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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
Adenoma-to-carcinoma sequence
APC inactivation (allows hyperproliferation) -\> Methylation abnormalities -\> Cox-2 overexpression -\> ADENOMA formation with K-ras activation + DCC inactivation + P53 inactivation -\> CARCINOMA
25
Non-disjunction may occur in which two phases of cell division?
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
26
Persistent lymphedema predisposes to development of this rare malignant neoplasm
LYMPHANGIOSARCOMA - may arise 10 years after radical mastectomy with axillary lymph node dissection for breast cancer
27
Key cells involved in cell-mediated immunity
MACROPHAGES, CD4+ helper T-cells, CD8+ cytotoxic T-cells and NK cells
28
Cleft lip results from improper fusion of these structures
MAXILLARY PROMINENCE and MEDIAL NASAL PROMINENCE
29
Receptor that stimulates insulin release and inhibits secretion of insulin
Alpha receptors INHIBIT insulin secretion and beta-receptors STIMULATE insulin secretion in pancreatic beta cells
30
What is the reason for producing lactic acid in anaerobic conditions?
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
31
What limits glycolysis in strenuously exercising muscle?
LIMITED REGENERATION OF NAD+ from NADH
32
Alkaptonuria
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
33
Minute ventilation vs Alveolar ventilation
in L/min = Tidal volume (L) x breaths/minute where alveolar veintilation in L/min is (TV - Dead space V) x breaths/min
34
Most frequent bacteria in aspiration pneumonia
Anaerobic bacteria in oral cavity: Fusobacterium, peptostreptococcus, Bacteroides
35
Anatomy of femoral hernia
Protrudes through FEMORAL RING, medial to femoral vessels and inferior to INGUINAL LIGAMENT (see pic)
36
Anatomy of direct inguinal hernia
Older men - Bluges through hesselbach's triangle, medial to inferior epigastric vessels, to reach external inguinal ring, caused by weakness of TRANSVERSALIS FASCIA
37
Anatomy of indirect inguinal hernia
Male infants - enters internal inguinal ring lateral to inferior epigastric vessels. Caused by persistent PROCESSUS VAGINALIS and failure of INTERNAL INGUINAL ring to close
38
Precursor protein responsible for localized amyloidosis in organs: Cardiac atria, thyroid, pancreatic islets, cerebrum, pituitary
ANP, calcitonin, islet amyloid protine, beta myloid, prolactin
39
3 components of a craniopharyngioma
Solid, cystic, and calcified; present in childhood, mass effect and visual deficits. Rathke's puch derivative from pharyngeal roof (AP forms from this)
40
t(14:18)
90% of patients with follicular lymphoma causing overexpression of antiapoptotic BCL2 gene product
41
Overexpression of N-MYC proto-oncogene
neuroblastoma and small cell carcinoma of the lung
42
translocation of C-MYC gene on chromosome 8
ALL BURKIT LYMPHOMAS
43
Generalized tonic-clonic seizure
DIFFUSE (generalized) ALTERNATING STIFFENING and MOVEMENT (tonic-clonic)
44
M/C cause of seizures in adults
#1 TUMORS (#1 metastasis (Lung, Breast, SKIN!)), #2 TRAUMA #3 STROKE #4 INFECTION
45
M/C causes of seizures in elderly patients
#1 STROKE #2 TUMOR #3 TRAUMA #4 METABOLIC #5 INFECTION
46
M/C causes of seizures in childen
#1 GENETIC #2 INFECTION (febrile) #3 TRAUMA #4 Congenital #5 Metabolic
47
How is gastric acid secreted?
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
Histamine-mediated symptoms of mastocytosis
Syncope, flushing, hypotension, tachycardia, broncospasm, SKIN - pruritis, urticaria, dermatographism.
49
Which artery runs with the Radial nerve?
Deep brachial artery, courses along posterior aspect of humerus. Midshaft fractures of the humerus risk injury to these structures.
50
Type B Chronic gastritis
ANTRUM-predominant or H. PYLORI associated chronic gastritis. Inflammatory cell infiltrate (LYMPHOCYE and PLASMA CELL predominant in chronic) Neutrophil in acute.
51
Type A Chronic gastritis
AUTOIMMUNE Chronic gastritis that is BODY-predominant (not antrum) chronic gastritis in which megaloblastic anemia occurs due to destruction of parietal cells
52
2 components of Reye syndrome
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
What is bronchiolotis obliterans
Chronic rejection of lung affets small bronchioli producing obstructive lung disease - lymphocytic inflamamtion and necrosis of bronchiolar walls.
