Test 76 Flashcards
x linked recessive inheritance
affected MALES produce unaffected sons and carrier daughters
Carrier females have a 50% chance of producing affected sons and carrier daugthers
G6PD def
X linked recessive
X linked dominant
affected individuals ahve at least 1 PARENT tha tis also affected
affected male will always produce affected daugthers but no sons will be affected
MC cancers in women in order of incidence
mortality
incidence: breast, lung, CRC
mortality: lung, breast, CRC
Fever pharyngitis sandpaperlike rash cicumoral pallor STRAWBERRY TONGUE
SCARLETT fever caused by GAS> pyrogenic EXOtoxins
can lead to ARF or glomerulnephritis
fever
strawberry tongue
rash
BILATERAL CONJUNCTIVAL INJECTION
Kawasake disease
parotitis fever malaise HA myalgias ORHITIS
mumps
neurological complications of measles
encephalitis
acute disseminated encephalomyelitis
subactue sclerosing panencephalitis
dendritic cells found in the SKIN
professional APC (interact closely w/ T)
derived from MYELOID LINE
racket shaped BIRBECK granules
Langerhans cells
MPHAGE derived cells in the LIVER
located in hepatic sinusoids
Kupffer cells
neuroendocrine cells in basal layer of epidermis
perceive touch
can cause carcinoma
Merkel cells
pigmented producing cells of epidermis
Melanocytes
NCC that migrate to BASAL layer of epidermis
Decreased outward K current during repolarization phase of cardiac AP> QT prolongation
major cardiac consequence of QT prolongation?
increased risk of v. tach, like torsades de pointes
dynamic L ventricular outflow obstruction
hypertrophic obstructive cardiomyopathy
dt mut in cardiac sarcomere proteins
where is pulmonary vascular resistance LOWEST
functional residual capacity
Increased lung volumes INCREASE PVR d/t longitudinal steretching of alveolar capillaries
DECREASED lung volumes incrase PVR d/t decreased radial traction from adjacent tissues on large alveolar vessels
direct hernias
often in OLDER men
weakness of TRANSVERSALIS FASCIA in hesselbachs triangle
MEDIAL to IEVs and protruce only through the EXTERNAL ring and are covered by EXTERNAL spermatic fascia
indirect inguinal hernia
male infant
enters internal inguinal ring LATERAL to IEV
caused by PERSISTENT PROCESSUS VAGINALS and filaure of internal ring to close
rare complication of measles that occurs several years after apparent recovery from intiial infection
subacute sclerosing panencephalitis
*oligoclonal bands of measles abs in CSF
progressive multifocal leukoencephalopathy
infectious demyelinating disorder caused by JC virus
prog neuro deficits in IMMUNOCOMPROMISED
fatty oxidation inhibitors
inhibit FA oxid>
SHIFT energy production to glucose OXIDATION>
promotes O2 effieciency
DECREASES amt of oxygen needed to support cardiac xn
DECREASES toxic FA metabolite production
where does ADh act
MEDULLARY segment of CCD
increases UREA and WATER reabsorption
anorexia nausea low grade fever bilirubinuria RUQ tenderness
Acute hepatitis
histology of acute hepatitis
hepatocyte BALOONING degeneration and apoptosis
Councilman bodies (eosinophilic apoptotic hepatocytes)
HBV, HCV, aflatoxin B, chronic hepatocyte injury
increase risk of hepatocellular carcinoma
fibrinoid necrosis
IC deposition> VASCULITIS
nodular regeneration of hepatocytes
pts w/ cirrhosis d/t CHRONIC hepatitis
uncomfortable sensation in legs accompanied by urge to move legs
worse when falling asleep
Tx?
Restless leg syndrome
(Fe def)
Da agonists
cataplexy tx
sudden loss of msucle tone
triggered by strong emotions
MUSCARINIC ANTAGONISTS
includes hte rhinovirus and enterovirus genera
picornaviridae
acid labile picoviridae virus that CANNOT colonize the GI tract or cause castroenteritis
RHINOVIRUS!!
