Set 29 Flashcards
A patient comes to the clinic complaining of severe low back pain that radiates down the back of her leg. What is the most likely explanation for her pain?
Herniated intervertebral disc compressing spinal nerve root (L5. S1 - sciatica)
What problem/abnormality is associated with the following buzzwords?
Calf pseudohypertrophy
Muscular dystrophy (most commonly Duchenne): X-linked recessive deletion of dystrophin gene
What problem/abnormality is associated with the following buzzwords?
Gower maneuver
Duchenne muscular dystrophy. Patients used upper extremity to help them stand up
What problem/abnormality is associated with the following buzzwords?
Subluxation of lenses
Marfan syndrome: fibrillin-1 gene mutation (CT disorder) AND homocystinuria
What problem/abnormality is associated with the following buzzwords?
Café-au-lait spots
Neurofibromatosis type 1 (von Recklinghausen disease): neurocutaneous disorder characterized by cafe-au-lait spots and cutaneous neurofibromas. Caused by mutations in NF1 gene on chromosome 17
What problem/abnormality is associated with the following buzzwords?
Tuft of hair on lower back
Spina bifida occulta: failure of bony spinal canal to close but no structural herniation
What type of cell differentiation and maturation takes place at the thymus? The thymus also functions to positively restrict major histocompatibility complex (MHC) at the corticomedullary junction. On which cells would you expect to find MHC I?
T cell differentiation and maturation (+/- selection at corticomedullary junction)
MHCI - Expressed on all nucleated cells (not RBCs)
MHCII - only on APCs
A 59-year-old man with a 50-pack-year history of smoking sees you for management of his COPD. What is the clinical definition of chronic bronchitis?
Productive cough for > 3 months per year (doesn’t have to be consecutive) for > 2 years
A 50-year-old woman develops a new onset of lower back pain without a specific injury. A lumbar x-ray reveals lytic lesions which raise suspicion for multiple myeloma. What is the characteristic finding on electrophoresis with multiple myeloma? What is the classic finding in the urine of a patient with multiple myeloma?
M (monoclonal) spike on serum protein electrophoresis
Ig light chains in urine (Bence Jones protein)
In your own words, describe what type I (alpha) error is.
Stating there is an effect or difference when there is not one
What trace element is essential to the function of carbonic anhydrase and lactic dehydrogenase?
Zinc
A 30-year-old man who is experiencing shortness of breath is diagnosed with obstructive lung disease on pulmonary function test. The patient does not have a history of asthma and has never smoked. The patient is subsequently diagnosed with α1-antitrypsin deficiency. How does the emphysema caused by smoking differ from the emphysema caused by α1-antitrypsin deficiency?
Alpha1-antitrypsin deficiency: misfolded gene product protein aggregates in hepatocellular ER —> cirrhosis with PAS globules in liver. In the lungs, decreased alpha1-antitrypsin leads to uninhibited elastase in alveoli (antitrypsin protects us from elastase)—> decreased elastic tissue —> panacinar (entire acinus) emphysema
Emphysema: enlargement of air spaces —> decreased recoil —> increased compliance and decreased DLCO (diffusion capacity lung for CO) resulting from destruction of alveolar walls. Can be centriacinar (associated with smoking) or panacinar (associated with alpha1-antitrypsin)
In what clinical scenarios would you see a “nutmeg” liver?
Nutmeg liver is due to backup of blood into the liver. Commonly caused by right-sided heart failure and Budd-Chiari syndrome. The liver appears mottled like a nutmeg. If the condition persists, centrilobular congestion and necrosis can result in cardiac cirrhosis
You are performing a radical mastectomy and exercise extreme caution as you dissect laterally along the serratus anterior muscle. You do this in order to avoid severing which motor nerve, which would result in what sequela?
Long thoracic nerve —> winged scapula (serratus anterior muscle deficit leading to an inability to anchor scapula to thoracic cage —> cannot abduct arm above horizontal position)
