Running list of JUST MEMORIZE Flashcards
1st aortic arch
Maxillary artery
1st arch is MAXimal
2nd aortic arch
Stapedial and hyoid arter
Second = Stapedius
3rd aortic arch
Common carotid and internal carotid
3rd = C
4th aortic arch
Left = aortic arch
Right = subclavian
4 Limbs
5th aortic arch
Obliterates
6th aortic arch
Proximal pulmonary arteries
Ductus arteriosus
Right recurrent vs. left recurrent laryngeal nerve
Right wraps subclavian
Left wraps aortic arch distal to DA
Pharyngeal clefts derived from
eCtoderm
Pharyngeal arches derived from
mesoderm and neural crest
ARCH = CREST
Pharyngeal pouches derived from
endoderm
Pharyngeal embryologic derivatives
CAP (outside to inside)
Cleft = ecto
Arch = meso/crest
Pouch = endo
1st pharyngeal cleft
External auditory meatus
2nd-4th pharyngeal clefts
Temporary cervical sinuses
Persistent = lateral neck cyst, immobile with swallow
Pharyngeal arch nerves mneumonic
When at golden arches: Chew (V2/V3 of V) Smile (VII) Swallow stylish (stylopharyngeus IX) Simply swallow (superior laryngeal X) Speak (recurrent laryngeal X)
1st pharyngeal arch derivatives
Maxiallary, Mandibular processes Malleus, Incus Masseter, Medial/lateral pterygoids Mylohyoid Anterior diagastric
2nd pharyngeal arch derivatives
Stapes Styloid Lesser horn of hyoid Stylohyoid ligament Muscles of facial expression Stapedius Platysma Posterior diagastric
3rd pharyngeal arch derivatives
Greater horn of hyoid
Stylopharyngeus
4th/6th pharyngeal arch derivatives
Arytenoids Cricoid Corniculate Cuneiform Thyroid
1st pharyngeal pouch derivatives
Ear
2nd pharyngeal pouch derivatives
Tonsils
3rd pharyngeal pouch derivatives
Dorsal -> inferior parathyroids
Ventral -> thymus
4th pharyngeal pouch derivatives
Dorsal -> superior parathyroids
Ventral -> ultimobranchial body, C cells
RDS of glycolysis
PFK-1
RDS of gluconeogenesis
Fructose 1,6 bisphosphate
RDS of TCA
Isocitrate DH
RDS of glycogenesis
Glycogen synthase
RDS of glycogenolysis
Glycogen phosphorylase
RDS of HMP shunt
G6PD
RDS of De novo pyrimidine synthesis
Carbamoyl phosphate synthetase II
RDS of De novo purine synthesis
PRPP amidotransferase
RDS of urea cycle
Carbamoyl phosphate synthetase I
RDS of fatty acid synthesis
Acetyl-CoA carboxylase
RDS of Fatty acid oxidation
Carnitine acyltransferase I
RDS of ketogenesis
HMG-CoA synthase
RDS of cholesterol synthesis
HMG-CoA reductase
Enzyme deficient in MSUD
Branched chain amino acid breakdown
Isoleucine, Leucine, Valine
Enzyme deficient in Alkaptonuria
Homogentisate oxidase
Blue-black disease
Enzyme deficient in homocystinuria (3 types)
treatment
Cystathionine synthase (dec met, inc cys, inc B12) Pyridoxal phosphate (inc cys, inc B6) Methionine synthase (inc met)
Enzyme deficient in cystinuria
CPT transport of Cystine, Ornithine, Lysine, and Arginine
Enzyme deficient in Von Gierke
Glucose-6-phosphatase
Inc Glycogen = Inc Gout
Enzyme deficient in Pompe
a 1-4 glucosidase
Pompe trashes the Pump
Enzyme deficient in Cori disease
Debranching enzyme (a 1,6 glucosidase)
Enzyme deficient in McArdle
Skeletal muscle glycogen phosphorylase
McArdle = Muscle
5 T’s of congenital heart dz
Truncus arteriosus (1 vessel) Transposition (2 switched vessels) Tricuspid atresia (TRI) Tetraology of Fallot (TETRA) - PROVe TAPVR (5 letters) - and what you have (probably not)
CYP450 induction
CHRONIC ALCOHOLics STeal PHEN-PHEN and NEver Refuse GReasy CARBs
Chronic alcohol use St. John's Wart Phenytoin Phenobarbital Nevirapine Rifampin Griseofulvin Carbamazepine
CYP450 substrates
Always Think When Ovulating, Silly!
