May3rd Flashcards
Name for common wart (hpv 1-4)?
Verruca vulgaris
What is a marker for a mature fetus?
lectin/sphingomyelin ration >1.9 (at 33 weeks)
how do you stimulate fetal surfactant production?
Corticosteroids
Entacapone MoA
Inhibit Catechol-omethyltransferase (COMT), inhibiting degradation of dopamine and levodopa (used with levodopa to increase bioavailability)
BUT only in periphery so no monoadministration
40s binds to
5’ cap of mRNA
Kozac sequence
With start codon, seres as initiator of translation
GCCGCCRCCAUG (R must be G or A)
Beta-thalassemia
Reduced b-globin synthesis (unpaired alpha precipitate and kill RBCs)
Result: hypochromic, microcytic anemia.
Path: basophilic stippling, anisopoikilocyosis, target cell
Path of naive t Cells
Double negative (CD4/8-) go from BM to thymus. TCR gene rearangement (beta first[w/CDX], then alpha) Positive selection incortex with thymic CORTICAL epithelial Negative selection in medulla with thymic MEDULLARY epithelium.
AV shunt hemodynamic changes
Bypass arterioles so total peripheral resistance down
Preload goes up (faster return of blood), afterload goes down (peripheral resistance)
LV has more volume and under less pressure.
AV shunt clinical Dx
Pulsatile mass with thrill on palpation
Constant bruit.
Consequence of B12 deficiency
Megaloblastic anemia, pancytopenia
Increased methylmalonic acid and homosysteine (m-coA mutase needs vitamin B12 Too).
methylmalonic acid accumulation demyelinates and casues subacute combined degeneration (dorsal collumn and lateral corticospinal tract damage).
Exclusively breast fed need what supplement?
VitD
Frontal lobe lesion sides and effects
Left: apathy/depression
Right: disinhibited behavior
Holosystolic murmur best heard in left sternal border
Ventricular septal defect
Giardia lamblia infection on microscope
See trophozoite in stool (pear-shaped, owl’s eye nuclei).
Attacked by body via IgA
Basophilic stippling seen in
Lead poisonining
Thallaseemia
Myelodysplastic syndrome
Lead poisoning symptoms
Microcytic anemia Constipation Mental status change Construction or babies. Basophilic stippling.
Cause of cholesteatomas
Squamous cell debri that accumulates (can grow).
Can cause hearing loss.
Left and right heart thromboembolism due to afib
Right: lung issues
Left: brain/leg/body
Concurrent atrial enlargement.
Psoriasis treatment
Vitamin D analongs (calcipotriene), calcitrol, tacalcitol
Promote inhibition of kertinocyte proliferation/differentiation
What is guaiac?
Test for occult blood
Gastric varices in fundus
From splenic vein thrombosis (due to chornic pancreatitis/cancer)
Short gastric veins drain fundus into splenic vein.
Azygos vein
Drains blood from esophagus to sVC (for esophageal varices in portal HTN)
Two causes for duodenical peptic ulcer disease (PUD)
NSAIDS
H. Pylori
Sarcoidosis
Black pple Bilateral hilar adenopathy Pulmonary complaints Constitutional symptoms (weight loss) Non-caseating granulomas
Class 1 antiarrythmics
Preferentiall bind to inactive/active site
Released in resting site
Two gates. Inactivation and activation. Activation replaces inactivation to activate. Both open: activated. Inactivation off/ activation gate on = resting.
Main causes of PID
N. Gonorrheoaea and chlamydia T
Peroneal nerve
Lateral leg, damaged with fibula damage.
Superficial: innervate foot everters. Sensation over dorsum of foot
Deep: dorsiflexors.
Loratadine is what kind of drug?
New generation antihistamine
No anti-muscarininc, serotonergic, or alpha adrenergic peroperties like older generation. Better for impaired cognitive function/elderly
What is phenytoin for and what is a sideffect
Treatment for clonic-tonic seizures, partial, and status epilepticus
Blocks Voltage gated Na channels
Gingival hyperplasia
Acute intermittent porphyria
Abdominal pain, neuro, NO photosensativity, wine colored urine
Due to Porphobilinogen deaminase deficiency (PBG deaminase). Accumulation of precursor PBG and ALA.
Low glucose activates ALA synthease (rate limiting in heme synth) which adds accumulation. Also Alcohol, smoking, puberty.
Henoch schlonlein purpura
Immune complex vasculitis (IgA, C3).
Get purpuric rash, colicky abdominal pain, joint pain.
Young boys.
Burkitt lymphoma
from CMV (bar kid). Histo: starry sky C-myc oncogene overexpression. Good prognosis. Jaw involvement common.
Where does Amphotericin B bind and what is it used for?
Aspergillis
Binds to the ergosterol in fungus (but to some degree cholesterol, causes renal toxicity)
Guillain Bare syndrome EM signs
Segmental demyelination
Endoneural inflammatory infiltrate
Progressive weakening of pleural difference with repeated phrenic activation
Neuromuscular junction issue.
Diaphragm becoming weaker. Most repsonsible for intrapeleural pressure fall during inspiration.
RPR (rapid plasma reagin) test what?
T. Palladium (syphilis) but not directly. Antibodies to cells destroyed by syphillis (false positive with lupus)
SLE false test
aPTT prolongation (paradoxical b/c produce hypercoagulable in vivo) RPR/VDRL (uses cardiolipin, antiphospholipid antibodies bind to it)
ACTH function on smooth endoplasmic reticulum
Promotes stimulation of glucoocorticoids, mineracorticoids, and androgens.
All cholesterol based.
Diabetic mom effect on fetus
Baby produces tons of insulin to deal with high glucose (insulin doesnt cross placenta).
Insulin -> IGF1 -> growth. Big baby.
What kind of cardiotoxicity does doxorubacin cause?
Dialated cadiomyopathy.
How does progesterone affect prolactin
Prolactin is inhibited by progesterone.
Annular pancreas. What is it? Why?
Pancreas sorrounds duodeunum.
Abnormal migration of VENTRAL pancreatic bud.
What is a good alterantive to aspirin to decrease blood clots?
Clopdogrel. Prevents platelet aggregation by blocking ADP receptor on platelet surface.
Atriovenous nicking found in
CHRONIC hypertension. Not acute.
Sickle cell presentation.
Dactylitis (painful swelling of hands and feet)
Hemoylsis (indirect bilirubin and lacate dehydrogenase up)
Decreased haptoglobin
Main sideffects of Thazolidinediones
Fluid retention (increased sodium reabsorption) = CHF Adipose weight gain
Alpha-1-antitripsin consequence:
panacinar Emphysema (scattered bilateral wheezing) Liver disease (jaundice, chirrhosis, cancer)
Where do you find great saphanous vein?
Inferior-lateral to pubic tubercle
Noninvasive treatment for gallstones
Hydrophilic bile acids
Rduce cholesterol secretion, increase acid conencetration= dissolve
Bosentan MoA
Endothelin receptor eantagonist (prevents vasoconstriction)
Used for decreasing pulmonary arterial pressure
Turner syndrome presentation and consequence (heart)
Short starture, short thick neck, broad chest. Short 4rth metacarpals.
Bicuspid aortic valve.
Targets of folic acid reduction to THF (by inhibiting Dihydrofolate reductase)
Trmethroprim - bacteria
Methotrexate - humans
Prymethamine - protozoa
Chorioretinitis is a consequence of what?
CMV, pizza eye
