All Flashcards
(724 cards)
1
Q
effect of main exposure on outcome is modified by presence of other variable
A
effect modification- not a bias
2
Q
effect modification vs confounding
A
effect modification is like only smokers have increased DVT but entire population does
confounding is like shoe size increasing sig. with intelligence- sig. gone with confounding factor of age
3
Q
segmented viruses
A
BOAR: Bunyavirus, Orthoyxovirus, Arenavirus, Reovirus (rotavirus)
4
Q
infected freshwater + painless hematuria (risk SCC) and pulm HTN
or + fibrosis and portal HTN
A
Schistosoma- snail
5
Q
conditions that promote sickling in sickle cell/ what is sickling
A
low oxygen, increased acidity, low blood volume, high 2,3- bPG/ hydrophobic aggregation
6
Q
Where and why traumatic aortic rupture
A
isthmus and because tethered by ligamentum arteriosum
7
Q
two microtubular motor proteins and their fx
A
dynein- negative end to nulceus
kinesin- positive end points to periphery
8
Q
virus of lung transplant pt on immunosuppresent
A
CMV
9
Q
histo of CMV
A
owl eyes, enlarged cells with intranuclear inclusions
10
Q
All herpes virus
A
enveloped, DS, linear, icosehedral
11
Q
eicosanoid that promotes neutrophil migration
A
Leukotriene B4
12
Q
link of hypothyroid and high cholesterol
A
decreased LDL receptor expression
13
Q
contralateral weakness with rigidity, hyperreflexia, and positive babinski stroke
A
internal capsule
14
Q
bladder of MS
A
hypertonic
15
Q
Addison’s disease electrolyte findings
A
hypoaldosterone- leads to hyponatremia leads to increased H+ and K+ absorption, and Cl- absorption
16
Q
riboflavin containing coenzyme and associated enzyme
A
FAD and succinate dehydrogenase
17
Q
significance of succinate dehydrogenase
A
in TCA cycle (succinate to fumirate) and ETC as complex II
18
Q
what is in the medulla of adrenal gland and what derived from
A
chromaffin cells from neural crest
19
Q
fx of chromaffin cells
A
stim by acetylcholine and secrete catecholamines
20
Q
cause of annular pancreas
A
fail of ventral bud to migrate and fuse with dorsal bud
21
Q
mutation of sickle cell
A
sub of valine for glutamic acid on 6th position of b globin
22
Q
DNA damage of radiation for cancer
A
double strand breakage and free radical accumulation
23
Q
pathogenesis of histoplasmosis
A
replicates in intracellular of macrophages, spread from lungs to lymph nodes
24
Q
where does complement bind on immunoglobin
A
Fc portion of heavy chain near hinge
25
apex of heart which structure and where reach
LV and 5th intercostal space MCL. Lung is superficial
26
most common CF mutation and problem associated
3 base pair deletion at AA position 508 for CFTR gene. impaired post translational processing of CFTR, misfoldf (ATP gated)-> shunting of CFTR to proteosome. high Na and Cl in sweat
27
contributors of resp drive for COPD vs normal
COPD: PaO2, normal: PaCO2
28
major stim of resp in healthy indvs and where
PaCO2 in arterial stim central receptors in medulla
29
hypoketotic hypoglycemia after significant fast
medium chain acyl Coa dehydrogenase deficiency
30
newborn with flat facies, limb deformities, pulm hypoplasia
Potter's sequence
31
which AA makes nitric oxide- which does what
arginine and NO- vasodilation-decrease preload and increase coronary blood flow
32
immunostain of poststrepotococal GN
IgG, IgM, and C3
33
critical cytokines for granuloma formation- TB
IL-12- help CD4 become Th1, IFN-gamma- activate macrophages, and TNF-alpha
34
characteristics of malignant cells
large amount of rRNA and prominent nucleoli
35
fx of eukaryotic RNA polymerase 1, 2, 3
1. rRNA
2. mRNA, snRNA, micro RNA
3. tRNA, rRNA for 60S
36
define Jarish-Herxheimer rx
acute inflammmatory rx after tx for spriochete infection like syphilis. b/c of rapid lysis of spirochetes
37
1st step in pathogenesis of TB (b4 CD4 activation of Interferon gamma)
intracellular replication in alveolar space and alveolar marcophages
38
MOA of etanercept
decoy to TNF alpha therefore do TB test b4 start Tx
39
timeline of psychotic disorders
brief: >=1 day and <1 month
schizphreniform: >=1month and <6 months
schizophrenia: = or more than 6 mo
40
epicanthal folds, upslanting palpebral fissures, protruding tongue, excess skin at nape of neck, hypotonia, cardiac defects
Down Syndrome
41
uncommon way to get Down Syndrome
Robertsonian translocation
42
stop codons
UAA, UGA, UAG
43
normal dev to 6-18 mo, loss of motor and language skills, hand movements, decel of head growth
Rett syndrome
44
CHF lung histo finding
pigmented, hemosideran laden macrophages
45
diabetic pt with early satiety, regurg undigested food, n/v
diabetic gastroparesis
46
pathophys of diabetic gastroparesis
destruction of enteric neurons due to chronic hyperglycemia
47
clue cells definition
epithelial cells covered with anaerobic gram variable rod
48
3 holosystolic murmurs
mitral regurg, VSD, tricuspid regurg
49
holosystolic murmur that increases intensity with inspiration
tricuspid regurg
50
enzyme deficient: vomit, lethargy, jaundice, E.coli sepsis
galactose 1-phophate uridyltransferase
51
vessel affected if get ulcer in lesser curvature
left gastric
52
transferance vs countertransferance
trans: pt's rxn to provider (elderly pt lloves dr. b/c resemble daughter
counter: provider rx to pt (res prescribe haloperidol to pt that insults her and reminds her of mean father)
53
Hot T-bone stEAK
IL-1: fever
IL-2: stim T cells
IL-3: stim bone marrow
IL-4: stim IgE production
IL-5: stim IgA production as well as eonsinophil activation and survival
IL-6: stim aKute phase protein production
54
SA and AV node location
SA: right atrial wall near SVC
AV: endocardial surface of RA near septal leaflet of tricuspid valve and coronary sinus
55
left vs right spermatic/gonadal vein
right: into IVC
left: into left renal
56
left vs right renal vein; artery
right: into IVC and short
left: cross aorta under superior mesenteric artery, pressure higher
57
branches of sciatic nerve and fx
sciatic: knee flex
common peroneal: dorsiflexion, sensation dorsal foot and posterolateral calf
and tibial: plantar flex and inversion, ankle reflex
58
late ASD findings
left ot riight shunt becomes right to left shunt because of lots of pulm HTN and sclerosis
59
virulence factor of TB and fx
cord factor-prevent macrophage mediated destruction, leads to formation of caseating granulomas-of macrophages that are differentiated into epithelioid histocytes and multinucleated giant cells
60
cephalosporins and penicillins bind...
transpeptidase
61
cephalosporin mechanism of resistance
structural change in penicillin binding proteins
62
sensory innervation of tongue
anterior 2/3 (ant to foramen cecum) chorda tympani VII (taste) and trigeminal nerve V3 (sensation)
posterior 1/3: glossopharygeal
very posterior +larynx+esophagous: vagus
63
MOA of desmopressin to tx von Willbrand bleed
release vWF from endothelial storage
64
MOA of varenicline
partial agonist of nicotinic acetylcholine receptors. reduce withdrawal sx and decrease pleasure of tobacco
65
glycolysis in eyrthrocyte vs other cells
erythro: produce 2,3-BPG (which decrease Hgb affinity for O2) instead of ATP
66
pathophys and EKG of sick sinus syndrome
degen of SA node, bradycardia with dropped P waves
67
absence of cerebellar vermis, cystic dilation of 4th ventricle, posterior fossa enlargement, non communicating hydrocephalus
dandy walker malformation
68
dorsal vs ventral pancreatic bud structures
dorsal: most of head, body, tail
ventral: uncinate process, inf/post of head, major pancreatic duct
69
long term effect of renal artery stenosis on JG cells
hyperplasia (of modified smooth muscle cells)
70
inflammatory mediators released in anaphylaxis
histamine (first released) and tryptase
71
what changes in IGE receptor and antibody cause degranulation in anaphylaxis
IgE ABs are crosslinked and cause aggregation of high affinity IgE receptors. activate non receptor tyrosine kinases-causes mast cell and basophil degeneration
72
gum welling or bleeding, lose teeth, poor wound healing, hyperkeratotic follicles, bruising; who affected
scury- vit C deficiency; alcoholic
73
fx of vit C
hydroxylation of proline and lysine in pro collagen
74
high prolactin in PKU
BH4 (tetrahydrobiopterin) variant of PKU- Dihydrobiopterin reductase deficiency
75
test for stool fat
sudan III stain
76
ulnar nerve injury at elbow motor prob
impaired wrist flexion and adduction (think ulnar deviation)
77
levetiracetam MOA
disrupt vesicle fusion
78
first line for social anxiety disorder
SSRI
79
action of Hgb in lungs vs peripheral
releasing CO2 and H+
| unload O2, take up CO2 (converts to CO3 and H+)
80
MOA of dobutamine and what used for
beta-1 agonist, increases HR and contractility and vasodilate, chemical stress test, immitate exercise
81
pathophys of stress test and stable angina
mismatch between O2 supply and demand, more than 70%
82
receptor stimulation of NE
alpha 1 and 2, B1 with no B2
83
B1 receptor fx
increase contractlity and HR
84
pathophys of tetanus
bacteria replicate, make toxin, retrograde thru LMN to spinal cord where blocks inhibitory interneurons, sporadic muscle contractions
85
sx of tetanus and dx
jaw stiffness, contracted facial muscles, spastic neck movments, resp failure; clinical
86
tx unconcious hypoglycemia in field vs in hospital
field: IM glucagon
hospital: IV dextrose
87
why can H flu cause upper resp and otitis
b/c those infections are non typal, without capsule
88
what cell bio wise leads to insulin resistance
phosphorylation of insulin receptor and insulin receptor substrate by serine kinase
89
phosphorylation that leads to insulin resistance is mediated by...
