Set 3 (Derm, MSK, Hep) Flashcards
1
Q
Secrete membrane bound vesicles into hair follicles rather than directly onto skin
A
Apocrine gland
Smelly
2
Q
Achondroplasia: inheritance
A
Sporadic 85%
Autosomal DOMINANT 15%
3
Q
Asboe-Hansen sign
A
bullae spread laterally w/ pressure
Seen in pemphigoid vulgaris
4
Q
Nikolsky sign
A
new bullae form w/ gentle traction (Seen in pemphigoid vulgaris) or Skin slipping off w/ gentle pressure (Seen in SSSS)
5
Q
Connexin defects underlie some specific forms of?
A
Palmoplantar keratoderma
Deafness-associated ichthyosis
6
Q
What has PTH receptors?
A
Osteoblasts
Which produce M-CSF, RANK-L
7
Q
Glycogen degradation is coupled w/?
A
Skeletal muscle contraction
due to calcium-mediated myophosphorylase activation
8
Q
Fever, urticaria, arthralgias, GN, LAD, LOW serum C3 5-10d after intravascular exposure to antigen
A
Serum sickness (Type 3 hypersensitivity) (complement-fixing immune complexes, vasculitis)
9
Q
Liver sulfate conjugation
A
into more POLAR drug for excretion
Ex: phenol, chloramphenicol
10
Q
Liver hydroxylation
A
CYP 450 oxidation rxn –> LESS lipid soluble
Ex: Pentobarbital, phenobarbital
11
Q
Liver hydrolysis
A
Involve: esterase, amidase
Ex: Procaine, lidocaine, ASA
12
Q
Plasma hydrolysis
A
Inactivate drug rapidly
Ex: Succinylcholine, tetracine, remifantanil
13
Q
Drug-induced lupus: what type of liver metabolism?
A
N-acetylation
14
Q
Thiazide: A/E
A
HYPOkalemic metabolic ALKalosis
HYPERuricemia (hypovolemia stimulates absorptino)
HYPERlipidemia
HYPERglycemia (decrease insulin secretion)
15
Q
Main toxin produced by C. perfringens
A
Lecithinase (Alpha toxin):
degrades lecithin (phospholipid membranes) –> cell death and widespread necrosis/hemolysis
16
Q
T cell and macrophage infiltration of peripheral NERVOUS tissue causing segmental demyelination
A
Guillain-Barre syndrome
17
Q
Autoantibody binding causes _______to receptors
A
Complement-mediated destruction
Ex: myasthenia gravis
18
Q
Osteoporosis Amenorrhoea Enlarged parotid gland Lanugo (fine downy body hair) Bradycardia, HYPOtension Cardiac atrophy
A
Anorexia nervosa (binge/purge type)
19
Q
Branched-chain ketoacid dehydrogenasse deficiency
A
Maple syrup urine disease
20
Q
homogentisic acid oxidase deficiency
A
Alkaptouria (AR)
pigments deposits in CT throughout body
21
Q
Perifollicular hemorrhage
Coiled (corkscrew) hairs
A
Scurvy
22
Q
Vitamin C and collagen synthesis
A
Post-translational modification in RER (hydroxylation)
23
Q
Thymidine kinase-deficiency VZV: tx
A
Foscarnet (pyrophosphate analog viral DNA polymerase inhibitor)
or
Cidofovir (nucleotide, only cellular kinases required for activation)
24
Q
deposition of UNmineralized osteoid
A
VitD deficiency (osteomalacia, or rickets)
25
Subperiosteal thinning
Hyperthyroidism
| Resorption of CORTICAL bones
26
Irregular sections of lamellar bones linked by cement line
Paget's disease of bone
27
Persistence of primary, unmineralized spongiosa in medullary canals
Osteopetrosis
28
"Currant jelly" sputum
Klebsiella
29
Influenced by disease prevalence
PPV, NPV
30
Annular scaling plaque w/ well-demarcated, raised erythematous borders and central clearing
Tinea corporis
31
Tx of dermatophytosis
Terbinafine
32
Terbinafine: MOA
Inhibit synthesis of ergosterol by suppressing enzyme squalene epoxidase
33
Amphotericin B and Nyastatin: MOA
Polyene antifungals: binds to ergosterol
34
Caspofungin: MOA
Echinocandin antifungals
Blocks synthesis of Beta (1,3)-D-glucan
