mixed deck 04/14 and 15 Flashcards
vasecotmy
- after vasecotmy viable sperm remain in the portion of the vas deferense proximal to the ligation
- 20% of patients still have some viable sperm in their ejaculate after 3 months and at least 20 ejaculations
corynebacterium diphtheriae
- non motile, unencapsulated, gram positive rod
- found in clumps resembling chinese letters or joined in V- or Y-shaped chains on microscopic examination.
- their cytoplasm contains metachromatic granules that statin with aniline dyes like methylene blue
Corynebacterium diptheriase produces a classic two subunit AB exotoxin
-B subunit binds to the heparin binding epidermal growth factor receptor found on cardiac and neural cells and it is responsible for the toxins affinity for heart and nervous tissue.
-A the active subunit inhibits host cell protein synthesis by catalyzing the ADP ibosylation of protein EF-2
EF-3 is necessary for tRNA to insert new amino acids into the growing protein chain during translation
ERB-B2 (Her2/neu) positivity in breast cancer is
consistent with more aggressive tumor that should respond to therapy with the monoclonal antibody trastuzumab
Symptoms indicative of both nicotinic blockade (diplopia, dysphagia) and muscarinic blockade (dry mouth)
strongly suffest food poisoning with botulinium toxin a preformed neurotoxin
- descending paralysis
- diplopia, dysphagia and difficulty speaking
- nausea, vomiting and abdominal pain may also occur in food-born botulisms
- 12-36 hour incubation period
- the toxin prevents binding and fusion of the AcH SYNAPTIC VESICLES WITH THE PLASMA MEMBRANE EFFECTIVELY BLOCKING RELEASE OF ACH FROM THE NEUROMUSCULAR SYNAPSE!
Distal vagina, vulva and scrotum drain to what lymph nodes?
superficial inguinal nodes
Follicular lymphoma
- most common indolent non-hodkin lymphoma in adults
- it is of b cell origin and present with painless waxing and waning lymphadenopathy
- t(14:18) is characteristic and results in over expression of the bcl-2 oncogene
de quervains thyroiditis
also known as subacute granulomatous thyroiditis
- features thyroxixosis, tenderness over the thyroid gland, increased ESR and a markedly-reduced radioactive iodine uptake are diagnostic
- mixed cellular infiltration with occasional multinucleate giant cells are characteristic histologic findings.
c-Myc
burkitt
-nuclear phosphoprotein that functions as a transcription activator
Congenital torticollis
-caused by birth trauma (breech) or malposition of head in utero (due to fetal macrosomia or oligohydramnios)
-2-4 weeks of age seen
-both result in SCM injury and fibrosis
Features:
-chin will point away from the contracted muscle
-bulge in contracted muscle (inferior 1/3 of the affected SCM)
-head tilted toward affected muscle
Most cases resolve with conservative therapy and stretching exercises
Malignant hyperthermia occurs after the administration of inhaled anesthetics and or succinylcholine to genetically susceptible individuals
-autosomal dominant trait, defect is related to ryanodine receptors of SR.
presentation:
-fever, muscle rigidity soon after surgery under general anesthesia, tach, HTN, hyperkalemia and myoglobinemia are characteristic.
treat: Dantrolene - acts on the ryanodine receptor and prevents further release of C into the cytoplasm of muscle fibers
Treatment of choice for early < 6 weeks ectopic pregnancies?
Methotrexate -irreversibly inhibits DHF recutase recall folic acid --> DHF--> THF -MTX inhibits DHF --> THF -thus we have a build up of DHF polyglutamate
Watch out for bblockers and non-dihydropyridine-type Ca channel blockers (verapamil, dilitiazem) when used concomitantly can cause
additive negative effects on HR, AV node conduction and myocadrial contractility.
-sinus brady and hypotension may occur
Daptomycin is a lipopeptide antibiotic
-disrupts the bacterial membrane through the creation of transmembrane channels. These channels cause leakage of intracellular ions leading to depolarization of the cellular membrane and inhibition of macromolecular (DNA, RNA and protein) synthesis which ultimately leads to cell death.
Treat:
-limited to gram-postive including MRSA!
tox:
-associated with increased creatine phosphokinase (CPK) levels and an increased incidence of myopathy
coronary sinus is where the coronary veins drain to before entering the RA. They have less O2 than systemic blood returning
- myocardial oxygen extraction exceeds that of any tissue or organ the body.
- resting myocardium extracts 75-80% of the oxygen present in the blood, while myocardium at work extracts up to 90% of oxygen from the blood.