Anti-epileptics Theophylline (PDE inhibitor, bronchodilator) Warfarin OCP's Statins
CYP450 inhibitors
AAA RACKS IN GQ Magazine
Acute alcohol abuse Ritonavir Amiodarone Cimentidine/cipro Ketoconazole Sulfonamides INH Grapefruit Juice Quinidine Macrolides (except Azy = A OK)
Mood disorder drugs
Larry’s Light Velvet Carbs
Lamotrigine (stuffed llama in sketchy)
Lithium
Valproic acid (banner in sketchy)
Carbamazipine (frozen car in sketchy)
Focal simple/complex seizure treatments
PHEN PHEN Grabs Carbs
Phenytoin
Phenobarbitol
Gabapentin
Carbamazipine (esp. trigeminal nerve myalgia)
Generalized tonic/clonic (myoclonic, atonic, absence)
Larry (the llama) Loves Touching Velvet
Lamotrigine - llama in sketchy
Levitracitam
Topiramate
Valproic acid
Can’t pee
Can’t see
Can’t climb a tree
Reiter’s
Can’t see
Can’t climb a tree
Can’t scream weeeeeee
Sjogren’s
Can’t pee
Can’t see
Can’t hear a bee
Alport syndrome (Col-IV mutation)
Epithelial cancer marker Lymphoid cancer marker Mesenchymal cancer marker Myeloid cancer marker Neuroendrocrine cancer marker
Epi= cytokeratin Lymphoid= CD20 (B), CD3 (T) Mes= Vimenten Myeloid= MPO Neuroendo= synaptophysin, chromogranin A
Trendelenburg gait
Ipsilateral foot drop on walking
Contralateral superior gluteal nerve injury (L4-S1)
Nerve is superior medial, therefore always inject superior lateral
Sudden traction on extended/pronated elbow in children
Nursemaid’s elbow
Annular ligament injury
Radial subluxation
Lesch-Nyhan syndrome
HGPRT defect, excess de novo purine Hyperuricemia Gout Pissed off Retardation dysTonia
Tx: allopurinol
Which way to dynein and kinesin move?
Dynein DIVES towards cell body (deep)
Kinesin moves to axon terminal
HSV/VZV reactivation = kinesin
Stop codons
What are they bound to?
UAG, UGA, UAA
Releasing factor 1 (not an amino acid)
Types of glial cells
Astrocytes: repair, structure, BBB, metabolic (GFAP+)
ODGs: myelin
Microglia (BM precursor): phagocytosis
Finger tingling and association with chronic hemodialysis
Carpal tunnel - often bilateral
Sensory impairment/pain
Thenar atrophy
Tinel/phalen
Most common benign liver cancer
Cavernous hemangioma
Neutrophil chemotaxis agents
Leukotriene B4
5-HETE
C5a (not C3a or C4a)
IL-8
Sudden, severe headache and/or “worst headache of my life”
What is it and most common mech?
Subarachnoid hemorrhage
Berry aneurism rupture
Ureter anatomy at level of abdomen, pelvic inlet and true pelvis
Ureter is posterior to gonadal vessels
Ureter is anterior to internal iliac
Ureter is posterior to uterine artery
Serum PTH and calcium findings in osteoporosis
NORMAL
Best NSAID for PUD
COX-2 selective
TORCH infections
Toxo Other: infant meningitis, hydrops (B19), VZV Rubella CMV HIV/HSV-2
Alright, it caught up to you: let’s walk through leukocyte accumulation
Margination: improved contact
Rolling: L-selectin (neuts) P/E selectin on endothelium
Activation:
Adhesion/crawling: CD18 (Mac-1, LFA-1) to ICAM-1
Transmigration: PECAM-1
Accuracy vs precision (along with reliability and validity)
Accuracy = validity = hitting bull's eye Precision = reliability = consistent
B1 coenzyme reactions
- Pryruvate DH
- a-ketoglutarate (CA cycle)
- branched chain a-ketoacid DH (branched chain AA)
- Transketolase (pentose shunt back to glycolysis)
Fractures and nerve injury: Surgical neck of humerous Midshaft humerous Medial epicondyle Radial sublux Carpal tunnel Guyon canal
Surgical neck of humerous: axillary Midshaft humerous: radial (wrist drop) Medial epicondyle: ulnar Radial sublux: radial (finger drop) Carpal tunnel: median Guyon canal: ulnar
Integrin function
Binds plasma membrane to collagen via fibronectin
Proto-onco genes
ABL BRAF HER MYC KRAS TGF-a
Always Buy HER Money, Krystal, Tigers
If BRAF is ABL
Tumor suppressor genes
APC/ßcatenin BRCA NF1 TP53 RB VHL WT-1
Always Borrow Nature To Remain Very Wealthy
Dihydrorhodamine test
Tests respiratory burst
Green fluroescence of neuts
What the balls is neprilysin
MMP that cleaves Natiuretic Peptide
NePrilysin
Riboflavin deficency (and enzyme)
Angular stomatitis and glosittis
Succinate DH
SUC’s to suck (stomatitis)
Red ragged fibers on Gomori Trichrome
Mitochondrial disease
Heteroplasmy
PCP vs. meth
Similar but PCP has nystagmus
Mu opioid fast adverse reaction
Sphincter of Odi contraction
Drugs preferentially eliminated by liver: characteristics
High volume of distribution
Lipophilic
Can re-enter blood after being filtered by kidney
Catecholamine synthesis
Tyrosine->DOPA->Dopamine->NE->Epi
Enzymes: Tyrosine H, Dopa DC, Dopamine ß-H, PNMT
Tired Dopes Don’t Never Eat
PNMT (+) by cortisol (stress)
What tumors have psammoma bodies?