TNF alpha, catecholamines, glucocorticoids, and glucagon
90
histo of pheochromocytoma
stains for synaptophysin, chromogranin, neuron specific enolase. EM shows membrane bound secretory granules
91
pacemaker action potential steps
1. Na in in funny current
2. Ca in in steep slope
3. K+ out
92
what is HER2 and how to treat HER2+, s/e
tyrosine kinase receptor-accelerates cell proliferation
| trastuzumab-cardiotox-decreased contraacility without destruction
93
findings of conductive hearing loss
Rinne: bone >air
Weber: localize to affected ear
94
examples of types of collagen
1. bone, tendons, ligaments, scar tissue, blood vessels
2. cartilage, nucleos pulpus
3. skin, lungs, intestines, blood vessels, bone marrow
4. BM
95
side effect of topical corticosteroids
dermis atrophy
96
primary virulence factor of strep pneumo
capsule evades phagocytosis and opsonization
97
histo brain tumor of dilated blood vessels with thin adventia, lack of structural support causes bleeding- also presents with seizures
cavernous hemangiomas
98
BRCA fx
DNA repair, tumor suppressor
99
Fetal circulation after umbilical vein
liver bypasses through ductus venosus, enters IVC, to heart
100
cells of bronchioles
simple cuboidal, some ciliated
101
tx urea cycle disorders
restrict protein
102
IV fluids effects on heart mechanics
increase left end diastolic volume/preload, stretches myocardium, increase in stroke volume
103
what does an S4 mean
diastolic dysfx- sound created atrial contraction against stiff ventricle---> aortic stenosis, hypertensive heart disease, hypertrophic cardiomyopathy
104
lecithin to sphingomyelin ratio significance
must be greater or equal to 2 to indicate adequant surfactant production
105
histo of C dif
pseduomembranes with neutrophil predominant infiltrate, fibrin, bacteria, and necrotic epithelium
106
complication of C dif
toxic megacolon
107
complete vs incomplete mole on presentation and karyotype
complete: no fetal structures (grapes), only parental DNA- 46XX
partial- fetal parts, 69XXX or 69XXY, fert by 2 sperm
108
tx for cyanide poisening and why
amyl nitrate- creates Fe3+ Hgb which binds cyanide- keeping it from inhibiting cytochrome c oxidase in mitochondria, creates methemoglobin + sodium thiosulfate-detox cyanide-binds
109
differentiate between 17, 21, and 11 deficiencies
17: only one to decrease sex hormones
21: only one with reduced BP
11: high sex hormones, high BP
110
nerve that provides sensation to suprapubic and gluteal regions, and motor fx to anterolateral abd wall muscles
-can be damaged by appendectomy
iliohypogastric
111
lipohyalinosis and microatheroma formation
lacunar infarct
112
MOA of amphoteracin B and complication
binds ergosterol in fungal membranes , renal toxicity- hypokalemia, hypomag
113
dental carries, aspiration, lower lobe consolidation
actinomycosis
114
histo of actinomycosis
filamentous branching patterns with sulfur granules that stain purple/blue
115
most common bacteria of dog and cat bite
Pasteurella multocida
116
permanent pacemaker placement + signs of RHF
tricuspid regurg
117
nursemaid's elbow/radial head subluxxation injury mech and to what structure
pulling arm up of child and annular ligament, hold elbow fixed and pronated
118
differentiating MENs
MEN 1: primary hyperpara, pituitary tumors, pancreatic tumors
MEN 2A: Medullary thyroid ca (calcitonin), pheochromocytoma, primary hyperpara
MEN 2B: Medullary thyroid ca (calcitonin), pheocchromocytoma, Marfanoid, mucosal neuromas
119
pathophys of acute hemolytic transfusion rxn-fever, hypotension, back pain, hemoglobinuria
type 2 hypersensitivity- complement mediated lysis
120
red neuron features
eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance
121
calculate maintanance dose
clearance x steady state plasma [ ]
122
calc loading dose
(vol dis x steady state plasma [ ] )/ bioavailablity
123
virus of maculopapular rash that starts on face and spreads, plus tedner llymphadenopathy behind ears
rubella- togavirus
124
debilitating arthalgias, blue black cartilage and sclerae, black urine
alkaptonuria- homogentisate oxidase deficiency
125
define premature ejaculation
within 1 minute occur for at least 6 months
126
esophageal adenocarcinoma occur where and why
distal esophagous due to Barrets
127
lung mass, cerebellar sx, cerebellar mass with Purkinje cell degeneration + mediators
subacute cerebellar degeneration + autoimmune of Anti Yo, Anti-P/Q, anti-Hu
128
neural crest derivatives
SOME SALT.
Schwanna cells, odontoblasts, melanocytes, enterochromaffin cells, spinal membranes, adrenal medulla, laryngeal cartilage, tracheal cartilage
129
nerve of trendelenburg sign, injured if IM too laterally
superior gluteal
130
pathogensis of rheumatic fever
anti GAS ABs cross react and attach cardiac and NS antigens
131
vein implicated in esophageal varices in cirrhosis
left gastric
132
pathophys and sx of Hyper IgM
```
defective CD40L in T cells- class switching defect;
opportunistic infections, GI and sinopulm infections
```
133
define false diverticulum
outpouching without muscularis layer
134
tx panic disorder
ssri
135
dependency on calcium for the three types of muscle
cardiac and smooth: depend on L type channels on surface for extracellular influx
skeletal: calcium release based on mechanical interaction between extracellular L and intracellular RyRr
therefore: verapamil no work
136
injury to radial nerve to produce motor sx of thumb and fingers
supinator canal
137
where nose bleed come from
Kisselbach plexus on anterior septum
138
how does renal excrete acid in acidosis?
through renal ammoniagenesis- metabolize glutamine to glutamate, generate ammonia for urine and bicarb for blood
139
MOA and use of diphenoxylate and loperamide
dip: opiod anti diarrheal, binds mu opiod receptors and slows motility
lop: opiod agonist, slow peristalsis, no cross blood brain barrier
140
electrolyte abnormality of bulemia
hypokalemia
141
clostridium perfringens causes
gas gangrene and delayed watery diarrhea after food poinsening
142
why down syndrome higher risk for Altzheimers
3 copies of amyloid precurser protein b/c on chrom 21
143
what is endothelin I?
stimulated by RAAS, cause vasoconstriction
144
hypovolemia leads to what ANS?
increased sympathetic activity
145
tx and goal of treating acute intermittent porphiria
glc and heme- attempt to inhibit aminolevonulate synthase, which creates ALA
146
s/e of erthyropoesis stimulating agents
HTN and thrombolic events
147
sore throat, fever, psuedomembrane in back of throat, cervical adenopathy, immigrant
Diptheria
148
diptheria toxin fx
adds ribose (ribosylation) to EF-2, promotes cell death
149
outbreak in close quarters: fever, cough, conjestion, conjunctivitis, pharyngitis
adenovirus
150
MOA of dantrolene
RYR receptor blocker, inhibits Ca release from sarcoplasmic reticulum
151
diarrhea, dermatitis, dementia
niacin (B3) deficiency/pellagra
152
Niacin
1. cofactor
2. and for which enzymes
3. how get
NAD and NADP; isocitrate dehydrogenase, alpha-ketoglutarate dehydrogenase, malate dehydrogenase
3. by diet or from tryptophan
153
what happens in chronic lung transplant rejection
scarring of small airways, leads to bronchiolitis obliterans
154
which cells secrete Intrinsic factor and where histo located
parietal and upper glandular layer of body and fundus
155
fx of sertoli and Leydig cells
sertoli secrete MIF
| leydig secrete T, differentiate wolf into male internal, while DHT responsible for male external
156
pathophys of S3
heard during rapid passive filling of ventricles, heard with increased left ventricular end systolic vol-volume overload, systolic CHF
157
enzyme that converts adenosine to inosine
ADA- if deficient, toxic to lymphocytes, one of the etiologies of SCID
158
phases of leukocyte adhesion and mediators
1. Margination
2. Rolling-L- seletin on Leuk and E and P selectin on on vasc
3. activation
4. crawling/tight adhesion: CD 11/18 on leuk, ICAM-1 on vasc
5. transmigration: PECAM-1
159
Rathkes pouch from
ectoderm
160
follicular lymphoma translocation and overexpression
14;18 and Bcl-2
161
matching ppl in study controls for...
