UW wrong 2 Flashcards
Beta blockers help in hyperthyroidism by
decreasing tachycardia
decreases peripheral conversion of T4 to T3
Increased acetylcholinesterase and AFP in amniotic fluid means
neural tube defects
fusion of edges of neural plate
nightmares are part of what of sleep
REM sleep
REM sleep is characterized by
muscle paralysis
social anxiety disorder should be treated first with
SSRI or SNRI
sterile platelet rich thrombi on the mitral valve is characteristic of
nonbacterial endocarditis
nonbacterial endocarditis is most associated with
malignancy
the MC presentation of nonbacterial endocarditis is
systemic embolization (stroke, acute limb ischemia) otherwise asymptomatic
Failed low dose dexamethasone test with suppressed cortisol with high dose dexamethasone is
cushing syndrome d/t pituitary adenoma
in primary osteoporosis, levels of calcium, phosphate, and PTH are typically
normal
Tay-sachs disease is caused by
beta-hexoaminidase A deficiency
a beta-hexoaminidase A deficiency in Tay-Sachs causes a build up of
GM2 ganglioside (cell membrane glycoprotein) within lysosomes
normal early development that suddenly regresses (neurologic deterioration), weakness, hypotonia, seizures, blindness, macrocephaly, abnormal startle reflex, cherry red macula
Nieman-pick
progressive neurodegeneration
peripheral neuropathy
optic atrophy
Krabbe disease
In Krabbe disease you get a build up of
galactocerebroside
globotriaosylceramide accumlation
Fabry disease
angiokeratomas
peripheral neuropathy
glomeropathy
that typically present in adulthood
Fabry disease
buildup of sphingomyelin
Nieman-pick disease
diseases with cherry red macula
Gaucher
Niemann-Pick
Tay-sachs
beta-glucocerebroside accumulation
Gaucher disease
build up of sulfatides
metachromatic leukodystrophy
difference between tay-sacks and niemann-pick
tay sach’s has no hepatosplenomegaly
BCR-ABL is an oncogene that codes for
fusion protein with constitutive tyrosine kinase activity
stimulates proliferation of granulocytic precursors
development of CML
c-myc is a
nuclear phosphoprotein that functions as a transcription activator
penicillins and cephalosporins function by
irreversibly binding to penicillin binding proteins such as transpeptidases
vancomycin works by
binds to d-ala-d-ala residues on cell wall glycoproteins
prevents transpeptidases from forming cross-links
NE affects BP by
stimulation of alpha 1
vasoconstriction via increased IP3 second messenger pathway
NE affects the heart by
stimulation of beta 1 in heart
increase contractility, conduction, HR
via increase cAMP through Gs mediated rec
acute ureteral constriction or obstruction causes
decreased GFR and FF
hormones that use the PIK system
oxytocin
ADH
GNRH
hormone that uses JAK/STAT path
erythropoietin
brain tumors of neuron origin stain with
synaptophysin
protein found on presynaptic vesicles of neurons
brain tumors of glial cell origin stain with
GFAP
astrocytomas, ependymomas, oligodendrogliomas
the most deoxygenated blood in the body is from
cardiac venous system in coronary sinus
noise induced hearing loss from trauma to
stereociliated hair cells of organ of corti
low frequency sound is registered in the
distal cochlea
Auer rods in AML stain for
myeloperoxidase
propionyl-CoA is derived from metabolism of
valine isoleucine methionine threonine odd chain FA
propionic acidemia presents as
lethargy poor feeding vomiting hypotonia 1-2 weeks after birth
Entacapone is a
COMT inhibitor for Parkinsons
MOA of entacapone
decrease peripheral metabolism of levodopa
what drug enhances the effect of endogenous dopamine
amantadine
end plate potential for MG
reduced amplitude
treat cholinergic toxicity in medicated MG patients with
antimuscarinics
glycopyrrolate
hyoscyamine
propantheline
liver changes in sarcoidosis
