Test78: All Flashcards
Absent P waves, narrow QRS complexes, and irregularly irregular R-R intervals?
Atrial fibrillation
Conditions where atria undergo rapid depolarization, what regulates the number of impulses that reach ventricles
AV node refractory period
- also determines ventricular contraction rate
Bundle branch conductivity determines what in EKG
QRS complex
what is the assume pacemaker in patients with severe bradycardia
Purkinje system
Patient with no apparent liver disease who have mild uncojucated hyperbilirubinemia, suggetsts
Gilbert
When does surfactant get made in fetal baby
end of pregnancy
what is a component of surfactant
Dipalmitoylphosphatidylcholine
- type of lecithin
What ratio indicates mature fetal lungs
lecithin-to-sphingomyelin ratio greater than 1.9
How is betamethasone administration to a pregnant women before 32 weeks delivery do to the baby
accelerates maturation of type II pneumocytes
Chronic lithium toxicity can be caused by what?
- volume depletion
- Thiazide
- Diuretics
- ACE inhibitors
- NSAIDS
Positive and negative predictive values are influenced by what
disease prevalence
Squamous cell carcinoma can produce whwat
HyperCalcemia from PTHrP
Growth hormone causes the release of what from where
Insulin-like growth factor -1 from liver
Laron dwarfism
defective GH receptors
Role of Homeobox genes
- encode DNA-binding transcription
- segmental organization of embryo along crania-caudal axis
Releasing factors recognize what
stop codons and terminate protein synthesis
What are the stop codons
UAA
UAG
UGA
Role of elongation factors
facilitate tRNA binding and translocation steps of protein synthesis
2 year old healthy boy with fever and mouth pain. Swollen gums and vesicular inflamed lesions of hard palate and lips. Enlarged tender cervical lymph nodes. probably has
HSV-1
Genome for HSV-1
Enveloped double stranded DNA
Genome for Adenovirus
non-enveloped double stranded DNA
Single-stranded, non-enveloped DNA
parvovirus
Double-stranded, positive sense, non-envoloped RNA
rotavirus
Genome for Coxsackievirus
- single stranded
- positive sense RNA virus
Difference between Coxsackie and HSV PE on child
HSV involves gums and hard palate not Hand-foot-mouth disease
Which drugs inhibit dihydrofolate reductase
- Trimethoprim
- Methotrexate
- Pyrimethamine
What is Imipenem always given with and why
Cilastatin - inhibits renal dehydropeptidase I
- decrease inactivation of Imipenem
MOA of imipenem
binds penicillin binding proteins
MOA for metronidazole
binds to DNA within susceptible cells
MOA of sulfamethoxazole
competes with PABA in inhibit dihydropteroate syntheses
Fever, cough, rhinorrhea, and conjunctivitis followed by maculoopapular rash that starts on the face and spreads downwards? Tiny white/blue gray lesions on buccal mucosa
Measles
PE for Galactokinase deficiency
- galactose in blood
- galactose in urine
- infantile cataracts
11 year old girl: blurry vision, bilateral lens opacities and reducing substances found in urine. What enzyme is deficient
Galactokinase
lactose is broken down into what
- galactose
- glucose
What causes cataracts in galactokinase deficiency
- galactitol
Aldolase B deficiency can’t metabolize what
fructose
Tay-Sachs disease is a deficiency of what
hexosaminidase A deficiency
Sphingomyelinase deficiency is seen in what disease
Niemann-Pick disease
2-year old boy has giardiasis which is treated. One week later gets frothy, loose, stools and abdominal bloating and cramping. What is the defective enzyme
Lactase
Acidosis stimulates what in the kidney
remal ammoniagensis
What is renal ammoniagenesis
- renal tubular epithelial cells metabolize glutamine to glutamate generating
1. ammonium that is excreted in urine
2. Bicarbonate is absorbed into blood
What does Alanine get converted to
pyruvate
What does aspartate get converted to
oxaloacetate
Role of Arginine
remove nitrogenous bases from blood
Pernicious anemia impacts what part of the stomach
body of stomach rather than antrum
What part of the stomach does H. pylori usually impact
gastric antrum
Chronic granulomatous disease is what? inheritance pattern
- Deficiency of NADPH oxidase
X-linked
Nitroblue tetrazolium dye reduction test is obsolete
Chronic granulomatous disease
Who produces Lecithinase
Clostridium perfingens
Where does intussusception usually occur
ileocecal valve
how does intussusception manifest
- intermittent, severe, colicky abdominal pain
- “current jelly” stool
- sometimes palpable mass
MOA for polyethylene glycol
- provide osmotic load to draw water into the GI lumen
How is Polyethylene glycol and lactase deficiency similar
both osmotic
Anterior compartment of the leg contains what nerve
deep perennial (fibular) nerve
What is located in the anterior compartment of the leg
- anterior tibial artery
2. deep perennial fiber
lateral compartment of leg contains what nerve
superficial peroneal nerve
the deep posterior compartment of the leg contains what nerve
tibial nerve
Branching papillary structures with interspersed calcified bodies of thyroid
Papillary thyroid cancer
Extensive stromal fibrosis that extends beyond the thyroid capsule in thyroid
Riedel thyroiditis
Follicular hyperplasia with tall cells forming intrafollicular papillary projections in thyroid
Papillary thyroid
Mixed cellular infiltration with occasional multinucleate giant cells in thyroid
Subacute ( de quervian, granulomatous) thyroditis
Mononucelar parenchymal infiltration with well developed germinal centers
Hashimoto thyroiditis
Brain natriuretic peptide has what 2 roles
- diuretic natruretic
2. vasodilator effect
What is Neprilysin
Metalloprotease that cleaves and inactivates endogenous peptides including natriuretic peptides
28 year old women with eye irritation and double vision. Complains of weight loss, mood swings, and heart palpitation. High BP. Bilateral eye redness and severe proptosis. What does she have? txt?
