Mon aug 17 Flashcards
what cells produce FGF 23?
osteocytes
what triggers osteocytes to produce FGF 23?
hyperphosphatemia, or increased 1,25vitD
function of FGF 23?
inhibits synthesis of 1,25 vit D - > decreased renal reabsorption of phosphate and intestinal phosphate absorption
if soeone has CKD, what can maintain normal phosphate levels?
FGF 23 may be responsible for maintaining normal phosphate leves and it will lead to decreased reaborption/absorption of phosphate in the intestines/kidneys
what is the most common outcome of a hep b infection?
complete resolution
which bowel disease has non caseating granulomas?
crohns disease
does amiodarine increase the PR interval ?
yes - via ca channel inhibtion
does amiodarone increase the QRS interval?
yes - via Na channel inhibition
does amiodarone increase the QT interval?
yes - via K channel prolongation
presentation of glucagonoma?
- hyperglycemia and diabetes
- necrolytic migratory erythema
findings of necrolytic migratory erythema?
- painful pruritic rash often on face, groin and extremities.
- small erythmetaous papules coalesce over time to form large indurated papulse with a central clearing that is often bronze coloured
do all strains of H influenza produce a capsule?
no
what is mutated in McCune-Albright syndrome?
the GNAS gene which encodes the stimulatory alpha subunit of protein-> constiutive activation -> hormone overproduction
presentation of McCune-albright syndrome?
- precocious puberty
- irregular cafe au lait macules (overactivity of melanocytes)
- polycystic fibrous dysplasia(overstimulation of osteoclasts from increased IL6)
complications of McCune-albright syndrome?
- thyrotoxicosis
- acromegaly
- cushing syndrome
what is calcitriol?
the active form of vit D
what is cincalcinet?
-a calcimimetic that activates the ca sensing receptor of the Parathyroid gland leadign to decreased PTH secretion
diabetes insipidus caused by damage to the hypothalmic neurons is usually permanent or transient?
permanent
diabetes insipidus caused by damage to the post pituitary neurons is usually permanent or transient?
transient (just a few days)
how does end diastolic volume change in a endurance ahtlete?
increased - the heart undergoes eccentric hypertrophy to have a larger cavity size adn there is reduced SVR
does the maximum cardiac output change in an endurance athlete?
yes - it increases since they have an increased stroke volume
does the left ventricular ejection fraction change in an endurance ahtlete?
no - it is unchanged (stroke volume and end diastolic volume both increased proportionatly)
what type of hypersensitivity reaction is serum sickness?
type III
presentation of serum sickness?
fever, pruritic skin rash, and arthralgias that begin 7-14 days after exposure to antigen. May have lymphadenopathy and proteinuria
common causes of serum sickness?
chimeric monoclonal antibodies (rituximab) and nonhuman immunoglobins (venom antitoxins) and some other drugs
findigns in serum sickness?
- immune complex deposition and complement consumption leading to hypocomplementemia
- fibrinoid necrosis and neutrophilic invasion of affected tissues on biopsy
how do beta blockers improve symptoms in patients with hypertrophic cardiomyopathy?
- they increase the LV volume which helps reduce outflow obstruction, via:
1. reduced heart rate - > increased diastole and filling time
2. reduce LV contractility- increased end systolic volume
is metastasis to lymph nodes considered low or high stage cancer?
higher stage
in diffuse axonal injury, where is the swelling most pronounced?
the grey-white matter junction
which stomach bug is a common cause of vomiting and diarrhea?
norovirus - VOMITING
is norovirus acid resistant or labile?
resistant
why are reticulocytes blue in colour?
they have residual ribosomal RNA
Someone taking opioids immediately develops hives, itching and wheezing most likely is experiencing what?
A pseudoallergy - from direct mast cell degranulation (this is more common on opioids than a true Type I hypersensitivity is)
does a pseudoallergic reaction involve igE?
no - mast cells are directly stimulated
