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Caleb's Step 1 > March 21 > Flashcards

March 21 Flashcards

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1
Q

Irreversible neuronal injury

A

neuronal shrinkage and intense cytoplasmic eosinophilia

–> Gliosis!

astrocyte proliferation and formation of a glial scar from astrocyte foot processes

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2
Q

Amyotrophic LateraL Sclerosis

A

ALS

atrophic precentral gyrus
thin anterior roots of spinal cord
loss of neurons at anterior horn - LMN lesion
loss of neurons in the hypoglossal and ambiguous cranial nerve nuclei
demyelination of lateral corticospinal tracts - UMN lesion

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3
Q

Relative Polycythemia aka Relative Erythrocytosis

A

normal RBC mass - Hct>52 in men or Hct>48 in women due to dehydration

as opposed to true erythrocytosis - increased RBC mass due to polycythemia vera or hypoxia

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4
Q

Cori Disease

A

defect in Debranching Enzyme

hepatomegaly
ketotic hypoglycemia
hypotonia and weakness
abnormal glycogen with short outer chains

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5
Q

McArdle Disease

A

defect in Muscle Glycogen Phosphorylase

weakness and fatigue with exercise
no rise in blood lactate after exercise
myoglobinuria

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6
Q

VonGierke Disease

A

defect in Glucose-6-phosphatase

Severe fasting hypoglycemia

increased: lactate, TGs, uric acid, liver glycogen (hepatomegaly)
hepatic steatosis

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7
Q

Typhoid Fever

A

Salmonella Typhi

Week 1: Fever, bradycardia, watery diarrhea

Week 2: abd pain +
salmon-colored rose spots on chest/abdomen = faint, erythematous maculopapular lesions

Week 3: HSM and GI bleeds

Salmonella is phagocytized by M-cells –> survive and proliferate in macrophages

complications: bowel perforation

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8
Q

Metabolism in the Mitochondria

A

beta-oxidation of fatty acids
TCA cycle
pyruvate carboxylation of gluconeogenesis

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9
Q

Metabolism in the Cytoplasm

A

glycolysis, fatty acid synthesis, pentose phosphate

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10
Q

elevated HbA2

A

Beta-thalassemia

can give falsely low HbA1c levels in diabetics with beta-thal

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11
Q

Paget’s Disease of the Bone

A

Bone deformity
Hearing loss - due to boney changes in skull

1st: increased osteoclast turnover of bone
2nd: disorganized bone reformation
- -> mixed bone sclerosis and lucency

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12
Q

Osteoclasts

A

multinucleated from mononuclear phagocytic cells that fuse (macrophage variant)

this requires:
M-CSF: macrophage colony-stimulating factor
RANK: NFkB

Osteoblasts have RANK-L aka NFkB-L and osteoclasts have the receptor RANK aka NFkB Receptor

normal osteoclasts have 2-5 nuclei
in pagets dz they have ~100 nuclei

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13
Q

Locations for Thoracentesis

A

Midclavicular @ 6-8th rib
–> lower can injure Right Hepatic Lobe
Midaxillary @ 8-10th rib

Paravertebral @ 10-12th rib

always go above rib!
below –> injury of subcostal neurovascular bundle

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14
Q

Anterior Humerus Dislocation

A

axillary nerve damage

deltoid and teres minor muscles and sensation over lateral shoulder

–> flattening of the deltoid

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15
Q

Pharyngeal Arch 1

A

Makes

Maxilla, Mandible, Muscles of mastication (masseter, temporalis, medial and lateral pterygoids)

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16
Q

Pharyngeal Arch 2

A

Some

Stapes
Styloid
Muscles of facial expression

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17
Q

Pharyngeal Arch 3

A

Interesting

Stylopharyngeus
Greater horn of hyoid

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18
Q

Pharyngeal Arch 4/6

A

Shit

pharyngeal and laryngeal muscles
cricoid and thyroid cartilage

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19
Q

Blinding in experiments prevents

A

Observer Bias

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20
Q

VSD

A

holosytolic murmur @ left sternal border

smaller = louder

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21
Q

Released on mast cell degranulation

A

histamine
MMPs - tryptase (measured)
heparin
eosinophilic chemotactic factors

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22
Q

Thymidine Kinase Independent antiviral

A

Cidofovir
Tenofovir
Foscarnet

for HSV, CMV, HIV

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23
Q

Source of NADPH

A

Pentose Phosphate Pathway

G-6-P –> –> Ribulose-5-phosphate
via G-6-P D (glucose-6-phosphate dehydrogenase)

