Myasthenia Gravis type ? hypersensitivity disorder?
Name another type ? hypersensitivity disorder.
Type II
Ab (IgG or IgM) binds to extracellular Ag or extracellular matrix components
also Type II is Goodpasture
Wolff Parkinson White syndrome
- name of accessory pathway
- part of the ECG affected and how
- bundle of Kent
- affects PR interval: shortened PR interval
affects QRS interval: elongated QRS
adds pre-excitation bump called a delta wave just before the nl Q wave, shortens the PR and elongates the QRS
Goodpasture syndrome
Type ? hypersensitivity disorder
Type II
Ab to GBM
Copper abs in the GI
In the liver copper is bound to ___________ to become __________.
Excreted into ____________.
alpha-2 globulin to form ceruloplasmin
excreted 85-95% into bile and stool
5-15% excreted renally
CN’s involved in the consensual light reflex
CN II afferent (in)
CN III efferent (out)
CN III palsy ssx
- ptosis
down & out gaze (unopposed lateral rectus VI and sup. oblique CN IV) - ciliary m. & iris sphincter (CN III parasympathetics) = fixed dilated pupil & loss of accommodation
most dreaded cause of CN III palsy
enlarging intracranial aneurism
bounding femoral pulse and carotid pulse assoc. with head bobbing.
which valve is affected and how?
Aortic regurgitation
bounding pulses due to increased left ventricular stroke volume
C. diphtheria AB toxin mechanism of action
A subunit attaches
B subunit enters cell: RYBOSYLATION. transfer ribose from NAD to histidine residue on EF-2. Inactivates EF-2 and inhibits protein synthesis -> cell death
FT-AB tests for…
Syphilis
tertiary syphilis effect on the heart
obliteration of vaso vasorum -> medial tear -> thoracic aortic aneurysm
preferred method for early detection of diabetic nephropathy
microalbuminuria (30-300 mg/day in 24 hr urine collection OR 30-300 micrograms / mg of creatine in spot test)
% of coronary blood flow during systole vs. diastole
30% systole
70% diastole
during systole compresson vessels limits flow/perfusion. during strenuous exercise increased HR and decreased diastole time is limiting factor for coronary blood flow
warfarin molecular mechanism of action
blocks glutamate residue carboxylation
Treatment for Acute Manic Episode
- Lithium
- Valproate
- Carbamazepine
+ - Atypical (Olanzapine)
Tx is effective in only 60% of pts
Aortic Regurgitation Murmur
Early Diastolic
Duration of murmur = severity of regurge
worse regurge = longer duration, even to holosystolic
less bad regurge = early
oxytocin production
paraventricular nuclei of the hypothalamus
ADH (vasopressin) production site
Supraoptic nucleus of the hypothalamus