usmle uworld and nbme Flashcards
drug that stimulates granulocyte colonies to increase WBC in neutropenic pts
filgrastim
used to prevent bone marrow suppression while using methotrexate
leucovorin
___ hyperstabilizes mictrotubule polymers while ____ inhibits microtubule polymers
paclitaxel, vincristine
sign of pum htn
P2 higher than A2, normally aortic valve closes louder than pulmonic valve due to higher pressure. in this case it is reversed
how do baroreceptors work
stretch receptors, will fire more when there is more fluid
hemmorhagic shock pathophys
low blood volume causes decrease stretch on baroreceptors so low arterial barororeceptor firing rate, low arterial (afferent) baroreceptor firing rate activates efferent sympathetic firing which activates raas and causes vasoconstriction (increased tpr and systemic vascular resistance. capillaries in kidneys will want to reabsorp contents not filter
place where pelvic free fluid goes to
pouch of douglas
itchy butt, egg on tape test, fecal oral transmission
enterobius vermicularis, pin worm
nematode that migrates from nose to mouth obstruction at iliocecal valve, biliary obstruction, intestinal performation, seen on stool microscopy
giant roundworm, ascaris lumbricoides
larvae from soil that penetrates intestinal wall, seen in feces on microscopy
strongyloides (thread worm)
larvae that causes microcytic anemia, serpiginous itchy rash, walking barefoot on beach, can be in intestine
ancylostoma (hookworm)
sensitivity=
1- FN
biphosphonates (alendronate, risedronate)
bind hydroxyapeatite on bone and inhibit osteoclast activity
leflunomide
inhibit dihyrdooroate dehydrogenase, prevent pyramidine synthesis supressing T cell proliferation, used in RA
salicycate Acid Base Finding
met acidosis and respiratory alkalosis, not compensatory respiratory alkalosis
teriparatide
recombinant pth analog that increases osteoblastic activity, increases risk of osteosarcoma, dont give for paget give biphosphonate
reason behind edema following injury
endothelial tight junctions become permeable so tha neutrophils and other immune immediators can travel to site of injury
what are the “tingibly Body” macrophages on the “starry sky” histo of burkitts
phagocytosed apoptic cells
transactivation of TAX gene leads to
Adult t cell lymphoma, caused by HTLV
desmopressin moA
activates aquaporin channels through ADH. ADH increases cAMP
hormones that work through non receptor tyrosine kinase
Insulin and the growth factors: IGF, FGF, PDgf, EGF
nonreceptor tyrosine kinase hormones
prolactin, immunomodulators (IL2,6, IFN) Growth hormone Erythropoien thrombopoieten and JAK STAT
cGMP
BNP, ANP, Nitric Oxide (EDRF)
IP3
GnRH, Oxytocin, ADH, TRH, Histamine, Angiotensin II, Gastrin (GOAT HAG)
Intracellular receptor Hormones
Progeserone, estrogen, testosterone, cortisol, aldosterone, t2 t4, vit D
fasting physiology timeline
glycogenolysis (6-24) gluconeogenesis (24)
chemotatic factor for neutrophils
C5a, leukotriene B4, lamin digest, platelet activating factor
mediastinal shift
tension pneumo
RSV properties
RNA virus, fusion protein entry, tx with palivisumab (blocks viral fusion)
Rhogam
binds and removes RhD antigens, preventing formation of maternal antibodies to RhD
fever, palmar erythema, lymphadenopathy after being treated with rabbit antithymocite IgG
Serem Sickness, type III hypersensitivity
Causes of serum sickness
foreing proteings, IgG, drugs (haptens, penicillin,) infections such as HepB
zoonotic infx in New mexico with necrotic lesions that drain blood, swollen infected lymph nodes or buboes
yersinia, similar presentation to fransicella but in midwest, tx both with aminoglycosides
external rotation of shoulder
teres minor and infraspinatus
which artery supplies parathyroid gland
inferior thyroid artery, branch of thryocervical trunk which branches from subclavian artery
superior thyroid artery branches off the
external carotid, runs along the superior laryngeal nerve
Ca Oxalate stone tx in patients with increased Ca in urine
thiazide diuretics, work on NaCl symporter to increase Ca reabsorption which causes hyperCa and decrease Ca urine
old person with blisters in areas of flexion, friction, do not break easily
pemphigus bullous, hemidesmisomes, break in basement membrane and keratinocytes
mec A- positivity in bacteria
bacteria is methicillin resistant, tx with vanc
genetic polymorphism
variation of alleles in a locus. variation in mutation of nucleotide that does not cause change the amino acid at the locus ex marfans
Type I and II pneumocytes during lung damage
any lung damage will cause depleion of type 1 pneumocytes since they make up 97% of lung surface. type II will proliferate in response to type I depletion.
