Test 75: All Flashcards
What is the PD-1 receptor and where is it found
- found on cancer cells
- inhibit T-cell activity
Where is CD28 found and role
- naive T cell
- binds to APC B7 receptor
- costimulatory signal for T cell activation
Normally, what are 2 sources of HCl neutralization
- submucosal (brunner) glands
2. pancreatic duct secretion
Presence of aid in duodenum and jejunum causes release of what
secretin
- stimulates secretion of bicarbonate from submucosal glands and pancreas
Where is bicarbonate secreted from from ileum and colon
ileum: villi
colon: crypts
What cytokines mediate systemic inflammatory response
IL-1
IL-6
TNF - alpha
what are acute phase reactants
- fibrinogen
- ferritin
- C-reactive protien
- serum amyloid A
- serum Amyloid P
- complement factors
role of Thromboxane A2
- vasoconstriction
- platelet aggregation
Impact of fibrinogen on erythrocyte sedimentation rate ( ESR)
fibrinogen increases ESR
What in cyclophosphamide causes hemorrhagic cystitis
- acrolein
Dexrazoxane
iron-chelating agent
- prevent anthracycline-induce cardiotoxicity
Filgrastim
G-CSF
Folinic acid
treat methotrexate overdose
Early systolic, high-frequency click over there right second interspace
bicupsid aortic valve
CSF flows from third ventricle to fourth ventricle via
cerebral aqueduct of Sylvius
Obstruction at foramen of Monro causes what.
enlargement of lateral ventricle
Obstruction of Magendie and Luschka causes what
enlargement of all 4 ventricles
What type of immunity is needed for listeria moncytogenes and why
- cell mediated
- rocket tails via actin polymerization that allows intracellular movement and cell-in broth, avoids antibodies
What is the virulence factor for Listeria?
Listeriolysin O: lyse vacuolar membrane
Excess of what vitamin can cause mental status changes, muscles weakness, constipation, polyuria/polydipsia, and dehydration
hypercalcemia
Sarcoidosis produces excess what
1,25-dihydroxyvitamin D
25-hyroxyvitamin D is converted to 1,25-dihydroxyvitamin D via what and where
1-alpha-hydroxylase in kidneys, regulated by PTH
how does granulomatous diseases such as sarcoidosis and tuberculosis create hypercalemia
expression of 1-alpha-hydroxylate in activated macrophages
Amino acid Tryptophan makes what
Niacin and Serotonin
Treatment for Actinomyces israelii
penicillin
Varicocele
- dilated veins in pampiniform plexus due to increase venous pressure
Esophageal varices, rectal varices, and periumbilical venous distention are signs of what
portal venous hypertension
what is not part of portal venous hypertension
renal veins
Tay-Sachs is a deficiency in what
Hexosaminidase A
What accumulates in Tay-Sachs
GM2 ganglioside
patient with cherry-red macular spot and neurodegeneration
Tay-Sachs
Patient with Hepatosplanomegaly, neurodegeneration, and cherry-red macular spot
Neiman-Pick
What iniates atherosclerosis
endothelial cell injury
What is the rate-limiting enzyme in the pentose phosphate pathway
Glucose-6-phosphate dehydrogenase
What does glucose-6-phosphate dehydrogenase convert
glucose-6-phosphate to 6-phosphogluconate
What does the pentose phosphate pathway produce
NADPH and ribose-5-phosphate
Relate pentose phosphate pathway and RBC
- RBC uses NADPH to maintain steady supply of glutathione
Yellow-green vaginal discharge and vaginal burning
Trichomas vaginitis
Best test to confirm diagnosis for Trichomas Vaginitis
Saline microscopy ( wet Mount)
Carbonxyhemoglobin, partial pressure of oxygen and methemoglobinemia concentration levels when CO poisoning
Carboxyhemoglobin increases
partial pressure of oxygen and methhemoglobinemia same
what are oxygen levels in CO poisoning
- decreases oxygen-carrying capacity
- decreases oxygen content of blood
- Normal oxygen dissolved in plasma
Injections given in the supermodel part of the buttock risk injury to what
superior gluteal nerve
Injections where have a risk injury to the sciatic nerve
- superomedial
- inferomedial
- inferolateral region of buttox
Trendelenburg gait
hip drops down as ipsilateral foot is lifted off the ground
Trendelenbrug gait is injury to what
contralateral superior gluteal nerve
- gluteus medius muscle
What is Enoxaparin
- Low molecular weight heparin
- binds and activates antithrombin III
- binds to factor Xa
- prevents prothrombin to thrombin
- primarily acts on Xa, not thrombin
tPA converts what
plasminogen to plasmin
- plasmin breaks fibrin
What is wrong in methylmalonic academy
complete or partial deficiency of methylmalonyl-CoA mutase
how do newborns present with methylmalonic acidemia
lethary, vomiting and tachypnea
lab values for Mathlamalonic acidemia
serum: hyperamminoa, ketotic hypoglycemia, metabolic acidosis
urine: methylmalonyl-CaA mutase
Acyclovir toxicity? prevention for toxicity
