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first assessment Flashcards

1
Q

paget’s dz of bone increases risk of

A

osteosarcoma; destruction of normal bone pattern, mixed radiodense/radiolucent areas, periosteal new bone formation, lifting of the cortex, “sunburst” pattern of adjacentsoft tissue

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2
Q

radiographic sign of avascular necrosis

A

crescent sign (subchondral collapse)

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3
Q

globus hystericus

A

sensation of a “lump in the throat” with no exam findings

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4
Q

vitamin A toxicity

A

micrcephaly, cardiac anomalies, early epiphyseal closure, growth retardation, spontaneous abortion

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5
Q

DNA laddering

A

used to distinguish apoptotic cells from necrotic cells; during karyorrhexis, endonucleases degrade DNA into 180 base pair fragments, equally spaced on gel electrophoresis

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6
Q

physostigmine

A

cholinesterase inhibitor

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7
Q

atropine

A

competitive inhibitor of acetylcholine

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8
Q

pralidoxime

A

antidote to organophosphorus anticholinesterase that inhibit cholinesterase through phosphorylation

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9
Q

anticholinergic toxicity

A

confusion, blurred vision, dry MM, intense thirst

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10
Q

acute promyelocytic leukemia

A

t(15,17)

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11
Q

burkitt lymphoma

A

round nuclei with basophilic cytoplasm containing prominent lipid vacuoles; t(8,14)

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12
Q

chronic myelogenous leukemia

A

immature myeloid cells t(9,22)

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13
Q

acute lymphocytic leukemia

A

t(12,21)

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14
Q

follicular lymphoma

A

malignant cells with notches or clefts; t(14,18)

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15
Q

IL-2 produced by, moa

A

antigen-stimulated T cells; stimulate growht and differentiation of T cells (binds IL-2R), B cells, NK cells, and macrophages

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16
Q

IL-1 produced by, moa

A

macrophages, activates lymphocytes and stimulates systemic illness (fever, lethargy, anorexia)

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17
Q

TNF-alpha produced by, fxn

A

activated macrophages, induces systemic inflammatory response (and in high levels, causes shock)

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18
Q

interferon-alpha produced by, fxn

A

monocytes, macrophages, B cells, NK cells; antiviral functions (replication inhibition w/i cells, protection of uninfected cells, and stimulation of cytotix lymphocyte and NK cell antiviral activity)

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19
Q

GM-CSF produced by, fxn

A

macrophages, t cells, Nk cells, mast cells, endothelial cells, and fibroblasts; stimulates rpoduction of granulocytes and monocytes

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20
Q

cadherins

A

Ca-dependent transmembrane proteins that participate in desmosome formation with cadherins of adjoining cells; do not parcitipate in hemidesmosome function

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21
Q

hemidesmosomes structure, fxn

A

integrin-mediated binding to basement membrane (type 4 collagen), facilitated by fibronectin

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22
Q

acid chyme in duodenum triggers what response?

A
  1. gallbladder bile release, and 2. stimulates S-cells in the crypts of lieberkuhn to release secretin into systemic circulation which stimulate pancreas to release bicarb-rich fluid (via CL/bicarb exchange protein on the apical surface of the pancreatic cells)
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23
Q

endometritis

A

uterus infection; fever, leukocytosis, uterine tenderness and foul discharge; most commonly caused by bacteroides

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24
Q

nunmular eczema

A

occurs in xerosis (dry skin); pw pruritic, coin-shaped, erythematous patches

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25
Q

sublimation vs displacement

A

former is a mature defense mechanism where one channels socially unacceptable thoughts/impulses into acceptable actions

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26
Q

tyrosine kinase receptor structure, and signals that use tyrosine kinase receptor

A

transmembrane proteins with ligand-binding extracellular region, hydrophobic transmembrane regino, and intracellular domain that dimerizes and has inducible tyrosine kinase activity; insulin, epidermal growth factor, PDGF and VEGF

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27
Q

receptor mediated endocytosis moa, example

A

receptors are pooled in clathrin-coated regions (“pits”) that are internalized upon binding; LDL receptor

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28
Q

interview: reflection vs summarizing

A

repeating what pt said; summarizing has multiple ideas

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29
Q

vasomotor rhinitis

A

chronic nasal congestion that worsens with abrupt changes in temperature/humidity or exposure to odors/alcohol

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30
Q

heminephrectomy effect on GFR

A

immedatiely, 50 percent; compensatory hyperfiltration and hypertrophy of remaining neurons leads to 80 percent in several weeks

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31
Q

erection intracellular moa

A

local release of NO increases activity of GC, stimulating cGMP which relaxes smooth muscle around the cavernous venous sinus of the corpora cavernosa

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32
Q

HSV encephalitis

A

m/c, affects both immunocompetent and immunosuppressed; affects temporal lobe, so pts can present with seizures, personality changes, psychosis on top of fever, HA, and malaise

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33
Q

bunyavirus encephalitis

A

transmitted by mosquitoes, rarely fatal and cause transient infection with HA and fever

