Quiz 51 Flashcards
Incomplete obliteration of the vitelline duct results in what?
Meckel diverticulum
Rathke’s pouch develops into what?
Anterior pituitary
What tumor arises from epithelial nests derived from Rathke’s pouch?
Craniopharyngioma
What does gross examination of a craniopharyngioma appear like?
Partly cystic mass filled with dark brown oily fluid
Histologically, what is seen in a craniopharyngioma?
Tumors derived from dental epithelium
What is the MOA of ropinirole?
Dopamine receptor agonist
What is the MOA of selegiline?
Inhibits MOA-B
What is the inheritance pattern of Wilson’s disease?
Autosomal recessive
What is defective in Wilson’s disease?
ATP7B - copper transporter
What chromosome is responsible for Wilson’s disease?
Chromosome 13
What is seen on eye examination of a patient with Wilson’s disease?
Kayser-Fleischer ring
How can one observe Kayser-Fleischer rings?
Slit-lamp examination
Name 5 AEs of valproic acid.
Teratogen (neural tube defects), alopecia, hepatotoxicity, pancreatitis, thrombocytopenia
What are schuffner’s dots?
Red granules in erythrocytes - indicative of malarial infection
What anti-malarial drug can cause worsening of psoriasis?
Chloroquine
What anti-malarial drug can cause retinopathy?
Chloroquine
What is seen on joint aspiration of gout?
Monosodium urate crystals
What is the appearance of monosodium urate crystals?
Needle shaped; negatively birefringent (blue when perpendicular)
What is the function of the interosseous muscles? What innervates them?
Abduction and adduction of the digits; innervated by the ulnar nerve
Ulnar deviation results when what nerve is injured?
Median nerve
What innervates oppenens pollicis? What is it’s action?
Median nerve; opposition of the thumb
What is seen on EEG of a patient with CJD?
Triphasic spikes
What can be found on lumbar puncture of a patient with CJD?
14-3-3 protein
What is a cause of relative polycythemia?
Increased RBC count due to decreased plasma volume (eg dehydration)
What are some causes of secondary absolute polycythemia?
Hypoxia (due to congenital heart disease, pulmonary disease, or high altitude) or ectopic EPO production ( RCC)
What is the term for the bulls eye rash or target seen in Lyme disease?
Erythema migrans
Why is doxycycline used over other efficacious agents in treating Lyme disease?
Doxycycline is effective in treating anaplasma phagocytophilum, a common coinfectious agent
What is the function of adductor pollicis? What innervates it?
Adduction of the thumb; ulnar nerve
The median nerve innervates what three muscles of the thenar eminence?
Flexor pollicis brevis, abductor pollicis brevis, opponens pollicis
What is the function of the 1st and 2nd lumbricals? What is their innervation?
Flexion at the MCP joint and extension at the interphalangeal joint; median nerve
Damage to 1st and 2nd lumbricals results in what hand formation?
Median claw hand
How does V2 exit the skull?
Foramen rotundum
What go through the carotid canal on the skull?
Internal carotid a. And carotid sympathetic n.
How does the mandibular nerve exit the skull?
Foramen ovale
What travels through the optic canal?
CN II and ophthalmic artery
What goes through the superior orbital fissure in the skull?
CN III, IV, VI, ophthalmic nerve (V1)
What goes through the foramen spinosum?
Middle meningeal artery
What goes through the jugular foramen?
CN IX, X, XI
What structure produces aqueous humor?
Ciliary body
What are astrocytes derived from?
Neuroectoderm
What are schwann cells derived from?
Neural crest cells
What are ependymal cells derived from?
Neuroectoderm
What are oligodendroglia cells derived from?
Neuroectoderm
What are the DRG derived from?
Neural crest
Name the virus families with segmented genomes.
Bunyaviridae, Orthomyxoviridae, Reoviridae, Arenaviridae
What cells release somatostatin?
D cells
What cells release gastrin?
G cells
What structure in the brain is affected by Parkinson disease?
Substantia nigra
Where is the substantia nigra located in the brain?
Midbrain (“mickey mouse”)
What neurotransmitter is affected in Parkinson disease?
Dopamine - decreased
What is the histologic hallmarks of Parkinson disease?
Loss of pigmented dopaminergic neurons form substantia nigra and Lewy bodies (intracytoplasmic eosinophilic inclusions)
What disease are granulovacuolar degeneration and Hiran bodies found in?
Alzheimer disease
When does when see Negri bodies? Where are they found?
Rabbies; found in Purkinje neurons and hippocampal pyramidal neurons
What disease are neurofibrillary tangles found in?
Alzheimer disease
What regions of the brain are affected by Pick Disease?
Frontotemporal regions
What neurotransmitter is important for the induction of REM sleep?
ACh
What are the affects of dopamine on sleep?
Produces arousal and wakefulness; dopamine levels rise with waking
What is the importance of NE in sleep?
NE is lower during REM
What neurotransmitter helps initiate sleep?
Serotonin
What neurotransmitter is high during REM?
Ach
What is acanthosis nigricans?
Hyperplasia of the stratum spinosum of the epidermis; thickened, hyperpigmented zones of the skin
What structure does the mandibular nerve pass through?
Foramen ovale
What is the MOA of gemfibrozil?
Atdivate proliferator-activated receptor-alpha – increases the expression of lipoprotein lipases
What are AEs of fibrates?
Gallstones and muscle toxicity
How long does it take to reach steady state of a drug?
Four to five half lives
What percentage of steady state is reached in one half life?
50%
What percentage of steady state is reached in 3 half lives?
87.5%
If a drug has a half life of 6 hours, how long does it take to reach 75% of steady-state?
Takes 2 half lives to reach 75% of steady-state; therefore 12 hours
Where is the chemoreceptor trigger zone located?
Area postrema in the floor of the fourth ventricle
What is the MOA of metoclopramide?
Dopamine antagonist
Clawing of the entire hand is from what type of brachial plexus injury?
Lower trunk lesion
What is Klumpke paralysis?
Damage to lower trunk of brachial plexus
Why is there an issue when a woman with PKU becomes pregnant?
PKU results in higher levels of phenylalanine, which can cross the placenta and act as a teratogen to the fetus