May 2- 1 Flashcards
C3 and IgG are depsited in what disease in what way? (Renal)
Goodpasture (type one RPGN).
Rapidly progressive glomerulonephritis (RPGN) key word and deposition (found with light microscopy)
Widespread CRESCENTS
Deposition of FIBRIN
Sertoli, Leydig, and SRY gene role in genetalia
SRY on chromosome Y (makes Testes Determining Factor) - makes testes.
Sertoli: Mullarian inhibiting factor -> no mullarian -> no female internal
Leydig: testosterone -> male internal.
Testosteron -> DHT -> male external.
Brachial plexus posterior nerve
Radial nerve
What is the recruiting of case study vs cross sectional?
Recruit control and disease, not randomly select from population (which implies prevalence finding).
Arsenic poisoning treatment of choice and presentation
GARLIC breath, insecticide/contaminated water
Dx: Dimercaprol
What IL is responsible for b cell proliferation?
IL-4
Via TH2 T helper cells.
Post-streptococcal glomerulonephritis desposits what where
immune complexes (Type III hypersensitivity) Electron dense subepithelial humps.
Allergic Bronchopulmonary Aspergillosis (ABPA)
Pts with asthma or cystic fibrosis become allergic to Asergillus fumigatus.
Usually there but not issue unless iComp
Eosinophillia, IgE, proximal bronchiactasis, transient lung infiltrates
Prompt treatment with penicillin after Upper respiratory infection prevents:
Acute rheumatic fever (group A strep)
Leads to mitral regurg
Common bacteremia after dental procedures?
Viridans streptococci
Gram-positive, produce dextrans from sucrose.
Bind fibrin.
Mitral valve history at risk for V. Strep. Staph A. If valve is previosuly intact.
Inheritability of Achondroplasia, mutation, and presentation
Heritability: AD
Mutation: FGFR3 (fatal if 2)
Presentation: normal short bones(protruded forehead) with short long bones.
Neisseria meningitidis vaccine
Given to colllege kids, military To polysaccharide (quadrivalent or capsule).
Hormone changes in cryptorchidism
Sertoli cells die from heat, no inhibin
Inhibin gone, high FSH
NR5A1/SF-1 mutation
Sertoli failure
LH and therefore leydig and testosterone unaffected.
Pressure consequence of excersize
Total systemic vascular resistance drops.
Everything constricts except muscle, which dialates.
Hemodynamic changes with mitral regurge (acute)
Blood flows back, increasing LV preload
Low pressure to LA decreases afterload
Low afterload, high preload= increased ejection fraction
walls of direct hernia
Protrude throuhg: hasselbach’s triangle
Medial: rectus abdominus
Inferior epigastric vessels lateral
Inguinal ligament inferior
Role of hormone-sensitive lipase
In adipose tissue, mobilizes triglycerides (into FFA and glycerol)
Glycerol -> gluconeogenesis (liver)
FFAs ->acetyl-coA-> ketone bodies
Extensor muscle of wrist origin
Lateral epicondyle of humerus
Does bulimia nervosa need to have throwing up?
No. Just binge and compensatory behavior.
Excess body shape worrying
Normal body weirght tho (as opposed to anorexia)
Binge eating: no compensatory.
Vitamin C role
Hydroxylation of proline and lysine (for collagen synthesis).
If not: easy bruising, periodontal disease, poor wound healing, hyperkaeratotic follicles.
Acute decompensated heart failure
From: reduced cardiac output
Causes: compensation (mediated through sympathetics): constrcction, renin/angioT, antidiuretic secretion
Diptheria is cimilar to what toxin
Exotoxin A from pseudomonus aeruginosa
Diptheria key words
Pharyngitis with exudate
Heart issue
NO vaccination
Cause of third nipple
Failed involution of mammillary ridge
Swell/become tender during menses, pregnancy, lactation.
Bioavailability of isosorbide dinitrate
Really low.
Requires higher dosing
Telomerase function
Adds TTAGG to 3’ of chormosomes (end)
Has telomerase reverse trascriptase part
Has telomerase RNA part
Subacute sclerosing panencephalitis is a consequence of what?
MEasules virus (rubeola)
NPH, glargine, detemir, regular, lispro, aspart, glulisine: basal or post prandial
NPH: tX a day, basal
Glargine/detemir: 1xDay, basal
Regular: best for IV, 2-4 hr peak, postprandial
Lispro/aspart/glulisine: short peak, best postprandial
Strongyloides stercoralis cycle
Penetrate skin, migrate to lung Lung to pharynx, swallowed Develop in intestine, lay eggs. Hatch Rhabditiform (noninfectious) larvae found in poop REINFECT
Strongilloides stercoralis presentation and treatment
Pruritic streaks (LARVA cuRRENS)
Treat w/ ivermectin
Larvae in stool
Upper motor neuron lesion effect on bladder
Hypertonic. No inhibitory signals.
Focal vs generalized seizure difference
Focal: one hemisphere (simple vs complex determiend by loss of consciousness
Generalized: both hemisphere: two sides of body or absence
Most common urea cycle disorder
Ornithine transcarbamylase deficiency
Key words for Kaposi’s sarcoma
Low CD3 count
Multipal hemorrhagic polypoidal lesions
Spindle cells with sorrounding vessel proliferation on biopsy
Creutzfeldt-jakob deisease
PrP (prion protein)
Rapidly progressive dementia with myoclonic jerks
Vacules in cytoplasm of nuetrophils and neurons.