Grave’s disease
- Glucocorticoids, antithyroid drugs do not have an impact of ophthalmopathy
which group of women have a higher bone density and lower risk of fractures than other women
African American
Flutamide MOA
competitive inhibitor of testosterone receptors
What is flutamide used for? What is it combined with
Prostate carcinoma
- Lueprolide
Inferior wall of left ventricle forms most of the interior surface of the heart and is supplied by who
Posterior descending artery
Right dominant: right coronary artery
What does right dominant heart mean
- Right coronary artery gives rise to posterior descending artery
Specifically where is the trigeminal nerve located
middle cerebellar peduncle at lateral aspect of mid pons
Function of Trigeminal nerve
- muscles of mastication
- Facial sensation
- Somatosensation from anterior 2/3 of tongue
Location of facial nucleus
Dorsolateral aspect of caudal pons
- exits at ventrolateral pontomedullary junction
Location of hypoglassal nuclea
medially on floor of 4th ventricle at level of medulla
Location of exit of trochlear nucleus
caudal midbrain and nerve exists dorsal midbrain just below inferior colliculus
What artery runs with the radial nerve
deep brachial artery
What type of injury can hurt both the radial nerve and deep brachial artery
mid shaft of humerus
Axillary nerve runs with what artery? type of injury
Posterior circumflex
- Surgical neck of humerus
Fluphenazine is what type of drug
1st generation antipsychotic
What are the high potency antipsychotics
Trifluoperazine
Fluphenazine
Haloperidol
Side of effects of high potency antipyschotics
neurologic /extrapyramidal symptoms
What are low potency Antipsychotics
- Chlorpromazine
- Thioridzine
Side effects of low dow antipsychotics
- histaminergic
- cholinergic
- noradernergic
blockade
What is the mitochondiral enzyme that activates capsizes and indirectly brings about cell death through intrinsic pathway apoptosis
cytochrome C
What prevents cytochrome c release
bcl-2
Who usually gets Hemosiderin accumulation
- hemolytic anemia
- frequent blood transfusion
Role of Succinate dehydrogenase
in electron transport chain that acts by oxidizing succinate into fumarate and reducing FAD to FADH2
What does bcl-2 bind to and what are their roles
- binds APAF-1
- normally binds cytochrome c and induces activation of capsize 9
MOA for organophosphate toxicity
prevent ACh degradation within synaptic cleft
MOA for Botulism
blocks presynaptic exocytosis of ACh vesicles
How can Botulinum toxicity be prevented
it is heat labile, throughly heating food prior to consumption
What organ is spared in polyarteritis Nodosa
lungs
Most common disorder of porphyrin heme synthesis
Porphyria cutanea tarda
Porphyria cutanea tarda is deficient in what enzyme
- uroprophyrinogen decarboxylase
Enyzme deficiencies in early steps of porphyrin synthesis causes what physical exam findings
- neuropsychiatric without photosensitivity
Late step enzyme deficiency leads to what physical exam
photosensitivity
Role of bilirubin glucuronyl transferase
- conjugation of bilirubin with glucuronide
- improves solubility for biliary excretion
What cofactor is needed for ALA synthase
pyridoxal phosphate
vitamin B6
PBG deaminase deficiency is seen in what problem
acute intermittent porphyria
What is subclavian steal syndrome
severe stenosis of proximal subclavian artery
- reversal blood flow from contralateral vertebral artery to ipsilateral vertebral artery
Symptoms of subclavian steal syndrome
- arm ischemia
- vertebrobasilar insufficiency ( dizziness, vertigo)
equation for relative risk reduction
( absolute risk control - absolute risk treatment) /( absolute risk control)
