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Step 1 Shit I'm Forgetting/embryogology > Shit i cannot remember for the life of me > Flashcards

Shit i cannot remember for the life of me Flashcards

1
Q

Partial mole

A

Classification: benign
Trophoblasts: focally hyperplastic
Villi: focally, enlarged hydropic
Fetal/embryonic tissue: present, triploid

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2
Q

Complete mole

A

Classification: benign
Trophoblasts: diffusely hyperplastic
Villi: difusely enlarged, hydropic
Fetal tissue: absent

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3
Q

Invasive mole

A

Class: malignant
Trophoblasts: diffusely hyperplastic with myometrial invasion
Villi: diffusely enlarged hydropic
Fetal tissue: absent

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4
Q

Gestational choriocarcinoma

A

Class: malignant
Trophoblasts: Diffusely anaplastic/necrotic with vascular invasion
Villi: Absent
Fetal tissue: present or absent

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5
Q

Properties of PAH

A

Free filtered from the blood in the glomerular capillaries to the tubular fluid in bowman’s space.

Also secreted from the blood into the tubular fluid by the cells of the proximal tubule by a carrier protein mediated process.

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6
Q

Familial chylomicronemia syndrome (type 1)

A

Protein defect: lipoprotein lipase and apoC-II
elevated lipoproteins: chylomicrons
Major manifestations: ACUTE PANCREATITIS, lipemia retinalis, eruptive skin xanthomas, hepatosplenomegaly

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7
Q

Familial hypercholesterolemia (type II A)

A

Protein defect: LDL receptor and apoB-100
Elevated lipoproteins: LDL
Major manifestations: premature coronary artery disease, corneal arcus, tendon xanthomas, xanthelasmas

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8
Q

Familial dysbetalipoproteinemia (Type III)

A

Protein defect: ApoE
Elevated lipoproteins: Chylomicron and VLDL remnants Major manifestation: Premature coronary artery disease and peripheral vascular disease, tuboeruptive and palmar xanthomas

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9
Q

Familial hypertriglyceridemia (Type IV)

A

protein defect: ApoA-V
Elevated lipoproteins: VLDL
Major manifestation: Increased pancreatitis risk, associated with obesity and insulin resistance

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10
Q

How is erythrocytosis defined as?

A

Hematocrit level >52% in men and >48% in women

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11
Q

How is type 1 multiple endocrine neoplasia classified as?

A
  • primary hyperparathyroidism (hypercalcemia)
  • pituitary tumors (prolactin, visual defects)
  • pancreatic tumors (especially gastrinomas)
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12
Q

How is type 2A multiple endocrine neoplasia classified as?

A
  • Medullary thyroid cancer (calcitonin)
  • pheochromocytoma
  • parathyroid hyperplasia
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13
Q

How is type 2B multiple endocrine neoplasia classified as?

A
  • Medullary thyroid cancer ( calcitonin)
  • pheochromocytoma
  • Muscosal neuromas/marfanoid habitus
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14
Q

How is autoimmune platelet destruction characterized as?

A

Signs: ecchymoses, petechiae, mucosal bleeding and no other obvious cases of thrombocytopenia (medications, bone marrow failure)

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15
Q

What are the nonmodifiable risk factors for osteoporotic fractures?

A
  • advancing age
  • female sex
  • white, hispanic, or asian ethnicity
  • personal or family history of fracture
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16
Q

What are the potentially modifiable risk factors for osteoporotic fractures?

A
  • decreased physical activity
  • low body weight
  • poor calcium and vitamin D intake
  • excessive alcohol or tobacco use
  • premature menopause
  • glucocorticoid use
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17
Q

Describe contracture

A

-deformities of the wound and surrounding tissue, most often on the palms, soles, anterior thorax or at serious burn sites

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18
Q

Mechanism of contracture

A

During wound healing, excessive matrix metalloproteinase activity and myofibroblast accumulation in the wound margins can result in contracture.

