Random Flashcards
bacterium acquires new genetic material from the environment
Transformation (if treated with DNAase, no colonies grow)
bacterium acquires new genetic material from another bacterium across a bridge
conjugation (eg Ecoli)
new genetic bacteria through bacteriophages (virus vector)
transduction
5HT3 receptor (eg granisetron for nausea) is what type of receptor?
ligand-gated ion channel receptor
why shouldnt fluoroquinolones be used with antacids?
antacids decrease absorption from the GI tract by increasing pH
What protects DNA from digestion by a restriction enzyme?
methylation of the restriction enzyme recognition sequence
Is CD4 or CD8 lymphocytes required for isotype switching?
CD4
staph aureus has protein A and coagulase. What do these 2 things do?
Protein A - VF that binds Fc portion of IgG, inhibiting complement fixation and phagocytosis.
coagulase binds fibrinogen and causes clot formation around bacteria to protect the bacteria from the immune system
Why do enveloped viruses and syncytial viruses require live-attenuated vaccines?
Strong cell-mediated immune response is needed. These viruses have strongly immunogenic proteins that can be hidden from the immune system
Most common drugs that cause drug-induced lupus?
hydralazine procainamide quinidine isoniazid diltiazem minocycline
leukocyte adhesion deficiency is a deficiency of what? How does it present?
CD18
Delayed healing and separation of the umbilical stump
Corneal reflex afferent sensory arc involves what nerves? efferent motor arc?
afferent - ophthalmic branch V1 of trigeminal nerve CN V
efferent - CN VII
GLUT is what kind of transporter?
Carrier-mediated transporter (facilitated diffusion of glucose)
Impaired balance, tremor, difficulty speaking, elevated LFTs with neg viral hep serology. Dx? How do you test for it?
Wilson’s disease
Slit lamp exam (Kayser-Fleisher rings)
Which polymerase functions exclusively in the nucleolus?
RNA pol I
Transcribes 45S pre-rRNA gene, which codes for most of the ribosomal RNA components
Which polymerase synthesizes mRNA, snRNA, miRNA?
RNA pol II
Which polymerase transcribes DNA to form tRNA and 5S rRNA?
RNA pol III
Genes for 5S rRNA lie outside the nucleolus
Injection in what quadrant of the buttock can cause superior gluteal nerve injury?
Superomedial Trendelenburg gate (gluteus medius affected)
What muscles contribute to thoracic outlet syndrome?
Sx?
Scalenes
Brachial plexus compression - Upper extremity numbness, tingling, weakness
Subclavian vein and artery compression
How does prostatectomy cause erectile dysfunction?
If the prostatic plexus gets injured (lies within the fascia of the prostate)
Sebaceous glands are what type of gland?
MOA?
Holocrine
Cell lysis releases entire contents of the cytoplasm and cell memb
Mammary glands are what type of gland?
MOA?
Apocrine
Cells secrete via membrane-bound vesicle
Salivary glands are what type of gland?
MOA?
Merocrine
Cells secrete via exocytosis
Apocrine sweat glands are what type of gland?
MOA?
Merocrine
Cells secrete via exocytosis
Daily HA, bilateraly symmetric papilledema, transient visul disturbance related to impaired cerebral venous outflow and inc ICP (eg worse during valsalva). Young obese women
Idiopathic intracranial hypertension (Pseudotumor cerebri)
Impaired optic n axoplasmic flow
Mixing of genomic segments in SEGMENTED viruses that infect the same host cell
Reassortment
Host cell coinfected with 2 viral strains and progeny virions contain unchanged parental genome from one strain and nucleocapsid proteins from other strain
Phenotypic mixing (progeny do NOT retain these traits)
Gene exchange through crossing over of 2 ds DNA molecules
Recombination
Poisonous mushrooms contain what toxin? What does the toxin do to cause sx (GI sx, acute hepatitis, renal failure)
Amatoxin
Inhibit RNA polymerase II (halt mRNA synth)
mRNA processing into mature mRNA involves what 3 steps?
