Deck 11 Flashcards
What type of Tx with restless leg syndrome? What else is associated with it?
Dopamine agonists (ropinirole, pramipexole); associated with iron deficiency anemia (sometimes only in substantia nigra)
The middle meningeal artery arises from what? What prominent location does it pass over?
From maxillary- passes over pterion (where frontal parietal and temporal meet)
Symptoms of typhoid fever?
fever, diarrhea or constipation, abd pain, salmon colored rose spots on chest/ abdomen, hepatosplenomegaly
What does leptin do?
Increase satiety: decreases production of neuropeptide Y (appetite stimulator) and stimulates POMC; serum leptin levels correlate to body fat content (released by adipocytes)
What arteries/nerves run anterior to elbow?
Radial nerve (lateral), Median nerve & brachial artery, basilic vein (medial)
In supracondylar humeral fracture from falling on extended arm, what is injured w anterolateral displacement? Anteromedial?
AL= radial nerve, AM = median nerve, brachial artery
Histo of kids with flu who take aspirin?
Reye syndrome- Liver = microvesicular steatosis, small fat vacuoles in cytoplasm of hepatocytes
Lung cancer that can stain for endocrine markers (chromagranin, enolase, synaptophysin)?
Small cell carcinoma
Characteristics of drugs to be excreted and metabolized by liver?
Lipophilic: poorly eliminated by kidney and can cross hepatocytes better
What organism causes meningitis by traveling through lymphatics? Through blood?
Lymph = h. flu; blood = neisseria
What causes warfarin induced skin necrosis?
Reduces gamma carboxylation of II, VII, IX, X, C, S»_space; Protein C is an anticoagulant but has a short half-life»_space;> gets inhibited first and leads to greater hypercoagulability before II, VII, IX, X are inactivated (2 weeks)
What factors does protein C cleave and inactivate?
Va, VIIIa
PKD with SAH…? Prophylactic Tx?
Berry aneurysm; give CCB’s (nimodipine) for prevention of vasospasm and ischemia
An infant with hypotonia, large anterior fontanelle, umbilical hernia, jaundice, dry skin, macroglossia, intellectual delay?
Congenital hypothyroidism
What cofactors are made from niacin?
NAD, NADP
What enzymes in TCA will need niacin for cofactors?
Isocitrate dehydrogenase, a-ketoglutarate dehydrogenase, malate dehydrogenase
What effect does sympathetic / parasymp simulation have on pancreatic B cells?
Para = increased insulin with smell/sight of food; Symp = B increases insulin, alpha inhibits insulin (predominates)
What is complication of schistosomiasis? What is mechanism?
Hematuria, dysuria, hydronephrosis, pyelonephritis, squamous cell of bladder; Th2 mediated granulomatous response to eggs (Th2, eosinophils, 2 macrophage)»_space; ulceration/ scarring of bowel/bladder/ureters….. Eggs can also go to portal vein»_space; “periportal pipestem fibrosis”
What are extraintestinal complications of Crohns?
Ankylosing spondylitis & peripheral arthritis (lower back pain & joint stiffness worse at night)
What vitamin deficiency occurs in Crohns?
Lack of bile acid reabsorption (terminal ileum) causes fat malabsorption»_space; A, D, E, K (think when Crohns and bleeding!)
What blast precursors express terminal deoxynucleotideyltransferase (TdT)
Lymphoblasts: B cell blasts (CD 19. 10), T cell blasts (CD 1a,2,3,4,5,7,8)
Etiology of recurrent pyelonephritis, dilated calyces & cortical atrophy in upper and lower poles of kidney?
Vesicoureteral reflux (ureter enters bladder at more perpindicular angle); Qid 833
What adds mannose residues to proteins? What does that do?
Golgi: marks them to go to lysosome
What vasculitis is associated with MI in kids (coronary vasospasm + thrombosis)
Kawasaki disease
Headache and jaw claudication, polymyalgia rheumatica? Complications? Tx?
Temporal (giant cell arteritis) = granulomatous formation of media with fragmentation of internal elastic lamina; may lead to ischemic optic neuropathy (blindness); immediate glucocorticoids
What other condition can be associated with spontaneous ruptured cerebral aneurysm?
Coarctation of aorta > associated with berry aneurysms of circle of Willis- Qid 31
What is NF-kB?
Proinflammatory transcription factor that increases cytokine production
What causes superior vena cava syndrome and what are characteristics?
Associated with small cell lung cancer = HA, facial and UE edema, dilated veins of upper torso
In neural tube defects- what doesn’t develop right and when?
Neuropores (ends of neural tube) don’t close by 4th week
Histo of lipofuscin?
intracytoplasmic granules tinged yellow-brown: product of free radical injury and lipid peroxidation
A patient has a blunt injury from seatbelt in MVA- what part of aorta is damaged? What results?
Aortic isthmus (descending loop): tethered by ligamentum arteriosum and is immobile; majority die from aortic rupture or widened mediastinum on xray, chest pain, SOB, etc.
What decreases during intense exercise?
overall systemic vascular resistance- Qid 1622
What is the result of the CGG repeat mutation in Fragile X?
DNA hypermethylation»_space; inactivation of FMR1 gene
What brain tumor has spindle cells with hairlike processes with microcysts and Rosenthal fibers and eosinophilic bodies?
Pilocytic astrocytoma
What brain tumor has small round blue cells, neuritic process (neuropil), stain for chromagranin, S100, and elevated homovanillic acid?
Neuroblastoma
What lung malignancy is most common, and most specific for asbestosis?
Most common = bronchogenic carcinoma; most specific = malignant mesothelioma
what is volume of intracellular/ extracellular compartments in body?
Total = 41 L; ICF = 2/3; ECF = 1/3 or 14 L (plasma is 3, interstitial is rest)
What is MOA of organophosphates? What is Tx?
Cholinesterase inhibitors; Tx = atropine, pralidoxime (binds to organophosphates to regenerate ACE)
What are organ features of edwards?
Cardiac defects (VSD, PDA), renal (horseshoe kidney), GI (Meckels diverticulum, malrotation)
What makes you think of fibromuscular dysplasia?
Women 20-30, renal artery stenosis, string of beads appearance of renal arteries
