Block 6 Flashcards
Painless hematuria 2-3 days following an upper respiratory tract infection.
Diagnosis is made by detection of IgA deposits in mesangium of glomeruli on immunofluoresence microscopy.
Cola colored urine.
IgA nephropathy (Berger disease)
IgA nephropathy w/ extra-renal syndrome
Skin: purpuric lesions on extensor surfaces of arms, legs, buttocks
GI: ab pain, vomiting, intestinal bleeding, intussusception
Renal: IgA nephropathy
Henloch-Schonlein disease
filtration fraction equation
FF = GFR/RPF
where RPF = RBF*(1-hematocrit)
what amino acids is elastin made up of?
non-polar amino acids: glycine, alanine, valine
also contains proline and lysine
what happens to tropoelastin once it is in the extracellular space?
side chains of some of the lysine residues are covalently bound to form a desmosine crosslink
what accounts for elastin’s resilient properties?
extensive desmosine crosslinking (interchain crosslinks involving lysine)
in what patients do you see acyclovir resistant VZV (thymidine kinase deficient) and what do you treat it with instead?
tends to only be in AIDS patients
treat with cidofovir because it only requires cellular kinases for activation
describe the mechanisms of acyclovir, valacyclovir, famciclovir, and ganciclovir
they are all nucleoside analogs that require both herpes viral and cellular kinases for conversion to their active nucleoside triphosphate form
what nerve transmits information from the carotid sinus to the solitary nucleus of the medulla?
glossopharyngeal nerve
what are the effects of doing vagal maneuvers such as carotid sinus massage and valsalva?
increase in parasympathetic activity and decrease HR through increase in AV node refractory period
describe the pathogenesis of Crohn’s disease
increased activity of Th1 helper cells –> increased production of IL-2, IFN-gamma, and TNF causing subsequent intestinal injury.
Non-caseating granulomas are characteristic
crypt abscesses and ulcers, bleeding, no granulomas, Th2 mediated
ulcerative colitis
G-protein-linked receptors whose actions are mediated through various secondary messenger pathways
One identified pathway involves increased potassium efflux
mu opioid receptors
binding of morphine to mu receptors results in…
G protein-coupled activation of K+ conductance causing hyperpolarization of post-synaptic neurons, blocking pain transmission
what causes bile precipitation and biliary sludge?
gall bladder hypomotility
an integrase inhibitor that disrupts the ability of HIV to integrate its genome into the host’s chromosomes, thus preventing host cellular machinery from being used to synthesize HIV or mRNA
raltegravir
what should you think with the following scenario:
a depressed patient who is getting treatment presents with hypotension, tachycardia, QRS prolongation, frequent premature beats
TCA overdose, which has quinidine-like effect on heart
antidote to TCA overdose
hypertonic sodium bicarbinate (NaHCO3)
results from an acquired mutation in the PIGA gene that causes absence of the GPI anchor and associated deficiency of CD55 & CD59 complement inhibitor proteins
causes anemia from complement activation
paroxysmal nocturnal hemoglobinuria
what is the triad seen in paroxysmal nocturnal hemoglobinuria?
1) hemolytic anemia
2) hypercoagulability
3) pancytopenia
HIV gag gene
group-specific antigens in virion core, nucleocapsid proteins p24 and p7
HIV pol gene
reverse transcriptase, integrase, protease
HIV env gene
envelope glycoproteins gp120 & gp41
structural genes of HIV
gag, pol, env
regulatory genes of HIV
tat, rev, vif, vpr, nef, vpu
tat and rev are required for relication, the rest are not and are considered accessory genes
in patients with essential fructosuria (fructokinase deficiency), what is the primary method of metabolizing dietary fructose?
metabolism of fructose by hexokinase to fructose-6-phosphate
what is required for allergens to cause degranulation?
cross-linking of 2 IgE molecules on the surface of the cell by one molecule of allergen
digoxin’s side effects
- AV block leading to escape beats –> ventricular tachyarrhythmia
- hyperkalemia
- fatigue, blurry vision, changes in color perception, nausea, vomiting, diarrhea, ab pain, HA, dizziness, delerium
characterized by medullary carcinoma of the thyroid, pheochromocytoma, and oral and intestinal mucosal neuromas
MEN2B
what is MEN2A associated with that MEN2B is not?
MEN2A is associated with parathyroid hyperplasia
delayed type hypersensitivity reactions (DTH)
examples: contact dermatitis, granulomatous inflammation, TB skin test, candida extract skin reaction
mediated by Th1-lymphocytes that release IFN-gamma to cause recruitment and stimulation of macrophages
take days to reach their peak activity
