uWorld 32 Flashcards
what is seen in a newborn with midgut malrotation
cecum wil rest in the right upper quadrant instead of the right lower quadrant
LADD’S (FIBROUS) BANDS connect the retroperitoneum to in the RLQ to the right colon/cecum by PASSING OVER the SECOND PART of the DUODENUM, causing INTESTINAL OBSTRUCTION in the process
obstruction presents as BILIOUS VOMITING during the FIRST DAYS of life
mesentery is vulnerable to tWISTING around the SUPERIOR MESENTERIC ARTERY- midgut VOLVULUS which comprises intestinal profusion and may lead to life-threatening bowel necrosis
what is seen if a lower cutoff point is used (in terms of sensitivity and stuff)
increase in number of overall positive results
sensitivity of the test increases
true positive values increase but false positive increase more
positive predictive value decreases
false negatives decrease
anovulation is a common cause of infertility how can this be treated
menotropin (human menopausal gonadotropin) is a treatment option that acts like FSH and trigger the formation of a dominant ovarian follicle
ovulation is then induced by administration of human chorionic gonadotropin which mimics the LH surge
when during menstruation are peak progesterone levels
mid luteal phase
after ovulation when the corpus luteum is formed
nitric oxide is formed from what
ARGININE, NADPH, and O2 by eNOS (endothelial nitric oxide synthase)
NO activates guanylyl cyclase → cGMP → less cytosolic coliseum and RELAXATION of vascular smooth muscle cells
arginine is used to make what
nitric oxide
urea (w/ help of aspartate)
creatine (w/ help of glycine and SAM)
aspartate is used to make what
urea (w/ help of arginine)
pyrimidines (w/ help fo glutamine
purines (w/ help of glycine and glutmaine)
glycine is used to make waht
heme (w/ help of succinyl CoA)
creatine (w. help of arginine and SAM)
purines (w/ help of glutamine and aspartate)
glutamine is used to make what
pyridines and purines
what is glutamate used to make
GABA
glutathione
what all is derived form tyrosine (which comes from phenylalanine itself)
dopamine epinephrine norepinephrine thyroxine melanin
what is asymmetrical dimethyarignine
an endogenous analog of arginine that work as a competitive inhibitor of eNOS
what is nor present in all tRNAs
variable loop (lies between the T and anticodon loops)
what is the T loop of tRnA
has the T(psi)C sequence- necessary for BINDING of tRNA to RIBOSOMES
(ribothymidine and pseudouridine, and cytidine presence tells you this is around)
what are ApoE3 and ApoE4 responsible for
found own CHYLOMICRONS and VLDL
binding hepatic apolipoprotein receptors for their removal
what is ApoA1 required for
esterification of free cholesterol in HDL particles by lecithin-cholesterol acyltransferase (LCAT)
ApoA1 and LCAT deficiencies result in low HDL levels and increased circulating free cholesterol levels
what is familial chylomicronemia syndrome and what causes it
AR disorder of defective LIPOPROTEIN LIPASE or ApoC3 (which activates LPL)
increased synthesis and decreased clearance of chylomicron particles (and VLDL)
why is DNA polymerase I unique
only prokaryotic polymerase that also has 5’ to 3’ EXONUCLEASE ACTIVITY
functions to REMOVE the RNA PRIMER reacted by RNA primase and REPAIR DAMAGED DNA sequences
what is the major early biochemical consequence of total myocardial ischemia and when does it happen
cessation of aerobic glycolysis and initiation of anaerobic glycolysis
transition occurs within seconds
although TOTAL ATP levels remain normal during first few minutes of ischemia, ATP is rapidly depleted form areas of cell with high demand
the DEPLETION of ATP in CRITICAL CELLULAR areas and the ACCUMULATION of TOXINS results in LOSS of CONTRACTILITY within about 60 seconds of total myocardial ischemia
when does ischemia become irreversible
after about 30 minutes of TOTAL ISCHEMIA
what are benign lung tumors
HAMARTOMAS
“coin lesions” found incidentally on chest x-ray
mature hyaline cartilage mixed with connective tissue, smooth muscle, and fat
what is seen in adenocarcinoma in site (aka bronchioloalveolar carcinoma)
consists of WELL-DIFFERENTIATED, dysplastic COLUMNAR CELLS (with or without MUCIN) that line the INTACT alveolar septa without vascular or stromal invasion
tendency to undergo erogenous spread and can progress to invasive disease if not resected
what causes edwards syndrome (trisomy 18)
MEIOTIC NONDISJUCNTION
error in oocyte division occurs prior to ovulation and fertilization and increases with maternal age over 35
what is seen in cri-du-chat syndrome
microdeleiton of 5p
cat-like cry as well as hypotonia, failure to thrive, developmental delay
microcephaly
low-set ears
hypertelorism
broad nasal bridge