Deck 8 Flashcards by Judy Garland

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

Up to the respiratory bronchioles

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

How well did you know this?

Not at all

Perfectly

What chromosomes and genes are abnormal in CML?

9:22 translocation
BCR-ABL gene
Active tyrosine kinase

How well did you know this?

Not at all

Perfectly

What does the infraorbital nerve innervate? Where is it?

Goes down infraorbital floor through maxilla

Innervates upper cheek, upper lip, upper gingiva

How well did you know this?

Not at all

Perfectly

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

INCREASED breath sounds AND tactile fremitus

Both with be decreased in things like pleural effusion or atelectasis

How well did you know this?

Not at all

Perfectly

Who gets recurrent neisseria infections?

People with complement deficiencies C5b-C9

How well did you know this?

Not at all

Perfectly

What cells secrete what substance to create pus?

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

How well did you know this?

Not at all

Perfectly

What does the speed of conduction via myelin depend on?

Length constant
Time constant

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

How well did you know this?

Not at all

Perfectly

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

Internal iliac artery behind

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

How well did you know this?

Not at all

Perfectly

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

Neuroendocrine cells

Carcinoid tumor- mimics appendicitis when found in appendix

How well did you know this?

Not at all

Perfectly

Person who gets angioedema randomly. What is cellular deficiency?

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

How well did you know this?

Not at all

Perfectly

What cancers is EBV associated with?

nasopharyngeal ca

Burkitt lymphoma

How well did you know this?

Not at all

Perfectly

Which antibiotic cannot be taken with SSRIs?

Linezolid –> has MAOI activity so can precipitate serotonin syndrome

How well did you know this?

Not at all

Perfectly

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

In skeletal and adipose –> increase glucose uptake

In liver –> decreases glycogenolysis and increases glycogen synthesis

In pancreas decreases glucagon secretion for alpha cells

How well did you know this?

Not at all

Perfectly

What antigen is associated with reactive arthritis?

HLA-B27

How well did you know this?

Not at all

Perfectly

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

Anterior = V3 of trigeminal nerve
Posterior is Glossopharyngeal nerve

Chorda tympani = taste for anterior part

How well did you know this?

Not at all

Perfectly

What is motor innervation for tongue?

Hypoglossal nerve CN XII

How well did you know this?

Not at all

Perfectly

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

Airflow resistance - obstructive

elastic resistance - restrictive

How well did you know this?

Not at all

Perfectly

Does restrictive or obstructive lung disease take rapid shallow breaths?

Restrictive - rapid shallow breaths

Obstructive - slow deep breaths

How well did you know this?

Not at all

Perfectly

Which gene is associated with clear cell RCC?

VHL von hippel lindeau
Secrete VEGF and angiogenic growth factors

Tx with anti-VEGF

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

Features of TCA overdose?

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

How well did you know this?

Not at all

Perfectly

What is omilizumab?

Anti-IgE binding antibody, inhibits mast cell degranulation

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

IN female- labia majora

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

How well did you know this?

Not at all

Perfectly

MOA for LMWH and unfraction heparin?

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

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

Metabolize warfarin, put people at risk for stroke via thromboembolism- inadequate anticoagulation Carbamazepine, barbituates, phenytoin, rifampin, St John's wort*, griseofulvin, modafinil, cyclophosphamide

What are CYP450 inhibitors?

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

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

Ca and Po low due to vit D deficiency | PTH high

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

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

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

Z line within the I band for actin | M line within the A band for myosin

What is the definition of a sarcomere?

Z line to Z line | With myosin being the thick part, actin being thin

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

Brown pigment and dilated heart Menstrual cycle helps relieve iron load

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

Histamine and tryptase (specific to mast cells)

What is the stimulus for mast cell degranulation?

IgE receptor aggregation and cross-linking of antigens

What does ALP signify?

Osteoblast activity

What are serum markers of osteoblast activity?

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

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

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

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

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

Where does secretin come from? What does secretin stimulate?

Duodenal cells release secretin in response to H+. Secretin stimulates release of HCO3- from pancreas Cl- secretion decreases as HCO3- increases

What are common causes of polyhydraminos?

Increased urination - high cardiac output, maternal hemorrhage, parvovirus infection Decreased swallowing - GI, duodenal, or esophageal atresia, anencephaly**** Maternal diabetes and multiple gestation

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

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

What tissue does direct hernias penetrate?

Transversalis fascia

What structures are anterior and posterior to esophagus in midsection?

Anterior- LA | posterior - descending aorta

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

Posterior pituitary** | They are SYNTHESIZED in hypothalamus

What does a wide, fixed S2 mean?

ASD present

WHat happens if ASD is left untreated?

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

What does AR do to diastolic pressure?

lowers it. Wide pulse pressure Collapsing pulses (waterhammer) are signs

SE of amphotericin B?

Nephrotoxicity* Increased permiability in distal tubule causing hypokalemia and hypomagnesemia Hypokalemia, weakness and arrhythmias

What are ECG changes with hypokalemia?

Flat T waves, ST depression, U waves

What are symptoms of lead poisoning?

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

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

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

HOw do alcohols and chlorhexidine kill bacteria?

Disrupt cell membrane

Which cleaning agents are active against spores?

Iodine | Hydrogen peroxide

What is antidote for benzo overdose?

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

What is antidote for SSRI overdose?

Cyroheptidine

Antidote for Anticholinergic overdose?

Physiostigmine

Antidote for opiod overdose?

Naloxone

Which antiarrhythmic drugs prolong QT interval?

Class III (K blockers)

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

Amiodarone

WHat do nitrates do to heart?

Decrease preload and end diastolic pressure | Mainly vasodilate venous system with moderate affect on arterioles (so they also decrease afterload)

What type of pericarditis do people with SLE get?

Fibrinous pericarditis | Causes triphasic friction rub

What does raburicase do?

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

How does carbon tetrahydrochloride cause hepatocyte damage?

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

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

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

What causes AS in older adults?

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