Deck 9 Flashcards
How can you suspect CML? Qid 1569
Elevated WBC (>50,000), increase in precursor forms
How can you distinguish leukemiod rxn from CML?
CML = decreased leukocyte alk phosph (aren’t planning on fighting), increased basophils
Laboratory findings of PSGN?
Low C3 & elevated anti-strep antibodies (anti-streptolysin O, anti-Dnase B, anti-cationic proteinase)
What germ cell does prolactinoma arise from?
Surface ectoderm (anterior lactotrophs) Qid8702
What two agents are important for NAD production? Qid 1064
Niacin + tryptophan; in pellagra can use tryptophan to make NAD; niacin can be consumed or made endogenously through tryptophan
Describe Call-Exner bodies in ovarian cancer? What do they secrete?
Cuboidal granulosa cells in rosette pattern with pink eosinophilic center & coffee bean nuclei; Estrogen (can have endometrial hyperplasia); a sex-cord stromal tumor
What is the possible cause of milder Turner syndrome?
Somatic mosaicism
What does the GU tract come from (embryonically)?
Metanephric blastema + ureteric bud
What is the last thing to canalize in GU tract?
utereropelvic junction
What suppresses lactation in pregnancy?
Progesterone
What is the most abundant amino acid in collagen?
Glycine: occupies every third spot in each of three alpha chains
Cause of elevated creatine kinase, fatigue, myalgia, myoedema
Hypothyroid myopathy
Where does angiotensinogen, ang I, ang II come from?
Angiotensinogen = liver; Ang I = converted from angiotensinogen in systemic circulation by renin; Ang II = converted from Ang I by endothelial bound ACE in pulmonary vessels
Whats wrong with high nitroprusside dose, altered mental status, seizures, lactic acid, bright red blood? What Tx?
Cyanide toxicity; Sodium thiosulfate (gives sulfates to rhodanse to form less toxic thiosulfate), hydroxycobalamin, sodium nitrite
What enzyme is deficient in familial chylomicronemia syndrome (type 1 hyperlipoproteinemia)? How can it be measured?
LPL: normally bound to heparin sulfate moieties- can be measured when administered heparin…. Pancreatitis!
What med is teratogenic - required for renal development and can cause oligohydramnios symptoms?
ACEI’s
What is most common cause of viral meningitis?
Enteroviruses
What are possible causes of hyperosmotic volume contraction?
Diabetes insipidus (vassopressin doesn’t lose NaCl like aldosterone), dehydration,, profuse sweating (due to hypotonic nature of sweat)
Second hand smoke increases chances of what in kid?
Sudden infant death syndrome, otitis media, asthma, other resp illnesses
Symptoms of PKU? Inheritance?
Intellectual disability, gait/ postural abnormality, eczema, musty body odor; auto recessive
Carcinoembryonic antigen is elevated in what?
Colorectal cancer
In complete mole, what does microscopy, immunochemistry, blood show?
Micro = large, edematous hydropic villi; Immuno = negative P57 (absent maternal genome); Blood = elevated b-HCG
In what condition do you see decreased ADAMST13?
Thrombotic thrombocytopenia purpura: normally degrades vWF»_space; clotting
What muscles are used for shoulder abduction?
Supra + deltoid to horizontal; Traps + serratus anterior rotate glenoid superiorly after that
What compounds are triggered by insulins tyrosine kinase?
Phosphorylates IRS1 (insulin receptor substrate) > PI3K (metabolic: more GLUT4, glycogen & fat synth) + RAS/ MAP kinase (mitogenic: DNA synth & cell growth)
What acetylcholinesterase inhibitor crosses BBB?
Physostigmine
What is bosentan used for?
Pulmonary arteriole hypertension: endothelin-1 receptor antagonist (vasodilation)
Chiari I vs Chiari II congenital malformations?
I = benign, low lyring cerebell tonsils, paroxysmal HA in early adulthood, dizziness, ataxia; II = more severe and in young kids, vermis, tonsils, and medulla through foramen magnum, non communicating hydroceph, medulla problems (dysphagia, stridor, apnea), lumbar myelomeningocele
Characteristics and findings of Pick disease?
Frontotemporal dementia - changes in behavior, slurred speech; frontotemp atrophy, Pick bodies (aggregates of cytoplasmic tau protein seen in silver stain)
Trosseau sign?
Carpal spasms with inflation of blood pressure cuff- hypocalcemia… DiGeorge?
What cells are in ovary?
Simply cuboidal that divide and proliferate rapidly to repair
Characteristics of Wiskott Aldrich? Whats wrong?
Eczema, recurrent infections, thrombocytopenia (WATER); X linked mutation with thrombocytopenia and immunodeficiency: combined B cell (incr pyogenic infections- capsule) & T cell (incr opportunistic)
Which UV rays absorb in upper dermis and cause sunburn and malignancy?
UVB
Which UV rays penetrate deeper and causes photaging? How?
UVA; ROS activate receptors & TF’s to DECREASE COLLAGEN FIBRIL PRODUCTION and increased MMP degradation
What makes you think SCID? Labs? Tx?
Defective T cell development & B cell dysfunction; Risk for infections of virus, fungi, protozoa, sinopulmonary bacteria; LABS: lymphopenia & hypogammaglobinulinemia; Tx: stem cell transplant
What is Tx from defect in ornithine transport?
(Urea cycle) = limit protein consumption - no excess amino acids being converted to urea (which can’t be excreted)
What ribs overlie the spleen? The kidney?
Spleen = 9, 10, 11; Kidney = 12
If a patient has general malabsorption with normal labs & exams, what is best next test?
Stool microscopy with Sudan III stain - looks for fats in stool (first nutrients to not be absorbed well)
What other condition should you expect with endocarditis w strep gallolyticus aka bovis (group D)?
Associated with colon cancer
In global ischemia of brain (cardiac arrest) what are most vulnerable areas to go first?
Hippocampus (pyramidal cells); also vulnerable = purkinje cells of cerebell & neocortex