- 5’ capping
- poly-A tail near 3’
- Splicing
What vitamin can become deficient in patients with biliary disorders, exocrine pancreatic insufficiency, or intestinal malabsorption?
Fat soluble vit (eg Vit A) –> night blindness, hyperkeratosis
List the 2 important roles vWF serves in hemostasis
- promote platelet adhesion by binding to and crosslinking Gp1b with exposed collagen
- protective carrier protein for factor 8
What type of lifestyle change is most likely to decrease recurrence of GERD?
Decrease smoking
Thyroid receptors are what kind of receptors?
nuclear/retinoid X(RXR) binding to DNA
In a series of normal skeletal mm twitches, ATP conc doesn’t fall much. why?
ATP is quickly regenerated from creatine phosphate
Sterilization of instruments in CJD patients?
- precleaning (sodium hydroxide for 1 h)
2. steam sterilization 132 C for 30min.
Passive form of voluntary reporting to ID active and latent safety problems. Protects staff and patients. Detects safety events and problems
Incident reports
Require patients to designate a PCP
PPO vs HMO?
HMO
Health maintenance organization
More expensive
PPO vs HMO?
PPO
Preferred provider organization
Pay physician directly for services and then get reimbursed
PPO vs HMO?
PPO
Preferred provider organization
Can visit out-of network physicians
PPO vs HMO?
PPO
Preferred provider organization
Require specialist referrals. Capitation payment structure?
PPO vs HMO?
HMO
Health maintenance organization
Capitation = payor pays fixed predetermined fee to provide all the services required by a patient.
What concept involves small-scale, rapid tests of new initiatives that uses the idea of “trial and error”
Plan, do, study, act (PDSA) model
What part of medicare limits what the government will pay for a given diagnosis and how much Medicare pays the hosp for services?
DRG (diagnostic-related groups)
Actions not carried out as intended or planned (eg nurse injecting insulin IV rather than subQ)
Slip
Failures that occur in attentional behavior
mistake
Ca sensing receptors are what kind of receptors?
G protein coupled receptors that regulate the secretion of PTH in response to circulating ca levels
Exposure to risk modifiers sometimes requires a significant amount of time before the exposure’s effect on the disease process is clinically evident. This is called what?
Latent period
Without T tubules in skeletal mm, what happens to mm cells?
Uncoordinated contraction of myofibrils.
T tubules transmit depolarization signals to the SR and trigger release of Ca
SSRIs stand for what? And what do they target?
Selective serotonin uptake inhibitors
block transporter of serotonin
Primary amyloidosis is associated with what abnormal proteins? Secondary amyloidosis?
Primary - AL (immunoglobulin light chain frag, assoc w/multiple myeloma or NHL)
Secondary -AA (assoc w/chronic inflam conditions like RA, Tb, osteomyelitis). AA is derived from SAA which is made in the liver.
Meniere disease can result in long term what?
Permanent hearing loss
What age do kids get rights of partial emancipation? What med decisions can they make?
15
STI screening and tx, substance abuse tx, prenatal care, birth control.
Dont need to notify parents for this.
Alk phos is found in bones and liver. Elevation in what marker would indicate rise in alk phos is due to the liver/gallbladder?
5’ nucleotidase - used as a liver function test in individuals that show signs of liver problems. The combined assays of serum 5’nucleotisase and alk phos help in ddx since serum 5’nucleotidase activity is increased in obstructive hepatobiliary disorders, but not in osseous disorders,
Note: gamma-glutamyl transferase (GGT) test may be used to determine the cause of elevated alk phos as well. Both ALP and GGT are elevated in disease of the bile ducts and in some liver diseases, but only ALP will be elevated in bone disease.
What are the best ways to exam kids and adolescents if their parents are present?
