Mixed Block Notes 11 Flashcards
1
Q
Xanthomas are most characteristic of
A
Hypercholesterol or Hypertriglyceride
2
Q
Familial hypercholesterolemia etiology
A
LDL Receptor
3
Q
Peutz-Jeghers mutation
A
Serine/Threonine kinase 11 (STK11) on 19
4
Q
Peutz-Jeghers manifestations
A
Skin lesions within first few years, intestinal polyposis follows
5
Q
Buccal mucosa pigmented lesions
A
Pathognomonic for Peutz-Jeghers
6
Q
Histology of Rhabdomyoma
A
Fascicles of polygonal cells with vacuolated cytoplasm and peripherally placed nuclei
7
Q
Where do Rhabodmyomas occur
A
Head and neck of younger males
8
Q
Dermoepidermal junction autoantibodies to type VII collagen
A
Epidermolysis Bullosa Acquisita
9
Q
Clomiphene is best used to
A
Achieve fertility in women with ovulatory failure who are normogonadotrophic, normoprolactinemic, euthyroid
10
Q
hCG therapy can be used to trigger
A
ovulatory cascade in an oocyte donor when her follicles are deemed mature
11
Q
HOCM murmur is louder/softer with
A
Louder with decreases in Preload or Afterload; Softer with increases
12
Q
IgA deficiency can lead to incr incidence of
A
Atopic, Autoimmune disease
13
Q
Excise RNA primers and replace with DNA
A
DNA Polymerase I
14
Q
AFP is associated with what repro malignancy
A
Yolk Sac tumors
15
Q
Classic AE’s with Prednisone
A
Avascular necrosis of femoral head, Insomina, Psych
16
Q
Glyburide
A
Sulfonylurea
17
Q
Cytoplasmic what accumulation is a hallmark of ischemic injury
A
Ca2+
18
Q
Tamm-Horsfall
A
Exclusively secreted by renal tubular epithelial cells in ascending LOH (Prerenal azotemia and low urine flow rate –> Accumulation to form hyaline casts)
19
Q
Findings in homocysteinuria
A
Marfanoid, Lens down and in, Thrombosis, Athersclerosis, Osteoporosis
20
Q
Warfarin embryopathy
A
Midfacial hypoplasia, Chondrodysplasia punctata, Hemorrhage, Organ hypoplasia, CNS
21
Q
Changing of pili in neisseria
A
Phase variation (on-off) and Antigenic variation
22
Q
Complementation
A
Production of distinct phenotypic trait resulting from homozygous mutations in more than on egene
23
Q
Important finding NOT found in McArdle’s
A
Hypoglycemia (liver glycogen phosphorylase intact)
24
Q
Glycogen synthase deficiency
A
Infancy = Hypoglycemia, Ketosis, Metabolic acidosis, Growth delays
25
Effects of beta blocker on K
Hyperkalemia
26
EKG signs of hyperkalemia
Peaked T, Loss of p, Prolonged PR, Widen QRS, Slow HR
27
EKG signs of hypokalemia
QT prolongation, U waves, ST depression --> Torsades
28
EKG signs of Hypo vs Hypercalcemia
Hypo causes QT prolongation; Hyper causes QT shortening
29
In general, a medullary lesion would result in
Contralateral spastic paresis, Ipsilateral CN XII defect
30
Phenylephrine
Selective alpha 1 agonist
31
Dobutamine
Mostly Beta 1 agonist - little effects on PVR
32
Isoproterenol
Non-selective beta agonist; Incr HR/CO/PP, Decr PVR
33
Epinephrine effects on HR and PVR
Incr HR, Decr PVR
34
CAAT box
Promoter - binding site for RNA polymerase II
35
Promoters/Binding sites for RNA polymerase II
CAAT, TATA
36
Enhancers are unique in that
they can be located very far away
37
Sublimation
Converting unacceptable feelings or drives into socially acceptable ones
38
Hepatic sinusoidal endothelial cells are unique in that
Fenestrated, Lack BM
39
Stellate cells
Vit A storage; Diff into myofibroblast upon injury --> Fibrosis
40
Block 23S rRNA of 50S
Macrolides, Clindamycin
41
Inhibition of 50S peptidyltransferase
Chloramphenicol
42
Decreasing [Kin]
Increases likelihood of neuronal depolarization w/out altering AP amplitude
43
Increasing [Kin]
Hyperpolarize neuron without altering AP amplitude
44
Mechanism for age-related lactase deficiency
Decr gene expression
45
