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missed qs Flashcards

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1
Q

hyperparathyroid bones

A

subperiosteal thinning; subperiosteal erosions of phalanges and salt and pepper calvarium on radiology

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2
Q

vit d deficient bones

A

unmineralized osteoid and widened seams

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3
Q

Paget’s bones

A

mosaic in lamellar bone, linked by cement lines

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4
Q

osteopetrosis bones

A

marble bone disease: unmineralized spongiosa in the medullary canals, (nl ppl replace w/marrow)

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5
Q

patient w/bitemporal hemianopsia and hyperCa what other tumor is likely

A

pancreatic bitemporal: pituitary hyperCa: PTH –> probably has MEN1

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6
Q

pathologic findings of cushing’s disease or ectopic ACTH cushing’s syndrome

A

hyperplasia! of fasiculata and reticularis (think congenital adrenal hyperplasia)

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7
Q

another name for somatomedin c

A

IGF-1

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8
Q

sensitive test for menopause

A

FSH (LH increases later)

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9
Q

insulin efffects: intrinsic TK–> what?

A

protein phosphatase: dephopsphorylates glycogen phosphorylase kinase and dephos glycogen synthase-> decr. glycogenolysis and incr. glycogen synthesis

and F16bPase –>glycogen synthesis and glycolysis

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10
Q

congenital adrenal hyperplasia tx

A

exogenous steroids–>suppress ACTH

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11
Q

Kallman syndrome

A

defective olfactory placode migration–>no GnRH secretors–>hypogonad and anosmia

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12
Q

anastrazole mech

A

aromatase inhibitor; for metastatic breast cancer

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13
Q

ketoconazole mech

A

decr. androgen synthesis

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14
Q

HER2/new activation–>which path

A

TK

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15
Q

Beta hydroxybutyrate: what is it

A

marker of insulin deficiency DM1 only

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16
Q

homocystinemia and insulin connection? atherosclerosis? tx effect

A

no insulin connection does –>athero folic acid tx helps

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17
Q

TZD mech

A

bind PPARy, an intracellular nuclear receptor

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18
Q

GLP-1 receptor

A

surface–>cAMP

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19
Q

complete vs. partial DI

A

complete: rise more than 50%

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20
Q

If someone has permanent central DI, where was the damage

A

hypothal NOT post. pit if it’s the pit that’s damaged, hypothal nuclei regenerate axons : )

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21
Q

prolactinomas and estrogen

A

untreated–>low E–>osteoporosis etc

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22
Q

glucagonoma symptoms

A

necrolytic migratory erythema! esp in groin + hypergly, stomatitis, cheilosis, abd pain

