test #19 4.9 Flashcards
osteocytes (trapped osteoblasts) are connected to one another via..
cytoplasmic extension travel from lacunae through canaliculi, connect via GAP JUNCTION. send signals & exchange nutrients & waste products
tight junctions
zona occludens (1st component of junctional compelx)
intermediate junctions
zona adherens (2nd component of junctional complex)
desmosomes
3rd component of junctional complex
maternal blood types A and B often have what type of anti-B and anti-A Abs (respectively)? what about type O?
A and B have IgM (doesn’t cross placenta).
type O have predominately IgG anti-A and anti-B type (can cross placenta & cause hemolytic disease of newborn in 3% of pregnancies). can happen w/ 1st pregnancy.
in what maternal blood type do we worry about erythroblastosis fetalis and hemolytic disease of newborn?
type O moms with type B or A babies. bc they make anti-B or A IgG.
common carotids from what aortic arch?
3rd
1st branchial/pharyngeal arch? associated w/ which n.
associated w/ trigeminal n.
neural crest cells make: Maxilla, zygoma, Mandible, vomer, palatine, incus, Malleus. (M’s)
mesoderm: muscles of mastication (temporalis, medial / lateral pterygoid, masseter) anterior belly of digastric, mylohyoid, tensor tympani, tensor veli palatini.
embryological origin of branchial arches (2)
muscle & arteries = mesoderm.
bone = neural crest cells
2nd branchial/pharyngeal arch? associated n?
associated w/ facial n.
neural crest: styloid process, lesser horn of hyoid, stapes.
mesodern: muscles of facial expression, stylohyoid, stapedius, posterior belly of digastric
4th and 6th arch
make up cartilaginous structures of larynx.
3 most common causes of metabolic alkalosis
- LOSS OF H+ from body: vomiting, nasogastric suction. loose HCl in gastric secretion, causes serum Cl- to decrease
(leads to DECREASED urinary Cl-, t help. SALINE-RESISTANT
bilateral lesions in mamillary bodies & periaqueductal grey area in hospital (in alcoholic)
due to glucose infusion w/o thiamine in thiamine deficient person. PDH needs thiamine!
wernicke encephalopathy
(1) opthalmoplegia: horizontal nystagmus, bilateral abducens palsy, complete opthalmoplegia
(2) ataxia: degeneration of all layers of cortex
(3) confusion, apathy, inattentiveness, disorientation: from encephalopathy.
characterestic hemorrhage into mamillary body
infuse glucose + ___ in alcoholics & bad diet
THIAMINE (B1)
heterophile negative mononucleosis (3)?
CMV, HHV-6, toxoplasmosis
coxsackie A causes (2)
(1) asceptic meningitis and (2) herpangina in children
nifedipine can..
elevate capillary hydrostatic pressure –> edema
common causes of lymphatic obstruction (3)
(1) filariasis,(2) invasive malignancy, (3) iatrogenic (surgical lymph node dissection & radiation therapy)
downstream signaling targets of insulin
generally: insulin receptor substrates (IRS), leading to acrivation of a PROTEIN PHOSPHATASE.
DEPHOSPHORYLATES GLYCOGEN SYNTHASE (1. activates glycogen synthase to promote glycogen synthesis & 2. dephosphorylates fructose 1,6 bisphosphatase to inactivate & block gluconeogenesis)
facial n. constituents.. (4)
- motor to facial muscles
- parasympathetic to lacrimal, submandibular, sublingual salivary glands.
- special afferent fibers for taste (ant 2/3)
- somatic afferents from pinna and external auditory canal
bell’s palsy: unilateral face paralysis (impaired eye closure, eyebrow sagging, inability to smile/frown on affected side, loss of nasolabial fold, mouth drawn to non-affected side. can have: decreased tearing, hyperacusis, loss of taste sensation over anterior 2/3rd of tongue
geniculate ganglion
parasympathetic ganglion for submandibular, sublingual, and lacrimal glands. innervated by facial n.
motor in trigeminal?
V3 – muscles of mastication and tensor tympani
filtration fraction
fraction of PLASMA entering the kidney that filters into renal tubular lumen.
FF = GFR/(1-Hct x RBF)
in gastrectomy, must supplement with
B12 (water soluble vitamin)
role of pepsin in digestion
activated by HCl, cleaves polypeptides at sites of aromatic amino acids. helpful, but not required for protein digestion.
premature ovarian failure age? mean age of menopause in US? marker?
ovarial failure before 35. mean age of menopause in US: 52. HIGH FSH (above 30uL)
urinary 17-ketosteroids
measure adrenal androgens (DHEA, DHEA-S, 4androstenedione)
chronic lymphedema is a risk factor for..
development of cutaneous angiosarcoma (St
chronic lymphedema is a risk factor for..
cutaneous (lymph)angiosarcoma.
classic: radical masectomy w/ axillary lymph node dissection –> multiple firm violaceous nodules
prognosis of angiosarcoma?
POOR, tumor usu wide spread by diagnosis.
histopathology of angiosarcoma
infiltration of dermis w/ slit-like abnormal vascular spaces
breast cancer is most likely to metastasize to..
bone, liver, lung
stewart-treves syndrome
chronic lymphedema —> angiosarcoma
presentation of hepatitis A virus
most often silent “anicteric”. sometimes: acute, self-limited illness characterized by jaundice, malaise, fatigue, anorexia, N/V, RUQ pain, or AVERSION TO SMOKING.
infxn usu more severe in adults
infection involving central venous catheters are often originate from…
patient’s skin flora OR bacteria on hands of HCW
gram positive cocci – coag neg staph & staph aureus
steps to reduce CVC infxn? what’s not needed?
most important: hand hygiene – washing & gloves. chlorhexidine for skin disinfection, avoid femoral insertion site. remove when no longer needed.
NOT NEEDED: TOPICAL antibiotics not needed (increase resistance & candida prolif), ORAL antibio, routine replacement.
process of type I collagen synthesis
in ER:
(1) HYDROXYLATE select pro & lys residue [vit C dep]
(2) GLYCOSYLATE select lys residue w/ galactose & glucose
(3) assemble into procollagen TRIPLE helix
golgi –> secreted
outside:
(1) terminal propeptides (INTRAchain disulfides) cleaved N- and C- procollagen peptidases —> TROPOCOLLAGEN.
(2) collagen fibrils spontaneously assemble
(3) LYSYL OXIDASE (Cu2+) covalently cross-links