Test 4-7: All Flashcards
which cells in the heart have the fastest firing rate
SA node
Where are Beta1 adrenergic receptors found
- cardiac tissues
2. renal juxtaglomerular cells
MOA for atenolol
selective Beta 1 antagonist
MOA for propranolol
nonselective beta blocker
Glycolysis of a single glucose molecule always yields pyruvate but sometimes generates no net ATP? What cell am i in?
Erythrocytes
Role of 2,3-BPG
decrease hemoglobin affinity for oxygen
What molecule makes 2,3-BPG, via? What is special about this reaction
- 1,3-bisphosphoglycerate via mutase
- bypasses ATP generating step of glycolysis, causing no net gain in ATP
What is used to measure GFR
creatinine and inulin
PAH is used to calculate what
renal plasma flow
How is G6PD deficiency inherited
X-linked recessive disorder
Role of viral encoded surface glycoprotein
mediates vision attachment to target host cell
A reduced Left ventricular heart compliance is what type of heart failure
diastolic dysfunction
What type of cardiomyopathy causes diastolic dysfunction
restrictive/infiltrative cardiomyopathy
Decreased protein/albumin levels in capillaries change what pressures
- lowers plasma oncotic pressure
- increases net plasma filtration in capillary beds
Pulmonary tuberculosis infection is controlled through the action of what cells
- CD4+ TH1 lymphocytes
- macrophages
Hematocrit
ratio of RBC to total volume of blood
In patients with sickle cell anemia and other chronic hemolytic disorders, the most common viral infection of erythroid progenitor cells is what
parvovirus B19
What is the difference between aplastic crisis and aplastic anemia
crisis: Sickle cell patient, Parvovirus, infection of erythroid precursor cell
anemia: pancytopenia not just anemia
genome for Parvovirus B19
non-envoloped single-stranded DNA virus
Both adenosine and dipyridamole have what same MOA
vasodilators of coronary vessels
What is coronary steal syndrome
- blood flow in ischemic ares is reduced due to arteriolar vasodilation in nonischemic areas .
Epicardial vessles
Large coronary arteries of heart, RC, LAD, LCA
How many patients need to be treated with Superstation to prevent one additional myocardial infarction. What calculation is this asking for
- Number needed to treat
- number of patients who need to be exposed to be treated for 1 patient to benefit
equation for number needed to treat
1/ARR
arrangement in which a payor pays a fixed, predetermined fee to provide all the services required by the patient
Capitation
payment arrangement in which an insurer pays a provider for each individual service provided at a pre-arranged, discounted rate
Discounted fee-for-service
arrangment in which an insurer pays a provider a single payment to cover all expenses associated with an incident of care
Global payment
patients have access to personal physician who coordinates care and sees the patient through all aspects of care
- can include captivated or fee-for-service
Patient-centered medical home
- patients must have primary care provider and obtain referrals for specialty consultations
- allows patients to see providers outside the network, (different from HMO)
Point-of-service
Most common site for unilateral fetal hydronephrosis
ureteropelvic junction
All 3 prokaryotic DNA polymerases have what same job
- remove misatched nucleotides via their 3’ to 5’ exonuclease ( “proofreading”) activity
What unique function does DNA polymerase I have
excises RNA primer with 5’ to 3’ exonuclease
What is the Electron microscopy for acute post streptococcal glomerulonephritis
- subepithelial immune complex humps
T-lymphocyte, moncytes and eosinophilic infiltration may be seen in what kidney problem
Acute interstitial nephritis
Prominent fibrin deposition is characteristic of what kidney disease
rapidly progressive glomerulonephritis
Hyaline, acellular deposits composed of plasma protein deposited in kidney is seen in what
Kimmelsteil-Wilson nodules of diabetic nephropathy
How is chronic granulomatous disease inherited
X-linked recessive
How can one test for Chronic granulomatous disease
- abnormal dihydrorhodamine (flow cytometry) test
- decrease green fluorescence - Nitroblue tetrazolium dye reduction test obsolete
Left anterior descending artery arises from what
left main artery
How does the left anterior descending artery course on the heart
-Anterior aspect of the anterior inter ventricular groove toward apex of heart
Where is coronary sinus located
runs transversely in the left AV groove on the posterior side of the heart
Deletion of a single nucleotide from the DNA sequence can cause what type of mutation
frameshift mutation
conservative mutation
- type of missense
- one amino acid is replaced with another amino acid similar in chemical structure
Missense mutation
- point mutation (nucleotide substitution) resulting in change in amino acid