Cyclosporine MOA
Binds cyclophilin --> inhibits calcineurin --> Inhibit calcium-dependent promotion of IL2 transcription
46
Basiliximab, Daclizumab MOA
mAb that blocks IL-2R
47
Tacrolimus MOA
Binds FKBP --> inhibits calcineurin --> inhibit calcium-dependent promotion of IL-2 transcription
48
Sirolimus (Rapamycin) MOA
Binds FKBP --> Blocks mTOR --> Prevents IL-2 response
49
Tardive Dyskinesia mechanism
Upregulate D receptors; Concomitant decr in cholinergic activity in Striatum
50
The plateau phase of cardiomyocyte AP corresponds to
ST segment (isoelectric)
51
Virus that carries its own DNA-dep RNA polymerase
Pox
52
What can decrease glomerular capillary filtration coefficient
Chronic HTN, DM --> Drop in GFR
53
Calcipitriol
Vit D analog for treatment of Psoriasis (topically)
54
Antibiotic efflux pumps are found in what type of bugs
Typically gram negative
55
Orlistat MOA
Lipase inhibitor
56
McArdle's disease severity
Typically begin in young adulthood --> Muscle cramps, Fatigue, Transient myoglobuinuria --> normal lifespan
57
Lipofuscin is produced when
ROS --> Membrane Lipids
58
Cholesterol Ester Storage disorder
Partial defect in lysosomal acid lipase --> Accumulation of cholesterol ester, TG's --> Hepatic fibrosis, Premature atherosclerosis
59
Clinical manifestations of Cryptosporidium
Mild enterocolitis with water, non-bloody diarrhea
60
Toxoplasmosis in immunocompetent
Nonspecific --> Fever, headaches, myalgia, lymphadenitis
61
Nephrotic Syndrome in adults
Membranous Glomerulonephritis
62
Methenamine silver stain showing thickening of glomelar BM
Membranous Glomerulonephritis
63
CCB's in pregnancy
Limb loss - decreased placental perfusion
64
BB's in pregnancy
Generally safe
65
Incr in endothelium-bound LPL activity
Insulin resistance
66
Increased cholesteryl ester storage in hepatocytes and endothelial cells
Cholesteryl Ester Storage disease - Lysosomal acid lipase defect
67
Insulin effect on Adipocyte vs Endothelial LDLR's
Upregulate on hepatocytes, Downregulate on endothelial cells
68
Complicated non-gonoccocal urethritis
Epididymitis --> 2 wks of doxy or 1 wk azithromycin
69
Probenicid and Penicillin
inhibits renal tubular secretion of penicillins, most cephalosporins,
70
Cilastatin and Imipenem
Prevent proximal tubular brush border hydrolysis of imipenem by dehydropeptidase
71
Stimultion of auricular branch of vagus nerve
Reflex coughing or vomitting
72
Bloom syndrome
Photosensitivity, Short stature, Erythema, Telangiectasias - Defect in DNA helicase gene -- Predisposed to lymphoproliferative and gastrointestinal malignancies
73
ATM gene is important for
DNA repair following ionizing radiation - Telangiectasias in eyes and ears, Lymphoproliferative malignancies
74
Tumors in Li Fraumenia
Breast cancer, Soft tissue sarcoma
75
Location of Lynch syndrome polyps
proximal
76
Histology of Follicular Lymphoma
Effacement; Small cleaved cells (centrocytes), Larger non-cleaved cells w/ multiple nucleoli (centroblasts)
77
Presentation of Sporadic Burkitt's
Ascites and abdominal mass from ileum, cecum, or mesentery
78
Manifestations of hyperestrogenism in cirrhosis
Spider angiomas, Palmar erythema, Dupuytren's, Decr body hair
79
Niacin MOA
(1) Impair VLDL production; (2) Inhibit Hormone Sensitive Lipase --> Decr TG; (3) Incr HDL by limiting cholesterol transfer form HDL to VLDL, slowing HDL clearance
80
intestinal Kaposi
Hemorrhagic nodules by endoscopy
81
Most common cause of Restriction Fragment Length Polymorphism
SNPs
82
RNA virus that replicates in nucleus
Influenza
83
High blood ammonia and Increased urinary orotic acid
OTC deficiency (Increased Carbamoyl Phosphate shunted to Orotic Acid)
84
Uncal herniation findings
