Flashcards in test #35 4.26 Deck (124)
cyclosporin and tacrolimus
germline mutations in RET proto-onco gene affect cells of what origin
neural crest cells!
men2a: medullary thyroid carcinoma (parafollicular C cells of thyroid), pheo, and parathyroid gland
men2b: medullary thyroid carcinoma, pheo, and mucosal neuromas
thyroid parafollicular cells arise from..
4th and 5th pharyngeal pouches
name development of pharyngeal pouches (5)
1. ears (middle ear, mastoid air cells, eustachian tube = endoderm lined)
3. inferior parathyroid, thymus
4. superior parathyroid, medullary thyroid parafollicular cell
5. medullary thyroid parafollicular cells
development of thyroid
thyroid follicular cells = outpouching of pharyngeal epithelium, migrate to lower neck & fuse with parafollicular C cells from 4/5th pharyngeal pouch.
pathophysiology of mutation in VHL
VHL gene regulates transcription of HIF-1 (hypoxia inducible factor).
unregulated HIF --> increased VEGF & EPO
also associated w/ pheos & RCC
misattributing one's own unconscious, undesired thoughts, feelings, impulses onto another person, who does NOT actually have them
occurs when a person ins unable to express difficult thoughts themselves.
transplant thoughts to another --> relieves difficult feelings without causing internal confluct of self-expression.
angry w/ parents, think parents mad at you.
lack insign and acknowledgement of their own motivations & feelings
modeling one's behavior after someone perceived to be more powerful / prestigious.
may be admirable or non admirable.
child of abusive father becomes child abuser
avoiding unacceptable feelings by behaving badly
expressing unwanted thoughts/impulses through action instead of reflection and mature discourse
most severe trisomy
trisomy 13 -- patau
usu die in first week
only 5% survive 6 months
describe trisomy 13-patau
associated w/ early defect in prechordal mesoderm
midface, eye, forebrain most affected.
1. head/neck: severe cleft lip/palate, microopthalmia or anopthalmis, coloboma, cylops, malformed/absent nose, deafness, scalp defects
2. CNS: severe MR, microcephaly, holoprosencephaly, absent olfactory nerve or bulb, NT defects
3. extremities: polydactyly, rocker-bottom feet
4. renal: polycystic kidney disease
5. GI: abdominal wall defects: omphalocele or umbilica hernia, pyloric stenosis
klinefelter; tall male w/ gynecomastia, small testes, and infertility
clinically silent, maybe slightly decreased IQ
tall stature, acne, delays in motor and language
k-ras mutations common in..
when is opening snap of mitral stenosis head
really really close to closure of S2
due to tensing of MV leaflet after cusps completed their opening excursion
relationship between time of A2-opening snap in mitral stenosis and severity
inverse. shorter interval, more severe.
bc higher steady state left atrial pressure.
control symptoms of a neonate in opiod withdrawal (leaky baby)
tincture of opium or paregoric
what maintains blood brain barrier
tight junctions [claudins & occludins]
between endothelial cells in capillary beds of CNS.
materials can only move transcellularly or carrier mediated.
why use naficillin usu
use often against s. aureus.
skin infections and soft tissue infection -- folliculitis, abscesses.
rx for lung abscesses
'above the belt' anaerobes'
petechia, purpura, ecchymoses? blanch?
do not blanch, bc RBC are not in vasculature. RBC leaked in skin/subcutaneous tissue
which blanch. telangietcasia or petechiae/purpura/ecchymoses?
teleangiectasia, bc in a vessel
intranasal glucocortoids localization
unlikely to cause systemic immunosuppression -- very localized
causes of candida vaginitis
1. ANTIBIOTIC use! suppress normal flora, facilitates candida overgrowth.
2. contraception, high estrogen
3. systemic corticosteroids
4. uncontrolled diabetes
normal pH of vagina? gardnerella infection? trichomonas? candida vulvovaginitis?
gardnerella: pH > 4.2 (more basic)
trichomonas: pH >4.5 (more basic)
candida: pH normal, acidic
major bacterial flora of vagina
gram + lactobacilli
also: corynebacterium, fungi (candida), group B strep, e. coli
usu pH ~4
decrease thickening of vaginal epithelium and decreased glycogen associated with..
postmenopausal & lactating women
elevation of vaginal secretion pH suggests (pH > 4.5)
gardnerella or trichomonas