STEP 1 Week 5 Flashcards
Innervation above and below the dentate line
Above: Inferior hypogastric plexus
Below: Inferior rectal nerve, branch of pudendal nerve
Leuprolide effect on GnRH
It is a GnRH agonsit but also exhibits inhibition of endogenous GnRH release
So eventual drop in GnRH, LH, and FSH
What kind of receptors on macrophages leads to inflammatory resposne
Activation of toll-like receptors by PAMPS
Leads to increased NF-kB
What is the most hemodynamically neutral anesthetic
Etomadiate - no effect on heart rate, BP, CO
Can decrease cortisol so not used in shock
Rifaximin MOA
It is a GI abx that reduces bacterial production of ammonia - good for hepatic encephalopathy
Drug tx for bulimia
Fluoxetine - SSRI
What CN is most impacted in uncal herniation
CN III - will have a blown pupil
What is Hawthorne effect vs Pygmalian effect
Hawthorne - observation. bias, change in behavior when you know youre. being watched
Pygmalian - researchers act differently based on beliefs in efficacy of treatment that can impact outcome
Where do squamous cell carcinomas spread first
Regional lymph nodes
Complications associated with sjogrens
Non-hodgkins lymphoma (B cell mediated so can become neoplastic)
Corneal damage, dental carries
Production of what 3 things required tetrahydrobiopterin (BH4)
Tyrosine, serotonin, DOPA
What can be seen on micro weeks to months after axonal damage
Persistent myelin debris with eventual glial scar (triggered by astrocytes)
What does ingestion of carbon tetrachloride cause (CCl4)
Produces free radicals (CCl3) that causes lipid peroxidation and hepatic injury
What happens in the right heart during a pulmonary embolism
Increase in size of the RV cavity and flow obstruction
What kind of reaction is serum sickness
Type III hypersensitivity - complexes and complement activation
Metabolic changes in methymalaonic coa mutase deficiency
AGMA, hypoglycemia, ketosis, hyperammonemia
Equation for a confidence interval of 95%
CI = mean +/- 1.96 x (SD/sqrt of n)
How to differentiate alcohol-related pancreatitis
Usually will have macrocytosis because of vitmain deficiency
Which hypertensive drugs can cause edema
Calcium channel blockers - preferentially dilate arteries which increases capillary pressure
Component of Hib capsule that makes it so virulent
polyribosylribitol phosphate (PRP)
Binds factor H which allows for avoidance of complement opsonization
What causes paraneoplastic cerebellar degeneration
Immune response against tumor cells that cross react with Purkinje neuron antigens - dizziness, disarhria, visual disturbance
Anti-yo, anti-hu, anti-p/q
What cells mediate formation of lung abscesses
Neutrophils - released granules cause liquefactive necrosis
How is insulin excreted
Both in the liver and kidney
In CKD diabetic patients, exogenous insulin can rise without excretion and cause hypoglycemia
Why is epinephrine administered with lidocaine
Epinephrine leads to vasoconstrichtion which:
- Reduces bleeding
- Increases duration of action (more remains at site of action)
- Less chance of side effects bc lower systemic absorption
Affinity of myoglobin for oxygen
Much higher than oxygen
Beta subunits of hemoglobin are similar in structure to myoglobin
Cherry vs strawberry hemangioma
Cherry - adult, benign tumor of blood vessels, dont regress
Strawberry - baby, can be deep, usually regress
What is the breakdown of the fluid compartments
What is capitation
The payment plan of HMOs
Doctors are payed a flat fee per patient from a providing organization
Effects of removing CD3+ cells from bone marrow transplant graft
Helps reduce the chance of graft-verus host but also dont get the benefit of donor T cells attacking any leukemia or current infections
What does the pressure volume look like for exercise
Preload increases and contractiltiy increases
APC and KRAS activating/inactivsting mutations
APC - inactivating, it is a tumor suppresor gene
KRAS - activating, it is a protooncogene
What vessels are likely to be ruptured in a penetrating ulcer to the lesser curvature of the stomach
Left and right gastric
Examples of bisphosphonates and MOA
alendronate and risedronate
Attach to hydroxyappetite on the bone and when they are taken up by osteoclasts they induce apoptosis
