Week 5 Flashcards by Brendan Knapp

_____ cells produce inhibin in response to ____.

sertoli;

FSH

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impaired sertoli function:

_____ inhibin, ____ FSH, _____ testosterone, _____ LH

decreased, increased;

normal, normal

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HCV lacks what proofreading enzyme that is responsible for its antigenic variation?

3–>5’ exonuclease

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what pregnancy complication is due to impaired decidual layer?

how does it present?

placenta accreta;

post partum bleeding

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____ ____ is defined by a decrease in systolic blood pressure of > 10 mm Hg with inspiration. seen in ?

pulsus paradoxus;

cardiac tamponade (also COPD, constrictive pericarditis)

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which thyroid hormone decreases first in hypothyroidism?

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what do EPO levels do in patients with aplastic anemia?

increase

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_____ ulcers are due mainly to increased gastric acid production; ____ ulcers are due to decreased mucosal production

duodenal;

gastric

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intestinal malration occurs when the ____ fails to rotate completely around the ____ –> intestinal obstruction,____ bands

midgut;
SMS;
LADD (fibrous)

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chronic NSAID use can cause what 2 kidney injuries?

interstitial nephritis;

papillary necrosis

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HLA-A,B,C are the loci of the MHC ____ complex. HLA-DP, DQ-DR are the loci of the MHC ___ complex

1, 2

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abdominal aortic aneurysm:

chronic ____ ____ –> extracellular matrix degradation –> weakening and expansion, typically ____ the renal arteries

transmural inflammation;

below

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what has higher pressures, pulmonary artery or right ventricle?

pulm artery (around 25/10 vs RV, which is 25/5)

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what fungal respiratory infection can complicate asthma? can cause recurrent ___ ____ and eventual ______ ( a lung disease)

aspergillosis (ie ABPA);

pulm infiltrates, bronchiectasis

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brown adipose tissue (in newborns) function to produce heat by _____ oxidative phosphorylation with the protein ____

uncoupling;

thermogenin

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abetalipoproteinemia:
inability to sythesize ____ –> can’t transport lipids into blood –> enterocytes with
____ cytoplasm

ApoB;

foamy

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Mitral valve prolapse:
____ click;
murmur _____ with squatting

midsystolic;

decreases

due to myxomatous degeneration

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methemoglobinemia can be caused by exposure to ____;

O2 content ____, O2 saturation _____, partial pressure O2 _____

nitrites;

decreases, decreases;

stays the same

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what is an example of stimulus control in treatment of insomnia?

leaving bed if unable to sleep;

vs sleep hygeine (limit caffeine, alcohol, naps)

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hepatitis E virus:
naked or enveloped?
DNA or RNA?
single or double strand?

naked, ss RNA

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mullerian aplasia:

present with _____ vagina, ____ ovaries, ____ secondary sexual characteristics

short;
normal;
normal

variable uterine development

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empiric treatment of staph epidermidis endocarditis?

vancomycin

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increased intracranial pressure compresses optic nerves externally, impairing ____ ____ –> ____

axoplasmic flow;

papilledema

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primary adrenal insufficiency:

_____ blood pressure, ____kalemia, metabolic _____, hyperpigmentation

decreased;
hyper;
acidosis

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prophylaxis for Mycobacterium avium complex?

azithromycin

MAC (myco avium) grows best at _____ temperatures

high (vs Tb) causes hepatosplenomegaly, anemia, increased ALP, increased LDH

how to differentiate between lacunar infarcts and charcot-bouchard aneurysms?

aneurysms rupture, cause hemorrhage which is visible on CT; | lacunar infarcts are small and often not initially seen on CT

where is meissner's plexus located? where is auerbach's plexus?

submucosa (secretes fluid, regulates blood flow); muscularis externa (motility)

translation of mRNA occurs in the ____ direction

5 to 3'

maximum flow to the ____ ventricle occurs during _____

left; diastole (RV = lower pressures=mostly constant perfusion)

what kind of lymphocytes are atypical lymphocytes seen in Mono?

CD8

benign liver tumors: which is most common? which can regress with stopping of OCPs?

cavernous hemangioma; adenoma

where is this reabsorbed? bile acids = iron = B12 = Folate =

terminal illeum; duodenum; terminal illeum; jejunum

aging: ____ chest wall compliance; ____ lung compliance; ____ elastic recoil

decreased; increased; decreased causes increased RV, decreased FVC, normal TLC

2 most common symptoms in glucagonoma?

necrolytic migratory erythema + hyperglycemia; also diarrhea

celiac disease most commonly affects the _____

duodenum

obstructive atelectasis: | unilateral pulmonary ____ + deviation of mediastinum toward _____-

opacification; | toward collapsed lung

what transfusion reaction is characterizedby fever, hypotension, chest/back pain, and hemoglobinuria? what kind of HSR is this?

acute hemoyltic transfusion reaction; type II HSR (ie ABO incompatibility)

what is the embryological cause of tetralogy of fallot?

anterosuperior displacement of infundibular septum

alcohol abuse: which liver enzyme is more increased? what is seen on blood smear?

