Block 1 Flashcards by Payton Sterba

Equation for TPR using MAP, right atrial pressure, and CO

TRP = (mean arterial pressure - right atrial pressure)/CO

How well did you know this?

Not at all

Perfectly

In multiple myeloma, what do oyu see in the plasma cells due to an accumulation of immunoglobulin?

Russell bodies

How well did you know this?

Not at all

Perfectly

In which disease do you see a “mosaic pattern of newly formed woven bone”

Paget’s disease

How well did you know this?

Not at all

Perfectly

Paget’s disease puts patients at risk for what cancer?

osteosarcoma

How well did you know this?

Not at all

Perfectly

How is the S3 sound best heard and why?

At apex with the bell while pt is in left lateral decubitus position and fully exhaled

Decreased volume in lungs brings the heart closer to the chest wall

How well did you know this?

Not at all

Perfectly

What is JAK2?

A non-receptor tyrosine kinase associated with the erythropoietin receptor

How well did you know this?

Not at all

Perfectly

In which disease is there mutations in JAK2 that cause constitutive kinase activation resulting in increased production of red blood cells

polycythemia vera

How well did you know this?

Not at all

Perfectly

What is the Hawthorne effect?

It’s the tendency of study subjects to change their behavior as a result of their awareness that they are being studied

How well did you know this?

Not at all

Perfectly

What is the Pygmalion effect?

Describes the fact that a researcher’s beliefs in the efficacy of treatment can potentially affect the outcome

How well did you know this?

Not at all

Perfectly

Describe the shunting pathway seen in esophageal varices

Shunting of portal blood from left gastric vein to the esophageal vein (systemic)

How well did you know this?

Not at all

Perfectly

What glands are unique to the duodenum and secrete alkaline mucous into ducts that track upward through the muscularis mucosae and into the crypts of Lieberkuhns and into the lumen?

Brunner’s glands

How well did you know this?

Not at all

Perfectly

These lymphoid aggregates are specific to the ileum

Peyer’s patches

How well did you know this?

Not at all

Perfectly

Peyer’s patches are specific to the ______.

Brunner’s glands are specific to the _______.

Peyer’s patches = ileum

Brunner’s glands = duodenum

How well did you know this?

Not at all

Perfectly

Name 2 types of eukaryotic promoter regions

TATA/Hogness box

CAAT box

How well did you know this?

Not at all

Perfectly

This promoter region is found 25 nucleotides upstream

TATA/Hogness box

How well did you know this?

Not at all

Perfectly

This promoter region is found 70-80 bases upstream

CAAT box

How well did you know this?

Not at all

Perfectly

Where are enhancers and repressors located relative to genes?

Upstream, downstream, near or far from genes –> variable locations

How well did you know this?

Not at all

Perfectly

Langhans giant cells are formed from what?

Activated macrophages (epithelioid cells)

How well did you know this?

Not at all

Perfectly

What is the ureteric bud a precursor for?

The caliceal system and ureters

How well did you know this?

Not at all

Perfectly

When and from what does the adult kidney form?

It forms by the 5th to 6th week of gestation from the uteric bud (metanephric diverticulum)

How well did you know this?

Not at all

Perfectly

What is the last segment of the fetal ureter to canalize?

Ureteropelvic junction

How well did you know this?

Not at all

Perfectly

What is the most common site of obstruction in the kidney?

Ureteropelvic junction

How well did you know this?

Not at all

Perfectly

In type-1 diabetes, what causes the destruction of beta cells?

Primarily through cell-mediated immunity (antibodies against islet antigens are detected)

How well did you know this?

Not at all

Perfectly

Which are more common: duodenal ulcers or gastric ulcers?

Duodenal ulcers

How well did you know this?

Not at all

Perfectly

Anterior duodenal ulcers result in what?

Perforation

Posterior wall ulcers results in what?

Hemorrhage of the gastroduodenal artery

What do you palpate when administering pudendal nerve blocks?

palpate ischial spines

What nerve is derived from S2-S4 and provides sensory innervation to the perineum and genitals as well as motor innveravtion to sphincter urethrae and the external anal sphincter?

pudendal nerve

MOA of ondansetron, granisetron, dolasetron?

5-HT3 receptor antagonists

Which drug class is highly effective in preventing chemo-induced vomiting and why?

5-HT3 receptor antagonists because they block vagus mediated nausea and vomiting and block serotonin in the chemoreceptor zone

What is the equation for flow?

Flow (Q) = (P1 - P2)/R where R = (viscocity)(length of vessel)/r^4

What is the compensatory mechanism to increases in capillary fluid?

Increases in tissue lymphatic drainage that occurs due to increased interstitial fluid pressure

What vitamin serves as an essential cofactor for transaminases (reactions that typically occur between an amino acid and an a-keto acid)?

pyridoxal phosphate (vitamin B6)

What happens to bicarbonate in metabolic acidosis?

bicarbonate is completely reabsorbed from tubular fluid in acidotic states

What happens to urine during metabolic acidosis?

Urinary pH decreases due to increased excretion of free H+, NH4+, and H2PO4-

Where are intracranial schwannomas located and what nerves can they affect?

