UW6 Flashcards
1
Q
high uric acid levels, dystonic movements,tendency to bite own lips
A
Lysch Nyhan (HGPRT deficiency)
2
Q
What enzyme is increased in lysch-nyhan syndrome
A
PRPP aminotransferase (due to accumulation of PRPP and in creased de novo purine synthesis) Xanthine oxidase increases due to degradation of xanthine and guanine to uric acid
3
Q
Disorganized ( insight, abstract reasoning, planning), Disinhibited (judgement, inappropriate social behavior), apathetic (motivation, personality)
A
Frontal lobe syndrome
4
Q
spatial and visual perception, writing and calculation, left to right differentiation, object identification
A
Parietal lobe damage
5
Q
Language, difficulty with sensory interpretation, impaired memory
A
Temporal lobe damage
6
Q
Pertussis adenylate cyclase toxin
A
functions as adenylate cyclase,increases cAMP levels causing edema and phagocyte dysfunction
7
Q
tetany, aortic arch abnormalities, underdeveloped madible
A
DiGeorge ( 3rd pharyngeal pouch)
8
Q
branchial cleft cyst
A
Second branchial cleft (pharyngeal groove)
9
Q
gives rise to tissues innervated by 9th cranial nerve ( glossopharyngeal), stylopharyngeus m, hyoid bone, posterior 1/2 of tongue
A
3rd branchial arch
10
Q
gives rise to tissues innervated by the superior laryngeal branch of vagus n and most muscles of the soft palate and pharynx
A
4th branchial arch
11
Q
Criteria for schizoprenia
A
2 or more symptoms for >6 month of at least 1 positive symptom of delusions, hallucinations or disorganized speech. Negative symptoms: flat affect, lack of speech or thought, social withdrawal
12
Q
Criteria for Manic episode
A
elevated, expansive or irritable mood for at least 1 week. At least 3 of the following: grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, psychomotor agitation
13
Q
Bipolar I
A
Manic episode + major depressive episode
14
Q
Bipolar II
A
hypomanic episode and depressive episode
15
Q
cyclothymic disorder
A
Dysthymia and hypomania lasting 2 years
16
Q
Respiratory distress, AMS, seizures, petechial rash over head, neck, thorax, axillae
A
Fat embolism
17
Q
Cleft plalet, polydactylyl, rocker bottom feet
A
Patau (trisomy 13)
18
Q
single palmar crease, endocardial cushion defect, duodenal atresia
A
Down syndrome, increased risk for AML, ALL, early alzheimer
19
Q
TTX blocks which channels
A
voltage gated sodium channels
20
Q
What channels does lidocaine block?
A
voltage gated sodium channels of sensory neurons, purkinje fibers and ventricular cells (anaesthetic and Class IB antiarrhythmic)
21
Q
Autoantibodies in Pemphigus Vulgaris
A
Desmosomal proteins (desmoglein 3)
22
Q
Autoantibodies in epidermolysis bullosa acquisita
A
Cutaneous basement membrane proteins
23
Q
Autoantibodies in bullous pemphigoid
A
Hemidesmosomal proteins (intact bullae) and mucosal involvment uncommon
24
Q
What happens when baroreceptors are stimulated?
A
stimulated by stretch and increased BP leads to increased number of signals leading to decreased baroreceptor signaling
25
what is carotid sinus syncope
external pressure causes baroreceptors to react as if there was a systemic BP increase causing hypotension leading to syncope
26
Which nerve is responsible for carrying signals from the carotid sinus?
Glossopharyngeal
27
Which nerve is responsible for carrying signals from the aortic arch?
Vagus
28
when are glycogen stores depleted?
12-18 hours after fasting
29
Pyruvates to PEP
Pyruvate carboxylase
30
Oxaloacetate to PEP
Phosphoenolpyruvate carboxykinase (PEPCK)
31
acetyl coA to palmitate
Fatty acid produced during lipogeneisis
32
acetoacetyla Coa to 3hydroxy3methyglutaryl coA
Cholesterol synthesis
33
Daptomycin use and side effects
Used for Gram positive, MRSA ( disrupts cell membrane) causes myopathy and CPK elevation. Not effective in treating pneumonias because it is inactivated by pulmonary surfactant
34
Linezolid Use and side effects
Used for MRSA (binds to 23rRNA on 50S to prevent formation of intiation complex), Can cause thrombocytopenia, optic neuritis and risk for serotonin syndrome
35
Common drugs for MRSA
Vancomycin, Daptomycin, Linezolid
36
Papilledema, dry skin, hepatosplenomegaly, visual difficulties
Vitamin A toxicity
37
widespread musculoskeletal pain, fatigue, tender points, normal inflammatory markers
Fibromyalgia
38
progressive pain and stiffness of spine, scaroiliitis
Ankylosing spondylitis
39
Bilateral pain and morning stiffness in shoulders and hips, elevated sed rate, associated with giant cell arteritis
Polymyalgia rheumatica
40
Side effect of thiazides
HYPER: uricemia, calcemia, glycemia, lipidemia. HYPO: kalemia, tension
41
gradula onset dyspnea, end-inspiratory crackles at lung bases, decreased FEV1 and FVC, increased ratio and decreased diffusion capacity
Pulmonary fibrosis
42
Post strep glomerulonephritis is seen after a strep skin infection or phayngitis or both?
