USLME world 1 Flashcards

1
Q

Collagen synthesis

A

RER: -Rough ribo: synthesizes Pre-Po-Alpha-chains -Signal Sequence cleaved: pro-alpha-chains -Hydroxylation: Proline & Lysine VITAMIN C DEPEnDENT -Glycosylation: of Galactose and Glucose -Assembly of pro-alpha chains into procollagen TRIPLE HELIX (transfered to Golgi and secreted) EXTRACELLULAR: -N and C terminals cleaved by peptidases: Tropcollagen -Spontaneous assembly: collagen fibrils -Covalent cross links made by Lysyl oxidase

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2
Q

Inulin PAH

A

Inulin=GFR, filtered PAH=filtered + secreted, renal plasma flow (better than creatinine for measuring bc creatinine not secreted as much)

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3
Q

Odds ration

A

ad/bc odds that the group with the disease was exposed to the risk factor (a/c) divided by the odds that the group without the disease was exposed (d/b) disease risk factor + - + a b - c d

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4
Q

Beck’s triad: -Jugular venous distension -hypotension -tachycardia -distant/muffled heart sounds -pulsus paradoxus

A

Cardiac tamponade -Elevated central venous pressure in superior vena cava–> JVD -low QRS and electrical alternans. -lung sounds nrml

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5
Q

Pleuritic chest pain + pericardial friction rub

A

Acute fibrinous pericarditis follows URI

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6
Q

Pulsus paradoxus

A

decreased amplitude of systolic blood pressure by > 10mmHg during inspiration. (Cardiac tamponade, astham, obstructive sleep apnea, pericarditis, croup)

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7
Q

6th aortic arch

A

pulmonary arteries & ductus arteriosus

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8
Q

1st aortic arch

A

maxillary artery

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9
Q

2nd aortic arch

A

stapedial artery and hyoid artery

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10
Q

3rd aortic arch

A

common carotid artery and proximal part of internal carotid artery

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11
Q

4th aortic arch

A

Left: aortic arch Right: proximal part of right subclavian artery

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12
Q

metalloproteinases

A

Zinc containing enzymes that degrade extracellular matrix (collagen, laminin, fibronectin). Metalloproteinases are essential for proper tissue remodeling during wound healing

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13
Q

FOscarnet

A

viral DNA polymerase inhibitor that binds pyrophosphate-binding site of the enzyme. DOES not require viral kinase activation. use: CMV retinitis if ganciclovir fails or in acyclovir-resistant HSV SE” Nephrotox Resistance: mutated DNA polymerase

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14
Q

Acute goutry arthritis tx, drug’s moa

A

NSAIDS-first line 2nd line: Colchicine: prevent MT formation by binding tubulin SE: diarrhea, nausea, vomiting, abdominal pain bc also disrupts MT in GI mucosa cells

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15
Q

drugs that act on MT

A

Mebendazole ( anti-helminthic) Griseofulvin (anti-fungal) Colchicine (anti-gout) Vincristine/Vinblastine (anti-cancer) Paclitaxel (anti-cancer)

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16
Q

Gingival hyperplasia SE drugs

A

Phenytoin, verapamil, cyclosporine, nifedipine

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17
Q

SLE like syndrome SE drugs

A

SHIPPE: Sulfa, Hydralazine (Vasodilation arteries>veins, increase cGMP-> smooth muscle relaxation. use: CHF, HTN in pregnancy) , INH, Procainamide (Class IA), Phenytoin, Etanercept (TNF receptor fusion protein)

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18
Q

Alveolar-arterial gradient (A-a)

A

Palveoli (O2)-Parterial (O2)=10-15mmHg=nrml If nrml-> no V/Q mismatch, no diffusino impairment If nrml and patient hypoxemic: alveolar hypoventilation or inspriing low P(O2)

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19
Q

4 major causes of hypoxemia

A

alveolar hypoventilation, ventilation perfusion mismatch,diffusion impairment, right-left shunting. The first one has nrml (A-a) gradient

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20
Q

Rifampin

A

Inhibits DNA dependent RNA polymerase Use: TB (NOT ALONE), with dapsone for leprosy to delay resistance, PROPHYLAXIS for meningococcal and chemoprophylaxis for H.influenza type B. Tox: Minor hepatotox, orange body fluids, Ramps UP CYP 450 (But Rifabutin doesnt!)

