uWorld 54 Flashcards
symmetrical proximal muscle weakness
increasing difficulty climbing stairs, getting up from chain, carrying heavy objects, combing hair
INCREASED MHC CLASS I expression on the sarcolemma and CD8+ cells
POLYMYOSITIS
EVELVATED MSUCLE ENZYMES (CK, aldolase)
anti- ANA, Jo-1(aka anti-histidyl-tRNA)
ENDOMYSIAL mononucelar infiltrate, patchy necrosis, and regeneration and fibrosis of the muscle fibers
associated with: INTERSTITIAL LUNG DISEASE, MYOCARDITIS
in multiple myeloma what causes the BONE RESORPTION
section of IL-1 (osteoclast activating factor) and IL-6 by neoplastic cells- activates osteoclasts
bone pain, pathologic fractures, “punched out” lytic lesions on X-ray
HYPERCALCEIMIA from bone destruction- CONSTIPATION, CONFUSION, FATIGUE
what is higher in pulmonary vein than artery from the RAAS
ANGIOTENSIN II- potent vasoconstrictor of the systemic circulation and causes a rise in blood pressure (increased after load) that worsens cardiac output
difference in minute vent and alveolar vent is what
dead space (tidal volume times Paco, Peco, Paco)
what causes hereditary pulmonary HTN
INACTIVATION mutation in BMPR2, which is transmitted AD
predisposition for dysfunctional endothelial and SMOOTH MUSCLE CELL PROLIFERATION
second insult (infection, drugs, ion channel defects) is then thought to activate the disease process, which involves increased ENDOTHELIN (vasoconstrictor) and decreased NO (vasodilator) and prostacyclin (vasodilator and platelet inhibitor)- TWO HIT HYPOTHESIS
vasoconstriction with vascular smooth muscle proliferation
increased pulmonary artery pressure can cause what
dyspnea, fatigue, and can be heard as an ACCENTUATION of the PULMONARY component of the SECOND HEART SOUND (P2)
can lead to cor pulmonale (angina, DJP, hepatic congestion, and peripheral edema)
how is relative risk calculated
(a/(a+b))/(c/(c+d))
used in cohort
how is odds ratio calculated
OR: ad/bc
used in case-control
perforating stab wound right above clavicle, what is pierced
LUNG APICES and CERVICAL PLEURA extend above CLAVICLE and FIRST RIB
stab wounds immediately above the clavicle and lateral to the manubrium can puncture the pleura and acute pneumothorax, tension pneumothorax, or hemothroax
how do beta blockers lower BP
reducing myocardial contractility and heart rate
decreasing renin release by the kidney
what are the areas in the colon most susceptible to non-occlusive ischemia (like due to diabetes or atherosclerotic arterial disease)
2 WATERSHED ZONES splenic flexture (SMA and IMA) RECTOSIGMOID JUNCTION (sigmoid and superior rectal arteries)
complications: acidosis, sepsis, gangrene, perforation
pale mucosa and petechial hemorrhages
myxomatous changes of large arteries are found in what
CYSTIC MEDIAL DEGENERATION
characterized by fragmentation of elastic tissue (“basket weave” pattern) and separation of the elastic and fibromusclar components of the tunica media by small, cleft-like spaces that become filled with amorphous extracellular matrix
MARFAN SYNDROME- AORTIC ANEURYSMS and DISSECTIONS
what is beta-aminopropionitrile (a chemical found in certain kinds of sweat peas)
causes inhibition of lysyl oxidase, an enzyme responsible for cross-linking elastin fibers and collagen fibers
ingestion can cause change in elasticity of the aorta that mimics myxomatous degeneration
a PALPABLE but NONTENDER GALLBLADDER (courvoisier sign), weight loss, and obstructive jaundice (pruritic, dark urine, dark stool) are indicative of what
ADENOCARCINOMA of the HEAD of the PANCREAS compressing the biel duct
associated with SMOKING, age, DM, chronic pancreatitis, genetic predisposition (hereditary pancreatitis, MEN 1, HNPCC, FAP)
a low-fiber diet is associated with what kind of cancer
colon adenocarcinoma