Running List of JUST MEMORIZE part 2 Flashcards
HLA-A3
Hemochromatosis
HA3mochromatosis
HLA-B8
Addison disease
Myasthenia gravis
HLA-B27
PAIR of 27’s
Psoriatic arthritis
Ankylosing spondylitis
IBD associated arthritis
Reactive arthritis
HLA-DQ2/DQ8
Celiac disease
I 8 2 much at Dairy Queen
HLA-DR2
MS
SLE
Goodpasture
HLA-DR3
T1DM SLE Graves Hashimoto thyroiditis Addison
HLA-DR4
Rheumatoid arthritis (4 walls in a rheum)
T1DM
Addison
HLA-DR5
Vitamin B12 deficiency (pernicious anemia)
Hashimoto thyroiditis
Uterine artery origin
Vaginal artery origin
Ovarian artery origin
Uterine/vaginal = internal iliac Ovarian = abdominal aorta (same for testicular)
Side effects of theophylline
Metabolized by P450 Cardio/neurotoxic Heart block Tachyarrhythmias Seizures
Sarcoid main hits
Widespread noncaseating granulomas
Elevated ACE (serum) and CD4/CD8 (BAL)
CXR/CT: coarse opacities, hilar/mediastinal adenopathy
Associations:
interstitial fibrosis, erythema nodosum, Bell’s, hypercalcemia (increased 1-a-hydroxlylase mediated vitamin D in macs)
ASA overdose acid/base findings
Initially resp alkalosis (resp. center stim), 12 hours
Later met acid with resp alk (CO2 too low)
Agents that can trigger IgE INdependent histamine release and allergic reaction
Opioids
Radiocontrast
Vancomycin
Sideroblastic anemia
Deficient enzyme
Substrate buildup
Fun fact
delta-ALA synthase
Glycine and succinyl-CoA
X-linked, basophilic stippling
Lead poisoning anemia
Deficient enzyme
Substrate buildup
Fun fact
ferrochelatase, delta-ALA dehydratase
delta-ALA, protoporphyrin
Basophilic stippling, exposure
Acute intermittent porphyria
Deficient enzyme
Substrate buildup
Fun fact
Porphobilinogen deaminase
Porphobilinogen
5 P’s: painful, port wine urine, polyneuropathy, psych, precipitated by drugs, EtOH
Tx: glucose and heme (inhibit ALA-synthase)
Por Phloks with Painful Porphyria
Porphyria cutanea tarda
Deficient enzyme
Substrate buildup
Fun fact
Uroporphyrinogen decarboxylase
Uroporphyrin (tea colored urine) (uroporphyrinogen III)
Blistering photosensitivity, most common
Late skin test induration - cell types responsible?
CD4+
Macrophages
Define pleiotropy
1 gene mutation affects many different tissues/expressions
Define locus heterogeneity
Many mutations can lead to same disease/trait/phenotype
Important enzyme in triglyceride metabolism?
Glycerol kinase
Glycerol -> glycerol-3-phosphate
via DHAP-> glycolysis
Conductive vs. sensorineural hearing loss
Conductive:
Rinne -> BC>AC with loss in affected ear
Weber -> lateralizes to affected side
Senorineural:
Rinne -> normal (AC>BC)
Weber -> lateralizes to unaffected side (can hear it in good ear)
Risk factors for transitional carcinoma of the bladder
Smoke
Occupation: rubber, analine dyes, textiles, leather etc
Causes of myopathy (nml and elevated CK)
nml CK:
GC induced
Polymyalgia rheumatica
elevated CK:
statin induced
inflammatory myopathy (poly/dermatomyositis)
hypothyroid myopathy
Dimercaperol
Treatment for arsenic/insecticide tox
TNF-a inhibitors and indications
Etanercept: decoy receptor (interception)
RA, psoriasis, AS
Infliximab/adalimumam: anti-TNF-a antibody
IBD, RA, AS, psoriasis
Careful of latent TB reactivation!!!
Zenker diverticulum
FALSE! - herniation through weak muscle
Elder MIKE has bad breath: Elderly Males Inferior pharyngeal constrictor Killian triangle Esophegeal dysmotility Halitosis
Clomiphene citrate
E2 modulator (antag at E2 receptor in hypothalamus) Useful for fertility in PCOS patients
Cresentric glomerulosclerosis but fluro neg
Pauci immune = ANCA
Elevated alk phos of unclear origin - follow up test?
gamma-glutamyl transpeptidase (GGT)
If elevated = hepatic origin
If not = bone origin
Drug induced vertical nystagmus??
PCP (phencyclidine)
NMDA antagonist
Sheehan’s pathophys
Pituitary grows in pregnancy - outgrows blood supply
Loss of blood with more intensive childbirths can lead to ischemic necrosis
Endothelium dependent vasodilation
In endothelial cell:
Arginine + O2 ——-(eNOS)——–> NO + citrulline
eNOS activated by Ach, BK, shear stress
In smooth muscle:
GTP ———–(guanylate cyclase)——-> cGMP
guanylate cyclase activated by NO
cGMP -> vasodilation
Acetoacetate - what is it?
