DIT Questions Flashcards
Where would you find the following in a lymph node? B cells T cells Plasma Cells Macrophages
B cells are in the follicle in outer cortex
T cells are in the paracortex
Plasma cells are in the medullary cords of the lymph node
Macrophages are in the medullary sinus
Forkhead Box Protein B3
From FOXP3 gene on the X chromosome.
Serves as a transcription factor for the development and function of regulatory T cells.
What are the female homologues of the following male structures?
Corpus Spongiosum –>
Cowper’s Glands (Blulbourethral glands) –>
Prostate –>
Glans Penis –>
Ventral Penile Shaft (penile urethra)–>
Scrotum –>
Corpus Spongiosum –> Vestibular bulbs
Cowper’s Glands (Blulbourethral glands) –> Greater Vestibular glands (of Bartholin)
Prostate –> Urethral and paraurethral glands (of skene)
Glans Penis –> Glans clitoris
Ventral Penile Shaft (penile urethra)–> labia minora
Scrotum –> labia majora
Remember you need Estrogen to get the female parts and Dihydrotestosterone to get the male parts
Intrinsic Apoptosis
Increased Bax (pro-apoptotic) and decreased Bcl-2 (anti-apoptotic) leads to increased mitochondrial permeability and cytochrome C released leading to activation of intracellular caspases
Extrinsic Apoptosis
Either:
- Fas ligand binds to FasR (CD95) or
- CD8 cell releases perforin and granzyme B
leads to activation of intracellular caspases
What is the important component of surfactant?
Surfactant made of lecithins, most important is Dipalmitoylphosphatidylcholine
What ratio indicates fetal lung maturity?
A lecithin:Spingomyelin of >2:1 in amniotic fluid
What amino acids are necessary for purine synthesis?
GAG: Glycine, Aspartate, Glutamine
Drug’s Clearance equation
Cl = (Vd x 0.7) / T1/2
What bacteria are well known for being obligate intracellular and why
Rickettsia and Chlamydia.
Unable to make their own ATP so they use the hosts ATP
“Stay inside the cell because it’s Really Cold out”
What is Achalasia?
Failure of relaxation of the lower esophageal sphincter due to loss of myenteric (Auerbach’s) plexus.
What is Peripheral Vascular Disease/Peripheral Arterial Disease?
Atherosclerosis of the peripheral arteries.
- Claudication
- Decreased peripheral pulses
- Feet may become cold to the touch
- Skin can become pale/shiny and hairless
What is a deep venous thrombosis?
A blood clot forming in the peripheral veins.
- Most likely due to immobilization.
- Leg is warm (Not cool)
- Increased calf circumference
- Moses Sign - calf tenderness with compression
- Homan’s sign - calf pain with ankle dorsiflexion (not a sensitive test)
What are the equations for cardiac output?
CO = SV x HR
CO = (rate of O2 consumption) / (arterial O2 content - venous O2 content)
What’s up with Vitamin K’s use?
Catalyzes gamma carboxylation of glutamic acid residues on various proteins.
Activates Factors II, VII, IX, and X and Protein C and Protein S
What two arachidonic acid products affect platelet aggregation?
Thromboxane A2 promotes platelet aggregation.
Prostacyclin (PGI2) inhibits platelet aggregation
What are some medications that act on microtubules?
Mebendazole (anti-helminthic) Griseofulvin (anti-fungal) Vincristine/Vinblastine (anti-cancer) Paclitaxel (anti-breast cancer) Colchicine (anti-gout)
What syndrome demonstrates a defect in microtubule polymerization?
Chediak-Higashi Syndrome.
AR, defect in lysosomal trafficking regulator gene (LYST)
Microtubule dysfunction resulting in failure of phagosome-lysosome fusion
What GI ligament separates the greater and lesser sacs?
Gastrosplenic ligament and Gastrohepatic ligament
What GI ligament may be cut during surgery to access the lesser sac?
Gastrohepatic ligament
What are the 2 GI ligaments that connect the spleen to other structures?
