Uworld 4 Flashcards
clasp kinife spasticity –> initial resistance to passive extension followed by a sudden release. ….upper motor neuron lesion = lose inhibition on spinal stretch reflex.
purely motor affecting contralateral arm, leg, and lower face
where is the lesion?
Internal capsule
lesion in caudate nucleus… caused by?
Huntington’s
chorea and athetosis…where is the lesion?
caudate nucleus
contralateral tremor, bradykinesia, and rigidity…where is the lesion?
putamen of basal ganglia (involved in initiation of movement)
difference between damaging the internal and external segments of the globus pallidus
lesion internal = excessive motion/ movements
lesion external= decreased motion
what dz is an arrest in the migration of neural crest cells
Hirschsprung
what region of the GI tract is always involved with Hirschsprung? and why?
Rectum (and anus)! cause it’s last to be innervated by the ganglion cells. nerve cells migrate caudally
what things are Down syndrome pts more at risk for?
alzheimers (early)
brushfield spots (speckled iris)
Simian crease (single transverse palmar crease)
Endocardial cushion defects (AV septal defects), ASD, VSD, PDA, ToF
duodenal atresia or stenosis, annular pancreas, TE fistula, Hirschsprung’s dz, omphalocele, imperforate anus
AML
ALL
hypo/hyperthyroidism, Type 1 DM, infertility in males
how does a bug get resistant to vancomycin?
changing the binding site from DalaDala to Dala D lactate
how does a bug get resistant to penicillin?
- makes beta lactamase. which destroys the beta lactam ring to render them ineffective. cephalosporins, carbapenems, and penicillinase resistance penicillins like nafcillin and methicillin are not susceptible.
- modify penicillin binding protein….like MRSA
but vanco is not a beta lactam drug! (has a different binding site)
how does a bug get resistant to tetracycline?
it binds to 30S subunit and inhibits binding of aminoacyl-tRNAs
resistance is through increased efflux of drug or the production of a protein that allows translation to take place anyways.
how is a bug get resistant to aminoglycosides?
it inhibits the 30S subunit.
resistance is by inactivating an aminoglycoside-modifying enzymes. makes a protein that modifies the antibiotic to decrease te binding ability
Pseudomonas = resist by decreasign anitbiotic entry into the bacterium
what 3 things affect the RAAS pathway?
macula densa, intrarenal barroreceptor, and beta adrenergic receptor pathways (thorugh B1 on the JG cells) -> norepi binds and causes release in renin
how does a Bblockers (like propanolol) affect the RAAS
decr. symp input, so inhibits renin release
high fructose in urine, but otherwise asymptomatic. what’s missing?
fructokinase
what will an absent galactose- 1 phosphate ruridyl transferase cause?
galactosemia. auto recessive. neonatal jaundice, bleeding diatheis feeding intolerance, hypotension, and death =[
Tx: eliminate all milk products from diet. feed with soy based formula
Don’t have aldolase B….what happens?
normally, aldolase B converts fructose 1 phosphate to DHAP and glyceraldehyde.
Tx. must eliminate dietary fructose. infants present with failure to thrive, hepatomegaly and cirrhosis
acid alpha glucosidase (or acid maltase) deficinecy causes what?
glycogen storage disease !!, pompe dz.
presents with hepatomegaly, cardiomegaly, and increased risk for cirrhosis
what lab findings will you find with post strep GN?
high ASO titers high antiDNase titers decreases C3 decreased total complement presence of cryoglobulins (C4 is usually normal)
what does coadministration with clavulanate do?
it is a beta lactamase inhibitor. it expands the ability (for ex. amoxicillin) to include strains of b-lactamase synthesizing bacteria….
what are GABAa and GABAc receptors?
ion channels. influx of cl-
what re GABAb receptors?
linked to G protein
name 3 things that bind to GABAa and facilitate the inhibitory action of GABA n the CNS
bensodiazepines, barbiturates, and alcohol
where is GABAc located?
retina
what has positive heterophil antibodies
Mono!
what cofactor is needed for the synthesis of tyrosine, dopa, serotonis, and NO?
BH4 = teetrabydrobiopterin
what is serotonin synthesized from?
tryptophan
go through the pathway to make Epi from phenylalanine
phen –> tyrosine–> dopa –> dopamine –> NE –> epi.
what is niacin made from?
tryptophan
what is the porphyrin in heme made from?
glycine
what is gaba made from?
glutamate
what is NO (and creatine and urea) made from?
arginine
what is melanin made from?
Dopa!
what is a cofactor needed to make NE from dopamine?
Vitamin C!
what is melatonin made from?
serotonin!
what CV abnorm. do you see with digeorge? (2)
tetro of fallot
interrupted aortic arch
(and persistant truncus arteriosus)
what CV abnorm. do you see with friedreich ataxia?
hypertrophic cardiomyopathy
what CV abnorm. do you see with Kartagener’s?
situs inversus
what CV abnorm. do you see with Marfan’s? (2)
cystic medial necrosis (aortic dissection or aneurysm)
mitral valve prolapse
(and aortic regurg)
what CV abnorm. do you see with tuberous sclerosis?
valvular obstruction due to cardiac rhabdomyomas =[
what CV abnorm. do you see with Turner’s? (2)
aortic coarctation
bicuspid aortic valve
what CV abnorm. do you see with fetal alcohol syndrome?
VSD, (PDA, ASD, ToF)
what CV abnorm. do you see with congenital rubella?
PDA, (septal defects, pulm artery stenosis)
what CV abnorm. do you see with maternal DM?
transposition of the great vessels
what CV abnorm. do you see with prenatal lithium exposure?
Ebstein anomaly
what CV abnorm. do you see with Williams syndrome?
Supravalvular aortic stenosis
what is the mechanism of buproprion?
mixed dopamine and norepi reuptake inhibitor
foot drop. what is injured and where?
common peroneal nerve. from trauma to the leg near the head of the fibula
reddish pink periodic acid schiff + granules in the periportal hepatocytes are…?
unsecreted, polymerized A1AT.
will develop panacinar emphysema (from destruction of alveolar walls from elastases)
and cirrhosis and HCC
borrelia burgdorferi
Lyme
treponema pallidum
syphilis
patchy skin anesthesia, hypopigmentation, bacteria invading Schwann cells
mycobacterium leprae
in what kind of pts does lepromatous leprosy occur? (the bad one)
pts with a weak Th1 response. macrophages are never given the signal to kill the mycobacterial organisms….
