Quiz 55 Flashcards
What is the equation for sensitivity?
TP/(TP+FN)
What is the equation for PPV?
TP/(TP+FP)
What is the equation for specificity?
TN/(TN+FP)
What is a NPV?
Probability of no disease in a person who receives a negative test result; or the probability that a person with a negative test is disease free
What is the PPV?
Person with a positive test does have the disease
Child with cystic neck mass on lateral aspect of right side just below the angle of the jaw
Branchial cleft cyst
Brachial cleft cysts result from what?
Failure of the 2nd branchial cleft to involute
Where is the most common site of ulnar nerve intrapment?
Cubital tunnel
What is the cubital tunnel?
A channel located near the medial epicondyle
How can one differentiate between ulnar nerve entrapment from the guyon’s canal vs. the cubital tunnel?
In Guyon’s canal entrapment, sensory nerve supplying the dorsum of the hand is spared
What activity predisposes patients to Guyon’s canal entrapment
Cycling
In wound healing, when do fibroblasts appear?
At one week
When do macrophages predominate wound healing?
Days three to five
What cells play an essential role in formation of granulation tissue in wound healing?
Macrophages
Fibroblasts lay down what type of collagen during wound healing?
Type III collagen (granulation tissue type), later replaced by type I collagen (fibrosis)
What is the most common site affected by Crohn’s disease?
Terminal ileum
What is the most common site affected by ulcerative colitis?
Rectum
Cobblestone appearance of colon is seen in what disease?
Crohn’s disease
Microscopically, what is seen in Crohn’s disease?
Noncaseating granulomas
Enzymatic deactivation of antibiotics is a common mode of resistance in what classes of antibiotics?
Aminoglycosides, chloramphenicol, sulfonamides
What is conn syndrome?
Primary hyperaldosteronism resulting from from an aldosterone-producing adrenal adenoma
What is parinaud syndrome?
Palsy of upward gaze, dissociation of light and accommodation, and failure of convergence
What is a common cause of parinaud syndrome?
Pinealoma
Pinealoma compresses what?
Tectum (superior colliculus)
What activates glycogen phosphorylase?
Phosphorylation by PKA
Activation of glycogen phosphorylase results in what?
Glycogenolysis
Chronic inflammatory disease can result in deposition of what type of amyloid?
AA
Long term hemodialysis can result in deposition of what type of amyloid?
A beta2 M
Secondary amyloidosis results in deposition of what type of amyloid?
AA
When is AL amyloid deposited?
Primary amyloidosis - deposition of light chain
In trauma, what lab test is good at differentiating between cardiac damage and skeletal muscle damage?
Creatine kinase - MB isoenzyme (also called creatine phosphokinase) is elevated with myocardial damagae vs. MM isoenzyme with skeletal muscle damage
What are the symptoms of rabies?
Excitability, agitation, hypersalivation, autonomic instability (lacrimation, sweating, pupillary dilation), hydrophobia (far of water ingestion due to pharyngeal spasms), aerophobia (pharyngeal spasms triggered by air drafts) and facial muscle spasticity
What is seen postmorten in rabies?
Intracytoplasmic neuronal inclusions (Negri bodies)
Where are Negri bodies most often located?
Hippocampus and cerebellar cortex
When does one see Negri bodies?
Rabies
What are antibodies directed against in Myasthenia gravis?
Nicotinic acetylcholine receptor
What is is the mechanism of action of the drug used to diagnose myasthenia gravis?
Edrophonium is a short acting acetylcholinesterase inhibitor
Myasthenia gravis is what type of hypersensitivity reaction?
Type II noncytotoxic
What is the mechanism of action of tetracyclines?
Prevent binding of aminoacyl-tRNA to ribosomes
What is the mechanism of action of chloramphenicol?
Inhibits the activity of peptidyl-transferase (inhibits formation of peptide bond)
What are Lisch nodules?
Pigmented iris harmartomas
When are lisch nodules seen?
NF1
What is the inheritance pattern of NF1?
AD
What is failure modes and effects analysis (FEMA)?
Method to identify where and how a given process might fail
What is an effective therapy for phobias?
Desensitization
What cofactors and coenzymes are used by pyruvate dehydrogenase?
Thiamine pyrophosphate (TPP - vitamin thiamine), lipoic acid, coenzyme A (from pantothenate), FADH2, and NADH
What symptoms are seen in Wernicke-Korsakoff syndrome?
Ophthalmoplegia, ataxia, confusion, memory deficits (confabulations)
What is the cause of Wernicke-Korsakoff syndrome?
Thiamine def.
What is dry beriberi?
Thiamine def. damagin peripheral nerves
What is wet beriberi?
Thiamine def. affecting the heart
What are the symptoms of RMSF?
Malaise, frontal headache, fever, rash on hands and feet that spreads to involved the trunk
What organism is responsible for RMSF?
Rickettsia rickettsii
What is the morphology of Rickettsia rickettsii?
Gram negative, obligate intracellular bacterium
What is the progression of tularemia?
Papule progressing to necrotic, ulcerative lesion; associated with fever, malaise and chills
What are the symptoms of the bubonic plague?
Enlarged, hemorrhagic lymph nodes
Fatal hemorrhagic mediastinal lymphadenitis is characteristic of what disease?
Inhalation of anthrax
Goodpasture syndrome results in what type of glomerulonephritis?
Rapidly progressive (crescentic)
What is the MOA of fluconazole?
Inhibitor of fungal cytochrome P-450 dependent enzyme lanosterol 14-alpha-demethylase
What happens when K+ levels are low in a patient on digoxin?
Digoxin is able to bind more readily to Na-K ATPase resulting in greater digoxin toxicity
Where is there a drug interaction between diuretics and digoxin?
Diuretics (loops and thiazides) can cause hypokalemia, resulting in digoxin toxicity
What is the inheritance pattern of Meknes disease?
X linked recessive
Mutation in what gene results in Menkes disease?
ATP7A - ATP dependent copper efflux protein in the intestine
Name three enzymes that need copper as a cofactor.
Lysyl oxidase (collagen synthesis), cytochrome C oxidase, and tyrosinase
What is a normal capillary wedge pressure?
6-12 mmHg
What are the affects of CCK on the pancreas, gallbladder and sphincter of Oddi?
Promotes pancreatic secretion, gallbladder contraction an sphincter of Oddi relaxation
What cells release CCK?
I cells
What is Trousseau’s syndrome?
Migratory thrombophlebitis - inflammatory thrombosis of veins producing redness, swelling, and tenerness
When does one seen Trousseau’s syndrome?
Mostly associated with tumors of the pancreas, lung, and colon
Painless obstructive jaundice, characterized by high direct bilirubin and alkaline phosphatase is seen in what type disease?
Pancreatic cancer
What are tumor markers for pancreatic cancer?
Carcinoembryonic antigen and CA 19-9
Immunosuppressed patient with ring enhancing brain lesions
Toxoplasma gondii
What is the definitive host of toxoplasma gondii?
Cats
What is the genetic mutation of congenital microvillus atrophy?
MYO5B
What does MYO5B code for?
Myosin Vb
What filament is important in the function of microvilli?
Actin microfilaments
Tumor marker CA 125 is associated with what type of malignancy?
Epithelial tumors of the ovary
What toxin is responsible for toxic shock syndrome?
TSST-1
What are the characteristic symptoms in TSS?
Fever, hypotension, diarrhea, and desquamating rash