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21
Q

Young Caucasian, Recurrent Sinusitis

A

Cystic fibrosis: -Auto recessive, chrm.7-CFTR gene defect: deletion of Phe508 CFTR: ATP-gated Cl channel secrete Cl in lungs & GI and reabsord Cl in sweat glands (sweat test). Mutation: misfolded, stays in RER. Increased intracellular CL leads to Increased Na reabsorption via epithelial Na channel therefore to H2O reabsorption-> abnml think mucus in lungs and GI. Increased Na reabsorption also means negative transepithelial potentia difference

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22
Q

Lecithin/Spingomyelin <1.5

A

Neonatal Distress Syndrome if below 2 by 35 gestational weeks Surfactant starts being secreted in 3rd trimester by penumocytes II Lecithin: phosphatidylcholine

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23
Q

Hemoptysis, hematuria, Histo: focal necrosis of alvelolar wall and intra-alveolar hemorrhage, Kidney nep

A

Goodpasture HLA DR2 associated Type II hypersensitivity reaction, antibodies to GBM and alveolar basement membrane, linear IF, glomerulonephritis with crescent of fibrin and plasma proteins, macrophages…

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24
Q

Subcutaneous nodules on knee, dorsum of hand, achilles tendon xanthomas. Elevated total cholesterol, elevated LDL cholesterol.

A

Familiarl hypercholesterolemia: auto dominant Defective or absent LDL receptors. Excessive LDL deposits in arteries as atheromas and in tendons and skin as xanthomas xanthomas=hyper TG and cholesterol

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25
Q

Mitral Stenosis

A

Late Diastolic murmur follows opening snap. If interval between S2 and OS decreases=worst!!!! Always Rheumatic Fever Leads to LA dilation Expiration: increases LA return: enhances MS

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26
Q

Rheumatic Fever

A

Group A Strep. Pyogenes, Beta-hemolytic, Coagulase positive, Catalase negative, Bacitracin sensitive (Causes : Pharyngitis,Cellulitis, Erysipelas, Rheumatic Fever, Post-strep GMN) Death cause: myocarditis Early lesion: mitral valve regurgitation (systolic holosystolic, high pitched, apex->axilla) BUT late lesion is mitral stenosis ASCHOFF BODIES: granuloma with giant cells & ANITSCHKOW cells: enlarged Mo. w/ ovoid, wavy, rod-like nucleus TYPE II hypersensitivity: Antibodies to M protein cross react with self antigens! FEVERS: Fever, Erythema marginatum, Valve damage, ESR increase, Red hot joints, Suubcutaneous nodules, Sydenham chorea!

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27
Q

Peutz Jeghers Syndrome

A

Auto DOMINANT, multiple nonmalignant hamartomas in GI tract + hyperpigmentation of mouth, lip, hands, genitalia. (can get intussusception, obstruction of GI)

Increase risk of CRC and other maligancies.

Mutation in Serine/Threonine kinase 11

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28
Q

mutliple cafe au lait macules, cutaneous neurfibromas, axillary or inguinal freckling, optic glioma, iris hamartomas, osseus lesions

A

NF1

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29
Q

Lipoma vs Liposarcoma

A

Lipoma: Soft, rubbery, mobile, subcutaneous nodules made of mature fat cells without pleomorphism.

Liposarcoma: Soft-tissue malignancies, many lipoblasts (cells that make non mb bound cytoplasmic lipid), nuclear indentations, scallopingof nuclear mb. Middle-aged, slow growing, painless of trunk or lower extremities (picture)

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30
Q

Fibrosarcoma

A

Fibroblast based malignancy, anaplastic spindle cells, marked disarray, pleomorphism, mitotic activity, hemorrhage, necrosis. Secondary to Piaget Bone disease.