Ketone body
Along with beta-hydroxybuterate
Role of calcineurin in the immune system
Drugs that interfere
Calcineruin dephos NFAT
NFAT goes to nucleus and stimulates IL-2 production
IL-2 recruits T cells
Cyclosporin and Tacrolimus both inhibit calcineurin
Annular pancreas vs. failure of fusion
Failure of ventral portion to migrate correctly
Results in duodenal compression
Failure of ventral and dorsal fusion = pancreas divism -> predisposes to acute/chronic pancreatitis
Hemorrhoids vs. fissure
Above pectinate line:
Internal hemorrhoids are painless - visceral innervation
Below pectinate line:
External hemorrhoids are painful if thrombosed - somatic innervation
Anal fissure - painful, blood on paper, posterior (poorly perfused)
Hemorrhoids - blood supply
Internal:
Arterial - superior rectal artery (IMA)
Venous - superior rectal vein -> IM vein -> portal
External:
Arterial - inferior rectal artery (internal pudendal)
Venous - inferior rectal vein -> internal pudendal vein -> internal iliac vein -> common iliac vein -> IVC
Hypothalamic nuclei - locals
Ventromedial: satiety
Lateral: hunger
Anterior: cooling
Posterior: heating
TAN HATS: Thirst, Anterior pit, Neuro pit, Hunger, Autonomic, Temp, Sexual urges
Hypothalamic nuclei - transit
Arcuate: dopamine, GHRH, GnRH
Paraventricular: ADH, CRH, oxy, TRH
Supraoptic: ADH, oxy
Suprachiasmatic: circadian rhythm, pineal gland fxn
TAN HATS: Thirst, Ant pit, Neuro pit, Hunger, Autonomic, Temp, Sexual urges
Thalamus
VPL: ST, DC/ML - pain, temp, touch, vib, prop
VPM: trigeminal, gustatory
LGN: CN II, to calcarine sulcus (Lat = Light)
MGN: superior olive, inferior colliculus (Med = Music)
Ventral lateral: basal ganglia, cerebellum, motor
Limbic system
Hippocampus, amygdala, fornix, mammillary bodies, cingulate gyrus
Feeding, Fleeing, Fighting, Feeling, and Sex
Dopaminergic pathways
Mesocortical: dec activity, neg symptoms
Mesolimbic: inc activity, pos symptoms
Nigrostriatal: dec activity, extrapyr sympt
Tuberoinfundibular: dec activity, inc PRL
Inc maternal serum AFP
Dec maternal serum AFP
Inc AFP: NT defect, ventral wall defect, multi/twin
Dec AFT: aneuplodies
Inc ßHCG: 21
Dec ßHCG: 18
Watershed zones in the colon
Splenic flexure (SMA and IMA) Rectosigmoid jxn (sigmoid and superior rectal)
ßhCG detection
Serum: 8 days (starts STB at day 6)
Urine: 14 days
What is responsible for decreased Ca++ levels after myocardial contraction?
Na/Ca exchanger
Malignant ovarian neoplasms:
EGS
Epithelial
Serous - most common. psomma
Mucinous - pseudomyxoma peritonei, mucus
Malignant ovarian neoplasms:
EGS
Germ cell
Dysgerminoma
adolescents, ßbHCG and LDH
Fried egg cells
Yolk sac (endodermal)
AFP
Schiller-Duvall bodies (mini-glomeruli)
Malignant ovarian neoplasms:
EGS
Stroma (sex) cell
Granulosa cell tumor
Increased estrogen, inhibin
Call-Exner bodies, coffee nuclei
Leydig/sertoli
Increased androgens
RA most commonly leads to what lung dz?
Exacerbated by what drug/treatment?
Fibrosis
MTX
EtOH inhibition of gluconeogenesis
Increased NAD+/NADH ratio
Inhibits all NAD+ requiring processes
Most common melanoma mutation
Treatment
V600E -> BRAF
Vemurafenib (Ben Franklin’s Venom)
MEN1
MEN2a
MEN2b
1: Pancreas (especially gastrinomas), Pituitary, Parathyroid
2a: Medullary thyroid (calcitonin), Pheo, Parathyroid
2b: Medullary thyroid (calcitonin), Pheo, CNS (also neurofibromas, marfan habitus)
All RET genes
Biopsy on:
Hashimotos
Dequervain
Ridels
Hash: mononuclear infiltrate with follicles (B cells)
Deq: mixed cells with granular/multinuc giant cells (pain)
Ridels: extensive fibrosis extending beyond capsule
NADPH functions
Cholesterol synthesis
Fatty acid synthesis
Glutathione antioxidant mechanism
Coronary artery dz in a SLE patient?
Cushing’s from exogenous steroid
Both SLE and Cushing’s increase risk for coronary artery dz
Adrenals will show bilateral atrophy
Patient with hx of autoimmune disorder presents with weight loss, hypotension, n/v (maybe hyperpigmentation)
Acute adrenal insufficiency
Needs shock tx with dex ASAP
Gynacomastia prevention?
Tamoxifen
RT PCR detects what?
mRNA in the sample
Abcess formation due to?
Lysosomal content release by macrophages
Power =
1 - ß
Brown/black pigment gall stones
Secondary to infection OR hemolytic anemia (conjuation of bili in ducts by beta-gluc)
Low cholesterol, high Ca++
Due to release of beta-glucuronidase by injured cells
Ecoli, ascaris, or fluke
Cheyene stokes breathing?
CHF patients
Chronic lung transplant rejection results in
Bronchiolitis obliterans (targets small airways)
Buerger Disease
Segmental vasculitis extending into the continuous nerve and vein
Ovary epithelial linig
simple cubodial
Acid vs base intranuclear inclusions
Acid = HSV Base = CMV
Extramammary paget dz vs. melanoma
Paget = PAS+, Keratin +, S100- Melanoma = PAS-, Keratin -, S100+
Paget’s = PAKET’S100 (S100 = - on the otherside ‘)