UW2b Flashcards
what are the nodules in cirrhosis made of
proliferating hepatocytes
what are cystic hygromas and in what conditions do they arise
cystic lymphatic malformations that most commonly involve the loose areolar tissue of the head and neck
presents as a painless, compressible mass that transilluminates
Turner syndrome, trisomies 13, 18, 21
where does the rash in Rocky Mountain spotted fever start and where does it spread
starts on ankles and wrists and spreads to trunk, palms, and soles
what components of a rash indicate allergic contact dermatitis from poison ivy
spotty papules
linear or streaky pattern where skin brushed against plant
what is the cause of adult onset lactose intolerance
steady decline in expression of lactase gene
lactase expression is high in infancy and childhood when mother’s milk is primary source of nutrition
what does tar dive dyskinesia present like
involuntary, rhythmic movements of the face, lips, and tongue
choreoathetoid movements of the trunk and extremities are possible but less common than the orofacial dyskinesia
why do long-term antipsychotics cause tardive dyskinesia
long term blockade of dopamine receptors –> receptor up regulation –> compensatory supersensitivity of the postsynaptic neurons
what is the central venous pressure in pts with a PE and why
what is the systemic vascular resistance and why
elevated central venous pressure due to impaired forward blood flow
increased SVR in an attempt to maintain adequate tissue perfusion
how do the pulmonary function tests change in COPD:
- tidal volume
- expiratory reserve volume
- forced residual capacity
- inspiratory reserve volume
- inspiratory capacity
- residual volume
- vital capacity
- TLC
- tidal volume: no change
- expiratory reserve volume: decreased
- functional residual capacity: increased
- inspiratory reserve volume: decreased
- inspiratory capacity: decreased
- residual volume: increased
- forced vital capacity: decreased
- TLC: increased
what is contact inhibition when plating cells on a petri dish
normal cells will reproduce until the medium is covered with a single layer of cells that just touch one another, then mitosis halts (mediated by cadherins and catenins)
if the cells keep dividing and start to pile up into mounds, then they are malignant
what are the main advantages of the oral polio vaccine compared to the inactivated one
promotion of mucosal IgA immunity in the oropharynx and intestines
also can induce contact immunity in others due to shedding of the vaccine virus in the stool
what phenomenon can cause a heterozygous female for an x-linked recessive disease to show manifestations of the disease
skewed X inactivation
what enzyme do DNA viruses use to replicate their viral genome in host nucleus
what enzyme do DNA viruses use to transcribe their viral DNA into mRNA
host cell DNA-dependent DNA polymerase
DNA-dependent RNA polymerase
what is the histological hallmark of rabies infection
eosinophilic cytoplasmic inclusions (negri bodies)
caused by accumulation of viral ribonucleic protein within neuronal cells
why does filtration fraction increase with renal afferent arterial constriction
decreased arterial pressure –> decreased renal plasma flow –> decreases GFR –> GFR autoregulation improves GFR –> renal plasma flow decreases to a greater extend than GFR due to GFR auto regulation –> filtration fraction increases
what is the pathogenesis of skin lesions in psoriasis
skin barrier disruption leads to activation of antigen-presenting dendritic cells –> produce IFN-a and other cytokines recruits T helper cells –> produce additional inflammatory cytokines –> stimulate local keratinocytes to proliferate
orlistat MOA
intestinal lipase inhibitor that reduces absorption of dietary fat
orlistate AE
GI effects (diarrhea, fecal incontinence, oily spotting)
membranous nephropathy can be idiopathic but can also occur in association with _____
solid tumors (lung carcinoma)
viral hepatitis
SLE
what is xerosis
asteatotic dermatitis (“winter itch”)
most common in older patients during winter months when indoor heaters lower the relative humidity of the ambient air
occurs in patients with defects in stratum corner permeability barrier
what is the management for xerosis
focuses on retaining the normal skin barrier and replenishing it from water loss
- lukewarm baths
- moisturize immediately after bathing to prevent excessive skin water loss
- emollient moisturizers
what are the non polar (hydrophobic) amino acids
- alanine
- valine
- leucine
- isoleucine
- phenylalanine
- tryptophan
- methionine
- proline
- glycine
mucormycosis can spread to what dural sinus
cavernous sinus
how does orchitis from mumps cause infertility
the significant swelling in orchitis can cause seminiferous tubule atrophy, which causes infertility, and leydig cell atrophy which causes decreased testosterone production
what populations are at an increased risk for entamoeba histolytica
men who have sex with men
probenecid function
why is it often paired with penicillin
inhibits organic anion transporters in the kidney (inhibits reabsorption of uric acid in PCT - treats chronic gout)
increases serum penicillin concentrations by preventing secretion of penicillin by organic anion transporters
teratogenic effects of tetracyclines
- can accumulate in fetal long bones causing retarded skeletal development
- localize in dentin and enamel causing teeth discoloration
symptoms of NF-1
neurofibromas (loose, disorganized proliferations of Schwann cells, fibroblasts, and neurites)
cafe au lait macules
axillary freckling (Crowe sign)
pigmented iris hamartomas (lisch nodules)
what is the presentation for primary ovarian insufficiency
amenorrhea in women <40 with elevated FSH and low estrogen levels
cause of primary ovarian insufficiency
inadequate supply of ovarian follicles or premature depletion of these follicles (apoptosis)
what can cause prayer willi syndrome
1) paternal microdeletion
