Test 14 Flashcards
What powers kinesin and what does it do?
microtubule associated ATP powered motor protein that facilitates ANTEROGRADE transport (towards the PLUS/growing end) of NT containing secretory vesicles down axons to synaptic terminals
What does Nissl substance in neurons correspond to?
RER
What protein aggregates mediate cell to cell adhesion between epithelial cells?
Desmosomes
What are small cylindrical extensions of apical plasma membrane that contain thin actin filaments?
microvilli
What is a disease that has a propensity to affect smokers and is characterized by a high fever, HA, confusion and diarrhea and often causes a unilateral lobar pneumonia.
Legionnaire’s disease
Gram - rod
not detected on Gram stain
Why should you associated Legionnare’s disease with a French soldier?
French legionnaire soldier with a SILVER (stain) helmet sitting around a CHARCOAL campfire with his IRON dagger he is no SISSY (cysteine)
charcoal yeast extract with (cysteine and iron_)
What lab findings and diagnostic tests are associated w/ legionella pneumonia?
Hyponatremia
Gram stain shows neutrophils
Legionella urine test
How do you tx a pt w/ legionnaire’s disease?
Respiratory Fluoroquinolones( levofloxacine) Newer macrolides (azithromycin)
What is an illness that predominates in YOUNG adults and causes pneumonia w an insidious onset, HA, nonproductive cough and patchy/diffuse infiltrates? Would these organisms be detected on a gram stain?
(prisons, military recruits)
Mycoplasma pneumonia
Not detected on gram stain b/c don’t have a cell wall (pleomorphic)
What is a major cause of nosocomial pneumonia as well as pneumonia in alcoholics and other debilitated patients?
Klebsiella
gram - rod
What is the role of platelets in the development of atherosclerotic plaques?
Release of PDGF by adherent platelets and endothelial cells and macrophages promotes the migration of smooth muscle cells from the media into the intima and their subsequent proliferation.
What happens to the polyprotein product of the env gene?
It’s glycosylated to become gp 160 which is then cleaved in the ER and GA to form gp 120 and gp 41.
gp 120= attachment to CD4 cells
gp 41= fusion and entry
Where do the envelope proteins from HIV come from?
Budding through the host cell plasma membrane
What do gag and pol code for?
gag= p 24
pol= Reverse transcriptase, aspartase, integrase
Who should obtain informed consent?
Physician preforming procedure as they are best able to describe the procedure and potential complications that may arrive
Thrombocytopenia (fewer and smaller platelets), Eczema and Recurrent infections (T lymphocyte def)
Wiskottt Aldrich Syndrome (WA-TER)
What does the radial nerve arise from?
Posterior cord of BP
How does radial head subluxation cause damage the radial nerve?
Deep branch of the radial nerve arises at the lateral epicondyle. Subluxation damages this branch and causes weakness of forearm and hand extensors but NO sensory deficits.
What is the MC congenital breast anomaly?
Accessory nipples
Asymptomatic and don’t require excision
Hyper pigmented freckles on sunexposed areas.
Ephelides
Raised and pigmented areas that arise from scratches or trauma to the skin.
Keloids
Benign, soft, flesh colored or lightly pigmented skin nodules consisting of schwann cells and neural fibroplasts.
Cutaneous neurofibromas
Fatty tumors beneath the skin.
lipomas
Common raised and hyperpigmented skin lesions not affected by the menstral cycle.
Nevi
Slowly progressive/symmetric postural/kinetic tremor that commonly affects the upper extremities (holding onto an object) and worsens with movement or when anxious. Pt’s often self medicate w/ ALCOHOL because it decreases tremor amplitude.
Essential tremor
(AD)
- drinking from a glass
- pouring tea
GRANDMA
How do you tx Essential tremor?
Propanolol (nonselective beta-adrenergic antagonist)_
What process is inhibited in the conjugation of bilirubin if energy dependent organic anion transport across the hepatocellular membrane is inhibited?
Increased bilirubin excretion in the urine by passive diffusion because conjugated bilirubin can’t be excreted through biliary system (isolated conjugated hyperbilirubinemia)
A pt presents w/ FEVER and SEVERE MUSCLE CONTRACTIONS after a surgical procedure.
Malignant Hyperthermia.
Occurs after administration of inhaled anesthetics or succinylcholine in genetically susceptible individuals.
How do you tx malignant hyperthermia?
Dantrolene
blocks ryanodine receptors and release of Ca into cytoplasm of skeletal muscle fibers
What is a common SE of TDZ therapy?
Weight gain and edema. Edema can exacerbate underlying CHF.
What dramatically increases the risk of developing emphysema in pt’s with a1-antitrypsin def?
Smoking
What bacteria can cause massive hemolysis and tissue necrosis (aka gas gangrene)?
C. Perfringes = PERForates the leg
What is the main toxin produced by C. perfringens?
Lecinthinase (alpha toxin)
Degrades lecithin (main component of cellular phospholipid membranes)> leads to membrane destruction> cell death> necrosis and hemolysis
Why can’t RBCs use ketone bodies for energy?
They don’t contain mitochondria and therefore can’t use ketone bodies because they lack enzyme succinyl CoA acetoacetate CoA transferase (thiophorase).
What is the relationship between GFR and Creatinine?
Every time GFR halves, Creatinine doubles
What is melanoma derived form?
NCC
malignancy of melanocytes
What are the MC metastatic tumors to the brain?
Lung cancer
Renal cancer
Melanoma
What is the difference between low doses and high doses of Da?
Low doses= stimulate D1 receptors in renal vasculature and tubules> increase in GFR, RBF and Na excretion
Med Doses= stimulates beta-1 adrenergic receptors in the heart> increased contractility, PP and SBP
High Doses= stimulates alpha-1 receptors in systemic vasculature> vasoconstriciton> decreased CO d/t increased afterload
