Test 27 Flashcards
location of compound tubular glands that secrete alkaline mucus
Brunner’s glands in the duodenum that secrete into ducts that empty into the crypts of Lieberkuhn
lymphoid aggregates specific to the ileum
Peyers patches
L/S ratio greater than 2 indicate
adequate surfactant produciton to avoid neonatal hyaline membrane disease
Lecithin production increases after 30,36 weeks, while syphingomyelin levels remain constant during the third trimester
Dipalmitoyl phosphatitoly choline and phosphatidly glycerol are major components of surfactant
recall bias
inaccurate recall of past exposure by people in the study–ppl who have stuffered an adverse eent are more liekly to recal RFs than those w/out adverse experiences
Referral bia
case and control pops differ d/t to admission/referral practices
detection bias
RF itself may lead to extensive diagnostic investigation and increase probability that disease is identified
Lead time bias
screening test dx a disease earlier than it would have appeared by natural hx so that hte time from dx until death is prolonged
allocation bias
way tx and control groups are assembeled
sampling bias
non random sampling of a population–study populatoin has characteristics that differ from the target population
hereditary defect in renal PCT and intestinal AA transporter that prevents resorption of cystine, ornithine, lysine, arginine (COLA) across the intestinal and renal tubular epithleium
cystinuria (AR)
what complication is a pt w/ cystinuria at risk for developing
excess cystine in the urine can lead to recurrent precipitation of hexagonal cystine STONES> recurrent nephrolithiasis
tx for cystinuria
urinary alkalinization (K citrate, acetazolamide) chelating agents
octahedron stones
calcium oxalate
calcium phosphate
sCuare
rectangular prisms (coffin lids) stones
Magnesium ammonium phosphate (struvite or triple phosphate
Yellow/red-brown diamond or rhombus
uric acid
effect of MI on CO
sharp DECREASE in CO ouput d/ tloss of myocardium (decreases slope and max height of line)
effect of chronic anemia on CO
increases CO to meet metabolic demand of tissues
effect of anaphylaxis on VR and CO
VR- decreases, d/t widespread venous and arteriolar dilation and increased capillary permeability
CO- increases/ d/t increased cardiac contractility to maintain bp
flu like sxs and erythema chronicum migrans following hiking in new hampshire
early lyme disease
key LYME pie to the
Flu like sxs/Facial nerve palsy
Arthritis
Cardiac block
Erythema chronicum migrans
AV block and bells palsy after hiking 6 mos ago
second stage of lyme’s
chronic assymmetric large joint arthritis and ecephalopathy following hiking months to years ago and bells palsy
lymes disease
how do you tx lymes
doxycycline
penicillin type antibiotics (ceftriaxone)
lymes transmission
borrelia burgdorferia spirochete by bite of ixodes tick in NE of USa nd europe
antimalarial drug used in prevention and tx of p. falciparum
mefloquine
transplant pt w/ pneumonia and intranuclear and cytoplasmic inclusion bodies (OWLS EYES)
opportunistic infection w/ CMV
enveloped DS DNA virus
CMV- common in pts w/ lung transplants, can be treated prophylactically w/ valganciclovir
site of ribosomal RNA synthesis
nucleolus
APP, presenilin 1, presenilin 2
EArly onset alzheimers
APP is located on chrom 21 and is why pts w/ Downs get Alz
Apo E4
late onset Alz
ApoE2
decreased risk of Alz
Familial hyperhcolesterolemia
defect in LDL
mutation in b myosin heavy chain
hypertrophic cardiomyopathy
cardiac SE of doxorubicin (daunorubicin, epirubicin, BICINS)
form FREE radicals in the myocardium> dose related dilated CARDIOMYOPATHY>
SXS of L and R ventricular CHF
9yo
red colored urine, periorbital edema, mild pedal edema
atopic dermatitis> predisposure to secondary skin infections
impetigo
Antecedent skin infection + acute hematuria and edema> PSGN
MC cause of acute nephritis in children
PSGN
Abs form against Ag expressed by GAS during infection. Ab combine w/ AG to form ICs (type III) that are deposited along BM
PSGN
GAS- impetigo, cellulitis, pharyngitis
second MC cause of CAH
11B hydroxylase def
prevents adrenal gland from synthesizing cortisol and aldosterone efficiently laeding to increased production of adrenal androgens d/t aldosterone and cortisol precursors being shifted there. Low cortisol further stimualtes production of ACTH> further increase in adrenal androgens
Female born w/ ambiguous genitalia, HTN and HYPOkalemia early in life.
