Uworld test 1 block 4 Flashcards
LH and FSH in PCOS
ovarian theca cells (which make androstenedione) are stimulated by excess circulating LH. testosterone and androstenedione levels increase. becasue FSH is decreased in proportion to LH, the granulosa cells can’t aromatize the antrogens to estrogens. anovulation results from decr. estrogen levels (high estrogen levels are needed for LH surge)
What are the layers of the epidermis? What is a callus?
layers of the epidermis (superficial to deep): stratum corneu, stratum lucidum, stratum granulosum, stratum spinosum, and stratum basale (californians like girls in strig bikinis). a callus is a painless additional thickening of the stratum corneum.
what kind of regulatory protein is able to dictate differentiation of a progenitor cell into a dermal cell?
transcription factor.
peutz-jeghers syndrome
autosomal dominant disease characterized by pigmented mucocutaneous macules and hamartomatous polyps in the GI tract. progressive growth can lead to malignant transformation
proper medical management of a patient after mechanical valve replacement?
WARFARIN (and then add aspirin)
What antibodies types do not undergo isotype switching?
IgM and IgD
infliximab
TNF alpha mediates local inflammatory rxns at low conc. and mediates systmeic effects like fever, anorexia, shock, cachexia, circulation of corticotropin releasing factor at high concentrations.
infliximab and etanercept target TNF alpha; infliximab is a monoclonal ab to TNF-alpha, while etanercept is a recombinant TNF receptor fusion protein
focal segmental glomerulosclerosis
often seen with HIV infection, heroin addiction, and sickle cell disease. only some glomeruli are collapsed and sclerotic. within the affected glomeruli, only some segments are involved. sceltoric segments feature BM collapse, incr. matrix production, and hyalinosis. collapsing glomerulopathy, which is characteristic of HIV associated nephropathy, the FSGS lesions are seen in addition to the collapse and sclerosis of the whole glomerular tuft. the glomerular epithelial cells tend to proliferate and hypertrophy, and marked tubular injury with accompanying microcyst formation is seen.
homeobox gene manifestations
hand foot and genital syndrome: clinodactly (hypoplastic great toes and thumbs), shortened thumbs, small feet, short great toes, and urinary tract abnormalities. GU probs: duplications of the repro tract in women and hypospadias in men
Pax-3 mutations
assocated with Waardenburg syndrome: heterochromia irides, poliosis (loss of color in head hair or eyebrows), dystopia canthorum (eye thing), deafness
ethylene glycol poisoning
anion gap acidosis that can cause sudden onset backpain, hematuria, and oliguria. metabolites are very toxic and can cause calcium oxalate crystal deposition in renal tubules, leading to renal failure (acute tubular necrosis). tx: fomepizole > ethanol or dialysis
What will increase contraction velocity?
decreased preload
what happens to the spleen in a patient with portal HTN?
red pulp expansion because of blood backup into the spleen.
Conn syndrome
a form of primary hyperaldosteronism.
patients will have high aldosterone levels: causes high blood pressure and low renin. aldosterone will cause hypokalemia and a metabolic acidosis. however, there will be NORMAL Na+.
Patients would have unsuppressable aldosterone.
tx: surgery or spironolactone
SIADH and volume status
body responds to water retention with decreased aldosterone to maintain a near normal volume status- but this can cause hyponatremia.
tx: fluid restriction, conivaptan, tolvaptan, demeclocycline.
