UW7 Flashcards
What is the length constant of a neuron?
how far along an axon an electrical impulse can propagate. Distance at which the originating potential decreases to 37% of its original amplitude
temporal summation
sequential impulses from the same same neuron over time
Spatial summation
simultaneous impulses from several different neurons
Time constant of a neuron
how long it takes for a change in membrane potential to achieve 63% of a new value. Lower time constants allow quicker changes in membrane potential, thus increasing axonal conduction speed
failure of obliteration during development leads to an abnormal connectionb etween the scrotum and the peritoneal cavity?
Processes vaginalis
what allows reassortment in viruses
segmented genomes (orthomyxo, rotavirus)
what does frothy, foamy urine indicate
Proteinuria or bile salts in urine
how does loss of protein in urine change fluid dynamics?
decrease plasma oncotic pressure (leads to edema)
how does a decrease in capillary hydrostatic pressure change fluid dynamics?
Decrease net plasma filtration
how does aldosterone levels change in nephrotic syndrome?
plasma oncotic pressure is decreased so effective circulating intravascular volume is decreased leading to an increased aldosterone level
macrpphages release what cytokines in septic shock
Il1 and TNFa
fever, rash, shock
Toxic shock syndrome mediated by TSST-1, exfoliative toxin or enterotoxin that brings MHC and TCR in close proximity to cause widespread acitivation of T cells leading to release of IL2 (Tcell) and IL1 and TNFa from macrophages
Where should thoracentesis be preformed?
between the 7th ribs along the midclavicular line, the 9th ribs along the midaxillary line and 11th ribs along the paravertebral line. Along the upper border of the rib
What are the borders of the pleura?
midclavicular: 7th, Midaxillary: 10th, Paravertebral: 12
Where do the intercostal vein, artery and nerve lie along the ribs
the lower border
Collagen type I
Dermis, bone, tendons, ligaments, dentin, cornea, blood vessels, scar tissue
Collagen type II
cartilage, vitreous humor, nucleus pulposus
Collagen type III
Skin, lungs, intestines, blood vessels, bone marrow, granulation tissue
Collagen type IV
Basement membranes
Nomal pCO2
40
Normal HCO3
24
normal pH
$7.40
pH 40
Respiratory acidosis. Renal compensation is slow and takes 3-5 days to have max effect (HCO3
pH 7.3, CO2=70, HCO3= 26
compensated respiratory acidosis (chronic)
low pH, low HCO3, low PCO2
diabetic ketoacidosis with respiratory compensation ( kussmaul breathing)
high pH, high HCO3, high pCO2
contraction alkalosis. Overuse of diuretics loss leads to compensatory aldosterone production which leads to loss of potassium and hydrogen ions by kidneys. Metabolic alkalosis
high pH, low pCO2 and slightly low HC03
panic attack ( acute so no compensatory response)
vagal efferent activity on bronchial smooth muscle
bronchial smooth muscle contraction (muscarinic M3 receptors) and increased mucous secretions
Anti-cholinergic drugs that cause bronchodilation
Tiotropium and ipratropium
lymphatic drainage of scrotum
superficial inguinal lymph nodes
lymphatic drainage of testis, glands penis
Deep inguinal lymph nodes
Lymphatic drainage from testes
Para-aortic lymph nodes
dyspnea, distended neck veins, distant heart sounds, pulsus paradoxus
pericardial effusion
headache, facial plethora, dilated veins of neck and upper torso
Superior vena cava syndrome (SCLC)
Degeneration of the putamen is seen in what disease
Wilson’s disease (medial to the insula and lateral to the GP)
Which brain structure is affected in Huntington’s disease
Caudate
Fibrous intimal thickening with endocardial plaques limited to the right heart
Carcinoid heart disease
5 hydroxyindoleacetic acid is a metabolite of
Serotonin
VMA is a metabolite of
Epinephrine and norepinephrine
elevated phenylalanine in urine
PKU (phenylalanine hydroxylase deficiency)
subendothelial immune complex deposition leads to thickening and thinning of the glomerular BM “tram track”
membranoproliferative GN
Subepithelial immune complex deposition leads to “spike and dome” on EM
Membranous GN
sclerotic changes in some portions of some glomeruli
Focal segmental glomerulosclerosis. Secondary to HIV infection, heroin abuse, severe obesity
proliferation of lymphocytes, endothelial cells within capillary loops
Diffuse proliferative GN
Catabolism of what amino acids leads to formation of proprionic acid
Valine, Isoleucine, threonine, methionine
What enzyme deficiency is responsible for propionic acidemia
proprionyl coA carboxylase ( conversion of proprionyl coA to methylmalonyl CoA)
what vitamin is given as an IM injection at birth?
