gold usmle: Pathology Flashcards
Mobitz I
Usually due to inferior MI. Rarely goes into 3rd degree block.
118. Txt w/ Atropine or Isoproterenol.
Mobitz II
BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI.
P wave
Atrial depol.
a wave
LA contraction
T wave
Vetricular repol.
Wavy fibers
Eosinophilic bands of necrotic myocytes. Early sign of MI.
Janeways lesions
Acute bacterial endocarditis.
125. Nontender, erythematous lesions of palms & soles.
Oslers nodes
Subacute bacterial endocarditis.
127. Tender lesions of fingers & toes.
Thiamine defcy
Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption
- Dyr Beri Beri = peripheral neuropathy
- Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss
Fibrinous Pericarditis
Associated w/ MI: Dresslers
Serous Pericarditis
Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction.
Friction Rub
Pericarditis association
Hemorrhagic Pericarditis
Associated w/ TB or neoplasm
Restrictive Cardiomyopathy
Aka infiltrative cardiomyopathy that stiffens the heart
- Due to amyloidosis in the elderly
- Due to , also see schaumann & asteroid bodies in young (
PMLs infectious agent
JC Virus (Papovavirus = dsDNA, naked icosahedral capsid)
Edema
↑Pc (more seeps out)
- ↓πc (less reabsorbed)
- ↑ permeability
- Block lymphatic drainage
Adult Polycystic Kidney
Disease
Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present.
144. 3 cysts in ea. Kidney w/ + family history confirms diagnosis
Malignant HTN & Kidneys
Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men
Nephritic signs
Hematuria; RBC casts; HTN
Nephrotic signs
Proteinuria; Hypoalbuminemia; Edema
Podocyte Effacement seen
w/
Minimal Change (Lipoid nephrosis) disease
ASO seen in
Acute post-streptococcal GN (due to βHGASrtep)
150. Anti streptolysin O
Crescentic GN
Rapidly progressive GN nephritic syndrome
152. Associated w/ multi system disease or post-strep/post infectious glomerular nephritis
Hereditary Nephritis
Alports syndrome. X linked
154. Renal disease w/ deafness & ocualr abnormalities
Membranoproliferative GN
Can be secondary to complement deficiency; chronic infections; CLL
156. See tram tracking
TypeI Membrano
Proliferative GN deposits
C3 & IgG deposits
TypeII Membrano
Proliferative GN deposits
Only C3 deposits
159. Aka Dense deposit disease
Focal segmental
glomerulosclerosis deposits
IgM & C3 deposits
Cold agglutinins
Seen in atypical pneumonia
Mycoplasma pneumoniae
162. It is IgM Ab with specificity for I Ag on adult RBCs
Scrofula
TB in the lymph nodes
Aspirin-Asthma Triad
Nasal polyps
Rhinitis
bronchoconstriction
Ferruginous bodies
Hemosiderin (pigment w/ Fe3-) covered macrophages that have been pahgocytised
Pancoasts tumor causes
Ulnar nerve pain & Horners syndrome
Fatty degeneration
Made up primarily of triglycerides
168. Most commonly due to alcoholism which commonly leads to hepatic cirrhosis
169. Associated w/ CCl4
-
Cloudy swelling
Failure of cellular Na pump
171. Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver
Hydropic degeneration
Severe form of cloudy swelling
173. Seen with hypokalemia induced by vomitting/diarrhea
Liquefaction necrosis
Rapid enzymatic break down of lipids
- Seen commonly in Brain & Spinal cord (CNS) injuries
- Seen in suppurative infections = pus formation
Coagulation necrosis
Result of sudden ischemia
178. Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen
Caseation necrosis
Combination of both coagulation & liquefaction necrosis
180. Seen w/ M. tuberculosis & Histoplasma capsulatum infection
Fibrinoid necrosis
Seen in the walls of small arteries
182. Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis
Fat necrosis
Result of lipase actions liberated from pancreatic enzymes
184. Seen w/ Acute pancreatitis = saponification results
Hemoptysis
Blood in sputum
Pulmonary embolism
Most commonly thrombus from lower extremity vein
Phlebothrombosis
From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt,
188. As a complicaiton in a pt w/ Pancreatic CA due to ↑d blood coagulability
Saddle embolus
Embolus lodged in bifurcation of pulmonary trunks
190. ↑↑ RV strain = RV & RA dilate = Acute cor Pulmonale
Paradoxical embolism
Right to Left shunt allows a venous embolism to enter arterial circulation
192. Patent ovale foramen or Atrial septal defect
Tuberculoid granuloma
Collection of macrophages w/o caseation
194. Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections
Cellulitis
Spreading infection due to streptococcus
PSA
Prostate Specific Antigen = elevated in prostatic CA
↑↑5-HT
In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist)
↑ αFeto Protein
Hepatocarcinoma
199. Neural tube defects
CEA
Carcinoembryonic Antigen = elevated in Colon CA
Chromosome 13
Retinoblastoma
Chromosome 11p
Wilms tumor of the kidney
Vinyl Chloride
Associated w/ Angiosarcoma of the liver
Agent Orange
Contains dioxin
205. Implicated as a cause of Hodgkin;s disease, non-Hodgkins lymphoma & soft tissue sarcomas
Parasites & CA
Schistosoma haematobium = Urinary bladder CA
- S. mansoni = Colon CA
- Aspergillus flavus = potent hepatocarcinogen
Ochronosis
Alkaptonuria
- Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine)
- Involving intervertebral disks = Ankylosing Spondilitis = Poker spine
- See dark urine; dark coloration of sclera, tendons, cartilage
Lead poisoning
Acid fast inclusion bodies
- ↑ urinary coproprophyrin
- Anemia: microcytic/ hypochromic
- Stippling of the basophils
- Gingival line & lead line in bones: x-ray
- Mental retardation
Heroin OD, clinically
Massive pulmonary edema w/ frothy fluid from the nostrils
Fetal alcohol syndrome
Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism
Atypical mycobacterium
M. kanasasii & M. avium intracellulare
Cold abscesses
Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation
Actinomyces isrealli
Farmers infection
224. Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus
Congenital Syphilis
Saddle nose, Saber shin, Hutchinsons teeth, nerve deafness, interstitial keratitis
Warthin-Finkeledy cells
Reticuloendothelial giant cells on tonsils, lymph nodes, spleen
Diphyllobothrium latum
Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host
Subacute Bacterial
Endocarditis
α Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem
Acute Bacterial Endocarditis
Staph aureus, β Hemolytic Streptococci, E. coli
231. Common among drug addicts & diabetics
Mitral Insufficiency
Ruptured papillary muscle
Left Anterior Descending
branch
Branch of the Left Coronary artery
- Highest frequency of thrombotic occlusion
- MI = anterior wall of the LV, especially in apical part of interventricular septum
Left Circumflex branch
Branch of the Left Coronary artery
237. Occlusion = MI of posterior/lateral wall of the LV
Dissecting Aneurysm
False aneurysm: it is splitting of the media of the aorta
239. Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia,
atherosclerotic disease, Marfans Collagen disease
240. Zones of medial necrosis +/- slitlike cysts = Medial Cystic Necrosis of Erdheim
Cor Pulmonale
Right ventricular strain, associated w/ right ventricular hypertrophy
Acute Cor Pulmonale
Sudden right ventricular strain due to a massive pulmonary embolism
Bronchopneumonia
Lobular (rather than lobar)
- Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli
- Abscess formation is common
Lobar pneumonia
Due to Strep. Pneumoniae infection (5% due to Klebsiella)
247. Red Hepatization: days 1-3 of the pneumonia
248. Gray Hepatization: days 3-8 of untreated pneumonia
249. Complicaitons: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis
media
Bronchiectasis
Permanent dilatation of the bronchi predisposed by chronic sinusitis and post nasal drip
- Supparation associated
- Lower lobe > than upper lobe involvement
Panlobular Emphysema
α1 antitrypsin deficiency, causing elastase ↑ = ↑ compliance in the lung
Bulla
Associated w/ Emphysema = Bleb = outpouching - If it ruptures causes Pneumothorax
Farmers Lung
Due to Micropolyspora faeni (thermophilic actinomycetes)
Bagassosis
Due to M. vulgaris (actinomycetes)
258. Inhalation of sugar cane dust
Silo-Fillers Lung
Due to Nitrogen dioxide from nitrates in corn
G6PDH Deficiency
Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans
261. Heinz Bodies appear in RBCs
HbF ↑↑
Sickle Cell Anemia
Multiple Myeloma
Lytic lesions of flat bones (salt & pepper lesions) = vertebrae, ribs, skull; Hypercalcemia; Bence-Jones
protein casts
Hodgkins Disease
Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection
265. Reed Sternberg cells
Polyarteritis Nodosa
Immune complex disease of Ag-Ab complexes on blood vessel wall
- Half of the immune complexes have Hepatitis B Ag
- Can see fever; abd.pain; ↓ wt; HTN; muscle aches
