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Maddy - First Aid > UW2b > Flashcards

UW2b Flashcards

1
Q

what are the nodules in cirrhosis made of

A

proliferating hepatocytes

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2
Q

what are cystic hygromas and in what conditions do they arise

A

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

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3
Q

where does the rash in Rocky Mountain spotted fever start and where does it spread

A

starts on ankles and wrists and spreads to trunk, palms, and soles

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4
Q

what components of a rash indicate allergic contact dermatitis from poison ivy

A

spotty papules

linear or streaky pattern where skin brushed against plant

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5
Q

what is the cause of adult onset lactose intolerance

A

steady decline in expression of lactase gene

lactase expression is high in infancy and childhood when mother’s milk is primary source of nutrition

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6
Q

what does tar dive dyskinesia present like

A

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

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7
Q

why do long-term antipsychotics cause tardive dyskinesia

A

long term blockade of dopamine receptors –> receptor up regulation –> compensatory supersensitivity of the postsynaptic neurons

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8
Q

what is the central venous pressure in pts with a PE and why

what is the systemic vascular resistance and why

A

elevated central venous pressure due to impaired forward blood flow

increased SVR in an attempt to maintain adequate tissue perfusion

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9
Q

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
A
  • 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
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10
Q

what is contact inhibition when plating cells on a petri dish

A

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

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11
Q

what are the main advantages of the oral polio vaccine compared to the inactivated one

A

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

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12
Q

what phenomenon can cause a heterozygous female for an x-linked recessive disease to show manifestations of the disease

A

skewed X inactivation

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13
Q

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

A

host cell DNA-dependent DNA polymerase

DNA-dependent RNA polymerase

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14
Q

what is the histological hallmark of rabies infection

A

eosinophilic cytoplasmic inclusions (negri bodies)

caused by accumulation of viral ribonucleic protein within neuronal cells

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15
Q

why does filtration fraction increase with renal afferent arterial constriction

A

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

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16
Q

what is the pathogenesis of skin lesions in psoriasis

A

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

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17
Q

orlistat MOA

A

intestinal lipase inhibitor that reduces absorption of dietary fat

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18
Q

orlistate AE

A

GI effects (diarrhea, fecal incontinence, oily spotting)

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19
Q

membranous nephropathy can be idiopathic but can also occur in association with _____

A

solid tumors (lung carcinoma)

viral hepatitis

SLE

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20
Q

what is xerosis

A

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

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21
Q

what is the management for xerosis

A

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
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22
Q

what are the non polar (hydrophobic) amino acids

A
  • alanine
  • valine
  • leucine
  • isoleucine
  • phenylalanine
  • tryptophan
  • methionine
  • proline
  • glycine
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23
Q

mucormycosis can spread to what dural sinus

A

cavernous sinus

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24
Q

how does orchitis from mumps cause infertility

A

the significant swelling in orchitis can cause seminiferous tubule atrophy, which causes infertility, and leydig cell atrophy which causes decreased testosterone production

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25
Q

what populations are at an increased risk for entamoeba histolytica

A

men who have sex with men

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26
Q

probenecid function

why is it often paired with penicillin

A

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

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27
Q

teratogenic effects of tetracyclines

A
  • can accumulate in fetal long bones causing retarded skeletal development
  • localize in dentin and enamel causing teeth discoloration
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28
Q

symptoms of NF-1

A

neurofibromas (loose, disorganized proliferations of Schwann cells, fibroblasts, and neurites)

cafe au lait macules

axillary freckling (Crowe sign)

pigmented iris hamartomas (lisch nodules)

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29
Q

what is the presentation for primary ovarian insufficiency

A

amenorrhea in women <40 with elevated FSH and low estrogen levels

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30
Q

cause of primary ovarian insufficiency

A

inadequate supply of ovarian follicles or premature depletion of these follicles (apoptosis)

31
Q

what can cause prayer willi syndrome

A

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)

32
Q

everolimus/sirolimus/zotarolimus MOA

indications

A

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

33
Q

where does influenza virus replicate

A

nucleus (unique among the RNA viruses)

34
Q

is adenovirus single or double stranded

A

double stranded

35
Q

where do almost all RNA viruses replicate

A

in the cytoplasm

36
Q

is influenza virus single or double stranded

A

single stranded

37
Q

how does insulin lower glucose levels

A

increase translocation of GLUT4 to the cellular membrane

38
Q

list the steps of collagen synthesis

A

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)

39
Q

what is transduction

A

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

40
Q

what is illness anxiety disorder

A

fear of having a serious illness despite few or no symptoms and consistently negative evaluations

