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Flashcards in first assessment Deck (96):
1

paget's dz of bone increases risk of

osteosarcoma; destruction of normal bone pattern, mixed radiodense/radiolucent areas, periosteal new bone formation, lifting of the cortex, "sunburst" pattern of adjacentsoft tissue

2

radiographic sign of avascular necrosis

crescent sign (subchondral collapse)

3

globus hystericus

sensation of a "lump in the throat" with no exam findings

4

vitamin A toxicity

micrcephaly, cardiac anomalies, early epiphyseal closure, growth retardation, spontaneous abortion

5

DNA laddering

used to distinguish apoptotic cells from necrotic cells; during karyorrhexis, endonucleases degrade DNA into 180 base pair fragments, equally spaced on gel electrophoresis

6

physostigmine

cholinesterase inhibitor

7

atropine

competitive inhibitor of acetylcholine

8

pralidoxime

antidote to organophosphorus anticholinesterase that inhibit cholinesterase through phosphorylation

9

anticholinergic toxicity

confusion, blurred vision, dry MM, intense thirst

10

acute promyelocytic leukemia

t(15,17)

11

burkitt lymphoma

round nuclei with basophilic cytoplasm containing prominent lipid vacuoles; t(8,14)

12

chronic myelogenous leukemia

immature myeloid cells t(9,22)

13

acute lymphocytic leukemia

t(12,21)

14

follicular lymphoma

malignant cells with notches or clefts; t(14,18)

15

IL-2 produced by, moa

antigen-stimulated T cells; stimulate growht and differentiation of T cells (binds IL-2R), B cells, NK cells, and macrophages

16

IL-1 produced by, moa

macrophages, activates lymphocytes and stimulates systemic illness (fever, lethargy, anorexia)

17

TNF-alpha produced by, fxn

activated macrophages, induces systemic inflammatory response (and in high levels, causes shock)

18

interferon-alpha produced by, fxn

monocytes, macrophages, B cells, NK cells; antiviral functions (replication inhibition w/i cells, protection of uninfected cells, and stimulation of cytotix lymphocyte and NK cell antiviral activity)

19

GM-CSF produced by, fxn

macrophages, t cells, Nk cells, mast cells, endothelial cells, and fibroblasts; stimulates rpoduction of granulocytes and monocytes

20

cadherins

Ca-dependent transmembrane proteins that participate in desmosome formation with cadherins of adjoining cells; do not parcitipate in hemidesmosome function

21

hemidesmosomes structure, fxn

integrin-mediated binding to basement membrane (type 4 collagen), facilitated by fibronectin

22

acid chyme in duodenum triggers what response?

1. gallbladder bile release, and 2. stimulates S-cells in the crypts of lieberkuhn to release secretin into systemic circulation which stimulate pancreas to release bicarb-rich fluid (via CL/bicarb exchange protein on the apical surface of the pancreatic cells)

23

endometritis

uterus infection; fever, leukocytosis, uterine tenderness and foul discharge; most commonly caused by bacteroides

24

nunmular eczema

occurs in xerosis (dry skin); pw pruritic, coin-shaped, erythematous patches

25

sublimation vs displacement

former is a mature defense mechanism where one channels socially unacceptable thoughts/impulses into acceptable actions

26

tyrosine kinase receptor structure, and signals that use tyrosine kinase receptor

transmembrane proteins with ligand-binding extracellular region, hydrophobic transmembrane regino, and intracellular domain that dimerizes and has inducible tyrosine kinase activity; insulin, epidermal growth factor, PDGF and VEGF

27

receptor mediated endocytosis moa, example

receptors are pooled in clathrin-coated regions ("pits") that are internalized upon binding; LDL receptor

28

interview: reflection vs summarizing

repeating what pt said; summarizing has multiple ideas

29

vasomotor rhinitis

chronic nasal congestion that worsens with abrupt changes in temperature/humidity or exposure to odors/alcohol

30

heminephrectomy effect on GFR

immedatiely, 50 percent; compensatory hyperfiltration and hypertrophy of remaining neurons leads to 80 percent in several weeks

31

erection intracellular moa

local release of NO increases activity of GC, stimulating cGMP which relaxes smooth muscle around the cavernous venous sinus of the corpora cavernosa

32

HSV encephalitis

m/c, affects both immunocompetent and immunosuppressed; affects temporal lobe, so pts can present with seizures, personality changes, psychosis on top of fever, HA, and malaise

33

bunyavirus encephalitis

transmitted by mosquitoes, rarely fatal and cause transient infection with HA and fever