Sprue
Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted
270. High titers of anti-gliadin Abs & ↑ IgA levels
Regional Enteritis
Crohns Disease
272. Association w/ Arthritis; Uveitis; Erythema Nodosum
Whipples Disease
Intestinal Lipodystrophy = malabsorption syndrome
Kulchitsky cells
Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas
Ulcerative Colitis
Inflammatory disease of the colon w/ ↑ colon CA incidence
- Crypt abscess in the crypts of Lieberkuhn
- Pseudopolyps when ulcers are deep
- Not transmural involvement
Vaginal Adenosis
Women exposed to DES (Diethylstilbesterol) in utero before the 18th week of pregnancy
280. Some develop clear cell adenocarcinoma of the vagina & cervix
Hofbauer Cells
Lipid laden macrophages seen in villi of Erythroblastosis Fetalis
Retinopathy of Prematurity
Retrolental Fibroplasia = cause of bindness in premies due to high O2 concentrations
IgA deficiency
Pt has recurrent infections & diarrhea w/ ↑ respiratory tract allergy & autoimmune diseases
285. If given blood w/ IgA = develop severe, fatal anaphylaxis reaction
Priamry Sjorgens
Dry eyes & dry mouth, arthritis. ↑ risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease.
Secondary Sjorgens
Rheumatoid arthritis, SLE, or systemic sclerosis association
288. RA association shows HLA-DR4
LDH1 & LDH2
Myocardium. LDH1 higher than LDH2 = Myocardial Infarction
LDH4 & LDH5
Liver cells
Keratomalacia
Severe Vit A deficiency. See Bitots spots in the eyes = gray plaques = thickened, keratinized ET
Metabisfite Test
Suspending RBCs in a low O2 content solution
294. Can detect Hemoglobin S, which sickles in low O2
Microangiopathic Hemolytic
Anemia
Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP)
296. See Helmet cells
Wrights stain
Stain for Burkitts lymphoma
Mononucleosis
Due to EBV infeciton
299. If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur.
T(8;14)
Burkitts lymphoma = c-myc oncogene overexpression
T(9;22)
CML = c-abl/bcr gene formation = Philadelphia translocation
Langerhan Cell Histiocytosis
Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma
303. Birbeck granules are present = tennis racket shape
Myeloid Metaplasia
Alkaline phosphatase ↑/normal compare to CML = low to absent
305. Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis
Multiple Myeloma
Weakness; wt. loss; recurrent infection; proteinuria; anemia; ↑ proliferation of plasma cells in BM =
plasma cell dx
307. Serum M protein spike most often of IgG or IgA
308. Hypercalcemia (↑ bone destruction)
T(14;18)
NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr) Lymphoma
Focal Segmental GN exs
IgA Focal GN = Bergers disease; SLE; PAN; Schonlein-Henoch purpura (anaphylactoid purpura)
Nephrotic Syndrome exs
Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep B;
Syphilis; Penicillamine
Schistosoma Haematobium
Infection is assocaited w/ Squamous cell CA of the Bladder (most common Bladder CA is transitional
cell type)
313. Associated w/ portal HTN due to intrahepatic obstruction
Penicillin Resistant PID
PID is usually due to N. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species
Duret Hemorrhages
We learned associated with transtentorial hemorrhages, they say:
Severe ↑ in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing a
compression on the brainstem w/ hemorrhaging into the pons & midbrain
316. Nearly always associated w/ death due to damage to the vital centers in these areas
Hypertensive Hemorrhage
Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages
Cerebral Embolism from
MI w/ Mural Thrombi; Atrial Fib Thrombi = Marantic thrombi; L-sided Bacterial Endocarditis;
Paradoxical Embolism of septal defect
Neurosyphilis
Tabes Dorsalis = ↓ joint position sensation, ↓ pain sensation, ataxia, Argyl Robertson pupils
- Syphilitic meningitis
- Paretic neurosyphilis
5p-
Cri di Chat: mental retardation; small head; wide set eyes; low set ears; cat-like cry
Trisomy 13
Pataus: small head & eyes; cleft lip & palate; many fingers
Acute Cold Agglutinaiton
Abs to I blood group Ag. Mediated by IgM Abs
325. Complication of EBV or Mycoplasma pneumoniae infections
Chronic Cold Agglutinaiton
Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs
RBC Osmotic Fragility
Hereditary Spherocytosis
Non-Hodgkins Lymphomas
Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL.
