Practice 1 Flashcards
Characterize the changes observed with analgesic abuse induced nephropathy:
marked thickening of the vasa recta capillaries and intermittent tubular necrosis. Eventually, papillary necrosis, FSGN, interstitial infiltration, and fibrosis can occur.
Is Pagets assoc with osteosarcoma or osteoblastoma?
osteosarcoma
What effect can prolonged use of high dose glucocorticoids have on bone?
avascular necrosis. pathognomonic crescent sign indicates subchondral collapse.
Esophageal webs are seen with what metabolic/nutritional deficiency?
Plummer Vinson syndrome (iron deficiency, esophageal webbing)
___ is the feeling of a “lump in the throat” without accompanying physical, endoscopic, or radiologic findings of esophageal obstruction.
Globus sensation.
Why do you get increased gouty attacks when you use thiazide diuretics?
Normally uric acid crystals have an ApoE or ApoB coating, but if uric acid levels fluctuate, bare uric acid crystals are exposed to circulating IgG»_space; IgG binding to uric acid crystal»_space; neutrophil phagocytosis and release of IL-1»_space; neutrophil and Mac infiltration and inflammatory changes.
What vitamin is indicated as first line therapy for nausea and vomiting in pregnancy?
B6
What’s the MOA of oseltamivir (Tamiflu) in treating influenza a and b?
Oseltamivir (Tamiflu) is a sialic acid analogue that inhibits neuraminidase of influenza A and B.
Forces the newly made virion particles to remain adherent to the host cell surface (forms viral aggregates unable to infect new cells)
What’s the MOA of ribacirin in treating HepC?
Ribavirin inhibits RNA pol and RNA fragment initiation and elongtation»_space; viral protein synth inhibition
Most follicular B cell lymphomas are assoc with a ___ translocation that leads to overexpression of what protein?
t(14;18)»_space; BCL2 overexpression.
What’s the Warburg effect?
Malignant cells can undergo high rates of glycolysis to produce the macromolecules needed for rapid cellular growth.
How does ACh cause bronchoconstriction?
Stimulates muscarinic M3 R on bronchial SM, activating G1q phospholipase C - IP3 pathway»_space; increase in intracellular Ca2+ and muscle contraction.
How does atropine promote bronchodilation?
Atropine is a competitive muscarinic antagonist that opposes the effects of ACh»_space; decreased muscle contraction.
MOA of edrophonium:
acetylcholinesterase inhibitor (used to Dx Myasthenia Gravis in Tensilon test)
Clinical manifestations of anticholinergic syndrome:
fever, dry skin and mucous membranes, flushing, mydriasis, cycloplegia, altered mental status:
“Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter”
Translocation in APL (acute promyelocytic leukemia)
t(15;17)
- Chr 17 - RARA
Chr 15 - PML gene
Rx for APL:
ATRA
- Should be started early to prevent early mortality from associated hemorrhage (APL causes pancytopenia and DIC)
Translocation in follicular lymphoma:
t(14;18) -»_space; BCL2 activation
How would an infection of molluscum contagiosum appear on histology?
Epidermal hyperplasia with molluscum bodies (large eosinophilic cytoplasmic inclusions made of virus particles)
Neurovascular elements at risk for damage in knee dislocation include:
popliteal artery, tibial nerve, common peroneal nerve
Why is popliteal artery commonly damaged in knee dislocation?
Popliteal artery is tightly proximal and distal to the popliteal fossa by the adductor magnus and soleus muscles respectively, making it susceptible to tearing via traction forces.
What’s the most important risk factor of post-partum endometritis?
C section delivery because this introduces microbial organisms and foreign bodies into the incised uterus. Signs and symptoms can include: fever, leukocytosis, uterine tenderness, and foul smelling vaginal discharge.
___ is a mature defense mechanism in which a person channels unacceptable thoughts or impulses into a socially acceptable behavior:
sublimation
Why is receptor dimerization necessary for RTK activation?
After the ligand binds to the extracellular part of the RTK, the tyrosine kinase receptor dimerizes and each subunit phosphorylates the other, causing a conformational change in the intracellular domains of the tyrosine kinase R dimer»_space; exposure of each subunit’s catalytic domain, and phosphorylation of the tyrosine residues on target proteins.
