Prometric Practice Flashcards
↑ megakaryocytes on biopsy
Immune Thrombocytopenia
Immune thrombocytopenia antibody
Anti-GpIIb/IIIa antibodies
splenic macrophage consumption of
platelet‑antibody complex. Commonly due to viral illness.
Inhibition or deficiency of ADAMTS 13
ADAMTS =vWF metalloprotease
Thrombotic
thrombocytopenic
purpura
platelet aggregation and thrombosis.
ADH is the same as
Vasopressin
Translocates an aquaporin
rare; characterized by widespread kidney damage due to granulomatous tissue containing foamy macrophages
Xanthogranulomatous pyelonephritis
Part of chronic pyelo
what is gemfibrozil
a fibrate
what is a side effect of fibbrates
↓ bile acid syntheisis–> gallstones
What are the side effects of statins
hepatic dysfunction
myopathy
What is a VIPoma
pancreatic islet tumor w/ ↑ VIP
increases stool Cl loss (which draws in h2o and more electrolytes)
Inhibits gastrin
x rashy ows air in biliary tree
gallstone ileus may be present. Gallstone obstructs ileocecal valve
What kind of gene is APC
tumor supressor
What does kras do
protooncogene. can lead to unregulated proliferation
what does a dcc mutation do
avoidance of apoptosis
What is wrong in essential fructosuria
fructokinase deficiency
benign because hexokinase can help you out still
what is wrong in hereditary fructose intolerance
↓ aldose b
toxic accumulation of fructose- 1 - phosphate
life threatening
What is beta oxidation of fat
breaking down fatty acid
where does beta oxidation of fat occur
mitochondria
what enzyme mediates b-oxidation of fat
carnitine acetyltransferase
what regulates the b-oxidation of fat
malonyl coa
What is the bioavailability of IV drugs
it is 100%
oral is usually never 100%
therefor use IV as the standard to compare oral to
where is the negative feedback for cortisol
hypothalamus and pit
feeds back to both
what does estrogen therapy do to thyroid
↑ thyroid binding hormone
but feedback still works
therefor normal levels of free T4
what are the two watershed areas of the colon
splenic flexure (SMA, IMA) rectosigmoid junction (sigmoid and superior rectal)
what enzyme cleaves bad bases in dna repair
glycosylase
cleaves altered base
what does endonuclease do
cleaves the 5’ bad site
what does lyase do
cleaves the 3’ end of bad site
what seals the nick in dna repair
ligase
what is hyperestrinism/ when do you see it
liver chirrosis
too much estrogen
causes: Boobs, spider angiomata, palmar erythema
↓ pubic hair, ↓ tests
what does a carcinoid tumor look like on histology
small blue cells
what does a hamartoma look like on histology (from colon)
disorganized glands, smooth muscle, connective tissue
seen in PJ and juvenile polyp
s/s: bleeding/ intussusception
what are the symptoms of a hyperplastic polyp
none usually
benign
well differentiated
describe primary biliary cirrhosis
autoimmune- lymph infiltrate and granuloma
destruction of bile ducts
anti- mitochondria ab, ↑ IgM
do klinefelter’s have sperm
no- none
47 xxy
what is the hormone panel like in klinefelter
↑ FSH and LH
↓ testosterone
has destruction of seminiferous tubes
UC or crohn’s has granulomas
crohn’s has non caseating granulomas
describe crohn’s
cobblestone mucosa
transmural inflammation
string sign
why is aflatoxin bad
causes p53 mutation
leads to hepatocellular carcinoma
in gluconeogenisis, the first step is pyruvate + co2 –> oxaloacetate
what enzyme does this, and what regulates the enzyme
pyruvate carboxylase does it
acetyl - coa (1st step into TCA) regulates it
what is the central step in pancreatic necrosis
trypsinogen–> trypsin
trypsin can activate other zymogens–> autodigestion
what liver marker indicates alcoholism
AST»ALT
>2 AST:ALT
Fun question, describe rectal lymph drainage
proximal to dentate line- int illiac
distal to dentate line- inguinal
why do mallory weiss tears happen
increased ab pressure from retching, vomiting, and abdominal straining
what is diphenoxylate
opiod anti-diarrheal
slows motility
atropine added in to avoid abuse
dolphin fountain
what is the most important risk factor for pancreatic cancer
smoking
s/s of pancreatic cancer
large non tender gallbladder
painless obstructive jaundice
pruritus, dark urine, pale stool
what is histology of Reye syndrome
microvesicular steatosis
↓ mitochondria and glycogen depletion
no necrosis or inflammation
alcohol and gallstones cause pancreatitis. what is a third more rare (20%) reason
try-glys over 1000 mg/dL
what does ammonia do to the brain
depletes a-ketoglutarate–> inhibits kreb
accumulation of glutamine–> astrocyte swelling and dysfunction
what is alpha ketoglutarate involved in
it is an intermediate in krebs and an intermediate in the ammonia transport alanine/glutamate cycle
what is the most common liver tumor (benign)
cavernous hemangioma
blood filled vascular space
biopsy –> fatal bleeding so not needed
what tumor is acs. w/ OCPs
hepatic adenoma
what the FUCK is sertaline
SERrtaline is an SSRI
SER=SSRI
what supplies majority blood supply to femoral neck
MEDIAL is MAJORITY of femoral neck
if you cant metabolize fructose, you also cant metabolize?
Sucrose
what is wrong in pku
phe–//–> tyrosine
due to ↓ phenylalanine hydroxylase
s/s: sz, retardation, pale
what supposedly good cholesterol drug raises tri glys as s/e
cholestyramine
what r the insulin independent body parts
Kidney Intestine Liver Brain RBCs
what is the receptor for insulin glucose uptake
GLUT 4
receptors for insulin independent glucose uptake
GLUT 1, 2, 3, 5
what is a rare reason to have PKU
tetrahydrobiopterin deficiency (a cofactor in the same path)
2% of PKU
UNIQUE: has increased prolactin
whats downstream in the PKU pathway
dopa
dopamine
norepi
epi
