uWorld 58 Flashcards
13 month old with history of otitis media, pneumonia, and thrush w/ pneumocystis
failure to thrive, chronic diarrhea
SCID
TX: stem cell transplant
TYPE IV HYPERSENSITIVITY is mediated by what cells
Th1 and MACROPHAGES, CD8
failure to generate a response to candida antigen infection is referred to as what
ANERGY (expected in SCID)
what is seen 4-12 hours after MI
early coagulation necrosis
edema
hemorrhage
wavy fibers
what is seen 12-24 hours after MI
coagulation necrosis and marginal contraction band necrosis
G6PD is inherited how
X-linked recessive
PANCYTOPENIA WITHOUT HEPATOSPLENOMEGALY
APLASTIC ANEMIA
phosphoribosyl pyrophosphate (PRPP) synthetase does what
responsible for production of the activated ribose necessary for de novo synthesis of purine and pyrimidine nucleotides
over activation causes HYPERURICEMIA and GOUT
NSAIDS affect what cells
NEUTROPHILS
what does hepatitis B do to help hepatitis D
HBsAg provides coating of the viral particles
most common cause of meningitis in ADULTS OF ALL AGES
STREP PNEUMONIAE (lancet-shaped Gram-positive cocci are found in paris)
alcoholics, sickle cell anemia patients, splenic individuals, and those in generally poor health are at greater risk
what are bean-shaped gram-negative cocci in pairs
Neisseria meningitidis
what is a facultative intracellular, motile, gram positive rod
LISTERIA
infants with what are especially at risk for vitamin K
CYSTIC FIBROSIS (poor absorption)
PARETNAL REFUSAL OF PROPHYLAXIS (like if they dont have vaccines and other meds)
EXCLUSIVE BREAST FEEDING
infants without prenatal care are also at risk
how does monocyte relaxation happen
CALCIUM EFFLUX form the cytoplasm
intracellular calcium is removed primarily via Na+/Ca2+ EXCHANGE PUMP (NCX) and sarcoplasmic reticulum Ca2+-ATPase (SERCA)
elevates serum levels of what contributes to acanthosis nigricans
FREE FATTY ACIDs
insulin resistance from T2DM causes increased LIPOLYSIS (insulin inhibits lipolysis normally) causing elevated FFA levels which then contribute to insulin resistance by impairing insulin-dependent glucose uptake and increasing hepatic gluconeogenesis
pro-carcinogens are metabolized by what
CYTOCHROME P450 MONOOXYGENASE- an enzyme system present in hepatic microsomes and the endoplasmic reticula of varied other tissues
what causes a ZENKER diverticulum
abnormal spasm or diminished relaxation of the cricopharyngeal muscles during swallowing (CRICOPHARYNGEAL MOTOR DYSFUNCTION) is thought to be the underlying mechanism of formation
results in early OROPHARYNGEAL DYSPHAGIA with feeling of food obstruction at the level of the neck and coughing/choking
increased oropharyngeal intraluminal pressure eventually results in herniation of the pharyngeal mucosa through a zone of muscle through a zone of muscle weakness (FALSE DIVERTICULUM) in the posterior hypo pharynx (Killian Triangle)
food retention with HALITOSIS/REGURGITATION
PULMONARY ASPIRATION of diverticular contents may also lead to recurrent pneumonia
fatiguability, weight gain, and myoedema (focal mounding of muscle following percussion)- what is the most likely cause of myopathy
HYPOTHYROIDISM
hypothyroidism myopathy may be one of the first manifestations (elevated creatinine kinase)
what is bronchiolitis
lower respiratory tract infection that usually occurs before age 2
most commonly caused by RESPIRATORY SYNCYTIAL VIRUS (RSV)
hypoxemia, TACHYPNEA, and RETRACTIONS with diffuse WHEEZES and CRACKLES
what gout mediation selectively binds to an INTERLEUKIN-1 INDUCIBLE ENZYME that is highly expressed by inflammatory cells and undetectable in the surrounding normal tissue
COX-2
what is consciously faking sick to play the sick role
FACTICIOUS DISORDER
what is MALINGERING
falsification or exaggeration of symptoms to obtain sternal incentives (SECONDARY GAIN)
what is somatic symptom disorder
excessive anxiety and preoccupation with more than 1 unexplained symptoms
what is the infundibulopelvic (IP) ligament
aka SUSPENSORY LIGAMENT OF THE OVARY
carries the blood supple to the ovary
ROTATION of the ovary around the IP ligament results in OVARIAN TORSION
what are risk factors for OVARIAN TORSION
rotation of the ovary around the IP ligament
presence of a LARGE OVARIAN MASS (CYST, NEOPLASM)- weight of mass causes the ovary to TWIST and OCCLUDE the OVARIAN VESSELS and NERVES
what happens to the ovary in blood flow is completely blocked in ovarian torsion
EDEMATOUS and ISCHEMIC
what maintains the ante flexion of the uterus
round ligament
runs form the lower aspect of the uterus through the inguinal ring to the labia majora and is not connected to the ovaries
during pregnancy, a woman may experience intermittent sharp pain due to irritation from sudden movements of the stretching round ligament
what does the uterosacral ligament do
connects the posterior aspect of the uterus to the anterior portion of the sacrum
hold the uterus in an anteverted or retroverted position; loss of this support contributes to uterine prolapse into the vagina
Henoch-Schonlein Purpura (HSP) affects what
GI Tract- intermittent abdominal pain
Kidneys
Skin
JOINTS- self-limited migratory arthralgia and arthritis are most commonly seen in the large joints of the lower extremities (ankle and knee joints), possibly because of their dependent nature
lipid looking shits in a biopsy of the UPPER EYELID of an elderly woman is seen in what
PRIMARY BILIARY CIRRHOSIS
XANTHELASMA
patient with PANCREATITIS and subsequent respiratory failure likely has what
ACUTE RESPIRATORY DISTRESS SYNDROME
hepatic angiosarcomas have what tumor marker
CD31
what causes functional hepatic amenorrhea
reduced circulating LEPTIN levels as a result of diminished adipose tissue stores
decreases in leptin inhibits pulsatile GnRH release from the hypothalamus, causing decreased pituitary LH and FSH secretion, low circulating ESTROGEN levels, and amenorrhea
what hormone stops lactation
PROGESTERONE
guillain-barre syndrome is an acute demyelinating disease with an immune-mediated pathogenesis of what
ENDONEURAL INFLAMMATORY INFILTRATE causing SEGMENTAL DEMYELINATION
in the CNS how long does Wallerian Degeneration
slow due to blood-brain barrier
slow removal of MYELIN DEBRIS can PERSIST for YEARS in eh degenerating tracts and SUPRESS AXONAL GROWTH via myelin-associated inhibitory factors
ASTROCYTES also release inhibitory molecules and proliferate in the weeks to months following injury, forming a GLIAL SCAR that act as a BARRIER to axon regeneration
