Red Flags Flashcards
HLA A3
hemochromatosis
HLA B8
addison disease and myasthenia gravis
HLA B27
psoriatic arthritis, ankylosing spondylitis, IBD arthritis, reactive arthritis
HLA DQ2 and DQ8
celiac disease
HLA DR2
MS, hay fever, SLE, Graves, hashimoto, addison
HLA DR4
Rheumatorid arthritis, diabetes type 1, addison
HLA DR5
pernicous anemai- B12 def and hashimoto thyroiditis
incidence of cancer in Women
breast, lung, colon/rectum
mortality of cancer in Women
lung, breast, colon/rectum
incidence of cancer in Men
prostate, lung, colon/rectum
mortality of cancer in Men
lung, prostate, colon/rectum
acanthosis nigricans cancer association
gastric adenocarcinoma or DM
Leser Trelat sign
multiple sebohoric keratosis- GI adenocarcinoma and other visceral malignancies
Hypercalcemia from PTHrP what malig
squamous cell carcinoma of the lung, HEENT, renal, bladder, breast and ovarian
increase d1,25 vitamin D3 in cancer
lymphoma
Cushing syndrome cancer
small cell lung cancer
hyponatremia cancer
small cell lung cancer
polycythemia cancer
RCC, hepatocellular, hemangioblastoma, pheochromocytoma, leiomyoma
pure red cell aplasia cancer
thymoma
Good syndrome cancer
hypogammaglobulinemia- thymoma
Trousseau syndrome cancer
migratory superficial thrombophelibitis- adenocarcinoma of the pacreass
nonbacterial endocarditis- cancer
pancreatic cancer
Anti-NMDA receptor encephalitis- cancer
psych issues, memory, seizures, dyskinesias, autonomic instability, language dysfunction- ovarian teratoma
opsoclonus mycolonus ataxia- dancing eyes dancing feet- cancer
neuroblastoma and small cell lung cancer
Paraneoplastic cerebellar degeneration-cancer
small cell lung cancer, gynocology and breast cancer, and hodgekin lymphoma
Lambert Eaton Myasthenic syndrome- cancer
presynaptic membrane receptor- small cell lung cancer
myasthenia gravis- cancer
thymoma- postsynaptic
oncogenes are…
gain of function so increased cancer risk. Only need to damage one allele
tumor suppressor genes are….
loss of function- need to damage both alleles
steps of collagen synthesis
1- synthesis of prepro collagen into an alpha chain with increased glycine. 2. hydroxylation of praline and lysine with vitamin C. 3. glycosilation of pro collagen. 4. exocytosis. 5. cleave the ends to procolalgen to tropocollagen 6. cross linking of tropocollagen which can be blocked by sweet peas.
look at page 243 FA
picture of autonomic drugs
irregularly irregular- what are the risk factors and what conditions can it lead to
afib- excess alcohol, CAD, HTN- can leadto thrombus from the left atrial appendage. the AV node drives this rhythm
sawtooth waves- what is it
atrial flutter
erratic rhythm with no discernible waves-when does it tend to occur
v fib- first 48 post MI
PR interval prolongation- what is it
first degree AV block
longer longer longer drop- what is it
Mobitz I- second degree AV block
dropped beats that are not preceeded in change of PR interval
Mobitz II- second degree AV block
the atria and ventricles beat independently- what is it and what can cause it
third degree AV block- can be from Borrelia Burgdoferi
list the pressures of the heart in the different sites
RA- 5 RV- 25/5 LA- 12 LV- 130/10 Pul artery- 25/10 Aorta- 130/90
when is PCWP>LVdia
mitral stenosis
what causes edema with capillary pressure increases
increased capillary press can be from HF
what causes edema with plasma protein changes
decreased plasma proteins, nephrotic syndrome, liver failure, protein malnutrition
what causes edema with capillary permeability changes
toxins, infections, burns cause increased capillary permeability
what causes edema with interstitial fluid colloid osmotic pressure
lymphatic blockage from tumor, inflammation, surgery- causes increased colloid protein in the intersititum
dilated cardiomyopathy what is it from
alcohol abuse, wet beri beri, coxsackie B, viral myocarditis, chronic coke, chagas, doxarubicin, hemochromatosis, sarcoidosis, peripartum xrdiomyopathy
what signs do you see of dilated cardiomyopathy
S3, HF, balloon heart on CXR
what type of dysfunction do you get and what would you see on gross exam
eccentric hypertrophy and systolic dysfunction
what are the causes of hypertrophic cardiomyopathy
beta myosin heavy chain mutation, frieerich ataxia
what are the signs of hypertrophic cardiomyopathy
syncope during excretes ventricular arrythmia
findings with hypertrophic cardiomyopathy
S4, systolic murmur, impaired mitral cage because of the leaflet moving forward leading to regard. Ventricular hypertrophy uneven on the septum leading to the outflow obstruction- diastolic dysfunction
causes of restrictive infiltrative cardiomyopathy
sarcoidosis, amyloidosis, postradiation fibrosis, endocardial fibroelastosis, loffler- endomyocardial fibrosis with prominent eosinophilic infiltrate, hemochromatosis
what type of dysfunction is associated with restrictive infiltrative cardiomyopathy
diastolic dysfunction with low voltage ECg because of thick myocardim
what is the criteria for metabolic syndrome
increased abdominal circumference, increased TG, decreased HDL, increased BP, and increased fasting blood glucose
hashimotos thyroditis
hypothyroidism and can be autoimmune with antithyroid peroxidase. It is associated with HLAD5 which has increased risk of B cell lymphoma. Can have hyperthyroid early because of follicle rupture
what is the histologic findings with hashi
see hurtle cells with are large oxyphillic cells with granular cytoplasm. Lymphoid aggregates with gemrinal centers or follicular epithelial cells with mononuclear infiltration
congential hypothydroidism
severe fetal hypothyroidism due to materna hypothyroidism, agenesis, dysgenesis(1), or iodine def, or dyshormongoestis. Pot belly, puffy face, umbilical hernia, large tongue and dumb
subacute granulomatous thyroiditis
self limited sieges following a virus infection. tender granulomatous infalmmation
Riedel thyroiditis
fibrous extension of the thyroid with inflammatory infiltrate can be from IgG related systemic diseases of autoimmune pancreatitis, retroperitoneal fibrosis, noninfectious aortitis
Graves
hyperthyroid from thyroid stimulating global.
