Sat Aug 8 Flashcards
presentation of temporomandibular joint disorder?
- jaw misalignment
- clenching/teeth grinding
- hypersensitivity of the trigeminal nerve
- dull waxing and waning pain
- clicking/popping of the jaw
patients with temporomandibular joint disorder may experience referred pain to which area?
The ear- due to auricolotemporal nerve (branch of trigeminal)
myeloperoxidase is predominantly found in which cells?
neutrophils
what is released from the granules of mast cells and basophils in anaphylaxis?
histmaine and tryptase
what will be elavated in the blood of someone with a diagnosis of anaphylaxis?
tryptase
tryptase is a marker of..
mast cell activation
explain the process of mast cell / basophil cell degranulation?
- the cells bind the Fc portion of igE
- when a multivalent antigen comes in contact with the cell, multiple igE antibodies become cross linked resulting in aggregation of the receptors on the cell. This clumping leads to activation of intracellular tyrosine kinases, leading to degranulation
greatest risk factor for completed suicide?
previous suicide attempt
explain the physiologic changes seen in an endurance athletes heart?
-increase in the volume load on the heart leads to eccentric hypertrophy with some concentric hypertrophy, and enhanced development of the coronary capillaries, and decreased resting HR
how may anabolic steroid use effect the heart?
-it can cause pathologic concentric LV hypertrophy
how does the ventilation/perfusion ratio changes with exercise?
it increases (ventilation increases more than perfusion does)
what are the gene mutations seen in lynch syndrome?
MSH2, MLH1, MSH6, PMS2
which cancers are associated with lynch syndrome?
Colon, endometrial, ovarian
which cancers are associated with BRCA1 mutation?
breast, ovarian
which is the only glycosolated HIV protein?
gp160
what is gp160?
-product of the env gene that is cleaved into gp120 and gp41
tamsulosin MOA
5-alpha reductase inhibitor
how may 5-alpha reductase inhibitors lead to gynecomastia?
-they prevent the conversion of testosterone to DHT and the excess testosterone is converted to estrogen
if you dont have diabetes are your cataracts caused by excess sorbitol in the lens?
NOOOO
does ethosuxamide treat tonic-clonic seizures?
no
is valproic acid broad spectrum or narrow spectrum?
broad spectrum -treats various types of seizures
what are carbamezapine, gabapentin and phenytoin used to treat?
focal onset seizures (narrow spectrum)
is an absence seizure a general onset or focal seizure?
general onset
what phase of the cell cycle does bleomycin inhibit?
G2
what antibodies are present in primary biliary cholangitis?
AMA
progesterone receptor and estrogen receptor expression on breast cancer is associated with what outcomes?
better outcomes
expression of HER2 on breast cancer is associated with what outcomes?
worse outcomes
manifestations of peripartum cardiomyopathy?
-usually dilated cardiomyopathy in the last month of pregnancy or wihtin 5 months of birth
how does the ejection fraction changed in diastolic cardiomyopathy?
decreased
how is the compliance changed in dilated cardiomyopathy?
increased
which hormone of pregnancy causes insulin resistance?
human placental lactogen
human placental lactogen effects
- cause insulin resistance to increase blood glucose
- increase maternal lipolysis to free lipids and ketones for energy for the mom (so the baby can have the glucose)
- also stimulates beta cells to produce insulin
which cells secrete human placental lactogen?
syncitiotrophoblasts
are corticosteroids used in PSGN?
no
are corticosteroids used in minimal change disease?
yes
where do the vertebral arteries travel through to get to the brain?
transverse foramina
effects of pulsatile GnRH secretion?
-pulsatile stimulation leads to upregulation of the GnRH receptors and thus increased FSH and LH secretion
use of administering pulsatie GnRH ?
to treat infertility
what nerve does negleria fowleri travel in?
olfactory nerve
what is responsible for the green colour of pus and sputum in bacterial infections?
myeloperoxidase
is shiga-toxin necessary for shigellosis?
No-many strains dont have it and shigella still invades the M cells of peyers pataches and causes cell death
what type of drug is dysopyramide?
Class IA antiarythmic
Class IA antiarythmic effects on length of action potential?
prolonged
Class IB antiarythmic effects on length of action potential?
shortened
Class IC antiarythmic effects on length of action potential?
no change
where are ringed sideroblasts seen in lead poisoning?
in the bone marrow NOT ON BLOOD SMEAR
will ringed sideroblasts be seen on blood smear of someone with lead poisoning?
NO they are in the bone marrow
how to treat male hypogonadism?
testosterone replacement
what electrolyte abnormality increases the risk of digoxin toxicity?
hypOkalemia - it increases the binding of digoxin to the receptor
which electrolyte abnormality is found in digoxin toxicity?
hypERkamia - digoxin is inhibiting the Na/K atpase, keeping K extracellular
An infarct occurs in the brain. 6 months later, what will be seen?
Persistent myelin debris- may persist for years
Why is myelin debris slowly cleared after an infarct in the brain?
-In the CNS phagocytic cells are recruited more slowly due to the BBB
-furthermore the oligodendrocytes infarcted undergo apoptosis and do not help clear debris
-
what is c-ANCA?
proteinaise-3-Anca which is an antiNEUTROPHIL cytoplasmic antibody
what is p-ANCA?
MPO-ANCA, or perinuclear anti-neutrophil cytoplasmic antibodies
what does anca stand for
anti-neutrophilic cytoplasmic antibodies
Rb mutations are associated with which bone cancer?
osteosarcoma