CNIII, Contralateral muscle paresis (cerebral peduncle)
85
Somatic Symptom Disorder vs Illness Anxiety Disorder
Minimal or no actual physical symptoms in Illness Anxiety
86
Pseudodementia
Cognitive dysfunction that occurs in patients with severe psych illness
87
Why hypoglycemia in MCAD
Acetyl-CoA is consumed by medium chain fatty acids that accumulate --> Low concentrations of AcetylCoA inhibit conversion of pyruvate to OAA (inhibiting gluconeogenesis
88
Anti-SRP antibodies
Autoimmune Myositis
89
MHC II pathway is particularly important for generating helper T response against
Extracellular and Intracellular membrane-bound pathogens
90
T lymphocyte antigen recognition is determied by
Specificity of TCR for both MHC variant allele and peptide fragment bound to it
91
Positive T lymphocyte selection
Thymic cortex - Responsible for generating T cells compatible with person's HLA haplotype
92
Individuals with HLA haplotypes that cannot bind certain polypeptide fragments
will not be able to mount T cell dependent immune response against these antigens
93
Most common opportunistic viral infection affecting GI tract of HIV patients
CMV - Ulcers, Mucosal erosions, Large cells with basophilic intranuclear & intracytoplasmic inclusions
94
Biopsy in HIV Cryptosporidium diarrhea
Organism confined to microvilli - basophilic parasites attached to mucosal brush border
95
Microsporidium diarrhea in HIV
Distortion of villous architecture w/out inflammation; Small spores with diagonal or equatorial belt-like structure
96
MAC diarrhea in HIV
Necrotizing and Non-necrotizing granulomas; Acid fact staining bacilli
97
HIV protease cleaves
gag and pol products
98
Carboxyhemoglobin
HbCO --> Loss of cooperativity, Unable to unload O2
99
Sclerosing Adenosis
Incidental finding (rarely palpable mass) --> Slight incr risk, Must biopsy
100
Mammary duct ectasia
Skin retraction, Thick creamy or bloody discharge, Palpable periareolar mass
101
Fibroblasts in a cartwheel or storiform pattern
Dermatofibrosarcoma protuberans
102
Dysplastic Nevus syndrome
CDKN2A on 9p21
103
LV End systolic volume, End diastolic volume and pressure in exercise
End systolic volume decreased, End diastolic volume up, End diastolic pressure same
104
Metencephalon -->
Pons and Medulla
105
Three vs Five embryonic vesicles
Pros, Mes, Rhomb --> Tel, Di, Mes, Met, My
106
Short a-helix with leucine resides at every seventh position
Leucine zipper dimerization domain --> TF's known as Basic Zipper Proteins
107
DNA-binding motifs
(1) Zinc finger; (2) Helix-loop-helix; (3) Leucine zipper dimerization domain
108
First reaction of Pyrimidine synthesis
Glutamine, CO2, 2 ATP --> Carbamoyl Phosphate in Cytosol
109
Peroxisome function
Lipid metabolism (beta oxidation), Oxidative reactions, Purine catabolism
110
Cellular location of G-6-Phosphatase
Smooth ER
111
CYP inhibition/induction effects on Warfarin
Inhibits incr Warfarin effect (decr inactivation)
112
2 most common sites for hypertension-related intracerebral hemorrhage
Thalamus, Putamen
113
Hyptertensive hemorrhage in pons
(1) Pinpoint pupils; (2) Loss of horizontal gaze; (3) Decerebrate posturing; (4) Coma
114
mechanisms of incr ICP in brain tumors
(1) Obstruction; (2) Disrupt BBB = vasogenic edema
115
Cutaneous findings in Reiter's
Keratoderma blenorrhagica, Balanitis circinata
116
Causes of nephrogenic diabetes insipidus
(1) Hypercalcemia; (2) Hypokalemia; (3) Post-obstructive diuresis; (4) Lithium, Amph B, Gentamicin, Cisplatin
117
Eptifibatide
Gp Iib/IIIa inhibitor that inhibits platelet aggregation by binding fibrinogen site
118
Effect of CYP inhibitors/inducers of Clopidogrel
Must be activated, so inhibitors decr drug levels