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31
Q

Pemphigus Vulgaris vs Bullous vs dermatitis herpetiformis

A

Pemphigus: IgG autoAb to desmogleins 1 and 3 (spinous stratum), IF: netlike pattern (reticular)

Bullous: autoAb to hemidesmosomes (attached to basmt mb), bellow epidermis. IF linear

Dermatitis herpetiformis: IgA depostio in upper papillary dermis

Epidermolysis bullosa acquisita: autoAb to type VII collagen

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32
Q

Horner syndrome

A

PAM is horny

Ptosis

Anhidrosis

Miosis

AM-hemifacial!

Hypothalamus -> spinal cord (down)-> (& back up) superior cervical ganglion-> eye, sweat glands of face

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33
Q

45XO

A

Turner Syndrome:

Short stature, shield chest, Primary amenorrhea, no barr body,complete monosomy XO or mosaicism

DECREASED estrogen w/ INCREASED LH&FSH

Ovarian streak (ovarian dysgenesis): infertile but have uterus and with IVF and estrogen and progesterone supplementation can get pregnant. Nrml uterus + vagina.

Bicuspid aortic valve, preductal coarctation of aorta. Horseshoe kidney, lymphatic defects (webbed neck or cystic hygroma, lymphedema of feet and hands)

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34
Q

Bromocriptine

A

Dopamine receptor agonist can inhibit prolactin and restore fertility in women with hyperprolactenemia

Or used for pituitary adenoma (prolactinoma)

or PARKINSON tx

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35
Q

Clomiphene citrate

A

blocks negative feedback of circulating estrogen at hypothalamus, increases FSH and LH

Use: PCOS, SERM, to treat infertility due to anovulation

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36
Q

drugs that cause Diabetes insipidus

A

lithium (used for mood stabilization in bipolar disoder, can also be used in SIADH) and

dimeclocycline (ADH antagonist_tetracycline family used in SIADH)

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37
Q

2yo, painless red bleeding per rectum with discharge that has gastric mucosal cells

A

Meckel diverticulum

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38
Q

Prokaryotic DNA polymerase I vs III

A

I: Removes RNA primers in lagging strand and replaces it with DNA

III: makes DNA in 5’ to 3’ direction

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39
Q

CA 125

alpha fetoprotein

CA 19-9

A

Ovarian cancer

Hepatocellular cancer, nonseminomaotus germ cell tumor (endodermal sinus yolk sac tumors)

adenocarcinoma of pancreas

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40
Q

Alkaptonuria

A

Inherites deficiency of homogentisate 1,2-dioxygenase in degradation of tyrosine to fumarate

auto recessive

Dark urine on standing/exposure to air

Destructuve arthritis later in lige bc homogentisic acid deposits in articular cartilage

Ochronosis, blue-grey discoloration of skin and ears too, brown in sclera.

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41
Q

Renin stimulation

A

Decreased NaCL

Decreased pressure in afferent arteriole

Sympathetic stimulation

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42
Q

EKG signs of hyperkalemia

HypoCalcemia

HyperCalcemia

Hypokalemia

A

Peaked T waves, loss of P wave, prolonged PR intercal, widening of QRS compkex, slowed HR–>venti fibrillation

Hypocalcemia: QT prolongation

HyperCa: QRS shortening

Hypokalemia: QT interval prolongation, U waves and ST depression

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43
Q

Parinaud syndrome

A

Paralysis of conjugate vertical gaze due to lesion in superior collliculi (pinealoma-> mass effect)

Upward gaze palsy, absent pupillary light reflex, failure of convergence and wide based gait.

