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UWorld FACTOIDs > Key Associations 2 > Flashcards

Key Associations 2 Flashcards

1
Q

Risks in PCOS

A

Endometrial adenocarcinoma and type 2 diabetes mellitus

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1
Q

Acute rejection

A

Usually seen within 6 months, antibody-mediated or cell mediated, if cell mediated - lymphyctic infiltrate of vessels, tubules, and interstitium may be seen

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2
Q

Length constant

A

How far along axon electrical impulse can propogate. Myelination increases length constant and decreases time constant.

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3
Q

Inheritance of achondroplasia

A

Autosomal dominant in 15%, sporadic in 85%

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4
Q

Why is pus or sputum green during bacterial infections?

A

Release of MYELOPEROXIDASE (MPO) from neutrophilic azurpophilic granules. MPO is a heme-containing pigmented molecule.

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5
Q

Vomiting resulting from systemic chemotherapy is the result of stimulating what structure? Where is it?

A

stimulation of the CHEMORECEPTOR TRIGGER ZONE (CTZ), which lies in the AREA POSTREMA of the DORSAL MEDULLA near the FOURTH VENTRICLE

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6
Q

Which bacteria produce Vero cytotoxins?

A

Shiga-like toxins are produced by EHEC, and Shigella dysenteriae - inhibit the 60s ribosomal subunit in human cells

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7
Q

Which bacteria produces a toxin similar to C. diptheria?

A

Pseudomonas aeruginosa produces exotoxin A, very similar to diptheria toxin in that it halts human cellular protein synthesis by inhibiting ELONGATION FACTOR-2

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8
Q

Similar toxin to enterotoxin choleragen produced by vibrio cholerae?

A

Heat labile toxin of ETEC causing increased intracellular cAMP

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9
Q

Intrapleural pressure at FRC?

A

-5 cm H2O, -7.5 cm H2O during inspiration

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10
Q

What is myocardial hibernation?

A

Reversible loss of contractile function, caused by a perisistent or repetitive low flow state that can be reversed by reperfusion

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11
Q

What is myocardial stunning?

A

Less severe form of ischemia-induced (<30 min) reversible loss of contractile function than himbernation recovery in hours to days. Repetitive stunning may result in hibernation.

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12
Q

What is ventricular remodeling?

A

Chronic changes in mass, volume, shape, and myocyte composition of the heart, to compensate for increased hemodynamic load.

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13
Q

Define hypokinesia

A

Abnormally SLOW muscle activity

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14
Q

Add Slide: ID location that parietal cells are located

A

Upper grandular layer (superficial region of gastric glands) Chief cells deeper region of gastric glands

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15
Q

$ NAME the 2 enzymes that are inactivated by LEAD!

A

ZINC-containing DELTA-AMINOLEVULATE DEHYDRATASE and FERROCHELATASE, Delta-ALA and protoporphyrin IX accumulate in lead poisoning, production of heme is reduced, and microcytic anemia occurs due to lack of Hb

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16
Q

What reaction does sunglight exposure catalyze?

A

First chain of vitamin D synthesis: 7-DEHYDROCHOLESTEROL to CHOLECALCIFEROL (Vitamin D3)

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17
Q

M/C elbow injury in children

A

RADIAL HEAD SUBLUXATION (Nursemaid’s elbow) Ages 1 to 4, sharp pull on hand wile forearm pronated and elbow extnded, causing ANNULAR LIGAMENT to tear from periosteal attachement at radial neck. Rx: reduce by supinating childs forearm followed by fully fle

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18
Q

Primary causes of lacunar infarcts

A

LIPOHYALINOSIS (destructive vessel lesion w/ loss of normal arterial architecture, mural foam cells, and fibrinoid vessel wall necrosis in severe cases) and MICROATHEROMAS (accumulation of lipid-laden macrophages within intimal layer of vessel)

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19
Q

Mechanism of uremic neuronal toxicity?

