uWorld 51 Flashcards
involuntary head bobbing is a sign of what and seen in what
WIDENED PULSE PRESSURE
seen in AORTIC REGURGITATION (unusually large LV stroke volumes and a heart murmur with the widened pulse pressure)
palpitations usually result from what implying what
result from forceful ventricular contractions ejecting LARGE STROKE VOLUMES (high stroke volume meaning wider pulse pressure)
if HBeAg persists for several months and host anti-HBeAg remain low or undetectable levels, suspect
CHRONIC HEPATITIS B infections with HIGH INFECTIVITY
the recurrent laryngeal muscle innervates what muscles
posterior cricoarytenoid lateral cricoarytenoid obligue arytenoid transverse arytenoid thyroarytenoid
the superior laryngeal nerve (cur at the superior pole of the thyroid lobe due to proximity of superior thyroid artery and vein) innervates what
supraglottic sensation (internal laryngeal branch)
CRICOTHYROID (external laryngeal branch)- TENSES VOCAL CORDS resulting in hoarseness
PE is an example of what kind of shunt
RIGHT-to-LEFT intrapulmonary shunt (often results in HYPOXEMIA)
under normal conditions how do astrocytes regulate neurotransmission
takin up glutamate present in the synapse, preventing excessive neuronal excitation
using glutamine synthetase, glutamate undergoes condensation reaction with AMMONIA to from GLUTAMINE (a non-neuroactive compound)
glutamine is then released by the astrocytes, teen up by neurons, converted back into glutamate to be used as a neurotransmitter
EXCESS AMMONIA in the blood from cirrhosis causes elevation of what in astrocytes
GLUTAMINE
extra glutamine in the astrocytes leads to intracellular osmolarity, causing astrocyte swelling and impaired glutamine release
decreases amount of glutamine available for conversion to glutamate in neurons, resulting in DISRUPTION of EXCITATORY NEUROTRANSMISSION
what happens to levels of alpha-ketoglutarate in hyperammonemia
they are depleted because ammonia is detoxified into glutamate via glutamate dehydrogenase- this causes impaired energy metabolism in the brain
what are the signs of primary carnititne deficiency
muscle weakness
cardiomyopathy
HYPOKETOTIC hypoglycemia
elevated muscle triglycerides
caused by deficit in protein responsible for carinitine transport across the plasma membrane- w/o carnitine, FAs can’t be transported from cytoplasm INTO MITOCHONDRIA as acyl-carnitine
mitochondria therefore cannot beta-oxdize the fact acids into acetyl CoA, the carbon substrate for the TCA cycle
cardiac and skeletal muscle cannot generate ATP from fatty acids and the liver is unable to synthesize KETONE BODIES wen glucose levels are low
what are signs of medium chain acyl CoA dehydrogenase (MCAD) deficiency
hypoglycemia
HYPOKETOTIC hypoglycemia
15 year old girl w/ gait instability, kyphoscoliosis, res caves, bilateral lower extremity ataxia
joint position and vibration sense are impaired
she has an inherited disease what is it and whats she gna die from
FREIDREICH ATAXIA
death by CARDIOMYOPATHY
DORSAL COLUMNS, DRG, LATERAL CORTICOPANIAL, SPINOCEREBELLAR all fucked
what is the inheritance of wilson disease
AR
aka hepatolenticular degeneration
liver failure, movement abnormalities, psychiatric symptoms
localized amyloidosis confined to cardiac atria (isolated atrial amylodiossi)
beta-pleated ANP-derived proteins
incidence increases with age
this form of senile cardiac amyloidosis may INCREASE RISK of ATRIAL FIB
localized amyloid to thyroid gland is due to what
abnormally folded CALCITONIN-derived peptides
localized amyloid to pituitary gland is due to what
abnormally folded PROLACTIN-derived peptides
localized pancreatic amyloidosis is due to what
islet amyloid protein (AMYLIN)
found in the pancreas of more than 90% of patients with TYPE 2 DIABETES
what is the MCC complication of VZV infection
POSTHERPETIC NEURALGIA- persistent local pain