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March 25 Flashcards

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1
Q

Acute Respiratory Distress Syndrome (ARDS)

A

injury and inflammation of alveolar pneumocytes and pulmonary endothelium

increased pulmonary capillary permeability –> hyaline membrane formation

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2
Q

Diabetic Nephropathy

A

mesangial expansion
glomerular basement membrane thickening
glomerular sclerosis

Kimmelstiel-Wilson lesion if the sclerosis if nodular

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3
Q

Cardiac Conduction Velocites

A

His-Purkinje 2.2m/s
Atria 1.1m/s
ventricle 0.3 m/s
AV node 0.05m/s

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4
Q

Osteosarcoma

A

bone tumor associated with Paget’s disease of the bone

“mixed lysis and sclerosis with focal periosteal elevation and reactive new bone formation”

mixed radiodense and radiolucent areas
periostal ew born formation
lifting of the cortex

adjacent soft tissue shows “sunburst” pattern of ossification

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5
Q

Dicoumarol

A

vitamin K depletor

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6
Q

MOA Rifampin

A

inhibits mRNA synthesis

via DNA-dependent RNA polymerase

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7
Q

Globus sensation

A

aka Globus hystericus
aka Globus pharyngeus

sensation of “something stuck in the throat: when there isn’t

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8
Q

Endometriosis

A

endometrial glands and stroma out of uterus

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9
Q

Adenomyosis

A

endometrial glands and stroma into myometrium

painful, heavy periods

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10
Q

What vitamin should not be supplemented in pregnancy

A

Vitamin A

can be real teratogenic: abortion, microcephaly, cardiac anomaly

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11
Q

Micturition

A

Stretch of detrusor - pelvic
detrusor contraction - hypogastric
sphincter relaxation - pudendal

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12
Q

Auer Rods

A

t(15:17) APML

tx - all-trans retinoic acid

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13
Q

Chromosomal Translocations

APML
Burkitt Lymphoma
CML
ALL
Follicular
A 
APML - 15:17 #auerrods
Burkitt - 8:14
CML - 9:22 #imatinib
ALL - 12:21
Follicular - 14:18
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14
Q

cytokine exclusive to T-cells

A

IL-2 - only released by T-cells

stimulates growth and differentiation of T, B, NK cels and macrophages

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15
Q

Molluscum contagiosum

A

poxvirus (enveloped linear dsDNA)

flesh colored papules (pruritic) with umbilicated centers contained white, curd-like material

microscopy: large eosiniphilic cytoplasmic inclusions aka cytoplasmic inclusion bodies

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16
Q

Vessel at greatest risk of injury @ Knee Dislocation

A

Popliteal artery is high risk for Anterior and Posterior knee dislocations

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17
Q

Postpartum endometritis

A

occurs after C-section and amniocentesis

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18
Q

Chronic cocaine abuse

A

chronic nasal discharge
atrophic nasal mucosa
perforation of the nasal septum

ulceration/perforation of the palate
oropharyngeal ulcers

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19
Q

Heminephrectomy

A

50% GFR immediately after removal of 1 kidney
65-70% GFR within the first week
80% by 4-6 weeks

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20
Q

Serratus Anterior

A

stabilizes and rotates the scapula upwards

injury causes winging of medial border of the scapula

innervated by the long thoracic nerve

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21
Q

Exocrine pancreatic secretions

A

fixed: High Na, Low K
at low flow: Cl- > HCO3-
at high flow HCO3- > Cl-

stimulate pancreas, shoot out bicarb because we have a big acidic chyme ball incoming

