Mixed Block Notes 11 Flashcards Preview

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Flashcards in Mixed Block Notes 11 Deck (118):
1

Xanthomas are most characteristic of

Hypercholesterol or Hypertriglyceride

2

Familial hypercholesterolemia etiology

LDL Receptor

3

Peutz-Jeghers mutation

Serine/Threonine kinase 11 (STK11) on 19

4

Peutz-Jeghers manifestations

Skin lesions within first few years, intestinal polyposis follows

5

Buccal mucosa pigmented lesions

Pathognomonic for Peutz-Jeghers

6

Histology of Rhabdomyoma

Fascicles of polygonal cells with vacuolated cytoplasm and peripherally placed nuclei

7

Where do Rhabodmyomas occur

Head and neck of younger males

8

Dermoepidermal junction autoantibodies to type VII collagen

Epidermolysis Bullosa Acquisita

9

Clomiphene is best used to

Achieve fertility in women with ovulatory failure who are normogonadotrophic, normoprolactinemic, euthyroid

10

hCG therapy can be used to trigger

ovulatory cascade in an oocyte donor when her follicles are deemed mature

11

HOCM murmur is louder/softer with

Louder with decreases in Preload or Afterload; Softer with increases

12

IgA deficiency can lead to incr incidence of

Atopic, Autoimmune disease

13

Excise RNA primers and replace with DNA

DNA Polymerase I

14

AFP is associated with what repro malignancy

Yolk Sac tumors

15

Classic AE's with Prednisone

Avascular necrosis of femoral head, Insomina, Psych

16

Glyburide

Sulfonylurea

17

Cytoplasmic what accumulation is a hallmark of ischemic injury

Ca2+

18

Tamm-Horsfall

Exclusively secreted by renal tubular epithelial cells in ascending LOH (Prerenal azotemia and low urine flow rate --> Accumulation to form hyaline casts)

19

Findings in homocysteinuria

Marfanoid, Lens down and in, Thrombosis, Athersclerosis, Osteoporosis

20

Warfarin embryopathy

Midfacial hypoplasia, Chondrodysplasia punctata, Hemorrhage, Organ hypoplasia, CNS

21

Changing of pili in neisseria

Phase variation (on-off) and Antigenic variation

22

Complementation

Production of distinct phenotypic trait resulting from homozygous mutations in more than on egene

23

Important finding NOT found in McArdle's

Hypoglycemia (liver glycogen phosphorylase intact)

24

Glycogen synthase deficiency

Infancy = Hypoglycemia, Ketosis, Metabolic acidosis, Growth delays

25

Effects of beta blocker on K

Hyperkalemia

26

EKG signs of hyperkalemia

Peaked T, Loss of p, Prolonged PR, Widen QRS, Slow HR

27

EKG signs of hypokalemia

QT prolongation, U waves, ST depression --> Torsades

28

EKG signs of Hypo vs Hypercalcemia

Hypo causes QT prolongation; Hyper causes QT shortening

29

In general, a medullary lesion would result in

Contralateral spastic paresis, Ipsilateral CN XII defect

30

Phenylephrine

Selective alpha 1 agonist

31

Dobutamine

Mostly Beta 1 agonist - little effects on PVR

32

Isoproterenol

Non-selective beta agonist; Incr HR/CO/PP, Decr PVR

33

Epinephrine effects on HR and PVR

Incr HR, Decr PVR

34

CAAT box

Promoter - binding site for RNA polymerase II

35

Promoters/Binding sites for RNA polymerase II

CAAT, TATA

36

Enhancers are unique in that

they can be located very far away

37

Sublimation

Converting unacceptable feelings or drives into socially acceptable ones

38

Hepatic sinusoidal endothelial cells are unique in that

Fenestrated, Lack BM

39

Stellate cells

Vit A storage; Diff into myofibroblast upon injury --> Fibrosis

40

Block 23S rRNA of 50S

Macrolides, Clindamycin

41

Inhibition of 50S peptidyltransferase

Chloramphenicol

42

Decreasing [Kin]

Increases likelihood of neuronal depolarization w/out altering AP amplitude

43

Increasing [Kin]

