UW17 Flashcards
Vascular lesion with IgA and C3 deposition
HSP
Henoch Schonlein purpura
Palpable purpura, arthralgia, GI pain. IgA and C3 deposition. Associated with IgA nephropathy
saddle nose, oligouria
Wegener’s (granulomatosis with polyangiitis)
Weak upper extremity pulses, fever, night sweats, arthritis, myalgia
Takayasu arteritis
Headache, blurred vision, jaw cladicaton
Temporal giant cell arteritis. Associated with polymyalgia rheumatica
IFN-y is secreted by
Secreted by TH1 cells
IL-12 is secreted by
macrophages which induce T cell differentiation into Th1
pyknotic superficial or immature squamous cell with dense irregularly staining cytoplasm and perinuclear clearing
Koilocyte
total resistance in organ
R(artery+arteriole+capillary+venule+vein)
resistance in a parallel circuit
1/Rn
Nitroprusside
venous and arterial vasodilator. Decreases preload and afterload without a reduction in stroke volume
Which artery supplies the inferior wall of the left ventricle (diaphragmatic surface)
Posterior descending (RCA)
histological findings in Hashimoto
Mononuclear infiltrate of lymphocytes and plasma cells with germinal centers. Oxyphilic cells with granular cytoplasm (Hurthle cells)
branching papillary structures with concentric calcifications in thyroid. Ground glass nucleus with intranuclear grooving
papillary thyroid cancer
Mixed, cellular infiltration with occasional multinuclear cells in thyroid
de Quervain’s
Extensive fibrosis of thyroid gland extending into surrounding structures
Riedel’s thyroiditis
Cleft lip is a failure fusion of what structures?
Maxillary prominences with the intermaxillary segment
Cleft palate is a failure of fusion of what structures
Maxillary prominence failure to fuse with one another or with the primary palate
Why does folate deficiency cause megalobastic anemia?
decreased dTMP production ( requires THF to donate a methyl group)
What else do you can you add to folate to treat megaloblastic anemia
Thymidine (increase dTMP) via thymidine kinase to make dTMP
Accumulation of transudative fluid can be due to what mechanisms
Increase capillary hydrostatic pressure (increase arteriolar dilation or impaired venous return). Decreased plasma oncotic pressure (decreased albumin). Sodium and water retention. Lymphatic obstruction (invasive malignancy)
How does inspiration affect venous return?
Increases venous return which increases right heart volumes
What is pulsus paradoxus
increased volume from inspiration pushes septum towards left to derease left heart volumes causing a decrease in BP during inspiration. Decrease in systolic BP greater than 10 with inspiration. Suggests cardiac tamponade, constrictive pericarditis, restrictive cardiomyopathy
Killed vaccines
cholera, hepA, Salk Polio, IM influenza, rabies
Live attenuated
MMR, Sabin Polio,yellow fever
Toxoid vaccine
Diptheria and tetanus
Recombinant surface protein vaccine
Hep B vaccine
Drugs used for secretory diarrhea
Bismuth subsalicylate, probiotics, octreotide
Rhonchi, wheezing indicate
turbulent airflow due to obstruction
Hernia that enters internal inguinal ring lateral to inferior epigastric vessels.
