Test 12 Flashcards
When does the metanephros begin to produce urine?
8-10 weeks of gestation after the ureters fully canalize
What is the MC cause of fetal hydronephrosis?
Inadequate recanalization of the ureteropelvic junction (junction between kidney and ureter)
How does the body respond to Ca loading with calcium gluconate?
PTH and synthesis of active form of vit D decreases
Calcitonin increases
What nerve innervates the flexors of the lower leg, the extrinsic digital flexors of the toes and the skin of the skin of the sole of the foot?
tibial nerve
Hemorrhages, subperiosteal hematomas, bleeding into joint spaces, gingival swelling, anema and impaired wound healing are all caused by…
Impaired collagen formation due to scurvy
beriberi and wernicke
B1 def
cheilosis stomatitis glossitis dermatitis corneal vascularization
B2 def
Cheilosis
glossitis
dermatitis
peripheral neuropathy
B6 def
Megaloblastic anemia and neural tube defects
Folic acid
Bleeding diathesis
Vit K def
Acrodermatitis
growth retardation
infertility
zinc def
What bacteria produce IgA protease?
SHiN. S. Pneumoniae H. Influenzae N. menigitidis N. gonorrhea
What does IgA protease do?
Bacterial virulence factor: enzyme that cleaves IgA at its hinge making it ineffective. IgA normally exists on mucosal surfaces and insecretions and acts to bind and inhibit the action of pili and any other crap that allows for mucosal adherence.
What is protein A?
VF expressed by S. Aureus
Binds Fc region of IgG and prevents opsonization and phagocytosis
What VF helps to prevent phagocytosis and is expressed by group A streptoccoci?
M protein
Has similar epitopes to human cell proteins and may underly hte AI response seen in acute RF
What are the hallmarks of generalized anxiety disorder?
Anxiety lasting > 6 months!
excessive worry over several different issues
How do you tx GAD?
antidepressants
benzodiazepines
What is adjustment disorder?
lasts < 6 mos
emotional sxs following an identifiable psychosocial stressor
What are natural anticoagulants present in the blood?
Anti-III
protein C and S
How does Warfarin cause a “paradoxical thrombosis”?
Inhibits protein C and S synthesis and can lead to skin/tissue necrosis d/t small vessel microthromboses.
Often in pts w/ a congenital def of protein C and S (usually in first week of therapy)
What is the mechanism of warfarin?
Inhibits gamma-carboxylation of vit K dependent clotting factors II, VII, IX, X, C and S.
How does warfarin affect the EXtrinsic pathway?
Increases PT
How do you reverse warfarin therapy?
give vit K
RAPID reversal–> give fresh frozen plasma
What is Heparin bridging?
Heparin activates antithrombin and enables anticoagulation during intitial, transient hypercoaguable state caused by warfarin.
*Initial heparin therapy reduces risk of recurrent venous thromboembolism/skin/tissue necrosis.
Where does the mutation occur that causes CF?
3 base pair deletion in the CFTR gene at AA position 508
How does the CFTR mutation affect post-translational processing of CFTR?
The mutation causes improper folding and glycosylation and leads to impaired posttranslational processing, which is detected by the ER. The abnormal protein is targeted for proteasomal degradation and doesn’t reach the cell surface.
What is most commonly transmitted unpasteurized dairy products and cold deli meats and can cause sepsis and meningitis in immunocompromised adults, or neonatal meningitis (placental or vaginal transmission)?
Listeria monocytogenes
Why does listeria often contaminate refrigerated food?
It grows well in cold temperatures
What is the only gram + organism to produce an ENDOtoxin and has a characteristic tumbling motility?
Listeria monocytogenes
What is the MC cause of an irregularly irregular tachyarrythmia in aconscious pt?
a. fib
What is seen on an EKG in a pt w/ a. fib?
absent p waves (coordinated atrial contractions don’t occur) and irregularly spaced ventricular contractions (variable R-R interval)
What are common causes of A. Fib?
- Holiday heart (binge alcohol consumption)
- increased cardiac SNS tone
- Pericardiditis
What does 5 alpha reductase do?
converts testosterone to DHT
What mediates the development of the external genitalia in the male fetus?
DHT
What is seen in male neonates w/ 5alpha-reductase def?
feminized external genitalia (small phallus and hyposapdias) that MASCULINIZES at pubery
What is responsible fore the INTERNAL male genitalia during embryogenesis, spermatogenesis and male sexual differentiation at pubery?
Testosterone
What mediates the development of hte external genitalia (penis/scrotum) in the embryo, growth of the prostate, facial hair and recession of hairline?
DHT
What causes virilization of the female fetus and salt wasting?
21 hydroxylase def
What does aromatase do?
catalyzes conversion of androgens to estrogens in gonads and peripheral tissues?
What is seen in aromatase def?
virilization of females
males not affected
What causes hypertension and undervirilization of male infants?
Def 17 hydroxylase
What is DHEA?
weak androgen produced by the adrenal cortex
def does NOT cause undervirilization
What provides somatic sensory innervation to the anterior 2/3 of the tongue?
Mandibular branch (V3) of the trigeminal nerve
What provides taste sensation to the anterior 2/3 of the tongue?
chordatympani
What provides somatic and taste innervation to the posterior portion of hte tongue?
CN9 glossopharyngeal
How do you dx sickle cell anemia and establish the carrier status of prospective parents?
Hb electrophoresis (hemoglobin S can be distinguished, moves slowly compared to normal Hb d/t loss of negatively charged AA glutamate)
What causes sickle cell anemia?
HbS point mutation that leads to a SINGLE AA replacement of the B cahin
When do you see a “crew cut” on skull x ray?
marrow expansion from increased erythropoiesis
- sickle cell or thallesemias
What is a prospective cohort study?
select a group of individuals, determine their exposure status, follow them over time, ovserve for development of disease of interest
What does a cohort study evaluate?
RR
Smokers had a higher risk of developing COPD than nonsmokers
What is a case control study?
Select pts w/ disease (cases),
select patients w/out disease (controls),
determine previous exposure status
What does a case control study evaluate?
ODDS ratio
Pt w/ COPD had higher odds of hx of smoking than those w/out COPD
What does a cross-sectional study evaluate?
frequency of disease/disease prevalence at a POINT in time
What are the most common organisms that cause intraabdominal infections?
B. Fragilis> E. coli
What gram-positive organism causes abscess formation on the skin?
s. aureus
What causes acquired angioedema?
ACE inhibitor treatment
Low CI esterase inhibitor activity leads to INCREASES in bradykinin activity> angioedema
What are low serum levels of C1 diagnostic for?
hereditary angioedema
How do timolol and other beta blockers decrease aqueous humor production?
diminish secretion of aq humor by ciliary epithelium