Both
43
Rheumatic fever is seen after strep pharyngitis, skin infection or both?
only with throat infection
44
Amino acid formula of collagen
GLY-X-Y where X and Y are proline or lysine
45
recombination
exchange of genes between two chromosomes via crossing over in non-fragmented, ds DNA genome
46
Transformation
uptake of naked DNA or uptake of viral DNA into host cell chromosome
47
Phenotypic mixing
coinfection of a host by two viral strains results in virion that contains nucleocapside proteins from one and genome of other strain
48
Interference
inhibition by one virus of the replication or release of second virus in same cell
49
Factor Xa inhibitors
Direct: Rivaroxaban, Apixaban. Indirect: Fondaparinux
50
Direct thrombin inhibitor
Argatroban, Bivalirubin, Dabigatran
51
how do Xa inhibitors affect PT, PTT and thrombin time
Prolongs PT, PTT and does not change thrombin time
52
contraindications of OCP
Prior history of stroke, hx of estrogen dependant tumor, smoker over 35, hyperTG, decompensated liver disease, pregnancy
53
painless hematuria 2-3 days after URI, IF shows electron dense material in mesangium
IgA nephropathy
54
purpura on extensor surface, Abdominal pain, vomiting, IgA nephropathy
Henoch Schonlein diease
55
Necrotizing vaculitis of small dermal vessels and areas of subepidermal hemorrhage of purpuric skin leions
IgA nephropathy
56
when does IgA nephropathy present after an URT infection?
2-3 days (vs PSGN which is seen after 2 weeks)
57
Treatments for A-fib
Calcium channel blockers, beta-blockers, digoxin
58
Side effect of digoxin
AV block and ventricular tachyarrythmia. Hyperkalemia in toxicity but hypokalemia can increase susceptilibity to toxic effects
59
Mechanism of digoxin
inhibits NaK ATPase slows conduction through the AV node by stimulatig the vagus nerve
60
Activity of Ciprofloxacin
Gram negative (legionella, pseudomonas)
61
Activity of Ceftriaxone
Gram negative bacilli (Hib, Neisseria, Serratia)
62
Activity of azithromycin
chlamydia, mycoplasma, H. influenze, Morazella
63
Activity of vancomycin
Gram Positive (MRSA, MRSE, C. diff)
64
adverse effects of succinylcholine
malignant hyperthermia ( esp. halothane), severe hyperkalemia in patients with burns,myopaties, crush injuries, dennervation
65
Succinylcholine is contraindicated in which patients?
Pts with burns, myopathies, crush injuries, denervating injuries because these states cause an upregulation of nACHR leading to a release of potassium and casing hyperkalemia ( arrythmia)
66
Pelvic surgery loss of thigh adduction
Obturator L2-L4
67
pelvic fracture or hematoma of iliopsoas, loss of flexion of thigh, extension of leg
Femoral L2-4
68
Fibula neck fracture, Loss of foot eversion, dorsiflexion, Lose sensation to dorsum of foot
Common peroneal L4-S2
69
Trauma to the knee causing loss of foot infersion, plantar flexion. Lose sensation to sole
Tibial L4-S3
70
Foot drop (plantarflexed and inverted). Steppage gait
Peroneal nerve injury
71
What criteria determine the malignant potential of adenomatous polyps?
Degree of dysplasia, villous adenomas are more likely to undergo malignant transformation than tubular. Size (\>4cm)
72
Types of non-neoplastic polyps
Hyperplastic, Hamartomas (Peutz Jeghers or juvenile polyposis), Inflammatory (UC, Crohns), Lymphoid
73
Avascular necrosis is associated with which conditions?
Sickle cell, SLE (due to vasculitis), high dose steroids, and alcoholism
74
groin pain exacerbated by weight bearing. Painful and restricted movement in affected joint. No swelling, erythema or temperature change
Osteonecrosis (avascular necrosis)
75
chronic, intermittent pain in groin area that radiates to lateral thigh. Pain increased with pressure on the affected hip and with walking. No restriction in joint movement
Trochanteric bursitis
76
Malformation of the mandible, maxilla, malleus, temporal bone.
First arch syndrome
77
pruritis after showering, facial plethora, splenomegaly.
