M 5/29 Flashcards
What does the dorsal pancreatic bud become?
The pancreatic body, tail, most of head, accessory duct
What does the ventral pancreatic bud become?
Uncinate process, portion of head, proximal portion of main duct
What cells express HLA I?
All nucleated cells
What cells express HLA II?
Antigen presenting cells
What do HLA I present?
Endogenous peptides to CD8
What do HLA II present?
Foreign antigens to CD4
What mutation is associated with MODY?
Glucokinase
What enzyme functions as a glucose sensor in B cells?
Glucokinase
What is insulin release stimulated by?
Inc in ATP
What does bradykinin do?
Dilates blood vessels
What occurs in C1 esterase inhibitor deficiency?
Unregulated kallikrein leads to an inc in bradykining; hereditary angioedema
What drugs are contraindicated in C1INH def
ACEI
What enzyme degrades bradykinin?
ACE
What is the mechanism of action of hydralazine
Inc cGMP –> sm m relaxation; arterioles > veins
What effect does hydralazine have on afterload?
Dec
What is hydralazine used for?
Severe/acute HTN
Hydralazine has a mortality benefit in HF when combined with what?
Nitrate
Is hydralazine safe in pregnancy?
Yes
How do you prevent reflex tachy w hydralazine?
Administer w a B blocker
How do the glitazones work?
Bind PPAR-g nuclear receptor; inc adiponectin; inc insulin sensitivity, FA oxidation, GLUT4 in peripheral tissues, inc TG storage/dec serum TG
What are the adverse effects of glitazones?
weight gain, edema, hepatoxicity, HF, inc risk of fx
V1 vasopressin rec
Gq - vasoconstriction, inc BP
V2 vasopressin rec
Gs - CD - H20 permeability (aquaporin) and reabs; vascular endothelium - vwF, F8 release
How do you calculate FF?
FF = GFR/RPF (N = 20%)
Cr clearance =
GFR
PAH clearance =
RPF
What is indomethacin used for?
Close PDA, acute gout, nephrogenic DI
How do you keep a PDA open?
PGE analogs
What is the inheritance of Peutz-Jeghers
AD
What are the features of Peutz-Jeghers?
Hamartomatous GI polyps, hyperpigmentation of hands/mouth/feet/genitals
What are Charcot-Bouchard microaneurysms associated with? Where do they occur?
Chronic HTN, small vessels (basal ganglia, thalamus)
What are the features NMS?
Rigidity, myoglobinuria, autonomic instability, hyperpyrexia
How do you treat NMS?
Dantroline, D2 agonist (bromocriptine)
What drugs cause NMS?
Antipsychotics
What does Fanconi anemia often progress to?
AML
