uWorld 40 Flashcards
what can you use to treat PSORIASIS that ACTIVATES and NUCLEAR TRANSCRIPTION FACTOR
CALCIPOTRIENE aka calcipotriol (calcitriol, tacalcitol)- topical vitamin D analog that bind s to and activates the vitamin D receptor, a NUCLEAR TRANSCRIPTION FACTOR that causes inhibition of keratinocyte proliferation and stimulation of keratinocyte differentiation
also shown to inhibit T cell prolieraftoin and other inflammatory mediators
what is ustekinumab (stelara)
human monoclonal antibody used in PSORIASIS the targets IL-12 and IL-23
it INHIBITS DIFFERENTIATION and ACTIVATION of CD4+ Th1 and Th17 cells
acute hemolytic transfusion reaction is caused by what
TYPE II HYPERSENSITIVITY (ANTIBODY MEIDATED)
anti-ABO usually IgM in the recipient bind the corresponding antigens on transfused donor erythrocytes, leading to COMPLEMENT ACTIVATION
ANAPHLATOXINS (C3a and C5a) causes vasodilation and symptoms of shock, while formation of MAC leads to COMPLEMENT-MEDIATED CELL LYSIS
fever, HYPOTENSION, CHEST and BACK PAIN, HEMOGLOBINURIA
what doe the different RNA pols make
RNA pol I: rRNA
RNA pol II: mRNA
RNA pol III; tRNA
MADE IN ORDER THEY ARE NEEDED TO MAKE SHIT
what is the toxin found in poison mushrooms
AMATOXINS (AMANITA PHALLOIDES) aka DEATH CAP
bind to RNA POLYMERASE II and halt mRNA synthesis, ultimately resulting in APOPTOSIS
really fucked up the liver, GI, and proximal convoluted renal tubules
6-24 hours after ingestion get abdominal pain, vomiting, and severe cholera-like diarrhea that may contain blood and mucus
acute hepatic and renal failure in severe poisoning
how does RICIN (Ricans communis) work
inhibits PROTEIN SYNTHESIS by cleaving the rRNA component of the eukaryotic 60S subunit
diagnosis of cellulitis from a gram positive thing in clusters, the organism synthesizes what protein that is part of peptidoglycan cell wall and what does it do
STAPH AUREUS
PROTEIN A
binds Fc portion of IgG resulting in decreased production of C3b, leading to impaired opsonization and phagocytosis
what pulmonary defense mechanism clears the respiratory tract of deposited particles less than 2 micrometers in size
PHAGOCYTOSIS
particels 2.5-10 micormeters in size ever the trachea and crunch and are cleared by the mucociliary transport
coughing, sneezing, and upper respiratory trapping are the mechanisms for clearing what sized particles
the largest
what are the signs/symptoms of ankylosing spondylitis
low back pain (onset less than 40, insidious onset, improves with exercise but not with rest, PAIN at NIGHT)
hip and buttock pain
LIMITED CHEST EXPANSION and SPINAL MOBILITY (HYPOVENTILATION)
ENTHESITIS (inflammation at the site of INSERTION of a TENDON to the bone)
systemic systems (fever, chills, fatigue, weight loss)
acute ANTERIOR UVEITIS (unilateral pain, photophobia, blurry vision)
ASCENDING AORTITIS which can lead to dilation of aortic ring and aortic insufficiency
sudden onset of DYSPNEA in the setting of CALF SWELLING is strongly suggestive of what
PULMONARY EMBOLISM
V/Q MISMATCH causing significant INTRAPULMONARY RIGHT-to-LEFT SHUNTING causing HYPOXIA
HYPERVENTIALION
structured handoffs that include specified key elements (a systematic procedure for sign-out, checklists of tasks that need to be completed, a standardized approach for each patient) have been shown to significantly reduce what
PREVENTABLE ADVERSE EFFECTS
what vitamin can be used to treat measles
VITAMINE A
dont forget about subacute sclerosis pan encephalitis years after the measles
vasopressin activates decreased the renal clearance of what
UREA
activates UREA TRANSPORTERS in the MEDULLARY COLLECTING DUCT, increasing urea reabsorption
passive absorption of urea in medullary collecting interstitial in the presence of ADH significantly increases the medullary osmotic gradient, allowing the production of maximally concentrated urine
brown pigment stones typically arise secondary to bacterial E. coli) or helminthic (Ascaris lumbricoides, Clonarchis sinensis) infection of the BILIARY TRACT, which results in relate of what
BETA-GLUCURONIDASE by injured hepatocytes and bacteria
this enzyme hydrolysis bilirubin glucoronides and increases the amount of unconjugated bilirubin
what kind of stones are seen in chronic hemolytic anemia
pigment gallstones (form the unconjugated bilirubin)