Spongiform encelopathy
ACE inhibitors vs antidiuretics
ACE inhibitors have the additional help in remodeling
PAtent ductus areteriosis is kept open/closed by what?
Prostoglandin E2 (precent in placenta).
Preterm babies can’t close.
Cause continous murmur.
Widened pulse pressure seen.
Pathologic finding for hep B?
accumulation of surface antigen (finely granular, homogenous, eosinophilic inclusions). GROUND glass appearance.
Machine like murmur is code for what?
Transposition of great arteries (pulm artery switched with aorta connection to heart)
Prefered method of diagnosis for toxic megacolon
Xray, plain
Toxic megacolon is caused by:
C. Diff
Ulcerative collitis
Spinal bifida inheritance
Multifactorial
What CN come out of jugular foramen?
IX, X, XI
Henoch-Schonlein purpura
Small vessel vasculitis
Post-Viral/treptococcal URI, IgA mediated (young boys)
bloody urine, palpable skin lesions (lower extremities) , joint pain.
What antibody treatment exists for severe asthma
Anti-IgE antibodies (IgG that binds to IgE and prevents binding, omalizumab)
Where does the tRNA bind the amino acid?
3’ OH group
Schistosomiasis is transmitted how?
Via freshwater contact (swimmin)
Vector: Snail
Schistosoma species and infectious organ
S. Japonicum and S. Mansoni cuase intestine/hepatic
S. Haematobium: urinary schistosomiasis
Protein targetting (sorting) to lysozome depend on what change to structure
Mannose residue phosphorlation
By phosphtransferase enzyme.
Inclusion cell disease heritability and disease
Missing phosphotransferase enzyme. Accumultion of debri in lysosome (inclusion bodies seen)
Autosomal RECESSIVE
Sertaline is what type of drug?
SSRI, antidepressant
Ragged red fibers on muscle biopsy, muscle weakness, and nervous system dysfunction is a problem of what?
Mitochondria. No ATP.
Calcification in arteries is a marker of what?
Necrosis
Organ where vitamin D precursors are activated
7-dehydrocholesterol (Skin)
D3 (cholecalciferol) (liver/25 hydroxylase)
25-hydroxyvitmain D (kidney, 1-alpha-hydroxylase)
1, 25 - dihydroxyvitimain D
Inulin, PAH, amino acid, urea in kidney
Inulin: only filtered. Not secreted or reabsorbed. (GFR)
PAH: filtered AND secreted. (Renal plasma flow). More clearance than GFR
amino acid: flitered and completely reabsorbed
Urea: excreted, filtered, and reabsorbed. Less than GFR
Axonal reaction?
Axon severed. Nucleus displaced to periphery, cell body rounded. Nissl substance fine and granular and dispersed (protein synthesis increased to repair damage)
Suprapubic insertion of needle will affect. Peritoneum?
No. Extraperitoneal (bladder)
Retinal artery feeds from what?
Opthalimic artery
Branch of Internal coraotid
Diplopia when walking down stairs affects waht muscle/nerve
Superior oblique/ trochlear nerve
What organism destroyes myenteric plexus?
Neurotoxin from T. Cruzi (dilated esophagus, no peristalsis)
Swannoma
High cellular areas with mixyoid regions of low cellularity.
S-100 due to neural crest origin.
Common at cerebello pontine angle
Can affect hearing.
Travellers diarrhea is caused by:
E. Coli. Two exotoxins: LT and (heat liable (cholera-like)) and ST (heat stable)
cAMP: LT. cGMP: ST.
Capitation;
Payor fixed predetermined fee to cover all medical fees (HMo)
Measles
Fever, cough, rhinorrhea, conjuctivitis w KOPLIK spots (buccal white on erythemetous background)
Function of suprachiasmatic hypothalamic nuclei
Circadian ryhtm
With class switching/isotype switching problem, what is overexpressed?
IgM (it’s first IgM, then turns into others)
CD40 absence on T lymphocytes
Increased methylmalonic acid and fatigue
AR disorder. No methylmanoyl-CoA mutase.
Cause metabolic acidosis.
Hypoglycemia (usage higher, can’t make TCA cycle work)
Free fatty acid : ketone.
Hyperammonemia
Donpezil MoA
Cholinesterase inhibitor for alzheimerse disease.
Alpha-1-trypsin deficiency
A-1-trypsin counteracts neutrophil elastase degradation of extracellular protein in alveolar walls.
Without opposing action, destruction.
Smoking makes MUCH worse.
Milrinone MoA
Phosphodiesterase 3 (PDE3) inhibitor Increased cAMP = increased contractility Tho also = arterial and venous dilation (same mechanism), can't use with hypotension
How to calculate half life
(.7X volume of distribution)/ Clearance
Phenytoin affects CYP450 in what way?
Induces
First generation antihistamine have what secondary effect
Antimuscarininc/cholinergic (double vision with close objects)
Antialpha adrenergic
Antiserotonergic
Cilliary muscle (accomodation of lens) controleld by parasympathetic edinger-westphal ganglion. No AcH, no parasympathetics, no accomodation.
Ceftriaxone MoA
Inhibitis transpeptidases (penicillin binding proteins)
What murmur increases with handgrip?
Handgrip = increased afterload
Increased holosystolic murmur due to ventrical septal defect.