AST > ALT; macrocytosis (e.g. folate deficiency)

what part of the spine is most commonly affected in RA?

cervical

order these in conduction velocity, from fastest to slowest: | atrial muscle, AV node, purkinje, ventricular muscle

Purkinje (fastest) > Atrial muscle > ventricular muscle > AV node Park At Venture Avenue

injury to the temporal lobe can cause contralateral _____ quadrantanopia; injury to the parietal lobe can cause contralateral _____ quadrantanopia

superior (pie in sky for Meyer's loop); inferior

prostatectomy can injure the _____ which lies in the fasica of the prostate. this can cause _____

prostatic plexus; erectile dysfunction

HUS: | ____ platelet count, ____ bleeding time, ____ PT, ___PTT, ____ LDH

decreased PC, increased BT; normal PT and PTT; increased LDH

the neural tube is usually formed by ____ weeks

4 if not-->spina bifida

besides the liver, what else can produce glucose during fasting?

kidney; | intestinal epithelium

pernicious anemia: | ____ gastric pH, ____gastrin, ____ parietal cells

increased, increased, decreased

"on off" phenomenon with parkinson's therapy is due to progressive ____ ___ --> decreased therapeutic window

progressive nigrostriatal degeneration

equation for half life?

t = (0.7 * Vd)/CL

why should you wait 2 weeks after stopping MAO inhibitors before starting SSRIs?

allow time for MAO regeneration

what drug class can mask symptoms of hypoglycemia?

non-selective beta blockers

equation for NNT

1/ARR ARR = difference between control and experimental group event rates

the electrolyte disorders seen in hyperaldosteronism cuase what 2 symptoms?

muscle weakness, paresthesias

most common cause of bronchiolitis in kids?

RSV see increased work of breathing, cough, tachypnea

tetrodotoxin _____ depolarization; ciguatoxin _____ depolarization

prevents (binds Na channels); causes (opens Na channels)

______ = tendency of study subjects to change behavior as they know they are being studied

hawthorne effect

chancroid vs granuloma inguinale: painful = lymphadenopathy = donovan bodies =

chancroid, chancroid; granuloma inguinale

what is JAK2?

cytoplasmic (non-receptor) tyrosine kinase

what removes RNA primers in DNA replication?

DNA polymerase 1 (5 to 3' exonuclease)

which of the coagulation factors has the shortest half life?

factor 7 so, first to decrease in liver disease --> prolonged PT

thoracic outlet syndrome is due to compression of the _____ trunk of the brachial plexus between a cervical rib and what?

lower; scalene muscles

a prominent left atrial "v wave" is a major finding for what valvular disorder?

mitral regurg; represents LA filling during systole

what is the toxic component of LPS?

Lipid A; widespread release of IL1 and TNF alpha

exposure to high temperature in patients with CF can cause what symptomatic electrolyte abnormality?

hyponatremia; hypochloremia also occurs, but no symptoms

effect on insulin release: M3 = Beta 2 = Alpha 2

increase; increase; decrease

what is the equation for alveolar ventilation?

Va = (Vt - Vd) * RR Vt = tidal volume, Vd = dead space

arterial ____ is a direct indicator of alveolar ventilation status

PaCO2 ie hyperventilation = decreased Pa CO2

nitrartes induce _____l ; can be used to treat ______

methemoglobinemia (Fe3+); | cyanide poisoning

nitroprusside: ____ preload; ____ afterload; _____ SV

decreased, decreased; unchanged arteriole AND venous dilator

pituitary apoplexy is ____ of the pituitary and most often occurs secondary to ______

hemorrhage; | pituitary adenoma

ventricular outflow obstruction in patients with HCM is due to which 2 structures?

mitral valve leaflet, IV septum | thiccc septum + anterior shifting of mitral leaflet toward aortic valve

which 2 opioids are used as anti-diarrheals?

diphenoxylate (With atropine); | loperamide

what is the best predictor of severity in a patient with mitral regurg?

presence of audible S3

name a drug that binds K+ channels, increasing post-prandial insulin release

repaglinide (a meglitinide)

the reid index is the ratio of the thickness of the mucosal gland layer to the thickness of what?

between resp epithelium and cartilage (ie not including cartilage)

pulmonary vascular resistance is lowest at what?

functional residual capacity

Myelination ____ the length constant and _____ the time constant --> improving axonal conduction speed

increases; | decreases

which Glucose transporter is insulin dependent? what cells have this?