2) uniparental disomy (error during meiotic division resulting in offspring with 2 copies of a chromosome from one parent and none from the other parent)
everolimus/sirolimus/zotarolimus MOA
indications
inhibit mTOR which blocks cell cycle between G1 and S phase to reduce smooth muscle proliferation
used to coat intracoronary stent surfaces to prevent neointimal hyperplasia and stent restenosis
where does influenza virus replicate
nucleus (unique among the RNA viruses)
is adenovirus single or double stranded
double stranded
where do almost all RNA viruses replicate
in the cytoplasm
is influenza virus single or double stranded
single stranded
how does insulin lower glucose levels
increase translocation of GLUT4 to the cellular membrane
list the steps of collagen synthesis
1) synthesis (translation of collagen alpha chains)
2) hydroxylation (hydroxylation of proline and lysin residues - requires vitamin C)
3) glycosylation (glycosylation of pro-alpha-chain hydroxylysine residues and formation of pro collagen - triple helix formation)
4) exocytosis (pro collagen goes into extracellular space)
5) proteolytic processing (cleavageC and N terminals –> insoluble tropocollagen)
6) cross linking (Lysyl oxidase reinforces the tropocollagen via lysin-hydroxylysin linkages)
what is transduction
the process by which bacterial DNA is transported from one bacterium to another by a virus (bacteriophage)
occurs when a bacteriophage causes lytic infection of a host bacterial organism
the bacteriophages have the ability to inject DNA into bacteria but cannot produce progeny
what is illness anxiety disorder
fear of having a serious illness despite few or no symptoms and consistently negative evaluations
what is somatic symptom disorder
excessive anxiety and preoccupation with 1 or more unexplained symptom
what are confabulations and what dz process are they seen in
memory fabrication without the intention to lie
Korsakoff syndrome
young patients with shingles should be tested for ____
HIV
immunosuppression
how does neprilysin inhibitors (sacubitril) affect angiotensin II levels
increases them
that’s why it’s paired with an ARB like valsartan
how does ARDS affect V/Q
right to left physiologic shunting occurs as the fluid-filled, non ventilated alveoli continue to receive blood
–> V/Q mismatch
symptoms of VHL disease
- cerebellar and retinal hemangioblastomas
- pheochromocytomas
- renal cell carcinoma
causes of right and left shifts in the oxygen-hemoglobin dissociation curve
left shift:
- decreased H+ (increased pH)
- decreased 2,3-BPG
- decreased temperature
right shift:
- increased H+ (decreased pH)
- increased 2,3-BPG
- increased temp
where does the copper accumulate in the eye in Wilson’s disease
descent membrane in the cornea
compare fat necrosis and fibroadenoma
fibroadenoma:
- solitary, well-demarcated, contender, firm, spherical, mobile nodules
- estrogen- sensitive (size increase in pregnancy or the luteal phase of the menstrual cycle, and decreases in size postpartum and after menopause)
fat necrosis:
- irregular, firm mass the can be accompanied by ecchymosis
- size not affected by estrogen
dysplastic nevus syndrome is associated with what gene and locus
CDKN2A on chromosome 9p21
what is the antidote for benzo OD
flumazenil
how do the following change during exercise:
- HR
- LV end systolic volume
- LV end diastolic volume
- LV end diastolic pressure
HR: increased
LV end systolic volume: decreased
LV end diastolic volume: increased
LV end diastolic pressure: unchanged
what develops from the prosencephalon
- cerebral hemispheres
- lateral ventricles
- thalamus
- hypothalamus
- retina
- 3rd ventricle
what develops from the mesencephalon
midbrain and cerebral aqueduct
what develops from the rhombencephalon
- pons
- cerebellum
- upper 4th ventricle
- medulla
- lower 4th ventricle
describe development of cerebral hemispheres and basal ganglia
prosencephalon –> telencephalon –> cerebral hemispheres and basal ganglia
describe development of thalamus and 3rd ventricle
prosencephalon –> diencephalon –> thalamus and third ventricle
describe development of pons, cerebellum, upper 4th ventricle
rhombencephalon –> metencephalon –> pons, cerebellum, upper 4th ventricle
describe development of medulla and lower 4th ventricle
rhombencephalon –> myelencephalon –> medulla and lower 4th ventricle
what are leucine zippers made of
transcription factors
where does synthesis of pyrimidines and purines first occur
in the cytoplasm
what three things are used at the start of pyrimidine synthesis
CO2, glutamine, 2 ATP
causes of dilated cardiomyopathy
- genetic (TTN gene)
- drugs (alcohol, cocaine, doxorubicin)
- infection (coxsackie B, chaga)
- ischemia
- hemochromatosis
- sarcoid
- thyrotoxicosis
compare MOA of amphotericin B and caspofungin
amphotericin B: binds ergosterol and creates pores in fungal cell MEMBRANE
caspofungin: inhibit cell WALL synthesis
griseofulvin MOA
binds to microtubules and disrupts mitotic spindle formation, inhibiting fungal mitosis
compare anti-glomerular basement membrane disease and goodpasture
good pasture is anti-glomerular basement membrane disease with antibodies also affecting the lung and causing pulmonary hemorrhage
(both have linear IgG deposits on IF)
compare complete and partial moles in terms of p57 staining
complete: p57 negative
partial: p57 positive
MOA retinoids (tretinoin, isotretinoin)
vitamin A analogues that normalize epidermal differentiation by increasing cell turnover and reducing hyperkeratinization in stratum corneum
does phenytoin induce or inhibit CYP450
induce
decerebrate posturing indicates a hemorrhage where
pons
most common presenting symptoms of tetanus
masseter muscle spasm (trismus/lockjaw) which can be elicited when the posterior pharynx is touched with a tongue depressor
what serological marker indicates current hepatitis B infection
HBsAg
Anti-HBs indicates
cleared infection or vaccination (long term immunity)
Anti-HAV IgM indicates
active HAV infection