How does hypocalcemia cause constipation
Causes impaired smooth muscle contraction and gastric motility by inhibiting nerve polarization - interferes with movement of sodium
What occurs during the proliferation phase of wound healing
Occurs 5 days-3 weeks
Fibroblasts migrate and proliferate, excrete ground substance and Type III collagen
Also secrete FGF and VEGF which leads to new vessek formation
TX for restless leg syndrome
Iron replacement and dopamine agonists - pramipexole and ropinirole
Where to perform a femoral nerve block
Right below the inguinal ligament, lateral to the femoral artery
Sx of allergic bronchopulmonary aspergillosis
High IgE and eosinophils
Asthma of CF, mucus plugs that can cause bronchiectasis
What diuretic can cause ototoxicity
Loop diuretics
There is a Na/K/2Cl symporter in the ear
Best drugs to stop alcohol cravings and MOA
Naltrexone - blocks mu opioid receptors and pleasure reward centers
Acamprosate - modulates glutamate in the NMDA receptors
Drugs with the most benefit for heart failure
Beta blockers and hormone regulators (ACEi, ARBs, Aldosterone bockers)
Impact of PEEP on FRC
Increases
What is the only DNA molecule with 5’ to 3’ exonuclease capability
DNA polymerase I
All of them can do proofreaading and exonuclease 3’ to 5’
What two conditions can give you a small anion gap
Multiple myeloma and hypoalbuminemia
Effect on diffusing capacity of carbon dioxide in emphysema and AAT deficiency
Decreases
Due to destruction of alveoli and cappilary beds
What blocks beta oxidation of fatty acids
Malonyl-coA
Inhibits carnitine acyltransferase so that newly synthesized FA arent immediately broken down
What kind of proteins are made in the RER
RER is especially developed in organs with lots of excretion
The RER makes proteins for extracellular excretion or for insertion into the membrane, along with proteins for the RER, GB, lysosome system
Where does calcium bind on thin filaments
On troponin
Then causes a conformation change to shift tropomyosin
What would be punctured at the left midclavicular line 5th intercostal
Left lung
Apex of the heart is at this point but deep to the lung
All other heart chambers lie medial to the MCL
What makes up the wall of a false diverticulum
Mucosa and submucosa
Dupuyetron contracture
Fibroblasitic proliferation and thickening of palmar fascia
What causes pus and sputum to be green
Myeloperoxidase - it i a blue-green heme based pigment
It helps neutrophils to form hydrochoorous acid for oxidative burst killing
What causes most infections in neutropenic patients (like due to chemo)
Patient’s own endogenous bacterial flora
Chemo damages the barrier in the gut that usually keeps bacteria in the gut, so they can travel to the blood
What would work well against a g(-) rod with B lactamase activity
Extended spectrum penicillin (like piperacillin) with a tazobactam/clavulanic acid
Drugs to avoid in elderly
What vessels should be ligated during uteral bleeding after birth
Internal iliac - where the uterine arteries. branch from
What causes ptosis
CN III paulsy - controls the levator palpebrae
What microscopically indicates axonal damage due to shearing of the white matter tracts
Widespread axonal swelling, accumulation of axonal transported proteins - amyloid precursor and alpha synucelin
What causes thrombocytopenia in HIT
When heparin-platelet-IgG complexes (from reaction with PF4) circulate they are removed by the liver causing a decrease in platelet number
They can also form clots that then cause even more platelets to be used
How can squatting reduce the murmur of mitral regurg
Squatting increases venour return, which increases the stretch on the LV, which helps to pull the valve more taught
Why is clear cell renal carcinoma clear
The cells have a high concentration of glycogen and lipid - removed on staining
What electrolyte imbalance does pancreatitis cause
Hypocalcemia and hypomagnesemia - necrotic fat oulls them out of the serum
What would be the first step in diagnosing malabsorption (what test specifically)
Looking for fat in the stool - sudan III stain
How can hypothyroidism cause prolactin release
Lactotrophs have TRH receptors so an increase in TRH can lead to an increase in prolactin
Path of CN V2