confounding
162
how to glc transported into cell
faciliated diffusion with carrier protein GLUT. Down [ ] gradient
163
how does heart use oxygen
myocardial O2 extraction exceeds any other tissue, therefore coronary sinus most deoxygenated in body
164
patient does not want to know result of test
right to refuse medical info
165
how do coal and dust get removed from airway
alveolar macrophages
166
how to tell if hypoglycemia from exogenous insulin or from glyperide or endogenous
exogenous will have normal C peptide, endogenous will have elevated C peptide
167
Class III antiarrythmics
AIDS: Amiodarone, Ibutilide, Dofetilide, sotalol
168
PCWP actually a measure of
left atrial and left ventricular end diastolic pressure
169
which cells cannot use ketones
erythrocytes b/c lack mitochondria
170
type of vaccine for N. meningitius
capsule
171
3 phases of Paget's disease
1. osteolytic/ osteoclast predominant
2. mixed/ osteoclastic-osteoblastic
3. osteosclerotic/ osteoblast predominant
172
medulloblastoma vs astrocytoma on imaging
astrocytoma cystic and solid features in parenchyma vs medulloblatoma solid and enlarged 4th ventricle
173
fx of clavulanic acid, sulbactam, and tazobactam
beta lactamase inhibitors which decreases amoxicillin cleavage by beta lactamase of bacteria
174
clinical manifestations of bartonella henselae
cat scratch, bacillary angiomatosis, culture negative endocarditis
175
low C1 esterase
hereditary angioadema
176
Beck's triad (hypotension, JVD, muffled heart sounds) + pulsus paradoxus
cardiac tamponade
177
high fever, cough, confusion, diarrhea, interstitial infiltrates
Legionella
178
lab finding of legionella
hyponatremia
179
cells of liver that mediate fibrosis
stellate cells- in quiet phase- store vit A, in actiavted phase- transform into myofibroblast to secrete collagen
180
cell marker for macrophages and monocytes
CD14
181
makeup of granuloma in TB
central region of necrotic debri surrounded bylarge epitheliod macrophages
182
where Vit C in cell and what do
RER because cofactor in hydroxylating proline and lysine in collagen synth
183
MOA of ezetimibe
prevents cholesterol abdorption at small intestine brush border
184
s/e of methmiazole and PTU
agranulocytosis
185
fx and innervation of lat
innervate by thoracodorsal nerve, action of internal rotation, adduction, extension
186
both apoptosis pathways end with
caspases
187
significance of suspensory lig of ovary
contains ovarian artery, vein, and nerve
188
location of Histoplasmosis and biopsy results
Ohio and Mississipi River Valleys, macrophages with small yeasts inside
189
intrabdominal infections pathogen
polymicrobial with predominant B. frag and E. coli
190
painless initial genital sores caused by
Syphilis and lymphogranuloma venereum (chlamydia trach)
191
what restrict in maple syrup urine disease
branched chain amino acids- leucine, isoleucine, valine
192
cross sectional vs ecological
cs: looks at exposure and outcomes in indiv simultaneously; selected based on criteria for the study
e: looks at populations
193
sx of glomus tumor and what cell derived from
painful red blue under nail, from modified smooth muscle cells of the thermoregulatory glomus body
194
MOA and use of cilostazol
phosphodiesterase inhibitor, increase cAMP in plts- inhibit aggregation, vasodilate; PAD to reduce sx
195
why give dexamethasone in meningitis
reduce cytokines released in response to bacteria
196
exam and histo of Asbesosis
pleural plaques and lower lobe fibrosis; interstitial fibrosis and ferruginous bodies
197
why ventilation perfusion mismatch if give COPD pt too much oxygen
pum vasoconstriction at baseline, high O2 reverses constriction away from well ventilated alveoli, increase dead space (well ventilated areas less perfused) less CO2 exchange
198
activation of the extrinsic pathway
1. FasL or TNF alpha bind to receptor
| 2. cytotoxic T cell release of granzyme
199
power of study
1-B
| B is type II error which is concluding no difference between groups when there is one
200
how are osteocytes organized in Haverian system
central canal surrounded bymultiple lamallae of bony matrix, each with lacunae filled with osteocytes and bone fluid. canicula connect the lacuna via gap junctions
201
3 stages of perfusion of anethesia drugs
1. central compartment -plasma
2. high perfused compartment- brain, liver, kidney, lung
3. poorly perfused compartment- muscle, bone, fat
202
MOA of cyclosporine and tacrolimus and s/e
inhibit calciurin activation which inhibits IL-2, which usually promotes growth and differentiation of T cells; nephrotoxicity
203
histo of brain in HIV dementia
microglial nodules (groups of macrophages/microglia surrounding necrosis) and multinucleated giant cells
204
bookends of intron in order to be able to splice out
GU at 5' site and AG at 3' splice site
205
murmur of pulmonary stenosis
mid systolic cres dec hear at P site, wide split S2
206
nitrates and PVR
modest decrease even tho arteriole
207
penile discharge + rash+ conjunctivitis + right knee pain + ___ = ____
+ sacroillitis = reactive arthritis
208
hypersegmented neutrophil, large RBC, weird purplish RBC
vit B12 deficiency
209
transmission, sx,and histo of Ehrlichia chaffeensis
tick from white tailed deer in SE and SW US, nonspecific sx + labs-lymphopenia, thrombocytopenia, eevated transaminases; mulberry shaped intracellular inclusions in monocytes
210
how is copper eliminated from body
old ceruloplasmin (circulating Cu) and unabsorbed Cu are secreted into bile and excreted into stool
211
fusion of HIV to cell requires
attachment of coreceptor CCR5 on macrophages or CXCR4 on T cells
212
adrenal mass plus hypertension, hypokalemia, renin down, normal sodium, metabolic alkalosis
Conn's syndrome- aldostersone secreting tumor, aldosterone escape limits edema and hypernatremia
213
cytochrome P450 inducers
barbituates, phenytoin, carbamazepine; rifampin, griseofulvin; cyclophosphamide; St. John's Wart; Modafinil, alcohol
214
what happens to the C peptide after cleavage
stored in granules until exocytosed
215
why hydroceole
patent processus vaginalis
216
carotid sinus reflex limbs
IX affarent then X efferent
217
proteins that make up cell junctions
cadherins: adherens and desmosomes
integrins: hemidesmosomes
connexins: gap junctions
claudins: tight junction
218
what is dev field defect and what is example
multiple malformations secondary to embryonic in adjoining group of cells; holoprosencephaly
219
bloody diarrhea in HIV patient not on retroviral, violet/red or hemmorrhagic lesions on endoscopy
Kaposi sarcoma
220
what can survive up to 248 F
spores of Bacillus and Clostridium
221
flex hip
rectus femoris, tensor fascia latte, iliopsoas: psoas major and minor +ilacus
222
action of infraspinatus, teres minor, and subscap
infra: ext rotate
teres minor: ext rotate and adduct
subscap: adduct and internal rotate
223
where does ADH act in nephron
medulary collecting duct
224
where does parvo replicate and what disease susceptible
bone marrow, toxic to erythoid precurser cells, sickle cell
225
5- hydroxyindoleacetic acid
end product of serotonin met
226
plaque like fibrosis tissue on R endocardium, tricuspid regurg and R HF
carcinoid syndrome
227
enzyme with which cort increases conversion of norep to ep
phenylethanolamine-N-methyltransferase
228
autoAB of polymyositis
ANA and anti-histidyl-tRNA synthetase (anti-Jo1)
229
pulmonary edema leads to
decreased compliance
230
undev part of lymph node in DiGeorge and why
paracortex b/c that's where the T cells are
231
pressure changes of aorta and LV in aortic regurg
aorta: increased systolic, decreased diastolic
LV: increased systolic and diastolic
232
meds to avoid in HOCM and why
- vasodilators: di Ca blockers, nitro, ACEi
- Diuretics
- b/c want to avoid outflow obstruction. anything that reduces preload is bad idea
233
structures of midgut
distal duo to proximal 2/3 of transverse colon
234
RF for pancreatic ca
1. smoking
235
Ehlers Danlos enzyme deficient and fx
procollagen peptidase deficiency; impaired cleavage of terminal propeptides in extracelllular space
236
3 types of RPGN
1. linear IF: Goodpasture
2. granular IF: lupus IgA, Henoch-sch (type III hypersen)
3. negative IF: pauci immune: microscopic polyangitis, Wegener
237
area implicated in Hirshsprung
always rectum
238
difference in graphs between facilitated diffusion and simple diffusion
faciliated: go up quick but flatten out because tranport saturated with facilitator protein
simple: same slope throughout
239
fx of type I vs type II pneumocytes
I: 95% of alveolar coverage
II: make surfactant and regenerate alveolar lining after injury
240
primary vs secondary TB lung findings
prim: Ghon focus of lower lobe and ipsilateral hilar node
sec: apical cavitary lesion
241
tRNA arms and bases
top: CCA-OH
T loop: bind to ribosomes, ribothymine, pseudouridine and cytidine
D loop:faciliate rec by tRNA synthetase: has dihydrouridine
242
describe case-control
look for exposure in people with disease and those without
243
atresia in utero due to
vascular occlusion
244
physiology of complete AV block
SA contract atria, AV contract ven, not in synch
245
what vessel a danger in horizontal c/s and why