scattered granulomas
cancer resistance to meds MOA
human multi-drug resistance gene codes P-glycoprotein
transmembrane ATP dependent efflux protein
broad specificity for hydrophobic compounds
reverse transcriptase PCR is used to detect
mRNA
Build up of arginine
progressive spastic diplegia
growth delay
abnormal movements
arginase deficiency
arginase is used in what cycle
urea cycle
diabetic neuropathy is caused by
- diabetic microangiopathy leading to nerve ischemia
- accumulation of sorbitol leading to osmotic nerve injury
endoneural inflammatory infiltration of peripheral nerves is characteristic of
Guillain-Barre syndrome
also see segmental demyelination
mutation of myelin protein gene
Charcot-Marie-Tooth disease
Symptom of Charcot-Marie-Tooth disease
weakness of foot dorsiflexion d/t common perineal nerve
severe bacterial and viral infections in infancy
chronic diarrhea
mucocutaneous candidiasis
possible absent thymus
severe combined immunodeficiency
recurrent infections that worsen with age
easy bleeding
eczema
wiskott-aldrich syndrome
severe bacterial and fungal infections
granuloma formation
chronic granulomatous disease
oculocutaneous albinism
pyogenic infections
progressive neurologic dysfunction
chediak-higashi syndrome
ataxia
telangiectasis
sinopulmonary infections
ataxia-telangiectasia
ions with negative equilibrium potential
potassium or chloride
ions with positive equilibrium potential
sodium of calcium
JAK kinase second messenger system
growth hormone
prolactin
interferon
interleukin
surface receptor for insulin is a
transmembrane protein with intrinsic tyrosine kinase activity in its cytoplasmic domain
Insulin promotes mitogenic functions like DNA synthesis and cell growth via
MAP kinase pathway
insulin promotes metabolic functions such as translocation of GLUT-4 to cell membrane, glycogen synthesis, fat synthesis via
PI3K activation –> activates protein phosphatase
what does protein phosphatase do in glycogen synthesis
dephosphorylates glycogen synthase
afferent limb of gag reflex via
CN IX
efferent limb of gag reflex via
CN X
nerve that mediates cough reflex
internal laryngeal nerve (branch of superior laryngeal nerve, CN X)
Damage to left piriformis recess damages what nerve
internal laryngeal nerve (CN X)
histology of interstitial lung disease
lymphoplasmacytic infiltrates focal fibroblastic proliferation areas of dense fibrosis honeycombing hyperplasia of type 2 pneumocytes (idiopathic)
therapy for interstitial lung disease directed at
slowing progression of fibrosis
inhibit TGF-beta and other fibrogenic growth factors (PDGF, fibroblastic growth factor, VEGF)
Pirfenidone is a
antifibrotic agent
inhibits TGF-beta
acute decompensated HF d/t dilated cardiomyopathy (doxorubicin) causes what changes in RA and LVED pressures
both increased
right atrial pressure is synonymous with
central venous pressure
virally infected cells secrete
type I interferon alpha and beta
what does type I interferon alpha and beta do to infected viral cells
transcription of antiviral enzymes to halt protein synthesis
only happens in presence of dsRNA which forms in infected cells from viral replication
pressure of the RA
<5
pressure of right ventricle
25/5
pressure of pulmonary artery
25/10
pressure of aorta
120/80
pressure of LA
<10
pressure of LV
120/10
how does propranolol work to stop essential tremors
prevents interaction of epi and NE interaction with receptors at adrenergic synapses
dampens sensitivity of muscle spindles/smooths out force of contraction
MC CFTR gene mutation
3 bp deletion of phenylalanine at AA position 508 (deltaF508)
causes impaired post-translational processing of CFTR that is detected by ER
once delta F508 mutation found my ER what happens
abnormal protein targeted for proteosomal degradation preventing it reaching cell surface
