Form 1 Flashcards
What are the cardinal symptoms of reactive arthritis?
Acute back pain, monoarthritis, and conjunctivitis following a GU or GI infection
HLA B27
With which dermatologic issue is celiac disease associated?
Dermatitis herpetiformis
With which HLA types is Celiac disease associated?
DQ2 and DQ8
What part of the epidermis forms a callus?
The uppermost layer, the stratum corneum
Which antibiotics inhibit the prokaryotic 30s ribosome?
Tetracyclines and aminoglycosides
Why does gastrin release increase in patient’s wth pernicious anemia?
The autoimmune destruction of the gastric mucosa leads to hypochlorhydria which induces more gastrin release from the antral G cells
Why are varicoceles more common on the left side?
Varicoceles are dilations of the pampiniform plexus. The spermatic vein drains at a perpendicular angle into the L renal vein. The left renal vein can be compressed between the SMA and the aorta
What skin finding is often found with GI malignancy?
Acanthosis Nigricans- especially if it appears suddenly and spreads quickly
What type of long term anticoagulation is recommended in patients with valve replacement?
Vitamin K epoxide reductase inhibitor- Warfarin
What are the clinical feature of DiGeorge Syndrome?
Conotruncal cardiac abnormalities Abnormal facies Thymic hypoplasia Cleft lip and palate Hypocalcemia--> tetany or seizures
What is hyper-IgM syndrome?
XLR absence of CD40 ligand on Th4 cells leads to inability to class swith to IgE, IgA, and IgG
What is found on electron microscopy in gaucher disease?
“wrinkled tissue paper” macrophages that have lysosomes filled with glucocerebroside due to a lack of beta glucocerebrosidase.
What are the symptoms associated with Gaucher’s?
bone pain crises, avascular necrosis, hepatosplenomegaly
What are the two drugs that block TNF-alpha?
Infliximab- antibody against it
Etanercept- recombinant TNF receptor fusion protein
How does aspirin inhibit thrombosis?
aspirin inhibits Cox-1, preventing the synthesis of TXA2, a potent stimulator of platelet activating factor and vasoconstrictor
What does aspergillus fumigatus show with methenamine silver stain?
broom-like appearance of conidiophore with terminal vesicles that have outwardly radiating phialides and condiospores attached.
Which bacterias can take up foreign DNA and incorporate it into their own genomes (Transformation)?
Competent bacteria: Haemophilus, strep, bacillus, and Neisseria
What is conjugation?
DNA passed between bacteria via direct cell to cell communication
What is transduction?
bacteriophage mediated transfer of DNA
What is hand-foot-genital syndrome?
AD HOXA13 mutation that leads to malformations of the distal limbs and mullerian fusion abnormalities
How can you increase skeletal muscle contraction velocity?
Decrease afterload
What symptoms and lab findings would be expected in ethylene glycol poisoning?
sudden onset flank pain, gross hematuria, oliguria
Anion gap metabolic acidosis
What is acyl-CoA dehydrogenase deficiency, what are the symptoms, and when does it usually present?
Most common genetic defect in beta oxidation of fatty acids
presents in the first few years of life with N/V, seizure, liver dysfunction, and hypoketotic hypoglycemia after prolonged fasting (often in the setting of a viral illness).
What is a medication to control the symptoms of carcinoid tumor?
octreotide- a somatostatin analog that reduces secretion of bioactive peptides by the carcinoid tumor
How are proteins necessary for apoptosis translated after caspases have degraded the eIFs?
Internal ribosome entry- with the site located in the 5’ untranslated region
What is the Kozak sequence?
Helps initiate 5’ cap-dependent translation in eukaryotes
What is the Shine-Delgarno sequence?
Helps initiate 5’ cap-dependent translation in prokaryotes
What can you do to improve the symptoms of hepatic encephalitis
Intestinal content acidification- draws in more NH3 and traps it as NH4+
What part of the bone is affected in osteomalacia?
the osteoid has decreased mineralization
How does aneurysmal dilation of the aortic arch cause hoarseness?
compression of the recurrent laryngeal nerve, which innervates all of the intrinsic muscles of the larynx that are responsible for sound production, except the cricothyroid.
What is the histopathology associated with Hashimoto thyroiditis?
intense, diffuse lymphocytic infiltration
Hurthle cells- enlarged epithelial cells with prominent nucleoli and abundant eosinophilic cytoplasm
Which axons are unmyelinated?
Afferent: slow pain, heat sensation, olfaction
Efferent: Postganglionic autonomic neurons
How are antigens processed by macrophages?
The invariant chain is removed from the MHC-invariant complex (alpha chain, beta chain, and invariant chain) and replaced by an external protein. This MHC peptide complex (alpha chain, beta chain, and external protein) is then expressed at the cell surface
Which bone tumor is most associated with paget’s disease?