A

Excess ammonia depletes glutamate, an excitatory neurotransmitter and causes accumulation of glutamine, resulting in astroyte swelling and dysfunction. Depletion of alpha-keoglutarate occurs, causing inhibition of the Krebs cycle and further impairing ene

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20
Q

Affect of Carnitine deficiency

A

Impairs fatty acid transport into mitochondria, restricting ketone ody production (Carnitine ayltransferase I on outer surface of inner mitochondrial membrane)

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21
Q

Associations with Polyhydramnios

A

EXCESSIVE accumulation of amniotic fluid either decreased fetal swallowing or increased fetal urination. GI obstructoin due to duodenal, esophageal, or intestinal atresia and ANENCEPHALY

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22
Q

Why does silicosis increase risk for TB infection?

A

Silicosis imparis MACROPHAGE KILLING of INTRACELLULAR MYCOBACTERIA - due to disruption of macrophage phagolysosomes by internalized silica particles.

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23
Q

Studies link increased expresion of this enzyme to some forms of colon adenocarcinoma

A

COX-2, aspirin protects from adenomatous polyp formation!

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24
Q

Adenoma-to-carcinoma sequence

A

APC inactivation (allows hyperproliferation) -> Methylation abnormalities -> Cox-2 overexpression -> ADENOMA formation with K-ras activation + DCC inactivation + P53 inactivation -> CARCINOMA

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25
Q

Non-disjunction may occur in which two phases of cell division?

A

Failure of HOMOGLOGOUS CHROMOSOMES to separate in MEIOSIS I (Majority in maternal meiosis I) or failure of SISTER CHROMATIDS to separate during MEIOSIS II or MITOSIS

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26
Q

Persistent lymphedema predisposes to development of this rare malignant neoplasm

A

LYMPHANGIOSARCOMA - may arise 10 years after radical mastectomy with axillary lymph node dissection for breast cancer

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27
Q

Key cells involved in cell-mediated immunity

A

MACROPHAGES, CD4+ helper T-cells, CD8+ cytotoxic T-cells and NK cells

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28
Q

Cleft lip results from improper fusion of these structures

A

MAXILLARY PROMINENCE and MEDIAL NASAL PROMINENCE

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29
Q

Receptor that stimulates insulin release and inhibits secretion of insulin

A

Alpha receptors INHIBIT insulin secretion and beta-receptors STIMULATE insulin secretion in pancreatic beta cells

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30
Q

What is the reason for producing lactic acid in anaerobic conditions?

A

NADH transfers protons to PYRUVATE to form LACTATE and to REGENERATE NAD+. NAD+ is required to convert glyceraldehyde-3-phosphate to 1-3-bisphosphoglycerate in glycolysis. Under aerobic conditions NAD+ is generated from the TCA in the ETC as this energy i

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31
Q

What limits glycolysis in strenuously exercising muscle?

A

LIMITED REGENERATION OF NAD+ from NADH

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32
Q

Alkaptonuria

A

Benign disorder of tyrosine metabolism, AR deficiency of HOMOGENTISATE OXIDASE blocks metabolism of phenylalaine and tyrosine at the level of HOMOGENTISIC ACID, preventing the conversion of TYROSINE to FUMARATE

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33
Q

Minute ventilation vs Alveolar ventilation

A

in L/min = Tidal volume (L) x breaths/minute where alveolar veintilation in L/min is (TV - Dead space V) x breaths/min

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34
Q

Most frequent bacteria in aspiration pneumonia

A

Anaerobic bacteria in oral cavity: Fusobacterium, peptostreptococcus, Bacteroides

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35
Q

Anatomy of femoral hernia

A

Protrudes through FEMORAL RING, medial to femoral vessels and inferior to INGUINAL LIGAMENT (see pic)

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36
Q

Anatomy of direct inguinal hernia

A

Older men - Bluges through hesselbach’s triangle, medial to inferior epigastric vessels, to reach external inguinal ring, caused by weakness of TRANSVERSALIS FASCIA

