Miscellaneous II Flashcards
When does Babinski reflex disappear by?
12 months
p53 tumor suppressor mechanism
p53 induces p21, which inhibits CDKs leading to hypophosphorylation (activation) of Rb –> hypophosphorylated Rb binds to and inactivates transcription factor E2F –> inhibition of G1-S progression.
Hydroxyurea MOA
Inhibits ribonucleotide reductase, leading to decreased DNA synthesis.
Benzos that don’t undergo phase 1 metabolism
LOT
Lorazepam
Oxazepam
Triazolam
Ribonucleotide reductase
catalyzes the formation of deoxyribonucleotides from ribonucleotides.
What lab technique do you use to detect single nucleotide polymorphisms (SNPs) and copy number variations (CNVS)?
microarrays
Why do you get liver malfunction with kwashiorkor?
fatty change due to decreased apolipoprotein synthesis.
other finding in fabry’s
hypohidrosis
Effect of pupillary muscle contraction
smooth muscle constrict and close pupil. This explains why pilocarpine causes miosis.
Muscarinic/cholinergic cardiac effects
decrease contractility + decrease conduction velocity
Displacement vs. projection
displacement = transferring avoided ideas and feelings o a neutral person or object (venting basically – mother yelling at her child because her husband yelled at her. kicking the cat).
Projection - Attributing an unacceptable internal impulse to an external source (man who wants to cheat on his wife accuses his wife of being unfaithful).
What is acral lentiginous melanoma? epidemiology?
Melanoma on palms, soles, oral mucosa. Most common type of melanoma in asians and blacks.
What is a MALT lymphoma?
Form of lymphoma (originating from B cells) in mucosa-associated lymphoid tissue, frequently in stomach, but can be pretty much any mucosal site.
MALT lymphoma associations
1) Sjogrens (presenting with parotid enlargement)
2) hashimoto’s
2) H pylori
Effect of aging on respiratory function…
1) decreased arterial pO2
2) increased A-a gradient
Muscle breakdown in esophagus
Upper 2/3’s = striated
Lower 1/3 = smooth
Burn grading + presentation
1st degree = epidermis, superficial burn.
2nd degree = extends into superficial dermis. Redness with clear blisters.
3rd degree = extends through entire dermis. *painless
4th degree = into fat, muscle and bone. Black, charred. Painless.
How would you tell proximal median nerve injury from distal ulnar nerve injury?
Pope’s blessing (median) and claw hand (distal ulnar) look the same in presentation except…
1) you’ll get atrophy of thenar with median lesion, and atrophy of hypothenar with ulnar.
AND
2) different sensory deficit.
What does clawing of the hand indicate? How can you test for it?
1) Distal lesion, either to median or ulnar nerves. The other flexors exaggerate the loss of the lumbricals and the other fingers extend out at MCP (flex at DIP and PIP).
2) Person can’t extend fingers at rest.
How do proximal hand lesions present? How can you test for it?
1) Can’t flex digits.
2) Person won’t be able to make a fist
McMurray tests for…
Meniscal tears.
Why would you get anovulation in chronic adrenal insufficiency?
Lack of estrogen due to disfunction of zone reticularis.
Biochem of 2 cell hypothesis
Granulose cells lack 17alpha-hydroxylase and 17,20 lyase. Theca cells express these enzymes but lack aromatase.
Uncoupling agents
1) 2,4-Dinitrophenol (used illicitly for weight loss)
2) aspirin
3) thermogenin (in brown fat)
Glycogenolysis pathway
Glucagon binds to receptor –> ATP to cAMP –> PKA –> glycogen phosphorylase kinase –> glycogen phosphorylase causes glycogen to glucose.
GLP-1 action
Released in response to nutrients –> potent anti hyperglycemic hormone, inducing glucose-dependent stimulation of insulin secretion and suppressing glucagon secretion. It’s inhibited by DPP-4. Therefore, by inhibiting DPP-4 you can increase GLP-1, which will increase glucose uptake in diabetics.
What’s the point of using alpha-glucoside inhibitors?
Decrease postprandial hyperglycemia. They delay carbohydrate hydrolysis and glucose absorption, thus preventing postprandial hyperglycemia.
alpha-glucosidase
Enzyme that sits in the brush border and breaks down starch and disaccharides to glucose.
Labs in hyperthyroidism
Low TSH
Raised T3 or T4
Why do you get amenorrhea with adrenal insufficiency?
CRH inhibits GnRH