Passes through the foramen rotundum thenthe pterygopalantine fossa then exits the skull through the infraorbital foramen
Damage to what part of the brain causes locked in syndrome
Bilateral ventral pons
What causes ganglion cysts
Mucoid degeneration of periarticular tissue leading to outpouching of tissue that serves as one way valve for mucinous fluid
How does prone position help in ARDS
Normally, the posterior parts of the lung are weighed down by the heart and abdominal organs pushing against the diaphragm
Prone position takes this pressure away allow for a more even ventialtion-perfusion match as collpased posterior basal alveoli open up
Eye side effects of PDE5 inhibitors
They can impact the PDE6 in the retina which can cause blue vision and nonarteritic anterior ischemic optic neuropathy - monocular vision loss with populary defect and optic disc edema
What antitussive can cause serotonin syndrome
Dextromethorphan
MOA of dextromethorphan
Inhibition of medullary cough center through sigma receptor activation
Inhivition of what enzyme can help reduce risk of colon cancer
COX-2 - NSAIDS
COX may play a role in prostogulandin production which aids in epithelial proliferation
What causes basophilic stippling
Lead poisoning
Cortisol and ADH relationship
Cortisol usually inhibits ADH
How does a carotid massage slow heart rate
Increases parasympathetic tone - prolonged AV/SA node refractory period
Flow of aqueous humor through the eye
Produced by the epithelial cells of the ciliary body and then flow through the pupil into the anterior eye chamber
Drained by the trabelcular network into the canal of schlemm and into conjunctival veins
MOA of timolol
Nonselective B blocker that lowers production of aqueous humor by the ciliary body
What finger movements does the median nerve control
Thumb abduction, thumb opposition, thumb flexion
Thumb adduction is ulnar
What are the contents of the portal triad
Hepatic artery, portal vein, common bile duct
If bleeding continue from liver after clamping, likely hepatic vein or IVC
What layers do you go through in a cricothyrotomy
- Skin
- Superficial cervical fascia (fat, part of platysma)
- Deep cervical fascia
- Crycothyroid membrane
Sx of chediak higashi
- Immunodeficiency from neutrophil phagosome-lysosome fusion dysfunction. Granules cant be released so see them in neutrophils
- Albinism
- Eye problems
How does ACTH/cortisol impact production of catecholamines
Cortisol activates phenyethaolamine-N-methyltransferase (PNMT) which converts norepinephrine into epinephrine
Pituitary damage/low cortisol would reduce activity of PNMT and reduce epinephrine
What drives LV remodeling after an MI
Angiotensin II
Acei can help stop remodeling and maintain a normal LV shape
What would mycobacterium avium complex look like on histo
Would look at bone marrow - Foamy macrophages, acid fast bacilli, possibly granulomas
What causes the vasovagal response (like after a vaccine)
Cardioinhibition and vasodepressor response that causes bradychardia and hypotension
Where is the damage in wernicke korsakov
Anterior and dorsomedial thalamic nuclei, mammilary bodies
Sequelae of etherothrombotic disease
Would see cholsterol clefts
Most common childhood brain tumor and location
Pilocytic astrocytoma - cerebellum
What coenzymes are necessary for alphaketoglutarate/pyruvate/branched chain dehydrogenase
B1,B2,B3, B5, lipoate
Location of lesion for decerebrate vs decordiate posturing
Decorticate (flexor) - above red nucleus (hemisphere, internal capsule)
Decerebrate (extensor) - below red nucleus (pons)
How does the Huntington mutation cause disease
Gain of function mutation that causes acetylation of histones that turn off genes necessary for cell survival
What is the only molecule with a gradient that draws it out of the cell
POtassium
Function of ristocetin
Activates Gp 1b to induce vWF to bind to the endothelial surface and cause aggregation of platelets
Where is inflammation localized in guillan barre
In the endoneurium - macrophages digest myelin
Damage to what part of the brain could cause hemiballism (uncontrolled movement)
Subthalamic nuclei
What would levels of CO2 and O2 be in PE/poor V/Q match
