Mixed Block Notes 6 Flashcards Preview

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Flashcards in Mixed Block Notes 6 Deck (105):
1

Soft Exudate

Grayish-white, cotton wool - due to microinfarct

2

Hard Exudate

Clear margins - due to leakage of protein

3

Absolute vs Relative Erythrocytosis

Red Cell Mass increased in Absoluate

4

Ureters lie antermedial to what structures in true pelvis

Internal Iliac

5

Death due to TCA toxicity

Cardiac Fast Na channel block --> Arrhythmia, Cardiogenic Shock

6

TCA's also block

mAChR, alpha1, Cardiac Fast Na, H1; NE and 5-HT reuptake

7

Common precursor of Beta-Endorphin and ACTH

POMC (also yields MSH)

8

Gastroeneteritis with intestinal invasion

Salmonella, Shigella, EIEC, Campylobacter, Entamoeba histolytica

9

Stacked-brick intestinal adhesion

EAEC

10

Characteristic histologic findings in GERD

Basal zone hyperplasia, Elongation of lamina propria, Inflammatory cells (eo's, Pmn's, lymph's)

11

First gen anti-histamines

Dim First Gen History Professors Dip Cope - Dimenhydrinate, Hydroxyzine, Promethazine, Diphenhydramine, Chlorpheniramine

12

Second gen anti-histamines

Second Gen History Certainly want tadine - Cetirizine, -adine

13

Bisphosphonates should be used carefully in patients with

Renal failure - Excreted unchanged

14

Common robertsonian translocations

14;21 and 21;22

15

Most susceptible parts of kidney to hypoxia

PCT, Thick Ascending Limb

16

Prophylaxis of cerebral vascular spasm following SAH

Nimodipine

17

Two types of pneumococcus vaccine

(23) Polysaccharide = B cell response = Less effective; (17) Polysaccharide conjugated to diph toxin = T cell response = better

18

Killed Vaccines

RIP Always = Rabies, Influenza, Polio, Hep A

19

3 adverse effects of all Protease Inhibitors

(1) Lipodystrophy; (2) Hyperglycemia; (3) P450 inhibition

20

What to use instead of rifampin for patients with mycobacterial infection in patients on protease inhibitors

Rifabutin

21

3 important mitochondrial syndromes

(1) Leber Hereditary Optic Neuropathy; (2) Myoclonic Epilepsy w/ Ragged-Red Fibers; (3) MELAS

22

Aortic Arch Derivatives

3 = Common/Internal Carotid; 4 = Aortic Arch, R Subclavian; 6 = Pulmonary Arters, Ductus Arteriosis

23

5 Dehydrogenase Cofactors

B1, B2 (FAD), B3 (NAD), B5 (CoA), Lipoid Acid

24

Prevention of neonatal tetanus

Vaccinate mom --> Placental transfer of IgG

25

Conversion of Pyruvate to PEP requires what 2 enzymes

Pyruvate Carboxylase, PEPCK

26

How can mitochondrial OAA be transported to cytosol

(1) Conversion to PEP; (2) Transamination to Aspartate; (3) Reduction to Malate

27

What step of CAC is GTP produced in?

Succinyl CoA to Succinate

28

Anti-arrhythmic specific for ischemic myocardium

Ischemic = Depolarized --> Lidocaine

29

What has currently replaced lidocaine for ventricular tachycardia

Amiodarone

30

Procainamide is more specific for arrhythmias arising from

Centers of normal automaticity

31

Prolonged administration of Verapamil pts with V Tach can

Lead to V fib and death --> Distinguish between Supraventricular and Ventricular Tach

32

Adenosine is used for

Acute treatment of Paroxysmal Supraventricular Tachycardia

33

Gene in PAH

BMPR2

34

Hypophosphorylated Rb prevents

G1 --> S (Hypophosphorylated = Active)

35

Colloid Cyst

Benign formation in third ventricle --> Lethal obstruction

36

Reticulin deposits and chronic inflammatory infiltrates in brain tumor

Xanthoastrocytoma

37

Activated Protein C inhibits

Factors Va and VIIIa

38

Aside from gas gangrene, C perf can cause

Late-onset food poisoining --> Transient watery diarrhea

39

X linked recessive disorders

Bruton, Wiskott, Fabry, G6PD, Ocular Albinism, Lesch-Nyhan, DMD, Hunter Syndrome, Hemphophilia, OTC Def

40

Autosomal Dominant disorders

HHT, Fam Hyperchol, FAP, MEN, NF1/2, Marfans, Her Spher, Achondroplasia, Huntingtons, Li-Fraumeni, BRCA1/2, Polycystic, Tuberous Sclerosis, vHL

41

HIV gene that is glycosylated and cleaved

ENV --> Gp140 --> Gp120 and Gp41

42

How does blood from Bronchial Arteries return

Majority to left heart in deoxy form via pulmonary veins (admixture); Some to right heart via azygous, acessory hemiazygous, or intercostal veins

43

Afferent fibers from Carotid and Aortic baroreceptors terminate in

Solitary nucleus of medulla

44

Histology of Psoriasis

Hyperparakeratosis, Acanthosis, Elongation of Rete Ridges, Mitotic activity above epidermal basal layer, Reduced or absent stratum granulosum

45

Munro microabscesses

PMNs form spongiotic clusters in superficial dermis and parakeratotic stratum corneum in Psoriasis

46

Advantage of proline in collagen

Kink the polypeptide chain and enhance rigidity b/c of their ring configuration

47

What happens to procollage once secreted

Cleaved C and N terminals --> Solubility decreases --> Collage fibrils --> Lysil Oxidase crosslinking

