Block 9 Flashcards
Retroperitoneal organs
Organs are :SAD PUCKERS Suprarenal gland Aorta and IVC Duodenum 2-4th parts Pancrease Ureter and bladder Colon (ascending and desencding ) Kidneys Esophagus Rectum (mid-distal)
Ovary epithelium
Cuboidal cell epithelium
Lumacaftor
Drug used in CF , it can partially correct the folding defect –> expression of functional CFTR.(in patients who have F508del mutation)
Reoviridae
Colorado tick fever
-rocky mountain states, charactrized by fever, vomiting , mylagia and weakness
Neagleria fowleri :
Causes rapid meningoencephalitis with a high mortality rate. Its found in fresh water, and transmission occurs through nasal inhalation during recreational activities (swimming,diving).
-symptomatic encephalitis, also taste and smell abnormalities. Inflammation in temporal and facial lobes, brain stem and meninges.
C-myc is
Transcription activator , the product of c-myc is a nuclear phosphoprotein that functions as a transcription activator controlling cell proliferation, differentiation and apoptosis.
Epithelium in genital tract
Ovary-> simple cuboidal
Fallopian tube,uterus , –> simple coulmnar
Cervix -> ectocervix -> stratified squamous non-keratinized
Endocervix –> simple cpulmnar’
Vagina -> stratified squamouse non keratinized.
Injury to intraperiotneal organs can lead to
Intraperitonieal bleeding (not hematoma)
Iron deficiency anemia : blood results
- Low ferritin values
- High Iron binding capacity / high transferrin
- Low MCV
- Decreased serum iron
- Decreased hemoglobin
- Microcytic microchromic
7.
TT measure
Thrombin time, measure the rate of conversion of fibrinogen to fibrin. Low in liver diseases. (Acquired dysfibrinogenemia in liver disease MCC)
Gullain barre syndrome
- ascending paralysis
- usually preceded by respiratory infection of GI infection.
- acute demyelinating disease with an immune mediated pathogenesis.
- antibodies against infectious ag’s cross react with mylin of spinal roots and PNS–> demylination.
- demyliniation leads to flaccid paralysis, areflexia, paralysis of respiratory muscles may occur as can paralysis of CN such as CN VII (bell palsy).
- CSF have increased proteins with normal or slightly elevated cell count.
Sarcoidosis, clinical, diagnosis
Inflammatory disease of unknown etiology, non-caseating granulomas.
- consist of epithelopoid cells (activated macrophages).
- multi-nucleated giant cells consistent with chronic granulomatous inflammation.
- typical patient: african american, non specific symptoms, lung involvement present in majority of patients.
- skin involvement : erythema nodosum (painful shin nodules).
- chset X-ray is essential for diagnosis.
X-linked agammaglobulinemia
Bruton tyrosine kinase gene causes failure of bone marrow pre B cells to develop into mature, circulating B lymphocytes. Patients have low or absent B cells.
- as a result they are at increased risk of infection with pyogenic (encapsulated ) bacteria. Also increased risk to viral infections such as enterovirus and giardia lamblia (parasite)
Xeroderma pigmentosum- defect in, clinical
- AR, extreme sensitivity to sun light, skin freckling ,ulcerations, and skin cancer.
- carcinomas and melanomas occurs early in life and most patients die of them.
- the most common deficiency is in excision endonuclease
- diagnosis is done by measuring the relative enzyme excision endonuclease in white cells of blood.
Ezetimibe
Decreases intestinal absorption of cholesterol by inhibiting the niemann pick C1- like 1 transport protein (NPCL1), which transport dietary cholesterol from GI lumen into intestinal entrocytes. As a result the total amount of dietary cholesterol reaching the liver increased LDL receptor expression, which draws cholesterol out of the circulation.
Craniopharyngyoma-microscopy
Rare, slow growing (benign ) intracranial tumors found in children and typically located Suprasellar location.
Microscopy shows: cystic, or partially cystic, usually filled with brownish yellow, viscous fluid that resembles machine oil due to the presence of protein and “cholesterol crystals”.
-dystrophic calcification of cyst is highly characteristic and may be detected on neuroimaging.
- cysts are lined by cords/nests of stratified squamous epithelium with peripehral palisading and internal areas of lamellar wet keratin.
Platelet function analyzer (PFA-100)
Monitors the time needed for patients blood to form a platelet based hemostatic plug in vitro.
Abnormal results are present in vWD, NSAID use and thrombocytopenia.
Anatomic area supplying stomach - prone to bleeding
- Proximal lesser curvature: left gastric
- Distal lesser curvature: right gastric
- Proximal greater curvature : left gastroepiploic (from splenic)
- Distal greater curvature : right gastroepiploic (from gastrodudenal)
- Proximal greater curvature above splenic artery : short gastric artery – > splenic
Ranibizumab ,bevacizumab
Anti VEGF – used to treat wet AMD and inhibit angio-genesis in cancer.
Asthma and COPD inflammatory cells
COPD: neutrophils, MAC, and CD8 T cell
Asthma : CD4+, eosinophils
Plantar wart
Warts, usually on the foot, caused by HPV 1,4 and have no malignant potential and doesn’t increase risk for CIN or CIS
Thoracic outlet syndrome
Compression of the lower trunk of the brachial plexus as it passes through the thoracic outlet causes (TOS) and present with upper extremity numbness, tingling and weakness. In addition, compression of the subclavian vein can cause upper extremity swelling whereas compression of the subclavian artery can cause exrertional arm pain .
-TOS most commonly occurs within scalene triangle, the brachial plexus and subclavian trunk passes between the anterior and middle scalenes , it can be due to anomalous cervical rib, scalene muscular anomalies or injury
Leydig cells
(Similar to theca cells )
-produces Testosterone in response to LH.
GnRH–> LH–> Leydig cells–> testosterone –> (-) feedback —> inhibit the axis
Milrinone indication
Inotropic agent in patients with refractory HF due to LV systolic dysfunction.
Dilated CM
Galactosemia vs hereditary fructose intolerance
.galactose is present in breast milk so as soon as breast feeding initiated –> symptoms , while fructose intolerance is manifested after 6 months ( after other foods are introduced in diet)
Deficiency in IFN-¥
-same mechanism as in IL-12. Receptor deficiency.
Autosomal recessive deficiencies of the IFN-¥ receptor result in disseminated myobacerial disease in infancy or early childhood, including disseminated infection by the BCG vaccine strain if administered. Once identified these require lifelong treatment with antimycobacterium antibiotics
Lynch syndrome is a consequence of
AD syndrome.
Nucleotide mismatch that escapes repair .
- the mismatch repair system involves several genese including MSH2 and MLH1–> codes for MutS and MutL homologs. –> mutation in these –> 90% of cases of lynch syndrome.