Splenorenal ligament and Gastrosplenic ligament
What GI ligament contains the portal triad?
Hepatoduodenal ligament.
Portal triad - hepatic artery, portal vein, common bile duct
What GI ligament connects the liver to the anterior abdominal wall?
Falciform ligament.
What is Narcolepsy and what are its characteristics?
Narcolepsy is disordered regulation of sleep-wake cycles.
Characteristics: - excessive daytime sleepiness
- hallucination - Hypnagogic (before sleep) and Hypnopompic (before awakening)
- Nocturnal and narcoleptic sleep both start with REM sleep
- Cataplexy
What is narcolepsy treated with?
Day time stimulants like amphetamines or modafinil.
Sodium oxybate can assist with sleep and reduce cataplexy
First-line treatment for erectile dysfunction and MOA
Sildenafil, Vardenafil, Tadalafil
Inhibits phosphodiesterase 5 causing increased cGMP, smooth muscle relaxation in the corpus cavernosum leading to increased blood flow and penile erection
What drugs are used to treat Crohn’s that target TNF-alpha?
Infliximab, Adalimumab and Certolizumab
What is a cholesteatoma?
Overgrowth of desquamated keratin debris located in the middle ear space against the inside of the tympanic membrane.
Can eventually erode the ossicles and external auditory canal leading to hearing loss.
Patient may present with chronic middle ear infections, grayish-white pearly lesion behind the tympanic membrane, conductive hearing loss, or vertigo
What are the adverse effects of exogenous testosterone in males?
In children: - premature puberty - premature closure of epiphyseal plates (growth restriction) In adults: - Erythrocytosis - Worsening of sleep apnea - Suppression of spermatogenesis - Increased LDL and decreased HDL
What is the initial treatment for torsades de pointes?
IV magnesium sulfate
What 3 structures give rise to the Blood brain barrier?
- Tight junctions between non-fenestrated capillary endothelial cells
- Basement membrane
- Astrocyte foot processes
what diuretics are used in hyperaldosteronism?
Spironolactone and Eplerenone: Competitive aldosterone antagonists in cortical collecting duct
Triamterene and Amiloride: Block sodium transport channels in the cortical collecting duct resulting in a decreased in the Na+/K+ exchanger
What are the different causes of homocystinuria? And how do you treat them?
- Cystationine synthase deficiency; TX with decreased methionine, increased cysteine, increased B12 and folate in diet
- Decreased affinity of cystathionine synthase for pyridoxal phosphate (B6); TX with increased vitamin B6
- Homocysteine Methyltransferase deficiency; TX with Vitamin B12
What is the pathway that the cochlea communicates a signal to the primary auditory canal?
Signal goes from cell bodies of the spiral ganglion (in cochlea) to the cochlear nuclei
then to the CL superior olivary nucleus
then to the lateral lemniscus to the inferior colliculus then the medial geniculate body
Lastly tot he primary auditory cortex
What is the structure of HbH?
This is an alpha thalassemia
Made of beta tetramers
What is the structure for Hb Barts?
This is an alpha thalassemia made of gamma tetramers.
Seen in infants and results in hydrops fetalis
What cholinergic agonist can be used to treat post-op ileus and urinary retention?
Bethanechol (direct cholinergic agonist)
What conditions can be made worse by using cholinomimetic agents?
Can exacerbate asthma, COPD, and peptic ulcers
What conditions can be helped with hyperbaric oxygen therapy?
Severe carbon monoxide poisoning
Decompression sicknes
Arterial gas emboli
Gas gangrene (Clostridium perfringens)
After a splenectomy, what would you expect to see on a peripheral blood smear?
Would expect to see Howell-Jolly Bodies
What organisms are asplenic patients susceptible to? And what vaccines should they get?
Encapsulated organisms --> SHiNE SKiS Streptococcus penumoniae Haemophilus Influenzae Neisseria meningitides E.coli Salmonella Klebsiella pneumoniae Group B Strep
What vaccines? S. pneumo, H flu type B and Neisseria meningitidis
What can increase contractility of the heart?