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19
Q

Henoch-schonlein purpura

A
  • affects young children and preceded by an Upper respiratory infection
  • IgA mediated hypersensitivity (leukocytoclastic) vasculitis commonly causes abdominal pain, joint pain, lower extremity palpable purpura and hematuria
  • Vasculitis
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20
Q

Placenta accreta

A

Impaired decidualization -> myometrial invasion by villous tissue and a placenta that is abnormally adherent to the myometrium

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21
Q

Placental abruption

A

Premature detachment of the placenta from the uterine wall prior to the delivery of the fetus. Signs: painful prolonged uterine contractions, tense abdomen, and vaginal bleeding prior to delivery

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22
Q

Risk factors for placental accreta

A

scar tissue from prior surgery )C-section -> malformed or absent decidual layer between the placenta and the myometrium

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23
Q

What are common triggers of asthma attacks?

A

Allergen inhalation- animal dander, dust mites, cockroaches, pollen, mold
Respiratory irritants: smoke pollution, perfumes
Infection: Viral upper respiratory infection and rhinosinusitis
Pharm: aspirin, NSAIDS, non-selective beta blockers
Other: Exercise and cold, dry air, GERD, emotions: stress and depression

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24
Q

Describe and define a Cavernous hemangiomas

A

Vascular malformations composed of abnormally dilated capillaries separated by thin connective tissue septa

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25
Q

Signs of Cavernous hemangioma bleed

A

Those that occur in the brain- neurologic deficits and seizures

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26
Q

How does lithium induced diabetes insipidus work?

A

Lithium’s antagonizing effect on the action of vasopressin on principal cells within the collecting duct system.

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27
Q

How can we make the diagnosis of Type 1 diabetes mellitus?

A

Fasting glucose greater than or equal to 126mg/dLL

Hemoglobin A1c greater than or equal to 6.5

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28
Q

Decerebrate (extensor) posturing

A

Damage to the brainstem at/below the level of the red nucleus (ex: midbrain tegmentum, pons)

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29
Q

Decorticate (flexor) posturing

A

Damage to neural structures above the red nucleus ( ex: cerebral hemispheres, internal capsule)

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30
Q

What is Cushing’s triad?

A

Hypertension, bradycardia, respiratory depression seen in brainstem compression ex: uncal herniation `

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31
Q

How can Crohn’s disease cause gallstones to form?

A

Crohn’s disease affects the terminal ileum- most common site of involvement
-prone to develop gallstones -> decreased bile acid reabsorption -> promotes cholesterol supersaturation of the bile -> gallstone formation

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32
Q

What is complementary DNA (cDNA)?

A

Double-stranded DNA that is synthesized from mRNA template

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33
Q

What is a result of a frameshift mutation?

A

Deletion or insertion of a number of bases that is not divisible by 3.

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34
Q

What is the active form of thyroid hormone?

A

T4 (inactive) -> T3(active)

-converted in the peripheral tissues and reverse T3

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35
Q

Describe the different dose effects of dopamine

A
  • low dose dopamine-> stimulates D1 receptors in the renal and mesenteric vasculature-> vasodilation and increased blood flow to these sites
  • Increasing doses of dopamine stimulate beta1 and alpha 1 receptors -> increased cardiac output and elevated systemic vascular resistance
  • @ higher end of the dose range -> increase in afterload can result in decreased cardiac output

DBA

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36
Q

What is foscarnet used for and it’s side effects?

A

Use: ganciclovir-resistant cytomegalovirus infections
-Analog of pyrophosphate that can chelate calcium and promote nephrotoxic renal magnesium wasting.
Toxicities: hypocalcemia and hypomagnesemia -> can cause seizures

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37
Q

How is glucagon used as a treatment for beta blocker overdose?

A
  • glucagon -> increases heart rate and contractility independent of adrenergic receptors
  • glucagon activates G-protein coupled receptors on cardiac myocytes -> activation of adenylate cyclase and raises intracellular cAMP -> calcium release from intracellular stores and increased sinoatrial node
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38
Q

What does the arteriovenous concentration gradient reflect?

A

Reflects the overall tissue solubility of an anesthetic.

ex: Anesthetics with high tissue solubility -> large arteriovenous concentration gradients and slower onsets of action.
- Influences the rate of induction

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39
Q

How is potency of anesthetic defined?

A

By minimal alveolar concentration (MAC)-> the alveolar concentration that prevents movement in 50% of patients exposed to noxious stimuli
Potent anesthetics -> low MAC

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40
Q

What do releasing factors recognize and function as?