malonyl coA
stimulates fatty acid synthesis, inhibits fatty acid degradation and beta oxidation
hexokinase vs glucokinase
converts glucose to G6P in tissues, used when glucose concentrations are low; glucokinase converts glucose to G6P in liver when glucose concentrations are hight
Glycolysis activators
AMP, fructose 2,6 biphosphate activate PFK1; fed state: increase insulin, decrease cAMP, decrease protein kinsase A, decrease FBPase 2, increase PFK2 which increase fructose 2,6 BP which activates PFK1
Gluconeogenesis regulating enzyme
fructose 1,6 BP (1,6 NOT 2,6)
glycolysis regulating enzyme
PFK1
Gluconeogenesis activators
ATP, Citrate; fating state: incease glucagon, increase cAMP, Incr protein kinase, Increase FBPase 2, decrease PFK2
FBPase 2
glycolysis/gluconeogenesis off/on switch. Increase FBPase 2 favors gluconeogenesis; Decrease FBPase 2 causes increase PFK 2 favors glycolysis
Fructose 2,6 biphosphate
increases glycolysis, decreases gluconeogenesis
TCA activators
Pyruvate dehydrogenase, ADP, citrate synthase, alpha keto glutarate dehydrogenase, isocitrate dehydrogenase
TCA inhibitors
ATP, Acetyl CoA, NADH, Succinly Coa
Alpha Keto Gluturate Dehydrogenase fxn & cofactors
converts alpha keto glutarate to Succinyl CoA in TCA; cofactors: B1, B2, B3, B5, lipoic acid
naegleria fowleri
CNS protozoa, swimmers get, travels through nose, olfactory nerve, will see amoebas in CSF, ruffs worst nightmare
CNS protozoa
toxo (meat & cat liter), naegleria fowleri (swimming), trypanosma brucei (african sleeping sickness, tsetse fly)
protozoa that causes hepatosplen, pancytopenia, and skin ulcers, macrophage contain amastigotes
leishmania, sandfly
old person with RLL pneumonia
think of aspiration pneumonia
contralateral weakness and loss of proprioception, ipsilateral tongue deviation
medial medullay syndrome, Anterior spinal artery
pain and temp contralateral body, ipsilateal face, ipsilateral horner, ipsilateral ataxia, dysphagia, hoarseness, gag
lateral medullary
laterally medullay CN
9,10,11,12
facial nucleus defect, paralysis of face, pain and temp contralateral body, ipsilateral face, ipsilateral deafness, ipsilateral horner
lateral pontine, AICA
pelvic frracture can damage ___ urethra
membranous, fluid leaks in retropubic space
straddle injury, blood in scrotum
bulbar spongy injury
odds ratio greater than 1 and 95% confidence interval has a range greater than 1
statistically significant results
irritation, abnormal insertion of patellor tendon
osgood schlatter dx
BK virus
cold like sx, occurs in kidney transplant pts who are on too much immunosuppressant
double hit mutation is needed in _______ diseases
autosomal recessive;