41
Q

what is somatic symptom disorder

A

excessive anxiety and preoccupation with 1 or more unexplained symptom

42
Q

what are confabulations and what dz process are they seen in

A

memory fabrication without the intention to lie

Korsakoff syndrome

43
Q

young patients with shingles should be tested for ____

A

HIV

immunosuppression

44
Q

how does neprilysin inhibitors (sacubitril) affect angiotensin II levels

A

increases them

that’s why it’s paired with an ARB like valsartan

45
Q

how does ARDS affect V/Q

A

right to left physiologic shunting occurs as the fluid-filled, non ventilated alveoli continue to receive blood

–> V/Q mismatch

46
Q

symptoms of VHL disease

A
  • cerebellar and retinal hemangioblastomas
  • pheochromocytomas
  • renal cell carcinoma
47
Q

causes of right and left shifts in the oxygen-hemoglobin dissociation curve

A

left shift:

  • decreased H+ (increased pH)
  • decreased 2,3-BPG
  • decreased temperature

right shift:

  • increased H+ (decreased pH)
  • increased 2,3-BPG
  • increased temp
48
Q

where does the copper accumulate in the eye in Wilson’s disease

A

descent membrane in the cornea

49
Q

compare fat necrosis and fibroadenoma

A

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
50
Q

dysplastic nevus syndrome is associated with what gene and locus

A

CDKN2A on chromosome 9p21

51
Q

what is the antidote for benzo OD

A

flumazenil

52
Q

how do the following change during exercise:

  • HR
  • LV end systolic volume
  • LV end diastolic volume
  • LV end diastolic pressure
A

HR: increased

LV end systolic volume: decreased

LV end diastolic volume: increased

LV end diastolic pressure: unchanged

53
Q

what develops from the prosencephalon

A
  • cerebral hemispheres
  • lateral ventricles
  • thalamus
  • hypothalamus
  • retina
  • 3rd ventricle
54
Q

what develops from the mesencephalon

A

midbrain and cerebral aqueduct

55
Q

what develops from the rhombencephalon

A
  • pons
  • cerebellum
  • upper 4th ventricle
  • medulla
  • lower 4th ventricle
56
Q

describe development of cerebral hemispheres and basal ganglia

A

prosencephalon –> telencephalon –> cerebral hemispheres and basal ganglia

57
Q

describe development of thalamus and 3rd ventricle

A

prosencephalon –> diencephalon –> thalamus and third ventricle

58
Q

describe development of pons, cerebellum, upper 4th ventricle

A

rhombencephalon –> metencephalon –> pons, cerebellum, upper 4th ventricle

59
Q

describe development of medulla and lower 4th ventricle

A

rhombencephalon –> myelencephalon –> medulla and lower 4th ventricle

60
Q

what are leucine zippers made of

A

transcription factors

61
Q

where does synthesis of pyrimidines and purines first occur

A

in the cytoplasm

62
Q

what three things are used at the start of pyrimidine synthesis

A

CO2, glutamine, 2 ATP

63
Q

causes of dilated cardiomyopathy

A
  • genetic (TTN gene)
  • drugs (alcohol, cocaine, doxorubicin)
  • infection (coxsackie B, chaga)
  • ischemia
  • hemochromatosis
  • sarcoid
  • thyrotoxicosis
64
Q

compare MOA of amphotericin B and caspofungin

A

amphotericin B: binds ergosterol and creates pores in fungal cell MEMBRANE

caspofungin: inhibit cell WALL synthesis

65
Q

griseofulvin MOA

A

binds to microtubules and disrupts mitotic spindle formation, inhibiting fungal mitosis

66
Q

compare anti-glomerular basement membrane disease and goodpasture

A

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)

67
Q

compare complete and partial moles in terms of p57 staining

A

complete: p57 negative
partial: p57 positive

68
Q

MOA retinoids (tretinoin, isotretinoin)

A

vitamin A analogues that normalize epidermal differentiation by increasing cell turnover and reducing hyperkeratinization in stratum corneum

69
Q

does phenytoin induce or inhibit CYP450

A

induce

70
Q

decerebrate posturing indicates a hemorrhage where

A

pons

71
Q

most common presenting symptoms of tetanus

A

masseter muscle spasm (trismus/lockjaw) which can be elicited when the posterior pharynx is touched with a tongue depressor

72
Q

what serological marker indicates current hepatitis B infection

A

HBsAg

73
Q

Anti-HBs indicates

A

cleared infection or vaccination (long term immunity)

74
Q

Anti-HAV IgM indicates

A

active HAV infection

Maddy - First Aid (23 decks)

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