A 
Stop codons (ex: UAA, UAG, and UGA) and terminate protein synthesis
-Facilitate release of the polypeptide chain from the ribosome and dissolution of the ribosome-mRNA complex.
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41
Q

What is BEERS criteria?

A

Common medications to avoid in older adults

  • Anticholinergic: first generation antihistamines, gastrointestinal antispasmodics
  • Cardiovascular: alpha 1 blockers, centrally acting alpha 2 agonists, many antiarrhythmics
  • Central nervous system: tricycle antidepressants, antipsychotics, barbiturates, benzodiazepines and other hypnotics
  • Endocrine: Long-acting sulfonylureas and sliding scale insulin
  • Pain: non-selective NSAIDs, skeletal muscle relaxants
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42
Q

What are the aromatase inhibitors and their function?

A

Anastrozole, letrozole, exemestane -> Decrease the synthesis of estrogen from androgens, suppressing estrogen levels and slowing progression of ER positive tumors.

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43
Q

Differences between Fevers vs. Heat stroke in children

A

Pathophys: Circulating cytokines (infections) vs. heat production exceeds heat dissipation (ex: Environmental exposure, exertion)
Hypothalamic set point: Elevated (fever) vs Normal ( heat stroke)
Organ dysfunction: Febrile seizures (benign) vs Permanent end-organ damage ( heat stroke)
Management: Acetaminophen or ibuprofen ( fever) vs Rapid external cooling (heat stroke)

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44
Q

What is first-order kinetics of drug metabolism?

A

Constant fraction (or proportion) of drug is metabolized per unit of time -> amount metabolized changes based on the serum concentration

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45
Q

What is zero-order kinetics of drug metabolism?

A

Constant amount of drug is metabolized per unit of time, independent of serum levels

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46
Q

Mechanism of how giving oxygen to a patient with COPD reduces respiratory drive.

A

In patients with COPD -> response to PaCO2 is blunted and hypoxemia (low oxygen) becomes an important contributor to the respiratory drive
-peripheral chemoreceptors -> sensing arterial PaO2 and can be suppressed with oxygen administration

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47
Q

Symptoms of digoxin toxicity

A

Cardiac: life-threatening arrhythmias
GI: Anorexia, N/V, abdominal pain
Neurologic: fatigue, confusion, weakness, color vision alteration

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48
Q

How would porcelain gallbladder present as?

A
  • Presents with right upper quadrant abdominal pain -> many are asymptomatic
  • Radiographic features include: thickened gallbladder wall with a rim of patchy or uniform calcification
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49
Q

What is procelain gallbladder assoicated with?

A

Increased risk of adenocarcinoma of the gallbladder

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50
Q

What happens when a stop codon is encountered on the ribosome?

A

Releasing factor proteins bind to the ribosome and stimulate release of the formed polypeptide chain and dissolution of the ribosome-mRNA complex

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51
Q

Acute necrotic pancreatitis

A

Destruction of blood vessel walls can cause hemorrhage into necrotic areas. Areas of white chalky fat necrosis are visible in pancreatic tissue -> can spread into the mesentery, omentum, and other parts of abdominal caivity.

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52
Q

Type 1 Hypersensitivity Reactions (Immediate)
Humoral components?
Cellular components?
Examples?

A

Humoral: IgE
Cellular: Basophils and mast cells
Examples: Anaphylaxis and allergies

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53
Q

Type 2 Hypersensitivity reactions (Cytotoxic)
Humoral components?
Cellular components?
Examples?

A

Humoral: IgG and IgM autoantibodies, complement activation
Cellular components: NK cells, eosinophils, neutrophils, macrophages
Examples: Autoimmune hemolytic anemia, Goodpasture syndrome, acute hemolytic transfusion reaction

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54
Q

Type 3 Hypersensitivity reactions (Immune complex)
Humoral components?
Cellular components?
Examples?

A

Humoral: Deposition of antibody-antigen complexes, complement activation
Cellular components: Neutrophils
Examples: Serum sickness, PSGN, Lupus nephritis

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55
Q

Type 4 (delayed type)

A

Humoral: None
Cellular: T cells, macrophages
Examples: Tuberculin test, contact dermatitis

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56
Q

Which pathway is involved in the breakdown of intracellular proteins, native and foreign, to be coupled to MHC I in the ER?