inf epigastric b/c no posterior sheath supporting
246
middle meningeal artery branch from what? and where located
maxillary artery and the pterion (where frontal, parietal, temporal, and sphenoid bones meet)
247
renal bx findings of TTP
plt rich thrombi in glomeruli and arterioles
248
major characteristic of Rotavirus and histo
infectious diarrhea in children-UNVACCINATED-dehydration
| histo: villus blunting in epithilium of duodenum and proximal jejunum
249
MOA of flutamide and use
anti-androgen, competitive inhibitor of testosterone receptors, used with GnRH agonists to tx prostate Ca
250
2 MOA of opiates
1. reduce influx of Ca presynapse
| 2. effflux K+ of cells post synapse
251
mechanism of washout after MAOi into SSRI
allow time for monoamine oxidase to build up
252
first line for CMV colitis and reitinitis and s/e. other tx and why special
ganciclovir, pancytopenia
| foscarnet and does not require intracellular activation
253
how is INH metabolized and why matter
by acetylation- slow acetylers have increased levels
254
PE findings for pneumonia vs pleural effusion
pneu: incraesed breath, increased tactile frem, dull to percus
pleur: decreased breath, decreased tactile, dull to percus
255
gene responsible for increase in polyp size
KRAS
256
sx and pathophys of xerdoerma pigmentosum
increased sensitivity to UV light and high incidence of cutaneous malignancy
257
area involved in chron disease and issue with that area
terminal illeum-bile acids reabsorbed here, can have fat malabsorption and def. in fat soluble vitamins
258
tx propionyl def
restrict valine, isoleucine, methionine, threonine, and odd chain FA (VOMIT)
259
why give allopurinal with 6 MP
can increase [ ] by inhibiting xanthine oxidase (which usually degrades 6 MP)
260
heat stroke can lead to
DIC
261
rise in CK levels after thrombus extraction
reperfusion injury mediated by free radicals, mito damage, inflammation, activate complement: lead to cell membrane permeability
262
MOA of killed vs live vaccines
killed: prevent virus from enter cell
live: destruction of cells by CD8 lymphocytes
263
Hct up in CHF patient in hospital
relative erythrocytosis from diuresis, only hypoxic if <92% or <65 mmHg
264
effect of ARBs on renin, ang I and II
all go up because fall in BP but can't do anything
265
what is SMA syndrome
transverse portion of durodenum entrapped between SMA and aorta causing partial obstruction
266
fx of gyri on either side of central sulcus
precentral gyrus = primary motor
| postcentral gyrus = primary somatosensory
267
intracellular, round oval protazoa with rod shaped kinetoplasts, + beach +skin finding
Leishmania
268
nontyhoidal vs typhoidal salmonella pathophys
non: invasion of erythrocytes and inflammatory response in Peyer's patches
typh: capsular antigen-> replication in macrophages
269
path of N. meningitis
pharynx-blood-choroid plexus-meninges
270
reentrant circuit of A flutter
large reentrant through cavotricuspid isthmus of R atrium
271
progressive weak diaphragmatic inhlation but intact phrenic nerve activity
Myasthenia gravis
272
pathophys of giant cell arteritis
granulomatous inflammation of media
273
where is rRNA transcribed
nuceolus
274
enzyme that catazlyes the mobilization of TG into free FA and glycerol
Hormone sensitive lipase
275
examples of drugs dosed by weight and why adjust for obese
aminoglycosides, heparin, analgesiacs: hydrophilic, not distribute into adipose
276
normal pressure of RV; LA
25/5; <12
277
cause of meningitis in immunocompromised adult and characteristic
listeria- tumbling motility
278
susceptibility to infarct organ ranking
brain> heart> kidney> spleen> liver (liver low because dual blood supply)
279
EKG of WPW 3 things
1. delta wave- upstroke of QRS
2. short PR
3. wide QRS
280
pathophys of WPW
accessory pathway that bypasses AV node
281
HIV esophagitis 3 ddx and appearance
1. candida: gray/white psuedomembrane
2. HSV-1: punched out lesions
3. CMV: linear ulcerations
282
most common protazoal inf, common in hiker, + histo
Giardia; idiodine stained stool, pear shaped, flagellated, smooth walls with 2+nuclei
283
vWF binds to...
collagen
284
virulence factor of Enterotoxic E coli
plasmid encoded, heat labile and heat stable enterotoxins
285
orotic aciduria vs OTC deficiency
Both: high orotic acid in blood and urine
oa: megaloblastic anemia
OTC: increased amonnia
286
what almost always necessary to dev acute pyelo
vesicoureteral reflux
287
2 areas of intestine prone to ishemic damage
splenic flexure and rectosigmoid junction
288
s/e of cyclophosphamide and how to prevent
hemmorrhagic cystitis and administer mesna
289
cocaine moa
inhibit reuptake of Nor, dopamine and serotonin
290
s/e of non di CCB (verapamil, diltiazem)
constipation, bradycardia, AV block, worse of HF
291
what arteries does splenic give rise to
left gastroepiploeic, pancreatic, short gastric
292
histo of alpha 1 anti trypsin
red/pink globules on periodic acid Shiff stain
293
history of angiography procedure, what can happen
showering of cholesterol-rich microemboli: kidneys, CNS, GI, skin
294
histo of celiac
crypt hyperplasia and villous atrophy
295
which ABs cross placenta
IgG
296
2 tx for hepatic encephalopathy and MOA
- lactulose: increase conversion ammonia to ammonium
| - rifaximin: decrease intraluminal ammonia production
297
CO effect on Hgb
same PaO2, increase carboxyHgb, no methhemoglobin
298
what are formed as result of UV light exposure
pyrimidine dimers, excised by endonuceases
299
what is plasma renin activity and what raises it
measure of angiotensin I generated over time; low sodium intake, antiHTN: ACE, diuretics, ARB
300
Class 1 antiarrythmic Na channel blocking
C>A>B
301
after hysterectomy, have flank pain and fever
ureter severed
302
bug of necrotizing fascitis
GAS
303
flow rate equation
flow rate = flow velocity x cross sectional area
304
steps of base excision repair
Glycosylase-Endonuclease-Lyase-Polymerase-Ligase
305
assoc with Pseudomonas bacteremia
ecthyma grangrenosum
306
lymphatic drainage distal and proximal to dentate line
prox: inferior mesenteric and internal iliac
dist: inguinal
307
hypo areas and fx/deletion: lateral, ventromedal, ant, post, suprachiasmatic, supraoptic and paraventricular
lat: "shrink laterally" hunger
ventromedial: "grow medial and lateral" satiety
ant: "A/C" cooling, parasympathetic
post: heating, sympathetic
suprachia: circadian rthymn
supraoptic/paravent: synth ADH and oxytocin
308
what happen if you inhibit proteasome
apoptosis due to accumulation of toxins
309
pathophys of tetrolagy of falot
nterosuperior displacement of infundibular septum
310
pathophys of opening snap of mitral stenosis
sudden open of mitral valve leaflets after pressure in LV falls below left atrial pressure
311
nodules that spread along lymphatics, caused by thorn prick
Sporothrix schenkii
312
clinical course of ascaris lumbricoides
transmitted via contaminated food or water, eggs hatch in small intestine, migrate across lung to alveoli, larvae coughed up and swallowed, mature into adult worms that shed eggs into stool
313
timeline for GAD
6+ months
314
genetic problem of DiGeorge
chromosome 22.q11.2 microdeletion
315
fever, flu like sx, anemia, indirect hyperbili
malaria
316
difference between plasmodium falciparum and vivax
fal: Africa
viv: non Africa, dormant liver phase
317
normal saline %
0.9%
318
who at risk for vibrio vulnificus and how transmitted
hemochromatosis and through raw seafood or marine contamination
319
caudate on coronal section of brain
bean near lateral ventricle
320
s/e of bisphosphates
esophagitis, osteonecrosis of jaw, atypical femoral fx
321
what is directly left and a little further left of internal capsule on coronal section, what is right
globus palidus then putamen; right is amygdala
322
pathophys of superantigen
interact with APC and T cells, cause widespread T cell activation
323
pathophys of abscess formation
neutrophil recruitment and activation leads to release of lysosomal granules which kill bacteria but also cause liquefying necrosis
324
most common site of compartment syndrome and what is in there
anterior compartment
| deep peroneal nerve and anterior tibial artery and vein
325
cause of neuromuscalar issues in hepatic encephalopathy
ammonia crosses blood brain barrier and causes glutamine to accumulate in astrocytes which decreases amount to be converted to glutamate in neurons
326
which cholesterol med increases TG levels
bile acid binding resins (cholestyramine, colestipol, colesevelm)
327
timeline of adjustment disorder
within 3 months of stressor
328
what secretes enzymes and proteases in COPD
neutrophils, CD8 T cells, and macrophages
329
most common complication of aneurysmal SAH, and what cause
vasospasm and delalyed cerebral ischemia
330
histo of renal cell carcinoma and common met place
clear cyto b/c of lipids and glycogen
| lung: cannonball lesions
331
moa of cromylyn and nedocromil
inhibit mast cell degranulation
332
s/e of fibrate b/c of MOA
formation of cholesterol gallstones, inhibit cholesterol 7 alpha hydroxylase, activate PPAR-alpha- leads to decreased VLDL production; and myopathy if combine with statin
333
integrase inhibitor MOA
inihibit HIV genome integration, inhibit viral mRNA formation.
