PT6 Flashcards by Shefali Pappu

For screening tests, it’s important to have high sensitivity or specificity?

SENSITIVITY - you want to be able to rule out anybody that does not have it (high sensitivity) and keep as many people who can possibly have it. Then, for SCREENING, you’d want a high specificity so you make sure those who test positive can be ruled in for good

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VIP (vasoactive intestinal peptide)

Responsible for secretory diarrhea (in VIPoma) - it promotes water and ion excretion from the body

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How to treat VIPoma

Can use somatostatin/ocreotide - will inhibit VIP

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Genetic defect in Fragile X

Defect found in long arm of X-chromosome, in the FMR-1 gene - you have lots of trinucleotide repeats (CGG) which causes HYPER-METHYLATION of the gene- making it inactive

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Nuclei that serotonin comes from

Raphe nuclei

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Nuclei that NE comes from

Nucleus ceruleus

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Nuclei that ACh comes from

Basal nucleus of Meynart

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Imperforate anus commonly associated with

Other GU problems (fistulas)

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IL-8

secreted by macrophages and surrounding endothelial cells during injury to recruit NEUTROPHILS via chemotaxis

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C3a

Inflammatory anaphylotoxin that recruits and activates eosinophils & basophils

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C5a

Inflammatory anaphylotoxin that recruits and activates neutrophils, monocytes, eosinophils, and basophils

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IL-3

Secreted by activated T-cells - stim. stem cells from bone marrow

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IL-10

Anti-inflammatory cytokine secreted by Th2 and macrophages - helps to downregulate pro-inflammatory mediators (IL-2, TNF-alpha, gamma-INF)

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How man g of protein yield 1 calorie?

4g protein = 1 calorie

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How many g of fat yield one calorie

9g fat = 1 calorie

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Cricopharyngeal muscle dysfunction

Caused by diminished relaxation - can build up pressure within esophagus and cause Zenker diverticulum to form (only contains the mucosal level so it’s a false/pulsion diverticulum) - causes dysphagia also you can aspirate food which can cause pneumonia

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NF-1

Single gene autosomal dominant - mutation in NF1 gene on Chr 17

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NF-2

hallmark = bilateral acoustic schwannomas causing hearing loss at young age

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Rabies virus vaccine

Killed virus

Polyhydramnios associated with

GI obstructions (atresia) & anencephaly

lac operon structure

Sequence of the E. coli genome which is required for the metab of lactose
Regulatory gene (i), promoter region (p), operator region (o), 3 structural proteins (z, y, a)
Z codes for beta galactosidase (beta-gal) - hydrolysis of lactose to glucose + galactose
y codes for permease (inc. perm of cell to lactose)
a encodes beta-galac transacetylase which transfers acetyl groups to beta-gal (unnecessary, really)

SINGLE mRNA TRANSCRIPT CODES FOR ALL 3 PROTEINS!!!!

With total gastrectomy, what do you need to supplement

Vitamin B12 (aka water-soluble vitamins) - you’ve removed intrinsic factor (secreted by parietal cells) so B12 absorption from gut is not sufficient - requires PARENTAL

CREST & relation to GI

C = calcinosis
R = Raynaud's
E = esophageal dysmotility
S = sclerodactyly
T = telangiectasias

With esophageal dysmotilty, you get atrophy & fibrous replacement of esophageal muscles which causes body and LES to become atonic & dilated = severe reflux (won’t be helped with antiacid use)

Main site of lipid digestion

Duodenum

Main site of lipid absorption

Jejunum

Bony landmark for 1st part of duodenum

L1 vertebra | Gastroduodenal artery courses posterior

Landmarks for 2nd part of duodenum

Head of pancreas L1-L3 vertebrae Ampulla of vater empties here

Landmarks for 3rd part of duodenum

1. 3rd lumbar vertebra 2. Abd aorta 3. IVC 4. Superior mesenteric a. 5. Uncinate process of pancreas

Which is important in preventing superficial candida infections?

T-cells (T-helper)

Which is important in preventing hematogenous spread of candida?

Neutrophils

Lactase deficiency is most likely to decrease __________ on lactose challenge...

Stool pH - bacterial fermentation of the lactose (because it doesn't get digested and accumulates in GI lumen) produces short-chain FA and excess H+ which acidifies stool

Autosomal recessive def of IFN-gamma receptor leads to...

Disseminated mycobacteria disease in infancy or early childhood (including infection by the BCG vaccine strain if administered)

Role of INF-gamma and mycobacteria protection

INF-gamma secreted by T-cell/NK cell in response to IL-12 secreted by infected macrophage; this causes binding of INF to receptor on macrophage surface - dimerization & activation of JAK/STAT pathways to enhance mycobacterial killing via phagocytes

Which cells are responsible for uptake of Shigella that initiates the infection?

Antigen-sampling M cells; located in Peyer's patch of ileum; then it causes ulceration of the mucosa which causes leakage of blood, inflammation elements and mucus into lumen

Arsenic antidote

Dimercaprol (displaces arsenic ions from the sulfhydryl groups of enzymes) - narrow TI for this drug though

Amyl nitrate treats

Cyanide poisoning

Treatment regimen to cure H. pylori related PUD

Triple therapy: 2 antibiotics + PPI | Ex: metronidazole/ tetracyline/ amoxicillin/ clarithromycin + PPI and/or bismuth for 2 wks

Chalky white lesions in mesentery, fat cell destruction, calcium deposition - suggests?

Acute pancreatitis -

Puppy had diarrhea, now little kid has diarrhea, abd. pain & fever - which agent is responsible?

Campylobacter- only enteric pathogen that can be transmitted from domestic animals to humans - moves in corkscrew fashion -can be transmitted via domestic animals (fecal/oral) and unpasteurized milk!

Which pancreatic structures are derived from ventral bud

Part of main pancreatic duct, uncinate process, part of the head

Dorsal pancreatic bud creates...

pancreatic tail, body, most of head, small accessory pancreatic duct

Which pathogens requires a very SMALL dose to be able to cause gastroenteritis?

Shigella (only like...10 organisms required!) , E. histolytica (as few as just 1) and giardia (as few as 1)

Retroperitoneal structures

Abd. aorta, IVC, pancreas (except tail), kidneys, adrenal glands, 2 & 3 of duodenum, ascending & descending colon, rectum, ureters, bladder, vertebral column, pelvic muscles

Liver is retro or intraperitoneal?

INTRA

Galactokinase function

galactose to galac-1-ph

Galactosemia

Sx start soon after breast feeding Due to def of GALT, galactokinase, or the epimerase Excess galactose converted to galactitol via aldose reductase high galactitol levels responsible for CATARACT FORMATION

ADA deficiency

leads to SCID- adenosine cannot be broken down into inosine and removed - builds up and is toxic to lymphocytes - widespread death of T and B lymphocytes (cellular and humoral immunodef) - inc. susceptibility to bacterial, viral, and fungal infections