UW16 Flashcards
low frequency sound is best detected at which part of the cochlea
Apex of the choclea near the helicotrema
high frequency sounds are best detected at which part of the cochlea
base of the cochlea near oval and round windows
archnodactyly, scoliosis, aortic root dilation
Marfan
Short stature, hypotonia, intellectual disability, obesity
Prader Willi syndrome
Contraindications for HCTZ
diabetics, gout, hypercalcemia
Hematuria/ hemoptysis. Focal necrosis of alveolar walls and intra-alveolar hemorrhages
Goodpasture
asthma, necrotizing vasculitis with granulomas, eosinophis. Bronchial wall thickening
Churg strauss
subplural cystic airspace enlargement
Honeycomb lung ( pulmonary fibrosis)
what amino acid becomes essential in PKU
Tyrosine
Why is there an increase in prolactin in Dihydrobiopterin reductase deficiency
Decrease in Dopamine synthesis
what enzyme is deficiency in alkaptonuria
Homogentisic acid oxidase
discharge from ear and exquisite ear pain in a diabetic patient
otitis Externa (pseudomonas)
inflamed, erythematous, bulging, immobile tympanic membrane
otitis media (fluid in middle ear)
what type of bonds causes the sickling seen in Sickle Cell
Hydrophobic interactions between Hb molecules
Anastrozole
aromatase inhibitor
MSH2 gene is implicated in what disease
HNPCC (DNA mismatch repair)
urokinase
tPA (thrombolytic)
babinski
Extension, dorsiflexion of toes following stroking of lateral plantar foot
muscle paralysis, hyperreflexia, spasticity indicates what type of lesion, positive babinski
Upper motor neuron
loss of tendon reflexes, muscle atrophy, fasiculations are seen in what type of motor neuron lesion
Lower moter neuron
which part of the kidney tubules is most susceptible to injury
Proximal tubule and thick ascending limb
Proto-oncogenes
Ras, myc, ERB, TGFa, Sis, abl
Tumor suppressors
BRCA, NF-1, APC, DCC, p53, RB, WT
Why should a cbc be done before starting chloramphenicol
can cause aplastic anemia
why should a cbc be cone before starting dapsone
can cause agranulocytosis
Side effect of ethambutol
optic neuritis, color blindness, central scotoma,
HIV infection and impaired vision
CMV retinitis
Foscarnet
Pyrophosphate analog. Chelates calcium, leads to renal wasting of magnesium. Which decreases PTH and leads to hypocalcemia
Ganciclovir
inhibits DNA polymerase. Requires viral kinase. Causes severe neutropenia
Indinavir
Protease inhibitor. Causes fat redistribution, insulin resistance (hyperglycemia) and hypertryglyceridemia
Lamivudine
Nucleoside Reverse Transcriptase Inhibitor (NRTI). Associated with peripheral neuropathy and lactic acidosis
inward deviation of the eye
abducens palsy
Regulator of the urea cycle
N-acetylglutamate
Rate determining enzyme of urea cycle
Carbamoyl phosphate synthetase I
increased blood ammonium and increased urine orotic acid excretion. What enzyme deficiency
Ornithine transcarbamylase
Why do you see an increase in orotic acid in ornithine transcrabamylase deficiency?