- Catecholamines
- Sympathetic stimulation
- Increased intracellular calcium
- Decreased extracellular sodium
- Digoxin
What can decreased contractility of the heart?
- Beta 1 blockade
- Heart failure
- Acidosis
- Hypoxia
- Calcium channel blockers like verapamil or diltiazem
- Decreased intracellular calcium
- Increased extracellular sodium
What is the pressure in the potential spaces of the body including pleural cavity, joint spaces, and pericardial cavity?
The hydrostatic pressure in these spaces is negative to help facilitate the diffusion of fluid into the spaces
- Pleural cavity: - 7 to -8 cm H2O
- Joint spaces: -3 to -5 cm H2O
- Pericardial cavity: -5 to -6 mm Hg
What is Standard deviation?
SD is a measure of how much variation there is between data in a sample
1 SD = 68%; 2 SD = 95%, 3 SD = 99.7%
What is standard error of the mean?
SEM is how well the mean of a particular sample can predict the mean of a population.
The larger the sample size, the close you get to the mean of the whole population.
SEM = SD/Sq. Rt (n)
The larger the sample size, the closer you get to the mean of the whole population
How do you calculate confidence intervals?
CI = range from [mean - Z (SEM)] to [mean + Z (SEM)]
95% CI, Z = 1.96
99% CI, Z = 2.58
The more confident you want to be, the wider your range
What are some lung cancers in NON smokers?
Most common - bronchial Adenocarcinoma
Bronchioloalveolar adenocarcinoma
malignant mesothelioma (technically a pleural cancer)
What are lung cancers that are associated with smoking?
Small cell carcinoma and Squamous cell carcinoma
Fibrous band that attaches the testis to the scrotum and aids in normal testicular descent
Gubernaculum.
Female equivalent is the Ovarian ligament and Round ligament of the uterus
Hereditary hemorrhagic telangiectasia
Osler-Weber- Rendu syndrome (AD) Findings: Telangiectasia (skin, mucous membranes, organs - liver, lung brain) Recurrent epistaxis Skin discolorations AVMs
can result in high-output heart failure
What is a case control study?
Observational and retrospective; compares a group of people with a disease to a group without a disease
Looking for a prior exposure or risk factor
Uses Odds ratio
What is a cohort study?
Observational and prospective or retrospective; compares a group with a given exposure or risk factor to a group without such exposure
Looks to see if a exposure increases the risk of a disease
Uses Relative Risk
What is a clinical trial?
Prospective, experiment
Should be controlled, randomized and double blinded
Compares outcomes from 2 different treatments
What are the actions of Prostaglandins E2?
Increases uterine tone
Causes vasodilation
Causes bronchodilation
NSAIDs inhibit PGE2!
What are the affects of Angiotensin II and Prostaglandins at the Renal arterioles?
Angiotensin II causes vasoconstriction of the efferent arterioles leading to increased GFR and filtration fraction
Prostaglandins cause vasodilation of the afferent arterioles leading to increased GFR
What’s the most common form of congenital adrenal hyperplasia?
21 hydroxylase deficiency
Decreased aldosterone and cortisol and increased androgens
Patients present with hypotension, hyperkalemia, volume depletion, masculination
What do Th1 and Th2 cells secrete?
Th1: IFN G and IL2
Th2: IL4, IL5, IL10, IL13
What inguinal hernia traverses through Hasselbach’s triangle?
Direct inguinal hernia. Begins protrusion medial to inferior epigastric vessels
What inguinal hernia traverses lateral to the inferior epigastric vessels?
Indirect inguinal hernia
What forms Hesselbach’s triangle?
Inguinal ligament, inferior epigastric vessels, and lateral wall of rectus abdominus
What are the 3 endogenous androgens in order from most potent to least?
- DHT
- Testosterone
- Androstenedione
Nonhemolytic, normocytic anemia caused by failure of destruction of myeloid stem cells
Aplastic anemia
What drugs can cause aplastic anemia?
