uworld 6?? Flashcards
type 1 collagen
dermis, bone, tendons, ligaments, dentin, cornea, blood vessels, scar tissue
type 2 collagen
cartilage, vitreous humor and nucleus pulposus
type 3 collagen
skin, lungs, intestines, blood vessels, bone marrow, lymphatics and granulation tissue!
type 4 collagen
basement membranes
how is calcium high in sarcoidosis?
T cells are active –> secrete gamma interferon which increases the activity of 1 alpha hydroxylase activity in macrophages–> converts 25 hydroxy vit D to 1, 25 hydroxy vit D.
where is 1 alpha hydroxylase normally found?
kidneys. macrophages have some too, but usually doesn’t do much unless have some chronic granulomatous thing when they’re super activated
what does ristocetin do?
activates gp1b receptors on platelets and makes them aailable for vWF binding
gingival bleeding, platelet count is normal, platelets aggregate normally to ADP but poorly to ristocetin. what is this?
vWF deficiency
what do you give for vWF deficiency? how does it work?
desmopressin. stimulates the release of vWF from endothelial cells. if super severe, then give blood products that have vWF…
mucocutaneous bleeding, incr bleeding time, platelet aggregation normal to ristocetin, decreased with ADP
Glanzmann thrombasthenia
what does glanzmann’s not have?
deficiency of GP2b/3a receptors
CYP 450 inducers
carbamazepine phenobarbital phenytoin rifampin griseofulvin
CYP 450 inhibitors
cimetidine ciprofloxacin erythromycin azole antifungals grapefruit juice isoniazid ritonavir (protease inhibitors)
neoplastic lymphocytes that have CD 19 and CD 5
mature B cell leukemia (eg. CLL or SLL)
red urine that darkens upon standing for 24 hours
Acute intermittent prophyria
mode of inheritance of acute intermittent prophyria?
autodom
what deficiency causes acute intermittent prophyria?
porphobilinogen deaminase deficiency
what is the nucleolus made of?
mainly rRNA–> mady by RNA pol 1
bilateral renal angiomyolipomas associated with what?
tuberous sclerosis. AD. cortical tubers and subendymal hamartomas in the brain. cardiac rhabdomyomas, facial angiofibromas, and ash leaf patches
cerebellar hemangioblastomas, retinal hemangiomas, and liver cysts are associated with what?
VHL dz. AD. at high risk for bilateral renal cell carcinomas!!
facial port wine stain and leptomeningeal capillary venous malformation is associated with what?
Sturge Weber syndrome. rare congenital vascular disorder
multiple telangiectasias on skin and mucosa–> typical presentation is recurrent epistaxis or GI bleeding (melena) is associated with what?
osler-rendu-weber syndrome or hereditary hemorrhagic telangiectasias
what cytokines are critical in granuloma formation?
IFN gamma, IL 12, TNF alpha.
macrophages release IL 12 to induce Th1 differentiation.
mature Th1s produce interferon gamma to activate macrophages and improve their ability to kill the ingested TB.
activated macrophages produce TNF alpha to recruit addnl monocytes and macrophages to the area.
what does IL 4 do?
promotes Th2 differentiation which stimulates B cells to isotype switch to IgE
what does C3a do?
stimulates mast cell histamine release –> vascular permeability and vasodilation
what does Leukotriene C4 do?
same as D4 adn E4 –> vasoconstriction, bronchoconstriction, and incr leukocyte adhesion to endothelium. (if sups low, then causes vasodilation and incr permeability of venules)
what does IL5 do?
growth and diff of b cells, eosinophils and isotype switch to IgA
where is the most common site of colonization of S aureus?
anterior nares…
where does all skin from the umbilicus down, including the anus (up to the dentate/pectinate line) but excluding the posterior calf drain to?
superficial inguinal lymph nodes.
where does the posterior calf drain?
popliteal lymph nodes
mutation for sickle cell
A-T in the betaglobin gene results in glutamate substituted by valine at position 6
what is homocysteine converted to?
methionine using BH4 and cobalamin
cysteine using B6 and serine
How is plasma glucose converted to sorbitol?
Aldose reductase.
Osmotic cellular injury => cataracts and peripheral neuropathy
alprazolam, triazolam, oxazepam are…?
short acting Benzos ( increased dependance, but decreased fall risk in elderly (shorter daytime drowsiness “hangover”
estazolam, lorazepam, emazepam are…?
medium Benzos (10-20 hours)