UWorld_3.27 Flashcards
Characteristics of restrictive lung disease
-decreased lung volumes -increased FEV1 due to increased elastic recoil (decreased compliance) & increased radial traction by fibrotic lung
Cells contained in TB granulomas
epithelial macrophages w/pale pink granular cytoplasm CD14 = cell marker
Structures @ retroperitoneum
- vessels: abdominal aorta, IVC + branches 2. solid organs: pancreas (except tail), kidneys, adrenal glands 3. hollow organs: segment 2,3, and part of 4 of duodenum + asc/desc colon + rectum, ureters, bladder 4. vertebrae and pelvic m.
Histo description of Burkitt’s
-medium-sized tumor cells (lymphocytes) -basophillic cytoplasm -proliferation fraction (Ki67 fraction) > 99%
Cause of warfarin skin necrosis
-Protein C deficiency -Protein C = natural anticoag completely depleted protein C ==> hypercoag state ==> thrombi @ microvasculature ==> skin necrosis
Characteristics of Criggler-Najar
-disruption in uncoj. bilirubin metabolism @ liver due to lack of UGT enzyme -UGT normally conjugates bilirubin with glucuronic acid - ==> unconjugated hyperbilirubinemia - unconj. bili bound to albumin ==> unable to be excreted by kidney ==> deposition in tissue - ==> brain deposition = kernicterus ==> severe jaundice, encephalopathy w/m. rigidity, seizures, lethargy ==> death
Molecules that increase insulin resistance in overweight individuals
-FFA -serum triglycerides
beta hydroxybutyrate =
-marker of insulin deficiency -present in DM1
Molecular mechanism of chemical interference with insulin receptor response
-**phosphorylation of serine and threonine residues** ==> decreased activity of insulin receptor ==> insulin resistance -e.g. TNF-a ; glucocorticoids; catecholamines; glucagon; FFA
High ethanol intake impact on glucose metabolism
-hypoglycemia + elevated intracell NADH ==> ethanol is being used as NRG source and gluconeo is inhibited -ethanol catabolism ==> production of NADH ==> favor conversion of pyruvate=>lactate and OAA=>malate -since OAA and pyruvate are gluconeogen intermediates; conversion to other molecules inhibits gluconeogen
High vs. low potency antipsychotics
high = fluphenazine, haloperidol low = chlorpromazine, thioridazine
Class of anti-arrhythmics that show “use-dependence” + example
-class I anti-arrhymics (Na-cahnnel blockers) -IC = strongest association w/Na; slow to leave ==> prolonged QRS, but no effect on overall AP ==> normal QT
Carbamazepime: MOA, use, SE
-MOA = blocks VSSC @ neurons -use = partial, partial complex, gen TC seizures + mood stabilizer -SE = bone marrow suppression
pleural thickening + calcifications @ lower lobes + small pleural effusion ==> dx?
abestosis
coal pneumo problems ==>
multiple discrete nodules @ upper lobes
silicon imapct @ pulm ==>
nodular densities + eggshell calcifications @ hilar nodes
pulmonary berylliuosus ==>
~sarcoidosis: non-caseating granulomas, enlarged hilar lymph, nodular infiltrates
Gq receptor pathway
- binding ==> phospholipase C converts mem. phospho ==> IP3 & DAG 2. IP3 ==> increased Ca release from SR 3. Ca + DAG activate PKC 4. PKC phosphorylates 2nd mess ==> downstream effects
Burr cells and helmet cells indicate…?
mechanical/traumatic hemolysis; e.g. prosthetic valve
Ethambutol SE
optic neuritis, color blindness ,etc.
Location of absent ganglia in hirschprung
-narrowed rectum/rectosigmoid = lack autonomic -lack submucosa (meissner) and myenteric (auerbach) -ganglia will be absent in submucosal layer
Nitrate with highest bioavailability
isosorbide mononitrate
Neonatal complications of maternal DM during preg.
- premature delivery 2. fetal macrosomia 3. congenital malformations: NTDs, CV, caudal regression 4. respiratory distress 5. transient hypoglycemia 6. polycythemia and hyperviscosity
Complications of pre-eclampsi
-DIC -acute fatty liver -ATN -HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) ==> eclampsia = seizures
Location/risks assoc. with BRCA-1/BRCA-2 genes
-both = tumor suppressor genes -BRCA-1 @ chr. 17 ==> increased risk of breast + ovarian -BRCA-2 @ chr. 13 ==> increased risk of breast cancer
Structures @ risk in total abdominal hysterectomy
-ureters = contained w/in broad ligament and run just posterior to uterine arteries -==> post-surgical acute renal failure