Benzene, chloramphenicol, alkylating agents, antimetabolites, NSAIDs, propylthiouracil, methemazole
What is decompression sickness?
When divers come up too quickly.
Gases (especially nitrogen) that had dissolved in the blood at high pressures form gas bubbles that can occlude blood vessels.
AKA “the bends”
What is closed/narrow angle glaucoma?
The iris and lens are stuck together/pushed up against each other and pressure builds up behind the iris since the aqueous humor can’t drain.
Can be chronic (asymptomatic)
or acute (ophthalmic emergency - rock hard eye that’s painful)
What is open/wide angle glaucoma?
Canal of Schlemm is blocked so fluid can’t drain from the trabecular meshwork like it normally would.
Gradual vision loss
What is the treatment for closed angle glaucoma?
- topical beta blockers - Timolol
- Topical alpha2 agonists - Apraclonidine
- Topical muscarinic agonist - pilocarpine
What is the treatment for open angle glaucoma?
- topical prostaglandins - latanoprost
- topical beta blocker
- topical alpha 2 agonist
What is the metabolism of ethanol?
Ethanol (Alcohol dehydrogenase) to Acetaldehyde (Acetaldehyde dehydrogenase) to Acetate
- Acetaldehyde gives you the N/V, headache
What drug blocks Acetaldehyde dehydrogenase?
Disulfiram
What medications are disulfiram-like?
Metronidazole Certain cephalosportins Procarbazine First generation sulfonylureas Griseofulvin
A patient with Xeroderma Pigmentosum has increased risk for what cancers?
Skin cancers melanoma, basal cell carcinoma and squamous cell carcinoma
Which thalamic nuclei are the relay stations for each of the following body sensations/activities?
- Auditory sensation
- Visual sensation
- Motor to the body
- Facial sensation
- Body sensation
- Auditory sensation - Medial geniculate nucleus
- Visual sensation - Lateral geniculate nucleus
- Motor to the body - Ventrolateral nucleus
- Facial sensation - ventroposteromedial nucleus
- Body sensation - ventroposterolateral nucleus
What is PPAR Gamma?
Peroxisome proliferator activated receptor gamma
nuclear receptor and transcription factor found in adipose that plays a role in adipocyte differentiation.
Thiazolidinediones bind PPAR gamma and improve insulin sensitivity
A bacteria that is found in lice that can cause recurrent infection
Borrelia recurrentis
can alter proteins expressed on it’s surface so it can keep causing new immune responses
What phases are a primary and secondary oocyte arrested in?
Primary oocyte - just before ovulation - arrested in Meiosis I, prophase I
Secondary oocyte - just prior to fertilization - arrested in Meiosis II, Metaphase II
What structures are pierced from exterior to interior for a lumbar puncture?
- skin/superficial fascia
- ligaments - supraspinous, interspinous, ligamentum falvum
- epidural space
- dura mater
- subdural space
- arachnoid space
- subarachnoid space (CSF)
What medications are used for pulmonary hypertension and what’s their MOA?
All work via vasodilation.
A. Endothelin-1 receptor antagonist - Bosentan
B. Prostaglandins - Iloprost, Epoprostenol
C. cGMP phosphodiesterase inhibitors - Vardenafil, tadalafil, sildenafil
D. Dihydropyridine CCBs - Nifedipine
Origin of the nucleus pulposus of intervertebral disc
comes from the notochord (mesoderm)
What are the stages of normal sleep and their EKGs?
Awake eyes open (beta - highest F and lowest A)
Awake eyes closed (alpha)
Stage N1 - Theta
Stage N2 - sleep spindles and K complexes
Stage N3 - delta (lowest F and highest A)
REM - Beta
Which T cell regulates the humoral response?
Th2 cells augment the humoral (plasma cell) response - generates IL4 and IL5
Which T cell regulates the cell mediated response?