(main component of Candida and Aspergillus cell wall)
35
Griseofulvin: MOA
Binds ot pomerized MT and disrupts fungal mitotic spindle (prevent mitosis)
ONLY effective in dermatophytosis
36
Flucytosine: MOA
Antimetabolite antifungal
(transform into 5-FU --> inhibit protein synthesis by replacing uracil)
(for SYSTEMIC fungal infections)
37
Femoral head and neck; blood supply
Inferior and superior gluteal artery
Medial and lateral femoral circumflex
(Medial is largest contributor; vulnerable to damage due to close a/w posterior femoral neck)
38
Acanthosis
Increase in thickness of stratum spinosum
| Psoriasis
39
Dyskeratosis
Abnormal premature kertinization of keratinocyte
Strongly eosinophlic
(Squamous cell carcinoma)
40
Hyperparakeratosis
Retention of nuclei in stratum corneum
| ex: actinic keratosis; normal in mucous membranes
41
Hypergranulosis
Excessive granulation in stratum granulosum
| Ex: lichen planus
42
Spongiosus
```
Intercellular epidermal edema (increase in width btwn cells)
Eczematous dermatitis (contact dermatitis)
```
43
Seborrheic dermatitis
Glossitis
Peripheral neuropathy
Pyridoxine deficiency (B6)
44
VitB12 necessary for?
Synthesis of methionine
| Synthesis of succinyl CoA
45
Soft tissue and joint hemorrhages
Hemophilia A
46
Musculocutaneous n.
C5-C7
Flexors of UPPER arm
Sensory innervation to LATERAL forearm
47
Sjogren syndrome is a/w?
Parotid gland enlargement.
| Increased risk of non-HL.
48
Paradoxically increased in SLE patients despite propensity twd thrombosis.
PPT
49
Systemic sclerosis: antibody
Anti-DNA topoisomerase I (Scl-70)
50
____degrade intracellular protein.
| ____degrade extracellular protein.
Proteasome: intracellular.
Lysosome: extracellular.
51
High PTH
| Low calcium
Renal failure
or
VitD deficiency
52
Osteoporosis: labs
NORMAL!
53
Contact dermatitis vs. Atopic dermatitis: hypersensitivty
Contact: type 4
| Atopic dermatitis: type 1
54
Sarcoidosis: hypersensitivity
Type 4
55
Hypersensitivity pneumonitis: hypersensitivity
Type 3
56
Sustained, involuntary muscle contractions, which force certain parts of body into abnormal, sometimes painful movements or postures
Dystonia
| impaired fxn of basal ganglia
57
spasmodic torticollis
Focal dystonia (cervical)
58
blepharospasm
Involuntary forcible closure of eyelids
(initial sx: uncontrollable blinking)
Example of focal dystonia.
59
Pathologic myoclonus (sudden, brief, sometimes severe muscle contraction)
Epilepsy
| Creutzfeldt-Jakob disease
60
Contralateral injury in or near subthalamic nucleus
Hemiballism
61
Weakness of quadriceps muscle
Loss of patellar reflex
Loss of sensation over anterior and medial thigh and medial leg
femoral nerve injury
| difficulty w/ stairs, "knee buckling"
62
Gram negative rod
Oxidase +
NON-lactose fermenting
Pseudomonas aeruginosa
63
Tx: P. aeruginosa
CefePIME
CeftaziDIME
(use penny and dime to treat "air")
Ticarcillin, Pipercillin
Certain aminoglycoside, fluoroquinolone (cipro, levo), carbapenems (imi, mero)
64
```
DOC for:
Pneumocystis jiroveci
Toxoplasma gondii
Nocardia
Stenotrophomonas maltophilia
```
TMP-SMX
65
Lichenification in flexural distribution
Atopic dermatitis
66
Hallmark of atopic dermatitis
Intense pruritis
67
Midsystolic click
| late systolic murmur
MVP
68
Pretibial myxedema
Thinning of hair
Alopecia areata
Hyperhidrosis
Hyperthyroidism (cutaneous manifestations)
69
Peptid ulcer disease can be a/w
MEN1
| Wermer syndrome
70
Xanthelasma occur in a/w?
