing, diminshed breath sound, barrel shaped chest
Cavernous hemangioma in the brain - clinical
- most patients are assymptomatic
- may cause neurological deficits and seziures due to compression of the surrounding tissue and irritation from recurrent bleeding.
- surgery indicated in case of symptoms
Superior fissure contain
Oculomotor nerve, CN VI, CN IV, V1(ophthalmic nerve)
Gustatory innervation
Anterior 2/3 : chorda tympani branch of facial nerve
Posterior 1/3 : glossopharyngeal
Posterior area of the tongue root, and taste buds of larynx and upper esophagus : vagus nerve
Diffusion impairment
Not common cause of hypoxemia, occurs in patients with end stage interstitial lung disease
Acute rejection
- occurs within 1-2 weeks after receiving the transplant. Its the recipient reaction to HLA of the graft. This is cell-mediated immune response, and CD8 T cells play a central role.
- in lung transplant acute rejection manifests with dyspnea, dry cough and low grade fever.
- immunosuppressant can prevent