Nonsense mutation
- single base substitution that introduces a premature stop codon
Silent mutation
- single base substitution within a codon that does not change amino acid coded for by codon
What are stop codons
UAA
UAG
UGA
What is minute ventilation? equation
total volume of gas entering lungs per minute
= tidal volume * Respiratory rate
how does increased elastic resistance in lung impact minute ventilation
- increase respiratory rate (rapid shallow breaths)
- decrease tidal volume
how does high airflow resistance in lung impact minute ventilation
- increase tidal volume
- decrease respiratory rates ( slow, deep breaths)
Leads I and aVL corresponds to what on the heart
Lateral Circumflex
What does lateral circumflex supply
- lateral and posterior walls of left ventricle, anterolateral papillary muscles
Anterior chest leads V1-V4 refer to what part of the heart and blood supply
- Left anterior descending artery
- anterior aspect of left ventricle and inter ventricular septum
Right coronary artery corresponds an ST elevation in what leads
II, III, aVF
Ureteric bud gives rise to what
collecting system of kidney
collecting tubule and ducts, major and minor calyces, real pelvis, and ureters
The metanephric mesoderm (blastema) gives rise to
- Glomeruli
- Bowman’s space
- proximal tubules
- Loope of Henle
- distal convoluted tubules
In phenotypically normal parents, the probability that a female sibling of male affected by an X-linked recessive disease will give birth to an affected child is what
1/8
Who produces interleukin-2
All T cells
What does IL-2 activate
- CD4 and CD 8 T cells
- B cells
- Natural killer cells
- monocytes
What part of the immune system is responsible for it’s anti-cancer effect on metastatic melanoma and renal cell carcinoma
T cells release IL-2 to activated natural killer cells release
pulmonary elastase enzyme is derived from what cell
alveolar macrophage and neutrophils
What gets rid of pulmonary elastase
antiprotease
Where are club cells found
terminal portions of bronchioles
What do club cells secrete
- proteins ( protect against airway inflammation)
2. surfactant components
Name the 5 dimorphic fungi
- sporothrix
- coccidioides
- histoplasma
- blastomyces
- paracoccidioides
What is the form os Aspergillus
mold
What is the form of candidia
budding yeast or forming pseudohyphae
Cyrptococcus is in what form
yeast
What is the FEV1/FEC ration, TLC, and diffusing capacity in emphysema
- decreased ( FEV1/FVC)
- increased ( TLC )
- decreased ( diffusing capacity)
What happens to the diffusing capacity in asthma
increased
What is the diffusing capacity for intrinsic restrictive lung disease and extrinsic
intrinsic: decrease
extrinsic: increase
What does carbon monoxide bind to in body and what is it called
- heme iron in hemoglobin
- carboxyhemoglobin
If only 1 out of the 4 heme sites has a CO molecule, how are the 3 remaining groups changed
increase oxygen affinity
At the cellular level, what does CO bind to
cytochrome oxidase
The probability that a child of parents from 2 populations with different mutant alley carrier frequencies will inherit an autosomal recessive disease is what
25% * carrier frequencies
What is the principal stabilizing force for the secondary structure of proteins
hydrogen bonds
A proteins’ primary structure is a sequence of amino acids linked by what bonds
covalent
disulfide bond connects what
2 cysteine residues
What is SaO2 lab value tell you
oxygen saturation of hemoglobin
what does PaO2 tell you
partial pressure of oxygen dissolved in blood
What are oxygen lab values for anemia
- decrease [Hb]
2. normal SaO2 and PaO2
What are oxygen lab values for cyanide
All normal
What causes tetralogy of fallout
anterosuperior displacement of infundibular septum
Primary infection with HSV-1 can cause
- gingivostomaitis
- dehydration
How does latent HSV-1 present
mild perioral vesicles
Homozygous DeltaF508 mutation is what disease
cystic fibrosis
What is sweat content of someone with cystic fibrosis
sweat high with sodium and high chloride
Which electrolyte disturbance is most likely to cause symptoms in cystic fibrosis
hyponatremia
Lesion in optic tract cuases
- contralateral homonymous hemianopia
- afferent pupillary defect ( marcus Gunn pupil) in pupil contralateral to tract lesion
18 year old college student as fever, petechial rash on trunk and extremities, including palms and soles. What does she have
Neisseria species
Deficiency of complement factors that form membrane attack complex results in recurrent infections of ?
Neisseria species
Some vaccines have what conjugated to them , enhancing immunogenicity by promoting T-cell activation and class swtiching
polysacharide capsule antigens
KRAS mutations are seen in what diseases
colon cancer, lung cancer, pancreatic cancer
