Questions Flashcards
true vocal cords
stratified squamous
paranasal sinus, laryngeal vestibule, false vocal cords, trachea
ciliated pseudostratified columnar mucus
pseudomonas
ecthyma gangrenosum; exotoxins perivascular
acute manic
lithium, valporate, carbamazepine + atypical (olanzipine)
wiskott-aldrich
thrombocytopenia, eczema, purpura; IgM low
immediate hypersensitivity
mast cells and basophils
Eosinophils
defense against parasites: when a parasite enters the bloodstream, binds to free IgE; this binds to an IgE Fc receptor (heavy chain) located on the eosinophil cell surface. Eosinophil –> major basic protein and other enzymes from its granules, substances that damage and destroy the antibody parasites. Antibody-dependent cellular killing (macrophages and NK cells also do this)
how to eosinophils regular type 1 hypersensitivity reactions
histaminase –> helps with atopic symptoms, granules also contain leukotrienes and peroxidases that facilitate inflammation
penetrating injury to the neck superior to cricoid cartilage injuries what nerve
ansa cervicalis
what is responsible for intimal thickening after intimal injury
smooth muscle cells –> synthesis of new collage, elastin, and proteoglycans
when does PPV increase
increase disease prevalence
when does NPV increase
decrease disease prevalence
what does carbidopa do in terms of side effects
lowers the peripheral side effects: nausea, vomiting, ventral extrasystoles, a. fib, postural hypotension; behavioral changes from levdopa worsen
tetrodotoxin
potent neurotoxin found in pufferfish; blocks voltage gated sodium channels in nerve membranes (passive transport)
NNRTIs
don’t rquire activation via intracellular phosphorylation: nevirapine, efavirenz, delavirdine
what happens when ribosome encounters a stop codon
releasing factors bind to the ribosome and stimulate release of the formed polypeptide chain and dissolution of the ribosome mRNA complex
neonatal opioid withdrawal
pupillary dilation, rhinorrhea, sneezing, nasal stuffiness, diarrhea, NV, shrill crying, tremor, seizures; tx: opium solution
astrocytes
tissue repair –> irreversible neuronal damage = gliosis –> scar –> glial hyperplasia Qstem: neuronal shrinkage and intense cytoplasmic eosinophilia
ARDS
Qstem: AA –> UTI–> shock, what is the lung look like: fluid accumulation in the alveolar spaces and alveolar hyaline membrane formation
zolpidem
short acting hypnotic agent, structurally unrelated to to benzos but binds to the same protion of GABAa receptor and increases the inhibitor actions of GABA on the CNS; treats insomnia, rapid onset, less potential for dependence
colonizing aspergillosis
old lung –> TB, emphysema, sarcoid; doesn’t invade lung tissue but grows inside the cavity –> fungus ball, asymptomatic may cough and hemoptysis
hypersensitivity aspergillosis
asthma, ABPA, wheezing fever migratory pulm infitrates
invasive aspergillosis
immunosuppressed, cough hemoptysis, pleuritic chest pain and fever, necrotizing pneumonia and granuloma formation, invades tissue, extrapulmonary involvement
propionyl CoA carboxylase defieicny
inccrease prop CoA –> poor feeding, vomiting, hypotonia, lethargy, anion gap acidosis
autosomal recessive deficiency of IFN-gamma receptor
disseminated myobacterial disease in infancy or early childhood, dissminated infect by the BCG vaccine
what are the risk factors for abscesses caused by peptostrep and fusobacteria (normally found in oral cavity)
alcohol, seizure, CVA and dementia
percholrate and pertechnetate
block iodide absoprtion by the thyroid gland via compettive inhibition
thionamides (meth and ptu)
decrease the formation of thyroid hormones by inhibiting thyroid peroxidase
Iodine salts
inhibits synthesis as well as release of thyroid horomones
treatment for psoarsis
topical: vitamin D analogs –> calcipotriene, calcitriol, taclcitol, activate the vit D receptor, a nuclear transcription factor that causes inhibition of keratinocyte proliferation and stimulation of keratinocyte differentiation
how to diagnose mild CF
measure nasal transepithelial potential difference; more negative nasoepithelial surface, increased luminal sodium absorption; results from CFTR protein fucked up so less Cl secretion and this inceased Na absorption (DIFF THAN SWEAT GLANDS)
How does etanercept reduce the biological activity of TNF-alpha
acts as a decoy receptor
TNF-a inhibitors
etanercept, adalimumab, infliximab (decrease macrophage function and may cause reactivation of TB)
what is the function of 16S rRNA in prokaryotic ribosomes
contains a nucleotide sequence complementary to an mRNA sequence (Shine-Dalgarno); essential for initiation of protein synthesis in prokaryotes
what does 23S rRNA found in the 50s subunit facilitate
peptide bond formation in protein translation
which of the following occurs outside of the osteoblast during collage synthesis
c-terminal propeptide removal
where do terminal propeptides get cleaved by N and C procollagen peptidases
RER
what do antipsychotics, esp TCAs and venlafaxine cause
mood switches, mania –> “i can buy the world, feeling great” after signs of depression such as low energy, decreased appetite, and insomia
what is BRCA-1 gene
located on chromosome 17; tumor surpressor gene
what is the major source of blood supply to the upper ureter
renal artery
how is the blood supply established with a donor kidney
anastomosing the donor renal artery with the recipients external iliac artery
