Block 6 Flashcards
Describe the clinical presentation of a patient with adenomyosis
UNIFORMLY enlarged uterus, dysmenorrhea[menstrual cramps], heavy menstrual bleeding
Differentiate adenomyosis from endometrial hyperplasia clinically.
Adenomyosis will be painful and irregular muenstrual cycles, while endometrial hyperplasia will be non-painful, usually presenting as postmenopausal vaginal bleeding.
Why is salmonella typhi so much more virulent that salmonella enteridis?
Salmonella typhi has the Vi virulence capsule that decreases neutrophil recruitment and phagocytosis, also preventing the macrophages from have the oxidative burst kill the bacteria. Thus typhi can actually survive and replicate inside the macrophages, and then disseminate into the lymphatics and RES.
Which enzyme increases in lesch-nyan disease?
PRPP amidotransferase
what opthalmological findings would you see in a noncompliant HIV patient with CMV retinitis.
Fluffy, yellow-white retinal lesions associated with hemorrhage.
What class of antibodies are found in the serum of type A or type B patients?
IgM
What class of antibodies are found in the serum of type O patients? What is the complication of this in pregnant women?
IgG usually. If type O mom and different type baby, then hemolysis can actually occur
What are the neoplasms associated with Von hippel lindau disease?
RCC, hemangioblastoma, pheochromocytoma
What is the function of procollagen peptidases in collagen synthesis?
They cleave the terminal propeptides [N and C terminals] in procollagen, allowing the collagen to become insoluble extracellularly
What is the repetitive amino acid sequence of collagen molecules?
Gly-X-Y
What is the WDHA syndrome?
It can be the result of a VIPoma causing watery diarrhea, hypokalemia and achlorhydria.
What are the side effects of SSRIs?
mania, sexual dysfunctions, SIADH, serotonin syndrome, GI distress, drowsiness
Describe the usage of trastuzumab?
Use as monoclonal antibody in HER2 + breast cancer and gastric cancer
Where do the glans penis and the skin of the posterior calf drain their lymph nodes?
Deep inguinal nodes
What are the structures that drain lymph into the superficial inguinal lymph nodes?
area surrounding anal canal, most skin below umbilicus and external genitalia
Name all the bacteria that can lead to a post-infection reactive arthritis
campylobacter, shigella, salmonella, yersinia, C. Difficile and chlamydia trachomatis, bartonella
What are the differences between nitroprusside and nitrates.
Nitroprusside- used in hypertensive emergencies, increases vasdilation of large veins and large arteries by producing NO and increased cGMP
Nitrates- used in angina, acute coronary syndrome, pulmonary edema. causes smooth muscle relaxation and venodilation in large veins selectively. Metabolized to nitric oxide and s-nitrosothiol
What is one of the most modifiable risk factors for falls.
Medication
What are the side effects of the first generation histamine blockers?
Sedation [because of the histamine blockade], antimuscarinic [blurry vision, loss of accommodations] and anti alpha adrenergic effects
What is the distinctive histology in babesiosis?
Maltese cross ring shaped intraerythrocytic inclusions
How does conversion of non-toxigenic diphtheria strain to a toxigenic diphtheria strain occur?
This occurs through the lysogenic bacteriophage called corynephage beta that inserts the tox gene resulting in the expression of the diphtheria AB toxin
What process does Strep pneumoniae use to gain capsule?
Transformation
What is a heparin-specific antidote?
protamine
What is the effective treatment for a rat poison ingestion following 48 hours? Why?
Fresh frozen plasma because we need to replenish vitamin K dependent clotting factors that were depleted due to warfarin toxicity
What structures are derived from the ventral pancreatic portion? What about the dorsal portion?
Ventral- main pancreatic duct proximal portion, uncinate process and portion of pancreatic head
Dorsal- tail, body, head, small accessory pancreatic duct
what is the difference between a mallory-weiss tear and a boarhaave tear?
Mallory-weiss tear is a mucosal tear in the esophagus while boarhaave tear is a transmural tear in the esophagus
What causes the esophageal dysmotility in CREST syndrome?
atrophy and fibrous replacement of muscularis in lower esophagus—> fibrous strictures, dilation, atonia, GERD and possible barrett’s
Where does the thoracic duct drain lymph from?
Entire left side of body and everything below umbilicus
What is the difference between incidence rate and cumulative incidence?
Incidence rate is the rate of new cases among all the people AT RISK per unit time.
Cumulative incidence does not take time into the denominator