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37
Q

Anatomy of indirect inguinal hernia

A

Male infants - enters internal inguinal ring lateral to inferior epigastric vessels. Caused by persistent PROCESSUS VAGINALIS and failure of INTERNAL INGUINAL ring to close

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38
Q

Precursor protein responsible for localized amyloidosis in organs: Cardiac atria, thyroid, pancreatic islets, cerebrum, pituitary

A

ANP, calcitonin, islet amyloid protine, beta myloid, prolactin

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39
Q

3 components of a craniopharyngioma

A

Solid, cystic, and calcified; present in childhood, mass effect and visual deficits. Rathke’s puch derivative from pharyngeal roof (AP forms from this)

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40
Q

t(14:18)

A

90% of patients with follicular lymphoma causing overexpression of antiapoptotic BCL2 gene product

41
Q

Overexpression of N-MYC proto-oncogene

A

neuroblastoma and small cell carcinoma of the lung

42
Q

translocation of C-MYC gene on chromosome 8

A

ALL BURKIT LYMPHOMAS

43
Q

Generalized tonic-clonic seizure

A

DIFFUSE (generalized) ALTERNATING STIFFENING and MOVEMENT (tonic-clonic)

44
Q

M/C cause of seizures in adults

A

1 TUMORS (#1 metastasis (Lung, Breast, SKIN!)), #2 TRAUMA #3 STROKE #4 INFECTION

45
Q

M/C causes of seizures in elderly patients

A

1 STROKE #2 TUMOR #3 TRAUMA #4 METABOLIC #5 INFECTION

46
Q

M/C causes of seizures in childen

A

1 GENETIC #2 INFECTION (febrile) #3 TRAUMA #4 Congenital #5 Metabolic

47
Q

How is gastric acid secreted?

A

Parietal cells in fundus and body of stomach by 3 substances: HISTAMINE (H2 receptors increase cAMP), ACETYLCHOLINE (M3 muscarinic receptors increase intracellular calcium) GASTRIN (increases calcium and stimulates histamine synthesis and release by ECL c

48
Q

Histamine-mediated symptoms of mastocytosis

A

Syncope, flushing, hypotension, tachycardia, broncospasm, SKIN - pruritis, urticaria, dermatographism.

49
Q

Which artery runs with the Radial nerve?

A

Deep brachial artery, courses along posterior aspect of humerus. Midshaft fractures of the humerus risk injury to these structures.

50
Q

Type B Chronic gastritis

A

ANTRUM-predominant or H. PYLORI associated chronic gastritis. Inflammatory cell infiltrate (LYMPHOCYE and PLASMA CELL predominant in chronic) Neutrophil in acute.

51
Q

Type A Chronic gastritis

A

AUTOIMMUNE Chronic gastritis that is BODY-predominant (not antrum) chronic gastritis in which megaloblastic anemia occurs due to destruction of parietal cells

52
Q

2 components of Reye syndrome

A

HEPATIC dysfunction - vomiting and hepatomegaly, jaundice rare) and ENCEPHALOPATHY - attributed to hyperammonemia on CNS leading to cerebral edema. NEVER administer aspirin to children under 16.

53
Q

What is bronchiolotis obliterans

A

Chronic rejection of lung affets small bronchioli producing obstructive lung disease - lymphocytic inflamamtion and necrosis of bronchiolar walls.

54
Q

Most common inborn error of methionine metabolism

A

Homocystinuria - caused by CYSTATHIONINE SYNTHETASE DEFICIENCY

55
Q

Catalase positive organisms

A

“No SSPACE for your cats”Nocardia, Staph Aureus, Serratia marcescens, PSEUDOMONAS CEPACIA, Aspergillus, Candida, E. coli, (Patients with CGD don’t have NADPH oxidase in neutrophils and are at risk for these sepcies)

56
Q

Chronic granulomatous disease

A

genetic defect in NADPH oxidase - normally NADPH kills microbes in neutrophil phagolysososmes. Patients develop recurrent pulmonary cutaneous, lymphatic and hepatic infections with granuloma formation