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34
Q

AIP

A

excess porphobilinogen and aminolevlinic acid in urine; many asymptomatic; begins after puberty, folllows consumption of drugs that increase heme synthesis; pw severe vague abdominal pain, N/V, motor/sensory neuropathy; no cutaneous findings/photosensitivity, completely symptom free between attacks

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35
Q

1st heart sound

A

closure of AV valve as systole begins

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36
Q

2nd heart sound

A

closure of the semilunar valves

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37
Q

light criteria

A

pleural protein/serum protein > 0.5; pleural LDH/serum LDH > 0.6; pleural fluid LDH > 2/3 upper limit of normal LDH

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38
Q

spherocytes

A

dense, spherical erythrocytes with no central pallor, increased MCHC

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39
Q

sickle cell/thalassemia on osmotic fragility test

A

decreased osmotic fragility

40
Q

echinocytes / burr cells (RBC with multiple surface proejctsion) means?

A

uremia or pyruvate kinase deficiency

41
Q

hereditary retinblastoma moa

A

germline mutation in tumor suppressor RB1 gene (c13); example of knudson’s 2 hit hypothesis

42
Q

parental imprinting

A

preferential transcription of genes from a set of a homologous pair of chromosomes depending on the parental origin of the chromosomes (e.g. prader-willi, angelmans)

43
Q

DKA: moa for hyperkalemia and hyponatremia

A
  1. hyperkalemia: decreased insuline (cant drive K into cells) and H+/K+ exchanger; 2. hyponatremia: osmotic activity of glucose and hyperglycemia-induced osmotic diuresis
44
Q

arnold-chiari malformation

A

downward displacement of elongated cerebellar tonsils through foramen magnum and into upper cervical canal; CSF is blocked

45
Q

dandy walker malformation

A

enlarged posterior fossa, absent/shrunken cerebellar vermis is replaced by large, midline cyst

46
Q

syringobulbia

A

fluied-filled cavities within medulla oblongata

47
Q

male genotype and female phenotype with normal external female genitali and blind-pouch vagina

A

complete androgen insensitivity syndrome

48
Q

leydig cell agenesis

A

male pseudohermaphroditism that presents with complete external female genitalia; LH/FSH levels are increased while testosterone levels are decreased

49
Q

phenoxybenzamine moa

A

irreversibly alkylates alpha-adrenergic receptors, with half life of 24 hours

50
Q

intraventricular hemorrhage in premature/respiratory distress syndrome infant

A

germinal matrix (highly cellular and vascular regino that generates neurons and glia during fetal development; no network fibers are present, which makes it vulnerable to hemorrhage)

51
Q

amiodarone lung SE

A

delayed-onset/chronic interstitial pneumonitis

52
Q

procainamide lung SE

A

delayed onset pleuritis generally associated with drug-induced SLE

53
Q

PG1 function; why does it get low; and how to fix

A

stimulate gastic epithelial cell mucous production and decrease parietal cell acid secretion; NSAID use; misoprostol is a PGE1 analog that binds to plasma membrane prostaglandin receptors

54
Q

palmitoylation

A

method to increase hydrophobicity of a protein by attaching a FA that is covalently anchored to PM cysteine residues (GPCR, V2 vasopressin)

55
Q

hereditary albright osteodystrophy moa, pw

A

pseudohypoparathyroid; end-organ resistance to PTH, TSH, and LH/FSH; pw skeletal/development defects (short stature, short metacarpal/metatarsal bones) and end-organ resistance to PTH

56
Q

allelic heterogeneity

A

different mutations in same genetic locust cause similar presentatinos (duchenne vs becker)

57
Q

phenotypic heterogeneity

A

mutatinos in the same gene result in different phenotypes

58
Q

bronchial asthma pathogenesis, rx

A

leukotriene D4 is synthesized by eosinophil/mast cells; induces bronchospasm and increase bronchial mucous secretion; anti-leukotriene medicatino like montelukast antagonists leukotriene D4 activity at the cysteinyl leukotriene receptor

59
Q

hemochromatosis moa, pw

A

AR excess GI absorption of iron, annual increase in stored Fe; hepatomegaly, hyperpigmentation, DM 2/2 pancreatic islat destruction, impotence, arthropathy and cardiac dysfunction (bronze diabetes); lab findings: elevated plasma iron with more than 50 percent saturation of transferrin, and elevated serum ferritin

60
Q

cirrohosis results in enlargement of what other organ

A

spleen 2/2 portal venous hypertension causing splenic vein hypertension

61
Q

indirect ELISA

A

anti-human IgG antibody coupled to a substrate-modifying enzyme (peroxidase) binds to serum antibodies bound to antigen; finally, substrate that is modified by the enzyme to elicit a detectable signal is added to see if the serum antibody is present

62
Q

s. epidermis found in wound culture: what does it mean?