Damage to oculomotor, trichlear and edinger westphal nucleus (parasympathetic innervation of eye)

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44
Q

Phenylepherine

A

alpha 1 adrenergic receptor agonist

Arterial vasoconstriction: increased in vascular resistance and BP–> increase in BP elicits baroreceptor-mediated vagal tone which leads to decreased stroke volume and slowed HR

(phenylephrine increase TPR so body decreases CO to maintain BP by decreasing HR and SV

BP=TPR*CO and CO=HR*SV)

Pulse-pressure is decreased bc of the reflex (decreased SV and increased afterload)

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45
Q

CAAT and TATA box

A

80-70bp upstream and 25bp upstreamof transcription start site ATP

Promote initiation=bdg site for RNA polymerase II=transcription initiator

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46
Q

Amyotrophic lateral sclerosis

A

muscle weakness and atrophy distally->proximally

Hyperreflexia and spasticity

47
Q

Cystic hygroma

A

cavernous lymphangioma of the neck. Associated to turner syndrome and trisomies so with chromosomal aneuploidy. Lymphatic lesion, doesnt connect to venous circulation. Children>adults. Painless. tranlluminate. Karyotype abnormalitis are present in 25-70% of children

48
Q

Rash (Stevens Johnson syndrome

A

Anti-epipileptic drugs (ethosuximide, carbamazepine, lamotrigine, phenytoin, phenobarbital) Allopurinol, sulfa drugs, penicillin

Steven Johnson has EPILEPTIC ALLergy to SULFA drugs and penicillin

49
Q

drugs that cause photosensitivity

A

SAT For Photo

Sulfonamides, Amiodarone, Tetracyclines, 5 FU

50
Q

SLE like syndrome

A

Having lupus is SHIPP-E

Sulfa, Hydralazine, **INH, **Procainamide, Phenytoin, Etanercept

51
Q

Myopathy drug side effect

A

statins, niacin, fibrates, colchicine, hydroxychloroquine, INF alpha, penicillamine,glucocorticoids

52
Q

Gingival hyperplasia

A

Phenytoin,verapamil, cyclosporine, nifedipine

53
Q

CYP inducers +

A

Chronic alcoholic Mona Steals **Phen-Phen **and Never

Refuses Greasy Carbs

Chronic Alcohol use

Modafinil (daytime stimulants used for narcolepsy)

St. Johns wort (herb for depression)

Phenytoin

Phenobarbital

Nevirapine (NNRTI)

Rifampin

Griseofulvin (anti-fungal for tinea and ringworm)

Carbamazepine

54
Q

CYP substrates

A

Always, Always, Always, Always Think When Starting Others

Anti-epileptics

Antidepressants

Antipsychotics

Anesthetics

Theophylline (blocks adenosine: bronchodilator by inhibiting phosphodiesterase, increase cAMP. (SE: cardiotoxicity, neurotoxocity), narrow therapeutic index

Warfarin

Statin

OCPs

55
Q

CYP inhibitors —

A

A cute Gentleman Cipped Iced Grapefruit juice Quickly And Kept Munching on Soft Cinammon Rolls

Acute alcohol abuse

Gemfibrozil (fibrate: increase LPL, increasing TG clearance, activates PPAR alpha and increase HDL synthesis)

Ciprofloxacin (Fluroquinolones)

Isoniazid

**Grapefruit juice **

Quinidine

Amiodarone

Ketoconazole

Macrolides

Sulfonamides

Cimetidine

Ritonavir (boaster)

56
Q

Kluver Bucy syndrome

A

Bilat lesion to amygdala (temporal lobe). associated with HSV-1. Hyperorality, hypersexuality, hyperphagia, dishinbited behavior, visual agnosia, aphasia, loss of nrml anger and fear, amnesia,

57
Q

Tardive dyskinesia

A

rhytmic involuntray mvmt of mouth and tongue during chronic neuroleptic therapy.

Due to upregulation of dopamine receptors and decrease in cholinergic tone in the striatum.

58
Q

Neuro finding of rabies

A

Eosinophilic cytoplasmic inclusions (Negri bodies=nucleocapsid material from the rabies virus) in the hippocampal neurons

59
Q

Sulfasalazine

A

NSAID used for IBD and RA

60
Q

Glucagon-life peptide 1

A

incretin stimulate insulin release following ORAL glucose consumption. GI hormones made by gut mucosa and stimulate pancreatic insulin secretion in response to sugar containing meals.