57
Q

Ulcer arising in the proximal duodenum associated with severe trauma or burns

A

Curling ulcer (impaired oxygenation)

58
Q

Ulcer arising in the esophagus, stomach, or duodenum in patients with high intracranial pressure particularly prone to perforation

A

Cushing ulcer (direct stimulation of vagus nerve by increased intracranial pressure)

59
Q

Transport of conjugated vs unconjugated bilitubin

A

Liver takes up unconjugated bilirubin passively (organic anion transporting polypeptide) and secretes conjugated bilirubin through an ACTIVE process (ATP-binding cassette protine MRP2 an organic anion transporter)

60
Q

Solubility of conjugated vs unconjugated bilirubin

A

Unconjugated bilirubin is INSOLUBLE in water and tightly complexed to serum albumin while in circulation. Conjugated bilirubin is WATER-SOLUBLE, non-toxic, and lossely bound to albumin, freely excreted in urine.

61
Q

Cultured on a cysteine-tellurite agar

A

C. diphtheriae, resultant colonies are black in color.

62
Q

Name 2 ways to culture C. diphtheriae

A
  1. Cysteine-tellurite agar (black colonies) or 2. METHYLENE BLUE (aniline dye) staining and intraellular polyphosphate granules called metachromatic granules are stained.
63
Q

$ Late sequelae of untreated GAS infetions

A

S. pyogenes (Group A Strep) can cause ACUTE RHEUMATIC FEVER (ARF) after 4-6 weeks and APSGN 1-5 weeks. APSGN can follow skin OR pharyngeal infection, occuring 1-5 weeks after onset. RF is ONLY ASSOCIATED with THROAT infection by GAS.

64
Q

Where is CSF absorbed?

A

SUBARACHNOID SPACE by ARACHNOID GRANULATIONS and then enters venous sinuses

65
Q

Site of CSF secretion?

A

CHOROID PLEXUS

66
Q

What are arachnoid granulations?

A

Tufted prolongations of pia-arachnoid composed of numerous arachnoid villi that penetrate dural venous sinuses and TRANSFER CSF to the venus system. ABSORB CSF

67
Q

Agammaglobulinema will prevent these structures in the lymph node

A

ABSENCE of B CELLS preventing PRIMARY LYMPHOID FOLLICLES and GERNIMAL CENTERS from forming in lymph node cortex

68
Q

What is Mycolic acid?

A

Long branched chain saturated fatty acid used in mycobacterial cell wall and forms virulence factors

69
Q

NAME 4 conditions most strongly associated with papillary necrosis

A
  1. SCD or trait(predipose to ischemia) 2. ANALGESIC NEPHROPATHY 3. DM (NEG compromises renal vasculature) 4. ACUTE PYELONEPHRITIS and UTO
70
Q

What type of edema is seen in ARDS?

A

Interstitial and alveolar edema due to increased pulmonary capillary permeability. ARDS is not due to a cardiogenic cause and thus has a NORMAL PCWP (minor diagnostic criteria)

71
Q

What is the mechanism of developing a pulmonary abscess?

A

LYSOSOMAL ENZYME release from NEUTROPHILS and MACROPHAGES

72
Q

INF-gamma causes:

A

PHAGOLYSOSOME FORMATION, indcuible nitric oxide synthase release, and development of granulomas and caseous necrosis

73
Q

IL-12

A

stimulates natural killer cells to destroy targets and is responsible for T helper cell secretion of INF-gamma

74
Q

Choledochal cysts

A

congenital dilations of common bile duct

75
Q

Location where very long chain fatty acids are oxidized

A

PEROXISOMES

76
Q

Peroxisomal diseases

A

rare inborn error in metabolism where peroxisomes are absent or nonfunctional. VLCFAs or fatty acids with branch point at odd-numbered carbons cannot undergo mitochonrial beta-oxidation, and are metabolized in PEROXISOMES defects leading to improper CNS m