A

Ubiquitin proteasome pathway

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57
Q

What are the pathologic features of polymositis and associated complications?

A

Pathologic features: Elevated muscle enzymes (CK, aldolase) AUTOANTIBODIES: Anti-Jo-1 and ANA
Biopsy: endomysial mononuclear infiltrate, patchy necrosis
Associated complications: interstitial lung disease and myocarditis

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58
Q

Prolactinomas -> mechanism of it’s pathology

A

High levels of prolactin suppress gonadotrophin-releasing hormone from the hypothalamus -> hypogonadism, anovulation, and amennorrhea

  • Associated with low bone density- low estrogen
  • Vaginal dryness- low estrogen
59
Q

Precursor amino acid-arginine gives rise to?

A

Nitric oxide

60
Q

Precursor AA: Arginine + Aspartate gives rise to?

A

Urea

61
Q

Precursor AA: Glycine and succinyl CoA gives to?

A

Heme

62
Q

Precursor AA: Glycine, Arginine, SAM gives rise to?

A

Creatine

63
Q

Precursor AA: Glutamate gives rise to ?

A

GABA and Glutathione

64
Q

Glutamine and Aspartate give rise to?

A

Pyrimidines

65
Q

Glutamine + Aspartate + Glycine give rise to?

A

Purines

66
Q

Histidine gives rise to?

A

Histamine

67
Q

Tyrosine gives rise to?

A

Dopamine, Epinephrine, Norepinephrine, Thyroxine, and Melanin

68
Q

Tryptophan gives rise to?

A

Serotonin, Melatonin, and Niacin

69
Q

How does enterococci gain resistance to aminglycosides?

A

They produce aminoglycosie-modifying enzymes that transfer different chemical groups to the aminoglycoside molecule and impair antibiotic binding to ribosomal subunit.

70
Q

What does it mean when a drug has a low volume of distribution? Factors that affect this.

A

-Tend to trap the drug in the plasma compartment-> low Vd

Factors: high molecular weight, high plasma protein binding, high charge, and hydrophilicity

71
Q

Excess estrogen affects the thyroid by?

A

Raising the circulating TBG levels -> reduction in free T4 and free T3 levels -> normal person -> increase in total T4 as well as T3 to compensate and maintain euthyroid levels

72
Q

Rectal administration of a drugs allows what?

A

Capable of partially bypassing first-pass metabolism as a proportion of rectal blood flow enters the systemic circulation directly.

73
Q

How do beta blockers treat the symptoms of thyrotoxicosis?

A
  • Decreasing the effect of sympathetic adrenergic impulses on target organs
  • Decrease the rate of peripheral conversion of T4 to T3 ; inhibits iodothyronine deiodinase
74
Q

What are stellate cells? What are their functions? What disease process do they contribute to?

A

Stellate cells are perisinusoidal cells.
Function: Storage site for retinoids (vitamin A metabolites) and secrete TGF Beta

Disease process: Activated in liver disease -> TGF-beta -> proliferate and produce fibrous tissue -> major contributors to cirrhosis

75
Q

What marker do Hepatocellular Carcinomas secrete?

A

-Alpha fetal protein

76
Q

What toxic exposures are associated with Hepatic Angiosarcoma?

A
  • Vinyl Chloride and Arsenic
77
Q

What is ankle sprain most commonly due to?

A

Inversion of a plantar-flexed foot

-Lateral ankle ligaments are weaker and are injured more often than the medial ligaments

78
Q

What ligament does the most common ankle sprai involve?

A

Anterior talofibular ligaments and presents with pain and ecchymosis at the anterolateral aspect of the ankle

79
Q

What are key characterisitics of chlamydia trachomatis?

A
  • Small and shallow ulcers
  • Large, painful, coalesced inguinal lymph nodes
  • Intracytoplasmic chlamydial inclusion bodies in epithelial cells and leukocytes
80
Q

Explain the innervation of the tongue?

A

Motor innervation: Hypoglossal nerve- CN 12 with the exception of the palatoglossus muscle innervated by CN 10
General Sensory:
Anterior 2/3 of the tongue: Mandibular branch of the trigeminal nerve (CN V3)
Posterior 1/3 of the tongue: Glossopharyngeal nerve (CN IX)
Posterior area of the tongue root: Vagus nerve (CNX)

Gustatory innervation (taste):
Anterior 2/3: Chorda tympani branch of facial nerve (CN VII)
Posterior 1/3: Glossopharyngeal nerve (CNIX)

81
Q

Renal Cell Carcinomas what mutation do they have?