61
Q

ACE inhibitor fetopathy

A

Secondary to ACE inhibitor therapy in mom. ANgiotensin II required for normal fetal renal development. Fetus have renal atrophy, renal hypoperfusion/ischemia, defective urine concentrating ability and anuria–>oligohydramnios (defecincy in amniotic fluid)->defective lungs and limb contractures–> poor fetal perfusion

62
Q

Probenecid

A

Inhibits reabsorption of uric acid in PCT (also inhibits secretion of penicillin)

used for chronic Gout tx

SE: pt with sulfa allergies might react!

Could be used with penicillin to reduce its secretion

63
Q

Imipenem

A

Beta-lactamase resistant carbapenem. ALways administered with cilastatin (inhibitor of dehydropeptidase I) to decrease inactivation of durg in renal tubules.

SE: SEIZURES

64
Q

Spider angiomas

A

Size correlate with liver damage. Can be sen in pregancy of malnourishment or nrml.

In cirrhosis: hyperestrogenemia causes it, Estrogen is usually metabolized by the liver.

Hyperestrogenemia: spider angioma, plamar erythema, gynecomastia, testicular atrophy, decreased body har, contractures.

65
Q

Loose and disorganized proliferations of Schwann cells (elongated, wavy cells with spindly nuclei), fibroblasts and neurites

A

Neurofibroma

66
Q

Loose & bloody stools

Endoscopy: erythematous, edematous, friable, granular mucosa from anal verge to proximal colon.

Neutrophils accumulation in crypt lumina=> crypt abscesses.

INFtion limited to mucosa

A

Ulcerative colitis

67
Q

Paclitaxel (and sirolimus)

A

drugs that coat stents they inhibit cell division and prevent intimal hyperplasia (=blood vessel due to these procedures, thickening of tunica intima

68
Q

RNA virus that replicate in nucleus

A

Influenza virus (orthomyxovirus-ssRNA (-) 8 segments) and retroviruses

69
Q

microsatellite instability

A

HNPCC (lynch syndrome), DNA mismatch repair genes

70
Q

GI infection in HIV positive pt

A

CMVcolitis.

CMV retinitis

Histology: acute and chornic inflammation changes, vasculitis, giant cells with large ocoid nucleic containing centralized intranuclear inclusions

71
Q

flank pain, flank mass, hematuria

A

renal cell carcinoma (90% renal malignancies). Inappropriate erythropoietin-> erythrocytosis

72
Q

Cerebellar, retinal hemangioblastomas

renal cell caricnoma

phemochromocytoma

A

Von Hippel Lindau syndrome

Auto. dominant, tumor suppresor gene chrm 3

73
Q

cerebellar degeneration, broad based gatie, leg ataxia, truncal instability

A

chronic alcohol consumption

74
Q

Severe fasting hypoglycemia, increased glycogen in liver, increased blood lactate, hepatomegaly

A

Von gierke disease (type I)

auto recessive

Glucose 6 phosphatase deficient

** **Tx: frequent oral glucose/cornstarch, avoidance of frucose and galactose

Cori disease Type III milder than I with nrml lactate levels: debranching enzyme deficient. auto recessive. Gluconeogenesis intact

75
Q

Cardiomyopathy and systemic findings leading to early death

Auto recessive

Severe: hypotonia, macroglossia, massive hypertrophic cardiomyopathy, early death

A

lysosomal alpha-1,4-glucosidase (acid maltase) deficient

—>glycogen accumulation in lysosomes

Pompe disease

Pompe trashes the pump

76
Q

Pontine hemorrhage

A

pinpoint pupils, loss of horizontal gaze, quadriparesis, decerebrate posturing, coma and death in a few hours

77
Q

Syncope, Angina, Dyspnea (SAD) on exertion

A

Aortic stenosis

Systolic murmur

Crescendo-Decrescendo

Loudest at heart base radiates to carotids!