334
imaging of acute acalculus cholecystitis
acute inflammation of GB in absence of gallstones
335
where is testicular ca, what can secrete
in tunica albuginea, hCG
336
who is at greatest risk of developing drug induced SLE
slow acetylers
337
s/e of statin other than muscle
liver tox
338
hypopigmentation of skin, hair, eyes and ___ = ___
catecholamine brain centers; PKU
339
median and mean of positve and negative skew
pos: mean > median
neg: median > mean
340
what happens with deacetylation of histones
prevent transcription
341
fx of thyroid peroxidase
1. catalyzes oxidation of iodide to iodine
2. iodination of thyroglobin tyrosine residues
3. iodotyrosine coupling rxn form T3 and T4
342
where from single vs multiple brain absesses
single from direct invasion
| multiple from hematogenous spread
343
airway resistance throughout resp tract
inversely related to total cross sectional area of all airways at that level; high in trachea, higher in medium bronchioles, progressively decreases from there
344
crutches, wrist drop, loss of tricep reflex
injury to radial nerve
345
Shigella pathogenesis
can hijack actin filaments to propel self and enter M cells that overly Peyer's patches
346
best way to prevent hospital acquired infections
hand hygeine
347
tx cholinesterase inhibitor s/e
muscarinic antagonists like glycopyrrolate, hyosycamine, propantheline
348
dopamine phases of action as dose increase
1. D1 stim: increase in renal blood flow
2. B1 stim: increase HR and contract
3. alpha 1 stim: generalized vasoconstriction
349
MOA of ampho B/nystatin vs echinocandins (caspofungin) vs azole
ampho: binds ergosterol in mem and causes cell lysis
echino: inhibit cell wall synth through B-glucan
azole: inhibits ergosterol synth
350
toxic effect of mannitol
pulm edema
351
s/e of niacin and how to pre treat
flushing,aspirin
352
linear vs grandular IF on picture
linear look like special mushroom, grandular is blotchy
353
histo of crytococcus + CSF of
yeast with thick polysacchride capsule, CSF is budding yeast
354
aortic arch derivatives and CN
1. V, maxillary
2. VII, stapedial
3. IX, common carotid
4. superior laryngeal X, true aortic arch
6. recurrent laryngeal X, pulm arteries, ductus arteriosus
355
recurrent kidney stones in young patient and histo
cystinuria and hexagons
356
what do acetylcholinesterase inhibitors do and what is a non med example
inhibit breakdown of acetylcholine into choline and acetate. organophosphate
357
role of BNP and ANP
diuresis (increase GFR) and peripheral vasodilation, inihibit RAAS
358
MOA of neprolysin inhibitors (sacubitril)
prevent degradation of BNP and ANP- antagonize RAAS
359
what can be used to synth glucose in gluconeo in DKA
glycerol from fatty acids, used by glycerol kinase
360
tumor lysis syndrome definition and electrolytes
large number of tumor cells destroyed, ions released and uric acid; hyperkalemia, hyperphosphatemia, hyerucicemia, hypocalcemia (PUCK)
361
how prevent tumor lysis syndrome
hydration and hypouricemic agents: allopurinal or rasburicase
362
uti after procedure
enterococcus
363
define somatic vs germline mosaic
somatic: produce clinical manifestations
germ: no clinical manifestations only in cells that give rise to gamete
364
why infertile given shot of hCG
simulate LH surge
365
stool histo of vibrio or e. coli diarrhea
toxin mediated so some mucous and noerythrocytes or leukocytes
366
HOCM vs VSD
handgrip: HOCM decrease intensity, VSD increase
367
why combine aluminum hydroxide and magnesium
aluminum hydroxide cause constipation and magnesium cause diarrhea
368
after calcium released from sarcoplasmic reticulum, where bind
troponin C
369
why continue 4 weeks after trip for malaria prophylaxis
to ensure elimination of hepatic schizonts
370
MOA of DPP-4 inhibitors
inhibit DDP-4 enzyme that deactivates GLP-1 therby increase glc-dependent insulin release
371
dimorphic yeast with bx of large, round with single bud
blastomyces
372
MOA of isoproteranol
B1 and B2 receptor agonist, increase contractility and decrease peripheral resistance
373
rheumatic fever vs infective endocarditis valve
RHeum: diffuse fibrosis thickening
IE: large friable vegetations and destruction instead of fibrosis
374
2 mutations of osteosarcoma
in mesenchymal stem cell: RB1 or TP53
375
virus of croup
parainfluenza
376
adult vs child spleen of sickle cell
```
adult = fibrosis and atrophy
child= conjestion and infarction
```
377
why sickle cell have macrocytossis
increased folic acid requirement from turnover
378
most common cause of viral gastroenteritis
norovirus
379
what are P bodies
mRNA translation regulation and degradation
380
mutation of familial hypocalciuric hypercalcemia
autosomal dom- defective Gs coupled Ca+ sensing receptor
381
what would increase CO, decrease resistance, and increase venous return
AV fistula
382
tx mycoplasma pneumonia
macrolides, tetracyclines
383
ethanol inhibits what to cause hypoglycemia
gluconeogenesis
384
MOA of phenytoin
blocks Na+ sodium channels
385
what are neurophysins
carrier proteins for oxytocin and vasopressin
386
pt hasnt seen doctor in a while, cough until vomit
pertussis
387
increased sensitivity to sound caused by
paralysis of stapedius muscle- innervated by branch of facial nerve
388
bone lesions in hyperparathyroid
subperiosteal resorption
389
mass of hypothalamus and pituitary that causes increase in a hormone and why
prolactinoma- dopamine negatively regulates in hypothalamus vs other hormones are positively regulated
390
property of drugs eliminated by liver
lipophillic
391
zero vs first order kinetics
zero: constant amount is metabolized
first: constant proportion met
392
increased LDL receptor recycling in what drug
statin
393
issue with looking down stairs or reading
trochlear nerve
394
define left shift on curve and etiologies
50% sat at lesser [ ]
| decrease H+, 2,3-BPG, temperature
395
splenomegaly, esophageal varices, normal liver
portal vein thrombosis
396
low TSH and T4
central hypothyroid (secondary)
397
most common cause of infectious encephalitis in US and how to prevent
arbovirus, and eliminating vector (mosquito)
398
most common site of urethral obstruction
UPJ
399
pathophys of I cell disease, what is low
defective phophotransferase enzyme that catalyzes phosphorylation of mannose residues on lysosomal bound proteins, Mannose 6 phosphate
400
why LA and RA lower O2 than alveolar capillaries
mix of ox blood from pulm veins with deox blood from bronchial circulation and thebesian veins
401
where should thoracentesis be done based on location
below 6th rib anterior, below 8th axilla, below 10th vertebral, but below 9th risk abd injury
402
lymphatic draining of lower extremities
```
lateral = popliteal and inguinal
medial = just inguinal
```
403
metabolic pathways of mito vs cyto
mito: B ox, TCA, gluconeo
cyto: glycolysis, Pentose phos, FA synth
404
sciatic nerve symtoms also known as... and why
piriformis syndrome and because pass thru greater sciatic foramen
405
pathophys of hyperacute transplant rejection
preformed ABs in recipient: anti ABO or anti- HLA
406
LV PV loop read
MAAM
COCO
start at left bottom corner and go cw
407
makeup of cholesteatomas
squamous cell debri
408
feedback of inhibin B
low levels --> high FSH
409
why high dose of oral isosorbide dinitrate
1st pass metabolism in liver
410
nonspeecific sx, lymphadenopathy, hepatosplenomegaly, not TB, AIDS patient
M. avium
411
bone marrow bx of mycobacterium
foamy epithelial cells and multinucleated langerhan cells
412
MOA of acyclovir and what used for, complication
guanosine derivative that is phosphorylated by viral TK, incoperated into viral DNA, DNA synth terminated; not as efffective with EBV and CMV b/c dont' have the same TK as HSV and VZV; crystalline nephropathy
413
mutation of TTP
ADAMT13
414
mutation of congenital prolong QT
mutation in K+ channel, delayed rectiifier current of AP.
415
pure red cell aplasia (no erythrocytes) associated with
thymoma, lymphocytic leukopenias, and parvo B19
416
histo of syphilis
endarteritis of small vessels and plasma cell-rich infiltrate
417
histo of aquamous cell carcinoma
ovoid epithelial cells with eosinophillic cytoplasm, keratin nests/pearls within/btwn cells, intercellular bridging
418
RF for squamous cell carcinoma of esophagous
alc, smoking, oven hot foods, pre existing esophageaal injury
419
saline responsive vs non responsive met alk
SR: vomit, NG suction, thiazide/loop diur
NR: hyperaldosterone, cushing
420
transporter assocaited with antigen processesing (TAP) proteins fx
allow loading of cytoplasmic/viral proteins onto MHC class I molecules
421
low Vd
3-5 L
422
what causes low Vd
high weight, charged, high plasma protein binding, hydrophillic --> trapped in plasma compartment
423
presentation of methylmalonyl- CoA mutase deficiency
MMA in urine, hyperammoninemia, ketotic hypoglycemia, metabolic acidosis
424
fluid level in old lung cavity
aspergilloma-colonization
425
same rate per employee either insurance company pay hospital or payor directly pay
capitation
426
AP film what are the border of the heart
Bot to top R: IVC, Right atrium, SVC
| Bot to top L: LV, LA, PA, Aortic knob
427
prolonged exposure to loud noises hearing loss pathophys
stereocilliated hair cells of organ of Corti
428
nerves of radial plexus superior to inferior
MARMU (MC, Ax, Rad, Med, Ul)
429
deficiency of McCardle's and what the enzyme does
Glycogen phosphorylase-breakdown glycogen to limit to 4 sugar on side of branch and extra G1P
430
presentation of neonatal tetanus
clench all muscles, arch back, lock jaw
431
MOA of enoxaparin/LMW heparin
bind and activates Antithrombin III, which binds to Xa and stops from converting prothrombin to thrombin
432
constrict efferent arteriole what happen to GFR
first increase then decrease
433
MOA of anastrazole, letrozole, and exemestane
aromatase inhibitors
434
pathophys of valve degneration of aortic stenosis
calcific dengeneration after cell necrosis
435
embryologic thryoglossal cyst derivative
endoderm of foramen caecum
436
what are the atypical cells of EBV
reactive CD8 T cells
437
order of ventricle drainage
lat ven- Monro- 3rd- sylvius/cerebral aquaduct- 4- Lushka or Magendie- SA space
438
course facial features, clouded corneas, restricted joints, high lysosomal
I cell
439
Bengay/ capsaisan cream MOA
depletes substance P
440
microtubule inhibitors
paclitaxel, vincristine, vinblastine,eribulin
441
defect of hereditary spherocytosis
proteins interacting with RBC mem skeleton and plasma membrane--> ankyrin, spectrin, protein 4.2
442
lipoprotein lipase def schematic
def causes increases in TG- deposit in skin, probs with pancreas and liver- diabetes
443
splanchnic nerves are...