329. Small Cleaved cell (Follicualr): low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene
330. Large Cell
331. Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL
332. Small Non Cleaved = Burkitts: high grade B cell lymphoma. EBV infection. Starry sky histo appearance.
T(8;14) c-myc proto-oncogene. Related to B-ALL
Singers Nodules
Benign laryngeal polyps associated w/ smoking & overuse of the voice
Paraseptal emphysema
Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax
Superior Vena Cava Syndrome
Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis.
Betel nuts
Associated to oral cancer.
Fundal (Type A) Gastritis
Antibodies to parietal cells; pernicious anemia; autoimmune diseases
Antral (Type B) Gastritis
- Associated w/ Helicobacter (Campylobacter) pylori infection. 90% of duodenal ulcer
Primary Biliary Cirrhosis
Autoimmune origin; middle aged women; anti-mitochondrial Abs
340. Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas)
Acute Pancreatitis
↑ pancreatic enzymes = fat necrosis; sapponification = hypocalcemia; ↑ serum amylase
342. Severe epigastric ab pain; prostration; radiation to the back
Radiating Back Pain
Chronic pancreatitis
Complete Hydatidiform Mole
No embryo. Paternal derivation only. 46XX
Partial Hydatidiform Mole
Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs
Cold Nodules
Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite: hot & do take up iodine]
Acidophils
Mammotrophs = Prolactin
348. Somatotrophs = GH
Basophils
Thyrotrophs = TSH
- Gonadotrophs = LH
- Corticotrophs = ACTH & FSH
Lacunar Strokes
Small/focal aa occlusions. Purely motor or sensory.
- Sensory: lesion of thalamus
- Motor: lesion of internal capsule
CSF of Bacterial Meningitis
↓ Glucose; ↑ Protein; ↑ Neutrophils; ↑ Pressure
CSF of Viral Meningitis
Normal Glucose; +/-↑ Protein; ↑ Lymphocytes
Marble Bone Disease
Osteoporosis: Albers-Schonberd Disease = inspite of ↑d bone density, many fractures = ↓ osteoclasts
C5a
Involved in Chemotaxis (for Neutrophils)
C3b
Involved in Opsonization (& IgG)
Anaphylotoxins
C3a & C5a (mediate Histamine release from Basophils & Mast cells)
Vasoactive Mediators
Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF
- Vasodilation: PGI2; PGD2; PGE2; PGF2α; Bradykinin; PAF
- ↑d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2α; LTC4; LTD4; LTE4; Bradykinin; PAF
Platelet Aggregation
ADP; Thrombin; TxA2; collagen; Epinephrine; PAF
Platelet Antagonist
Prostacyclin (PGI2)
Intrinsic Pathway
F XII (Hagman): APTT
Extrinsic Pathway
F VII: PT
Lines of Zahn
Aterial thrombi = pale red colored (dark red is venous thrombi)
Currant Jelly appearance
Post mortem clots
Emigration: Chemotaxis
Margination
- Pavementing
- Adhesion
- Chemotaxis
- Phagocytosis
- Intracellular microbial killing
Transudate
Specific gravity
Exudate
Specific gravity > 1.020 high protein
Hurlers
Lysosomal storage disease α L Iduronidase Heparan/Dermatan Sulfate accumulation
Galactosemia
Deficiency of Galactose 1 Phosphate Uridyl Transferase. ↑ Galactose 1 Phosphate
Phenylketonuria
Deficiency: Phenylalanine Hydroxylase. ↑ Phenyalanine & degradation products
381. Mousy body odor
Autosomal Dominant Diseases
Adult Poly Cystic Kidney Disease
- Familial Hypercholestrolemia Disease
- Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu)
- Hereditary Spherocytosis
- Huntingtons Disease (chromosome 4p)
- Marfans Syndrome
- Neurofibromatosis (von Recklinghausens)
- Tuberous Sclerosis
- Von Hippel Lindau Disease
Autosomal Recessive
Diseases
