Thurs July 9 Flashcards
what do neural crest cells give rise to in the intestines?
the submucosal (Meissners) and myenteric (Aurbachs plexus)
what is the timeline of neural crest migration in the intestines, during embryo?
they present in the proximal colon at 8 weeks and are in the rectum by 12 weeks
what is the treatment for an ACUTE episode of gout?
NSAIDS, but if contraindicated, colchicine
what treatments are given for CHRONIC GOUT?
probenicid and allopurinal
how does probenecid work?
inhibits tubular reabsorption of uric acid
what is homocysteine broken down into?
Homocysteine -> cystathione -> cysteine
what condition results from a defect in cystathionine synthase?
homocystinuria
what cofactor is required for cystathionine synthase?
B6
how does homocystinuria present?
hypercoagulability, ectopia lentis and intellectual disability, fair complexion and marfanoid habitus
why may obese women have increased estrogens after menopause?
small amounts of androgens are still produced from the ovaries (normal), and in obese women these are converted to estrogens in adipose tissue
how does peripheral resistance change in someone with hypovolemic shock?
it is high due to sympathetic activation to try to maintain blood pressure. It also shifts blood towards vital organs and helps blood return to the heart
how does a pineal gland tumour present?
Obstructive hydrocephalus and
Parinaud syndrome
what is parinaud syndrome?
Limited upward gaze (preferentially looks down), bilateral lid retraction, and light-near dissociation (pupils that accomodate but dont react to light)
which zone in the liver is effected by viral hepatitis?
zone I
which zone in the liver is effected by yellow fever?
zone II
which zone in the liver is the first to be affected by ischemia?
zone III
which zone in the liver has the highest CYP450 concentration?
zone III
which enzyme converts tyrosine to DOPA?
tyrosine hydroxylase
what enzyme converts DOPA to dopamine?
dopa decarboxylase
which enzyme converts dopamine to NE?
dopamine-beta-hydroxylase
what enzyme converts norepinephrine to epinephrine?
PNMT
which hormone increases the enzyme PNMT?
cortisol (thus increases production of epinephrine)
what is the most common type of thyroid cancer?
papillary
how will papillary carcinoma appear on biospy?
cells with ‘orphan annie eyes’, cytoplasmic inclusions/grooves, and possibly psammoma bodies
how does anaplastic thyroid cancer appear on biopsy?
Pleomorphic cells including irregular giant cells and biphasic spindle cells
chronic pancreatitis can lead to a thombus is which vein?
the splenic vein - runs posteriorly to the pancreas
if there is a thrombus in the splenic vein, the drainage of which other veins are compromised?
the short gastric veins which drain the fundus of the stomach and drain into the splenic vein
side effects of nitrates?
headaches, cutaneous flushing, lightheadedness, hypotension and reflex tacycardia
what is jervell and lange-nielson disorder?
autosomal recessive disorder characterized by sensorineural hearing loss and QT prolongation
mutations in which channel can result to a prolonged QT?
voltage gated K channels
what type of genetic material does zika virus have?
ss RNA
what family does zika virus belong to?
flavivirus
how is the zika virus spread?
via the bite of the aedes mosquito, but infected persons can spread it via genital secretions
what cells does the zika virus target in a growing fetus?
neuroprogenitor cells
presentation of congenital zika virus?
microcephaly
craniofacial disproportion
neurological abnormalities (calcification, ventriculomegaly, cortical thinning)
ocular abnormalities
does rh disease occur in the first pregnancy?
no
can hemolytic disease of the fetus or newborn occur in the first pregnancy?
yes - anti-A and anti-B are formed throughout life from exposure to antigens in food, from bacteria, etc.
when a mother with blood type A or B forms anti B or A antibodies, what type of antibody are they?
ig-M
therefore do not cross the placenta
when a mother with blood type O forms anti B or A antibodies, what type are they?
igM and igG - therefore can cross the placenta
what is female sexual interest/arousal disorder?
a disorder characterized by a lack of or significantly reduced sexual interest/arousal, with normal lubrication/orgasm ability
Must rule out other physical and mental causes
what are the two types of age-related macular degeneration?
dry and wet
how does dry age-related macular degeneration present?
gradual vision loss in one or both eyes
how does wet age-related macular degeneration present?
acute vision loss with metamorphopsia (distortion of straight lines)
how to treat patients with age-related macular degeneration?
both dry and wet: antioxidants and smoking cessation
wet - VEGF inhibitors
explain the pathway of golgi tendon organs when they sense too much muscle tension?
the golgi tendon organs, when sensing too much tension, are associated with Ib sensory axons, that then synapse in the spinal cord with interneurons, which synapse onto alpha motor neurons -> muscle relaxation
what chromosomes are present in someone with klinefelters?
XXY
what hormone changes are found in someone with klinefelters, as a result of hypogonadism?
increased FSH and LH (due to no negative feedback from inhibit/testostone), decreased testosterone and absent sperm count
which bacteria is described as pear shaped?
trichomonas
which bacteria is characterized by having clue cells on wet mount?
Gardnerella vaginosis
what are clue cells?
epithelial cells covered with gram variable rods
what is metaclopramide?
dopamine receptor blocker
what is diphenhydramine?
an antihistamine that can be administered with dopamine blockers to prevent motor side effects
what is canafligozin?
SGLT2 inhibitor