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22
Q

Exocrine salivary secretions

A

fixed: HCO3 > Cl
at low flow: K > Na
at high flow: Na > K

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23
Q

Acute Stress Disorderq

A

PTSD but shorter

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24
Q

Wound Healing 1-3days

A

Inflammatory

cells: platelets, nuetrophils, macs

clot formation, increased vessel permeability, and neutrophil migration

@ day 2 macrophages clear debris

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25
Wound Healing 3days - weeks
Proliferative Phase cells: fibroblasts, myofibroblasts, endothelial cells, keratinocytes, macrophages deposition of granulation tissue, type III collagen, angiogenesis, dissolution of clot,
26
Wound Healing weeks - months
Remodeling Phase cells: fibroblasts replace type II collagen with type I collagen (increases tensile strength of tissue) via metalloproteinases
27
overexpressed in a keloid scar
PDGF platelet derived growth factor
28
Erythema multiforme
infections and drugs (sulfa and beta-lactam) macules, papules, vesicles, target lesions
29
Herpes encepahlitis
tends to affect temporal lobe hallucinations, personality change, delirium
30
Acute Intermittent Porphyria
Autosomal Dominant defect in Porphobilinogen deaminase abd pain, port-wine colored urine, PBG and ALA in urine, neuro changes (restless, irritable, aggressive) precipitated by CYP450 inducers: EtOH, smoking
31
sterile urine cultures and pyuria (puss in the urine)
Chlamydia or neisseria g.
32
Myasthenia gravis
fatigable chewing, diplopia, weakness of the face muscles 10% get thymoma
33
DKA electrolyte changes
increase K decrease Na increase H increase ammonia due to muscle degradation
34
Preoperative medical management of Pheochromocytoma
Phenoxybenzamine - alpha adrenergic blocker prevents hypertensive crisis during removal
35
Intraventricular hemorrhage in a premature infant
due to germinal matrix fragility the germinal matrix @ subependymal zone
36
Cisplatin
ototoxic, damages hair cells in the cochlear membranous labyrinth tx for: testicular, bladder, ovary, lung carcinoma cross-links DNA nephrotoxic, ototoxic, peripheral neuropathy prevent ADRs: amifostine and hydration
37
aspirin-exacerbated airway disease
dysregulation of arachadonic acid pathway towards 5-lipoxygenase pathway --> leukotrienes LTC, LTD, LTE - bronchoconstrictive
38
Birbeck Granules
Langerhans cells S-100+ #langerhanscellhistiocytosis lytic bone lesion + eczema like rash
39
Melanin distribution
Black - free melanin Asian - in a melanosome above the nucleus White - in a melanosome anywhere in the cell
40
Hemodynamic affects of Nitrates
vasodilate --> less preload = Decreased End-Diastolic LV Volume decreased SV and decreased BP reflex Tachy, increase HR to preserve CO
41
Histone Acetylation
Activates - relaxes DNA coiling and allows for transcription
42
Linker Histone
H1
43
Pseudohypoparathyroidism
end-organ resistance to PTH hypocalcemia, hyperphosphatemia, increased PTH short stature, short fingers, round face
44
Allelic heterogeneity
different allele mutations cause same disease presentation ex. mutations in different exons still make beta-thalassemia
45
Exercise-induced asthma
exercise/cold --> shest tightness, wheezing eosinophils and mast cells --> LTC/LTD/LTE --> bronchospasm and increase bronchial mucus secretion tx: Montelukast -antileukotriene medication
46
Hereditary Hemochromatosis
"Bronze Diabetes" hyperpigmentation, arthralgia hepatomegaly --> cirrhosis --> hepatocellular carcinoma DM & hypogonadism & hypothyroidism restrictive/dilated cardiomyopathy excessive iron uptake in the gut
47
Portal Hypertension
can cause increased pressure in the splenic vein --> splenomegaly
48
N-terminal peptide signal sequence of mRNA