Younger kids + parents
Adolescents no parents
Medicare covers what group of individuals?
- 65+ who have a work hx
2. younger individuals with disabilities
Stages of change model
- precontemplation (not thinking about behavior mod)
- contemplation (thinking about behavior mod)
- Preparation (planning behavior mod)
- Action (putting plan into action)
- Maintenance (maintaining new behavior)
Audiogram for SNHL vs CHL
SNHL - symmetrical dip ~4000hz
d/t noise exposure (organ of corti), age, infectious or postinflam, acoustic neuroma
CHL - asymmetrical
d/t cerumen impaction, ossicular chain abnormalities, TM perf, middle ear fluid
Garlic breath sign of what poisoning?
Arsenic
Tx - dimercaprol - forms stable nontoxic soluble chelates. Displaces arsenic ions from the sulfhydryl groups.
Lead toxicity tx?
CaNa2EDTA - forms nonionizing salts to inc urinary lead excretion
Iron overdose tx
Deferoxamine - binds circulating Fe and facilitates urinary excretion
Methemoglobinemia tx?
Presents with choclate colored blood.
Methylene blue - artificial electron transporter for reduction of methemoglobin through the NADPH path
Burnt almond smell, factory worker
tx?
Sx - cherry red skin, vomiting, abd pain
Cyanide poisoning
Hydroxycobalamin - Vit B12 precursor that binds to intracellular cyanide forming cyanocobalamin which can be excreted in urine
amyl nitrite, sodium nitrite, sodium thiosulfate
Jehovah’s witness mom and kid need blood emergently. Do you give without consent if unconscious?
Yes
Common causes of vertigo
- Meniere disease - inc pressure and endolymph vol (unilat hearing loss and tinnitus)
- BPPV - otoliths in semicirc canals (brief episodes due to head mvt)
- Vestibular neuritis - inflam of vestibular n (single episode that lasts days. No hearing loss)
Round, pearly mass behind the tympanic membrane in the middle ear. Can cause hearing loss due to erosion into the auditory vesicles.
Cholesteatoma - collection of squamous cell debris
Aging results in what changes in the following organs:
- kidney
- lung
- heart
Kidney: Age-related renal insufficiency
Lung: Dec chest wall compliance but inc in lung compliance due to loss of elastic recoil (inc in RV, dec in FVC, unchanged TLC, dec arterial Po2, inc Aa gradient)
Heart: dec in LV apex-to-base dimension, sigmoid-shaped ventricular septum, myocardial atrophy with inc collagen deposition, lipofuscin in cardiomyocytes
Reverse transcriptase PCR is used to detect ad quantify levels of what in a sample?
mRNA
Uses mRNA template to create a complementary cDNA template
Can be used to dx CML, but IDing an mRNA transcript containing both BCR and ABL exons
What diet is most effective in preventing T2DM?
Low calorie - inc veggies and reduce ETOH and simple sugars.
What causes increased lymphatic flow?
Increased blood flow (eg IV infusion of 0.9% saline for 5 min)
Say a protein in brown adipose tissue caused a leak of H+ ions inward across the inner mito memb, what would happen to the o2 consumption to ATP generation ratio?
INCREASED ratio
Oxygen is still being consumed at normal rate to create a proton gradient. But some of these protons are leaking across inner mitochondrial membrane instead of passing through ATP synthase.
What happens to Central blood volume, ADH and ANP when you’re submerged in cold water?
Vasoconstriction –> inc central blood volume
Dec ADH and Inc ANP bc body sense you have enough volume
Patient exposed to high levels of radiation 1 hour ago appears agitated and fearful, but with no symptoms. What sx will present next?
GI Stages of Acute radiation Syndrome 1) prodrome...nausea, vomiting, anorexia, fatigue, diarrhea, abdominal cramping, and dehydration which are GIT Symptom 2) clinical latency, 3) manifest illness, and 4) recovery or death
