Deck 7

Question 0

What is the mechanism of death in pts with TCA overdose?

Answer 0

-inhibition of fast sodium channels in the heart —> arrhythmias

Question 1

Phosphorylated Rb is ________, allowing cells to _______

Answer 1

• Inactive

- Proceed from G1—>S phase

Question 2

What is the RL step for bile acid synthesis?

Answer 2

-Cholesterol-7-alpha hydroxylase

Question 3

Pancreatic cysts most commonly form in the _______. THier walls are made of _______

Answer 3

• Lesser peritoneal sac

- Granulation tissue and fibrosis

Question 4

Interstitial myocardial clumps of immune cells following infection = ______

Answer 4

-Bacterial myocarditis (ARF)

Question 5

What is the treatment for acute Arsenic poisoning?

Answer 5

• Dimercaprol

* SE = nephrotox and HTN

Question 6

What is seen histologically in an atrophied kidney?

Answer 6

• crowded glomeruli
• tubulointerstitial atrophy and fibrosis
• focal inflamm infiltrates

Question 7

Describe the adenoma to carcinoma sequence of colon cancer:

Answer 7

• Normal mucose to small polyp —> due to APC mutation
• Growth of polyp –> mutation of K-ras (stimulation of cell cycle progression)
• Malignant transformation —> p53 and DCC mutations

Question 8

Where is damage typically done in patients with autoimmune gastritis causing B12 deficiency?

Answer 8

-Body of the stomach

Question 9

Name some drugs that cause hyperUricemia and may cause gouty attack?

Answer 9

• Niacin
• HCTZ
• cyclosporine
• pyrazinamide

Question 10

Pathophys and presentation of Fabry dz?

Answer 10

Path:

• Alpha-galactosidase deficiency
• ceramide trihexoside accumulates in tissues

Clinical:

• Hypohidrosis
• acroparesthesia (debilitating burning extremity pain)
• angiokeratomas (non-blanching macules and papules between umbilicus and knees)
• Progressive renal insufficiency –> death

**Fabry loved CERAMIC HEXagons too much. He ate them and they destroyed his kidneys

Question 11

WHat ligament is affected with radial head sublaxation?

Answer 11

-Annular ligament

Question 12

histology of contact dermatitis?

Answer 12

-Spongiosus

Question 13

What is the major morphologic sign in cardiac myocytes of early stage doxorubicin cardiomyopathy? WHat happens next? What drug prevents toxicity?

Answer 13

• Swelling of the sarcoplasmic reticulum
• loss of cardiomyocytes
• Prevent with Dexrazoxane

Question 14

Amiodarone side effects:

Answer 14

• thyroid dysfunction
• corneal micro-deposits
• blue-gray skin discoloration
• hepatitis
• pulmonary fibrosis (rare but deadly)

Question 15

What does MMP at a wound do?

Answer 15

• degradation of collagen and other ECM proteins
• encourages myofibroblast accumulation at wound edges and scar tissue remodeling (myofibroblasts initiate wound contraction)
• Too much MMP = excessive wound contraction

Question 16

Hyperammonemia in hepatic encephalopathy depletes what 2 substrates?

Answer 16

• Alpha-keto-glutarate
• Glutamate

*Glutamine excess occurs –> neurotoxicity

Question 17

Name the 3 areas involved in the micturition center and each of their functions:

Answer 17

• Sacral micturition center - S2-S4 –> PNS to cholinergics in bladder
• Pontine micturition center - retic. formation –> coordinates relaxation of sphincter with contraction of bladder
• Cerebral cortex - Inhibits sacral center (damage –> urge incontinence)

Question 18

What is cord factor of TB? What about sulfatide?

Answer 18

Cord factor:

• virulence factor that allows TB to grow in parallel, serpentine chains. No cord factor = no infection
• Inactivates neutrophils, damages mitochondria, induces TNF release

Sulfatide:
-Inhibit fusion of phagosomes to lysosomes

Question 19

Mutation for polycythemia vera?

Answer 19

• Replaces valine with phenylalanine at 617 position
• makes hematopoetic stem cells more sensitive to growth factors
• LOW EPO levels
• dont forget they can have gout and peptic ulcers (histamine from basophils)