targets to RER without this you accumulate in the cytosol
49
MSUD
deficiency in branched chain alpha-keto acid dehydrogenase - requires Thiamine pt presents with severe metabolic acidosis and increased amounts of branched-chain alpha-keto acids in the blood and urine also poor feeding and vomiting inability to decrease Leucine, Isoleucine, Valine
50
Glucagon
Glucagon --> Gs --> adenylate cyclase --> increase cAMP --> PKA --> glycogenolysis and gluconeogenesis
51
Hyperhidrosis
increased sympathetic nervous system activity ANS cholinergic neurons innervate eccrine and apocrine glands Surgical sympathectomy - cut the sympathetic trunk at T2 Thoracic Sympathetic Trunk!
52
Red Safranin
cartilage (collagen type II) = carTWOlage mast cell granules mucin peptidoglycan layer (gram negatives)
53
Gubernaculum remnant in females
round ligament attaches uterus to labia majora via inguinal canal round ligament is covered in broad ligament round ligament is inferior to fallopian tube
54
Pheo outside of adrenals
Paraganglioma origin: chromaffin cells at the organ of Zuckerkandl (which is a collection of chromaffin cells at the aortic bifurcation) these secrete epi and norepi elevated Vanillylmandelic acid (breakdown product)
55
ABG for PE
pH increased CO2 decreased O2 decreased
56
Pulmonary endothelial dysfunction
Pulmonary Arterial Hypertension --> cor pulmonale
57
Uterine Fibroids
aka Uterine Leiomyomas - benign heavy menstrual bleeding due to venous ectasia (dilation) from vasoactive growth factors secreted by the tumors can also present with an irregular and enlarged uterus
58
Ischemic Colitis
crampy abdominal pain, tenderness to palpation, bloody stools early: mucosal hemorrhage and patchy areas of necrosis late: bowel wall thickening, edema, and transmural infarction can be caused by hypoperfusion (shock) or decreased CO (thrombosis and embolism)
59
Why do sclera appear blue in OI?
defective type I collagen --> thin sclerae and visible underlying choroid
60
Medium Chain Acyl-CoA Dehydrogenase Deficiency
hypoglycemia hypoketones hepatomegaly hypoglycemia after fasting + low ketones = impaired beta-oxidation most common cause is MCAD deficiency
61
Protein that functions to transduce signals from the cell membrane to the nucleus by activating other molecules?
Ras (promotes mitogenesis) GTP binding protein proto-oncogene with 1 hit GAIN of function cholangiocarcinoma pancreatic adenocarcinoma
62
Osteoarthritis
progressive erosion of articular cartilage pain is worse with activity and at end of the day increasing age is biggest risk factor other risk factors: obesity, female, trauma, abnormal joint alignment
63
Carcinoid Syndrome
serotonin producing tumor that has metastasized to the liver flushing, hypotension, diarrhea, bronchospasm, pellagra (all the tryptophan is used to make 5-HT, none left to make niacin) tx: octreotide
64
Initiation of translation
5' cap of mRNA binds small rRNA --> scanning for AUG start codon @ apoptosis an alternate method is used IRES (Internal Ribosome Entry Site) allows rRNA binding and translation in the middle of an mRNA
65
DM medication that induces differentiation of preadipocytes into adipocytes and increased GLUT4 expression on the adipocyte cell membrane
Thiazolidinedione ex. Pioglitazone decreased insulin resistance via increased GLUT4 (insulin-responsive glucose transporter @ adipocytes and skeletal muscle)
66
most frequently involved site for Crohn's
terminal ileum
67
most frequently involved site for Celiac
distal duodenum and proximal jejunum
68
treatment for hyperammonemia
lactulose acidifies gut lumen, NH3 comes in and gets trapped as NH4+ for excretion
69
treatment of acute severe asthma attack
Albuterol! beta2-adrenergic agonist activates G2 --> increased cAMP --> bronchial smooth muscle relaxation
70
Osteomalacia
