Deck 8 Flashcards

1
Q

How far down the respiratory tree do ciliated mucosal epithelia go?

A

Up to the respiratory bronchioles

Will still be present below mucosal glands to cough up any fluid

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2
Q

What chromosomes and genes are abnormal in CML?

A

9:22 translocation
BCR-ABL gene
Active tyrosine kinase

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3
Q

What does the infraorbital nerve innervate? Where is it?

A

Goes down infraorbital floor through maxilla

Innervates upper cheek, upper lip, upper gingiva

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4
Q

What are breath sounds and tactile fremitus like when lobar consolidation is present?

A

INCREASED breath sounds AND tactile fremitus

Both with be decreased in things like pleural effusion or atelectasis

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5
Q

Who gets recurrent neisseria infections?

A

People with complement deficiencies C5b-C9

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6
Q

What cells secrete what substance to create pus?

A

Macrophages secrete IL-8 for neutrophil chemotaxis and induces neutrophil phagocytosis
Pus = dead neutrophils

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7
Q

What does the speed of conduction via myelin depend on?

A

Length constant
Time constant

velocity = length/time
Demyelination INCREASES time constant and DECREASES length constant

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8
Q

What artery lies behind ureter? Which ones lie in front of ureter?

A

Internal iliac artery behind

Gonadal (uterine) arteries in front (water under the bridge)

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9
Q

Uniform eosinophilic cytoplasm cells with oval/round nuclei in appendix causing abdominal pain. What are they?

A

Neuroendocrine cells

Carcinoid tumor- mimics appendicitis when found in appendix

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10
Q

Person who gets angioedema randomly. What is cellular deficiency?

A

C1 inhibitor deficiency. Excessive cleavage of C2-C4 and overproduction of bradykinin**

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11
Q

What cancers is EBV associated with?

A

nasopharyngeal ca

Burkitt lymphoma

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12
Q

Which antibiotic cannot be taken with SSRIs?

A

Linezolid –> has MAOI activity so can precipitate serotonin syndrome

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13
Q

What are actions of insulin in skeletal, adipose, liver, and pancreatic tissues?

A

In skeletal and adipose –> increase glucose uptake

In liver –> decreases glycogenolysis and increases glycogen synthesis

In pancreas decreases glucagon secretion for alpha cells

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14
Q

What antigen is associated with reactive arthritis?

A

HLA-B27

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15
Q

What is the sensory innervation for anterior and posterior part of tongue?

A

Anterior = V3 of trigeminal nerve
Posterior is Glossopharyngeal nerve

Chorda tympani = taste for anterior part

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16
Q

What is motor innervation for tongue?

A

Hypoglossal nerve CN XII

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17
Q

What type of lung disease increases airflow resistance? What type of lung disease increases elastic resistance?

A

Airflow resistance - obstructive

elastic resistance - restrictive

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18
Q

Does restrictive or obstructive lung disease take rapid shallow breaths?

A

Restrictive - rapid shallow breaths

Obstructive - slow deep breaths

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19
Q

Which gene is associated with clear cell RCC?

A

VHL von hippel lindeau
Secrete VEGF and angiogenic growth factors

Tx with anti-VEGF

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20
Q

Treatment for TCA overdose that is causing cardiac arrythmias and lengthening QRS?

A

Sodium bicarb.
TCAs block Na+ fast channels and cause arrythmias. Give sodium bicarb if signs of ventricular arrythmias and QRS widening occur

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21
Q

Features of TCA overdose?

A

Anticholinergic symptoms
Resp depression
Tachycardia, arrythmias, lengthening PR/QRS/QT

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22
Q

What is omilizumab?

A

Anti-IgE binding antibody, inhibits mast cell degranulation

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23
Q

What does stimulation of M3, Alpha2, and BEta2 receptors do to insulin release?

A

M3 - increases release (sight of smell and food)
B2- increases release
A2- inhibits release

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24
Q

What do the urethral (urogenital) folds become in male and female? Failure to fuse?

A

IN female- labia majora

In male- underside of penis. Hypospadias if failure to fuse

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25
Q

MOA for LMWH and unfraction heparin?

A

unfractioned heparin binds antithrombin (increased action against Xa) and thrombin
LMWH binds antithrombin only

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26
Q

What are CYP450 inducers? What do they do to warfarin?

A

Metabolize warfarin, put people at risk for stroke via thromboembolism- inadequate anticoagulation

Carbamazepine, barbituates, phenytoin, rifampin, St John’s wort*, griseofulvin, modafinil, cyclophosphamide

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27
Q

What are CYP450 inhibitors?

A

Amiodarone, cimetidine, quinolone, Azoles, clarythromycin, grapefruit juice, isoniazid, ritonavir (protease inhibitor)

28
Q

What are calcium, phosphorus, and PTH levels in coeliac disease?

A

Ca and Po low due to vit D deficiency

PTH high

29
Q

What are bleeding time, PTT, and TT in vWD?

A

increased PTT (intrinsic due to low VIII) and prolonged bleeding time (test of platelet function)

30
Q

What is the part of the sarcomere that involves actin binding to structural proteins? What part involves myosin binding to structural proteins?

A

Z line within the I band for actin

M line within the A band for myosin

31
Q

What is the definition of a sarcomere?