Hyperpolarize neuron without altering AP amplitude

44

Mechanism for age-related lactase deficiency

Decr gene expression

45

Cyclosporine MOA

Binds cyclophilin --> inhibits calcineurin --> Inhibit calcium-dependent promotion of IL2 transcription

46

Basiliximab, Daclizumab MOA

mAb that blocks IL-2R

47

Tacrolimus MOA

Binds FKBP --> inhibits calcineurin --> inhibit calcium-dependent promotion of IL-2 transcription

48

Sirolimus (Rapamycin) MOA

Binds FKBP --> Blocks mTOR --> Prevents IL-2 response

49

Tardive Dyskinesia mechanism

Upregulate D receptors; Concomitant decr in cholinergic activity in Striatum

50

The plateau phase of cardiomyocyte AP corresponds to

ST segment (isoelectric)

51

Virus that carries its own DNA-dep RNA polymerase

Pox

52

What can decrease glomerular capillary filtration coefficient

Chronic HTN, DM --> Drop in GFR

53

Calcipitriol

Vit D analog for treatment of Psoriasis (topically)

54

Antibiotic efflux pumps are found in what type of bugs

Typically gram negative

55

Orlistat MOA

Lipase inhibitor

56

McArdle's disease severity

Typically begin in young adulthood --> Muscle cramps, Fatigue, Transient myoglobuinuria --> normal lifespan

57

Lipofuscin is produced when

ROS --> Membrane Lipids

58

Cholesterol Ester Storage disorder

Partial defect in lysosomal acid lipase --> Accumulation of cholesterol ester, TG's --> Hepatic fibrosis, Premature atherosclerosis

59

Clinical manifestations of Cryptosporidium

Mild enterocolitis with water, non-bloody diarrhea

60

Toxoplasmosis in immunocompetent

Nonspecific --> Fever, headaches, myalgia, lymphadenitis

61

Nephrotic Syndrome in adults

Membranous Glomerulonephritis

62

Methenamine silver stain showing thickening of glomelar BM

Membranous Glomerulonephritis

63

CCB's in pregnancy

Limb loss - decreased placental perfusion

64

BB's in pregnancy

Generally safe

65

Incr in endothelium-bound LPL activity

Insulin resistance

66

Increased cholesteryl ester storage in hepatocytes and endothelial cells

Cholesteryl Ester Storage disease - Lysosomal acid lipase defect

67

Insulin effect on Adipocyte vs Endothelial LDLR's

Upregulate on hepatocytes, Downregulate on endothelial cells

68

Complicated non-gonoccocal urethritis

Epididymitis --> 2 wks of doxy or 1 wk azithromycin

69

Probenicid and Penicillin

inhibits renal tubular secretion of penicillins, most cephalosporins,

70

Cilastatin and Imipenem

Prevent proximal tubular brush border hydrolysis of imipenem by dehydropeptidase

71

Stimultion of auricular branch of vagus nerve

Reflex coughing or vomitting

72

Bloom syndrome

Photosensitivity, Short stature, Erythema, Telangiectasias - Defect in DNA helicase gene -- Predisposed to lymphoproliferative and gastrointestinal malignancies

73

ATM gene is important for

DNA repair following ionizing radiation - Telangiectasias in eyes and ears, Lymphoproliferative malignancies

74

Tumors in Li Fraumenia

Breast cancer, Soft tissue sarcoma

75

Location of Lynch syndrome polyps

proximal

76

Histology of Follicular Lymphoma

Effacement; Small cleaved cells (centrocytes), Larger non-cleaved cells w/ multiple nucleoli (centroblasts)

77

Presentation of Sporadic Burkitt's

Ascites and abdominal mass from ileum, cecum, or mesentery

78

Manifestations of hyperestrogenism in cirrhosis

Spider angiomas, Palmar erythema, Dupuytren's, Decr body hair

79

Niacin MOA

(1) Impair VLDL production; (2) Inhibit Hormone Sensitive Lipase --> Decr TG; (3) Incr HDL by limiting cholesterol transfer form HDL to VLDL, slowing HDL clearance

80

intestinal Kaposi

Hemorrhagic nodules by endoscopy

81

Most common cause of Restriction Fragment Length Polymorphism

SNPs

82

RNA virus that replicates in nucleus

Influenza

83

High blood ammonia and Increased urinary orotic acid

OTC deficiency (Increased Carbamoyl Phosphate shunted to Orotic Acid)

