Test 20 Flashcards
Channeling unacceptable impulses into productive activity
altruism
excessive or opposite reaction
reaction formation
MCC of opportunistic mycosis
Candida albicans (part of normal skin/mucous membrane flora)
Yeast, pseudohyphae and a positive GERM TUBE TEST (tennis rackets). Innoculated at 37 (98.6)
Candida
Causes meningitis and lung infections in Aids pts. OVAL BUDDING YEAST WITH THICK CAPSULE. India ink stain w/ clear zone around nucleus.
Cryptococcus Neoformas
Oval yeasts cells HIDING in mphages. Mississippi and Ohio River Valles.
HISTO HIDES in mphages
Southwestern US and california. Spherules filled w/ endospores.
Coccidioides
Elevated pulmonary wedge pressure, pulmonary HTN, decreased vascular compliance, right ventricular dilation, functional tricuspid regurge.
Mitral stenosis
Diastolic pressure in LV is usually normal or decreased w/ mitral stenosis
What mediates immunity to myobacterium TB?
Th1 cells leads mphage mediated immunity and drive granuloma formation
cytokines cytokines critical in formation and maintenance of granulomas
IFN-y
IL-12
TNF-a
Formed after tissue mphages encounter pathogens/substances that can’t be easily digested/removed
granulomas
IL-12
induces T helper cells to differentiate to TH1
IFNy
activates mphages
C3a
Stimulates mast cell histamine release leading to increased vascular permeability/vasodilation
IL-4
Th to Th-2
B cell growth and isotype switching
IL-5
differentiation of B cells and eosinophils
Isotype switching to IgA
LC4, D4, ER
vasoconstriction
increased vascular permeability
bronchospasm
Platelet activating factor
platelet aggregation
vasoconstriction
bronchoconstriction
leukocyte adhesion
Thromboxane A2
platelet aggregator and vasoconstrictor
Glucose sensor in pancreatic beta cells
Glucokinase–high km> senses high levels of glucose
*inactivation mutations can lead to mild hyperglycemia exacerbated by pregnancy
Converts glucose to glu-6-p in pancreas/liver
glucokinase
Allosteric inhibition of glucokinase
glu-6-+
MODY enzyme
glucokinase defects
What type of twin placentation is most likely present with twins, male and female?
Dichorionic/diamnionic
Fertilization of 2 oocytes by 2 different sperm
Dizygotic twins
*always have 2 amnions and 2 chorions
Monozygotic twins
fertilization of single oocyte
*twinning can occur at different stages of embryogenesis which affects fetal membranes
Monozygotic twinning (day 0-4)
dichorionic/diamnionic
Monozygotic twinning (day4-8)
Monochorionic
Diamniotic
Monozygotic twinning (day 8-12)
monochorionic
monoamniotic
Monozygotic twinning (>13d)
monochorionic monoamniotic conjoined twins
Bilateral cleft lip, microencephaly, micropthalamus. Viscera protrude through abdominal wall.
Trisomy 13
cause of Trisomy 13
nondisjunction during maternal meiosis I associated w/ advanced maternal age
GI abnormalities associated w/ trisomy 18
Meckel’s and malrotation
GI abnormalities associated w/ trisomy 21
Duodenal atresia
TE fistula
47XXX
Clinicall silent
woman may have slightly lower IQ scores
47XXY
Klinefelter syndrome
mild mental retardation or normal.
male adult w/ gynecomastia, small testis, infertility
Linefelter
47XYY
Tall stature, severe acne, mild delays in both motor and language development.
Phenotypically normal.
Calcium efflux prior to myocyte relaxation
Na/Ca exchange mechanisms
+ Ca ATPase
Electrical depolarizaiton of cell allows Ca from extracelular flulid to enter cell through..
Voltage dependent Ca channels> begins contraction cycle
Ryanodine receptors
Ca allowed into cell by VG channels stimualtes RR to allow release of larger pool of Ca stored in sarcoplasmic reticulum
Troponin C
Ca released from sarcoplasmic reticulum binds to troponin C>
tropomyosin moves out of way so actin and myosin can interact and myocardial cell contracts
calmodulin
binds and activates plasma membrane Ca ATPase>
removes Ca from cell by hydrolyzing ATP
(indirect contributor to efflux)
Unsloping left atrial “v wave” during cardiac catheterization
mitral regurgitation
*sign of increased LA filling
Elevated LV diastolic pressure and decreased aortic pressure
aortic regurgitation
LV systolic pressure much higher than aortic systolic pressure
aortic stenosis
Ascites, increased JVD and peirpheral edema
RHF (can be assoc. w/ tricuspid regurge)
CO formulas
CO= SV x HR CO= O2 consumption? ateriovenous O2 difference
React w/ a3 chain of collagen type IV in GBM
anti-GBM antibodies seen in Goodpasture syndrome
Pulmonary hemorrhages (hemoptysis and RPGN)
Goodpasture
Glomerular crescent formation consisting of fibrin and plasma proteins (C3b)
RPGN
Immunofluorescene of RPGN
linear deposits of IgG and C2 along GBM
Basement membrane splitting
Alport syndrome and MPGN type 1 (HPV, HCV)
Diffuse capillary and GBM wall thickening
Membranous glomerulopathy
Nonspecific IgM and C2 deposits in sclerotic areas of glomeruli
FSGS
Children + nephrotic syndrome+ Normal glomeruli
MCD
*recent infection
2,3 biosphosphoglycerate
Increase w/in erythrocytes to increase O2 delivery to perhipheral tissues in presence of lower blood O2 concentration.
2,3-BPG decreases affinity of Hb for O2
Lab results associated w/ strongloides stercoralis infeciton
rhabditiform (noninfectious) larvae in stool
Skin penetration by filariform (infectious) larva)> hyperinfection syndrome characterized by massive dissemination of organism> multiorgan dysfunction and septic shock
Strongloides sterocoralis
Trophozoites and cysts
Protozoal infections from giardia or entamoeba