Tay-Sachs 392. Gauchers Page 25 393. Niemann-Pick 394. Hurlers 395. Von Gierkes 396. Pompes 397. Coris 398. McArdles 399. Galactosemia 400. PKU 401. Alcaptonuria
X Linked Recessive Diseases
Hunters Syndrome (L-Iduronosulfate Sulfatase deficincy, ↑ Heparan/Dermatan Sulfate)
- Fabrys Disease (α Galactosidase A deficiency, ↑ Ceremide Trihexoside)
- Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, ↑ Ceremide Trihexoside)
- Lisch-Nyhan Syndrome (HGPRT deficiency, ↑ Uric acid)
- G6Phosphatase deficiency (G6PDH deficiency, ↑ Ceremide trihexoside)
- Duchennes Muscular Dystrophy (Dystrophin deficinecy, ↑ Ceremide Trihexoside)
Hypersensitivity Reactions
ACID
Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives
409. Type II (Cytotoxic): Warm Ab autoimmune hemolytic anemia; hemolytic transfusion reactions;
Erythroblastosis Fetalis; Graves Disease; Goodpastures
410. Type III (Immune Complex): Insoluble complement bound aggregates of Ag-Ab complexes. Exs: Serum
sickness; Arthus Reaction; Polyarteritis Nodosa; SLE; Immune Complex Mediated Glomerular Disease
411. Type IV (Delayed = Cell mediated immunity): Delayed hypersensitivity. Involves memory cells. Exs:
Tuberculin reaction; Contact dermatitis; Tumor cell killing; Virally infected cell killing
Transplant Rejections
Hyperacute Rejection = occurs w/in minutes of transplant. Ab mediated.
413. Acute Rejection = occurs w/in days to months of transplant. Lymphocytes & macrophages. Only
rejection type that can be treated w/ therapy.
414. Chronic Rejection = occurs months to years of transplant. Ab mediates vascular damage.
Blood Metastasis
Sarcoma, exception renal cell CA: early venous invasion
Lymph Metastasis
Carcinoma, exception renal cell CA: early venous invasion
Aflatoxin
Seen w/ Aspergillus. ↑ risk for Hepatocellular CA
Cleft Lip
Incomplete fusion of maxillary prominence w/ median nasal prominence
Cleft Palate
Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial
palatine prominence
Craniopharyngioma
Pituitary tumor - usually calcified
Lateral Geniculate Nucleus
Inolved in Vision relay
Medial Geniculate Body
Involved in Hearing relay
Lung Development
Glandular: 5-17 fetal weeks
Canalicular 13-25 fetal weeks
Terminal Sac 24 weeks to birth
Alveolar period birth-8yoa
Hearts 1st Beat
21-22 days
Foregut
Mouth -> Common Bile Duct - supplied by Celiac Artery
Midgut
Duodenum, just below Common Bile Duct ! Splenic flexure of the Colon supplied by Superior Mesenteric
artery
Hindgut
Splenic Flexure ! Butt crack ! supplied by Inferior Mesenteric Artery
Hypnagogic Hallucinaitons
Narcolepsy
Type I Error
α: Convicting the innocent accepting experimental hypothesis/rejecting null hypothesis
Subdural Hematoma
Ruptured cerebral bridging veins
Epidural Hematoma
Ruptured middle meningeal artery intervals of lucidness, 2ry to Temporal bone fracture
Type II Error
β: Setting the guilty free fail to reject the null hypotesis when it was false
Power
1 - β
Sensitivity
TP/TP + FN
Specificity
TN/TN + FP
Positive Predictive Value
TP/TP + FP
Negative Predictive Value
TN/TN + FN
Odds Ratio
ad/bc
d-Dimers
DIC
Delusion
Disorder of thought content
Loose Association
Skip from topic to topic
5 Stages of Death
Denial Anger Bargaining Depression Acceptance
1st Branchial Arch
Meckels cartillage gives rise to incus/malleus bones of ear
2nd Branchial Arch
Reicherts cartillage gives rise to stapes bone of ear
Median nerve lesion
No pronation
Radial nerve lesion
Wrist drop seen w/ humerus fracture
Common peroneal lesion
Foot drop. No dorsiflexion or eversion of the foot
Diract inguinal hernia
Goes through superficial inguinal ring.
