test #23 4.12 Flashcards Preview

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Flashcards in test #23 4.12 Deck (88)
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1

congenital lactase deficiency

rare autosomal recessive. caused by gene near (but separate from) lactase gene

2

bacterial fermentation of undigested lactose leads to..

fermentation, producting short-chain fatty acids and excess hydrogen ---> acidic stool

3

stool osmotic gap

most stool osmolality --> Na and K. gap = colonic fermentation products.

when mostly electrolytes, osmotic gap low (< 50mOsm/kg).
when poorly absorbable substances present, osmotic gap large > 100mOsm/Kg

4

D-xylose absorption test

absorption of D-xylose diminished in numerous malabsorptive conditions. like celiac sprue. not associated w/ lactose intolerance.

D-xylose, a monosaccharide that does not require digestion for absorption; just needs an intact mucosa.

can distinguish between musocal & nonmucosal causes of malabsorption (i.e. celiac vs. pancreatic insufficiency)

5

lactose deficiency individuals have... (3)

increased stool osmotic gap, increased breath hydrogen content, and decreased stool pH upon lactose challenge.

6

pancreatic location in abdomen

head, neck, body retroperitoneal. tail is intraperitoneal.

head overlies L2. body overlies L1 and L2. posteriorly contacts aorta, superior mesenteric vessels, left kidney. tail courses w/ splenorenal ligament alongside splenic vessels

7

anthax most commonly acquired via

exposure to infected animals / animal products OR use as a biological weapon

not person-to-person

8

forms of anthrax (3)

(1) cutaneous, most common
(2) pulmonary, 5% (but nearly 100% mortality)
(3) gastrointestinal, rare

9

ERB-B2 gene aka.. expressed in..

Her-2/Neu.

overexpressed in breast cancer, adenocarcinoma of ovary, stomach, lung, salivary glands.

codes for transmembrane glycoprotein w/ tyrosine kinase activity.

normally expressed in small amounts.

10

n-myc associated with..

neuroblastoma and small cell carinoma of lung

11

sis proto-oncogene codes for.. overexpressed in?

platelet-derived growth factor. overexpressed in astrocytoma and osteosarcomas

12

rx for cryptococcus meningitis

amphotericin B + flucytosine. long-term maintenance w/ fluconazole

13

schizoid vs. avoidant

avoidant strongly desires acceptance. schizoid do not care.

avoidant: inadequacy, timidity, fear of rejection

14

diffuse esophageal spasms

periodic, non-peristaltic contractions of esophagus.

usu painful. "cork-screw" on barium esophogram.

intermittent dysphagia w/ occasional chest pain. can mimic UNSTABLE ANGINA. rule out w/ complete cardiac work-up

15

symptom of GERD

heartburn: burning, central pain frequently after meal or night. DES = crampy, not burn

16

digital rectal exam of BPH vs. prostate cancer.

BPH: rubbery.
cancer: nodular & firm

17

changes resulting from BPH upstream

bladder wall hypertrophies: increase contractile force.

ureter, pelvis, calyces dilate (hydronephrosis)

renal parenchyma atrophic and scarred due to reflux of urine & damage.

18

3rd pharyngeal puch

inferior parathyroid glands & thymus

19

pharyngeal pouches

1, 2, 3, 4
ears, tonsils, bottom to, top
ears, palatine tonsils, inferior parathyroid & thymus, superior parathyroid & ultimobranchial body

20

thyroid diverticulum from

floor of the foregut

21

laryngeal cartilage originates from

4th and 6th pharyngeal arches

22

mutation in polycythemia vera

clonal myeloproliferative disease of pluripotent hematopoietic stem cells. 95% have V617F mutation involving JAK2 gene.

replaces a valine w/ phenylalanine at 617 --> makes hematopoetic cells more sensitive to growth factors (like EPO and TPO)

23

EPO producing tumors

hepatocellular carcinoma, renal cell carcinoma

24

shigellosis can be caused by..

shigella dysenteriae, flexneri, boydii, sonnei.

80% are sonnei in US

25

shigella entry into body

M cells in peyer's patches in mucosa of ileum

26

substrates in urea cycle

ordinarily, careless crappers are also frivolous at urination

in mito: ornithine + carbamoyl, citrulline,

in cytosol: aspartate, arginosuccinate, fumarate, arginine, urea (and regenerate ornithine)

27

N acetylglutamate is needed for

activity of carbamoyl synthetase II. to convert NH3 + CO2 + ATP ---> carbamoyl phosphate

28

myasthenia gravis particularly affects

waxing & waning progressive weakness of voluntary muscles, particularly those innervated by motor nuclei of brainstem (ocular, masticatory, facial, deglutitional (swallowing), and lingual movement)

29

what happens when anti-nAChR binds in myasthenia gravis?

receptor internalization & complement fixation (degradation).

less opening of nicotinic cation channels --> reduced end plate potential

30

classic presentation of multiple sclerosis

SIIN
- scanning speech, internuclear opthalmoplegia, intention tremor, incontinence, nystagmus