Indirect inguinal ( failure of inguinal ring to close seen in infants)
Hernia that bulges through Hesselbach’s triangle, medial to inferior epigastric vessels
direct inguinal (caused by weakness of transversalis fascia) older men
Protrudes through femoral ring medial to femoral vessels inferior to inguinal ligament
Femoral hernia seen often in women
Biochemical abnormality in Alzheimer
Decreased acetylcholine levels in basal nucleus of Meynert (memory and cognition) due to decrease activity of choline acetyltransferases
Atrophy of caudate nucleus
Huntinton due to depleteltion of NMDA receptors in striatum
Located in caudal pontine central gray matter and contains large amounts of NE
Locus Ceruleus
Raphe nuclei
Serotonergic neurons (play a role in depression, sleep, anorexia)
Epithelium of ovary
Simple cuboidal ( serous, mucinous, endometrioid, clear cell, Brenner tumors)
Epithelium of fallopian tube
Simple columnar (cilated cells and Peg cells that secrete nutrients)
Epithelium of Uterus
Simple columnar (endometrial CA)
Epithelium of Cervix
Simple columnar (endocervix) ad Stratified squamous (ectocervix) (condyloma acuminata, squamous cell, adenocarcinoma)
Epithelium of vagina
Stratified squamous non-keratinized (squamous cell CA)
Sterile vegetations along cardiac valve cusps
Non-bacterial thrombotic endocarditis
What cancers are non-bacterial endocarditis associated with
Mucinous adenocarcinoma of pancreas and lung ( pro-coagulant effect of circulating mucin)
Trousseau syndrome
migratory thrombophebitis (tumor associated release of procoagulants) seen in disseminated cancers
what is lambert eaton syndrome
Decreased presynaptic ach release (seen in oat cell carcinoma)
Pyruvate kinase
converts PEP to pyruvate
Cerebellar ataxia,blanching nests of distended capillaries, increased risk of infections
Ataxia telangiectasia (AR mutation in ATM gene responsible for DNA repair)
what arteries perfuse the lesser curvature of the stomach?
Left and right gastric
which arteries supply blood to the pylorus and proximal part of duodenum
GDA
surface marker useful for diagnosing Hodgkin lymphoma
CD 15 Reed sternberg cell
low immunoglobulin of all types
XLA
what is the bezold Jarisch reflex
increase in vagal discharge leads to hypotension and bradycardia
what is a potential limiting factor when initiating ACE inhibitors
first dose hypotension ( hyponatremia, hypovolemia, blow blood glucose, high renin or aldosterone levels, renal impairment or heart failure)
Chronic abdominal pain with diarrhea or constipation. Relieved with bowel movements
Irritable bowel Syndrome
Ciliated mucosal epithelium
up to proximal portal of respiratory bronchioles
Globlet cells entend to
end of bronchi
Hemolytic, hypercoagulabiity, pancytopenia
Paroxysmal nocturnal hemoglobinuria
What is deficient in paroxysmal noctunral hemoglobinuria
CD55 and CD59 (proteins that inactivate complement and prevent membrane attach complex from forming)
What nerve mediates somatic sensation (pain, touch, pressure) from the tongue
Lingual nerve (V3)
site of synthesis and assembly of ribosomal components
Nucleolus. All rRNA is (except 5S rRNA is transcribed in nuceolus)
Verapamil
Class IV antiarrhythmic to treat atrial arrythmia by slowing conduction through AV node (SVT)
Adenosine
acute treatment of paroxysmal SVT
Digoxin
A-fib
Standard deviation
68/95/999
Mechanism of action of corticosteroids as anti-inflammatory
inhibit phospholipase A2
Risk factors for coronary heart disease
noncoronary atherosclerotic disease, diabetes, chronic kidney disease
lens subluxation, elongated limbs, scoliosis, osteoporosis, risk for thrombosis
Homocystinuria ( deficiency of cystathionine synthetase) that requires B6 as cofactor
at what level does the renal vein join the IVC
L1/L2
At what level does the common iliac vein merge to become the IVC
L4
what is the mechanism of opioid tolerance
increased adenylyl cyclase or NO levels. NMDA receptor activation can cause increased phosphorylation that leads to increased NO (increase morphine tolerance)
TdT positive, CD 10 and CD19 positive
B-ALL
TdT, CD1a positive
T-ALL
CD5 and CD19 positive
Mature B cell (CLL)
Risk factor for atherosclerosis and hypertension
Diabetes
Risk factor aortic aneuryms
High cholesterol
Risk factor for Thromboangiitis obliterans
smoking ( buerger disease)
Factors that affect diffusion
directly proportional to concentration difference, surface area, solubility. Inversely to thickness and molecular weight