Medial to inferior epigastric artery
Seen in older men
Indirect inguinal hernia
Goes through deep & superficial inguinal ring
Lateral to inferior epigastric artery
Seen in young boys processus vaginalis did not close
@ Diaphragm T8, T10, T12
T8 = Inferior vena cava T10 = Esophagus/ Vagus T12 = Aorta/ Thoracic duct/ Azygous vein
Hemiballismus
Wild flailing of 1 arm. Lesion of the sub thalamic nucleus
O Linked Oligosaccharide
In the Golgi
N Linked Oligosaccharide
In the RER
MLF Syndrome
Internuclear Ophthalmoplegia: medial rectus palsy on lateral gaze; Nystagmus on abducting eye.
Seen w/ MS
ADA Deficiency
SCID
Raphe Nucleus
Initiation of sleep via 5HT predominance
β waves
Alert; Awake; Active mind also seen in REM, therefore we say paradoxical sleep
Irreversible Glycolysis
Enzymes
Hexokinase
PhosphoFructo Kinase = Rate Limiting Step
Pyruvate Kinase
Pyruvate Dehydrogenase
Irreversible Gluconeogenesis
Enzymes
PyruvateCarboxy Kinase PEPCarboxyKinase Fructose 1,6 BiPhosphatase Glucose 6 Phosphatase **muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium
Pellagra
Diarrhea, Dermatitis, Dementia Niacin Deficiency (Vit B3 deficiency) Hartnups Disease Malignant Carcinoid Syndrome INH use
TLCFN
Needed as co-factor for Pyruvate DH complex & α Ketoglutarate DH complex
LCAT or PCAT
Esterification of cholesterol: lecithin cholesterol acetyltransferase
Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase
HMGCoA Reductase
Rate limiting step in cholesterol synthesis
Changes HMGCoA ! Mevalonate
(-) by Lovastatin
Ketogenic amino acids
Leucine & Lysine
Glucogenic amino acids
Methionine, Threonine, Valine, Arginine, Histadine
Keto & Gluco amino acids
Phenylalanine, Trytophan, Isoleucine
Carnitine Shuttle
Feeds FA into the mitochondria for their consumption
Cori Cycle
Keeps muscles working anaerobically.
Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use
(-) Na+ Pump (ATPase)
Ouabain [(-) K+ pump]
Vanadate [(-) phosphorylation]
Digoxin [↑ heart contractility]
TCA Cycle Products
Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation
Citrate ! Aconitate ! Isocitrate ! α Ketoglutarate ! Succinyl ! Succinate ! Fumarate ! Malate !OAA
Cones
Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity.
Rods
Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision.
Gastrula
Seen @ 3rd week: Ecto, Meso & Endo
Epiblast
@ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto.
Sydenhams Chorea
Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus
(+) Frei Test
Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum
Sabourauds Agar
Culture for all Fungi ie Culture Cryptococcus neofromans which is found in pigeon droppings
FMR1 Gene Defect
Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation
Barr Body
Barr Body
Aortic Insufficiency Signs
Traube Sign = Pistol shot sound over the femoral vessels
Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation
Scleroderma :CREST
Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis
Cretinism
Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation
Endemic: no Iodine in diet: protruding belly & belly button
Hemochromatosis Triad
Micronodular pigment cirrhosis; Bronze Diabetes; Skin pigmentation = due to ↑ Fe3+ deposition