```
Primary or Secondary hyperlipidemia
Cholestatic conditions (ex: PBC)
```
71
Dactylitis
Painful swelling of hands and feet
| Common presentation in Sickle cell disease in YOUNG children --> DECREASED haptoglobin
72
Median nerve: location
w/ brachial artery in groove between biceps and brachialis
Btwn humeral and unlar heads of pronator teres
Btwn flexor digitorum superficialis and flexor digitorum profundus
73
Loss of thenar eminence
| "Ape hand" deformity
median n. injury @ wrist
74
Btwn flexor carpi ulnaris and flexor digitorum profundus
```
Ulnar nerve
(injury= "claw hand" due to paralysis of intrinsic m. of hand)
```
75
Bisphosphonate: MOA
Structural analogues of pyrophosphate (component of hydroxyapatite) --> make hydroxyapatite more insoluble.
Decrease bone resorption by interfering w/ osteoclasts.
76
Bisphosphonate: use.
Osteoporosis.
Paget's disease of bone
Malignancy-induced HYPERcalcemia.
(fasting state w/ plenty of water due to poor bioavailability, upright to prevent reflux esophagitis)
77
Unmineralized osteoid matrix
Widened osteoid seams
Harrison's sulci
Craniotabes (softening of skull)
Rickets
78
Hematogenous osteomyelitis
m/c in children
| Metaphysis of long bone (slower blood flow, capillary fenestrae)
79
Upper respiratory infection followed by diarrhea
Rotavirus
80
Tx of ascites 2/2 cirrhosis
Restriction of Na intake
| Furosemide + spironolactone
81
Factor 9 deficiency
hemophilia B
| X-linked recessive
82
Hypoxanthine phosphoribosyltransferase deficiency
Lesch-Nyhan syndrome
(X-linked recessive)
(hypoxanthine --> IMP, and guanine --> GMP; purine salvage)
83
Leber hereditary optic neuropathy: inheritance
Mitochondrial
84
Galactose-1-phosphate uridyltransferase gene affeted
```
Classical galactosemia
(autosomal recessive)
```
85
Antibodies in celiac disease cause clinical dz by?
x-reacting w/ reticulin (anchoring fibrils of epidermal BM)
86
STD
| White, umbilicated papule on penis, vulva, groin
Molluscum contagiosum (poxvirus)
87
Erythema multiforme: classic target lesions suggests this as m/c etiology
Herpes simplex infection
88
2 eukaryotic promotors
1) TATA (Hogness) box: 25 nucleotides upstream.
| 2) CAAT box: 70-80 bases upstream
89
anti-HBsAg
When hepatitis B infection begins to resolve
90
Anti-HBcAg: protective?
NO
91
Hepatocellular carcinoma: which hepatitis virus is most associated?
HepB
92
Acneiform eruptions: what drugs can cause this?
Methyltestosterone
EGFR inhibitors
Lithium
93
Ephedrine
Sympathomimetic for:
Bronchial asthma
Stimulant, appetite suppressant, decongestant.
94
k-RAS mutations are common in?
Pancreatic malignancies.
95
N-myc
Transcription factor
96
Protein kinase A regulates target protein activity via?
Phosphorylating SERINE and THREONINE.
97
DNA glycosylase
Base excision repair.
98
Southwestern blot
DNA-bound protein
99
Northern blot
mRNA
100
Hepatitis B viral genome replication
dsDNA --> + RNA (template) --> dsDNA (progeny)
101
Poliovirus viral genome replication
+ssRNA --> -ssRNA (template) --> +ssRNA (progeny)
102
Viral genome replication:
Influenza
Measles
Rabies
-ssRNA --> +ssRNA (template) --> -ssRNA (progeny)
103
Parvovirus B19 viral genome replication
ssDNA--> dsDNA (template) --> ssDNA (progeny)
104
```
viral genome replication:
papvavirus
adenovirus
herpesvirus
poxvirus
```
dsDNA --> dsDNA (template) --> dsDNA (progeny)
105
Lipodystrophy
HYPERglycemia
P450 INhibitor
A/E of all protease inhibitor (anti-retrovirals)
106
Zidovudine
Nucleoside reverse transcriptase inhibitor (NRTI)
(Suppression of DNA synthesis from viral RNA)
A/E: bone marrow toxicity --> anemia
107
MAC infection in HIV: tx
Azithromycin
108
CMV infection in HIV: tx
Foscarnet
| A/E: nephrotoxicity, electrolyte disturbances (HYPOcalcemia, HYPOmagnesemia, HYPOkalemia)
109
m/c/c of death in patient with TCA poisoning
Cardiac arrythmias
| tx: sodium bicarbonate
110
Barbiturate poisoning: tx
Diuretic
| Urinary alkalinization
111
Acetominophen toxicity: tx
N-acetyl cysteine
112
Hypoglycemia following fructose ingestion
Aldolase B deficiency
113
GALT defciency
Classic galactosemia
| vomiting, lethargy, failure to thrive after breastfeeding begins
114
Galactosemia can result in?