NADPH restores glutathione for antioxidant activity
NADPH is required for cholesterol, steroids and fatty acid synthesis

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24
Q

Narcolepsy

A

caused by decreased hypocretin (=orexin) from lateral hypothalamus

tx: modafinil > amphetamines

hypnaGOgic -hallucinations while GOing to sleep
hypnopompic - hallucinations upon waking
cataplexy - loss of muscle tone following strong emotions (laughing and crying)

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25
Paroxysmal Nocturnal Hemoglobinuria
mutation in PIGA gene --> GPI (glycosylphosphatidylinositol) deficiency --> CD55 and CD59 deficiency GPI anchors CD55 and CD59 on RBC membranes - these CDs prevent complement-mediated hemolysis Triad: hemolytic anemia, hypercoag, pancytopenia --> PNH
26
Biceps Reflex
C5-C6
27
Triceps Reflex
C7-C8
28
Pick's Disease
Frontotemporal dementia disinhibition, apathy, social inappropriateness, compulsive behavior, irritability/aggression, decreased speech atrophy of frontal and temporal lobes Pick Bodies = cytoplasmic inclusions of tau
29
Alzheimer Disease
neuronal loss in temporal and parietal lobes intracellular neurofibullary tau tangles - hyperphosphorylated tau protein beta-amyloid plaques - extracellular at gray matter decreased ACh (synth at Basal nucleus of Meynert) tx: AChE agonists: donepezil, rivastigmine
30
Neurofibrillary tangles
intracellular hyper-phosphorylated tau protein Alzheimer disease Pick bodies
31
Senile Plaques
extracellular amyloid deposition in gray matter
32
Cytokine associated with Cachexia
TNF-alpha suppress appetite and increase basal metabolic rate
33
Leukocyte Adhesion Deficiency
Autosomal Recessive absence of CD18 CD18 necessary for integrins which are necessary for leukocyte adhesion recurrent skin and mucosal infections with poor wound healing and no pus (no neutrophils at infection site) delayed umbilical cord separation >3weeks persistent leukocytosis - neutrophils trapped in vessels
34
Always give Thiamine with Glucose
glucose without thiamine can precipitate encephalopathy thiamine is required for glucose metabolism, if you only give glucose you will make thiamine deficiency WORSE
35
Phenotypic mixing
host cell is infected with 2 viruses genomes are unchanged progeny are packaged in the others capsid/envelop can infect target animal of other virus but progeny revert back to OG because thats the genome they have
36
Pancreatic islet amyloid deposition
Type II DM
37
Diabetic Opthamoplegia
down and out with reactive pupil and ptosis due to nerve ischemia @ CN III
38
Graft-vs-Host
Weeks after transplant Triad: Hepatitis, Dermatitis, Gastroenteritits
39
Acute Transplant Rejection
Weeks to Months CD8+ against donor MHC I vasculitis of graft vessels with lymphocytic infiltrate Type IV
40
Chronic Transplant Rejection
CD4+ Type II (antibody mediated) and Type IV (delayed) arteriosclerosis
41
Sensory below dentate=pectinate
Pudendal Nerve and its branches (external hemorrhoids @ inferior rectal nerve)
42
Achondroplasia
Autosomal Dominant 2 copies = fatal mutation at FGFR3 (fibroblast growth factor receptor) inhibition of chondrocyte proliferation
43
Statistical Power
1-beta ability to detect a difference when one exists probability of rightfully rejecting a null hypothesis when it is truly false increase sample size : increase power
44
Null Hypothesis = H0
hypothesis that there is no difference/no relationship
45
Alternative Hypothesis = H1
there is a difference
46
Type I error = alpha
false positive, accepting H1 when you should accept H0 saying there is a difference when there is not alpha = probability of making a type I error = p-value if p/alpha is very low we can be confident that we made a true positive.