GLUT4; | adipose tissue, striated muscle

what nerve runs between the Flexor digitorum profundus and superficialis? what runs between the 2 heads of the pronator teres>?

median, median

what lipid lowering drug can slightly increase TG levels?

bile acid resins ie cholestyamine, colestipal

unlike sporadic colorectal carcinoma, carcinomas associated with long standing ulcerative colitis are more likely to be what?

multifocal in nature; also early p53 mutation, higher grade

most common cause of sudden cardiac death in first 48 hours post acute MI?

ventricular fibrillation

which RNA polymerase functions exclusively in the nucleolus?

RNA pol 1

metyrapone ____ cortisol synthesis. in normal patients, causes a _____ in ACTH, a ____ in 11-deoxycortisol

inhibits (via inhibition of 11-beta-hydroxylase); increase, increase

which thyroid problem causes elevated creatine kinase?

HYPOthyroidism

the external branch of the ____ ___ nerve can be injured during thyroidectomy due to proximity to the superior thyorid arter/vein; what muscle does it innervate?

superior laryngeal; cricothyroid (4th arch)

11-beta hydroxylase deficiency: ____ blood pressure; ____ K+; genitals?

increased; decreased; virilized (if XX)

17-alpha hydroxylase deficiency: ____ blood pressure,; ___ K+; ____ sex hormones

increased; decreased; DECREASED

21-hydroxylase deficiency: _____ blood pressure; ____ k+; ____ sex hormones

DECREASED; INCREASDED; increased (ie virilized if XX)

carotid sinus massage: | _____ afferent baroreceptor firing --> ____ --> decrease HR

increased; | prolonged AV refractory period

insulin shifts K+ ____ the cell. beta agonists shift K+ ____ the cell

in, in

how are cells infected with HBV characterized as?

granular eoisinophilic "ground glass" appearance (due to HbSAg accumulation)

acetyl coa stimulates what enzyme in gluconeogenesis?

pyruvate carboxylase

an elevated ALP of unclear etiology should be followed up with what test?

gamma-glutamyl transpeptidase

infection, pain, and sleep deprivation cause ____glycemia; | exercise can cause ____glycemia

hyper; | hypo (by upregulating GLUT4 transporter)

``` aortic dissection: type A (ascending aorta) usually orginiates where? ``` where does type B (descending aorta) originate?

sinotubular junction; near origin of left subclavian vein

what drug prevents the synthesis of HIV mRNA?

integrase inhibitors ie raltegravir

what nerve runs medial to the ischial spine, through the sacrospinous ligament?

pudendal nerve i.e. for perineal anesthesia

G6P dehydrogenase catalyzes the conversion of G6P to what?

6-phosphogluconate | and 6-phosphogluconate to ribulose 5-phosphate

what drug is indicated in treatment of bradycardia that can also cause increased intraocular pressure and acute _____ glaucoma?

atropine-->acute closed angle

what kind of channel is mutate in CF?

ATP-gated chloride channel

spinal stenosis is characterized by ____ ____ hypertrohpy, disc herniation, and osteophyte formation affecting the ____ joints

ligamentum flavum; | facet

Tb: _____ establishes virulence thru PMN inhibition, TNF release, and mitochondrial destruction; _____ inhibit phagolysosome fusion

cord factor; sulfatides

what ovarian tumor often secretes estrogen? | characteristic _____ _____ on histologyu

granulosa cell tumor; | Call-exner bodies

erosions penetrate into the ____ ____ but do not extend all the way through. ulcers extend all the way into the ______

muscularis mucosa; | submucosa

bilateral renal angiomyolipomas are associated with that disease?

tuberous sclerosis; also seizures, angiofibromas, ash-leaf spots etc..

drugs with LOW Vd have a ____ molecular weight, ____ plasma protein binding, ____ charge, and are hydro____

high; high; high; hydrophilic stay in plasma compartment

what should be given to patients exposed to nuclear accidents to prevent the development of radiation induce thyroid carcinoma?

potassium iodide

uric acid stones precipitate at a ____ urine pH, which can occur in the setting of chronic _____

low; diarrhea (diamond/rhomboid shaped crystals)

the rER is invovled in transfer of proteins to the _______ and ______

cell membrane, extracellular space