Tues July 14 Flashcards
cancers may cause hypercalcemia by secreting which substance?
PTHrP (parathyroid hormone RELATED PEPTIDE)
where is the inflammation primarily found in chronic lung transplant rejection?
small airways
pathophysiology of chronic lung transplant rejection?
Submucosal lymphocytic infiltrates in the small airways lead to inflammation and subsequent granulation tissue into the lumen, which leads to obstruction and obliteration
what will be found on histology of HYPER ACUTE lung transplant rejection?
preformed host antibodies against donor tissue lead to immediate inflammation consisting of hemorrhage and fibrinoid necrosis
what will be found on histology of ACUTE lung transplant rejection?
this is a cell-mediated response so there will be mononuclear infiltrate - found in the small vessels which may expand into the alveolar walls
What are the steps in activation of G q coupled proteins?
Gq activates phospholipase C, which breaks down PIP2 into DAG and IP3. IP3 increases intracellular calcium, which activates protein kinase C
will a PCA aneurysm effect the CN III fibers of the ipsilateral eye or contralateral eye?
ipsilateral
which insulins are the only human recombinant insulins that do not have changes to the amino acid sequence?
Regular insulin and NPH
Rupture at which part of the bladder can result in intraperitoneal free fluid?
At the dome - this portion is covered by the peritoneum and rupture here may result in urine going into the intraperitoneal space
is the relationship between creatinine level and GFR linear or exponential?
EXPONENTIAL - non linear
pathophys of tetanus?
-enters via wound - the pathogen stays at the infection site and the toxin enteres the presynaptic terminals of lower motor neurons and travels retrograde to the spinal chord, where it blocks inhibitory interneurons
which region in the lymph nodes is populated by t cells?
paracortex
whats the function of tracheal toxin in bortedella pertussis?
directly damaged and destroys ciliated epithelial cells leading to a loss of airway protection
whats the function of pertussis toxin in bortedella pertussis?
enters cells and activates adenylyl cyclase leading to alterations in cell signalling that inhibit phagocytosis
which substances are responsible for coronary blood flow autoregulation?
adenosine and NO - maintain blood flow wihtin a constant range
what occurs in the first few weeks of mycobarium TB infection?
the mycobacteria get into macrophages and inhibit phagolysosome function, allowing them to replicate within cells. It takes a few weeks before the t cells are activated
giant pronormoblasts may be seen in which conditions?
Aplastic crisis caused by parvovirus 19
what does a LOW blood/gas partition coefficient mean?
The gas is poorly soluble in blood, it will saturate very quickly leading to fast rise in partial pressure
what does a HIGH blood/gas partition coefficient mean?
The gas is highly soluble in blood, the blood will saturate slowly leading to a slow rise in the partial pressure of the gas in the blood
what conditions is someone receiving testosterone replacement at risk for?
- increased risk of prostate cancer (metabolized into DHT which stimulates the prostate)
- erythrocytosis - it leads to increased blood viscosity secondary to increased intestinal iron absorption and thus increased risk for clots
what measurements should be monitored after starting someone on testosterone replacement therapy?
PSA and hematocrit
the presence of which marker in a pregnant woman with Hep B indicates a very high risk of vertical transmission to the baby?
HBeAg
how does administration of corticosteroids to a pregnant women at risk of premature labour help prevent respiratory distress in the infant?
it accelerates maturation of the type II pneumocytes in the baby’s lungs
what deposits in the glomerulus in post-strep glomerulonephritis?
IgG and C3
what will be seen on IF and EM of post strep glomerulonephritis?
IF - granular staining along GMB
EM - subepithelial humps
methadone may increase risk for which cardiac condition?
long QT syndrome
what is torsades de pointes?
a ventricular arythmia that may cause syncope and SCD
A patient has multiple myeloma with bony lesions, what will their PTH, 1,25 vit D and urinary Ca levels be?
decreased PTH (via negative feedback from increased serum calcium), decreased 1,25vitD (from decreased conversion in kidney due to decreased PTH), and increased urinary Ca (loss of Ca due to lack of PTH)
how does digoxin cause heart rate lowering effects?
Increases vagal tone slowing down the ventricles
-by blocking the Na/K atpase in vagal afferent fibers it sensitizes baroreceptors
kegels strengthen which muscles?
the levator ani
wide and fixed splitting of S2 is suspicious for…
an atrial septal defect
what can cause a transient shunt reversal of the left to right shunt?
activites that increase the right pressure such as coughing or straining
A patient who has just received blood transfusions has tingling or muscle spasms. What is going on?
There are experiencing symptoms of hypocalcemia due to chelation of calcium with citrate. Donated blood is mixed with citrate to prevent coagulation. Large transfusions can result in chelation.