Excess carbamoyl phosphate is converted to orotic acid (CPS II for pyrimidine synthesis)
obstruction of what % of a coronary artery lumen produces symptoms of stable angina
75.00%
Endothelial cell tumor associated with arsenic or polyvinyl chloride exposure
Liver angiosarcoma (CD31)
Terbutaline
Beta mimetic tocolytic drug that suppresses uterine contracts to delay labor
tinnitis, vertigo, sensorineural hearing loss
Meniere’s (Rinne AC >BC, Weber lateralizes to healthy side)
Loss of neurons in the caudate nucleus and putamen
Huntington
Thyroid biopsy that shows nests of polygonal cells with Congo Red Positive deposits
Medullary Carcinoma of the thyroid
medial granulomas in Takayasu arteritis typically affect which vessel
aortic arch
Medial Band like calcifications
Moncheberg’s medial calcific sclerosis
Side effect of Ca channel blocker
Blocks L type Ca channels, reducing muscle contractility. SE: cardiac depression, AV block, constipation
Side effect of digoxin
Na/K ATPase inhibit leads to inhibition of Na/Ca to increase Ca. Stimulates vagal nerve to decrease HR/ SE: cholinergic (n/v/d), blurry yellow vision, AV block, can lead to hyperkalemia
necrolytic migratory erythema, (edematous rash near groin area)
glucagonoma
jejunal ulcers
gastrinoma
Klinefelter
destruction of seminiferous tubules causes decreased inhibin leading to increased FSH. Leydig cells are also damaged causing decreased testosterone. Increased FSH and LH
Labs in Klinefelter
low T, no sperm, High LH and FSH, increased estrogen
Bilateral gynecomastia, with small, firm testes, long lower extremities
Klinefelter Syndrome
precocious pubuerty, parinaud syndrome, obstructive hydrocephalus
Germinoma (pineal region)
Precious puberty in boys vs girls
Boys
paralysis of upward gaze
parinauds (superior colliculi)
tremor, rhinorrhea, sneezing and diarrhea
opioid withdrawal symptoms
Opioids
decreases synaptic transmission to decrease release of Ach, NE, 5HT, glutamate, substance P
what do you give a neonate in opioid withdrawal
tincture of opium ( withdrawal can lead to seizures)
Oligoclonal bands of IgG in CSF
Multiple sclerosis
Mechanism of fibrates
inhibits 7a hydroxylase
How does estrogen increase risk of gallstones
Increases biosynthesis of cholesterol by inreasing HMG-CoA reductase
Erb-B2
tyrosine kinase activity. Associated with breast and ovarian cancers
Tx for HTN that can lead to flushing and peripheral edema
Amlodipine
Tx for HTN and BPH
alpha 1 blocker
Tx for HTN that can cause gynecomastia
Eplerenone
Tx for a-fib that can cause constipation and gingival hyperplasia
Verapamil
Where does the RNA polymerase bind the lac operon
promoter region
what does the repressor protein of the lac operon bind?
Operator region
Ecoli grown in lactose
Lactose binds to repressor protein to prevent attachment of repressor to allow transcription
Ecoli grown in glucose
decreases cAMP to prevent expression of lac operon
Ecoli grown without glucose
increases cAMP which activates CAP (catabolite activator protein). CAP-cAMP binds to promoter and increases expression of lac operon
Outcome of Hep C infection
most develop chronic infection
when is PaO2 decreased
obstructive airway disease (asthma) due to poor alveolar ventilation
When is increased SaO2 of VENOUS blood seen
CN intoxication due to failure of oxygen unloading in tissues
When is decreased SaO2 seen?
CO poisoning
DNA sensitivity to ionizing radiation, repeated pulmonary infections, ataxia
Ataxia telangiectasia
Fanconi anemia
Sensitivity to DNA cross-linking agents
insulin dependent glucose transporter
GLUT 4
Back pain: relieved with rest and worse with activity. Brief morning stiffness
Degernative spondylosis (osteoarthritis)
Back pain: radiates to butt or leg, relieved with knee flexion, + straight leg raise
Disc herniation
Back pain: pain with walking or standing. Relieved by sitting and bending forward
Spinal Stenosis
Back pain: Man age
Ankylosing spondylitis
Back pain: constant dull pain that worsens at night. Not responsive to position changes
spinal metastasis
Back pain: worse at night, tenderness to gentle percussion. Fevers night sweats. Recent infection or IVDU
Vertebral osteomyelitis
Aldolase B
Fructose 1-P –>DHAP & Glyceraldehyde
Fructokinase
Frutose to Fructose 1 P
Aldose reductase
Glactose to Galactitol
Fructose in the blood and urine
Essential fructosuria (fructokinase)
Hypogycemia, vomiting, urine dipstick negative
Fructose intolerance (aldolase B)
High levels of galactose leading to cataracts
Aldose reductase (galactose to galactitol)
Hypoxia in gram negative sepsis
ARDS
ARDS
Adult respiratory distress syndrome. pulmonary interstitial and intra-alveolar edema, inflammation and alveolar hyaline membranes
Heinz Body
G6PD (denatured Hb)