STEP 1 Week 6 Flashcards
Contents of the anterior compartment of the leg
Deep peroneal nerve, anterior tibial a and v
SX of hereditary. hemorrhagic telangectasia
Telangectasias, recurrent epistaxis, visceral organ AVMs (GI bleeding, lung shunts, liver)
Autosomal dominant impairment of TGF-B
Impact of AchE inhibitors on Alzheimers
Improve symptoms but are not neuroprotective so no change in disease course
Impact of proteasome blocking
Leads to aggregation of ubiquinated misfolded proteins that leads to cell apoptosis - good for multiple myeloma
What is a longterm complication of hookworm infection
Microcytic anemia - from blood loss
How to find attributable risk
(risk in exposed - risk in unexposed)/(Risk in exposed)
What causes visual changes and headaches with preeclampsia
Widespread endothelial dysfunction leads to vasospasm
What is a subgaleal hemorrhage
Bleeding between the periosteum and galea apaneurosis due to breaking of emissery veins
What is CD56
Neural cell adhesion molecule - would stain for neural cell tumors
MOA of imiquimod
Antiviral and antiproliferative
Activates toll-like receptor 7 and upregulates NF-kB which helps to trigger immune response
How to diagnose botulism
CLinical and also presence of toxin or spores in stool
Chronic lymphadema predisposes for what
Angiosarcoma - inflitration of dermis with slit-like vascular infiltratin, see violascous nodules
How can placental abruption cause DIC
Abruption causes decisdual damage and ischemia. which triggers tissue factor release - tissue factor
What is the MOA of triptans
Stimulate trigeminovascular serotonin receptors
5-hydroxytriptamine 1B/1D agonists that bind to serotonin receptors and prevent the release of CGRP
Supplementation with what would help DNA synthesis in a folate deficiency
Thymidine
What artery runs with the radial nerve in the upper humerus
Deep brachial artery
What do mushroom toxins inhibit
RNA polymerase II - mRNA synthesis
What is cerebral amyloid angiopathy
B-amyloid deposits in small to medium size cerebral arteries that causes recurrent hemorrhages, often in occipital and parietal regions
What muscle controls the TMJ
Lateral pterygoid muscle
Why does expiratory flow rate increase in interstitial lung diseases
The fibrosis pulls open the airways (radial traction) that leads to a reduction in airflow resistance out of the lung
What are councilman bodies
Seen in Hepatitis and yellow fever - caused by apoptotic cells
How does JAK2 work
It is an cytoplasmic non-receptor tyrosine kinase - phosphorylates the erythropoetin receptor that then triggers STAT to go to nucleus
What is myositis ossificans
A benign formation of extraskeletal bone in muscle
Caused by severe trauma - painful firm, mobile mass
Looks like outer layer of bone and inner layer of fibroblasts
What is procalcitonin
It is a precursor to calcitonin and serves as a acute phase reactant
Rises when there is a bacterial infection, falls when there is a viral infection
What can nitrate OD cause
Methemaglobinemia
How does an increase in triglycerides lead to pancreatitis
Triglycerides usually are bound to albumin but when they are high they exceed the capacity and cause direct damage to pancreatic acinar cells
What would a bronchus obstruction look like on X-ray
The obstruction leads to atelectasis which causes the trachea to shift to the affected side
Loss of radioluscent air and shift of organs causes opacities
What happens to myocytes with age
Decreased number, so the remaining myocytes hypertrophy to maintain EF (concentric hypertrophy)
What is a glomus tumor
Tumor of glomus cells - vascualr formation that helps to regulate skin temperature
Bluish and under the nail
What is latanoprost
Prostoglandin analog used in glaucoma to increase the outflow of aqueous humor
Why do calcium channel blockers not affect skeletal muscle
They are not dependent on extracellular calcium for contraction
Best indicators for liver disease prognosis
Albumin levels, PT (coag factors made in liver)
What is the weakest point of the male urethra
Membranous
What is sick sinus syndrome
COmes from age related degeneration of the SA node
Will get bradychardia with a dropped p waves and escape beats where the AV node fires alone - narrow QRS with no P
Age related renal changes
Reduced number of glomeruli - lower GFR and creatine clearance
Reduced renal blood flow
Reduced response to hormones
How does a pancreatic pseudocyst form
Acute pancreatitis can cause leaking of pancreatic enzymes outside of the pancreas. This causes inflammation of other oragans and leads to granulation tissue formation around the fluid - fibrotic wall
MOA of epinephrine for anaphylaxis
Binds B2 receptors on mast cells and stops degrnulation
Binds a1, B1, and B2 receptors - less vasodilation and vascular permeability, increased cardiac output, bronchodilation
What happens to FRC in lung collapse (atelectasis, no surfactant)
Lower FRC - the lung collapses so residual volume falls
At what rib level does the right lung stop
8th rib - 2 above where the pleura stops
What structures are in the poorly perfused peripheral compartment
Skeletal muscle
Bone
Fat
Other cancer risk with hereditary retinoblastoma
Sarcomas - like osteosarcoma
What kind of hemolysis does lupus cause
Extravascular - IgG autoantibodies against RBCs form that are then targeted by macrophages in the spleen
How does total resistance change going down the airways
Small increase and then steady decrease
How to treat drug induce parkinsonism
Benztropine - anticholinergic
Actions of deep fibular vs common fibular nerve
Common - sensory over dorsum of foot, foot eversion and dorsifelxion. Injury at neck of fubula
Deep - foor dorsiflexion and sensory between big toe. Anterior compartment syndrome
What causes neuromuscular weakness in critical disease
Atrophy of myofibers
Axonal degeneration due to inflammation
What can cause hypothyroidism with high TSH in infants
If the mother was taking an antithyroid medicine like PTU
What is. used in a STEMI to break up a clot
Fibrinolytics - tPa and analogs (altaplase, tenecteplase)
Most common complication after subarachnoid hemorrhage
vasospasm from vasoconstricter release from damaged erythrocytes that causes ischemia
Medications that cause long QT
How do opiates work
Block calcium influx on primary nerves and cause potassium eflex from secondary nerves
What does a leukomoid reaction look like on smear
Basophilic oval inclusions in mature neutrophils
What are the signs of hemolytic anemia
Spherocytes (IgG binds to RBC and some cytoplasm is taken off in spleen)
Reticulocytes (big, bluish) and nucleated RBC - shows response by BM