K
What drugs cause vasodilation of arterioles in nonischemic regions leading to decreased perfusion in ischemic areas?
adenosine and dipyridamole (coronary steal)
What part of the stomach does H. pylori affect
antrum
which part of the stomach does autoimmune chronic gatritis affect
body of the stomach ( destruction of parietal cells)
Solitary ring enhancing lesion on Brain MRI in HIV pt
Primary central nerveous system lymphoma
pupillary dilator muscle has which adrenergic receptors
alpha 1 ( phenylephrine is selective alpha agonist for pupil dilation)
adrenergic receptors on the uterus
Beta 2 (uterine relaxation; terbutaline is a B2 agonist)
Adrenergic receptors on the bladder
alpha 1 (contraction of internal urethral sphincter)
adrenergic receptors on the lungs
Beta 2 (bronchodilation)
Pathophysiologic basis of depression
dysregulation of monoamine (serotonin, NE, dopamine)
what drug inhibits inositol monophosphat e
Lithium
What is nafcilin used to treat
skin and soft tissue infections ( folliculitis, abscesses) due to S. aureus
What antibiotic is used to treat lung abscesses in alcoholic patients
Clindamycin (coveres anaerobic)
Side effect of low potency anti-psychotics
Chlorpromazine, Thioridazine (Sedation, anti-cholinergic, orthostatic hypotension)
Side effect of high potancy anti-cholinergic
Haloperidol and Fluphenzine (extrapyramidal sxs)
High doses of nitroprusside caninduce what toxicity
Cyanide
AMS, sizures, cardiovascular collapse, lactic acidosis, bright red venous blood
Cyanide toxicity
How do you manage CN toxicity
Sodium nitrate: promotes metHb formation which binds to CN. Sodium thiosulfate: acts as ao sulfur donor to convert CN to thiocyanate to be excreted. Hydroxycobalamine binds to CN which can be excreted
Dose dependent increase in cardiact contractiliy and dose dependent decrease in vascular resistance
Isoproterenol. Low dose: B2 causes relaxation of vascular smooth muscle. No alpha effects
Early virilization and accelerated linear growth in boys. Ambiguous genitalia in girls
21 hydroxylase deficiency (adrenal hyperplasia)
What is the treatment for congenital adrenal hyperplasia?
Exogenous steroids to decrease ACTH
bronchoalveolar lavage in sarcoidosis
predominance of CD4 T cells (high CD4/CD8 ratio)
bronchoalveolar lavage in hypersensitivity pneumonitis (bird handling)
predominance of CD8 T cell
Surface markers for pre-B cell
CD10, CD19, CD20
surface markers for pre T cells
CD2, CD3, CD4, CD5, CD7, CD8
fever, malaise, bleeding, bone pain, hepatosplenomegaly with blast cells
B - ALL
dysphagia, superior vena cava syndrome, blast cells
T- ALL
Treatment of Arsenic poisoning
Dimercaparol
Treatment for lead or mercury poisoning
EDTA
Treatment for CN poisoning
Amyl nitrite
Treatment for iron poisoning
Deferoxamine
treatment for metHb
Methylene blue
Stomach pains, vomiting, delirium, garlic odor
Arsenic poisoning
Tunnel vision in low ambient light ddx
toxic retinopathy due to phenothiazides, chloroquine, Vit A deficiency, congenital rubella, diabetic retinopathy
Pupillary light reflex
Afferent: II Efferent: III
Corneal reflex
Afferent V1 Efferent: VII (close eyelids)
Jaw jerk
Afferent V3 Efferent V3 (massert contraction)
Vestibuloocular reflex
Afferent: VIII Efferent III, IV, VI
Carotid sinus reflex
Afferent IX Efferent X (decrease HR and BP)
Cough reflex
Afferent and efferent X
Gag reflex
Afferent IX and Efferent X (contraction of phayngeal constrictor muscles)
What is effect modification
Effect of main exposure is modified by the presence of another variable. Not a bias. Can be confused with confounding
inactivated influenza virus induces antibodies against what antigen
Hemagglutinin ( prevents viral entry)
Labs in anorexia
decreased FSH, LH, Estradiol
Enzyme defect in Maple syrup urine disease
Branched chain alpha ketoacid dehydrogenase
Thiamine, Lipoate, CoA, FAD and NAD are required by which enzymes
Branched chain alpha ketoacid dehydrogenase, pyruvate dehydrogenase and alpha keto glutarate dehydrogenase
When is pyridoxine supplmentation required
Sideroblastic anemia and hyperhomocysteinemia
PKU can result from a deficiency of in which cofactor for phenylalanine hydroxylase
Tetrahydrobiopterin (required for phenylalanine hydroxylase)
Before starting treatment for RA, what should be tested?
