Deck 14 Flashcards
Where is the site of attachment of immunoglobulins?
Fc portion = constant region of heavy chain
What do you do if you suspect asthma but spirometry is normal?
Methacholine (or histamine, exercise, cold air) challenge: try to illicit symptoms (causes bronchoconstriction
What is the result of the mutation CFTR gene in CF?
Impaired post-translational processing»_space; targeted for degradation, preventing it from reaching the surface
The greatest risk of dying from Friedrich Ataxia is from what?
Cardiomyopathy
What is most serious side effect of amphotericin B?
Nephrotoxicity
Small cell carcinomas stain for neuroendocrine markers, such as…?
Neural cell adhesion molecule, neuron-specific enolase, chromogranin, synaptophysin
What is vimentin and what malignancy is it seen in?
Intermediate filament in mesenchymal-origin cells; mesenchymal (sarcomas) and others (see FA pg. 60)
Describe replication of Hep B?
Partially DsDNA»_space; ssRNA to either translate proteins or»_space; reverse transcriptase to ssDNA intermediate then partially DsDNA again
Vitamin supplementation with what may help with MSUD? Enzyme?
Thiamine; a-ketoacid dehydrogenase
Who requires arginine as essential amino acid?
Disorders of urea cycle
What murmur increases with inspiration?
Tricuspid regurgitation
Where is K absorbed?
2/3rds in proximal tubule; 25-30% in ascending loop; 5-10% DCT; Hyperkalemia = secreted by principal cells in collecting duct (5-100+%) or Hypokalemia = K absorption of a-intercalated cells
What s the cause of spontaneous pneumothorax in thin/ tall individuals or smokers?
Apical subpleural bleb rupture - Qid 490
What does TNF-a cause?
Cachexia (muscle wasting, anemia, also called cachectin btw), fever, symtpoms of septic shock, causes hepatic release of acute phase reactants (C-peptide, fibrinogen)
Leser-trelat sign?
Suddent onset of multiple seborrheic keratosis: indicative of underlying carcinoma of GI tract
Difference between 23 valent/ 13 valent pneumococcal vaccine?
23 = polysaccharide capsule > protects against wider range of serotypes & not immunogenic, but shorter immunity; 13 = conjugate vaccine (with diphtheria protein) > boosts immunity through T cell recruitment»_space; development of memory B cells, higher antibody levels, herd immunity
Tx for narcolepsy?
First line = Modafinil (non-amphetamine stimulant); second line = amphetamines
What drug causes R atrial ventriculization in fetus?
Lithium»_space; Ebsteins anomaly
Hemangiomas in brain, angiomatosis in skin, and renal cell carcinoma or pheo?
Von hippel lindau
Cutaneous facial/ leptomeningeal angiomas, skin involvement in V1-V2 trigem, tram track opacities in skull..?
Sturge Weber
Which sequelae of endocarditis results from immune complex lesions and not microemboli?
Osler nodes (nodes seen on fingertips and toes) & Ruth spots (retina)
What are DNA methyltransferases used for?
Imprinting
Cause of waxing and waning painless lymph node enlargement?
Follicular lymphoma, t(14:18) translocation- overexpression of bcl-2 oncogene
Characteristics of Bells palsey?
Functions of CN VII: sudden unilateral facial paralysis, decreased tearing, hyperacusis (sensitivity to sound), loss of sensation/taste of anterior 2/3 of tongue
Most commonly affected areas in charcot-bouchard aneurysm (from hypertension) deep intracerebral hemorrhage?
Basal ganglia/putamen (lenticulostriate arteries), cerebellar nuclei, thalamus
Characteristics of basal ganglia hemorrhage?
Usually involves adjacent internal capsule»_space; contralateral hemiparesis, hemianesthesia & ICP symptoms
Venous drainage of internal/ external hemorrhoids?
Internal = middle > internal iliac & superior rectal veins > inferior mesenteric; External = inferior rectal vein > internal pudendal > internal iliac
Difference in decerebrate vs decorticate posturing?
Decerebrate = extensors predominate (below red nucleus [loss of rubrospinal tract, unopposed vestibulospinal]); Decorticate = flexors predominate (above red nucleus [loss of descending inhibition of red nucleus])
What causes the decreased Ach in alzheimers? Where?
Deficiency of choline acetyltransferase most notably in basal nucleus of Meynert (projects to neocortex)
What does inactivated X chromosone look like on microscopy?
Condensed heterochromatin = compact body at periphery of nucleus (Barr body); heavily methylated DNA and deacytelated histones
What cancer is associated with pure red cell aplasia? What infection can cause it?
Thymoma; Parvovirus B19
What processing of mRNA only occurs in cytoplasm?
Interaction with P bodies (regulation, storage, turnover)
What is cause of familial hypocalciuric hypercalcemia?
Defective Ca-sensing receptor (G-protein that helps mediate release of PTH)
What does MacConkey agar grow?
Gram negative (bile salts and crystal violet prevent gram +); if ferment lactose»_space; turns pink red, non lactose remains colorless
What are available treatments for AZ?
- Donepezil (cholinesterase inhibitor) 2. Vit E aka a-tocopherol (prevents oxidative damage 3. Memantine (NMDA antagonist)
External auditory canal is innervated by what?
Mostly CN V mandibular branch; Posterior part, concavity of concha is CN X, VII
Symptoms of arsenic poisoning and Tx?
Garlic breath, vomiting, watery diarrhea, QT prolongation; Tx; dimercaprol
Mechanism of arsenic poisoning?
Binds sulfhydryl groups and impairs cell respiration via pyruvate dehydrogenase, gluconeogenesis, glutathione metabolism
What translocation is associated with Burkitt lymphoma?
c-Myc gene on chromosone 8 to heavy chain of 14 = t(8;14)
In what malignancy is there overexpression of antiapoptotic BCL2?
Follicular lymphoma, t(14;18)
What is statistical power?
1- b (b is the possibility of commiting type II error) = studies ability to detect a difference when one really exists
What are features of a glucagonoma?
DM, necrolytic migratory erythema: painful pruritic rash in face, groin, extremities that coalesce to to large, indurated plaques with a central clearing that appears brown or bronze