A

Patients with both sporadic and hereditary (associated with von Hippel-Lindau disease) -> renal cell carcinoma are found to have deletions or mutations involving the VHL gene on chromosome 3p.

82
Q

What paraneoplastic syndromes are assoicated with renal cell carcinomas?

A

-ectopic EPO, ACTH, PTHrP, renin

83
Q

What is the triad for Von Hippel-Lindau disease?

A

-Cerebellar hemangioblastomas, clear cell renal carcinomas, and pheochromocytomas

84
Q

What is Treacher-Collins Syndrome?

A

Abnormal development of the 1st and 2nd pharyngeal arches

  • Compromised airway and feeding difficulties
  • absent or abnormal ossicles-incus, malleus, stapes-> profound conductive hearing loss
85
Q

What is the function of IL-2?

A
  • Stimulates the growth of CD4+ and CD8+ T cells and B cells
  • Activates NATURAL KILLER CELLS AND MONOCYTES
86
Q

When is Pulmonary vascular resistance lowest at?

A

-Functional residual capacity

87
Q

When does Pulmonary vascular resistance increase?

A
  • Increased lung volumes increase PVR -> longitudinal stretching of alveolar capillaries by the expanding alveoli
  • Decreased lung volumes also increase PVR due to decreased radial traction from adjacent tissues on the large extra-alveolar vessels.
  • Mid-way point- FRC
88
Q

What is adenomyosis?

A

-The presence of endometrial glandular tissue within the myometrium.
-Menorrhagia and dysmenorrhea
-Uniformly enlarged uterus with normal-appearing endometrial tissue on biopsy
Biopsy shows secretory endometrium

89
Q

What is the earliest manifestation of diabetic nephropathy?

A
  • Moderately increased albuminuria (urine albumin levels <300 mg/day)
  • Screening is best achieved through the use of albumin specific urine dipsticks.
90
Q

Describe Trisomy 18

A

-Most commonly the result of meiotic nondisjunction due to advanced maternal age
KEY FINDINGS: Fetal growth retardation, hypertonia (clenched hands with overlapping fingers), rocker bottom feet, and cardiac/gastrointestinal/renal defects, Prominent occiput, micrognathia (small mandible) , low set ears limited hip abduction

91
Q

Characteristics of Trisomy 13

A
  • Midline defects: Microcephaly/holoprosencephaly, microphthalmia, cleft lip/palate
  • Cardiac and renal defects
  • Cutis aplasia (hole in the head)
  • Polydactyly
  • umbilical hernia/omphalocele
  • Rocker-bottom feet
92
Q

Characteristics of Trisomy 21

A
  • Low set small ears
  • Epicanthic folds
  • Furrowed tongue
  • Sandal toe deformity
  • Brushfield spots
  • Single transverse palmar crease
  • short neck with excess skin
93
Q

Major toxicity of amphotericin B

A

-Renal toxicity: Magnesium wasting and potassium wasting

94
Q

What organ is extraperitoneal?

A

The bladder

-Surrounded by the abdominal wall not the peritoneum

95
Q

What is the carpal tunnel?

A

Defined by the carpal bones on the dorsal surface and the transverse carpal ligament on the volar surface

  • Contains the tendons of the flexor digitorum profundus and superficialis and flexor pollicis longus
  • Plus the median nerve
96
Q

what the blood brain barrier composed of?

A

-Tight junctions between nonfenestrated capillary endothelial cells that prevent the paracellular passage of fluid and solutes

97
Q

Nephritic syndrome: Anti-glomerular basement mebrane antibodies react with what?

A

Type IV collagen causing rapidly progressive glomerulonephritis with glomerular crescent formation on light microscopy
IF- linear deposits of IgG and C3 along the glomerular BM

98
Q

What is the urachus?

A

Remnant of the allantois that connects the bladder with the yolk sac during fetal development. Failure of the urachus to obliterate at birth -> patent urachus

99
Q

What is urachal sinus?