48

Alkaptonuria is a defect in what pathway

Tyrosine to Fumarate

49

What causes nipple inversion with breast cancer

Invades central region

50

What causes skin retraction in breast cancer

Infiltration of Cooper ligaments

51

Alternative to SSRI when sexual side effects occur

Bupropion

52

Xanthoma vs Xanthelasma

Xanthoma is surrounded by inflammatory cells and fibrotic stroma, Xanthelasma not

53

Ergonavine MOA

Constricts SM by stimulating both alpha adrenergic and 5-HT receptors

54

Phentolamine MOA

a1 and a2 blocker

55

In what part of bone is hematogenous osteomyelitis most likely

Diaphysis

56

Hyper IgM syndrome results from

Absence of CD40L on t cells or Genetic deficiency in isotype switching enzyme

57

Hyper IgM manifestations

Recurrent sinopulmonary infections; Lymphoic hyperplasia

58

IgA class switching is induced by

TGF-beta

59

Specific marker of mast cell activation

Tryptase (released in degranulation)

60

Antimicrobials that block ENaChannels

Trimethoprim, Pentamadine

61

Why is serum Na normal in Mineralocorticoid Excess

Aldosterone Escape via ANP --> Prevents edema and Na increase

62

Contraction alkalosis

Reabsorption of HCO3-

63

Where does uric acid precipitate in tubules

Low pH of Distal Tubules and Collecting Ducts

64

Penicillinase-stable penicillins

Nafcillin, Oxacillin, Methicillin

65

Prognosis of Capillary Hemangioma

Initially progress, eventually regress

66

Histology in De Quervain's Thyroiditis

Mixed, cellular infiltrate with multinucleated giant cells

67

Opsoclonus-Myoclonus syndrome

Neuroblastoma

68

Why not use TCA with BPH?

Anti-Cholinergic --> retention

69

Why not use TCA with Orthostatic Hypotension?

Antagonizes alpha 1 peripherally

70

Causes of Hypercalciuria

Mainly Idiopathic; Also Hyperoxaluria, Hyperuricosuira, Low urinary volume, Hypocitratruria

71

Causes of Hyperoxalouria

Diet (chocolate, nuts, spinach; Low calcium diet (more oxalate absorbed)

72

Main radiographic finding in Mesothelioma

Nodular or smooth pleural thickening

73

Gold standard for Mesothelioma diagnosis

EM = Numerous long, slender microvilli with abundant tonofilaments (adenocarcinoma has short, plump microvilli)

74

Bronchioalveolar carcinoma has a characteristic

Distribution along alveolar septa w/out vascular or lymphatic spread

75

Gemcitabine vs Cytarabine

Both pyrimidine analogs, but Gemcitabine is not S phase specific, likely due to additional cytotoxic functions (eg inhibition of ribonucleotide reductase)

76

Methotrexate vs 5-FU

Both inhibit thymidalate formation, but only MTX overcome by Folinic Acid supplementation

77

Gottron papules and heliotrope rash

Dermatomyositis

78

Antidote for Cyanide (nitroprusside) toxicity

Sulfur (Sodium Thiosulfate) = Donates sulfur to liver rhodanase to enhance conversion of cyanide to thiocyanate

79

Microangiopathic hemolytic anemia

Small vessels = DIC, TTP, HUS

80

Triggers of G6PD

Bactrim, Dapsone, Antimalarials, Nitrofurantoin, Fava Beans

81

What is low in G6PD deficiency

NADPH

82

Cause of Lipofuscin

Free radical injury and lipid peroxidation

83

Most common location of supine aspiration

Right Lower Lobe

84

What underlies most cases of Hereditary Hypothalamic Diabetes Insipidus

Neurophysin II mutations

85

SPINK1

Trypsin inhibitor secreated by pancreatic acinar cells

86

Germ tubes when incubated at 37 degrees

Candida --> True Hyphae

87

Hep B replication

dsDNA --> Template +RNA --> dsDNA

88

Fate of tRNA that is mischarged

Will incorporate wrong AA into polypeptide chain (not corrected when charged by AA-tRNA synthetase proofreading)

89

MOA of mushroom toxins

Inhibit DNA-dependent RNA polymerase Type II = mRNA

90

RNA polymerase I vs II vs III

I = rRNA; II = mRNA; III = tRNA

91

MOA of Ricin

Cleaves rRNA component of 60S subunit

92

Resistance to Ethambutol

Increase production of Arabinosyl Transferase

93

Resistance to Streptomycin

Modification of 30S protein structure

94

Resistance to Pyrazinamide

Modify Pyrazinamidase, which must activate Pyrazinamide

95

MOA of Bosentan

Endothelin-receptor antagonist

96

Neutrophil Alk Phos

Elevated in Leukemoid reaction, Decr in CML

97

Acute Leukemia blast percentage

Greater than 20%

98

Eyelid manifestation of Primary Biliary Cirrhosis

Xanthelasma

99

Primary acceptor of amino groups during breakdown of other Amino Acids

Glutamate

100

Glycine + Methylene Group

Serine

101

What type of colonic adenoma can secrete mucus

Villous

102

Perfusion defect anatomically matched by ventilation defect

Collapsed lung

103

First test for PE

CT angiography

104

First line treatment for open angle glaucoma

Prostaglandins

105

Muscle responsible for accomodation? control?

Ciliary muscle - solely under cholinergic (m3) control