There would be low CO2 from hyperventilation but O2 wouldnt be high because hemoglobin in the perfused area can only absorb so much O2- cant comoensate for unperfused part
So low CO2 and low O2
How are lysosomal storage deficiencies treated
You can replace the deficient enzyme
Have to use IV because the enzymes are large polyproteins - enter the cell by endocytosis
Morphine and renal failure
Morphine is metabolized into two active metabolites that are renally excreted
In renal failure, these metabolites can cause OD
Odds ratio formula
OR = (a/c)/(B/d)
MAB that targets CD20+ cells
Rituximab
What could cause a pure red cell anemia
Autoimmune destruction of red cell rpecursors - thymoma or parvovirus
Best diagnostic tool for toxic megacolon (bloody diarrhea, abdominal pain, shock, fever)
Plain abdominal X-ray
What to give post MI in the case of bradycardia
Atropine - anticholinergic effects
Where to biopsy for celiac
Duodenum and PROXIMAL jejunum
What is persistent depressive disorder (dysthymia)
depressed mood for 2 years with >2 sx
What happens to the vena cava in cardiac tamponade
Becomes engorged because of restricted diastolic filling
Complement vs phagocyte?
D - complement
E - phagocyte
What cells are targeted by azithioprine
It is not specific - B and T cells, so drop in IL-2 and Ig
How to diferenciate bw demyelinating and axonal nerve damage
Demyelinating - delayed conduction
Axonal damage - lower amplitude of impulse
What is abiraterone
It is a 17-alpha-hydroxylase inhibitor used for refractory prostate cancer - stops the production of androgens in the adrenals
What are angiosarcoma and expsure risks
A vascular tumor that is highly aggresses - expresses CD31 (PECAM 1)
Risks: PVC, arsenic, thorotrast (contrast medium)
What are causes of dilated cardiomyopathy
Infection (chagas, viral), chemical (alcohol), familial (mutation in titin gene)
Most common lung cancer cause of SIADH
Small cell lung cancer
What is rasburicase
It is an analog of an enzyme called urate oxidase that turns uric acid into allantoin, a more soluble metabolits
Good for tumor lysis syndrome
IMpact of an arteriovenous fistula on SVR, SV, etc
Decreased SVR - less pressure
Increased venous return - higher preload
Higher SV
Where is preload on a AV curve
It is the volume during isovolumic contraction
What causes bleeding in diverticulosis
Disruption to the vasa recta - diverticuli often occur where the vasa recta penetrate the smooth msucle and then the vessels can become damaged
What kind of virus has infectious RNA - the RNA itself can cause infection
+SS RNA - must be able to use the host machinery without any other proteins being produced
EX: rhinovirus
What would be present within an unstable plaque
Many macrophages that release metaloproteases that degrade the collagen of the cap and lead to possible rupture
What is pralidoxime
Reactivates cholinesterase - would be used after atropine in an organophosphate poisoning to reverse neuromuscular sx (atropine doesnt work in muscle)
Innervation of pelvic floor muscle and external anal/urethral sphincters
Pudendal nerve
Can lose anal wink reflex bcause skin from S2-S4 is no longer innervates
What causes a change in skin color in chronic venous insufficiency
Statis dermatitis - deposits of hemosiderin after RBC. have gone into the extracellular space
How to tell if a frameshift mutation has occured
The number of bases that has changed will not be divisible by 3
What is Kallman syndrome
Presents as delayed puberty due to a failure of GnRH secreting neurons to migrate to the hypiothalamus from the olfactory placode - also presents as anosmia
When is prinzmetal angina worse
At night - when vagal tone is highest
How to treat ingestion of rat poison
Rat poison contains “super warfarin” so would give FFP
What is it called when there is only one safe medical option
Directive counseling
What is stained by PAS
Polysaccharides (fungal), mucosubstances, glycoprotein (whipples)
What happens to pulm artery systolic pressure in left MI
Increases due to increased PCWP and LA pressure
What causes achalasia
Reduced number of inhibitory neurons in the esophagus so there is an imbalance favoring contraction - decreased peristalsis in upper esophagus and increased contraction in lower
Blood supply of papillary muscles
Anterolateral pappilary - LAD and left circumflex
