Test 60 Flashcards
increased aspartate aminotransferase and alanine amiontransferase
hepatcellular damage
increased alkaline phosphatase and gamma-glutamyl
AST > ALTtranspeptidase
bilitary injury
labs that have greatest prognostic significance in pts w/ cirrhosis
impaired biosynthetic capacity:
serum albumin
prothrombin time
imapired transport/metabolic capacity:
bilirubin
observer bias
investigators decision is affected by prior knowledge of exposure status
selection bias
subjects are selected for a study or from selective losses during follow up
confounding
part of exposure-disease relationship can be explained by another variable
wheal observed from an insect sting
Type I hypersensitivity
allergens in insect venom> Ab class switching to IgE>
subsequent exposure>
degranulation of mast cella nd basophils>
release of histamine/heparin
Depressed mood occuring most days for at least 2 years+ 2 of the following: pooor appetite insomnia low energy low self esteem poor concentration feeling of helplessness
dysthymic disorder
major depression
at least 5 sxs are present for at least 2 weeks
SIGECAPS
wound at 5th intercostal space along left midclavicular line
left lung
left ventricle
reaches as far as 5th intercostal space at left midclavicular line
*all 4 champers lie medial ot the line
thoracocentesis
ABOVE the o7th rib in the midclavicular line
9th rib midaxillayr line
11th rib along posterior scapula
insertion of needle below 9th rib at the middle axiallary line
liver injury
cause of alteration in gene expression in huntington disease
deacetylation of histones
prevents trxn of certain genes that code for neurotrophic factors> neuronal cell death
inhibits histone acetyltransferase
hypoacetylated histones
bind tight to DNA
prevent trxn of gnes in associated regions
can cause release of ANP and BNP from ventricular myocytes>
natriuresis and diuresis
ventricular hypertrophy**
volume overload
reperfusion injury
resutls from rgeneration of oxygen free radicals
reflects osteoBLASTIC activity
alkaline PHOSPHATASE
Tartrate resistant acid phosphatase
urinary hydroxyproline
urinary deoxypyridinolone**most reliable
osteoCLASTIC activity
Necrotizing fasciitis pYR positive beta hemomlytic Gram + cocci grows in chains
S. pyogenes (GAS)
PYR positive
candida albicans associations
wearing dentures
diabetes
immunosuppression
tx for absence AND tonic clonic
sodium valproate
ehtosuximide
ONLY absence
phenytoin
tonic clonic seizures
carbamezapine
complex partial seizures
generalized tonic clonic
oculomotor dysfxn
ataxia
confusion
wernicke syndrome
MOst resolve after thiamine administration
korsakoff syndrome
complication of Wernicke encephalopathy
permanent memory loss and confabulation
uninhibited bladder contractions tx
urge incontinence
ANTIMUSCARINIC DRug (M3 receptors)–oxybutynin
ADULT onset ASTHMA
eosinophilia
p-ANCA
mononeuropathy–> wrist drop
Churg Strauss syndrome
pANCA
antibodies against neutrophil myeloperoxidase
chronic restrictive granulomatous interstitial lung disease
elevated ACE levels
Sarcoidosis
hemoptysis
circulating autoAbs agasinst a-3 chain of collagen IV> damage alveolar and glomerular basement membranes
Goodpasture syndrome
inhibit synthesis of ergosterol by fungal p450 enzyes
suppress human p450> drug drug itneractions
itraconazole
amphotericin B
binds ergosterol in cell membrane> pore foramtion/cell lysis
Terbinafine
accumulates in hair/nails
inhibits fungal squalene 2,3 epoxidase
how does shigella gian acess?
M cells in peyers patches in ileum through endycoytosis
how does TPN induce gallstone formation
secondary to bile stasis d/t ABSENT enteral stimulation/disturbance of enterohepatic bile acid cirucliont in those w/ ileal resections
complications of recovery phase of acute tubular necrosis
dehydration
HYPOkalemia d/t high volume, hypo tonic urine
key GFs that promote angiogneesis in neoplastic nad granulation tissue
VEGF and FGF
how do proinflammatory cytokines indirectly promote angiogenesis
IL-1 and IFNy thorugh increased VEGF expression
progressive dyspnea
fine crackles
clubbing
diffuse reticular opacities
interstitial lungn disease>
pulmonary fibrois w/ thickening and stiffening of pulmonary interstitium
What causes supernormal expiratory flow rates (higher than normal) in pts w/ interstitial lung disease?
pulmonary fibrois> increased elastic recoil> airway wideningi d/t outward pulling> decrease in airflow resistance> supernormal expiratory flow rates
anaplastic tumors
bear NO resemblance to the tissue of origin
pleomorphic cells w/ large hypochoromiatic nuclei that gorw in a disorganized fashion
atrial myxoma histological findings
scattered cells w/in a mucopolysaccharide stroma
large peduculated mass in left atrium
leads to strictures and fistulas in Chrons
TRANSMURAL INFLAMMATIoN