Th1 cells augment the cell mediated (cytotoxic T cell) response - generate IL2 and IFN gamma
What can cause primary amenorrhea?
Primary amenorrhea (NEVER had a period before)
- Turned syndrome
- Imperforate hymen
- Androgen insensitivity syndrome
- Mullerian duct agenesis
- Delayed puberty
Cystic enlargement of the central canal of the spinal cord
Syringomyelia.
Can damage the crossing fibers of the spinothalamic tract first leading to “cape-like” bilateral loss of pain and temperature sensation in upper extremities
What skin cancer is associated with exposure to arsenic?
Squamous cell carcinoma
Irreversible alpha blocker
Phenoxybenzamine. Used pre-op for pheochromocytoma removal.
Can cause orthostatic hypotension and reflex tachycardia
Alpha and Beta (1+2) agonist
Epinephrine
Alpha agonist only
Phenylephrine
What are the steps of conversion of vitamin D to its active form?
7-dehydrocholesterol in the skin (UV light) to Cholecalciferol (in the liver) to 25-hydroxycholecalciferol AKA calcidiol (1 alpha hydroxylase in kidney) to 1,25 dihydroxycholecalciferol AKA calcitriol
What beta lactamase inhibitors are added to penicillins to aid in their activity against bacteria?
Clavulanic acid, sulbactam, and tazobactam
What is the most common benign tumor of the salivary gland?
Pleomorphic adenoma
presents as a painless, mobile mass. Composed of cartilage and epithelium and recurs frequently
What is a Warthin’s tumor?
AKA Papillary cystadenoma lymphomastosum
a benign cystic tumor with germinal centers
What bacteria are most commonly responsible for sialadenitis?
Sialadenitis = inflammation of the salivary glands
Staph aureus, strep viridans
What shows an EKG of ventricular tachycardia with shifting sinusoidal waveforms?
Torsades de pointes
Caused by anything that prolongs the QT interval
What are the characteristics of an MRI?
MRU does not use ionizing radiation
Caution with metal objects
used for looking at soft tissue - brain, spinal cord, ligaments, cartilage
Bones appear gray
What are characteristics of CT?
Uses ionizing radiation
Used for bone detail and recognition of blood
Bones appear white
What enzymes to obligate anaerobes lack and what do they do?
Catalase - converts hydrogen peroxide into water and CO2
Superoxide dismutase - converts oxygen radicals to hydrogen peroxide and water
Incomplete fusion of paramesonephric ducts
Bicornuate uterus
can result in multiple miscarriages
What do the paramesonephric ducts form?
AKA Mullerian ducts
Forms fallopian tubes, uterus and upper portion of the vagina
What ovarian germ tumor can arise from a Hydatidiform mole?
Choriocarcinoma
What clinical features will you see with a platelet disorder?
Increased bleeding time
Microhemorrhages - petechiae, mucus membrane bleeding, epistaxis, purpura
What clinical features will you see with a coagulation factor defect?
Increased PT and/or PTT
Macrohemorrhages - hemarthrosis and easy bruising
What is necessary for Vitamin B 12 to be absorbed?
Intrinsic factor released from parietal cells is necessary for vitamin B 12 to be absorbed from the terminal ileum
What is the blood flow into and out of the thyroid gland?
Arteries: External carotid artery gives rise to the superior thyroid artery
Thyrocervical trunk gives rise to the inferior thyroid artery
Veins: superior, middle and inferior thyroid veins
What is first degree heart block?
Prolonged PR interval (> 200 msec)
Patients are asymptomatic
What part of the brain results in a coma when it has a lesion?
Reticular activating system (in the midbrain)
What is a desmosome (macular adherens) and what is the name of the disorder for autoantibodies against desmosomes?
A desmosome connects cells to other cells. Structural support via kertain interactions.
Autoantibodies result in Pemphigus vulgaris
What is a hemidesmosome and what is the name of the disorder for autoantibodies against hemidesmosomes?