sympathetic except for pelvic splanchnic
444
2 phases of succinylcholine
1. block potentiated by cholinesterase inhibs
| 2. reversed with cholinesterase inhibs
445
pathopys of TSS
1. replicate locally and release superantigen into blood
2. bind to MHC-II and activate T cells
3. Dramatic release of cytokines
446
T cell vs B cell ALL
B cell most common, T cell present with mediatinal mass-dysphagia
447
Cori vs von Gierkes enzyme and sx
both: hypoglycemia, ketosis
Cori: debranching enzyme, no lactic acidosis, hypotnoia
vG: Glc-6-phosphatase, lactic acidosis, hepatic steatosis
448
contents of reactive T cells
granules with perforin and granzymes
449
vesicles on lips and hard palate, lymphadenopathy, fever
gingivostomatitis- HSV in young child
450
presentation of arsenic poisening and where come from
n/v, hypotension, garlic breath
| -from insecticides and contaminated water
451
1st line for arsenic poisening
dimercaprol
452
daptomycin MOA and what used for and s/e
MOA: depol bacterial cell mem and inhibit DNA, RNA, protein synth
use: MRSA, not pneumonia
s/e: increased CPK, myopathy
453
lower> upper extremity cyanosis and clubbing without BP discrepancies
PDA
454
MOA of finasteride
5 alpha reductase inhibitor- tx BPH
455
structures from the metanephic blastema
glomeruli, Bowman's space, proximal tubules, loop of Henle, distal convoluted tubule
456
rhabditiform larvae in stool
strongyloides
457
mutations and its pathophys for hemochromatosis
HFE gene; excessive intestinal absorption of iron
458
sleep walking and night terrors sleep stage and wave
non REM3- delta
459
where does median nerve travel in forearm
humeral and ulnar heads of the pronator teres and betweeen flexor digitorum superficialis and flexor digitorum profundus
460
testis vs scrotum lymph drainage
testis: para-aortic (b/c orignially in abdomen)
scro: superficial inguinal
461
gingival hyperplasia as s/e
phenytoin
462
coinfection cell by 2 viral strains, have capsid proteins from one strain and genome from other; next generation is unmixed phenotype
phenotypic mixing
463
paradoxical emboli because of what
PFO, ASD, VSD, large pulm AV malform
464
angiogenesis is driven by...
VEGF and FGF-2
465
MOA of iprotropium
anticholinergic-bronchodilator, block parasympathetic stim of tracheobronchial mucosal galnds
466
renal fail + hypoglycemia in DM patient
reduced insulin clearance
467
MOA of sevelamer
binds intestinal phosphate, reduce absorption
468
where are H pylori colonized and how lead to ulcer
antrum of stomach, less somatostatin from D cells, more gastrin-more acid production, ulcer
469
histo of Beurger's
inflammatory intraluminal thrombi with vessel wall sparing, extension into nearby veins and nerves
470
mediation of calcium efflux prior to relaxation
Na+/Ca+ exchange pump
471
anesthetic injury of halothane to liver
shrunken, elevated LFTs, long PT
472
brain location of locus cerulus
paired brainstem nucleus in posterior rostral pons near lateral floor of 4th ventricle
473
med s/e: arrythmia, vision change, hyperkalemia, n/v
digoxin
474
MOA of carbamazepine and s/e
reduce ability of Na channels to recover from inactivation; bone marrow suppression and SIADH
475
tx spasticity of MS and other
Baclofen-GABA agonist
476
corneal reflex limbs
Af: V1
Ef: VII
477
slow vs fast insulin names
slow: d, d, glarg
fast: GAL (glu)
478
histo of meningioma
whorled pattern of cellular growths that form nests, may calcify into psammoma bodies
479
apple green with Congo red=
amyloid, which is also found in Altzheimers
480
calc number needed to harm (number treated before 1 adverse event occurs)
1/ absolute risk increase
481
MOA of entacapone
prevent peripheral L-DOPA degradation by inhibiting COMT
482
asthma, eosinophila, rhinosinusitis, involve peripheral nerves
churg strauss (eosinophillic granulomatosis with polyangitis)
483
cholinergic tox mneumonic
DUMBELS: diarrhea, urination, miosis, bronchospasm, emesis, lacrimation, salivation
484
muscle targeted with Kegels
levator ani
485
where are anal fissures located
posterior midline
486
cause of transposition of great vessels
fail of spiral of fetal aorticopulmonary septum
487
define pulsus paradoxus
fall in BP >10 mm during inspiration
488
what measure b4 metformin and why
Cr b/c bad kidneys predispose to lactic acidosis
489
derivatives of POMC
ACTH, MSH, and beta-endorphins (opiod peptide)
490
ureter course through abdomen
posterior to uterine artery and anterior to internal iliacs
491
MOA of benzos
allosterically modify binding of GABA, result in increase freq of Cl ion channel opening, influx of Cl cause hyperpol and inhibit AP
492
lack of tissue necrosis in PE?
collaterol circulation
493
MOA of milrinone
PDE-3 inhibitor, in cardiac myocytes: increase contractility; in vascular smooth muscle- vasodilation
494
atrition bias is a type of ___ bias and defined as
- selection
| - unequal loss of follow up
495
net filtration pressure equation
nfp= (hydrostatic cap- hydrostatic interstitium)- (oncotic cap-oncotic interstit)
496
MOA of decrease AV node conduction by increasing parasympathetic vagal tone. positive ionotrope
digoxin
497
aortic stenosis compensatory occurance and why bad
atrial contraction contributes to ventricular filling. AF means less preload
498
area postrema significance and location and tx
vomiting reflex-less dev blood brain barrier; dorsal medulla/caudal 4th ventricle; serotonin receptor antagonists-odansteron
499
adrenergic regulation of insulin
release stim by beta 2, inhibit by alpha 2
500
intraventricular hemmorrhage location and presentation
germinal matrix into lateral ventricles; premee-bulge fontanelle, hypotonic, seizure
501
mediators for osteoclast differentiation
start from hematopoetic progenitor cells; M-CSF and RANK-L important factors for differentiation
502
histo of mesothelioma
cuboidal, flattened, spindle cells-stain positive for cytokeratins and calretinin
503
why restricted have increased flow rates if correct for lung volume
increased elastic recoil results in increased outward pulling of the airways (radial traction)
504
kidney injury of rhabdo and why
heme pigment mediated tubular injury- ATN
505
MOA of thiazolidinedoines
decrease insulin resistance by activating PPAR-gamma, increases GLUT-4-increases glc uptake; increases adiponectin-which increase differentiation of preadipocytes into insulin-responsive adipocytes
506
unilateral RAS- what happens to the other kidney
high BP cause arteriolar wall thickening
507
what does carotid massage do
increase parasym vagal tone- slow conduction thru AV node
508
resistance to chemo agents
MDR1 gene- code for ATP dependent efflux pump protein-reduce influx of drugs into cyto
509
MOA of Ramelteon
melatonin agonist
510
unilateral pulm opacification and trachea deviated towards that side
obstructive lesion in main stem bronchus leads to collapse of that lung
511
histo of graves
scalloped colloids
512
upper extremity LMN, lower extremity UMN, kyphoscoliosis, loss pain and temp in upper extremity
syringomyelia
513
carotid waves and fx
a: R Atrial contract
c: RV Contract
x desc: R atrial relaX
v wave: venous f(v)ill RA
y descent: RA emptY into RV
514
rat poisen is..