A

normal skin flora, not commonly associated with skin disease; regard as contaminant

63
Q

achondroplasia moa

A

AD point mutation (arg for gly in position 375) of FGFR-3 on c4, which causes increased function of FGFR-3 which inhibits cartilage proliferation; pw shortened proximal extremities (with normal trunk length) and enlarged head with frontal bossing

64
Q

bruton’s agammaglobulinemia

A

X-linked defect in the signal transduction molecule known as bruton’s tyrosine kinase which is important in B cell maturation

65
Q

signal recognition particles

A

recognize translatin of N-terminal sequences in the cytosol, after which they halt translation and carry ribosome to RER so that the polypeptide is fed into RER; composed of 15-20 AA, mostly hydrophobic

66
Q

maple syrup urine dz moa

A

defect in branched-chain alpha-keto acid dehydrogenase complex, responsible for catabolism of leucine, isoleucine and valine; requires B1 as a coenzyme

67
Q

hydrops fetalis

A

severe form of alpha-thalassemia with four nonfunctional alpha globulin loci, pw pallor, edema, and massively enlarged liver (extramedullary hematopoesis)

68
Q

how does the seminiferous tubules and epididymis concentrate testosterone?

A

sertoli cells produce androgen-binding protein which binds to testosterone/dhydrotestosterone and makes these hrmones less lipophilic, allow them to be concentrated in the luminal fluid

69
Q

RAS-GTP cascade

A

Ras-GTP triggers mitogen-activated protein kinase cascade that controls entry of cell into cell cycle; intrinsic GTP-ase converts oncoprotein back to GDP-Ras; many tumors have reduced GTPase activity that allows continued GTPase activity

70
Q

glucagon moa

A

promotes glycogenolysis and gluconeogeneis in hepatocytes; enhances activity of AC, increases cAMP, activates glycogen phosphorylase;

71
Q

epinephrine affects glycogenolysis and gluconeogensis how?

A

bind to beta-2 receptor on hepatocytes, which activates Gs and adenylate cyclase

72
Q

sweating moa

A

SNS activation of eccrine (cholinergic) and apocrine glands

73
Q

hyperhidrosis rx

A

systemic antiCh, local ACh injectables like botulin toxin, and surgical sympathectomy of the thoracic sympathetic trunk (for axillary)

74
Q

red safranin O stains for

A

cartilage, mast cells, and mucin

75
Q

cartilage in articular cartilage

A

hyaline cartilage, chondrocytes embedded in a matrix of proteoglycans and collagens

76
Q

keratin is

A

cytplasmic intermediate filament produced by squamous cell cells of skin

77
Q

sphingomyelin is

A

found in myelin sheath

78
Q

round ligament

A

vestige of the gubernaculum, projects from uterus through the inguinal canal into labia majora

79
Q

NE to epi; epi to metanephrine requires what biochemical steps?

A

methylation

80
Q

platelet activating factor (PAF)

A

phospholipid inflammatory mediator (works via Gq pathway) that causes platelet aggregation (with microthrombus formation), bronchoconstriction, vasoconstriction

81
Q

platelet activation has what kind of intracellular pathway?

A

IP3-mediated release of Ca from the ER

82
Q

prostaglandin fxn and synthesis pathway

A

strongly inhibits platelet functions and increase platelet cAMP synthesis by stimulating adenylate cyclase; COX convert AA to PGH2, the precursor to prostaglandin

83
Q

vanc-induced red man syndrome is not what

A

though it releases histamine from mast cells, it is not an IgE mediated reaction

84
Q

cyclin D1

A

promotor of G1 to S phase transition

85
Q

Km

A

inversely related to affinity of the enzyme for substrate; affected by competitive agonists (lower affinity, higher Km); unrelated by amount of enzyme

86
Q

bile salt function in GI system

A

microbicidal emulsifying agents that disrupt the outer membrane of GN enteric bacili; chronic cholestatsis permits bacterial overgrowth and translocation across the gut wall in the distal small intestine

87
Q

prokaryote

A

haploid genome consistenting of single chromosome, no nuclear membrane

88
Q

eukaryote rRNA synthesis

A

28, 18, 5.8S rRNA formed from single 45S pre-rRNA, transcribed by RNA polymerase I; 5S rRNA formed separately by RNA polymerase III

89
Q

rosiglitazone/thiazolidenones

A

PPAR agonist that increases GLUT-4 expression at SK and adipose tissue, which increases insulin sensitive glucose uptak

90
Q

change in warfarin metabolisms manifests clinically in how many days?

A

gradually

91
Q

lactulose moa in HE rx

A

acidifies GI content, converting NH3 to NH4

92
Q

ostemalacia (2/2 vita D deficiency): bone type

A

excessive, unmineralized osteoid matrix in bone

93
Q

MEN1 vs MEN2: difference in gene mutation

A

MEN1 loss of tumor-suppressor gene; MEN2 gain of function mutation on protooncogene

94
Q

HNPCC increase risk of

A

colorectal and endometrial cancer

95
Q

papomavirus

A

papillomavirus and polyomavirus, replicate within host cell nucleus

96
Q

poxvirus unique characteristics

A

among DNA viruses, only one that replicates in cytoplasm

step 1 (17 decks)

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