54
Most common inborn error of methionine metabolism
Homocystinuria - caused by CYSTATHIONINE SYNTHETASE DEFICIENCY
55
Catalase positive organisms
"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
Chronic granulomatous disease
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
Ulcer arising in the proximal duodenum associated with severe trauma or burns
Curling ulcer (impaired oxygenation)
58
Ulcer arising in the esophagus, stomach, or duodenum in patients with high intracranial pressure particularly prone to perforation
Cushing ulcer (direct stimulation of vagus nerve by increased intracranial pressure)
59
Transport of conjugated vs unconjugated bilitubin
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
Solubility of conjugated vs unconjugated bilirubin
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
Cultured on a cysteine-tellurite agar
C. diphtheriae, resultant colonies are black in color.
62
Name 2 ways to culture C. diphtheriae
1. Cysteine-tellurite agar (black colonies) or 2. METHYLENE BLUE (aniline dye) staining and intraellular polyphosphate granules called metachromatic granules are stained.
63
$ Late sequelae of untreated GAS infetions
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
Where is CSF absorbed?
SUBARACHNOID SPACE by ARACHNOID GRANULATIONS and then enters venous sinuses
65
Site of CSF secretion?
CHOROID PLEXUS
66
What are arachnoid granulations?
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
Agammaglobulinema will prevent these structures in the lymph node
ABSENCE of B CELLS preventing PRIMARY LYMPHOID FOLLICLES and GERNIMAL CENTERS from forming in lymph node cortex
68
What is Mycolic acid?
Long branched chain saturated fatty acid used in mycobacterial cell wall and forms virulence factors
69
NAME 4 conditions most strongly associated with papillary necrosis
1. SCD or trait(predipose to ischemia) 2. ANALGESIC NEPHROPATHY 3. DM (NEG compromises renal vasculature) 4. ACUTE PYELONEPHRITIS and UTO
70
What type of edema is seen in ARDS?
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
What is the mechanism of developing a pulmonary abscess?
LYSOSOMAL ENZYME release from NEUTROPHILS and MACROPHAGES
72
INF-gamma causes:
PHAGOLYSOSOME FORMATION, indcuible nitric oxide synthase release, and development of granulomas and caseous necrosis
73
IL-12
stimulates natural killer cells to destroy targets and is responsible for T helper cell secretion of INF-gamma
74
Choledochal cysts
congenital dilations of common bile duct
75
Location where very long chain fatty acids are oxidized
PEROXISOMES
76
Peroxisomal diseases
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
Location where normal fatty acids are oxidised
mitochondrial beta oxidation
78
Location where Very long chain fatty acids are oxidised
special form of beta oxidation in PEROXISOMES
79
Location where branched chain fatty acids are oxidized (ie phytanic acid)
ALPHA OXIDATION in the PEROXISOMES
80
Mechanism of TB infection
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
3 main kinds of botulism
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
$ Action of IL-4
ISOTYPE SWITCHING, particularly to IgE. It is produced by TH2 subset of T-helper cells, facilitates growth of B cells and TH2 lymphocytes.
83
First interleukin produced by T-cells after contact with antigen
IL-2, TH1 cells secrete and allow development of CD4+ T helper cells, CD8 cytotoxic cells and B cells
84
Define Agranulocytosis
neutrophil count less than 500/mL
85
C3a
component of complement system - recruits and ativates EOSINOPHILS and BASOPHILS, NOT neutrophils
86
Leukotriene C4
triggers intense vasoconstriction, increased vascular permeablility and bronchospasm (along with its cousins Leukotriene D4 and E4)
87
Interleukin-8
chemokine produced by macrophages that induces CHEMOTAXIS and phagocytosis in neutrophils. Leukotriene B4, 5-HETE and C5a also recruit
88
Leukotriene C5a
CHEMOTAXIS
89
Most common cause of Congenital Adrenal Hyperplasia (CAH)
Deficiency of 21-hydroxylase (90% of cases)
90
Common cause of hypoglycemia in a type 1 diabetic
Vigorous exercise (increased glucose uptake by muscles or rapid subqutaneous insulin absorption when injection occurs in limb that is exercised)
91
Nerve at risk for injury during thyroidectomy (surgeon ligates the superior thyroid but accidently severes a nearby nerve!)
EXTERNAL BRANCH of SUPERIOR LARYNGEAL nerve (innervates CRICOTHYROID MUSCLE) due to proximity of superior thyroid artery and vein
92
Sensory innervation above the vocal cords
Internal branch of superior laryngeal nerve
93
Innervates all laryngeal muscles except cricothyroid and sensory innervation BELOW the vocal cords
Recurrent laryngeal nerve
94
Reason for high RBC chloride content in venous blood
"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
Effect of emphysema on diffusing capacity of lung
REDUCED! (DLCO diminished due to destruction of alveoli and adjoining capillary beds!)
96
Well known complication of nephrotic syndrome
Hypercoagulable state (LOSS OF ANTICOAGULANT FACTORS like antithrombin III) causing RENAL VEIN THROMBOSIS
97
Rubeola (what virus family?)
Measles (PARAMYXOVIRUS,enveloped negative sense RNA)
98
Rubella (what virus family?)
German measles (TOGAVIRUS, enveloped positive sensed, nonsegmented RNA virus)
99
Paramyxoviruses
RSV (brassy cough), Parainfluenza (Croup), Measles, Mumps

UWorld FACTOIDs (10 decks)

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