Age related calcification or bicuspid aortic valve

78
Q

MI + nrml coronary arteries

mitral valve thickening with vegations

A

coronary arteritis, hypercoagulability with acute thrombosis or coronary vasospans

infectious endocarditis, rhaumatic valvulitis, libman sacks endocarditis associated with SLE and non-bacterial thrombotic endocarditis.

79
Q

Fixed S2 splitting

A

Atrial septal defect: left to right sunt. Increased blood flow thru the pulmonary artery

*Muscular pulmonary arteries may develop laminated medial hypertrophy that if severe over time increase pulmonary resistance above systemic resistance.

Eisenmenger syndrome occurs where the shint now becomes right to left! die tot chronic pulmnoary HTN and we see cyanosis, clubbing and polycythemia. Pulm vascular sclerosis becomes irreversible.

80
Q

Persistent fever, bilateral conjunctivitis, lymphadenopathy, cutaneous involvemnt: oropharyngeal-palatine mucosa, fissured lips, strawberry tongue, peripheral extremeties_edema, erythema, and desquamation of hands and feets, generalized rash-polymorphous, extremities->trunk

A

Kawasaki

81
Q

mononuclear blindnesss

A

temporal arteritis complication

82
Q

Congenital QT interval prologation + congenital neurosensory deafness

A

Jervell and Lange-Nielsen Syndrome

auto recessive

mutation in K or Na channel of cardiac cells

predisposes to syncopes and torsades de pointes aka sudden death

83
Q

RNA polymerase I

RNA polymerase II

III

A

i: in nucleolus, makes rRNA
ii: makes mRNA
iii: makes tRNA and small rRNA oustide of nucleolus

84
Q

ANOVA (analysis of variance)

A

usedto compare the MEANS of 2 or MORE groups

85
Q

Two-sample z test

Two sample t test

A

used to compar the MEANs of 2 groups

86
Q

chi test

A

checks difference btwn 2 or MORE PERCENTAGES or PORPORTIONS of CATEGORICAL outcomes NOT MEANS

87
Q

Daptomycin

A

Disrupts bacterial membrane by creating transmb channels->depolarization of mb, inhibitionof protein synthesis ->cell death

use: Gram positives only including MRSA, VRE

SE: Myopathy and CPK elevation. Inactivated by pulm. surfactant!

88
Q

HAMARTOMA in lung

A

islands of mature hyaline cartilage, fat, smouth muscle, and clefts lined with respi epithelium_ disorganized firbous, cartilage, and adipose tissue

Benign, coin lesion, 50-60y

89
Q

tryptase

A

marker of mast cell activation_sign of mast cell degranulation and therefore of anaphylaxis

90
Q

PECAM1: CD31 expressing cells

Exposure to arsenic, throtrast, polyvinyl chloride

(Platelet endothelial cell adhesions molecule)

Leukocyte migration

A

Liver angiosarcoma: rare malignant endothelial ell associated with carcinogen exposure: arsenic, thorotrast and polyvinyl chloride.

91
Q

Nodular or smooth pleural thickening with calcifications

EM: numerous, very long, slender microvilli and abundant tonofilaments joined together by desmosomes

A

Mesothelioma (from abestosis)

92
Q

Migratory thrombophlebitis

A

=cancer (hypercoag very common paraneoplastic syndrome seen in adenocarcinoma of pancreas, colon, lung)

or small vessel hypersentivity type vasculitis

Trousseau syndrome: Superficial venous thromboses appear and disappear to appear elsewhere: redness and tenderness on palpitation of extremities

93
Q

fat embolism

A

respi distress, non-focal neuro dusturbance, chest lesions consistent with thrombocytopenia after suffereing mutliple long bone fractures or liposuction, anemia!