A

Failure to close the distal part of the urachus (adjacent to the umbilicus). Presents as periumbilical tenderness and purulent umbilical discharge due to persistent and recurrent infection

100
Q

Urachal cyst?

A

Failure of the central portion of the urachus to obliterate.

101
Q

During dehydration what parts of the nephron will be the most concentrated and which parts will have the most dilute fluid?

A

Dehydration stimulates ADH -> acts on collecting ducts-> collecting ducts will have the most concentrated fluid

-Thick ascending limb- absorbs electrolytes no water
-Distal convoluted tubule- reabsrobs Na+ and Cl-, Ca2+
(most dilute urine)

102
Q

What is the function of stop codons?

A

Halt protein synthesis by binding a release factor

-THEY DO NOT ADD AMINO ACIDS TO THE POLYPEPTIDE CHAIN!

103
Q

Describe the valsalva and the muscles and nerves involved

A
  • Increases vagal tone and can be used to abolish paroxysmal supraventricular tachycardia
  • Rectus abdominis-> most important muscle in acheiving the increased intraabdominal and intrathoracic pressure of the valsalva maneuver
104
Q

Piriformis syndrome explain

A
  • Piriformis passes through the greater sciatic foramen and is involved with external hip rotation
  • Piriformis syndrome- muscle injury or hypertrophy can compress the sciatic nerve in the foramen.
105
Q

Hartnup disease

A

-Impaired transport of neutral amino acids in the small intestine and proximal tubule of the kidney
-Symptoms: pellagra-like skin eruptions and cerebellar ataxia-> niacin deficiency
Dx: Excessive amounts of neutral amino acids in the urine

106
Q

What is the difference between hormone sensitive lipase and Lipoprotein lipase

A
  • HSL- Found in adipose tissue -> mobilization of stored TGs into FFAs and glycerol
  • LPL-Found in endothelial cells that functions to degrade TGs found in chlyomicrons and VLDL
107
Q

Explain the mechanism of Digoxin

A
  • Inhibits the Na+/K+ ATPase pump in myocardial cells -> decrease in sodium efflux and an increase in intracellular sodium levels
  • Increased intracellular sodium levels -> reduce the forward activity of the Na+/Ca2+ exchanger -> increased intracellular calcium concentration and improved myocyte contractility
108
Q

How do penicillins and cephalosporins function?

A

Irreversibly binding to penicillin binding proteins such as transpeptidases

109
Q

Damage to the Posterior pituitary gland vs Hypothalamic nuclei
-Central DI

A

PP- only transient central DI

HN-permanent central DI

110
Q

Where can ACE be found?

A

Endothelial- bound angiotensin converting enzyme in the small vessels of the lung

111
Q

What is lymphatic drainage for above vs below pectinate line?

A

Above; Internal iliac lymph nodes

Below: Superficial inguinal nodes

112
Q

Which way is the proofreading exonuclease activity?

A

3’ -> 5’

113
Q

What is Li-Fraumeni Syndrome

A

Autosomal Dominant mutation in the tumor suppressor gene TP53
Characterized by what types of malignancies: leukemias, SARCOMAS, and tumors of the breast, brain, and adrenal cortex

114
Q

What cancers are associated with Lynch Syndrome?

A

-Colorectal, endometrial, and ovarian

115
Q

What cancers are associated with familial adenomatous polyposis?

A

-Colorectal, desmoids and osteomas, and brain tumors

116
Q

What tumors arise from von Hippel- Lindau Syndrome?

A

Hemangioblastomas, clear cell renal carcinoma, pheochromocytoma

117
Q

What are the clinical manifestations for congenital hypothyroidism?

A
  • initially normal at birth
  • symptoms develop after maternal T4 wanes: lethargy, ENLARGED FONTANELLE, protruding tongue, umbilical hernia, poor feeding, constipation, dry skin, jaundice
118
Q

What do integral membrane proteins contain in their transmembrane domains?

A

Composed of alpha helicies with hydrophobic amino acid residues (alanine, valine, leucine, isoleucine, phenylalanine, tryptophan, methionine, proline, glycine)
-Transmembrae domains help anchor the protein to the phospholipid bilayer of the cell membrane

119
Q

Name the 3 different components of the G protein- coupled receptors

A
  • extracellular domain responsible for ligand binding
  • Transmembrane domain
  • Intracellular domain
120
Q

What pharyngeal/branchial pouches are malformed in Digeorge syndrome?

