uWorld 13 Flashcards
elastase in the lungs is released from what cells
macrophages (in lysosomes)
neutrophils (azurophilic (primary) granules)
when is beta-hCG first detectable in the serum
8 days after fertilizations
6 days at the earliest b/c that is when IMPLANTATION OCCURS
beta-hCG is produced by the SYNCYTIOTROPHOBLAST after implantation
detectible in urine 14 days after fertilization (less sensitive than serum pregnancy test)
what is a crossover study
subjects are randomly allocated to a sequence of 2 or more treatment given consecutively
simplest model is AB/BA type of study in which subjects are allocated to the AB study arm receive treatment A followed by treatment B and vice versa in the BA arm
allows PATIENTS TO SERVE AS THEIR OWN CONTROLS
what is a disadvantage of crossover studies and how is it limited
principle drawback is that effects of one treatment may “carry over” and alter the response to subsequent treatments
to limit this a washout (no treatment) period is often added b/w consecutive treatments
what is a case series
a descriptive study that tracts patients with a known condition (a particular exposure, risk factor, or disease) to document natural history or response to treatment
a qualifying study that cannot quantify statistical significance
a left shift in the hemoglobin curve causes what sequelae in the a patient
ERYTHROCYTOSIS (compensatory to maintain normal oxygen delivery)
hint: hypoxia (low tissue O2 from the left shift and less unloading at the tissues) causes ERYTHTROYCYTOSIS b/c the kidneys sense the low tissue O2 and synthesize ERYTHROPOIETIN
what is the pre-contemplation stage of change (transtheoretical) model
no thinking about behavior modification
denial
what is the contemplation stage of change (transtheoretical) model
thinking about behavior modification
acceptance
what is the preparation stage of change (transtheoretical) model
planning behavior modification
panning
what is the action stage of change (transtheoretical) model
putting plan into action
what is the maintenance stage of change (transtheoretical) model
maintaining new behavior
what kind of drug is fenoldopam and what is it used for
DOPAMINE-1-RECEPTOR AGONIST (little or no effect on alpha or beta-adrenergic receptors)
used in hypertensive emergency especially when there is ACUTE KIDNEY INJURY b/c fendolopam has prominent RENAL VASODILATION effects and thus INCREASES RENAL PERFUSION
INCREASES NATRIURESIS
what is homocysteinuria and what is the most common cause
condition that leads to HYPERCOAGULABILITY and THROMBOEMBOLIC OCCLUSION
premature acute coronary syndrome, ECTOPIA LENTIS (DOWN and OUT displacement), and INTELLECTUAL DISABILITY
MCC = CYSTATHIONE SYNTHASE defect
cysteine is essential in diet
what does IL-3 do
promotes growth and differentiation of bone marrow stem cells
what promotes class switching to IgE
IL-4
IL-13
what is seen histologically in high-grade CIN
expansion of immature basal cells to the epithelial surface
what cells in the bone form from mononuclear phagocytic cell lineage and are ultimately formed when several precursor cells fuse to create a multinucleated mature cell
what factors are essential for the differentiation of these cells
osteoclasts
macrophage colony-stimulating factor (M-CSF)
receptor for activated nuclear factor kappa-B ligand (RANK-L)
what is osteoprotegerin (OPG)
physiologic decoy receptor that decreases binding of RANK-L to RANK
middle meningeal artery is a branch off of what
MAXILLARY ARTERY
the PTH receptor and calcium-sensing receptors (CaSR) are what kind of receptors
transmembrane G-protein0 coupled (metabotropic) receptors
what use transmembrane ligand-gated ion channels (inotropic receptors)
acetylcholine
serotonin
NMDA
GABA
what use transmembrane receptors that recruit Janus Kinase
GH
prolactin
erythropoietin
true aneursyms of the ventricular wall are bound by scarred myocardium is seen when after a large transmural infarct
late complication (greater than 1 month)
can cause thrombus, arrhythmias, and HF but rarely rupture
what are signs and symptoms of ventricular free wall rupture seen within 5-14 days of an MI
hemoperricardium and cardiac tamponade
profound hypotension
shock
rapid progression to pulseless electrical activity and death
what causes an S4 in older adults
age-related decrease in left ventricular compliance (relatively benign finding)
the louder it gets the more pathologic it is- like left ventricular hypertrophy following prolonged hypertension or restrictive cardiomyopathy
what is the second most common cause of ring-enhancing lesions with mass effect (seizures) in HIV pts
Primary Central Nervous System Lymphoma (PCNSL)
b-cell origin from epstein-barr virus
lymphadenopathy behind the ears is indicative of rubella or rubeola
rubella
rash of rubella typically spreads faster and does NOT DARKEN or COALESCE
what drug competitively inhibits iodine transport
potassium perchlorate or pertechnetate
what TB drug requires intracellular catalase peroxidase activity to be activated
Isoniazid (INH)- inhibits mycelia acid synthesis but needs to be processed by mycobacterial catalase peroxide for the drug to be activated within the bacteria
how does cyanide work
potent mitochondria toxin that binds Fe3+ in CYTOCHROME C OXIDASE inhibiting the electron transport chain and halting aerobic respiration in the cell
tonofiliaments, long slender microvilli in proliferation of epithelioid-type cells that are joined by desmosomes is indicative of what lung cancer
mesothelioma
pancytokeratin immunohistochemical marker is helpful
what is seen in the bladder of a MS patient
bladder hypertonia w/ increased urinary frequency and urge incontinence
what characterizes primary biliary cirrhosis
chronic autoimmune liver disease
infiltrate of macrophages, lymphocytes, plasma cells, and eosinophils that results in granulomatous destruction of INTRAHEPATIC, INTERLOBAR BILE DUCTS (“florid duct lesion”)
primary biliary cirrhosis presents in who
insidiously in middle-aged women
FATIGUE and PRURITITS (usually worse at night) are usually first symptoms
hepatosplenomegaly and CHOLESTASIS (jaundice, pale stool, dark urine)
XANTHELASMA formation
what is seen in disseminated HSV infection
primarily in immunocompromised ppl and presents with diffuse vesicles on an erythematous base
NO erythema multiform