transference
unconscious shifting of emotions or desires associated w/ one person (sibling, parents, etc.) to another (physician, therapist)
displacement
shifting of feelings or conflicts from one situation or person to another seen as safer less distressing. (medical resident fucked over by attending so then the medical resident slaps his medical student with a shit ton of work)
when does renal compensation occur
48 hours after the onset of hyperventilation –> kidneys will excrete bicarbonate in the urine to make up for the resp alkalosis
how does colchicine work
binds to the protein subunit of microtubules and prevents their aggregation; this disrupts membrane-dependent functions such as chemotaxis and phagocytosis
If ASD is not fixed in time what can happen
irreversible pulmonary vascular sclerosis
In a boy with DM1, why is there so much peeing
increased tubular osmolality
72 year old man abrupt onset of fever, headache, myaglgias, malaise, cough, and throat pain; two grand daughters school because had this earlier; mild hyperemia of the throat w/o exudate and patient is sent home on whatever; then comes back and has progressive dyspnea, chest pain, and productive cough
staph aureus, strep pneumo, and H. influenza b/c people with influenza can develop secondary bacterial pneumonia mostly old farts
phencyclidine
agitation, dissociation, hallucinations, violent behavior, memory loss; nystagmus, ataxia
cocaine
euphoria, increased arousal, agitation, chest pain, headaches, seizure; tachycardia, hypertension, mydriasis
methamphetamine
agitation, psychosis, diaphoresis, violent behavior; tooth decay, HTN, tachy, choreiform movements
LSD
visual hallucinations, depersonalization, euphoria, occasional dysphoria, and panic; mild tachy, mild HTN, alert and orientated
Marijuana
increased appetite, euphoria, slowed reflexes, impaired time perception; dry mouth, conjunctival injection, mild tachy
heroin
mild euphoria or lethargy to come; miosis, decreased respiratory rate, decreased bowel sounds
interferons a and b work how
act on neighnoring cells (paracrine signaling) stimulating them to synthesize antiviral proteins that degrade intracellular mRNA and impair protein synthesis.
interferon y
produced by NK and T cells and functions to promote Th1 differentiation, induce class II MHC expression, and activate macrophages
haldane effect
(lungs) binding of oxygen to hemoglobin drives the release of H+ and CO2 from hemoglobin
bohr effect
(peripheral tissues) high concentrations of CO2 and H+ facilitate oxygen unloading from hemoglobin
acute mitral regurg
near normal left atrial compliance; tend to develop marked pulmonary hypertension and pulmonary edema
chronic mitral regurg
adaptive increase in LA volume and compliance; more prone to a filb and mural thromembolism
which class of class 1 antiarrhthymics are the slowest to dissociate from sodium channels
class 1 c: flecainide –> use dependence –> sodium blocking effects intensify as the heart rate increases due to less time between action potentials for the medication to dissociate from the receptor
upper motor neuron lesions
corticospinal tracts of the spinal cords, the meddula, pons, and the midbrain, the internal capsul, or the precentral gyrus
amyloidosis of the heart
deposition of abnormally folded (B pleaded sheet conformation) atrial natriuretic peptied derived proteins
HIV replication cycle
polyprotein precursors are encoded by structural genes (gag, poly, env); only the polyprotein product of env gene is glycosylated to become gp 160; the gp160 is proteolytically cleaved by bindign to the CD4 receptors of susceptible cells; lastly, transmembrane gp41 anchors gp120 through oncovalent interactions, mediating the fusion process between viruses and target cells
what do mutations in splice sites result in
formation of larger proteins that are usually nonfunctional, but often retain the immunoreactivity of the normal protein (binding to antibodies)
what does B6 do to levodopa
motherfucker increases the peripheral metabolism of levodopa and decreases its effectiveness
digital clubbing
associated with prolonged hypoxia; large cell lung cancer, tb, cystic fibrosis, suppurative lung diseases: empyema, bronchiectasis and chronic lung abscesses
hemosiderin
prussian blue stain differentiates this from lipofuscin; both appear golden yellw or brownish cytoplasmic granules; then hemosiderin turns blue black
hemosiderin containing alveolar macrophages
heart failure cells = indicate that episodes of pulmonary congestion and edema associated w/ chronic left-sided heart failure
what does chronic lymphedema predispose you to
development of angiosacroma (stewart-Treves syndrome)
when the combined effect of two drugs is equal to the sum of the effects expected from the individual drugs
additive effect
when the combined effect exceeds the sum of individual drug effects
synergistic
what does niacin potentiate
effects of some anti-hypertensive medications because of its vasodilatory effects
what can niacin do in diabetic patients
cause insulin resistance, so have to increase diabetes medications
how does tNF-a facilitate decrease in glucose uptake
upregulates serine residue phosphorylation –> insulin resistance (this can occur in the presence of catecholamines, glucocorticoids, and glucagon)
what are the oxidative reactions of HMP shunt necessary for?