34

AIP

excess porphobilinogen and aminolevlinic acid in urine; many asymptomatic; begins after puberty, folllows consumption of drugs that increase heme synthesis; pw severe vague abdominal pain, N/V, motor/sensory neuropathy; no cutaneous findings/photosensitivity, completely symptom free between attacks

35

1st heart sound

closure of AV valve as systole begins

36

2nd heart sound

closure of the semilunar valves

37

light criteria

pleural protein/serum protein > 0.5; pleural LDH/serum LDH > 0.6; pleural fluid LDH > 2/3 upper limit of normal LDH

38

spherocytes

dense, spherical erythrocytes with no central pallor, increased MCHC

39

sickle cell/thalassemia on osmotic fragility test

decreased osmotic fragility

40

echinocytes / burr cells (RBC with multiple surface proejctsion) means?

uremia or pyruvate kinase deficiency

41

hereditary retinblastoma moa

germline mutation in tumor suppressor RB1 gene (c13); example of knudson's 2 hit hypothesis

42

parental imprinting

preferential transcription of genes from a set of a homologous pair of chromosomes depending on the parental origin of the chromosomes (e.g. prader-willi, angelmans)

43

DKA: moa for hyperkalemia and hyponatremia

1. hyperkalemia: decreased insuline (cant drive K into cells) and H+/K+ exchanger; 2. hyponatremia: osmotic activity of glucose and hyperglycemia-induced osmotic diuresis

44

arnold-chiari malformation

downward displacement of elongated cerebellar tonsils through foramen magnum and into upper cervical canal; CSF is blocked

45

dandy walker malformation

enlarged posterior fossa, absent/shrunken cerebellar vermis is replaced by large, midline cyst

46

syringobulbia

fluied-filled cavities within medulla oblongata

47

male genotype and female phenotype with normal external female genitali and blind-pouch vagina

complete androgen insensitivity syndrome

48

leydig cell agenesis

male pseudohermaphroditism that presents with complete external female genitalia; LH/FSH levels are increased while testosterone levels are decreased

49

phenoxybenzamine moa

irreversibly alkylates alpha-adrenergic receptors, with half life of 24 hours

50

intraventricular hemorrhage in premature/respiratory distress syndrome infant

germinal matrix (highly cellular and vascular regino that generates neurons and glia during fetal development; no network fibers are present, which makes it vulnerable to hemorrhage)

51

amiodarone lung SE

delayed-onset/chronic interstitial pneumonitis

52

procainamide lung SE

delayed onset pleuritis generally associated with drug-induced SLE

53

PG1 function; why does it get low; and how to fix

stimulate gastic epithelial cell mucous production and decrease parietal cell acid secretion; NSAID use; misoprostol is a PGE1 analog that binds to plasma membrane prostaglandin receptors

54

palmitoylation

method to increase hydrophobicity of a protein by attaching a FA that is covalently anchored to PM cysteine residues (GPCR, V2 vasopressin)

55

hereditary albright osteodystrophy moa, pw

pseudohypoparathyroid; end-organ resistance to PTH, TSH, and LH/FSH; pw skeletal/development defects (short stature, short metacarpal/metatarsal bones) and end-organ resistance to PTH

56

allelic heterogeneity

different mutations in same genetic locust cause similar presentatinos (duchenne vs becker)

57

phenotypic heterogeneity

mutatinos in the same gene result in different phenotypes

58

bronchial asthma pathogenesis, rx

leukotriene D4 is synthesized by eosinophil/mast cells; induces bronchospasm and increase bronchial mucous secretion; anti-leukotriene medicatino like montelukast antagonists leukotriene D4 activity at the cysteinyl leukotriene receptor

59

hemochromatosis moa, pw

AR excess GI absorption of iron, annual increase in stored Fe; hepatomegaly, hyperpigmentation, DM 2/2 pancreatic islat destruction, impotence, arthropathy and cardiac dysfunction (bronze diabetes); lab findings: elevated plasma iron with more than 50 percent saturation of transferrin, and elevated serum ferritin

60

cirrohosis results in enlargement of what other organ

spleen 2/2 portal venous hypertension causing splenic vein hypertension

61

indirect ELISA

anti-human IgG antibody coupled to a substrate-modifying enzyme (peroxidase) binds to serum antibodies bound to antigen; finally, substrate that is modified by the enzyme to elicit a detectable signal is added to see if the serum antibody is present

62

s. epidermis found in wound culture: what does it mean?

normal skin flora, not commonly associated with skin disease; regard as contaminant