what type of HSN is graves
II
what stimulates the periorbital myxedema
it is from infiltration of retrorbital space by IFN game nd TNF alpha and there are increased GAGs which causes osmotic diffusion and can be exopthamosis
thyroid storm
fever agitiation, delirum, diarrhea, coma, tachy
treatment of a thyroid storm
beta blocker, propylthiouracil, corticosteroids, lugol
what does beta blocker do during thyroid storm
it decreases the conversion of T4 to T3 because it blocks 5’ iodothyronase
Jod Basedow
thyrotoxicosis from iodine replacement in a person with a hyper functioning autonomous nodule
thyroid ademona
benign growth like follicular cancer but does not invade surrounding tissue
papilalary carcinoma- histology
empty appearing nuclei with groves, central clearing, and psammoma bodies, and increased wit hRET and BraF and childhood radiation
follicular cacinoma
thyroid capsule and vessels are invaded have uniform follicles- RAS mutation
medullary carcinoma- stain and histology
parafollicular C cells produce calcitonin sheets of cells in an amyloid stroma- from Ret mutation- stains with congo red
anaplastic thyroid cancer
older patient with fibrous local invasion of the thyroid
what type of cancer is associated with hashimoto thyroiditis
B cell lymphoma
what are the branches of the celiac artery
common hepatic, splenic, and left gastric arteries
what are the short gastric off of and what does it supply
spelenic artery and its doing the fundus
what are the branches of the common hepatic artery
right gastric, proper haptic, gastroduodenal
the prosencephalon forms the
- telencephalon cerebral hemispheres and basal ganglia
- diencephalon- thalamus, hypothalamus, optic nerve
the mesencephalon forms the
mesencephalon- midbrain
the rhombencephalon forms the
- metencephalon- pons or cerebellum
- myelencephalon- medulla
what hormones does the hypothalamus make
ADH and oxytocin
what carries the hypothalamic hormones down the icons to the posterior pituitary
neurophysins- mutations in this can cause DI from decreased ADh release
lateral area of hypothalamus
hunger- destruction leads to anorexia, failure to thrive in infants, and stimulate by gherkin and inhibited by leptin
ventreomedial area of hypothalamus
satiety-destruction leads to hyperphagia, stimulated by leptin
what can cause destruction of the ventromedial nucelus
craniopharyngioma
anterior hypothalamus
cooling and parasympathic
posterior hypothalamus
heating and it is sympathtic
suprachiasmatic nuc
circadian rhythm
supraoptic nucelus secretes what
ADH
arcutate nucles secretes what
pulsatile GnRH
preoptic nucelus secretes
GnRH
paraventrirular secretes
oxytocin secretion
what regulates melatonin
pineal gland from light and dark
what is OA
mechanical wear and tear leading to chrondrocye degradation, and it is age, obesity, and joint trauma, and pain n weight bearing joints, and knee cartilage is los. There are osteophytes, joint narrowing,and subchondral sclerosis, and does not involve the MCP
tight junction
zonula occlusents- prevents paracellular movement of solutes and is composed of claudins and occludins
adheres junction- zone adhrenes
forms the belt around and actin skeleton loss of this leads to mets- E cadherns
desmosomes
structural support via intermediate filament interactions
gap junctions
channel proteins called conexons permit electrical and chemical communication between cells
hemidesmosomes
connets keratin n basal cells underlying the basal membrane
integrins
membrnae proteins that maintain, integrity of basolateral membrane by binding to collagen and lamina in the bm by hibrodnectin
inspiratory reserve volume
air that still be breathed in after a normal reespiration
tidal volume
air that moves into lung with each quiet inspiration, typically 500ml
expiratory reserve volume
air that can still be breathed out after normal expiration
residual volume
air in lung after maximal expiration
inspiratory capacity
IRV+TV
functional residual capacity
RV+ERV- volume of gas in lungs after normal expiration includes RV.
vital capacity
TV+IRV+ERV maximum volume of gas that can be expired after a maximal inspiration
total lung capacity
IRV+TV+RV+ERV volume of gas present in lungs after inspiration can include the RV. IC+FRC and VC+RV
physiologic dead space
include the anatomic dead space plus the airways that are not contributing like the poorly perfused well ventilated apex of the lung
pathologic dead apce
it is a part of the respiraotry zone that is unable to perform gas exchange, and it is unable to perform gas exchange. Ventilated but not perfused
when is the anatomic dead space equal to physiologic dead space
in the normal lung
what does the minute ventilation not include
anatomic dead space
draw the pressure volume loops
FA619
