test #49 5.6 Flashcards Preview

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Flashcards in test #49 5.6 Deck (78)
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1

phagocyte dysfxn immunodeficiency present with..

recurrent abscesses

(can't kill what they phagocytose)

2

candida skin test

tests for cell-mediated immunity, since we have all been exposed to candida, we should mount a response to it

via macrophages, CD4+, CD8+, NK cells

absence of response suggests SCID

type 4 HSR

3

most common causes of spontaneous intracerebral hemorrhage (3)

1. arteriovenous malformations
2. ruptured cerebral aneursyms
3. abuse of sympthatomimetic drugs (cocaine)

4

cause of death in adult-type coarctation of aorta

HTN-related complications

left ventricle failure, ruptured dissecting aortic aneursym, intracranial hemorrhage (bc increased blood flow tere)

5

typical site of pathology w/ crohn's disease

terminal ileum

6

why may crohn's have increased gallstones?

bc loss of bile acid reabsorption in terminal ileum

7

sharp pull on outstretched hand while forearm is pronated and elbow is extended

radial head subluxation (nursemaid elbow)

most common elbow injury in children

tear annular ligament that holds radius to ulna at elbow

will hold in that position

8

which antipsychotics help treat negative symptoms of schizophrenia

atypicals!

emotional range, poverty of speech, loss of interest, loss of drive

9

rx for prevention of GBS meningitis in neonate

intrapartum ampicillin

(rx earlier still leaves mom susceptible at time of birth)

10

V2 vasopressin increases CD permeability to (2)

1. water (aquaporins)
2. urea

11

two ways of regulating lac operon expression

negatively: bind repressor protein to operon locus

positive: cAMP-CAP binding upstream promoter

12

receptors w/ Gq activation

a1, m1, m3
oxytocin
V1 ADH (vascular)
angiotensin II
GHRH
TRH
GnRH

think:
'vasoconstrictors'
adh V2, ang II, histamine
&
hypothalamic reproductive
GnRH, oxytocin
& TRH

13

calcipotriene, calcitriol, tacalcitol

topical vitamin D analog
used to treat psoriasis

activate vitamin D receptor nuclear transcription factor, inhibits keratinocyte proliferation & stimulates differentiation

14

utekinumab

human monoclonal antibody used in psoriasis, targets IL-12 and IL-23.

inhibits differentation and activation of CD4+ Th1 and Th17 cells

15

aortic regurg murmur

VERY EARLY diastole.
listen carefully, might sound like systole

16

hypertrophic cardiomyopathy murmur

definitely LVOT
can ALSO have mitral regurg bc of impaired valve closure

both systolic murmurs

17

alcoholic w/ megaloblastic anemia

likely folate deficiency
1. poor intake
2. poor absorption, utilization, enterohepatic recycling

(not B12)

18

rx for acute coronary syndrome, angina

aspirin
clopidogrel (irreversible ADP block)
ticlopidine

19

considerations before giving metformin

kidney fxn!

worry about lactic acidosis

contraindicate in any condition that might raise lactic acid levels: liver dysfunction, heart failure, alcoholism, sepsis

20

where does inferior mesenteric vein drain?

into SPLENIC vein, which joins SMA --> portal vein

note: different from arterial supply

21

what component of meningococcus correlates w/ patient morbidity & mortality

LPS equivalent: outer membrane lipooligosaccharide

in serum


leads to sepsis, petechiae, waterhouse-friederichson

[note: not the capsule]

22

how do nitrates cause vasodilation

NO, stimulate guanylate cyclase, convert GTP -> cGMP

-decreases intracellcular Ca2+
-decreases myosin lightchain kinase

--> myosin light chain dephosphorylation & smooth muscle relaxation

23

histology of schwanomma

spindle cells

biphasic:
antoni A pattern: highly cellular
antoni B pattern: myxoid areas of low cellularity

antoni A areas may form "palisading" patterns like a picket fence

S-100 positive

24

impt S100 tumors

melanoma
schwanoma

both neural crest derivatives

25

what is the only CN that cannot develop a schwanoma

CN II optic nerve!
covered by oligodendrocytes

26

what are CN myelinated by? exception

normally schwann cells (PNS)

except CN II optic: oligodendrocytes

27

histology of psoriasis

hyperparakeratosis
acanthosis (increased spinosum)
elongation of rete ridges
mitotic activity above epidermal basal cell layer
reduced/absent stratum granulosum

epidermal layer above dermal papillae = thinned & contained dilated vessels --> pinpoint bleeding-- AUSPITZ sign

neutrophils may form clusters in superficial dermis & parakeratotic stratum corneum --> MUNRO MICROABSCESSES

28

signs of portal HTN w/ normal liver biopsy suggests

presinusoidal process (aka not budd chiari)

must be portal vein thrombosis

unlikely to see ascites bc obstruction is presinusoidal

29

differentiating portal HTN due to budd chiari vs portal vein thrombosis

liver biopsy.

if it was budd-chiari (occlusion of hepatic vein, which drains hepatic & portal circulation into systemic circulation), would see centrilogular congestion & fibrosis in liver.

see nothing w/ portal vein thrombosis

30

acetaminophen overdoses causes what type of liver histology

centrilobular hepatic necrosis and failure in 24-48 hrs after ingestion