47
Type II error = beta
false negative = accepting H0 when you should accept H1 saying there is no difference when there is! increase power by decreasing beta increase sample size increase precision of measurement
48
Hyperammonemia and Astrocytes
astrocytes take up excess ammonia in the blood --> increase glutamine production --> increased intracellular osmolarity --> astrocyte swelling --> less glutamine released to neurons --> less glutamine to glutamate conversion in neurons --> disruption of excitatory transmission
49
Measles
paramyxovirus Koplik spots, cough, conjunctivitis, fever rash on face --> trunk --> arms and legs acute infection depletes vitamin A stores giving Vitamin A can speed recovery and decrease morbidity
50
Dermatomyositis
Anti-Jo, CD4+ heliotrope rash = rash @ eyelids and/or SLE-like malar rash plus worsening proximal muscle weakness increased aldolase increased creatinine kinase
51
IFN-beta
MS
52
Where does mRNA processing occur?
``` in the nucleus 5'-cap poly AAA tail intron splicing (in the trash) methylation of 5'Guanine cap ```
53
Alternate to aspirin for stroke prevention?
Clopidogrel blocks the P2Y12 component of ADP receptors at platelet and prevent aggregation
54
increased 14-3-3 protein
Creutzfeldt-Jakob Dz
55
Jet lag
suprachiasmatic nucleus
56
elevated urinary 5-hydroxyindoleacetic acid
carcinoid syndrome elevated 5-HIAA in the urine due to 5-HT breakdown
57
Secondary bacterial pneumonia after influenza infection in pts >65
step pneumo > staph aureus > haemophilus influenzae
58
Clostridium perfringens
anaerobic gram positive bacillus gas gangrene food poisoning --> transient watery diarrhea
59
Cardiac tamponade
Becks Triad - JVD - hypotension - diminished heart sounds + pulsus paradoxus - inspiration causes drop is systolic BP >10mmHg
60
Adrenal Crisis
Seen in pts with adrenal insufficiency ``` severe hypotension abd pain vomiting weakness fever ``` give fluids + glucocorticoids
61
Cheyne-Stokes breathing
advanced congestive heart failure | dying patients
62
Thoracic outlet syndrome
compression of the brachial plexus lower trunk @ the scalene triangle scalene triangle: anterior and middle scalene and 1st rib symp: upper extremity numbness, tingling weakness, pain
63
Methotrexate causes an accumulation of
dihydrofolate polyglutamate inhibits DHFR = dihydrofolate reductase
64
Drug-Induced Lupus
``` Hydralazine Procainamide Isoniazid Minocycline Quinidine ``` +ANA +anti-histone no anti-dsDNA
65
Osteoporosis drug similar to pyrophosphate
bisphosphonates alendronate riseronate bind to hydroxyapatite preferentially in areas of increase osteoclast activity --> taken up by osteoclasts --> osteoclast dysfunction :) decrease osteoclast activity (also increase osteoclast apoptosis)
66
Decreased choline acetyltransferase activity at nucleus basalis
Alzheimers Dz decreased ACh in basal nucleus of Meynert
67
Vitamin E deficiency
Vitamin E is an antioxidant hemolytic anemia - RBCs receive more oxidative damage degeneration of spinocerebellar and dorsal column - ataxia, impaired proprioception
68
Periodic Acid-Schiff (PAS) Stain
highlights glycogen and glycoproteins polysacchrides of fungal cell walls mucosubstances from epithelia basement membranes alpha-1-antitrypsin deficiency @ liver
69
spindle cells with surrounding blood vessel proliferation
Kaposi carcoma
70
Metabolism of 6-MP (6-mercaptopurine)
inactivation by xanthine oxidase | activated by HGPRT
71
Silicosis
eggshell calcification of hilar lymph nodes | birefringent silica particles surrounded by dense collagen fibers

Caleb's Step 1 (16 decks)

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