11 hydroxylase def
MC type of CAH
21 hydroxylase def
Female w/ ambiguous genitalia (androgen excess) and HYPOTN and HYPOkalemia (mineralcorticoid def)
21 hydroxylase def
Females are born with NORMAL genitalia but males are undervirillized. AFfected individuals DONT undergo puberty and develop HTN and hypokalemia (excess mineralcorticoids)
17a hydroxylase
contralateral spastic rigidity
hyperreflexia
paresis (weakness in voluntary movement
UMN lesion (can affect any part of pyramidal motor system)
caudate nucleus
Huntingtons
lesions> chorea and athetosis (slow writhing of fingrs/movements)
Integrates body state and emotions with ANS and conscious experience of vsiceral sensations
insular cortex
initiates movements
lesions> contralateral tremor, bradykinesia, rigidity
putamen
pure motor weakness affecting contralateral arm, leg and lower face
*contralateral spasticity, hyperrefelxia, positive Babinski
Internal capsule stroke
MAO inhibitor that can prevent MPTP induced damage of dopaminergic neurons
selegiline (delays parkinsons!)
Preferred combination for treating Parkinsons
Selegiline
Anticholinergics
Amantadine
then levo/carbi introduced
Amantadine
antiviral influenza agent
has some dopaminergic and anticholinergic actions> can provide mod improvement to Parkinson pt
Increases levels of DA in the brain
Ldopa
carbidopa
given with L dopa to increase bioavailability in the brain
Peroglide
DA agonist, providesmodest improvement in park sxs
High fever
cough
confusion
diarrhea
Legionella pneumophilia
MC lab abnormality seen w/ legionella
HYPOnatreamia
sputum shows many neutrophils
this disease can be suspected w/ recent exposure to contaminated water (cruise ships, spas,, hotels)
Legionella
cold agglutinin formation
mycoplasma pneumonia (young adults)
Healthy volunteers orally inoculated w/ pathogenic strains of c. diff don’t develop signs of infection. Which protective mechanism is responsibel?
Intestinal bacteia that are normally present in our flora effectively suppress overgrwoth of d. diff and compete for nutrients and adhesion to the gut
class of drugs taht has been showsn to decrease the progression of diabetic nephropathy
ACE-I and ARB
first line medication for tx of essential HTN
HTZ
Hormones that use G proteins and cyclic AMP
Glucagon
PTH
TSH
(FLAT ChAMP + calcitonin, GHRH, glucagon)
Activate PPAR-gamma and alters trxn of genes responsible for glucose and lipid metabolism
TDZ–> decrease insulin resistance
Activate PPAR-gamma and alters trxn of genes responsible for glucose and lipid metabolism
TDZ–> decrease insulin resistance
what reduces the risk of non-hereditary ovarian and endometrial cancer
OCPs!!
multiparity
breast feeding
what is the most potent cerebral vasodilator
pCO2
decreases vascular resistance leading to increased cerebral perfusion and ICP
affect of COPD on pulmonary resistance
chronic hypoxia caused by COPD> pulmonary vasoconstriction
MC malignant hepatic lesion
metastis form anotehr primary site (breast, lung, colon)
MC malignant hepatic lesion
metastis form anotehr primary site (breast, lung, colon)
Urinary urgency, frequency, hesitency assocaited w/ BACK PAIN in an ELDERLY man
metastatic prostate cancer
**strong predilection for BONES