Posteromedial - Posterior descending (just one supply so more easily ruptured)
What allows influenza A to enter a cell
The surface glycoprotein - hemagglutinin
What is the diagnostic tests for TTP
Peripheral blood smear that shows thrombocytopenia and hemolysis
Some have fever, neurologic sx, kidney disease
What causes weak bones in osteogenesis imperfecta
Deficient type 1 collagen leads to less osteoid production by osteoblasts
What causes spinal stenosis and sx
Usually caused by degenerative arthritis where the intervertebral disk starts to bulge into the spnal canal, leads to a change in pressure and thickening of ligamentum flavum
Neurogenic claudication - parasthesias, pain walking, weakness, worse with extension
First line TX for OCD
SSRIs
How do glucorticoids lead to weaker bones
- Inhibit osteoblasts
- Block osteoprotegrin and increase expression of RANK/RANK-L
- Block intestinal absorption of Ca
How can large stable plaques allow for no symptoms
They are slow growing and the gradual shift to ischemia allows for time for collateral vessels to form
What causes petechial rash and CNS sx in fat embolism
Small arteriovenous shunts allow for fat to flow into the CNS and skin
Salivary changes in elderly
Acinar atrophy with fatty infiltration - reduced saliva production
What eye problem can occur in neonatal CMV
Chorioretinitis
What causes a zenker diverticulum
Cricopharyngeal motor. dysfunction - abnormal spasm or diminished relaxation that leads to increased pressure and creation of a false diverticulum
Clonidine MOA
Alpha 2 agonist in the rostral ventrolateral medulla that leads to decreased presynaptic release of norepinephrine - slower HR and vasodilation
Histo of medullary thyroid carcinoma
Polygonal cells in an amyloid stroma - stains with congo red
Glioblastoma multiforme histo
Increased vascularity with pseudopalisading tumor cells around areas of necrosis
Signs of a pure motor stroke
Clasp-knife rigidity, hyperreflexia, positive babinski
Would be in the internal capsule
MOA of sirolimus
Binds to FKBP which inhibits the mTOR cellular pathway to stop the transcription cascade started by IL-2
What causes billirubin stones
Occurs when a large amount of unconjugated billirubin is released into the billiary system
Usually secondary to an infection - damaged hepatocytes release beta glucaronidase that hydrolizes billirubin and leads to an accumulation of unconjugated billirubin
What neurotransmitters are used in each type of SNS and PNS tracts
Notable : SNS uses Ach in adrenals and eccrine sweat glands
Where are T cells and B cells located in the lymph node
T - paracrotex
B - germinal centers and medullary cords
What is given in a heparin OD
Protamine sulfate - binds to heparin and forms a complex with no anticoagulant effect
What defines a mild cognitive impairment
Abnormal cognitive assesment (<26/30) but still functioning independently
Effects. of androgen deprivation in men
Aneurysmal compression of CN III vs diabetic opthalmoplegia
In compression, there is primarily mydriasis - SNS fibers are on periphery, and then can become down and out
In diabetic ischemia, the core of the nerve is impacted first, where the motor fibers are. This causes down and out first with preservation of pupillary reflexes
What can cause hypocalcemia after a transfussion
There is citrate in the blood to stop coagulation but it can bind to calcium and chelate causing hypocalcemia
What occurs in germinal centers
B cells undergo isotype switching or remain as memory cells, also undergo affinity maturation (hypermutation for best Ig fit)
What levels would be low in SLE
Low C3 and C4 because circulating immune complexes would cause complement activation
What disease has anti-mitochondrial antibodies
PBC
What is. the acid-base disturbane in pregnancy
There is chronic hyperventilation - progesterone triggers a feeling of being short of breathe and there is horme related laxity of. the chest wall leading to a higher TV
This leads to a respiratory alkalosis with a renal compensation of increased bicarb excretion
Neck finding in Turner syndrome
Cystic hygroma - posterior neck mass composed of cystic. spaces and connective tissue
Due to lympphedema
Is eisenmenger syndrome reversible?