A

3rd(inferior parathyroid and thymus) and 4th (superior parathyroid) pharyngeal/branchial puches

121
Q

Adhesion of cells to the extracellular matrix involves integrin-mediated binding to?

A

-Fibronectin, collagen, and laminin

122
Q

What are fibronectins?

A

Large glycoproteins produced by fibroblasts and some epithelial cells

  • bind to integrins, matrix collagen, and GAGs
  • Correlates with malignant behavior in a number of tumors including melanoma
123
Q

What structure would be affected most in a traumatic aortic rupture?

A

-Aortic isthmus -> tethered by the ligamentum arteriosum and fixed and immobile compared to adjacent descending aorta

124
Q

Amiodarone -risk of torsades de pointes?

A
  • Associated with a very low risk of torsades de pointes
125
Q

What diseases does H influenza type b cause?

A

Meningitis (in kids), pneumonia, epiglottis, and sepsis

-Predilection to the meninges -> most cases of Hib present as meningitis

126
Q

What do crescent in rapidly progressive glomerulonephritis consist of?

A

Glomerular parietal cells, monocytes, macrophages, and fibrin

127
Q

What is mnemonic for net filtration equation?

A

CICI

-Net filtration pressure= Hydrostatic( Capillary-intersititum) - oncotic (Capillary- interstititum)

128
Q

Before birth what are ovaries in?

A

Oogonium under mitosis -> primary oocyte

129
Q

Childhood to puberty the oocyte is arrested in?

A

Meiosis I arrested in prophase

130
Q

From puberty to menopause what stage are the oocytes in?

A

Primary oocyte-> meiosis I completed -> ovulation occurs meiosis II arrested in metaphase (stage where it is fertilized)

131
Q

What happens when certain mRNA sequences associate with cytoplasmic P bodies?

A

Fundamental role in translation repression and mRNA decay and contain numerous proteins including RNA exonucleases, mRNA decapping enzymes, and constituents involved in mRNA quality control and microRNA-induced mRNA splicing

132
Q

How can subserosal leiomyomas (fibriods) present as?

A
  • Irregular uterine enlargement -> pelvic pressure
  • If they arise from the posterior subserosal surface of the uterus-> constipation
  • Anterior- displace uterus upward -> obstructive urinary symptoms
133
Q

Maple Syrup Disease

A
  • irritability, dystonia, poor feeding, and a maple syrup scent to the patient’s urine within the first few days of life
  • BRANCHED CHAIN AA- LEUCINE, ISOLEUCINE, VALINE (restriction)
134
Q

Aspiration of the lung supine vs upright

A

Supine(laying down)- posterior segments of upper lobes and superior segments of lower lobes

Upright- basiliar segments

135
Q

How can you get Enterococci infective endocarditis?

A

-After GU procedures (cystoscopy)

Can grow in bile and 6.5% NaCl

136
Q

What arises from the 3rd pharyngeal pouch?

A

Thymus and inferior parathyroid gland

137
Q

What arises from the 4th pharyngeal pouch?

A

Superior parathyroid glands, ultimobranchial body

138
Q

Posterior urethral injury is caused by?

A

Pelvic fracture

139
Q

What are the 2 most significant risk factors for the development of esophageal squamous cell carcinoma in the united states?

A

-Smoking tobacco and drinking alcohol

140
Q

Important risk factors for esophageal squamous cell carcinoma in asian countries?

A

-Betel nut chewing and consumption of foods containing N-nitroso compounds

141
Q

Recurrent laryngeal nerve vs Superior laryngeal nerve?

A
  • Recurrent laryngeal nerve is in close proximity to the inferior thyroid artery and can be injured during thyroid surgery
  • Superior laryngeal nerve- in close proximity to the superior thyroid artery
142
Q

Free ribosomes vs attached ribosomes

A

Free- translating proteins found within the cytosol, nucleosol, peroxisome matrix and nuclear encoded mitochondrial proteins
Attached- synthesize most secretory proteins, integral membrane proteins of the nucleus and cell membrane, and proteins within the ER, golgi network, and lysosomes`

143
Q

What is beck’s triad?

A

Muffled heart tones, hypotension, and JVD

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