Deck 7 Flashcards
Where are pro & lysine residues hydroxylated in collagen? What is necessary cofactor?
In the RER; vit C
What phase of cardiac cycle does adenosine affect? How?
Phase IV: A1 receptors on surface to increase K conductance (efflux) to remain negative longer & inhibits L-type Ca channel (usually opened at -40 to trigger AP)
Adenosine is useful for what?
Paroxysmal SVT
Which chemoreceptors mainly detect CO2 levels? O2 levels?
CO2 = Central (decrease in pH in CSF through CO2); O2 = peripheral (carotid, aortic)
What does vWF bind to?
- Platelet glycoproteins Gp1b with exposed collagen 2. is a carrier protein for Factor VIII
What step in TCA cycle is impaired in alcoholics?
a-ketoglutarate to succinyl coA: Thiamine is necessary cofactor for a-ketoglutarate dehydrogenase (also pyruvate dehydrogenase)
A mutation in a gene that encodes BRAF protein kinase causes what cancer?
Melanoma
Nasal mucosal ulcerations and glomerulonephritis are characteristc of what?
Granulomatosis with polyangiitis; C-anca (Abs against neutrophils)
What abnormalities are seen w lack of obliteration of vitelline (omphalomesenteric) duct?
Persistent vitelline duct, Meckel diverticulum (partial closure of fibrous band to umbilicus with patent portion attached to ileum), vitelline sinus (patent portion open at umbilicus), vitelline duct cyst (closed ends, patent middle); Qid: 322
What do club cells do in lungs?
Nonciliated cells primarily in terminal bronchioles- secrete club cell secretory protein (protects against airway inflammation and oxidative stress) & surfactant components (prevent bronchiolar collapse)
What can cause a wide fixed split S2?
ASD
What part of bone does osteomyelitis affect?
Metaphysis (therefore affects kids more); vertebral body is more common in adults
What condition arises in diaphysis then?
Ewing sarcoma
What does COX-1 acetylation block? Effects?
Generation of thromboxane A2 in platelets (antithrombotic)
What does COX-2 acetylation block? Effects?
Prostaglandin production in inflamm cells- lymps & neutrophils (anti-inflam, anti-pyretic, analgesic)
What interval is affected by drugs that slow AV conductance? (BBs)
PR
How does PTH stimulate osteoclasts?
Causes osteoblasts to incr production of RANK-L and M-CSF -> stimulate osteoclast precursors to differentiate to mature osteoclasts
What medication stimulates prostaglandins in kidney? What effect?
Loop diuretics: vasodilation -> increased blood flow
What effect does Ang II have on vessels? ACEI’s?
Ang II constricts efferent (restore GFR); ACES’s: lower Ang II => systemic vasodilation + efferent dilation to lower glomerular pressure…. Can see an increase in GFR within 2-5 days of starting ACEI
What is the role of NF-kB/ IkB in inflammatory cells?
NF-kB is normally present/ inactive when bound to IkB -> extracellular signal activates IkB kinase which tags IkB for ubiquination -> now NF-kB can go into cell -> transcription of inflam proteins. Qid: 11955
Lab finding in klinefelters?
Decreased negative feedback -> incr gonadotropins (FSH, LH) -> increase estrogen
What portion of nephron is affected in renal cell carcinoma?
Proximal renal tubule
What antibiotic for aspiration pneumonia?
Clindamycin
What cell types are increased in COPD?
Neutrophils, Mx, CD8+ T lymphocytes
Neprolysins are MMPs that degrade what?
Endogenous peptides: natriuretic peptides, glucagon, oxytocin, bradykinin
What antihyperlipidemic med could cause increased triglycerides?
Bile-acid binding resins (cholestyramine) - Qid 163
What antioxidant enzymes convert ROS to water and O2?
Superoxide dismutase, catalase, glutathione oxidase
What enzymes could produce ROS in reperfusion injuries?
Xanthine oxidase, NADPH oxidase, nitric oxide synthase
Describe the adenoma to carcinoma sequence in colon?
- Mutation of APC tumor suppressor gene 2. activation of KRAS protooncogene causes growth 3. Mutation of P53 tumor suppressor gene– Qid 421
What muscles are injured in pelvice floor injury/ used in Kegels/ stress incontinence?
Levator ani muscles; Qid 11820
What activates trypsin so that it can activate all other zymogens?
Enterokinase from intestinal mucosa
What cell in pancreas secretes somatostatin? What would tumor of these cells cause?
Delta cells; somatostatinoma = hyper or hypoglycemia, steatorrhea, gallstones (excessive CCK)
Describe allergic bronchopulmonary aspergillosis
Patient with asthma or CF; High serum IgE, eosinophilia, airway inflammation and mucus plugging with exacerbations and remissions, may produce transient infiltrates and proximal bronchiectasis
Why is selegiline used to delay progression of parkinsons?
A metabolite of MPTP produced by MAO causes MPTP-associated parkinsonism symptoms
What should you give in BB overdose?
Glucagon: increases cAMP in cardiac myocytes
What happens if child is born to HBe-Ag positive mother?
> 90% chance of infection; have high viral loads and high HBeAg levels; but usually asymptomatic with greater chance of developing chronic infection/ complications -> administer Hep B vaccine and immunoglobulins asap
What is the pathway of tetanus?
Wound > retrograde transport up motor neuron > spinal cord & medulla > inhibits inhibitory interneurons
What antibodies are seen in CREST syndrome?
Anti-centromere
What is inflammatory response in RA?
CD4 helper T cells secrete cytokines & induce B cells to secrete anti-citrullinated protein Abs, and rheumatoid factor (Anti IgG Fc IgM molecule)
By what mechanism does the huntingtin gene cause neuronal damage?
Transcriptional repression (silencing): Causes histone deacetylation making DNA less accessible