77
Q

Location where normal fatty acids are oxidised

A

mitochondrial beta oxidation

78
Q

Location where Very long chain fatty acids are oxidised

A

special form of beta oxidation in PEROXISOMES

79
Q

Location where branched chain fatty acids are oxidized (ie phytanic acid)

A

ALPHA OXIDATION in the PEROXISOMES

80
Q

Mechanism of TB infection

A

Aerosolized respiratory Droplet from infected person carries about 5 organisms, gravity to lower lung fields, phagocytosed by alveolar macrophages (Ghon focus) and SULFATIDE virulence factor allows intracellular bacterial proliferation -> enter lymphoat

81
Q

3 main kinds of botulism

A

food-borne, wound, and infant. Botulinum neurotoxin in food PREVENTS the RELEASE OF ACETYLCHOLINE form the NERVE TERMINALs at the NMJ, preventing muscular contraction.

82
Q

$ Action of IL-4

A

ISOTYPE SWITCHING, particularly to IgE. It is produced by TH2 subset of T-helper cells, facilitates growth of B cells and TH2 lymphocytes.

83
Q

First interleukin produced by T-cells after contact with antigen

A

IL-2, TH1 cells secrete and allow development of CD4+ T helper cells, CD8 cytotoxic cells and B cells

84
Q

Define Agranulocytosis

A

neutrophil count less than 500/mL

85
Q

C3a

A

component of complement system - recruits and ativates EOSINOPHILS and BASOPHILS, NOT neutrophils

86
Q

Leukotriene C4

A

triggers intense vasoconstriction, increased vascular permeablility and bronchospasm (along with its cousins Leukotriene D4 and E4)

87
Q

Interleukin-8

A

chemokine produced by macrophages that induces CHEMOTAXIS and phagocytosis in neutrophils. Leukotriene B4, 5-HETE and C5a also recruit

88
Q

Leukotriene C5a

A

CHEMOTAXIS

89
Q

Most common cause of Congenital Adrenal Hyperplasia (CAH)

A

Deficiency of 21-hydroxylase (90% of cases)

90
Q

Common cause of hypoglycemia in a type 1 diabetic

A

Vigorous exercise (increased glucose uptake by muscles or rapid subqutaneous insulin absorption when injection occurs in limb that is exercised)

91
Q

Nerve at risk for injury during thyroidectomy (surgeon ligates the superior thyroid but accidently severes a nearby nerve!)

A

EXTERNAL BRANCH of SUPERIOR LARYNGEAL nerve (innervates CRICOTHYROID MUSCLE) due to proximity of superior thyroid artery and vein

92
Q

Sensory innervation above the vocal cords

A

Internal branch of superior laryngeal nerve

93
Q

Innervates all laryngeal muscles except cricothyroid and sensory innervation BELOW the vocal cords

A

Recurrent laryngeal nerve

94
Q

Reason for high RBC chloride content in venous blood

A

“Chloride shift” - bicarbonate ions diffuse out of RBC into plasma and chloride ions diffuse into RBC to maintain electrical neutrality. Carbonic anhydrase within RBC forms bicarb from CO2 and water.

95
Q

Effect of emphysema on diffusing capacity of lung

A

REDUCED! (DLCO diminished due to destruction of alveoli and adjoining capillary beds!)

96
Q

Well known complication of nephrotic syndrome

A

Hypercoagulable state (LOSS OF ANTICOAGULANT FACTORS like antithrombin III) causing RENAL VEIN THROMBOSIS

97
Q

Rubeola (what virus family?)

A

Measles (PARAMYXOVIRUS,enveloped negative sense RNA)

98
Q

Rubella (what virus family?)

A

German measles (TOGAVIRUS, enveloped positive sensed, nonsegmented RNA virus)

99
Q

Paramyxoviruses

A

RSV (brassy cough), Parainfluenza (Croup), Measles, Mumps

UWorld FACTOIDs (10 decks)

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