uWorld 59 Flashcards
what is messed up in Wilsons Disease (AR)
hepatic damage from free radicals
cornea- Keyser-Fleischer rings in DESCEMET’S membrane
basal ganglia
where are enterococci found
the GI (cystoscopy or other GI invasive procedures can cause enterococci to seed causing endocardiditis
sinus infection are usually caused by what
S pneumoniae
H. Flu
Moraxella catarrhalis
what is acorchordon
SKIN TAG
pedunculate outgrowth of normal skin
typically seen in areas of friction (neck, axilla, inframammary groin) of patients with DIABETES and OBESITY
what is a cavernous hemangioma
DILATED VASCULAR SPACES with thin-walled ENDOTHELIAL cells
presents as soft blue, compressible masses up to a few centimeters in size
found on skin, mucosa, deep tissues, and viscera
when found on skin- most frequently based in the semis
VON-HIPPEL-LINDAU disease association when found in brain and viscera
what is a cherry hemangioma
small, red, cutaneous papule common in aging adults
do not regress spontaneously and typically increase in number with age
LM shows proliferation of capillaries and post-capillary venules in papillary dermis
what is a superficial hemangioma
aka infantile, capillary, or strawberry hemangioma
first weeks of life
initially grow rapidly and then frequently regress spontaneously by late childhood
bright red when near the epidermis and more violacious when deeper
how does ribavirin work
multifactorial- includes inducing lethal hypermutation, inhibiting RNA polymerase and inosine monophosphate dehydrogenase (deleting GTP), caddying defective 5’ cap formation on viral mRNA transcripts, and modulating a more effective immune response
INTERFERES WITH DUPLICATING VIRAL GENETIC MATERIAL
what is raltegravir
integrase inhibitor
inhibits integration of viral DNA into the shots genome
what is hereditary pancreatitis
rare disorder that results from mutations involving the TRYPSINOGEN or SPINK1 genes
leads to production of abnormal trypsin that is not susceptible in inactivating cleavage by trypsin
always amount of trypsinogen that activates prematurely within the pancreatic acini and ducts, these protective mechanisms are critical for preventing pancreatic auto digestion
what is SUBCLAVIAN STEAL SYNDROME
significant stenosis of the SUBCLAVIAN ARTERY PROXIMAL to the origin of the VERTEBRAL ARTERY
subclavian stenosis is typically caused by atherosclerosis but Takayasou arteritis and complications from heart surgery (aortic coarctation repair)
lowered distal subclavian arterial pressure leads to reversal in blood flow (“steal”) form the contralateral vertebral artery to the ipsilateral vertebral artery , away from brainstem
ARM ISCHEMIA in the affected extremity (exercise-induced fatigue, pain, paresthesias)
or VERTEBROBASILAR INSUFFICIENCY (dizziness, vertigo, drop attacks)
significant difference (over 15) in brachial systolic blood pressure between affected arm and normal arm
doppler ultrasound establishes diagnosis
someone with a TIA. what do you give them
optimal blood pressure control and statin therapy, also LOW-DOSE ASPIRIN is commonly used to PREVENT ISCHEMIC STROKE in patients with TIA
low-doses predominantly blocks COX-1, preventing platelet synthesis of thromboxane A2, which IMPAIRS PLATELET AGGREGATION and reduces vasoconstricton
neuronal shrinkage and intense cytoplasmic eosinophilia suggests what kind of damage
IRREVERSIBLE- gliosis would occur at this area resulting in GLIAL HYPERPLASIA via ASTROCYTES
homocysteinuria is most frequently caused by what
AR deficiency of CYSTATHIONINE BETA-SYNTHASE, and enzyme that is PYRIDOXINE dependent
TX: with PYRIDOXINE and restriction of methionine from diet
UNCAL HERNIATION can result int he compression of what
IPSILATERAL THRID CN as it exits the MIDBRAIN at the same level
OCULOMOTOR PALSY with a fixed DILATED PUPIL due to damage to preganglionic parasympathetic fibers running on outer portion of CN3
if lesion becomes transtentorial- vestibular-ocular reflexes lost and decorticate followed by decerebrate posturing
cerebellar peduncles can be compressed- flaccid paralysis and hyporeflexia(initially) then UMN damage
abducens palsy is associated with what
brainstem (central) hernaiton due to reaction along the clivus
pinpoint pupils are usually associated with what brain lesion
bilateral pontine lesions caused by damage to descending sympathetic tracts
how does flutamide work
competitive androgen receptor-binding
so does cyproterone and spironolactone
whats anastrozole
aromatase inhibitor
zidovudine inhibits what part of viral genome replciation
3’-5’ phosphodiester bond formation
3’OH group is required for new nucleotides to be added to replicating DNA, the aside group on AZT prevents DNA CHAIN ELONGATION
thymidine analog
what are the retroperitoneal abdominal organs
SAD PUCKER
Suprarenal (adrenal) glands Aorta and IVC Duodenum (except 1st part) Pancreas (head and body) Ureters and bladder Colon (amending and descending) Kidneys Esophagus Rectum (mid-distal)
what is a common cause of retroperitoneal hemorrhage
pancreatic injury
what are most vulnerable areas in brain to hypozia
pyramidal cells of the HIPPOCAMPUS and neocortex and the PURKINJE cells of the cerebellum
HIPPOCAMPUS if the FIRST area damaged in GLOBAL cerebral ischemia
what does the RET proto-concogene code for
TYROSINE KINASE membrane bound receptor
seen in MEN 2 and MEDULLARY THYROID carcinoma
PAS stains what
glycoprotein
polysaccharides in fungal cell wall, mucosubstances secreted by epithelia, basement membranes
periodic acid oxidizes C-C bonds, forming aldehydes that produce a brilliant magenta color upon reacting with the fuchsin-sulfurous acid
RIGHT-SIDED COLON CANCER
micro satellite deletions (MSH2, MLH1, MSH6, PMS2 mutations)
DNA MISMATCH REPAIR- Lynch Syndrome (colorectal cancer, endometal cancer, ocarina cancer)- AD due to inactivating of tumor suppressor
FAP is associated with what
APC gene mutations- AD due to inactivating of tumor suppressor
colorectal cancer (polyps)
DESMOIDS and OSTEOMAS (GARDNERS)
brain tumors
peptic ulceration is implicated in the development of lower intestinal bleeding dup to what
Mickey diverticulum
what is the test of choice for bronchiectasis
high-resolution chest CT
what is seen in dermatomyositis
skin manifestation- GROTTEN PAPULE (red or violacious, flat-topped papule over JOINTS and BONY prominency, especially on the HANDS) and HELIOTROPE RASH (erythematous or violacious edematous eruption on the upper eyelids and periorbital skin
myopathy- proximal muscle weakness (difficulty climbing stairs, combing hair), elevated muscle enzymes (creatine kinase, aldolase
whats lichen sclerosis
patchy, whitish thinning of the skin