No - pulmonary artery remodelling to become thicker is irreversible
What muscles are innervated by the accessory nerve CN XI
Trapezius and sternocleidomastoid
Can be damaged in lymph node surgery
What would be seen in brain injury caused by seizures
Reactive gliosis - proliferation of astrocytes
What hemolytic disease is diagnosed by testing for increased osmotic fragility
Hereditary spherocytosis - mutation in ankyrin and spectrin leads to increased fragiloity (hemoglobin will leak out in a hypoosmptic solution)
What are the sx of an anterior humerus dislocation
Flattening of the deltoid muscle, protrusion of the acromium, anterior axillary fullness
Decreased sensation of the upper arm - axillary nerve is compressed
What would hashimotos look like on histo
Lymphoplasmacytic inflitrate with formation of germinal centers
Hurthle cells - granular and eiosinophilic cytoplasm
What type of amyloid is deposited in dialysis patients
B2 - microglobulin - Component of MHC I that is usually filtered out of kidney
Characteristics of Hyper IgE syndrome
Deficiency in Th17 cells due to STAT3 mutation - impaired neutrophil migration
ABCDEF
Abscesses, Baby teeth, Coarse facies, Derm problems (eczema), IgE, Fractures from minor trauma
What is the goal of randomization
To make the underlying characteristics between groups the same - not necessarily to be the same size
What causes hypocalciuric hypercalcemia
Calcium sensing receptors (CaSRs) in the parasthyroid (G-protein membrane) are not evry sensitive and require a higher level of calcium to release PTH
Bones of the Hand
Some Lovers try positions that they cant hzndle
How does resistance to isoniazid occur
Decreased expression of mycobacterial catalase peroxidase - needed to activate INH
Which speech area causes word salad
Wernicke’s area - Wernicke word salad
What kind of necrosis happens in the brain and what does it look like
Liquefactive - Hydrolytic enzyme induced tissue digestion. CSF filled spaces after digestion
Signs and tx of arsenic poisoning
Basically affects all organs - long qt, vomiting, garlic breath
TX: Dimercaprol (chelates and pee out in urine)
MOA of Beta blockers for graves
Blocks the upregulated beta receptors and also stops conversion of T4 to T3
What is transferance
Unconscious shifting of desires or emotions from a person in the past to a person in the present
What is the HIV window period
When there is high levels of viral RNA but there has not been an immune response yet - no Ig
What anticonvulsant to give IV in status epilepticus and MOA
Phenytoin - Na channel blocker
What can be given for variceal hemorrhage
Somatostain/ocreotide or vasopression - contrict portal vessels by stopping release of hormones that usually cause dilation
What causes mitral dysfunction in marfans
WIthout fibrillin-1, TGF-beta can work unopposed and causes increased metalloproteases that reduce tissue integrity - fragmentation of elastin and collagen leading to myxomatous mitral degeneration
What causes anemia in chronic kidney disease
Decrease in EPO
What would cause portal hyopertension sx (big spleen, varices) with no liver involvement
Portal vein thrombosis
How is PKU inherited
Autosomal recessive
What are the molecules needed for osteoclast differentiation
M-CSF and RANK-L
What cofactor is needed for the conversion of phenylalanine to tyrosine
Dihydrobiopterin reductase (recycles BH4)
What is the psoas sign
Pain/resistance of leg extension - causes stretching of the muscle
What can lead to death in rheumatic fever
Severe regurgitation or myocarditis/pancarditis
Cytokines that cause systemic inflammation in sepsis
TNF-a, IL-1, IL-6
What causes minieres disease and sx
Vertigo, nausea, sensorineural hearing loss
Caused by increased pressure of endolymph in the inner ear
What happens if VEGF is unchecked in wound healing
