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Flashcards in miscellaneous Deck (125):
1

liquefactive necrosis

Enzymatic digestion of cells. Necrosis associated with bacterial and fungal infection and abscesses. Common in CNS.

2

splenic rupture presentation

scenario: blunt abdominal trauma + abdominal pain radiating to left scapula + marked hypotension + peritoneal hemorrhaging.

3

structure passing beneath uterine arteries

ureter

4

Weber Test, analyzing results

Lateralizes to affected ear in cases of conductive deafness and to the normal ear in cases of sensorineural hearing loss.

5

proteoglycans and clinical significance

1) Heavily glycosylated proteins that form a component of the ECM.
2) Inability to break down proteoglycans is characteristic of mucopolysaccharidoses (lysosomal enzymes usually break them down).

6

Enzyme kinetics - kcat

Turnover number -- the number of substrate molecules each enzyme site converts to product per unit time.

7

Treatment for bilateral hydronephrosis

Acute treated by insertion of a nephrostomy tube. Chronic treated by insertion of a stent.

8

Foley catheter use?

Foleys are just a flexible tube inserted through urethra and into the bladder for people who can't urine (eg BPH, sedated, genital injury)

9

Locations of fat necrosis

pancreas, breast, salivary glands, neonates after a traumatic delivery.

10

hyaluronic acid

Glycosaminoglycan that is a chief component of ECM.

11

exercise electrolytes...

hyponatremia

12

phospholamban

Protein that regulates the calcium pump in cardiac muscle and skeletal muscle cells.

13

melena indicates...

upper GI bleed

14

Proteoglycans and relevance

Heavily glycosylated proteins that basically serve to absorb water and maintain lubrication. This is why pleura and peritoneum are rich in proteoglycans.

15

C-jun

Transcription factor involved in cardiac remodeling. Increased with cardiac disease

16

endothelin and cardiac relevance

Implicated in cardiac remodeling. Thus, will go up with heart disease.

17

How do you distinguish between choriocarcinoma and GTN?

No villi in choriocarcinoma

18

Choriocarcinoma vs. gestational trophobolastic disease

Choriocarcinoma is a malignancy of the trophoblastic tissue on the malignant end of the spectrum in gestational trophoblastic disease.

19

trophoblast

Cells forming the outer layer of a blastocyst.

20

anti-Jo 1 targets

tRNA

21

Normal reflexes

2+

22

osteoclast markers

1) hydroxyproline
2) deoxypyridinoline

23

fibronectin

Part of ECM that binds integrins, providing structural support.

24

Aldosterone escape -- why does chronic aldosterone not lead to edema in hyperaldosteronism?

Increased Na and water reabsorption causes back flow of Na and water into the tubules.

25

How does aldosterone increase Na reabsorption?

Stimulation of ENac channels in principal cells of the renal collecting tubules.

26

Receptor that endotoxin binds to to activate macrophages?

TLR4 (CD14)

27

Problem with occult blood testing for CRC?

Low sensitivity (specificity is high)

28

Buerger's...

Berger = IgA nephropathy
Burger = thromboangiitis obliterans

29

Accelerated atherosclerosis

Chronic transplant rejection in the heart.

30

Normal A-a gradient

10-15 mm Hg

31

paraesophageal hernia vs. sliding hiatal hernia

sliding hiatal hernia --> esophagus slides up. GEJ moves up.
paraesophageal hernia --> fundus protrudes into the stomach.

32

What do you give someone for severe anemia?

Packed RBCs

33

What do you give someone for acute blood loss?

Packed RBCs

34

Wilms tumor characteristic

Highly vascularized

35

Neuropathy pain description

Burning pain

36

Pralidoxime MOA

Binds to AChe and regenerates AChE.

37

Organophosphate poisoning mechanism

AChE inhibitors

38

Inhibitory neurotransmitters

Glycine + GABA

39

Stimulatory neurotransmitter

Glutamate

40

antimuscarinic used to inhibit oral secretions

glycopyrrolate

41

Aspirin affect on PT, PTT, bleeding time.

- Increases bleeding time.
- No affect on PT or PTT.

42

Conversion disorder + presentation + epidemiology

- Loss of sensory or motor function (eg paralysis, blindness, mutism) often following an ACUTE stressor.
- Patient is aware of but sometimes indifferent toward symptoms.
- More common in females + adolescents + young adults.

43

Primary hypothyroidism vs. central (secondary) hypothyroidism

Primary = inadequate function of the thyroid gland. TSH will be elevated.
Secondary = Not enough stimulation by TSH. TSH will be low.

