Clues From Heather Flashcards
Corticosteroid (= prednisone) therapy can increase which type of WBC?
Neutrophils
Steps for Granuloma formation
Pathogen (= TB) triggers CD4+ T cells to release IFN gamma
IFN gamma activates macrophages
Macrophages differentiate into epithelioid histiocytes
Epithelioid histiocytes join with horseshoe-shaped, multinucleated Langhans giant cells to form granuloma
(Langhans giant cells = fused, activated macrophages)
What interleukin is produced by CD4, CD8, and NK cells?
IL-2
Strong pro-inflammatory & some anti-inflammatory
High-dose IL-2 used in treatment of advanced renal cell carcinoma & metastatic melanoma.
-> can lead to long-lasting remission d/t increased cytotoxic activity of NK cells against the tumor
PTH function in bones
Indirect activation of osteoclasts
-> increase bone resorption
Releases Ca and phosphorus
PTH function in kidneys
Decr reabsorption of phosphate in PCT
Incr reabsorption of calcium in DCT and CD
Upregulates 1-alpha-hydroxylase => more active vit D (1,25-hydroxyvitamin D)
Causes of Relative erythrocytosis
(Normal RBC mass)
Dehydration
Excessive diuresis
(Incr total RBC mass indicates absolute erythrocytosis)
Causes of Absolute erythrocytosis
(True increase in RBC mass)
Polycythemia Vera
- all 3 cell lines increase
Secondary erythrocytosis
- only RBC increases, but platelets and WBCs are normal
- d/t hypoxia or EPO-producing tumors
Kinesin
- what is it?
- function?
- example?
Microtubule-associated ATP-powered motor protein
Facilitates anterograde transport towards “plus” end of microtubules
EX: NT-containing secretory vesicles down axons to synaptic terminals
Alternative Dx, presenting with:
- solitary brain lesions
- HIV/AIDS or immunocompromised
- low CD4+ count
- high viral load
Primary CNS lymphoma (= non-Hodgkin lymphoma)
- most common for all S&Sx listed
Others:
Bacterial abscess
Cerebral toxoplasmosis
Primary brain tumors (= glioblastoma)
Metastatic lesions
5 Steps of urea cycle
1) entry into urea cycle
- create carbamoyl phosphate
- substrates = HCO3 & NH3
- product = carbamoyl phosphate
2) carbamoyl phosphate + ornithine => citrulline
3) citrulline + Aspartate => arginosuccinate
4) hydrolysis of arginosuccinate => arginine + fumarate
5) hydrolysis of arginine => urea + ornithine
5 Enzymes and locations for urea cycle
1) carbamoyl phosphate synthetase 1
(in mitochondria of liver)
2) ornithine carbamoyltransferase
(Mitochondria)
3) argininosuccinate synthetase
(Cytosol)
4) arginosuccinase
(Cytosol)
5) arginase
(Cytosol)
Vit D deficiency
Decr intestinal Ca absorption
Hypocalcemia
Incr PTH secretion
Incr PTH-mediated bone resorption
Wiskott-Aldrich syndrome triad
Thrombocytopenia (from birth)
Eczema (develop around 6 to 12 months of age)
Combined B and T cell deficiency (develop around 6 to 12 months of age)
Acid-base for salicylate poisoning
Primary respiratory alkalosis
Primary anion gap metabolic acidosis
Electrolytes levels in Fanconi syndrome
d/t generalized PCT dysfunction
Urinary loss of:
- glucose
- phosphate
- potassium
- water
- amino acids
Serum chloride rises to maintain electronegative balance from bicarb loss
Serum glucose remains normal d/t counterregulatory mechanisms.
Type 2 RTA
Unable to reabsorb bicarb in PCT
Commonly a part of Fanconi syndrome
Fanconi syndrome
Generalized resorption dysfunction (= tubular damage) affecting PCT
- decr HCO3 -> metabolic acidosis
- incr serum Cl
- serum glucose remains normal
- low serum phosphate -> rickets
- low serum potassium -> muscle weakness
- aminoaciduria
- growth failure (d/t chronic acidosis, hypophosphatemia, hypokalemia)