PSaMMoma bodies:
Papillary cancer of the thyroid (PFMA)
Serous ovarian
Meningioma
Mesothelioma
Niacin dependent enzymes in TCA
Pyruvate DH
Isocitrate DH
a-ketoglutarate DH
Malate DH
All take NAD+ to NADH (NAD+ depends on B3)
Complement deficiencies
C1 esterase inhibitor deficiency: unregulated activation of kallikrein, increased bradyk, ACEI contraindicated
(A C Esterase Inhibitor problem = ACEI CI)
C3 def: suscep. to type III hypersensitivity
C5-C9 def: suscep. to Neisseria
Complement functions
C3a, 4a, 5a = anaplylaxis (5a = little chemotaxis)
C3b = opsonization (binds bacteria)
Cytokines: IL1-IL8
Hot T-bone stEAK - clean up on 8
IL-1: fever, endothelial adhesion expression IL-2 stimulates T cells IL-3: stimulates bone marrow IL-4: IgE production IL-5: IgA production IL-6: aKute phase protein IL-8: neutrophil chemotaxis IL-10: Tones it down - T-cells
Cytokines secreted by macrophages
Cytokines secreted by T cells
Macrophages: IL-1 IL-6 IL-8 IL-12 (stimulates Th1 pathway) TNF-a
T-cells: IL-2 (all) IL-3 (all) IL-4 (Th2) IL-5 (Th2) IL-10 (Th2, Treg)
Oxidative burst
No SuperMen Per Republican Goals
NADPH oxidase Superoxide dismutase Myeloperoxidase glutathione Peroxidase glutathione Reductase G6PD
Phagosome = 1-3
Inside neut = 4-6
Sarcoma vs. carcinoma spread
Sarcoma = hematogenous Carcinoma = lymphatic Except: Run Home Forest RCC HCC Follicular of the thyroid
Pyruvate DH requirements
TLC For Nancy
Thiamine (B1) Lipoic acid (inhibited by arsenic -> vomit, rice water, garlic breath) CoA (B5) FAD (B2) NAD (B3)
Vitamins in pregnancy: Folic acid Calcium Iron A B6
Folic - neural tube defects, good early
Calcium - indicated with inadequate diet, bones
Iron - mom heme and baby, placenta
B6 - indicated to treat nausea
A - not indicated, teratogenic in 1st tri
Trouble chewing (stops buying gum) Diplopia with long TV/reading sessions
Myasthenia gravis
Associated with thymoma -> usually removed
What does red safarin stain?
CarTWOledge (type 2 collagen)
IRES vs. Kozak sequence
Kozak: normal initiates translation in euk with 5’ cap
Shine-del: in bacteria
IRES: initiates translation outside those -> independent of 5’ cap (present in poliovirus)
Apoptotic cells can still translate protein using IRES
MHC-II complex
a and ß subunit
Invarient chain present upon synthesis (placeholder)
Destroyed and replaced with external protein that is to be presented
Prader Willi inheritence
Double MOM from 15 (uniparental disomy)
Dad = deleted
Hypotonia, hyperphagia, hypogonad
Angelman inheritence
Double DAD from 15 (uniparental disomy)
Mom = deleted
Ataxic, seizures, inappropriate laughter/smiling
HOXA13 mutation
Hand-foot-genital syndrome