Mix11 Flashcards
What’s the first choice method for treating hirsutism in PCOS?
OCP - oral contraceptives suppress LH release from pituitary»_space; decreased androgen production. Can also increase sex hormone binding globulin produced from liver»_space; decreasing free testosterone levels.
The ___ sequence in humans is the equivalent of the Shine Dalgarno seq in E coli:
Kozac sequence. Occurs on eukaryotic mRNA and acts translation initiation. Has the following seq; (gcc)gccRccAUGG where R can be either Guanine or Adenine.
During polypeptide synth, the ribosome moves 3 nucleotides toward the 3’ end of the mRNA, advancing the peptidyl tRNA from the A site to the P site (translocation). This process of translocation is catalyzed by ___ and requires GTP hydrolysis.
EF2 (elongation factor 2)
OF the four leg compartments (anterior, lateral, deep posterior, and superficial posterior) which is the most susceptible to compartment syndrome in a break?
Anterior compartment. Affects deep peroneal (fibular) nerve, and is the most common site of ACS. Affects foot extensor muscles. Injury to the deep peroneal nerve»_space; decreased sensation between first and second toes, decreased dorsiflexion of the foot, drop foot, and claw foot.
Sacubtril is a neprilysin inhibitor. Why might this be helpful in treating Pt with heat failure?
In HF patients, there is volume overload»_space; atrial stretch and release of ANP. ANP causes peripheral vasodilation and increased urinary excretion of sodium and water»_space; decrease in volume.
Neprilysin is a metalloprotease that inactivates a ton of peptides (including ANP, bradykinin, glucagon, enkaphalin, etc).
What nerve innervates the lat dorsi?
Latissimus dorsi is innervated by thoracodorsal nerve (C6-C8 roots). Primary function is extension, adduction, and internal rotation of the humerus.
Riboflavin (B2) is a precursor of the coenzymes FMN and FAD. FAD participates in TCA cycle and ETC as an e- acceptor for ___
Succinate dehydrogenase, which converts succinate to fumarate. Causes FAD to be released as FADH2.
Why do you tend to get calcium oxalate kidney stones in Crohn’s Disease?
Impaired bile acid reabsorption in terminal ileum»_space; loss of bile acids in feces with fat malabsorption. Lipids then bind Ca2+ and the resulting soap is excreted. This prevents Ca2+ from binding to dietary oxalate»_space; oxalate reabsorption»_space; kidney stone formation.
Formula for NNH (number needed to harm)
NNH = 1/attributable risk
Attributable risk = event rate in treatment - event rate in ctrl
Orotic aciduria is a rare autosomal recessive disorder of de novo (pyrimidine/purine) synthesis that occurs due to a defect in ___
pyrimidine synth. Defect in uridine 5’ monophosphate (UMP) Synthase. Supplement with uridine monophosphate to bypass the defective enzyme.
Deficiency normally presents as physical/mental retardation, mebaloblastic anemia (elevated MCV, low reticulocyte count), elevated urinary orotic acid levels. Can also have hyperammonia encephalopathy due to impaired urea synth.
What’s the timeline for Dx of separation anxiety?
Sx must be present for > 4 wk in kids and > 6 mon in adults.
The liver synthesizes which coag factors?
II, VII, IX, and X. These can be decreased in the incidence of cirrhosis.
** Failure of prothrombin time (PT) to correct with Vit K supplementation indicates CF VII deficiency (these all require Vit K epoxidation to be in active form)
VIII is made by endothelial cells.
What serotypes of chlamydia trachomatis can cause lymphogranuloma venereum?
L1 to L3. LGV is characterized initially by a small painless ulcer containing infected cells. The painless nature helps distinguish LGV from other diseases. This is followed weeks later by a painful coalescing inguinal node (buboe) that can develop stellate abscesses and rupture. If left untreated it can cause fibrosis and lymphatic obstruction.
How does clinical presentation differ between dengue and chikungunya?
Classic Dengue = acute febrile illness with headache, retro-orbital pain, and joint and muscle pain.
Chikungunya = febrile illness with flulike Sx, prominent arthralgias, and diffuse macular rash
Both are found in tropical/subtropical regions and can be transmitted by aedes mosquito.
How does isoniazid work only within the mycobacterial cells?
Isoniazid inhibits mycobacterial mycolic acid synth. Requires mycobacterial catalase peroxidase for the initial conversion of IMH to its active metabolite within the mycobacterial cells.