Most commonly located at the cerebellopontine angle, found between cerebellum and lateral pons They can affect CNs 8, 7, 5

Describe the mechanism of acyclovir

Acyclovir is converted into acyclovir monophosphate via virus encoded thymidine kinase. The monophosphate is converted into acyclovir triphosphate which is incorporated into the viral DNA chain and DNA synthesis is terminated

Describe malassezia furfur

Hypo/hyperpigmented skin patches that become more visible with sun tan

What should you suspect if a patient from Central or South America presents with achalasia?

Trypanosoma cruzi

Mutations in which genes are responsible for emergence of HIV protease variants that are resistant to standard protease inhibitors?

Pol genes of HIV

Neutropenia is seen in about 1% of patients on this drug and typically presents with fever and mouth ulcers. Name this drug

ticlodipine

1st and 2nd most common causes of SCID

Most commonly X-linked 2nd most common = adenosine deaminase

Describe adenosine's cause of SCID

adenosine accumulation is toxic to lymphocytes and leads to widespread death of both T and B lymphocytes

All Burkitt's lymphoma are associated with what genetic abnormality?

c-myc translocation on chromosome 8

t(8;14) involves...

the heavy chain gene locus

t(8;22) involves...

the lambda light chain gene locus

t(2;8) involves...

the kappa light chain gene locus

what is phenazopyridine?

an analgesic with special properties that can provide pain relief in the GU tract

where do carcinoid tumors commonly metastasize to?

the liver

malignant skin tumor that forms "pearly papules" on sun-exposed skin, palisading of the basal cell-like nuclei at the edge of clusters of cells penetrating into the dermis

basal cell carcinoma

bengin, hyperplastic cells that have a basaloid appearance, pseudo-horn cyst formations, in which small cystic spaces with keratin formation are seen in the epidermis

seborrheic keratoses

what are Roth spots?

fundoscopic lesions/areas of retinal ischemia commonly due to emboli from bacterial endocarditis

1-cm, waxy, flesh colored lesions with a rolled edge, telangiectasias, and central ulceration

nodular basal cell carcinoma

what happens if you adminster epinephrine after administration of an alpha-receptor antagonist like phentolamine?

there's only beta stimulation, so you get increased vasodilation

what are ICAM-1 and LFA-1 necessary for?

diapedesis (passage of cells through intact walls of the capillaries

this tumor has pale-staining, rod-shaped inclusions known as crystal of Reinke and may produce androgens or estrogens

Leydig (interstitial) cell tumor

what is the inability to recognize despite adequate sensation?

agnosia

describe the visual ventral pathway/stream

the "what" pathway, projects to temporo-occipital association cortex

describe the visual dorsal pathway/stream

the "where" pathway, projects to pparieto-occipital association cortex

what is a Baker cyst?

popliteal cyst

from what vein does a hemorrhoid below the dentate line come from? is it painful?

below the dentate line: PAINFUL variscosities in the inferior rectal vein inferior rectal vein --\> pudendal vein --\> internal iliac --\> IVC

from what vein does a hemorrhoid avove the dentate line come from?

above the dentate line: NO PAIN variscosities in the superior rectal vein superior rectal vein --\> inferior mesenteric vein --\> portal system

which selective COX-2 inhibitor can be used in pts with a history of ulcers?

celecoxib

patients with iron or vitamin B12/folate deficiency anemia may have falsely high levels of what?

falsely high levels of HbA1c (seen with low red cell turnover)

what type of epithelium covers the esophagus?

nonkeratinized, stratified, squamous epithelium

describe the musculature of the esophagus

upper 1/3: skeletal middle 1/3: skeletal/smooth lower 1/3: smooth

X-linked condition characterized by thrombocytopenia, immunodeficiency, and eczema (TIE). platelets are small, have a shortened half-life, and are deficient in CD43. serum IgM decreased, serum IgE increased mutation in WASP gene

Wiskott-Aldrich syndrome

this drug is good at treating aspiration pneumonia in alcoholics, lung abscesses, and oral infections, as well as anaerobic infections above the diaphragm

clindamycin

name three big side effects of carbamazepine

bone marrow suppression (agranulocytosis) hepatotoxicity may cause SIADH

what is Ebstein's anomaly?

characterized by apical displacement of tricuspid valve leaflets, decreased volume of the righ ventrical, atrialization of the right ventricle

what is rituximab?

a monoclonal antibody used in lymphoma immunotherapy that specifically targets the CD20 surface immunoglobulin

most common neurological complication of VZV infection?

localized dermatomal pain that persists for more than one month after a zoster eruption

what does lithium therapy do to kidneys?

reduces the ability of the kidneys to concentrate urine primarily by antagonizing the action of ADH in collecting tubules and ducts

what are calcipotriene, calcitriol, and tacalcitol and what are they used for?

topical vitamin D analogs, frequently used to treat psoriasis, they inhibit keratinocyte proliferation and have shown to inhibit T cell proliferation

what heart abnormalities are associated with Turner syndrome (45, XO)?

aortic coarctation, bicuspid aortic valve