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23
Q

VIP presentation

A

intractable diarrhea, metabolic acidosis!, hypoK

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24
Q

somtatostatinoma presentation

A

abd pain, gall stones, constipation, steatorrhea

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25
gestational diabetes tx
diet and light exercise then Insulin!
26
leuprolide mech
GnRH inhibitor
27
finasteride mech
DHTR inhibitor
28
GLUT1 cells and features
RBC, CNS: basal transport
29
GLUT2 cells and features
hepatocytes, B cells: insulin release regulation
30
placental glucose transporter
GLUT3
31
GLUT4 cells and features
muscle and adipocytes: insulin mediated
32
GLUT5 cells and features
sperm and GI tract: insulin mediated!
33
clomiphene mech
antiestrogen: for infertility from anovulation stops E neg fb on GnRH
34
mifepristone mech
RU486 antiprogestin, antiglucocorticoid
35
danazol mech
synthetic androgen; for endometriosis and hereditary angioedema
36
spironolactone and testosterone
antiandrogenic: hirsutism tx
37
flutamide mech
antiandrogen (binds testosterone Rs)
38
f26bP effect on PFK1 and F16bPase
incr. PFK1, decr. F16bPase
39
B blockers and thyrotoxicosis: mech
decr. symp to organs and decr peripheral T4-3!
40
+ focal neuro signs disease?
NF1 + cafe au lait, lisch nodules these are neurofibromas optic gliomas bony abnormalities other tumors (i.e. brain tumors)
41
caudal regression syndrome signs and causes
flaccid legs dorsiflexed contractures of feet urinary incontinence anything from anal atresia to sirenomelia \*maternal diabetes assoc
42
membranous glomerulopathy histo
diffuse, uniform, thick GBM (LM) irregular dense deposits btwn GBM and epithelial cells; look like spikes (EM) IgG and C3 granular (IF)
43
Colon cancer progresion of mutations
APC: small polyp (tumor suppressor) K-RAS: bigger polyp (proto-onco) p53 and DCC: malignant
44
colon adenomas size and progression to cancer risk
\<1cm: very unlikely \>4 cm: very likely
45
source of most airway resistance
Medium! and small bronchi (\>2mm) the right balance of narrowness but not parallel circuits
46
lamotrigine use
refractory partial seizures or tonic clonic or bipolar
47
lamotrigine toxicity
better than most anticonvulsants \*\*serious hypersensitivity--\>rash
48
tiagabine mech/use
anticonvulsant (refractory partial) inhibit GABA (tiaGABine) uptake
49
topiramate mech/use
anticonvulsant (refractory partial) block Na (and enhance GABA effect)
50
Vigabatrin mech/use
anticonvulsant (refractory partial) inhibit GABA trans-aminase, incr. concentration (viGABA-TRin)
51
clara cell fxn
lungs: secrete clara cell secretory protein, some surfactannt stuff detox stuff via p450
52
Wernicke enceophalopathy autopsy
foci of hemorrhage and necrosis in mamillary bodies and periaqueductal gray
53
transketolase pathway and cofactor
hexose monophosphate: pentoses to G3P \*B1
54
diagnosis of thiamine deficiency
increase in RBC transketolase activity post thiamine injxn
55
lacunar infarct locations
post limb int. capsule pons cerebellum BG
56
causes of lacunar infarcts
lipohyalinosis and microatheromas
57
meyer's loop visual defect
pie in the sky (temporal)
58
59
CF nasal test results and why
incr. potential difference btwn resp. epithelium and interestitium nl CFTR inhibits Na channels + not pumping Cl out, means bringing more Na in from the surface So more relatively negative epithelium!
60
Delta F508 mutation
del phe (3 base pairs) -\> abnl processing and degradation
61
reasonn for tissue destruction in TB
type IV HSR!
62
CF reproductive features
azoospermia, infertility b/c\*\*\*absent vas deferens!!
63
aspiration of stomach contents vs. oropharyngeal contents complications
stomach: chemical pneumonitis oral pharyngeal: abscess
64
anatomical cause of SVC
mediastinal mass! (CA or thrombus from indwelling catheter)
65
ABPA presentation
allergic bronchopulmonary aspergillosis d/t aspergillus fumigatus compl. of asthma - \>transient, recurrent infiltrates and eventual proximal bronchiectasis and eosinophilia more common in steroid dependent asthma
66
Pulm Embolism ABG
hypoxiemia, respiratory alkalosis
67
chronic rejection in the lungs affects?
small airways (bronchiolitis obliterans) (other txpl i.e. renal affects vascular)
68
acute rejection in lung txpl pres
1-2 wks post, vascular damage perivascular and peribronch9ial lymphos dyspnea, dry cough, low grade fever
69
rifampin mech
inhibit DdRp
70
Ethambutol mech
somehow inhibits mycobact wall synth
71
INH mech
inhibits mycolic acid synthesis used in wall and virulence factors (sulfatides, wax D, cord factor)
72
streptomycin mechanism
AG inhibits 30s used to treat plague and tularemia and mycoavium
73
when does incr. epo as a response to elevation kick in?
takes 10-14 d before that you see resp. alk w/met compensation once epo kicks in, PaO2 becomes pretty much normal
74
long term high altitude adjustments
incr. epo AND incr. capillary density, incr. myoglobin, incr. mitochondria
75
TB drug-\> neuropathy
INH: similar shape to B6-\> competes in synthesis of GABA-\>defective end products also increases B6 urinary excretion B6 deficiency: peripheral neuropathy
76
TB drug activated by bacterial catalase-peroxidase
INH
77
tx for abscesses above the diaphragm below?
clinda above metronidazole below
78
caspofungin mech
inhibit glucan synth | (polysaccharide for cell wall)
79
primary vs. reactivated TB lung lesions
primary: lower lobe, ghon focus: a calcified granuloma + hilar adenopathy once TB invades lymph 2\*: upper lobe cavitations
80
lower borders of the pleura
R side: mid clavicular 7 - mid axillary UPPER border of rib 10 - paravertebral 12 L side: mid clavicular 7 - mid axillary LOWER border of 10 - paravertebral 12
81
lower border of lung relative to lower border of pleura
lung ends 2 intercostal spaces above
82
TB drug requiring acidic environment?
pyrazinamide
83
pleural effusion trachea direction
away
84
85

missed qs (1 decks)

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