Hemidesmosomes connect cells to the underlying basement membrane
Autoantibodies result in Bullous pemphigoid
Describe delirium
Delirium is a waxing and waning level of consciousness with acute onset
usually secondary to acute illness
most commonly reversible
Describe dementia
Gradual decline in intellectual ability or cognition
does not affect level of consciousness
not associated with acute illness and is irreversible
What is Kallmann syndrome
Defective migration of GnRH cells and olfactory bulb.
Patient presents with anosmia and hypognoadism
- Will have decreased GnRH, FSH, LH, testosterone and sperm count
What is Virchow’s triad?
- stasis
- hypercoagulopathy
- endothelial damage
Risk factors for clot formation
What’s the most common inherited hypercoagulability syndrome?
Factor V Leiden
produces mutant factor V that’s resistant to degradation by activated protein C
What’s a Reid index?
Reid index = thickness of gland layer/total thickness of bronchial wall
>50% in Chronic bronchitis
What is the rate limiting step in cholesterol synthesis?
Rate limiting step is catalyzed by HMG CoA reductase which converts HMG-CoA to Mevalonate
This enzyme is blocked by statins
Which adrenergic antagonists can be used to treat hypertension as well as urinary retention in patients with BPH?
Alpha 1 selective blockers
Prazosin, terazosin, doxazosin, tamsulosin
What arteries supply the adrenal glands?
Superior adrenal artery from the inferior phrenic A
Middle adrenal artery from the aorta
Inferior adrenal artery from the renal artery
what neoplasm is associated with ACTH leading to Cushing’s syndrome?
Small cell lung carcinoma
What neoplasm is associated with PTH-related peptide leading to hypercalcemia?
Squamous cell lung carcinoma
Renal cell carcinoma
breast cancer
What neoplasm is associated with erythropoietin leading to polycythemia?
Renal cell carcinoma
Hemangioblastoma (vascular tumor of the CNS)
Hepatocellular carcinoma
Phemochromocytoma
What neoplasm is associated with ADH leading to SIADH?
Small cell lung carcinoma
Intracranial neoplasms
What does increased or decreased SHBG cause in men and women?
Increased SHBG in men leads to less free testosterone, leads to gynecomastia
decreased SHBG in women leads to more free testosterone, leads to hirsutism.
Note that SHBG level are increased in pregnancy
Does the regeneration of neurons occur in the CNS or PNS?
Regeneration of neurons occurs in the PNS at a growth of 1-2 mm/day
CNS –> myelin from oligodendroglia, secretes chemical that inhibits axonal growth
PNS –> myelin from Schwann cells, secretes chemotropic growth factor
What are the treatments for Crohn’s disease?
Coritcosteroids, azathioprine, methotrexate, infliximab, adalimumab
What’s the equation for determining volume of distribution?
Vd = amount of drug in the body / plasma drug concentration
In what stage of sleep does bed wetting, night terrors and sleepwalking occur?
In Stage N3, the deepest non-REM stage, has delta waves.
Alcohol, benzodiazepines and barbiturates decreased REM and delta sleep
night terrors and sleepwalking can be treated with Benzos
What is Eisenmenger’s syndrome?
Uncorrected VSD, ASD or PDA leads to compensatory pulmonary vascular hypertrophy which can lead to pulmonary hypertension
As pulmonary resistance increases, the shunt reverses from L to R to R to left which causes late cyanosis, clubbing, and polycythemia
Spironolactone, Antidepressants (SSRIs), Antipsychotics, Ketoconazole, Cimetidine, sympathetic blockers (clonidine, methyldopa, guanethidine) and thiazide diuretics
Cause erectile dysfunction
What are the rule of 2’s with a Meckel Diverticulum?
2 inches long 2 feet from ileocecal valve 2% of population commonly in first 2 years of life 2 types of epithelia - gastric and pancreatic
What’s the associated gene deletion with renal cell carcinoma?
A gene deletion on chromosome 3
Can be sporadic or inherited as von-hippel-lindau syndrome
What malignancy presents as a child with right flank mas and hematuria?