Osteosarcoma
What are the signs and symptoms of anticholinergic syndrome? what seed can cause it?
fever, dry skin and mucous membranes, flushing, mydriasis and cycloplegia, and altered mental status.
Jimson weed
With which leukemia are auer rods associated?
APL t(15;17) Can lead to DIC
Which cytokine is produced exclusively by lymphocytes?
IL-2: produced by T cells to stimulate growth and differentiation of T cells- clonal proliferation
What forms the intercellular adhesions between epithelial cells?
Cadherins- interact intracellulary with intermediate proteins that bind them to intermediate or micro-filaments. Calcium dependent!
What do hemidesmosomes mediate?
cell adhesion to the basement membrane
Describe the gross and histologic pathology of molluscum contagiosum
Umbilicated, flesh-colored papules on the skin and mucus membrane. Caused by a poxvirus that looks like eosinophilic cytoplasmic inclusions
What causes the secretion of bicarbonate into the duodenum?
Low pH–>S cells release secretin into systemic circulation–> pancreas generates bicarb rich fluid.
What is the primary concern in anterior and posterior dislocations of the knee joint?
Injury to the popliteal artery, because it is located close to the articular surface of the joint.
What is most commonly injured in blunt trauma to the lateral knee?
the common peroneal nerve
What type of infection is common after cesarean delivery?
postpartum endometritis- fever, lower ab pain, malodorous lochia
What percentage of normal GFR is expected to return after heminephrectomy? (timeline)
Acutely: 50%
1 week: 65-70%
4-6 weeks: 80%
Which nerve is damaged with injury to the lateral chest wall? What muscle does this paralyze?
Long thoracic nerve
Serratus anterior- stabilizes and rotates scapula upward. If injured, can’t raise arm overhead and there is protrusion of the scapula when outstretched arm is pushed against resistance
What are the chloride and bicarbonate secretions from the pancreas like during high versus low flow
high flow: HCO3 increases and chloride drops
low flow: opposite
What is the difference between acute stress disorder and PTSD
Acute stress disorder is <1month
PTSD is >1month
What is the difference between schizophreniform disorder and schizophrenia
schizophreniform lasts <6months (also >1 month), but does not require functional decline
schizophrenia last >6 months and requires functional decline
What lobe is herpes encephalitis most likely to affect?
Temporal–> olfactory hallucinations or anosmia, temporal lobe seizures, bizarre behavior, delirium, aphasia, hemiparesis
With which thymic issue is myasthenia gravis associated?
hyperplastic thymic tissue (60-70%)
Thymoma (10-15%)
What are the most common septic arthritis causative agents?
S. Aureus, GC, Streptococcus, H flu, and gram - bacilli
What causes intraventricular hemorrhage in premature babies?
Weak vasculature network of the germinal matrix is vulnerable to spontaneous hemorrhage
How does cisplatin cause ototoxicity?
damages the apical stereocilia on hair cells
What lung complication can be caused by amiodarone? Name some other medications associate with interstitial lung dz
Interstitial pneumonitis- slowly progressive dyspnea and nonproductive cough
nitrofurantoin, methotrexate, bleomycin
Also, RA, sarcoidosis, vasculitidies, and amyloidosis
How does misoprostol help to prevent and treat NSAID induced peptic ulcers?
PGE1 analog- protects gastric mucosa from acidic juices by stimulating mucous production.
What are the most common sites of head and neck squamous cell carcinomas?
ventral tongue, floor of mouth, lower lip, soft palate, and gingiva
What are the clinical manifestations of hemochromatois?
hyperpigmentation, arthralgia, hepatomegaly/cirrhosis/carcinoma, DM, hypothyroidism, restrictive or dilated cardiomyopathy, increased susceptibility to listeria, vibrio vulnificus, and yersinia enterocolitica
usually presents after age 40
How do most bacteria develop resistance by decreasing their intracellular accumulation of a drug?
Efflux pump that is powered by moving protons alongs their gradient out of the cell
What features are associated with achondroplasia?
Macrocephaly frontal bossing midface hypoplasia shortened limbs trident hand genu varum (bowing of tibia)
What are the inheritance pattern and labs associated with Bruton agammaglobulinemia?
XLR
Defect in Bruton’s tyrosine kinase leads to B cells that cannot leave the bone marrow–> no Abs. Normal T cells, but low or absent B cells.
How are high concentrations of testosterone maintained in the seminiferous tubules and epididymis?
Sertoli cells produce androgen-binding protein
What innervates sweat glands in the armpit?
Thoracic sympathetic trunk
What is the remnant of the gubernaculum in males? females?
scrotal ligament
round ligament- passes through the inguinal canal and attaches to the labia majora