A

Z line to Z line

With myosin being the thick part, actin being thin

32
Q

What do you see on Prussian blue stain of myocardium in people with hemochromatosis? WHy are women symptomatic later in life?

A

Brown pigment and dilated heart

Menstrual cycle helps relieve iron load

33
Q

What substances are released from mast cells and basophils in anaphylaxis?

A

Histamine and tryptase (specific to mast cells)

34
Q

What is the stimulus for mast cell degranulation?

A

IgE receptor aggregation and cross-linking of antigens

35
Q

What does ALP signify?

A

Osteoblast activity

36
Q

What are serum markers of osteoblast activity?

A

ALP and N-terminal propeptide of type 1 procollagen (PINP) from collagen fibrils

37
Q

What does hypoxemia with hypercapnia and normal A-a gradient mean?

A

Alveolar hypoventilation is occuring- obesity, neuromuscular disordrs, high altitude (low inspired O2)

38
Q

What does it mean if pt is hypoxic with elevated A-a gradient?

A

R-L shunt, pulm edema, V/Q mismatch, impaired diffusion ILD)

39
Q

Where does secretin come from? What does secretin stimulate?

A

Duodenal cells release secretin in response to H+. Secretin stimulates release of HCO3- from pancreas

Cl- secretion decreases as HCO3- increases

40
Q

What are common causes of polyhydraminos?

A

Increased urination - high cardiac output, maternal hemorrhage, parvovirus infection

Decreased swallowing - GI, duodenal, or esophageal atresia, anencephaly**

Maternal diabetes and multiple gestation

41
Q

What symptoms does damage to the vermis, cerebellar hemispheres, and fluconodular lobe cause?

A

vermis - truncal ataxia
hemispheres- limb dysmetria, past pointing and intention tremor
flucclonodular lobe- vertigo and nystagmus

42
Q

What tissue does direct hernias penetrate?

A

Transversalis fascia

43
Q

What structures are anterior and posterior to esophagus in midsection?

A

Anterior- LA

posterior - descending aorta

44
Q

Where are neurophysins (post-translational hormone processing), oxytocin, and ADH secreted from?

A

Posterior pituitary**

They are SYNTHESIZED in hypothalamus

45
Q

What does a wide, fixed S2 mean?

A

ASD present

46
Q

WHat happens if ASD is left untreated?

A

Normally ASD causes L-R shunt
Pulm artery hypertrophy occurs
Eventually reversal of shunt to R-L occurs (Eisemenger syndrome) and clubbing and cyanosis can occur

47
Q

What does AR do to diastolic pressure?

A

lowers it. Wide pulse pressure

Collapsing pulses (waterhammer) are signs

48
Q

SE of amphotericin B?

A

Nephrotoxicity* Increased permiability in distal tubule causing hypokalemia and hypomagnesemia

Hypokalemia, weakness and arrhythmias

49
Q

What are ECG changes with hypokalemia?

A

Flat T waves, ST depression, U waves

50
Q

What are symptoms of lead poisoning?

A

SOB, microcytic anemia, pallor, anemia with basophilic stippling, abdo pain, constipation*, peripheral neurop
Normal ferritin and iron stores
Inhibits heme synthesis pathway

51
Q

What is seen on urinalysis, light microscopy, and serum levels with PSGN?

A

Urinalysis- RBC casts
Anti-streptococcal antibodies, Low C3**
Light microscopy- enlarged hypercellular glomeruli

52
Q

HOw do alcohols and chlorhexidine kill bacteria?

A

Disrupt cell membrane

53
Q

Which cleaning agents are active against spores?

A

Iodine

Hydrogen peroxide

54
Q

What is antidote for benzo overdose?

A

Flumazenil - bind as antagonist to GABA-a sites to block action of benzos

55
Q

What is antidote for SSRI overdose?

A

Cyroheptidine

56
Q

Antidote for Anticholinergic overdose?

A

Physiostigmine

57
Q

Antidote for opiod overdose?

A

Naloxone

58
Q

Which antiarrhythmic drugs prolong QT interval?

A

Class III (K blockers)

59
Q

Which antiarrhythmic drug will prolong QT interval without risk of tosades de pointes?

A

Amiodarone

60
Q

WHat do nitrates do to heart?

A

Decrease preload and end diastolic pressure

Mainly vasodilate venous system with moderate affect on arterioles (so they also decrease afterload)

61
Q

What type of pericarditis do people with SLE get?

A

Fibrinous pericarditis

Causes triphasic friction rub

62
Q

What does raburicase do?

A

Increases conversion of uric acid into water soluble metabolites (allantoin, excreted in urine)

63
Q

How does carbon tetrahydrochloride cause hepatocyte damage?

A

Creation of free radicals
CYP450 inducer - lipid degredation and lipid peroxidation with H202
“fatty change and hepatocyte necrosis”

64
Q

Equation to determine whether an autosomal recessive trait (such as CF) will pass on to child if both parents are carriers?

A

(1/4 from mother) x (probability within race for mother) x (1/4 from father) x (probability within race for father)

65
Q

What causes AS in older adults?

A

Aortic calcification

Fibroblasts become osteoblast like cells depositing bone matrix on valves and progressive causing calcification