what does 7-alpha-hydroxylase do
catalyzes conversion of cholesterol to 7-alpha-hydroxycholesterol (first step in BILE ACID SYNTHESIS)
net effect of this enzyme is to lower the cholesterol to bile acid ratio and lower risk of cholesterol stones
what are pigment stones
made up of CALCIUM and UNCONJUGATED BILIRUBIN and typically arise secondary to bacterial or helminthic infection of biliary tract
beta-glucoronidcdase related hydrolyzes the bilirubin glucornides to unconjugated bilirubin
what is tetrodotoxin
pufferfish poisoning
neurotoxin produced by microorganisms associated with the fish
binds VOLTAGE-GATED SOIDUM CHANNELS in NERVE and CARDIAC tissues, preventing sodium influx and depolarizaiton
what is the most important risk factor for development of intimal tears leading to AORTIC DISSECTION
HYPERTENSION
Burger disease (thromboangiitis obliterans) is what
vasculitis in SMOKERS that affected medium and small arteries but mainly TIBIAL and RADIAL nerves
what causes eversion of the food
SUPERFICIAL PERONEAL NERVE (via PERONEUS LONGUS and BREVIS)
also does sensory over lateral leg and dorsolateral foot
what is seen in COMMON PERONEAL NERVE INJURY
susceptible at the LATERAL NECK of the FIBULA caused by COMPRESSIOn (prolonged lying during surgery, crossing the legs, leg casts) or PROXIMAL FIBULAR FRACTURE
“FOOT DROP” from deep peroneal (innervation of anterior compartment muscles responsible for ankle dorsiflexion via TIBIALIS ANTERIOR and toe extension via extensor digitorum longs, extensor hallucis longus)
superficial peroneal nerve involvement causes impaired foot EVERSION (peroneus longs and brevis) and sensory loss over the lateral leg and dorsolateral foot
femoral nerve injury results in what
weakness on hip flexion and knee extension due to iliopsoas and quad involvement
medial leg and anteromedial thigh sensory fucked
what does the sciatic nerve do
leg flexion at the knee and also supplies TIBIAL AND PERONEAL NERVES so everything they do
sensory the the entire foot via dural and postural tibial nerve and posterolateral leg
maple syrup urine disease is treated how
avoid Ilosleucine, leucine, and valine (branched chain amino acids)
SUPPLEMENT with THIAMINE (B1)
“I Love Vermont maple trees w/ B1ranches”
why B1? uhhh alpha-keto DEHYDROGENASE is fucked bruhh these dehydrogenase things need B1 (pyruvate dehydrogenase complex does to nigga)
what is the most common valve affected by infective endocarditis, what is the most common underlying valvular disease predisposing this valve to development of infective endocarditis
MITRAL VALVE
MITRAL VALVE PROLAPSE (with or without regurgitation)
check for DENTAL EXTRACTION or PROCEDURE in question stem
also valvular sclerosis, mechanical valves, and rheumatic heart disease are important predisposing factors just not as important as MVP
what congenital heart lesions predispose to infective endocardiitis
bicuspid aortic valve
ventricular septal defects
patent ductus arterioles
unreported tetralogy of Fallot
what is a frequent cause of infective endocarditis in developing countries
rheumatic heart disease
what are some findings of NF1
PSEUDOARTHROSIS CAFE-au-LAIT spots neurofibromas lisch nodules (asymptomatic hamartoma of the iris) optic nerve gliomas SPHENOID DYSPLASIA SCOLIOSIS meningiomas astrocytomas gliomas pheochromocytoma
trabecular thinning with fewer interconnections is seen in what
osteoporosis (primarily in trabecular, aka spongy, bone)
increased deposition of unmineralized osteoid is very characteristic of what
vitamin D deficiency
histologically, osteoporosis is characterized by what
persistence of primary, unmineralized SPONGIOSA in the medullary canals
(in normal peeps, the primary spongiosa is replaced by bone marrow)
aortic dissection is initiated by what
TEAR in the AORTIC INTIMA
where is the psoas muscle located
anterior surface of transverse processes and lateral surface of there vertebral bodies at T12-L5
acts in FLEXION of thigh at HIP and also contributes somewhat to lateral rotation and abduction of the thigh
inferior (at around the level of the inferior ligament), the psoas muscle combines with the iliac muscle to form the ILIOPSOAS mSUCLE, which function in hip flexion
what are risk factors for primary psoas abscess development
HIV
IV drug use
diabetes