44

location of sella turcica

https://www.google.com/search?q=sella+turcica&biw=1149&bih=556&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwi-95Kz2vHLAhVpvoMKHVRPBxkQ_AUIBigB#imgrc=Lsaj4pZ8HUEHGM%3A

45

Most common type of pituitary adenoma

prolactinoma

46

Where are very long chain fatty acids metabolized?

peroxisomes

47

Antisocial personality disorder presentation

History of criminality and impulsivity. More common in males. Must be over 18. Disregard for and violation of rights of others.

48

ABO hemolytic disease of the newborn presentation

Mild jaundice in the neonate within 24 hours of birth.

49

How does histamine cause edema? AKA MOA for edema in anaphylaxis...

Causes gap formation between endothelial cells.

50

Origin of connective tissue (fibroblasts, etc.)...

mesoderm

51

paraxial vs. intermediate mesoderm

Pretty much all impt mesoderm-derived structures are from paraxial mesoderm (muscle, connective tissue and dermis)

52

cervix drainage

internal iliac

53

lupus hematologic abnormality

thrombocytopenia (antibodies against platelets)

54

IkB function in NF-kB pathway

Releases NF-kB after undergoing phosphorylation

55

Insulin-dependent Type 2 DM

They lose ability to synthesize insulin thus blood levels will be very low.

56

Diphtheria vaccine mechanism

Killed toxin (toxoids)

57

Fat necrosis in pancreatitis mechanism

pancreatic enzymes autodigesting cells

58

Origin of adrenal medulla

neural crest cells

59

why is prolactin increased with craniopharyngiomas or pituitary adenomas?

compression of the pituitary stalk and reduced inhibition by dopamine.

60

respiratory zone histology

Mostly cuboidal cells in respiratory bronchioles, then simple squamous cells up to alveoli.

61

When do cilia terminate?

respiratory bronchioles (since cilia everywhere except alveolar ducts and alveoli)

62

good syndrome

paraneoplastic hypogammaglobulinemia associated with thymoma

63

explain epinephrine reversal

epinephrine is an agonist at A1,A2, B1,B2. give phentolamine after epic, thus epic can only stimulate beta receptors, which produces a decrease in BP.

64

Large difference in blood pressure between upper and lower limbs in an older person think...

severe atherosclerosis

65

Flow through what artery is responsible for perfusion of lower extremities in pt with aortic coarctation?

Internal thoracic (mammary) arteries

66

First line drug for T2DM

sulfonylureas

67

2nd gen sulfonylureas

**glimepiride
glipizide
glyburide

68

difference between adenomatous polyps and hyperplastic polyps

Adenoma means nuclear atypia by definition (dysplasia).
Hyperplastic is a proliferation of glands without atypia.

69

Differentiating serrated and hyperplastic polyps

Both have a saw-tooth pattern, but serrated are premalignant so should have neoplastic features.

70

Polyp genetics

BRAF ---> serrated
Adenomatous (villous and tubular) --> APC + KRAS

71

berger presentation + impt lab feature

***RBC casts
*glomerulonephritis post gastroenteritis
*serum complement remains normal

72

explain lead-time bias.

False estimate of survival rates. Patients seem to live longer with a disease if a screening test picks it up but there's no effect on outcome, there just diagnosed earlier.

73

GI secretory cells in the antrum

G cells
D cells

74

Miosis pathway

1) 1st neuron: Edinger-Westphal nucleus to ciliary ganglion via CN III
2) 2nd neuron: short ciliary nerves to pupillary sphincter muscles.

75

Mydriasis pathway

1st neuron: hypothalamus to ciliospinal center of Budge (C8-T2)
2nd neuron: exit at T1 to superior cervical ganglion (travels along cervical sympathetic chain near lung apex, subclavian vessels)
3rd neuron: plexus along internal carotid, through cavernous sinus; enters orbit as long ciliary nerve to pupillary dilator muscles. Sympathetic fibers also innervate smooth muscle of eyelids (minor retractors) and sweat glands of forehead and face.

76

CN III carries what type of fibers?

Parasympathetics.

77

Adduction of the thumb is a function of what nerve?

Adductor pollicis, which is innervated by ulnar

78

Surface location of spleen

Lies between 9th and 11th ribs

79

"popping" of LP indicates...

Penetration of the dura

80

thoracentesis

/invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. /always ABOVE the rib so as not to poke vessels or nerves of the rib. Blocks of hash + ivy running up and down midclavicular/midclavicular line = between 6th and 8th ribs. ivy + ties running up and down midaxillary line/midaxillary line = between 8th and 10th ribs. tin cans lining midscapular line + red ties wrapped around them/paravertebral line = between 10th and 12th ribs.

