Miller's Biology Flashcards
(124 cards)
1
Q
high strain cells in healing
A
fibroblasts -> fibrous union
2
Q
cells that respond to medium strain, low oxygen in bone healing
A
chondroblasts -> cartilage
3
Q
cells that respond to low strain, high oxygen in bone healing
A
osteocyte/osteoblast -> bone healing/formation
4
Q
What secretes sclerostin?
Function of sclerostin?
A
Osteocytes
inhibits osteoblasts via Wnt pathway
5
Q
PTH effect on sclerostin
A
increases
6
Q
Calcitonin effect on sclerostin
A
decreases
7
Q
Osteoclast cell of origin
A
macrophage lineage
8
Q
molecules involved in osteoclast attachment to bone
A
integrins to vibronectin (RGD sequence)
9
Q
major proteolytic enzyme in bone resorption
A
cathepsin K
10
Q
mutation in Cathespine K causes
A
Pyknodysostosis
Cath’rine Pyknod the wrong profession so we stole her distal phalanges (represents distal phalanx osteolysis)
11
Q
mutation in carbonic anhydrase causes
A
osteopetrosis
12
Q
what does calcitonin act on
what is effect
A
acts on receptor on osteoclast to decrease its activity
13
Q
secreted by tumor cells to cause osteolysis
A
IL 1
PTHrP
14
Q
tensile strength to bone
A
collage
15
Q
gives compressive strength to bone
A
proteoglycans
16
Q
single most important factor determining bone healing
A
blood supply
17
Q
cartilaginous extracellular matrix is degraded in fracture healing by
A
MMP13
18
Q
increases mechanical strenth of callus and produces nano motion
A
LIPUS
19
Q
how is cancellous graft incoroporated
A
creeping substitution
20
Q
cell of origin for calcitonin
A
clear cells of thyroid
21
Q
physis zone of rickets
A
zone of provisional calcification
22
Q
PHEX gene mutation
A
X linked familial hypophosphatemic rickets
cannot absorb phosphate
23
Q
rickets and patient is totally bald
A
Vit D dependent rickets
24
Q
medications that disrupt bone mineralization
A
prednisone PPIs seizure meds SSRIs heparin
25
clonazepam can cause osteoporsis via
increase in sclerostin
26
1 compression fx increases risk of hip fx by
5x
27
avg year of bisphosphonate use leading to atypical subtroch fx
4 years
28
osteoporosis med CA in Pagets
teriparatide (forteo)
29
progression of nerve recovery sx's
```
sympathetic activity
pain
temp
touch proprioception
motor
```
30
most prominent proteoglycan in tendon
decorin
| bglycan
31
initial collagen in tendon healing
III
32
proteoglycan that regulates tendon diameter
decorin
33
tendon is weakest at what point in healing process
7-10 days
34
stress equation
Force/Area
35
strain equation
change in length/original length
36
maximum stress a material can sustain before breaking
ultimate strength
37
diff btw yielf point and fx point
ductility - how much it can bend before breaking
38
molecule of ligament that allows for toe region
elastin
39
instant center of motion in wrist
capitate
40
mutation causing defective sulfate transporter
Diastrophic Dysplasia
41
Genetic Defect in SOX9
Campomelic Dysplasia
- short long bones
- bowed femurs
- all die at infancy: hear, kidney, lung defective
42
Location of Type X collagen in cartilage
Calcified zone
43
Cartilage layer with highest Lubricin
Tangential zone
44
Type A cells of synovium
mAcrophage like cells that remove waste and such
45
What molecule contributes most to joint fluid viscosity
Hyaluronic Acid
46
Nonnewtonian - less viscous with stirring
| Thixotropic - flows more easily with shear stress and is shear thinning
Synovial fluid
47
CAuses of Neuropathic Arthritis
Charcot (DM)
Syphilis (hip/knee)
Syrinc (shoulder/elbow)
Leprosy
48
AR defect of homogentisic acid oxidase
Ochronosis (Alkaptonuria)
49
Diabeteis, increase LFT's, hyperpigemented skin
| Mulitple arthritic joints
Hemochromatosis (Bronze Diabetes)
| - elevated ferritin
50
crystal with X in it
Ca+ Oxalate
51
Positive birefringent
Pseudogout - calcium pyrophosphate
52
Normal function of FGF-23
decreaese renal reabsorption of PO4 (thus decreases serum phosphate)
53
2 causes of tumoral calcinosis
FGF23 defect
| Renal disease
54
Synovial biopsy shows macrophages with CHICV RNA "hijacked" and natural killer cells
Chikungunya = chronic viral polyarthritis
| - RNA alpha virus via mosquitos
55
Arthritis with morning stiffness lasting longer than an hour
RA
56
Mopst sensitive and specific lab testing for RA
Anti-CCPa
57
What is humoral immunity
soluble components in the serum that kill microorganisms inactive toxins clump and lyse RBCs increase macrophage phagocytosis
58
Main cell involved in Humoral immunity
B cell -> secreste Ig
59
What is rheumatoid factor
IgM to IgG
60
ANA + diseases
Lupus
| Scleroderma
61
Type of reaction
| - Aseptic lymphocyte vasculitis-assoc lesion
Type IV hypersensitivity
62
Seronegative Spondyloarthropathies
Ank Spon
Psoriatic Arthritis
Reactive Arthritis (Reiter's Syndrome)
63
Most common cause or Reiter's
