tues aug 11 Flashcards
cyclosporine MOA
calcineurin inhibitor - blocks IL 2 production and release thus decreasing t cell actiavation
adverse effects of cyclosporine?
- neprhotoxicity
- neurotoxicity
- hirsutism
- gingival hyperplasia
tacrolimus MOA
calcineurin inhibitor - impairs IL2 production and release
adverse effects of tacrolimus
nephro/neurotoxicity
sirolimus MOA
-blocks mTOR -> decreased t cell induced proliferation
what kind of necrosis occurs in the lungs in the situation of a lung abcess?
liquefactive necrosis
how does adenosine effect the heart?
decreases heart rate and conduction velocity
where do you access the herniated fragment in disc herniation, when performing a laminectomy?
the lamina
myenteric plexus AKA
aurbachs
submucosal plexus AKA
messenteric
what is the cytokine effect seen in cancer??
release of cytokines in chronic disease that can lead to cachexia (TNFalpha, IL1,IL6 etc may activate ubiquitin system in cells causing cell death)
what neoplastic syndromes are seen in small cell lung cancer?
siADH
ACTH
lambert eaton
what neoplastic syndrome may be seen in squamous cell lung cancer?
PTHrp leading to hypercalcemia
idiopathic pulmonary fibrosis lung findings
fibroplastic foci and patchy fibrosis
-no granulomas
fibroplastic foci is buzzword for..
idiopathic pulmonary fibrosis
findings of cryptogenic organizing pneumonia?
- lymphocytic infiltrate
- fibrosis
what is solar elastosis (actinic elastosis)
an accumulation of abnormal elastin in the dermis of the skin or conjuctiva of the eye which occurs from cumulative effects of sun exposure (photoaging)
how do alcohol based products work against pathogens?
they disrupt lipid membranes
what toxin of group A strep causes scarlet fever?
erythrogenic toxin
which toxin of group A strep causes toxic shock?
speA and speC
which toxin of group A strep causes necrotizing fascitis??
speB
is subacute thyroidits (dequiverns thyroidits) painful?
yes
histology of subacute thyroiditis?
granulomas
at low doses dopamine activates
D1 receptors -> increased renal blood flow
D1 receptor is coupled to..
Gs
D2 receptor is coupled to…
Gi
at medium doses dopamine acts on…
B1 receptors
at high doses dopamine acts on…
alpha 1 receptors
what is found in the urine of someone with acute interstitial nephritis?
pyuria, classicaly with eosinophils
causes of acute interstitial nephritis (tubulointerstitial nephritis)?
diuretics, NSAIDS, penicillins, PPIs, rifampin, quinoloes, and may occur secondary to infection/disease
findings in hereditary hemorrhagic telangiectasia? (osler-weber-rendu syndrome)?
- telangiectasias
- reccurrent epistaxis
- skin discolourations
- AV malformatinos
- GI bleeds
- hematuria
what are paneth cells?
cells found in the intestines and secrete antimicrobial peptides
which part of the ureter is the last to recanulize?
the proximal portion
function of petroleum jelly on wound?
acts as a barrier so things dont get in it and keeps moisture in
what do HOX genes code for?
transcription factors needed during embryognesis
how do prostaglandins effect the uterus?
increase uterine contractions
what substances are combined by ALAS to make ALA?
succinyl-coa and glycine
buzz word for rotavirus?
wheel-like shape
what is the shape of the capsid of rotavirus?
icosahedral
what type of genetic material does rotavrius have?
segmented, DS rna
why are ACTH secreting tumours associated with bone fractures?
cortisol causes osteoporosis
what is a pseudocholinesterase deficiency?
an autosomal recessive inheritance of a blood enzyme. Results in increased sensitivity to certain anesthetics
inheritance of pseudocholinesterase deficiency?
AR
what is thought to provoke attacks in vasospastic angina?
increased vagal tone (this is why its seen more at night)
explain the pathophys of vasospastic angina?
- caused by endothelial dysfunction and autonomic imbalance
- Ach from the vagus nerve stimulates endothelial muscarinic receptors to release NO and cause vasodilation, but the endothelial cells have deficient endothelial NO and instead spasm
what are the types of germ cell tumours in males?
seminomas and non-seminomas (embryonal carcinoma, yolk sac tumour, choriocarcinoma)
what is often detectable in the blood of someone with a germ cell tumour?
hormons such as LDH, beta hCGH and alpha fetoprotein
what do leydig cell tumours secrete?
estrogen or testosterone
presentation of ALS?
both upper and motor neuron symptoms
microscopic neurological findings of ALS?
- loss of neurons in anterior horn (LMNs)
- loss of lateral corticospinal tracts (UMNs)
- loss of neurons in the motor nuclei (V, IX, X, XII)
- denervation atrophy of muscles
where does poliomyelitis damage?
the anterior horns
does polio effect both the lower and upper motor neurons?
NO JUST THE LOWER
huntington disease presentation?
-progressive dementia, beahviour changes, choreiform movements
damage to the brainstem below the red nucleus causes what kind of posturing?
-decerebrate (extensor) - due to loss of excition to the upper limb flexs
damage to the brainstem above the red nucleus causes what kind of posturing?
decorticate (flexor posturing) - due to loss of excitation to the upper limb extensors
what condition causes a widely split fixed S2 with a midsystolic ejection murmur?
ASD - due to increased blood going to the right side
does a VSD cause a split S2?
yes but it is not fixed
what kind of murmur is heard with a VSD?
-holosystolic with split S2
how do thryoid hormone levels change in response to temperature?
Hypothermia -> increased thyroid hormones
Hyperthermia -> decreased thyroid hormones
what reaction does lactate dehydrogenase perform?
Converts pyruvate to lactate (this regenerates NAD from NADH)
how do patients with a lactate dehydrogenase deficiency present?
-during strenous muscle activity leading to aneorobic conditions in the muscle, these patients cannot generate lactate and thus cannot regenerate NAD. Normally NAD+ would feed back into glycolysis so glycolysos would continue, but now it cannot and this leads to muscle breakdown, pain, fatigue
presentation of lactate dehydrogenase deficiency?
fatigue, muscle pain, and cramps during exercise
which structure contains the ovarian artery?
-suspensory ligament (infundibular ligament)
nosocomial bloodstream infections are usually from which source?
intravascular catheters
