question sets Flashcards
What is the mechanism of action of local anesthetics? Which nerve fibers are blocked first with local anesthesia? (FA15p499)
mechanism: block Na+ channels by binding to specific rec. on inner part of channel, bind to activated Na+ channels, so most effective in rapidly firing neurons.
3o amine local anesthetic penetrate membrane in uncharged form, then bind to ion channel in charged form
–>prevent nerve firing
small, myelinated fibers are blocked first
What medications are used in the treatment of urge incontinence?
muscarinic antagonists/anticholinergic: Oxybutynin, solifenacin, tolterodine, darifenacin, trospium
What are the three different eukaryotic RNA polymerases? What type of RNA does each make?
(FA15 p68) (FA16 p54)
RNA polymerase I makes rRNA (most numerous RNA, rampant).
RNA polymerase II makes mRNA (largest RNA, massive).
RNA polymerase III makes tRNA (smallest RNA, tiny).
Prokaryotes only have 1 RNA polymerase
Which cell types do not require insulin for the uptake of glucose? (FA15 p314) (FA16 p308)
GLUT-1: RBCs, brain, cornea
GLUT-2 (bidirectional): β islet cells, liver, kidney, small intestine
GLUT-3: brain
GLUT-5 (fructose): spermatocytes, GI tract
BRICK L (insulin-independent glucose uptake): Brain, RBCs, Intestine, Cornea, Kidney, Liver.
GLUT-4: requires insulin for glucose uptake
What are the layers of the epidermis beginning with the most superficial layer? What is Auspitz sign?
(FA15 p436, 439) (FA16 p437, 440)
Stratum Corneum (keratin) Stratum Lucidum Stratum Granulosum Stratum Spinosum (desmosomes) Stratum Basale (stem cell site)
bake some good luscious cookies/ come let’s get sun burned
Auspitz sign—pinpoint bleeding spots from exposure of dermal papillae when scales are scraped off. Can be associated with nail pitting and psoriatic arthritis. (psoriasis)
What is Kallmann syndrome? (FA15 p579) (FA16 p586
usually sporadic, but X-linked if familial, sometimes AD, AR
Failure to complete puberty; a form of hypogonadotropic hypogonadism. (dec. testosterone, dec. LH)
Defective migration of GnRH cells and formation of olfactory bulb; dec. synthesis of GnRH in the hypothalamus; anosmia; midline facial defects, dec. GnRH, FSH, LH, testosterone.
Infertility (low sperm count in males; amenorrhea in females).
A 67-year-old man with congestive hear failure lost his job and medical insurance, so he stops buying and taking his digoxin, and develops dyspnea. What will this do to his cardiac output (CO)? What are the mechanisms behind his development of dyspnea?
digoxin: + inotrope used for HF
stopping it will decrease his CO via decreasing contractility.
the reduced contractility can also cause a backwards bloodflow, congesting the pulmonary circulation–>dyspnea
A 17-year-old girl is brought to the emergency room for abdominal pain and vomiting. She has a fever, and further questioning and exam reveal that the pain is in the right lower quadrant and has rebound tenderness. She says the pain began around the umbilicus. She is very nauseated and vomits again during the exam. What must be ruled out prior to coming to the final diagnosis in this patient? (FA15 p363) (FA16 p360)
this is classic presentation for acute appendicitis, but MUST RULE OUT PREGNANCY (get a B-hCG)
A 31-year-old man is post-op day 1 after an exploratory laparotomy. The surgery was performed emergently for intraperitoneal hemorrhage after a motorcycle crash. His creatinine today is elevated to 2.0 mg/dL. His pain is currently uncontrolled. Explain why an NSAID could lead to a potential complication in this patient. (FA15 p530, 533) (FA16 p535, 538)
NSAIDs block renal-protective prostaglandin synthesis (via inhibiting COX-1) –> constriction of afferent arteriole–>reducing RPF and GFR; this may result in acute renal failure.
Which phagocyte dysfunction disease increases patient susceptibility to Staphylococcus aureus and Escherichia coli? What is the cause of this disease? (FA15 p215) (FA16 p209)
Chronic granulomatous disease:
Defect of NADPH oxidase–> dec. reactive oxygen species (e.g., superoxide) and respiratory burst in neutrophils; X-linked recessive most common.
-inc. susceptibility to catalase ⊕ organisms (Need PLACESS): Nocardia, Pseudomonas, Listeria, Aspergillus, Candida, E. coli, S. aureus, Serratia. (due to these organisms using up H2O2, so phagocytes cannot utilize for killing)
Abnormal dihydrorhodamine (flow cytometry) test. Nitroblue tetrazolium dye reduction test is ⊝.
In your own words, describe what type I (a) error is. (FA15 p54) (FA16 p38)
Stating that there is an effect or difference when none exists
Also known as false-positive error.
α = you saw a difference that did not exist (e.g., convicting an innocent man).
What trace element is essential to the function of carbonic anhydrase and lactate dehydrogenase?
Zinc, needed for protein folding
A 30-year-old man who is experiencing shortness of breath is diagnosed with obstructive lung disease on pulmonary function testing. The patient does not have a history of asthma and has never smoked. The patient is subsequently diagnosed with α1-antitrypsin deficiency. How does the emphysema caused by smoking differ from the emphysema caused by α1-antitrypsin deficiency? (FA15 p371, 610) (FA16 p369, 618)
α1-antitrypsin deficiency: uninhibited elastase in alveoli elastic tissue–>panacinar emphysema, lower lobes
smoking: Centriacinar, upper lobes


In what clinical scenarios would you see a “nutmeg” liver? (FA15 p297, 370)
RHF, Budd-Chiari syndrome
-increased central venous pressure, increased resistance to portal flow.
You are performing a radical mastectomy and exercise extreme caution as you dissect laterally along the serratus anterior muscle. You do this in order to avoid severing which motor nerve, which would result in what sequela? (FA15 p419) (FA16 p420)
Long thoracic n., “winged scapula”
A patient comes to the clinic complaining of severe low back pain that radiates down the back of her leg. What is the most likely explanation for her pain?
disc herniation; L5, S1 nerve root compression
What problem/abnormality is associated with the following buzzwords? Calf pseudohypertrophy (FA15 p624) Gower maneuver (FA15 p85)
Duchenne muscular dystrophy