Chlamydia
| Diarrheal Illness: Shigella, Yersinia, Salmonella
64
Most common bug of cellulitis
Group A strep
65
Most common bug of necrotizing fasciitis
Group A strep (strep pyogenes)
66
Skin finding particular to nec fasciitis
non-blanching skin
67
bla gene mutant
resistant to penicillin
68
mecA gene
provides methicillin resistance
69
Alternative to Vanc for MRSA
Linezolid
70
When to repeat intraop abx
1 L blood loss
| at 3 hours
71
Heavy EtOH effect on bone
decreases
impairs fx healing
inhibits Wnt pathway
decrease fibroblast propduction of collagen type I
72
When to stop RA biologics
For the duration of dosing + 1 wk
73
indication that Lupus is severe
nephritis/renal issues
74
lysine analog that binds plasminogen
TXA
75
how much bacteria do you need to cause an infection
>100k
76
Indication that Lupus is severe
nephritis/renal issues
77
Abx for human and animal bites
Augmentin
78
How much bacteria do you need to cause an infection
>100k
79
culture negative bacteria in osteomyelitis in kid think
| - how is it ID'd in the lab
Kingella Kingae
| - PCR
80
Cytokine that triggers proteolytic enzymes that destroy cartilage in infection
IL-1
81
Culture negative bacteria in osteomyelitis in kid think
| - how is it ID'd in the lab
Kingella Kingae
| - PCR
82
MSK infection after URI in < 5 yo
Kingella Kingae
83
Treatment of gonococcal arthritis
Ceftriaxone
84
Intracellular gm - diplococci
gonnococcal
85
Lytic lesion in late stage AIDS and cate exposure
Bartonella
86
Treatment for Chronic non-bacterial osteomyelitis
NSAIDs
aka- Chronic Recurrent Mulitfocal Osteomyelitis
it's an autoinflammtory bone disease
adult version is SAPHO- synovitis Acne pustulosis hyperostosis osteitis
87
Rrisk of HIV transmission with single needle stick
0.3%
88
Single stick tramission risk with hep B
30%
89
Single stick transmission risk with Hep C
2-3%
90
Anti-centrome ab's
CREST syndrome
91
Anti-histone
drug induced Lupus
92
Anti-U
mixed connective tissue diseases
93
anti-smith
Systemic Lupus
94
how to treat bilateral winging in fascioscapulohumeral muscular dystrophy
scapulothoracic fusion
95
2 fertilized eggs that merge together that create one organism
chimera- XX/XY = gives rise to remale phenotype
96
Turn on or off gene
- fibrous dysplasia
- NF1
fibrous dysplasia-> on (somatic mutation NOT inherited)
| NF1- turning of tumor suppressor gene
97
only X linked dominant
hypophophatemic rickets
98
ortho issue in Down syndrpome
Laxity
COL6 on chromosome 21
- collage VI is overexpressed
99
cancer cause by chromosmal deletion
Mulitple Myeloma
| - chromosome 13 copy is missing
100
which embryologic layer dores msk system come from
mesoderm
101
marker of osteoblast differentiation
alk phos
- the by product of conversion of pyrophosphate (PPi) to phosphate ion which favors ossification
- via hydrolosys
102
rickets like picture with low alk phos
hypophospohatasia
| - AR where PPi accumulates and inhibits bone mineralization
103
most potent/abundant osteoblast stimulator
PGE2
104
gene that guides radial/ulnar limb growth
Sonic hedge hog
| - hand - high levels is pinky side, low side is thumb side
105
genetic basis for fibular hemimelia
poor sonic hedge hog protein
106
genetic basis for postaxial polydactyly
sonic hedge hog overexpressed
107
gene stimulates/regulates dorsal/ventral limb pattern growth
Wnt
108
bone formation method by which distraction osteogenesis works
intramembranous
109
first bone to ossify
clavicle
| - also the last
110
notable enzymes of osteoclasts
```
Carbonic anhydrase
Chloride channel giving rise to hydrochloric acid
Cathepsin K- dissolves organic matrix
TRAP- a marker for osteoclasts
Vacuolar H+ ATPase
```
111
Cathepsin K deficiency disease
pyknodysostosis
112
enzyme messed up in Morquio
galactose sulfatase
113
defect in enzyme function is what inheritance
AR
114
defect in protein function is what inheritance
AD
115
avoid ligamentous procedures in
Ehlers Danlos
116
Virchow's Triad
hypercoagability
endothelial damage
stasis
117
Indications for IVC filter
CA to anticoagulatio
Failure of anticoagulation
complication from anticoagulation
118
Indications for IVC filter
CA to anticoagulation
Failure of anticoagulation
complication from anticoagulation
119
Andexanet
antidote for Xarelto
120
recommendation for long plane flights
stay hydrated
| walk the cabin
121
treatment for ARDS
ventilation with PEEP to keep alveoli open
| - only intubate if necessary
122
best clinical indicator of inadequate fluid rescitation
| best lab for inadequate resus
urine output < 30cc/hr
| lactate > 2.5
123
best clinical indicator of inadequate fluid resuscitation
| best lab for inadequate resus
urine output < 30cc/hr
| lactate > 2.5
124
earliest sign and most sensitive/specific sign of malignant hyperthermia
uneplzined rise in end tidal CO2