super warfarin
515
tx pulm HTN and MOA
bosentan; endothelin receptor antagonists
516
MOA of sulfonurea (glyberide)
inhibit ATP K+ channel on beta cell mem, induce depol and L-type Ca channel open--> insulin release
517
lesion of cerebellar- vermis vs hemisphere
vermis= truncal ataxia
| lat hemisphere=limb dysmetria
518
5 P's of lichen planus
purple/pink, pruritic, polygonal, papule, plaques
519
histo of lichen planus
thickened stratum granulosum and sawtooth rete ridges
520
ANCA stand for
antineutrophil cytoplasmic AB
521
JAK2 receptor type, and mutated in what
non-receptor tyrosine kinase;PV, essential thrombo, primary myelofibrosis
522
Retroperitonel structures
SAD PUCKER
Suprarenal glands/adrenal glands, Aorta/IVC, Duodenum 2nd-4th, Pancreas-not tail, Ureters, Colon-desc and asc, kidneys, esophagous, rectum-part
523
pathophys of alzheimer's
decreased levels of acetylcholine in nucleus basalis of meynert and the hippocampus, deficiency in acetyltransferase
524
origin of type A vs type B aortic dissection
A: near sinotubular junction
B: near subclavian artery
525
midshaft hummerous fx injure
brachial artery and nerve
526
acid base of PE
resp alkalosis
527
gigantism cause
increased IGF-1 from liver
528
MOA of metyrapone stimulation test
block cortisol synth thru inhibit 11-B hydroxylase
529
PMS I Cry
Poststrep, membranous proliferative, SLE, IgA, cryglobinemia
530
things secreted in sarcoid
Th1 mediated- secrete IL-2 and IFN-gamma
531
calculate odds ratio
(a/b)/(c/d)
532
P450 inhibitors
cimetidine, cipro, erythro, azole antifungals, protease inhibs (ritonavir), INH, grapefruit juice, diltiazem, verapamil
533
translocation of CML vs AML
9;22- Philly, BCR-ABL;; 15;17
534
urinalysis of AIN
WBC and white blood cell casts
535
pathoophys of NSAID cause prerenal azotemia
COX normally dilates afferent arteriole, inhibit COX- slow GFR
536
nerve facilitate erection
cavernous nerve- can be injured if clip prostatic plexus
537
anesthetics that are hepatotoxic
halogenated- end in "rane" or "thane"
538
MOA of ethosuxamide
blocks T type Ca+ channels in thalamus
539
pathophys of struvite stones
recurrent upper UTI with urease pos orgs-Klebsiella, Proteus; hydrolysis of urea to produce ammonia, increase urine pH, precip of magnesium ammonium phosphate salt
540
bone marrow bx of primary myelofibrosis
fibrotic marrow with clusters of megakaryocytes
541
endoscopic findings of eosinophilic esophagitis
stacked ringlike indentations, linear furrowing, scattered whitish papules
542
cytokines of systemic inflammation
IL-1, IL-6, TNF-alpha
543
what papillary muscle at risk of rupture and why
posteromedial b/c single blood supply from posterior descending artery
544
what give after iodine nuclear accident
potassium iodide- competitively inihibits uptake of radioactive iodine
545
histo of Guillan Barre
demyelination of peripheral nerves- ascending, endoneural inflammatory infilltrate
546
injury to musculocuteanous nerve
loss biceps reflex, loss forearm flexion, loss sensation lateral forearm
547
pathophys of complete 3rd degree AV block
degenerative changes of AV node
548
pathophys of diabetic neuropathy
post sx: small fibers
| neg sx: large fibers
549
right shift hgb curve
ACE BAT: acid, CO2, exercise, 2,3-BPG, Altitude, temperature; facilitate unloading O2 into tissues
550
what is increased in diastolic CHF (preserved EF)
systemic vascular resistance
551
what is reverse T3
inactive form generated from T4
552
RF for uric acid stones
increased uric acid excretion, increased urine concentration, low urine pH
553
target rash mediated by CD8+, after HSV, myoplasma,cancers or autoimmune
erythema multiforme
554
vasopressin action in nephron
V2 receptor mediated increase in water and urea permeability in collecting duct-increase water and urea reabsorption
555
3 drugs for open angle glaucoma and MOA
1. timolol 2. acetyazolamide; decrease aqueous humor production by ciliary epithelium
3. prostaglandin (-prosts): increse outflow of aqueous humor
556
ring sideroblasts vs basophillic stippling
ring in marrow, stippling in peripheral blood
557
low PCWP and RA pressure
cardiogenic shock from RHF
558
necrolytic migratory erythema seen in
glucogonoma
559
cell injured what happens to ions
increase intracellular Na and CA, decreased K
560
alpha error what is it and how change it
false positive- nothing
561
niacin (nicotinic) MOA
inhibits cholesterol breakdown to VLDL
562
pathophys postprtum thyroiditis
lymphocytic inflitrate causing transient hyperthyroid, hypothyroid, or hyper followed by hypo
563
compliance equation
tital vol/ (end inspiratory-end expiratory)
564
sporatic retinoblastoma
unilateral, two spontaneous mutations
565
MOA of spironolactone
decrease luminal permeability to Na+ in collecting duct, inhibit Na/K ATPase
566
aminoglycoside mech of resistance
abx-modifying enzymes, add chemical group to abx- unable to bind ribosome
567
bone marrow bx of aplastic anemia
hypocellular marrow filled with fat cells and marrow stroma
568
chalk white areas of fat necrosis in mesentary
necrotizing pancreatitis
569
branchial arch derivatives mneumonic
ear, tonsils, bottom to top
570
thymus embryological derivative
3rd branchial pouch
571
pathophys of bullous impetigo
bacterial toxin induced desmoglein cleavage
572
tx PCOS and MOA
estrogen receptor modulator, prevents negative feedback in hypothalmus, increases FSH and LH secretion
573
how MI cause mitral regurg
ischemia to papillary muscle
574
acid base findings of altitude
resp alk with hypoxemia
575
preventative migraine tx
beta blockers, TCA, valproate, topiramate
576
histo of gliobastoma multiforme
pseudopallisating tumor cells around area of necrosis and new vessel formation
577
Whipples disease mnemonic
Foamy whipped cream in a CAN: Foamy macrophages, Cardiac sx, Arthalgias, Neruo, plus steattorrhea
578
junctional vs compound vs intradermal nevus
J: dermoepidermal jx
C: dermal and epidermal involvement
I: older, only dermal, dome shaped
579
what cells produce EPO
peritubular interstitial cellls
580
eat toxic mushroom Amantia phalloides
hepatotoxicity, inhibit RNA poly II
581
how does NO cause smooth muscle contraction
increase intracellular cGMP, lead to myosin chain dephosphorylation
582
saddle anethesia and cauda equina which nerve roots
S2-S4
583
regular insulin start peak dead
start 30 mins, peak 2-4 hours, lasts 5-8
584
voluntary portion of pooping
puborectalis muscle relaxes and external sphincter relaxes
585
what is in urine of multiple myeloma
light chains
586
mechanism of lithium nephrogenic DI
antagonize ADH action on principal cells at collecting duct
587
clinical features of hypoaldosteronism
HTN, muscle weakness, paresthesias
588
ATN affects what part of kidney and why
medulla b/c low blood supply, straight portion of proximal tubule and thick loop of henle
589
esophagous on CT
between vertebral body and trachea
590
myelination __ length constant and ___ time constant
increases; decreases
591
action of gluteus medius
hip abduction
592
causes of methehemoglobinemia
nitrates, local anesthetics, sulfa drugs
593
equation of half life
(0.7 x Vd)/ CL
594
pathophys of huntington's disease
accumulation of huntingtin protein in neural cells, especially GABA neurons in caudate
595
why hypercalcemia in sarcoid vs multiple myeloma
1-alpha hydroxylase expression in activated macrophages, causes PTH independent production 1,25 dihydroxy vitamin D
-lytic bone lesions
596
hox gene code for and fx
transcription factor and segmental organization of embryo over cranial caudal axis
597
when during cell cycle does vincristine work and s/e
S and peripheral neuropathy
598
mneumonic for acute pancreatitis
I GET SMASHED: Idiopathic, Gallstone, Ethanol, Trauma, Steroids, Mumps, Autimmune disease, Scorpion, Hypercalcemia/Hypertriglyceridemia, ERCP, Drugs (sulfa, 6-MP, NRTI, protease)
599
tumor suppression path
1. p53 induce p21 which inhibits CDKs
2. hypophosphorylation of Rb
3. inhibit G1S progression
600
what happens to systemic vascular resistance in exercise
goes down
601
MOA of pembrolizumab
programmed-death receptor 1 (PD-1) inhibitor;; normally PD-1 is a checkpoint inhibitor that downregulates cytotoxic T cell response
602
tx varicella zoster in AIDS
foscarnet or cidofovir
603
pioglitazone is ___. MOA
thiazolidinedione; binds PPAR-gamma: transciprtion factor that affects glc nd insulin metabolism
604
genetics of Fragile X
trinucleotide repeat CGG, hypermethyltion and decreased expression
605
urethral injury
bulbar/ spongy in catheter, membranous in fx
606
infraorbital fx
maxillary branch of V damaged and damage to inferior rectus
607
DM patient with red-brown calfs
venous stasis-depostion of hemosideran
608
cause of stress incontinence vs urge incontinence vs overflow
stress: urethral spinchter tone relax, urge, MS: detruser hyperactivity, overflow: impaired detruser contracility, bladder outflow obstruction
609
wht causes outflow obstruction in HOCUM
systolic motion of the anterior leaflet of the mitral valve towards the hypertrophied interventricuar septum
610
pathophys of angina in aortic stenosis without occlusion
increased myocardial oxygen demand from increase in LV mass and wall stress
611
pathophys of photaging
exposure to UVA, decreased collagen fibril production and increased degradation of collagen and elastin in dermis
612
diffuse axonal injury (type of TBI) pathophys
disruption of white matter tracts: axonal swelling at gray-white junction with accumulation of transport proteins
613
why can glucagon tx BB overdose
activates G protein coupled receptors, cause activation of adenylyl cyclase and raise intracellular cAMP. Ca+ release and SA node fire
614
candida defense variations
local: T cells, systemic: neutrophils
615
nodular infiltrates, non caseating granulomas, enlarged lymph nodes- not sarcoid
berryllioisis- aerospace
616
ependymoma location and origination
originate from ependymal cells that line the ventricular sys and central canal of spinal cord; can block flow through interventricular foramen- obstructive hydrocephalous
617
how join SMA and IMA
marginal artery
618
what concentrations increase across proximal tubule and which decrease
increase: PAH, inulin, urea
decrease: bicarb, glc, AA
619
failure of ristocetin assay
von willebrand and bernard soulier
620
more rapid clearance of biologic
antidrug antibodies
621
xray findings of osteosarcoma
periosteal new bone formation with lifting of the periosteum- Codman's triangle
622
where does sildenifil act, s/e
corpus cavernosa-two "eyes"
| blue vision, sudden monocular vision loss due to ischemic optic neuropathy
623
injure long thoracic nerve
paralysis of serratus anterior: also injured during chest tube placement
624
enzyme deficient in AIP vs porphira cut tarda
AIP: porphobilinogen deaminase
PCT: Uroporphyrinogen decarboxylase
625
s/e of cisplatins/platins
ototoxicity and nephrotoxicity
626
fx of androgen binding protein and where from
from Sertoli cells; secretedinto semineferous tubule lumen, bind T and DHT less able to diffuse out
627
high PTH, low Ca, short 4th/5th digits, short stature, defective Gs protein from MOTHER
pseudohypoparathyroidism- Alright hereditary osteodystrophy
628
different mutations in same loci produce same phenotype
allelic hetergeneity- B thalassemia
629
mutation of achondroplasia
FGFR3
630
short stature, blue sclera, scoliosis, hearing loss, increased skin laxicity, easy bruising; gene,
osteogenesis imperfecta, COL1A1 and 2. glycosylation step of collagen synth
631
what is Ras
oncogene so susceptable to gain of fx mutation: signals from cell mem to nucleus: promote mitosis
632
Li Fraumeni mutation
p53
633
muslces innervated by R and L recurrent laryngeal
5 arytenoids
634
efferent nerves myelinated except for
postganglionic autonomic neurons
635
pathophys of achalasia
degeneration of inhibitory ganglion cells in myenteric (Aurebach) plexus
636
acanthosis nigracans assoc with
gastric adenocarcinoma
637
what in sarcomere changes with contraction and relaxation
I band: lengthen during relaxation, shorten during contraction
638
define imprinting
inactivated by methylation, one parental chromosome is inactivated
639
myositis with delayed reflex relaxation
hypothyroid induced
640
myositis normal CK
glucocorticoid and PMR
641
elastin cross linked by...
