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Step 1 > Test 12 > Flashcards

Test 12 Flashcards

1
Q

When does the metanephros begin to produce urine?

A

8-10 weeks of gestation after the ureters fully canalize

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2
Q

What is the MC cause of fetal hydronephrosis?

A

Inadequate recanalization of the ureteropelvic junction (junction between kidney and ureter)

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3
Q

How does the body respond to Ca loading with calcium gluconate?

A

PTH and synthesis of active form of vit D decreases

Calcitonin increases

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4
Q

What nerve innervates the flexors of the lower leg, the extrinsic digital flexors of the toes and the skin of the skin of the sole of the foot?

A

tibial nerve

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5
Q

Hemorrhages, subperiosteal hematomas, bleeding into joint spaces, gingival swelling, anema and impaired wound healing are all caused by…

A

Impaired collagen formation due to scurvy

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6
Q

beriberi and wernicke

A

B1 def

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7
Q 
cheilosis
stomatitis
glossitis
dermatitis
corneal vascularization
A

B2 def

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8
Q

Cheilosis
glossitis
dermatitis
peripheral neuropathy

A

B6 def

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9
Q

Megaloblastic anemia and neural tube defects

A

Folic acid

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10
Q

Bleeding diathesis

A

Vit K def

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11
Q

Acrodermatitis
growth retardation
infertility

A

zinc def

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12
Q

What bacteria produce IgA protease?

A 
SHiN. 
S. Pneumoniae
H. Influenzae
N. menigitidis
N. gonorrhea
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13
Q

What does IgA protease do?

A

Bacterial virulence factor: enzyme that cleaves IgA at its hinge making it ineffective. IgA normally exists on mucosal surfaces and insecretions and acts to bind and inhibit the action of pili and any other crap that allows for mucosal adherence.

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14
Q

What is protein A?

A

VF expressed by S. Aureus

Binds Fc region of IgG and prevents opsonization and phagocytosis

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15
Q

What VF helps to prevent phagocytosis and is expressed by group A streptoccoci?

A

M protein

Has similar epitopes to human cell proteins and may underly hte AI response seen in acute RF

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16
Q

What are the hallmarks of generalized anxiety disorder?

A

Anxiety lasting > 6 months!

excessive worry over several different issues

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17
Q

How do you tx GAD?

A

antidepressants

benzodiazepines

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18
Q

What is adjustment disorder?

A

lasts < 6 mos

emotional sxs following an identifiable psychosocial stressor

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19
Q

What are natural anticoagulants present in the blood?

A

Anti-III

protein C and S

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20
Q

How does Warfarin cause a “paradoxical thrombosis”?

A

Inhibits protein C and S synthesis and can lead to skin/tissue necrosis d/t small vessel microthromboses.

Often in pts w/ a congenital def of protein C and S (usually in first week of therapy)

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21
Q

What is the mechanism of warfarin?

A

Inhibits gamma-carboxylation of vit K dependent clotting factors II, VII, IX, X, C and S.

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22
Q

How does warfarin affect the EXtrinsic pathway?

A

Increases PT

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23
Q

How do you reverse warfarin therapy?

A

give vit K

RAPID reversal–> give fresh frozen plasma

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24
Q

What is Heparin bridging?

A

Heparin activates antithrombin and enables anticoagulation during intitial, transient hypercoaguable state caused by warfarin.

*Initial heparin therapy reduces risk of recurrent venous thromboembolism/skin/tissue necrosis.

25
Q

Where does the mutation occur that causes CF?

A

3 base pair deletion in the CFTR gene at AA position 508

26
Q

How does the CFTR mutation affect post-translational processing of CFTR?

A

The mutation causes improper folding and glycosylation and leads to impaired posttranslational processing, which is detected by the ER. The abnormal protein is targeted for proteasomal degradation and doesn’t reach the cell surface.

27
Q

What is most commonly transmitted unpasteurized dairy products and cold deli meats and can cause sepsis and meningitis in immunocompromised adults, or neonatal meningitis (placental or vaginal transmission)?