63

achondroplasia moa

AD point mutation (arg for gly in position 375) of FGFR-3 on c4, which causes increased function of FGFR-3 which inhibits cartilage proliferation; pw shortened proximal extremities (with normal trunk length) and enlarged head with frontal bossing

64

bruton's agammaglobulinemia

X-linked defect in the signal transduction molecule known as bruton's tyrosine kinase which is important in B cell maturation

65

signal recognition particles

recognize translatin of N-terminal sequences in the cytosol, after which they halt translation and carry ribosome to RER so that the polypeptide is fed into RER; composed of 15-20 AA, mostly hydrophobic

66

maple syrup urine dz moa

defect in branched-chain alpha-keto acid dehydrogenase complex, responsible for catabolism of leucine, isoleucine and valine; requires B1 as a coenzyme

67

hydrops fetalis

severe form of alpha-thalassemia with four nonfunctional alpha globulin loci, pw pallor, edema, and massively enlarged liver (extramedullary hematopoesis)

68

how does the seminiferous tubules and epididymis concentrate testosterone?

sertoli cells produce androgen-binding protein which binds to testosterone/dhydrotestosterone and makes these hrmones less lipophilic, allow them to be concentrated in the luminal fluid

69

RAS-GTP cascade

Ras-GTP triggers mitogen-activated protein kinase cascade that controls entry of cell into cell cycle; intrinsic GTP-ase converts oncoprotein back to GDP-Ras; many tumors have reduced GTPase activity that allows continued GTPase activity

70

glucagon moa

promotes glycogenolysis and gluconeogeneis in hepatocytes; enhances activity of AC, increases cAMP, activates glycogen phosphorylase;

71

epinephrine affects glycogenolysis and gluconeogensis how?

bind to beta-2 receptor on hepatocytes, which activates Gs and adenylate cyclase

72

sweating moa

SNS activation of eccrine (cholinergic) and apocrine glands

73

hyperhidrosis rx

systemic antiCh, local ACh injectables like botulin toxin, and surgical sympathectomy of the thoracic sympathetic trunk (for axillary)

74

red safranin O stains for

cartilage, mast cells, and mucin

75

cartilage in articular cartilage

hyaline cartilage, chondrocytes embedded in a matrix of proteoglycans and collagens

76

keratin is

cytplasmic intermediate filament produced by squamous cell cells of skin

77

sphingomyelin is

found in myelin sheath

78

round ligament

vestige of the gubernaculum, projects from uterus through the inguinal canal into labia majora

79

NE to epi; epi to metanephrine requires what biochemical steps?

methylation

80

platelet activating factor (PAF)

phospholipid inflammatory mediator (works via Gq pathway) that causes platelet aggregation (with microthrombus formation), bronchoconstriction, vasoconstriction

81

platelet activation has what kind of intracellular pathway?

IP3-mediated release of Ca from the ER

82

prostaglandin fxn and synthesis pathway

strongly inhibits platelet functions and increase platelet cAMP synthesis by stimulating adenylate cyclase; COX convert AA to PGH2, the precursor to prostaglandin

83

vanc-induced red man syndrome is not what

though it releases histamine from mast cells, it is not an IgE mediated reaction

84

cyclin D1

promotor of G1 to S phase transition

85

Km

inversely related to affinity of the enzyme for substrate; affected by competitive agonists (lower affinity, higher Km); unrelated by amount of enzyme

86

bile salt function in GI system

microbicidal emulsifying agents that disrupt the outer membrane of GN enteric bacili; chronic cholestatsis permits bacterial overgrowth and translocation across the gut wall in the distal small intestine

87

prokaryote

haploid genome consistenting of single chromosome, no nuclear membrane

88

eukaryote rRNA synthesis

28, 18, 5.8S rRNA formed from single 45S pre-rRNA, transcribed by RNA polymerase I; 5S rRNA formed separately by RNA polymerase III

89

rosiglitazone/thiazolidenones

PPAR agonist that increases GLUT-4 expression at SK and adipose tissue, which increases insulin sensitive glucose uptak

90

change in warfarin metabolisms manifests clinically in how many days?

gradually

91

lactulose moa in HE rx

acidifies GI content, converting NH3 to NH4

92

ostemalacia (2/2 vita D deficiency): bone type

excessive, unmineralized osteoid matrix in bone

93

MEN1 vs MEN2: difference in gene mutation

MEN1 loss of tumor-suppressor gene; MEN2 gain of function mutation on protooncogene

94

HNPCC increase risk of

colorectal and endometrial cancer

95

papomavirus

papillomavirus and polyomavirus, replicate within host cell nucleus

96

poxvirus unique characteristics

among DNA viruses, only one that replicates in cytoplasm