lysine, allows for rubber band like effects
642
calculate CI
CI = mean +/- [z score] x SE
643
high CD4/CD8 ratio
sarcoid
644
substance P increase in chemotherapy 1-5 days after, cause vomiting, how treat
-aprepitant, neurokinin-1 receptor antagonists because NK-1 is activated by substance P
645
how do eosinophils fight parasites
AB dependent cell mediated toxicity
646
MOA of emicizumab
mimics factor VIII by binding both IXa and X
647
renal clear cell carcinoma arise from and gross pathology
proximal tubules and golden yellow tissue with necrosis and hemorrhage
648
DM neuropathy vs compression CN III monoinjury
DM: nerve ischemia to middle: only have down and out and ptosis
comp: above plus pupil dysfx
649
abesence of melanocytes
vitiligo
650
anemia, thombocytopenia, high WBC, stain CD20
CLL
651
acute complication of left ventricular MI in lungs and histo
pulm edema and engorged alveolar capillaries, aceullar pink material
652
mneumonic for familial dyslipids
1 LP, 2 LD, b add V, 3 is E, 4 adds more
653
Peutz- Jeghers syndrome triad
autosomal dom, 1. hamartomas in GI 2. hyperpigmented macules mouth lips, hands, 3. increased risk breast and GI cancer
654
pemphigous vul vs bullous pem clinical presentaiton
PV: oral mucosa, nikolsky pos, extend blister on pressure
BP: spare oral, tense blisters, nikolsky neg
655
ataxia, truncal instability, postural tremor of fingers
alcholic cerebellar degeneration
656
wide split S2: Aortic then pulm valve close
pulm HTN, pulm stenosis, RBBB
657
mutation of Lynch syndrome
mismatch repair genes, lead to microsatellite instability: MSH2, MLH1, MSH6, PMS2
658
substantia nigra located in
midbrain
659
what types of drugs cross the placenta
lipophillic, water soluble cannot
660
EKG of hyper vs hypokalemia
hyper: peak T wave, progress to v tach
hypo: QT prolong, ST depression, progress to torsades
661
pathophys of Grave's opthalamos
stimulated by orbital fibroblasts by thyrotropin receptor ABs and cytokines released from T cells; fibroblasts proliferate and secrete glycosaminoglycans, excess adipose too
662
most important RF for thyroid cancer
radiation exposure
663
Kluver- Bucy syndrome
disinhibited behavior- bilateral amygdala
664
midshaft fx of humerus
radial
665
only DNA virus replicate in cyto
Adeno
666
fall in renal perfusion pressure (renal art stenosis, systemic hypotension) lead to
cause efferent arteriole constriction, help improve GFR at expense of RPF
667
counter effect of orthostatic hypotension- what receptor
alpha 1
668
mneumonic for membranous nephropathy, histo
"tumors, hepatitis, and rheumatoid arthitis", diffuse GBM thickening
669
venous drainage above vs below dentate line
above: superior renal vein- inferior mesenteric vein- splenic vein-portal
below: inferior rectal- internal pudendal- internal iliac-common iliac- IVC
670
MOA of probenacid
block organic anion transporters on renal tubular cells; inhibit secretion of Abx (penicillin)
671
high estrogen in cirrosis clinical findings
spider angiomas, pallmar erythema, gynecomastia, testicular atrophy, less body hair
672
after insulin binds to insulin receptor- what 2 paths happen?
1. RAS/MAP kinase path- cell growth and DNA synth
| 2. PI3K path-glycogen, lipid, prot synth and GLUT4 translocated to membrane
673
deep vs superficial peroneal nerve
deep: foot eversion and toe extension; sensory between big and second toe
super: foot eversion; sensory lat calf and dosri foot
674
ACTH, LH, and renin in 17 hyrdxylase def
ACTH and LH increased, renin decreased
675
common phrase of HIV meds
NNRTI: EfaVIRenz
PI: ritoNAVIR
InteGRAse inhibitor: ralteGRAVIR
FUsion inhibitor: EnFUvirtide
676
leucine zippers are in...
eukaryotic transcription factors
677
what is required for de novo pyrimidine synth
CO2, glutamine, 2 ATP
678
moa of retinoid in acne
reduce hyperkeritinization, deccrease sebum production
679
moa of di CCB
selective for arteriolar smooth muscle, decrease afterload
680
stroke with dysarthria, contralateral face and body hemiparalysis
medial pons
681
PV loop cardio explain
left line ESV, right line EDV, increase size right is increase preload, increase size up is increase afterload
682
nitroprusside vs nitro moa
nitropruss: decrease preload only
nitro: decrease preload and afterload
683
wrist bone mneumonic
s start at low thumb, that start at thumb again
684
how drug get into blood brain barrier
inhibit p-glycoprotein which usually efflux pump put
685
telangiectesias of skin and mucous mems that can rupture and cause bleeding
Osler-Weber-Rendu
686
what nerve is involved: TMJ pain, muffled hearing/ ear pain
V3
687
only insulin dependent glucose transporter and location
GLUT-4, adipose and striated muscle
688
sympathetic system 2nd neuron is usually ___, but what are the 2 exceptions
Usually: postsynaptic release NE
1. chromaffin cells of adrenal medulla-stim by acetylcholine
2. sweat glands are cholinergic
689
IgE independent degranulation
opiods, radiocontrast, vanc
690
dilated cardiomyopathy in 35 year old after illness
viral myocarditis
691
clavicle displaced superior vs inferior
inf: deltoid
sup: sternocleido and trapezius
692
two ways of absess formation in liver
1. S aureus: hematogenous seed of liver
| 2. Eneric bacteria ( e coli, klebsiella, enterococci): ascend biliary tree
693
urine: where see RBC free vs RBC casts
RBC free: kidney stones
| RBC casts: nephritis
694
how is eosinophil toxic to helminth
secrete major basic protein
695
cause of comunicating hydrocephalus
comm: dysfx of subarachnoid villi- where CSF absorbed
696
what cause insulin to increase way more in oral glucose
incretins: GLP-1 and GIP
697
beta 2 adrengeric stim
vasodilation, bronchodilation, uterus relax
698
alpha 1 adrenergic stim
increase SBP, mydraisis, contraction internal urethral sphincter
699
increased renin and aldosterone
secondary hyperaldosteronism: renal artery stenosis, diuretic use, malignant htn, renin secreting tumor
700
acetazolamide act at the
proximal tubule- urinary bicarb wasting
701
itraperitoneal fluid after trauma
bladder dome rupture
702
tx homocystenuria
pyroxidine
703
jaw jerk reflex limbs
V3, V3
704
HUS from..
Shigella or E. coli
705
net excretion rate of substance
NER= (inulin cl x plasma [] of substance) - tubular reabsorption
706
mutation of xeroderma piigmentosum
UV specific endonuclease
707
esophageal cancers location and type
top 2/3- SCC
| low 1/3- adenocarcinoma
708
alpha 1 vs smoking emphysema location
alpha 1: panacinar
| smoking: centriacinar
709
TB reactivated vs primary
secondary: top
primary: bottom
710
ovarian torsion ligament
infundibulopelvic ligament
711
low elastase, elevated HgA1c, positive Sudan stain
chronic pancreatitis
712
leuprolide MOA
GnRH analog
713
---navir hiv moa and s/e
protease inhibitor and lipidystrophia, hyperglycemia, inihibit P450
714
after 12-18 hours of fasting, start
gluconeogenesis
715
tx orodic aciduria
uridine
716
moa of zolpidem
GABA agonist
717
triad of Plummer-Vinson
1. dysphagia 2. Iron deficiency 3. esophageal webs +glossitis
718
pigmented stones pathophys
biliary tract infection leads to release of B-glucuronidases- increase unconjugated bili
719
G6PD prevents creation of ___ which is used in....
NADPH- FA synth, reduce glutathione
720
steady state reached in __ half lives
4-5
721
action and sensory of obturator nerve
adduct thigh, medial patch just superior to knee
722
bioavail equation
AUC oral/ AUC IV
723
chloride in arterial vs venous
ven> art
724
transport of ammonia by alanine
alanine carry NH3, give to alpha ketoglutarate by ALT with B6 as cofactor