81

Thoracostomy

Think of picture below with tube covered in hair and hailing onto the chest/chest tubes (thoracostomy) are placed into the 4th or 5th intercostal space in the midaxillary line through the serratus anterior line.

82

How does cortisol increase conversion of NE to epinephrine in the adrenal medulla?

Increasing the expression of phenylethanolamine-N-methyltransferase.

83

Larynx muscle innervation

Recurrent laryngeal innervates all the intrinsic muscles of the larynx except for the cricothyroid muscles, which is innervated by the superior laryngeal nerve.

84

Overall stage grouping for cancer:

Stage 0: Carcinoma in situ
Stage I: Cancer localized to one part of the body.
Stage II: Locally advanced cancer.
Stage III: Locally advanced. specific staging of II or III depends on cancer type.
Stage IV: Metastasis.

85

Ang II mechanism in adrenal cortex

Stimulates aldosterone synthase

86

Glycyrrhetic acid (active ingredient in licorice) mechanism in adrenal cortex

Inhibits cortisol --> cortisone

87

17,20 lyase mechanism

17-hydroxypregnenolone --> DHEA
17-hydroxyprogesterone --> androstenediione

88

origin of adrenal gland

medulla from neural crest, cortex from mesoderm.

89

Omphalomesenteric cyst is just a...

viteline duct cyst

90

Normal saline concentration

0.9

91

saline to use for sepsis

0.9 (normal saline)

92

hypertonic saline concentration

3%ase

93

How do you give bad news....

be honest and tell them it's bad.

94

Enzyme that converts dopamine to NE

dopamine beta-hydroxyl

95

cofactor for carboxylation reactions

biotin

96

Don't confuse ADRENAL with RENAL medulla

ok

97

paralysis caveat

Can still by hyper reflexive.

98

What happens with cold and blood flow physiologically?

Shunts blood toward central organs and vasoconstricts peripheries. Body doesn't want to lose heat.

99

Central blood volume

Combined volume of blood in heart, lungs, and arterial tree.

100

Cytokines mediating sepsis

**IL-1
Pas
TNF-alfa
Interferon

101

Primary sites of gluceoneogenesis other than the liver

Kidney
Intestinal epithelium

102

Eremites -- what does increase or decrease indicate?

Increase = denser or inflamed lung tissue.
Decrease = air or fluid in pleural spaces.

103

Temperature sensitive cells in the gonad and metabolic effects of cryptorchidism

*sertoli cells are temp sensitive.
*

104

Examples of psychomotor agitation

- wringing one's hands
- uncontrolled tongue movements
- ripping, tearing, chewing at skin
- biting nails

105

what nerve transmits the cremasteric reflex?

Genitofemoral nerve

106

SIGECAPS caveat

9th symptom is depressed mood.

107

agraphesthesia due to

parietal lobe damage

108

agraphesthesia

Disorder of directional cutaneous kinesthesia (can tell orientation of skin sensation across space)

109

babesiosis on smear

1) ring forms
2) maltese cross

110

gamma hemolysis means..

no hemolysis

111

gamma-hemolytic bugs

1) S bovis
2) enterococcus

112

All hindgut innervation is..

pelvic splanchnic

113

External anal sphincter innervation...

pudendal

114

Location of SA node

Junction where SVC enters the right atrium.

115

Corticosteroids immunosuppressive effects

1) Inhibit NF-kappaB
2) Suppress both B- and T-cell function by decrease transcription of many cytokines.
3) Induce apoptosis of T lymphocytes.

116

Classic immune cell elevated in Hodgkin's

eosinophils due to increased IL-5

117

Listeria catalase negative or positive?

Positive

118

Catalase positive organisms

Cat-s Need PLACESS to Belch their Hairballs
Nocardia
Pseudomonas
Listeria
Aspergillus
Candida
E Coli
Staphylococci
Serrate
B cepacia
H pylori

119

Thyroid type with high output cardiac failure

Hyperthyroidism (due to increased beta receptors)

120

omeprazole interactions

Inhibits absorption of drugs that depend on an acidic environment, such as ketoconazole or atazanavir.

121

21-hydroxylase deficiency pathophys

Defective conversion of 17-hydroxyprogesterone to 11-deoxycortisol. This leads to a buildup of 17-hydroxyprogesterone.

122

Mineralocorticoids in 11beta-hydroxylase

1) decreased aldosterone
2) Increased 11-deoxycorticosterone (results in higher BP)

123

when do you get decreased androstenedione?

17alpha-hydroxylase deficiency

124

osteoprotegerin

Decoy receptor for RANKL, thus inhibits osteoclast action.

125

Gastrosplenic contains what vasculature?

Short gastric + left gastroepiploic