TB (TNFa blocker can predispose pts to infections)
Drugs that cause drug induced lupus
Hydralazine, procainamide, isoniazid (positve ANA)
SE: Thyroid dysfunction, lung fibrosis, liver toxicity, blue, gray discoloration of skin
amiodarone
SE: negative inotrophy, constipation, gingival hyperplasia
Verapamil
SE: chest burning, flushing, transient hypotension
Adenosine
Leaking of urine with coughing, sneezing, laughing, lifting
loss of urethral support and intraabdominal pressure exceeds sphincter pressure
Sudden, overwhelming or frequent need to empty bladder
Detrusor overactivity
Constant involuntary dribbling or urine and imcomplete emptying
impaired detrusor contractility or bladder outlet obstruction
Mifepristone
progesterone antagonist that acts as an abortifacient (leads to decidual necrosis and expulsion of products of conception)
Misoprostol
Prostaglandin E1 analog causes uterine contraction
Diazepam
anxiolytic (GAD and panic attacks), Sedative-hyponotic (insomnia), Anticonvulsant (status epilepticus), muscle relaxant
Chlorpheniramine
anti-histamine that can penetrate BBB and lead to sedation by blocking H1 receptors
Loratadine
anti-histamine that blocks peripheral H1 receptors does not cross BBB
Ranitidine
Inhibits gastric acid secretion by blocking H2 receptors
CD for macrophages
CD14
69XXX
partial mole
46XX
complete mole
elevated hCG after molar pregnancy
Choriocarcinoma
vaginal bleeding, hypertonic uterus, intense painful contractions in 3rd trimester
Abruptio placentae
Diseases transmitted by tick bites
Leishmaniasis, plasmodium, chagas (reduviid bug), lyme (Ixodes)
first line treatment for acute gout
NSAIDS
Why are xanthine oxidase inhibitors not given in acute gout?
can exacerbate acute arthritis
ataxia, dysarthria, loss of position and virbration sense
seen in Friedreich ataxia, vitamin E deficiency
Difference between topoisomerase I andII
I induces single stranded nicks to relieve negative supercoiling while II makes double stranded breaks to relieve both positive and negative supercoiling
What drugs inhibit topoisomerase I
Irinotecan and topotecan
what drugs inhibit topoisomerase II
Etoposide
cough, hemoptysis, sinusitis, mucosal ulceration, rapidly progressive GN
Wegnener granulomatosis with polyangiitis
Posterior Cruciate Ligament
attaches to the lateral surface of the medial condyle
Anterior Cruciate ligament
Attaches to the medial surface of the lateral condyle
hepatomegaly, cardiomegaly, macroglossia, hypotonia, mental retardation, glycogen accumulation
Acid maltase deficiency
Normal blood sugar, severe cardiomegaly, glycogen accumulation
Pompe (a glucosidase deficiency)
weakness and fatigue with exercise. Little or no rise in blood lactate levels after exercise
Glycogen phosphorylase deficiency (McArdle)
Hepatomegaly, fasting hypoglycemia, lactic acidosis, hyperuricemia
Glu6 phosphatase deficiency (von Gierke)
Beta thalassemia
mutation that results in defective transcription, processing and translation of beta globin mRNA
Example of protein folding defect
Z mutation in alpha antitrypsin
Hypothalamus: ventromedial
Satiety (stimulated by leptin)
Hypothalamus: Lateral
Hunger (inhibited by leptin)
Hypothalamus: anterior
Heat dissapation
Hypothalamus: posterior
Heat conservation
Hypothalamus: arcute
secretion of dopamine, growth hormone releasing hormone and gonadotropin
Hypothalamus: paraventricular
AND, CRH, oxytocin,TRH
Hypothalamus: supraoptic
ADH and oxytocin
Hypothalamus: suprachiasmatic
Circadian rhythm and pineal gland function