- crystalline nephropathy
- acute renal failure
- need to adequately hydrate
What drug is a resistance mechanism of substitution of D-lactate in place of D-alanine during peptidoglycan cell wall synthesis
vancomycin
What is the binding site of vancyomycin
D-alanyl-Dalanine
What stimulates gastric acid secretion
cephalic and gastric phases
what reduced gastric acid secretion
intestinal influences
What is Latanoprost
prostglandin analog
MOA for Latanoprost
increase outflow of aqueous humor
side effects of latanoprost
- darkens color of iris (browning)
- eyelash growth
Define open angle glaucoma
increased intraocular pressure
Increased formation of new blood vessels at the optic disc is characteristic feature of what problem
diabetic retinopathy
Patients treated with clozapine are required to have what monitered
absolute neutrophil count due to risk of life-threatening agranulocytosis
Which second-generation antipsychotic is the only antipsychotic that has consistently shown superior efficacy in treatment-resistant schizophrenia
Clozapine
what should be monitored for lithium
thyroid function and creatine
common adverse effect for Ziprasidone
prolonged QT interval
Adverse effect of Risperidone
hyperprolactinemia
Drugs that have been shown to improve long-term survival in patients with heart failure due to left ventricular systolic dysfunction are
- beta blockers
- ace inhibitors
- angiotensin II receptor blockers
- Aldosterone antagonists
Calcitriol
active form of vitamin D
Alendronate
inhibits osteoclast function
Cinacalcet
decrease PTH
Sevelamer
decrease absorption of phosphate in GI tract
Cannulation (puncturing) above the inguinal ligament increases risk of hemorrhage where
retroperitoneal hemorrhage
During skeletal muscle contraction cycle, ATP binding to myosin causes what?
release of myosin head from its binding site on the actin filaments
in muscle contraction Calcium binds to what
Troponin C
- shifts tropomyosin away from myosin binding site on actin
Myosin light chain kinase phosphorylates the myosin light chain, activating myosin to bind actin filaments in what type of muscle
smooth muscle cells
Complete or partial loss of an X chromosome results from what process
paternal meiotic nondisjunciton
Uniparental disomy
indivicual inherits 2 copies of a chromosome from one parent and no copies of the chromosome form other parent
Prader-Willi
2 maternal copies of chromosome 15 due to deleted or unexpressed maternal chromosome
Angelman syndrome
2 paternal copies of chromosome 15 due to deleted or unexpressed maternal chromosome
Symptoms of Internal carotid artery
- ipsilateral nasal hemianopia
- damage uncrossed optic nerve fibers from temporal portion of retina
lesion in lateral aspect of optic chiasm causes
ipsilateral nasal hemianopia
Interferon-gamma does what
- activates macrophages
- increase MHC
- promote T helper 1 cells differentiation
who produced interferon-gamma
T lymphocytes
Natural killer cells
Interferon-gamma release assay tests for what
Latent tuberculosis infection
What arises from 3rd pharyngeal pouch
thymus and inferior parathyroid gland
Myasthenia gravis patients usually have what organ problem
thymoma or thymic hyperplasia
what arises from 4th bronchial pouch
- superior parathyroid
- ultimobranchial body
- parafollicular cells of thyroid
What arises from 2nd branchial much derivatives
epithelial lining of palatine tonsil
what arises from 1st branchial pouch derivative
- middle ear cavity
- eustachain tube
- mastoid air cells
Ethanol inhibits what glucose pathway? causes?
gluconeogenesis
- cause hypoglycemia once hepatic glycogen stores are depleted
how does alcohol prevent gluconeogenesis
- pyruvate to lactate
2. Oxaloacetate to malate
Ethanol increases what ratio
NADH/NAD+
How does aflatoxin lead to hepatocellular carcinoma
G-to-T mutation in gene p53
High synovial fluid leukocyte count and absent crystals on microscopic examination suggests
bacterial join infection
MOA of Allopurinol
lowers serum uric acid levels
MOA of Colchicine
reduces acute inflammation of gouty arthritis by inhibiting neutrophil migration into inflamed areas
MOA of Selegiline? what is it used for
- inhibitor of MAO, type B
- blocks conversion of dopamine to DOPAC
- delay progression of Parkinson disease
Amantadine MOA for Parkinson’s
- increase dopamine release
- decrease dopamine uptake
MOA of Pergolide
dopamine agonist of D2 receptors
Triad for Plummer-Vinson syndrome
- dysphagia
- iron deficiency anemia ( shiny red tongue, koilonychia - spoon shaped nails)
- esophageal web
Progressively weakening diaphragmatic contractions during maximal voluntary ventilation with intact phrenic nerve stimulation indicates
- neuromuscular junction pathology
2. abnormal rapid diaphragmatic muscle fatigue