anabolic reactions that use NADPH as an electron donor (cholesterol and FA synthesis)
what is drug-induced parkinsonism caused by
dopamine 2 receptor blockade in the nigrostriatal pathways
how does the liver take up indirect bilirubin
pass process using organic anion transporting polypeptide ( OATP)
how does the liver secrete direct bilirubin into the biliary system
active transport by a specific ATP-binding cassette protein known as MRP2 (organic anion transporter)
combination of cyanotic toe discoloration and renal failure in old man follwing an invasive vascular procedure
atheroembolic disease of renal arteries (renal biopsy = cholesterol crystals in arterial lumen)
what causes an increase in both systolic and diastolic blood pressures and a decrease in heart rate
a1-adrenergic agonists (phenylephrine, methoxamine)
contraction of pupillary dilator muscle
mydriasis
what is signet-ring carcinoma associated with
infiltrative growth within the stomach wall causing a leather bottle stomach (linitis plastica)
cefuroxime
second generation cephalosporin; beta lactam antibiotics related to penicillins
pure red cell aplasia
rare form of marrow failure characterized by severe hypoplasia of marrow erythroid elements in the setting of normal granulopoiesis and thrombopoiesis
pathogenesis of pure red cell aplasia
inhibition of erythropoietic precursors and progenitors by IgG autoantibodies or cytotoxic T lymphocytes; associated with thymomas and lymphocytic leukemia; can also be caused by parvovirus B19
what is the length constant
(space constant) measure of how far along an axon an electrical impulse can propagate (myelin increases length constant by increasing membrane resistance and reducing charge dissipation)
time constant
the time it takes for a change in membrane potential; lower time constants allow quicker changes in membrane potentia, increasing axonal conduction speed; myelination decreases membrane capacitance, which reduced the time constant
what is narcolepsy with cataplexy most often caused by?
lack of hypocretin-1 (orexin A) and hypocretin-2 (orexin B) which are produced onyly in neurons located in the lateral hypothalamus (these shits function to inhibit REM sleep-related phenomena and promote motherfucking wakefulness
low CSF 5 hydroxyindole-acetic acid concentraton
associated with impulsive, destructive behaviors, particularly aggression, suicide, and violence
elevated amounts of 14-3-3 protein in CSF
diagnosing Creutzfeldt Jakob disease
what has the greatest potential in preventing recurrence of HSV-2
daily oral valacyclovir, acyclovir, or famciclovir
antidepressants serotonin syndrome
SSRI
SNRI
MAOIs
TCAs
analgesics serotonin syndrome
tramadol
anti-emetics serotonin syndrome
5-HT3 receptor antagonists (ondansetron)
antibiotics serotonin syndrome
linezolid
neuropsychiatric serotonin syndrome
triptans
what does atropine not reverse in organophosphate toxicity
nicotinic receptor effects: muscle paralysis; use prax.
what should be used to diagnose toxic megacolon
plain abdominal X-ray
orientation
providing name, location, current date
comprehension
following multistep commands
concentration
reciting months of the year backwards
short-term memroy
recalling three unrelated words after 5 min
long-term memory
providing details of significant life events
language
writing a sensible sentence containing a noun and verb
visual spatial
drawing a clock face
classic histology for Burkitt lymphoma
diffuse medium-sized lymphocytes and high proliferation index represented by the high ki-67 fraction; starry sky –> prsence of benign macrophages
what drugs are first line for isolated systolic htn in nondiabetic patients
thiazide diuretics and dihydropyridine calcium antagnoists
what is the preferred treatment for DKA
after an initial insulin bolus, continuous intravenous regular (short-acting) insulin is preferred
