mixed world set 1

Question 1

Primary cilliary cirrhosis is a chronic liver disease characterized by AI destructio of the intrahepatic bile ducts and cholestasis

Answer 1

histo:
-focal and variable with a wide range in severity
-precirrhotic stage:
intralobular bile ducts are destroyed by granulomatous inflammation (florid duct lesion)
-heave portal tract infiltrate of macrophages, lymphocytes, plasma cells and eosinophils is present.

The similarity of these finding to those seen in the graft vs host disease suggests that Immunologic injury is repsonsible for disease manifestations

Question 2

Raloxifene

Answer 2

SERM

• estrogen agonist at bone
• breast and uterus estrogen antagonist

Question 3

Dysthymic disorder

Answer 3

chornic low-intesity mood disorder that responds well to antidepressant meds

sorta like major depressive disorder but more mild

need:
depressed mood occuring most days for at least 2 years
two of the following:
poor appetite or overeating
insomnia or hyperinsomnia
low energy or fatigue
low self esteem
poor concentration of difficult making decisions
feelings of hopelessness

Question 4

Major depression

Answer 4

5 of the following are present for at least 2 weeks must include either depressed mood or anhedonia
SIGECAPS
sleep
interest
guilt
energy
concentration
appetitde
psychomotor retardation or agitation
suicidality

Question 5

Chemotactic agents

Answer 5

• n-formylated peptides
• leukotried B4
• 5-HETE (leukotried precurser)
• C5A
• IL-8

Question 6

IL-8

Answer 6

• produced by macrophages

- induces chemotaxis and phagocytosis in neurtophils

Question 7

eorosions vs ulcers

Answer 7

erosions do not fully extend through the muscularis mucosa

ulcers can go into the submucosa and below

Question 8

Sodium - equilibration movements under physiologic conditions

Answer 8

Charge: positive
Major location: extracellular
Potential: + 60mv
Equilibration in a cell with resting membrane potential of -70:
the large extracellular concentraiton gradient drives Na into the cell making the membrane potential more positive until the equilibrium potential is reached.

Question 9

Potassium - equilibration movements under physiologic conditions

Answer 9

positive
intracellular
-80mv

large intracellular concentration gradient drives positvely charged K+ out of cell, making the membrane potential more negative until the equilibrium potential is reached

Question 10

Chloride movement under phsiologic conditions

Answer 10

negative
extracelluar
-90 mV

large extracellular concentration of Cl drive the negative Cl into the cell making the membrane potential more negative until the equilibrium potential is reached

Question 11

lcalcium movement under physiologic conditions

Answer 11

positive
extraceullular
+125 mv
large extracellular concentration gradient drives positively charged Ca into cell, making the membrane potential more positive until the equilibrium potential is reached

Question 12

succinylcholine

Answer 12

Depolarizing neuromuscular-blocking agent that, like acetycholinge attaches to the nicotine acetyclcholine receptor and depolarizes the neuromuscular end plate.

No succinylcholineesterase–> continous stimulation of the endplate (reflected by intital transiet fasiculations).
Na channels surround the end plate rapidly become inactivated and cannot reopen until the plate is depolarized
Flaccid paralysis phase 1
-continue administration of succinylcholine, the continous depolarization gives way to a gradual repolarization as the receptors become desensitized by the effects of succinylcholine
-this is phase II block and is similiar to non-depolarizing blockade

note) nAChR is nonselective cation channel, its opening not only allows sodium influx but also K release!!!! uh oh

Question 13

succinylcholine side effects

Answer 13

malignant hyperthermia (especially with halothane) in genetically susceptible patients

• severe hyperkalemia in patients with burns, myopathis, crush injuries and denervation
• bradycardia from parasympathetic stimulation or tach from sympathetic ganglionic effects

Question 14

what can help CF for malabsorption?

Answer 14

-pancreatic enzyme supplementation like pancreatic lipase

Question 15

stenocleidomastoid

Answer 15

CN XI
Turn head in opposite direction
insertions 3:
sterno- manubrium
cleido- medial clavicle
mastoid- mastoid process of skull

fracture the clavivle, it will cause the upward traction of the medial section of the fractured clavicle

Question 16

fibula and tibia

Answer 16

tibula is medial

fibula is lateral

Question 17

how is the ACL connected?

Answer 17

intercondyle tibia to the LATERAL femoral condyle at the medial part

look for the lateral fibula to orientate yourself

Question 18

how is the PCl connected?

Answer 18

intercondyle tibia to the MEDICAL femoral condyle and behind the ACL at the lateral potion

look for the fibula to orientate yourself, as it is lateral

Question 19

parvovirus in adults causes arthritis involving?

Answer 19

PIP, metacarpal knee and ankle joints

Question 20

systemic mastocytosis

Answer 20

-abnormal proliferation of mast cells and increased histamine secretion

symptoms:
increased production of gastic acid due to influence on parietal cells
-syncope
-flushing
-hypotension
-tach and bronchospasm
-skin: pruitis, urticaria and dermatographism

Question 21

imperforate anus in newborn

Answer 21

absecne of the anal opening is most often associated with urorectal, urovesical or urovaginal fistulas.

most common congenital malformations are urogential tract anomalies

Question 22

imperforate anus more common with isolated urogential anomolies but there are other associations VACTERL syndrome:

Answer 22

V - vertebral defects
A- anal atresia
C- cardiac anomalies
T- Tracheoesophageal fistula
E- esophageal atresia
R- renal anomalies
L- limb anomalies