Polycythemia vera
78
Mutation in Polycythemia vera
JAK2 (cytoplasmic tyrosine kinase)
79
which factors bind to receptors with intrinsic tyrosine kinase activity
insulin, growth factors
80
capillary hemangioblastoma in the retina or cerebellum, cysts in the kidney, liver, pancreas
Von Hippel Lindau (AD)
81
neurofibroma, optic nerve glioma, Lisch nodules, café au lait spots
Von Recklinghausen (NF 1)
82
Cranial nerve 7 Schwannomma and meningioma
NF type 2
83
facial angioma, mental retardation, hemiplegia, skull radiopacities, tram track calcifications on xray
Sturge Weber
84
Kidney, liver, pancreatic cyst, cortical and subependymal hamartoma, renal angiomyolipoma, cardiac rhabdomyoma
Tuberous sclerosis
85
Telangiectasia that rupture to cause recurrent epistaxis, Gi bleeding
Osler weber rendu
86
Fever, hypotension, diarrhea, oliguria, vascular compromise, DIC
Septic shock
87
What is responsible for the toxic properties of LPS in gram negative sepsis
Lipid A of LPS activates macrophages and granulocytes to make IL1 and TNF
88
Hypercellular glomeruli
Post strep glomerulonephritis
89
Round basophilic bodies in the nucleus
Nucleolus
90
Function of the nucleolus
site of rRNA transcription. RNA pol I transcribes rRNA
91
Dopamine dose dependant effects
Low dose: acts on D1 receptors on renal vaculature and increases glomeruar filtrate rate. Med: B1 increaes contractility and BP. Higher doses stimulates alpha1 causing vasoconstriction
92
mutation in HFE protein
Primary hemochromotosis leading to iron accumulation due to increased expressiosn of divalent metal transporter protein and decreased hepcidin synthesis
93
Micronodular cirrhosis, diabetes mellitus and skin pigmentation
Primary hemochromatosis
94
Superficial inguinal lymph nodes
external genitalia and anus up to pectinate line
95
Deep inguinal lymph nodes
glans penis and clitoris
96
Radial nerve innervates
Extensors, skin on dorsum of the hand
97
Wrist drop
Radial head subluxation (nursemaid elbow)
98
Carpal tunnel
Median nerve
99
weakness in intrinsic muscles of the hand
Ulnar nerve
100
Fracture of the surgical neck of humerous
Axillary nerve
101
afferent limb of light reflex
Optic nerve
102
efferent limb of light reflex
occulomotor nerve
103
IL1
neutrophil and macrophage migration. Acute phase reactants, fever and shock
104
IL2
T cell activation and proliferation
105
IL3
Hematopoiesis
106
IL4
TH2 cell differentiation, B cell growth, Isotype switching to IgE
107
IL5
Differentiation of eosinophil, IgA isotype switching
108
IL6
T and B cell growth. Osteoclast activity. Acute phase reactant and fever
109
IL8
neutrophil activation and chemotaxis
110
IL 10
Decrease TH1 differentiation, decrease cell mediated and APC activity. Increase B cell function
111
IL12
TH1 differentiation, increase NK cell and CD8 activity
112
TGFB
decrease immune cell function, increase matrix synthesis and angiogenesis
113
TNFa
increase inflammation , acute phase reactants, fever and shock
114
LTC4, LTD4, LTE4
vasocontriction, increased vascular permeability and bronchospasm
115
Oculomotor dysfunction, ataxia, mental status change (disorientation, aptahy and decreased attention span
Thiamine deficiency
116
damage to the anterior and dorsomedial thalamic nuclei
memory loss and confabulation in Korsakoff syndrome (inability to form new memories)
117
excitation-contraction coupling
Ca released from sarcoplasmic reticulum. Ca binds troponin C, tropomyosin shifts to exposed actin binding sides for myosin to allow contraction
118
Progressive ataxia, hypertrophic cardiomyopathy, kyphoscoliosis, pes cavus, DM
Friedreich ataxia (AR)
119
rapidly spreading, pruritic rash with erythematous papules and excoriation on flexor surfaces. Worse at night
Scabies
120
Bisphosphonates
analog of pyrophosphate (important for hydroxyapatite) used for osteoporosis, Paget's, malignancy of hypercalcemia
121
why should you not use non-selective beta blockers in diabetics
mask symptoms of hypoglycemia
122
cheilosis, stomatitis, glossitis, dermatitis, corneal vascularization
Riboflavin deficiency B2
123
Cheilosis, glossitis, dermatitis, peripheral neuropathy
Pyridoxine B6 deficiency
124
Acrodermatitis enteropathica, growth retardation and infertility
Zinc deficiency
125
gradual vision loss, subretinal inflammation with abnormal extracellular matrix formation that appear as drusen deposits
Dry Age related macular degeneration
126
Acute vision loss with metamorphosia. Funduscopy show grayish green subretinal discoloration
Wet age related macular degeneration
127
myotonia, cataracts, frontal balding, gonadal atrophy
myotonic dystrophy (CTG repeats)
128
nausea, vomiting, changes in color vision, arrythmia
Digoxin toxicity
129
mutation in hereditary PAH
BMPR II
130
apocrine glands
secrete sweat into hair follicles rather than directly to skin
131
Holocrine glands
found in association with sebaceous glands. Discharge of entire secretory cells that undergo breakdown to release secretory product
132
Eccrine (merocrine) glands
Present in skin (except lips) and secretes sweat directly to skin surface
133
approximately how much of filtered urea is reabsorbed by PT?
50.00%
134
how much of filtered sodium is reabsorbed?
99.00%
135
how is glucose handled at low and high filtered loads?
at low filtered loads: all is reabsorbed. At high loads: increasing fractional excretion. Increases beyond saturation point do not result in increased absorption