What tetrad can this above malignancy be seen in?
Wilm’s tumor (Nephroblastoma) - the most common renal malignancy in 2-4 yo
WAGR complex = Wiedemann syndrome Wilm's tumor Aniridia Genitourinary malformation Retardation (mental)
What syndrome presents due to immotile cilia?
Kartagener’s Syndrome (Primary ciliary dyskinesia)
Defect in dynein arm
patient presents with infertility, bronchiectasis, recurrent sinusitis
Also associated with situs inversus
The air that moves into the lungs with quite inspiration
Tidal volume
usually 500mL
The air that’s left in the lungs after maximal expiration
Residual volume
can’t be measured
Maximum volume of gas that can be expired after a maximal inspiration
Vital capacity
VC = TV + IRV + ERV
what proto-oncogene is most commonly associated with Hirschsprung disease?
RET gene mutation
endomyocardial fibrosis with a prominent eosinophilic infiltrate
Loffler’s syndrome
How do you treat primary hyperaldosteronism?
Sprionolactone: K+ sparing diuretic that is a aldosterone antagonist
Treatments for acute gout
Cochicine
NSAIDs (indomethacin, ibuprofen, naproxen, celecoxib)
Glucocorticoids (Prednisone)
Treatments for chronic gout
Allopurinol
Febuxostat
Probenecid - increases the excretion of uric acid
Why would you place an AIDS patient on TMP-SMX when his CD4 count drops below 200?
Prophylaxis for PCP - pneumocystics jirovechi pneumonia
What medication targets CD3 and is used to prevent acute transplant rejection?
Meuromonab
OKT3
Cancers associated with asbestos
Malignant mesothelioma and Bronchogenic adenocarcinoma
what do asbestos fibers look like in the lungs?
Asbestos (Ferruginous) bodies are golden-brown fusiform rods resembling dumbbells
Site on DNA where RNA polymerase binds and promotes gene expression and transcription
Promoter region
TATA box or CAAT box
Stretch of DNA that alters gene expression by binding transcription factors
enhancer region
What are the signs of right-sided heart failure?
Systemic problems: hepatomegaly (nutmeg liver), peripheral edema, JVD
What are the signs of left-sided heart failure?
Pulmonary problems: Pulmonary edema, paroxysmal nocturnal dyspnea, orthopnea (shortness of breath when supine)
What causes right sided heart failure?
Most commonly left sided heart failure
if it’s isolated right heart failure think cor pulmonale
How many umbilical vessels are there and which have the highest O2 content?
2 umbilical arteries and 1 umbilical vein
The umbilical vein has the highest O2 content supplying oxygen from the placenta to the fetus
What lab value would you be like OMGOSH this is an alcoholic liver
AST>ALT of 2:1
“A Scotch and Tonic”
Where do dorsal root ganglia come from?
Dorsal root ganglia come from neural crest cells (which comes from ectoderm)
what centrally acting alpha-2 agonist is often used to treat hypertension in pregnancy?
alpha methyldopa
What do ACE-I and ARBs do to a baby developing?
in First trimester - cardiac and CNS malformations
in second and third trimester - renal malformations
Intracranial hemorhage with crescent shaped radiopacity that follows the contour of the skull and crosses suture lines
Subdural Hematoma
–> BRIDGING VEINS!
Uric acid crystals that are needle shaped and appear yellow when parallel to the light
Gout
Calcium pyrophosphate crystals that are rhomboid shaped and are blue when parallel to the light
Pseudogout
A child presents with nephritis, deafness and ocular dysfunction
Allport syndrome - abnormal Type IV collagen
“Can’t see, can’t pee, can’t hear me”
What collagen is important in bone, skin and tendon organization?
Type I collagen
What collagen organizes cartilage?
Type II colagen
What test can be used for hereditary spherocytosis?
Osmotic fragility test
Defect in RBC cytoskeleton proteins (either spectrin, Band 3, Protein 4.2 or Ankyrin)