**Fat **dislodges from bone marrow enter marrow vascular sinusoids and occlude microvessels

hypoxemia, neuro abnrmlities, petechial rash

94
Q

Ethambutol

A

SE: optic neuritis

decreased visual acuity, central scotoma, color-blindness

(reversible)

95
Q

Olser Weber Rendu

A

Telangiectasia, recurent epistaxis, skin discolorations , arteriovenous malformations, GI bleeding, hematuria

Hereditary hemorrhagic telangiectasia

Auto dominant

96
Q

transmural inflammation with fibrinoid necrosis

A

polyarteritis nodosa

NOT in the LUNG

fever, abdominal pain, peripheral neuropathy, weakness, weight loss, muscualr aches and pains. Associated with Hepatitis B!!!!

97
Q

Melanoma

A

malignancy of melanocytes derived from neural crest cells

can spread to CNS (manifest with seizures), GI, bone, liver, lungs.

98
Q

mental retardation, eczema, mousy, musty body ordor

A

phenylketonuria (PKU)

autosomal recessive disease

mutation of phenylalnine hydroxylase or decrease in tetrahydrobiopterin cofactor

Tyrosine is essential

increase levels of phenylalanine, and increased levels of phenylketones in urine

avoid artificial sweetener (aspartame contains phenylalanine)

99
Q

chediak higashi syndrome

A

auto recessive

immunodeficiency, albinism, neurologic defects, nystagmus

defect in neutrophil phagosome lysosome fusion

abnrml giant lysosomal inclusions!

dx in childhood

recurrent pyogenic infections due to Staph and Strep

100
Q

pellagra

A

dermatitis, diarrhea, dementia

Dermatitis: bilateral and symmetric on sun-exposed areas, roughened, thickened, scaly

Diarrhea: columnar epithelium atrophy of GI

Dementia: 2ndary to neuroal degeneration in brain and spinal cord ~ pernicious anemia.

101
Q

dermatitis herpetiformis

A

bilaterally, symmetrically on extensor surfaces ,elbows, knewws, upper back and buttocks

vesicular, pruritic papules and bullae

association to celiac disease

IgA and IgG antibodies agaisnt gliadin, cross react with reticulin

102
Q

Spherocytes

A

small, round, without nrml central pallor

hereditary spherocytosis, autoimmune hemolytic anemia burns, un-fresh blood samples

103
Q

Bite cells

A

G6PD deficiency

Splenic monocyte-macrophage system removes Heinz bodies from RBCs.

104
Q

Target cells

A

HALT

HbC disease,

Asplenia,

Liver disease

Thalassemia

105
Q

DVT, cerebral vein thrombosis, recurrent pregnancy loss

A

factor V leiden

mutation in factor V cant Protein C cant bind it anymore!!

ALso Va leiden in circulation increases thrombin release=>increasing coagulation

106
Q

sickling promoted by

A

low oxygen levels, increased acidity, low blood volume (dehydration), high 2,3 DPG

107
Q

stop codons

A

UAG, UAA, UGA

108
Q

pancytopenia, arthritis, nephritis

A

SLE

109
Q

low Hg, thrombocytopenia, absetn hemotopoietic cells in bone marrow

A

aplastic anemia

Cause:

Radiation and drugs (Benzene, chloramphenicol, alkylating agents, antimetabolites)

Viral Agents (Parcocirus B 19, EBV, HIV, HCV)

Fanconi anemia (DNA repair defect)

Idiopathic-may follow acute hepatitis

110
Q

DIC vs TTP-HUS

A

DIC: Pt bleed, coagculation cascade is activated, PT and PTT are prolonged, low fibrinogen, icreased FDP

TTP-HUS: DO NOT BLEED, ONLY platelets are activated, nrml PT and PTT, nrml fibrinogen

111
Q

celecoxib

A

cox 2 inhibitor

112
Q

Heparin overdose

A

protamine sulfate (heparin antagonist)

113
Q

Hemolytic uremic syndrome (HUS-TTP)

A

bloody diarrhea (Shiga toxin from EHEC O157:H7,undercooked ground beef)

Schistocytes, no plt, nrml PT and PTT