Sweep 1 Flashcards

1
Q

Marfan Syndrome- ——– disorder of connective tissue due mutation of the ——- gene, resulting in abnormal —–,

A

Autosomal dominant, FBN1, fibrillin

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2
Q

Fibrillin:

A

a glycoprotein necessary for normal elastic fiber production.

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3
Q

• Familial Hypercholesterolemia- Mutation in the gene for the ——. results in ——————–.

A

LDL (low density lipoprotein) receptor, impaired metabolism and increased LDL cholesterol in the plasma

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4
Q

• Phenylketonuria- ————- disorder that affects 1 in 10,000 Caucasian infants. Severe lack of ———–, leading to ————–.

A

Autosomal recessive
phenylalanine hydroxylase
hyperphenylalaninemia and PKU

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5
Q

Phenylketonuria; Affected infants are normal at birth, but elevated phenylalanine levels

A

impair brain development, and mental retardation is evident by 6 months of age.

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6
Q

• Lysosomal Storage Diseases- ————- transmission. Commonly affect —————. Accumulation of ———–

A

Autosomal recessive
infants and young children

insoluble large molecules (sphingolipids and mucopolysaccharides) in macrophages with hepatosplenomegaly

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7
Q

Lysosomal storage diseases: Frequent

A

CNS involvement, mental retardation and/or early death

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8
Q

Mucopolysaccharidoses- Affected patients often have

A

coarse facial features, clouding of cornea, joint stiffness and mental retardation

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9
Q

• Hurler Disease (MPS type I)- AR, caused by deficiency of

A

alpha-L-iduronidase (laronidase).

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10
Q

Hurler disease: Life expectancy of

A

6-10 years untreated. Cost of the enzyme→$300k annually

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11
Q

• Hunter Syndrome-

A

X-linked, deficiency of L-iduronate sulfatase.

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12
Q

Hunter syndrome: Absence of

A

corneal clouding and milder clinical course, but otherwise similar to Hurler syndrome

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13
Q

Injury by therapeutic agents- Adverse drug reactions (ADR’s) are common affecting an estimated

A

7-8% of hospitalized persons and about 10% of these are fatal.

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14
Q

o Aspirin (Acetylsalicylic acid or ASA) – overdose may be accidental (young kids) or intentional (adolescents/adults). Ingestion of as little as ———- (kids) or ———– (adults) may be fatal.

A

2-4 gms, 10-30 gms

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15
Q

Aspirin OD: The major acute injury is a

A

metabolic one – first there is respiratory alkalosis followed by metabolic acidosis. It may progress to seizures and coma.

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16
Q

o Acetaminophen (Tylenol®) – overdose occurs after large ingestion ——-. Toxicity is by damage to the ——–.

A

(15-20 g)

liver which occurs over several hours to days

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17
Q

Tylenol OD: Early symptoms are

A

non-specific – nausea, vomiting, diarrhea, but will be followed by jaundice and shock as the liver failure progresses. There may also be heart and kidney damage as well.

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18
Q

Lead-. Patients develop a

A

microcytic hypochromic anemia.

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19
Q

Lead: Treatment is generally by

A

chelation therapy (starting at 45 ug/dL) and supportive measures

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20
Q

o Hyperthermia• Heat exhaustion- most common, failure of the

A

CV system to adjust to hypovolemia

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21
Q

o Hyperthermia: Heat stroke- abnormal elevation of body temp

A

> 40*;

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22
Q

Heat stroke: Peripheral vasodilatation causes “

A

pooling” and decreased circulating blood volume. Tissues become ischemic, necrosis of the muscles and heart may lead to DIC.

23
Q

Organ system changes- Hematopoietic, lymphoid-

A

Lymph nodes and spleen shrink in size.

24
Q

Organ system changes- Granulocytes decrease over

A

1-2 wks and rebound in 2-3 months, pts are susceptible to infections at this time!

25
Q

Organ system changes: Lungs-

A

endothelial changes, pulmonary congestion and edema, ARDS, alveolar-capillary block

26
Q

Fatal acute radiation syndromes-

o Hematopoietic –

A

2-10 Sv, GI symptoms, decreased white blood cells, platelets, and anemia; resultant sepsis and bleeding problems, death in 2 to 6 weeks

27
Q

Fatal acute radiation syndromes-

o Gastrointestinal –

A

10- 20 Sv, severe GI symptoms, bloody diarrhea, producing dehydration, shock, sepsis and death in 5-14 days

28
Q
  1. Somatic protein compartment - ——- - can assess loss of this compartment by measuring ———-
A

skeletal, skinfold thickness

29
Q

• Vitamin A- Functions:

1. augments differentiation of

A

specialized epithelial cells (mucus-secreting)

30
Q

o Infants are especially susceptible to

A

Vit A toxicity.

31
Q

Symptoms of acute Vit A Toxicity =

A

nausea, vomiting, irritability, headache, blurred vision (papilledema).

32
Q

Symptoms of chronic toxicity =

A

anorexia, hair loss, dry skin, pruritis, dry mucus membranes, fissured lips, fatigue, weight loss, bone & joint pain.

33
Q

• Vitamin C-
o Functions:
1. conversion of tyrosine to

A

catecholamines

34
Q

Vit c deficiency: o

A

Wound healing- is impaired, Ability to localize infections is impaired, anemia (due to bleeding and iron deficiency) is common.

35
Q

o (glycoprotein Ib/IX binds to

A

vWF) -something to do with vit C

36
Q

o release of second messenger molecules within the platelet that lead to shape change from

A

discoid to spherical, secretion of cytoplasmic ADP, activation of the glycoprotein IIb/IIIa receptor, and contraction of the platelet mediated through actin fibers

37
Q

Fibrin Clot Formation- =

A

Secondary Hemostasis

38
Q

o Kallikrein activates

A

factor XII

o

39
Q

Factor XIIa activates

A

factor XI

40
Q

o Factor XIa activates

A

IX

41
Q

• Extrinsic pathway- activation of factor VII by

A

tissue factor

42
Q

• Common hemostasis pathway-

A

o Activation of X→Xa
o Conversion of prothrombin → thrombin
o Conversion of fibrinogen → fibrin

o Stabilization of fibrin monomers by factor XIII

43
Q

• Common hemostasis pathway-

A

o Activation of X→Xa
o Conversion of prothrombin → thrombin
o Conversion of fibrinogen → fibrin

o Stabilization of fibrin monomers by factor XIII

44
Q

• Antithrombins- inhibition the activity of

A

thrombin and other serine proteases of the coagulation cascade by forming an inactive enzyme-inhibitor complex

45
Q

o Antithrombin II in presence of heparin→

A

complex with thrombin

46
Q

Antithrombin II • Destroys ability of thrombin to participate in generation of

A

fibrin monomers

47
Q

• Protein C System- regulation of factors

A

Va and VIIIa

48
Q

• Fibrinolysis- limits generation of

A

fibrin clot,

Tissue plasminogen activator in presence of fibrin

49
Q

Fibrinolysis: • Leads to conversion of

A

plasminogen→plasmin

50
Q

o Uncontrolled activation of plasmin→

A

fibrinogenolysis

51
Q

Familial cholesterolemia treatment

A
  • Iomitapide
52
Q

• Klinefelter Syndrome increased frequency of

A

taurodontism

53
Q

Visceral compartment

A

internal orgs - liver namely

54
Q

Somatic compartment

A

Skeletal muscle