enteroviruses are acid STABLE and therefore can pass through the stomach to infect hte gI tract
MCC of e. coli bacteremia
UTIs
E. coli use FIMBRIAE to colonize UTI tract
major risk factor for progression to ARDS
Acute necrotizing pancreatitis
ARDS
Acute pancreatitis, trauma, sepsis, shock>
diffuse injury to alveolocapillary membrane>
interstitial and intraalveolar edema, acute inflammation, alveolar HYALINE MEMBRANES (fibrin exudate and plasma protein rich edema)
destruction of interalveolar septae
pt w/ emphysema
ONLY class 3 antiarrhythmic w/ beta-adrenergic blocking abilities (bradycardia) and calss 3 K channel blocking properities that can prolong both the PR itnerval and the QT interval
Sotalol
Metoprolol
proanolol
carveidilol
BETA BLOCKERS
decrae HR and contractility by SLOWING AV nodal conduction
Ca channel blockers that affect cardiac tissue
Verapamil (most cardioselective, gingival hyperplasia and constipation)
Chlorpheniramine
diphenhydRAMINE
first gen H1 blockers
SEDATION
Diazepam
long acting BENZO: anxioloytic SEDATION anticonvulsant muscle relaxant
drugs that also cause SEDATION should not be used with diazepam
Loratadine
2nd genration antihistamine
blocks H1
does NOT enter CNS, does NOT cause drwoseiness
Ranitidine
H1 receptor antag
inhibits gastric acid secretion
stroke
intestinal/foot ischemia
renal infarction
…should make you think of EMBOLI
can arise from : atrial clots ventricular clots, vulvular vegations, aortic atherosclerotic plaques
liver injury by HBV
NOT cytotoxic itself
viral HBsAg and HBcAg on CELL SURFACE stimulate host’s cytotoxic CD8 T cells to destroy infected hepatocytes
Peau d/ orange
pitting edema in subcutaneous berast tissue accompanied by SKIN thickening around exaggerated hair follicles
occurs when neoplastic cells plug dermal LYMPAHTIC channels
required for emergence of small adenomatous polyps from normal colonic mucosa
APC mutation (first step in adenoma to carcinoma sequence)
DCC
plays a role in teh FINAL step of progression of large adenomatous polys in adenocarcinoma
Kras
responsible for SIZE incrase in adenomatous polyps
MSH2
one of genes responsible for DNA mismatch repiar
inherited from of CRC: HNPCC or LYNCH
SE of chlorpheniramine and diphenhydramine
ANTIMuscuarine
anti-alpha adrenergic
anti-serotonergic
erythroid precursors in liver and spleen
sign of extramedullary hematopoiesis
MCC of extramedullary hematopoiesis
severe chronic hemolytic anemias (like B thalassemia)
MAJOR CAUSE OF AAA
ATHEROSCLEROSIS>can progress to weaken underlying MEDIA
Intimal FATTY STREAKS are the earliest lestion of atherosclerosis
intimal tear
can initiate formation of disecting aortic aneurysm
medial degeneration
fragmentation of elastic tissue and separation of tunica medai
medial inflammation
arteritis
vasa vasoram obliteartion
how syphillis produces aortic aneurysms
UNCOMMON in US
stage
extend of tumor EXPANSION
grade
degree of tumor DIFFERENTIATION
most important for determinng tumor prognosis
THE STAGE— is it going into other tissue
hemochromatosis
HLA-H gene on chrom 6
affects Fe ABSORPTION from GI tract
marked incrase in FERRITIN
immunosuppresed pt w/ febrile neutropenia has increased susceptibiltiy to…
GRAM - orgs like p. aeruginosa
ecthyma gangrenosum
assocaited w/ p. aeruginosa bacteremia
skin patches w/ ulceration and necrosis d/t insufficient blood flow
MC outcome in HBV infected adults
> 95% is acute hepatitis w/ mild sxs that completely resolve
respiratory distress, confusion, upper body petechial rash (thrombocytopenia) w/in dyas of long bone fxs
FAT embolism syndrome
multiple fat emoboli in pulmonary microvascularture stain BLACK w/ osmium tetroxide
heparin
increases the effect of naturally occuring anticoagulant anti thrombin III
Pulmonary artery HTN
TWO Hit hypothesis:
abnormal BMPR2 gene predisposes to pullmonary vascular disease
second insult: activates disase process
VASCULAR SM proliferatoin in pulmonary vasculature> elevated pulmonary pressures
fish odor
KOH
clue cells
bacterial vaginosis
complications of long term tx of parkinsons w/ levodopa
periodic and unpredictable fluctuations in motor fucntion (on-off phenomenon)
d/t progressive nigrostriatal neurodegeneration leading to decrased therapeutic window for ldopa
flat topped violaceous papules over joints of fingers
heliotrope rash
cutaneous involvement of dermatomyositis
may also see myopathy
elevated CK
positive ANA
langerhans giant cells
indicative of granulomatous conditions
multiple nucle organized in horseshoe shape
mphages actavated by CD4 T cells
causes sxs similar to SVC syndrome but on ONE side of the body
brachiocephalic vein obstruction