decreased mineralization of Osteoid (generally due to decreased calcium and phosphorus) causes: VitD deficiency, malabsorption, chronic kidney disease, renal tubular acidosis symp: bone pain, tenderness, muscle weakness, fractures
71
Li-Fraumeni
autosomal dominant early onset malignancies (breast, bone, soft tissue, brain, adrenocortical) due to inactivating mutation affecting 1 allele two-hit hypothesis @ tumor suppressor gene (TP53) other genes and syndromes like this Lynch - MSH2, MLH1, MSH6 FAP - APC VHL - VHL MEN1 - MEN1 activating gain of function mutation seen at MEN2A - RET gene
72
Papillomavirus
HPV naked circular dsDNA
73
Poxvirus
Molluscum Contagiosum enveloped linear dsDNA virus
74
Polyomavirus
JC Virus - Junky Cerebrum (progressive multifocal leukoencephalopathy in HIV BK virus - Bad Kidney - transplant pateints naked circular dsDNA
75
ASD murmur
fixed splitting of S2 left to right makes the RV receive extra blood, increased pulmonary blood flow, and delayed closure of the pulmonic valve
76
Esophageal aperistalsis
Achalasia absence of esophageal peristalsis in the distal esophagus and tonic LES
77
G6PD deficiency
acute onset anemia in an African/Asian/Mediterranean individual TMP-SMX, other sulfonamides, fava beans
78
Lesion to Broca's area
Broca's aphasia inferior frontal gyrus of dominant (usually left) hemisphere non-fluent, agrammatic, intact comprehension, poor repetition
79
Normally unmyelinated fibers
slow pain, heat, olfaction. autonomic postganglionic nerves
80
Picornavirus
positive linear naked ssRNA ``` P - polio E - echo (aseptic meningitis) R - rhino C - coxsackie (hand food mouth, meningitis, myocarditis, pericarditis) H - HAV ```
81
MHC class II (HLA-D) antigen presentation
Macrophage/Dendritic cell/B-cell = APC invariant chain brings alpha and beta chains together in the RER invariant chain @ RER --> golgi --> endocytic compartment --> proteolytic degradation --> exogenous protein is then inserted between alpha and beta chains Invariant chain is digested by macrophages during antigen presentation
82
Iron Deficiency Anemia
hypochromic, microcytic anemia tongue pain/ burning sensation in the mouth, dry mouth, reduced taste due to atrophy of tongue papillae, alopecia
83
Quellung reaction
capsular swelling - for encapsulated bacteria
84
PCOS
increased Testosterone
85
PCOS
increased Testosterone
86
Pilocarpine
Cholinomimetic - acts like ACh @ eye causes miosis via contraction of pupillary sphincter muscle stimulator of sweat, tears, saliva
87
Pernicious Anemia
autoimmune destruction of parietal cells --> decreased gastric acid production --> increased gastrin release
88
scrotal mass that is palpable when standing but disappears when lying down?
varicocele
89
Acanthosis nigricans
insulin resistance and obesity malignancy @ GI tract (stomach, liver) and lungs ex. gastric adenocarcinoma
90
Prophylaxis for mechanical prosthetic valve
warfarin = Vitamin K epoxide reductase inhibitor
91
Cardiac anomaly for DiGeorge
disturbed truncus arteriosus --> outflow tract defects like persistent truncus arteriosus (both ventricles to aorta AND pulmonary veins) , interrupted aortic arch, ToF
92
Inositol triphosphate
IP3 @ Gq --> vasoconstriction
93
Infliximab
TNF-alpha inhibitor --> decreased inflammation
94
Collapsing glomerulopathy
Focal Segmental Glomerulosclerosis common HIV-associated nephropathy collapse and sclerosis of the whole glomerulus + glomerular epithelial cell proliferation and hypertrophy
95
Hand-Foot-Genital syndrome
mutation in Homeobox gene HOXA13 --> hypoplastic first digit + mullerian fusion abnormalities
96
Vitamin D supplementation (effects on Calcium, Phosphate, PTH)
increase calcium increase phosphate decrease PTH
97
Citalopram
SSRI also fluoxetine, paroxetine, sertraline
98
Growth Hormone Signaling
Jak-STAT

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