A

Listeria monocytogenes

28
Q

Why does listeria often contaminate refrigerated food?

A

It grows well in cold temperatures

29
Q

What is the only gram + organism to produce an ENDOtoxin and has a characteristic tumbling motility?

A

Listeria monocytogenes

30
Q

What is the MC cause of an irregularly irregular tachyarrythmia in aconscious pt?

A

a. fib

31
Q

What is seen on an EKG in a pt w/ a. fib?

A

absent p waves (coordinated atrial contractions don’t occur) and irregularly spaced ventricular contractions (variable R-R interval)

32
Q

What are common causes of A. Fib?

A
  1. Holiday heart (binge alcohol consumption)
  2. increased cardiac SNS tone
  3. Pericardiditis
33
Q

What does 5 alpha reductase do?

A

converts testosterone to DHT

34
Q

What mediates the development of the external genitalia in the male fetus?

A

DHT

35
Q

What is seen in male neonates w/ 5alpha-reductase def?

A

feminized external genitalia (small phallus and hyposapdias) that MASCULINIZES at pubery

36
Q

What is responsible fore the INTERNAL male genitalia during embryogenesis, spermatogenesis and male sexual differentiation at pubery?

A

Testosterone

37
Q

What mediates the development of hte external genitalia (penis/scrotum) in the embryo, growth of the prostate, facial hair and recession of hairline?

A

DHT

38
Q

What causes virilization of the female fetus and salt wasting?

A

21 hydroxylase def

39
Q

What does aromatase do?

A

catalyzes conversion of androgens to estrogens in gonads and peripheral tissues?

40
Q

What is seen in aromatase def?

A

virilization of females

males not affected

41
Q

What causes hypertension and undervirilization of male infants?

A

Def 17 hydroxylase

42
Q

What is DHEA?

A

weak androgen produced by the adrenal cortex

def does NOT cause undervirilization

43
Q

What provides somatic sensory innervation to the anterior 2/3 of the tongue?

A

Mandibular branch (V3) of the trigeminal nerve

44
Q

What provides taste sensation to the anterior 2/3 of the tongue?

A

chordatympani

45
Q

What provides somatic and taste innervation to the posterior portion of hte tongue?

A

CN9 glossopharyngeal

46
Q

How do you dx sickle cell anemia and establish the carrier status of prospective parents?

A

Hb electrophoresis (hemoglobin S can be distinguished, moves slowly compared to normal Hb d/t loss of negatively charged AA glutamate)

47
Q

What causes sickle cell anemia?

A

HbS point mutation that leads to a SINGLE AA replacement of the B cahin

48
Q

When do you see a “crew cut” on skull x ray?

A

marrow expansion from increased erythropoiesis

  • sickle cell or thallesemias
49
Q

What is a prospective cohort study?

A

select a group of individuals, determine their exposure status, follow them over time, ovserve for development of disease of interest

50
Q

What does a cohort study evaluate?

A

RR

Smokers had a higher risk of developing COPD than nonsmokers

51
Q

What is a case control study?

A

Select pts w/ disease (cases),
select patients w/out disease (controls),
determine previous exposure status

52
Q

What does a case control study evaluate?

A

ODDS ratio

Pt w/ COPD had higher odds of hx of smoking than those w/out COPD

53
Q

What does a cross-sectional study evaluate?

A

frequency of disease/disease prevalence at a POINT in time

54
Q

What are the most common organisms that cause intraabdominal infections?

A

B. Fragilis> E. coli

55
Q

What gram-positive organism causes abscess formation on the skin?

A

s. aureus

56
Q

What causes acquired angioedema?

A

ACE inhibitor treatment

Low CI esterase inhibitor activity leads to INCREASES in bradykinin activity> angioedema

57
Q

What are low serum levels of C1 diagnostic for?

A

hereditary angioedema

58
Q

How do timolol and other beta blockers decrease aqueous humor production?

A

diminish secretion of aq humor by ciliary epithelium

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