Test 40: Random Flashcards
Glucagon increases what? and how
serum glucose via increasing hepatic glucose production via glycogenolysis and gluconeogenesis
Glycogenolysis
breakdown of glycogen
Gluconeogenesis
production of glucose from noncarbohydrate sources
what is the predominant initial means of rapidly increasing blood glucose levels during hypoglycemia
glucagon-induced glycogenolysis
Glucagon interacts with what receptors on hepatocytes
G protein
- increase cAMP
- protein kinase A
- glycogen phosphorylase
how does glucagon stimulate gluconeogenesis
activating gluconeogenetic enzymes and decreasing intracellular fructose-2,6-bisphosphate levels
Epinephrine is more effective that glucagon in stimulating gluconeogensis in what organ
renal
how does glucagon impact insulin
-stimulates insulin
Direct inguinal hernias protrude through what
Hesselbach’s triangle
- weakness of transversals fascia
boundaries of Hesselbach’s triangle
- inguinal ligament
- epigastric vessels
- rectus abdominus
Transversalis fascia forms floor of triangle
What does the direct hernia go through
external (superficial) inguinal ring only
what covers the direct hernia
only external spermatic fascia
Who usually gets indirect inguinal hernias
infants, children, and young adults
What causes indirect inguinal hernia
- failure of processes vaginalis to obliterate
- failure internal inguinal ring to colse
Where is femoral hernia located
- below inguinal ligament
- through femoral ring (medial to femoral sheath and lateral to lacunar ligament)
What is in the femoral sheath
femoral artery and vein
who usually gets direct hernias
older men
Who usually gets Sarcoidosis
african americans
clinical findings for sarcoidosis
cough and dyspnea
CXR of lungs show for sarcoidosis
- bilateral hilar adenopathy
- coarse reticular opacities
biopsy for sarcoidosis shows
non-caseating granuloma
Serum levels for sarcoidosis
- elevated serum calcium ( sarcoid granuloma produce 1,25-dihydroxy-cholecalciferol)
- elevated ACE
Main immune response in sarcoidosis
CD4+ T cells
patient has nocturnal back pain, spinal tenderness and enlarged prostate, what does he have
prostate cancer with bony metastases
Therapy for prostate cancer
androgen deprivation therapy
What is Leuprolide
gonadotropin-releasing hormone (GnRH) analog
What is the difference in continuous use and initial use of Leuprolide
initial: increase pituitary LH secretion
continuous: surpasses LH
equation for relative risk
[a/(a+b)] / [c/(c+d)]
risk among exposed/ risk among unexposed
How how mitochondrial disorders inherited
from mother
heteroplasmy
- presence of both normal and mutated tDNA
- variable expression in mitochondirally inherited disease
Name 3 mitochondrial symptoms
- Leber hereditary optic neuropathy
- Myoclonic epilepsy and ragged-red fibers
- Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes ( MELAS)
What is myoclonic epilepsy with ragged-red fibers
myoclonic seizures and myopathy associated with exercise
Anticipation
increase in severity of genetic disorders is subsequent generation
Variable expressivity
differences in severity of autosomal dominant disorders
How does spinal accessory nerve (CN XI) course and innervate
- through posterior triangle of neck
- sternocleidomastoid and trapezius
function of trapezius
- elevate scapula
- rotate inward
- stabilize shoulder
What nerve must be accounted for in cervical lymph node dissection
spinal accessory
symptoms of trapezius weakness
- drooping of shoulder
- impaired abduction of arm above horizontal
- winged scapula
nerve innervation for deltoid
axillary nerve (C5-6)
weakness of deltoid presents
impaired abduction of arm at angles blow horizontal line
Latissimus dorsi innervation
thoracodorsal nerve
role of Latissimus dorsi
- adductor of arm
- assists with extension and medial rotation
innervation of levator scapulae
C3 and C4 cervical nerve and dorsal scapular nerve
role of elevator scapulae
elevate the scapula and raise the medial border
innervation of rhomboid major
dorsal scapular nerve ( C5)
role of rhomboid major
draws scapula upward and medially
describe signet rings
mucin-filled cells with peripheral nuclei
Where are signet rings usually located and why
stomach wall due to loss of cell adhesion protein E-cadherin
gastric cancers involve what other organs usually
- Virchow node: supraclavicular node
2. Sister Mary Joseph Nodule: periumbilical nodes