Hypergranulation with lots of vasculation
What is the most serious side effect of thyroid blocking drugs
Agranulocytosis - can present as a severe infection
What muscle is pierced by the superficial inguinal ring
External oblique
Cremaster muscle originates from internal oblique
Most common illnesses seen in Hib
Systemic - meningitis, bacteremia, pneumonia, epiglotitis
Why does GFR increase early in diabetes
Higher glucose in urine leads to more reabsorption of Na in the PT (SGLT) which leads to less in the DCT - activates JG cells and RAAS system
What causes myopia
Nearsightedness
increased posterior-anterior diameter of the eye - image is focused anterior to the retina
What causes hypercalcemia in sarcoidosis
Activated macrophages in the lung that produce 1-alpha hydroxylase which makes more activated vitamin D - hugher intestinal absorption, some bone turnover
Initial tests for diabetes
Fasting plasma glucose > 126
HBA1C > 6.5%
Random nonfasting glucose > 200
Urinalysis may show glucose but it is not specific
Where are serotonergic neruons primarily found
Raphe nucleus of the brainstem - cell bodies throughout CNS
What bleeding disorder is seen in renal dysfunction
Uremic platelet dysfunction
Uremic toxins that arent filtered out of the kidney circulate and cause platelet dysfunction - prolonged bleeding time but normal PT, PTT, platelet count
MOA of entanercept
It is a biologic made uo of an Fc portion and a fake TNF-a receptor
Serves as a soluble receptor decoy protein as TNF-a binds to it instead of its real receptor
meaning of -mab, -cept, -nib
- mab = monoclonal antibody
- cept = receptor molecule
- nib = kinase inhibitor
How do mabs lead to tumor destruction
Antibody dependent cellular cytotoxicity
The mabs/IgG bind to the host or foreign cell. NK cells bind to the Fc portion (with CD16) and then release granzymes that kill the cell
What measure of comparison is used for case-controls
Odds ratio
Innervation of the auditory canal
Posterior - vagus
Rest - CN V3
Acid disturbance seen in chronic kidney disease
Metabolic acidosis (accumulation of uric acid) with respiratory compensation
What is associated with itching, fatigue, and ulcerative cholitis?
Primary Sclerosing Cholangitis
Cardinal sign of irreversible cellular injury
Membrane damage - plasma membrane, mitochondria (vacuoles and leaking of cyt c), lysosomes
Associations with ADPKD
Berry aneurysms, liver cysts, mitral valve prolapse
Hypertension, hematuria
Where is the bladder most likely to be damaged
Dome - less supported and extends into peritoneal cavaity - would get urine in peritoneum
Hormone changes after ball removal
testosterone levels out but still low sperm count because cant compensate
What is late stage radiation dermatitis
Fibrosis and homogenization of collagen (TGF-B), vascular damage, dilated microvasculature (telangectasia)
How can beta blockers impact hypoglycemia
Beta blockers can remove the signals of hypoglycemia so individuals dont realize - blocks NE/Epi which are the drivers of tachicardia and anxiety in low glucose
Epinephrine also stimulates peripheral glycogenolysis and hepatic gluconeogeneiss so none with B blockers
What is celecoxib
A selective COX-2 inhibitor that is good for inflammation without impacting GI
What breast cancer marker is indicative of aggressive cancer
HER2
Other than histamine what is released from mast cells in anaphylaxis
Tryptans
How does binding of IgE lead to degranulation
Binding of IgE to a multivalent antigen leads to a shifting of IgE receptors so that they come into closer proximity and all bind the antigen
Triggers a non-receptor tyrosine kinase that triggers degranulation
Pre-eclampsia is caused by …
Abnormal cytotrophoblast invasion that leads to low perfusion and low proangiogenic chemicals so dont get vessel remodeling by VEGF - high resistance vessels