what FA can’t undergo mitochondrial beta oxidation
very long chain FA
certain branched chain FA (phytanic acid)
undergo beta and alpha oxidation in peroxisomes instead
what are two peroxisomal diseases
Zellwegger syndrome
X-linked adrenoleukodystrophy
widened sutures large anterior fontanelle hepatomegaly hypotonia/seizures/developmental delay death within months of initial presentation
Zellweger syndrome
peroxisomal disease
defective transport of VLCFA into peroxisomes
X-linked adrenoleukodystrophy
childhood or adulthood neurological deterioration
adrenal insufficiency
X-linked adrenoleukodstrophy
protein modification
sorting/transport
golgi
digestion of cellular debris and pathogens
lysosomes
TCA cycle
FA oxidation
E transport chain (ATP synthesis)
Apoptosis
mitochondria
oxidation of VLCFA and branched FA
hydrogen peroxide degeneration
peroxisomes
degradation of ubiquitinated proteins
proteasomes
synthesis of integral membrane and secretory proteins
rough ER
drug detox
lipid, phospholipid, steroid synthesis
smooth ER
watery diarrhea stool findings
no leukocytes or RBC
dysentery of inflammatory diarrhea stool findings (shigella, salmonella, campylobacter, EIEC, yersinia, clostridium, entamoeba)
PMN
with or without RBC
enteric fever stool findings (salmonella typhi)
mononuclear leukocytes
isoniazid must be processed by
mycobacterial catalase peroxidase
accessory conduction pathway
atrioventricular conduction tract bypassing the atrioventricular node
WPW syndrome
drug directed at CD20
lymphoma
rituximab
CML
drug that inhibits proliferation of BCR/ABL expressing cells without inducing apoptosis
Imatinib
chimeric (human/murine) IgG1 monoclonal Ab to TNF-alpha
Infliximab
use in RA, AS, fistulizing Crohn’s
IL-2 is used for
RCC
melanoma
chimeric mouse-human Ab against platelet GpIIb/IIIa receptor
Abciximab
administered during angioplasty in patients w/ACS
treatment for hemophilia A or B
thrombin
hemophilia A and B lead to
failure to convert prothrombin into thrombin and deficient thrombus formation
Treatment of bradycardia from infer MI
atropine
atropine MOA
blocks vagal influence on SA and AV nodes
increases HR
Atropine is contraindicated in
patients with glaucoma
muscarinic receptor blockade
mydriasis = narrowing of anterior chamber angle, diminished outflow of aqueous humor
cause closed angle glaucoma
base excision repair steps
glycosylase endonuclease lyase polymerase ligase
“GELPL”
glycosylate cleaves
the altered base leaving an AP site (first step)
endonuclease cleaves
5’ end (2nd step)
lyase cleaves
3’ end (3rd step)
DNA polymerase does what in base excision repair
fills single nucleotide gap (4th step)
Ligase does what
seals the nick (5th step)
hypertensive hemorrhage at posterior rostral pons near lateral flow of fourth ventricle
locus ceruleus
NE
pigmented chemical made in the midbrain
DA
substantia nigra
NE is converted into Epi primarily in the
adrenal medulla
bursitis d/t repetitive or prolonged kneeling
prepatellar bursitis
bursitis in those with OA or inflammatory joint disease
popliteal bursitis
bursitis d/t direct blue to distal thigh or prolonged/repetitive quad activity (running)
supra patellar bursitis
increased orotic acid in urine
kid with increased blood ammonia levels
sleepiness, vomiting, fever
tachypnea
ornithine transcarbamylase deficiency
what will build up in ornithine transcarbamylase deficiency
orotic acid in urine
carbamoyl phosphate
where does ornithine transcarbamylase work
mitochondria
self-mutilation and hyperuricemia is characteristic of
Lesch-Nyan
HGPRT deficiency
GAS is
PYR positive
bacitracin sensitive
in sickle cell disease sicking of cells will cause
permanent deformation
premature RNC destruction by macrophages
mechanical stress
intra and extravascular hemolysis