84

Uncal herniation findings

CNIII, Contralateral muscle paresis (cerebral peduncle)

85

Somatic Symptom Disorder vs Illness Anxiety Disorder

Minimal or no actual physical symptoms in Illness Anxiety

86

Pseudodementia

Cognitive dysfunction that occurs in patients with severe psych illness

87

Why hypoglycemia in MCAD

Acetyl-CoA is consumed by medium chain fatty acids that accumulate --> Low concentrations of AcetylCoA inhibit conversion of pyruvate to OAA (inhibiting gluconeogenesis

88

Anti-SRP antibodies

Autoimmune Myositis

89

MHC II pathway is particularly important for generating helper T response against

Extracellular and Intracellular membrane-bound pathogens

90

T lymphocyte antigen recognition is determied by

Specificity of TCR for both MHC variant allele and peptide fragment bound to it

91

Positive T lymphocyte selection

Thymic cortex - Responsible for generating T cells compatible with person's HLA haplotype

92

Individuals with HLA haplotypes that cannot bind certain polypeptide fragments

will not be able to mount T cell dependent immune response against these antigens

93

Most common opportunistic viral infection affecting GI tract of HIV patients

CMV - Ulcers, Mucosal erosions, Large cells with basophilic intranuclear & intracytoplasmic inclusions

94

Biopsy in HIV Cryptosporidium diarrhea

Organism confined to microvilli - basophilic parasites attached to mucosal brush border

95

Microsporidium diarrhea in HIV

Distortion of villous architecture w/out inflammation; Small spores with diagonal or equatorial belt-like structure

96

MAC diarrhea in HIV

Necrotizing and Non-necrotizing granulomas; Acid fact staining bacilli

97

HIV protease cleaves

gag and pol products

98

Carboxyhemoglobin

HbCO --> Loss of cooperativity, Unable to unload O2

99

Sclerosing Adenosis

Incidental finding (rarely palpable mass) --> Slight incr risk, Must biopsy

100

Mammary duct ectasia

Skin retraction, Thick creamy or bloody discharge, Palpable periareolar mass

101

Fibroblasts in a cartwheel or storiform pattern

Dermatofibrosarcoma protuberans

102

Dysplastic Nevus syndrome

CDKN2A on 9p21

103

LV End systolic volume, End diastolic volume and pressure in exercise

End systolic volume decreased, End diastolic volume up, End diastolic pressure same

104

Metencephalon -->

Pons and Medulla

105

Three vs Five embryonic vesicles

Pros, Mes, Rhomb --> Tel, Di, Mes, Met, My

106

Short a-helix with leucine resides at every seventh position

Leucine zipper dimerization domain --> TF's known as Basic Zipper Proteins

107

DNA-binding motifs

(1) Zinc finger; (2) Helix-loop-helix; (3) Leucine zipper dimerization domain

108

First reaction of Pyrimidine synthesis

Glutamine, CO2, 2 ATP --> Carbamoyl Phosphate in Cytosol

109

Peroxisome function

Lipid metabolism (beta oxidation), Oxidative reactions, Purine catabolism

110

Cellular location of G-6-Phosphatase

Smooth ER

111

CYP inhibition/induction effects on Warfarin

Inhibits incr Warfarin effect (decr inactivation)

112

2 most common sites for hypertension-related intracerebral hemorrhage

Thalamus, Putamen

113

Hyptertensive hemorrhage in pons

(1) Pinpoint pupils; (2) Loss of horizontal gaze; (3) Decerebrate posturing; (4) Coma

114

mechanisms of incr ICP in brain tumors

(1) Obstruction; (2) Disrupt BBB = vasogenic edema

115

Cutaneous findings in Reiter's

Keratoderma blenorrhagica, Balanitis circinata

116

Causes of nephrogenic diabetes insipidus

(1) Hypercalcemia; (2) Hypokalemia; (3) Post-obstructive diuresis; (4) Lithium, Amph B, Gentamicin, Cisplatin

117

Eptifibatide

Gp Iib/IIIa inhibitor that inhibits platelet aggregation by binding fibrinogen site

118

Effect of CYP inhibitors/inducers of Clopidogrel

Must be activated, so inhibitors decr drug levels