Impaired liver fxn
HYPERchloremic metabolic ACIDosis
Aminoaciduria
115
Galctokinase dficiency: m/c manifestation
Cataract
116
t1/2=
0.7Vd/CL
117
Glycogen accumulation in lysosomal vesicles
```
Acid maltase (alpha glucosidase) deficiency
(Type II: Pompe's disease)
```
118
```
Hepatomegaly, Cardiomegaly
Macroglossia, HYPOtonia
Mental retardation
Glycogen accumulation in lysosomes
NORMAL blood sugar levels
```
```
Acid maltase (alpha glucosidase) deficiency
(Type II: Pompe's disease)
```
119
Hepatomegaly
HYPOglycemia, Lactic acidosis
Hyperlipidemia, Hyperuricemia
Increased glycogen storage but NORMAL structure
Glucose-6-Phosphate deficiency
(Type 1: Von Gierke's disease)
(involves ONLY liver b/c NOT present in muscle)
120
Poor exercize tolerance
Muscle cramping, pain, rhabdomyolysis during exercise
No rise in blood lactate after exercize
HIGH level of glycogen in muscle
Muscle glycogen phosphorylase deficiency
| Type 5: McArdle's disease
121
```
Hepatomegaly
Growth retardation
HYPOglycemia
HYPERlipidemia
Muscle weakness
```
Debranching enzyme deficiency
| Cori or Forbes disease
122
Galactokinase deficiency: main manifestation
Cataract
123
Chronic hemolytic anemia
Splenomegaly
Poor exercize tolerance
Pyruvate kinase deficiency
124
Production of larger protein w/ altered fxn but preserved immune reactivity
Splice site mutation
125
Can hepatocyte utilize ketone bodies?
NO, lack succinyl-CoA-acetoacetate CoA transferase (thiophorase)
(other cells that cannot utilize ketones: cells w/o mitochondria: erythrocytes)
126
PolyA tail is transcribed from DNA?
NO, added as post-transcriptional modification downstream of consensus sequence (AAUAAA)
127
TPN-induced gallstones
1) biliary stasis (2/2 decreased CCK release)
| 2) ileal resection: distrubance of enterohepatic bile acid circulation
128
Hepatic adenoma
Women + lengthy history of OCP use.
Abdominal pain
Can rupture and cause intra-abdominal bleeding
129
Reye's syndrome is characterized histologically by?
Micovesicular steatosis
130
Serious acetominophen overdose: histology
Centrilobular necrosis (that can extent to ENTIRE lobe)
131
Interlobular bile ducts: florid duct lesion
| granulomatous inflammation
Primary biliary cirrhosis
132
Acantholysis
Loss of cohesion btwn keratinocytes in epidermis or adnexal structures
(Ex: Eczematous dermatitis)
133
Urticaria is characterized by?
Superficial DERMAL edema, lymphatic channel dilation
| NO epidermal changes
134
reddish-pink
periodic acid-Schiff-positive granules
resist digestion by diatase
A1AT
135
Myoglobinemia
Weakness following exercize
Elevated muscle TG
HYPOketonemia
Skeletal muscle carnitine deficiency
136
Hypoglycemia
| Hypoketonemia
Median chain acyl-CoA dehydrogenase deficiency
| MCAD deficiency
137
```
Elevated ALP
NORMAL GGTP (gamma-glutamyl transpeptidase)
```
Problem with BONE
| NOT in liver; since GGTP is is liver, NOT bone
138
Followup of moderately elevated ALP of unclear etiology
GGTP