sickle cell disease will show what changes to indirect bilirubin and LDH
Increased both
decrease haptoglobin
what does haptoglobin do
binds circulating Hgb and reduces renal excretion of free Hgb
preventing tubular injury
motion sickness
vertigo
treat with
H1 or M1 receptor antagonist (vestibular cause) diphenhydramine meclizine scopolamine
mechanical and chemical irritants to Gi tract nausea treat with
5-HT3 receptor antagonist
zolfran
cancer drug vomiting treat with (central nausea)
D2 receptor antagonist
metoclopramide
prochlorperazine
Ejection fraction
EDV-ESV/EDV
Crohn’s disease people get what kind of kidney stones
oxalate stones
reduced intestinal calcium oxalate formation from malabsorption, ends up in urine
what kind of kidney stones do people with myeloproliferative disease and hemolytic anemia
uric acid stones
hyper acute renal transplant reaction
min to hours
preformed antibodies
acute renal transplant reaction
less than 6 months
exposure to donor antigens induces (host T-cell sensitization) humoral/cellular activation of naive immune cells
chronic renal transplant reaction
months to years
chronic low grade immune response refractory to immunosuppressants
superior vena cava syndrome is caused by
mediastinal mass
with TCA overdose, widened QRS interval or ventricular arrhythmia are an indication for
sodium bicarbonate
cardiac symptoms from TCA overdose are d/t
blockage of cardiac fast sodium channels
lesions of the macula cause
central scotomas
first step of infective endocarditis
disruption of normal endocardial surface
followed by formation of sterile fibrin-platelet nidus
stool findings for strongyloides stercoralis
rhabditiform larvae
detection of parasite eggs in stool is used to diagnose
schistosomiasis
mansion or japonicum
dorsal pancreatic bud forms
majority of pancreas
body
tail
most of head
ventral pancreatic bud makes
precursor of uncinate process
inferior/posterior portion of head
major pancreatic duct
low back pain relieved with leaning forward due to
spinal stenosis
intervertebral disc herniation
ligamentum flavum hypertrophy
osteophyte formation affecting facet joints
Fabry disease is at most risk for development of
renal failure
TIA/stroke
cardiac disease (LVH)
burning pain in hands and soles
hypohidrosis
exacerbated by exercise or stress
Fabry disease
dermatomyositis and polymyositis is associated with
being paraneoplastic syndrome with adenocarcinoma (ovary, lung, pancreas)
HER2 is a
transmembrane tyrosine kinase
what makes salmonella typhi worse than salmonella enterica
extensive intra-phagocytic multiplication
blunted neutrophil response d/t capsular antigen Vi
inactivated viral vaccines primarily generate
humoral immune response against extracellular viral antigens
prevents viral entry into cell
live attenuated viral vaccines generate
strong cell-mediated immune response that can kill virally infected cells in addition to providing humoral immunity
kinesin is a
microtubule motor protein
what does kinesis do
anterograde transport of intracellular vesicles and organelles toward the plus ends of microtubules
nitrates relieve chest pain by increasing cGMP that lead to
myosin light chain dephosphorylation resulting in vascular SM relaxation
Paget disease starts with increased activity of
osteoclasts
initially healthy baby with dark urine gray stools elevated direct bilirubin and GGT jaundice firm hepatomegaly
biliary atresia
biopsy of biliary atresia would show
intrahepatic bile duct proliferation
portal tract edema
fibrosis
Clomiphene is A
estrogen receptor modulator
osmolarity of renal proximal tubule
300
osmolarity of descending limb
400-1000
osmolarity of ascending limb
200-800
osmolarity of DCT
100
osmolarity of collecting tubule
300-1200
in bacteria, RNA primers are removed by
DNA polymerase I
