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Flashcards in uWorld 13 Deck (35):
1

elastase in the lungs is released from what cells

macrophages (in lysosomes)
neutrophils (azurophilic (primary) granules)

2

when is beta-hCG first detectable in the serum

8 days after fertilizations
6 days at the earliest b/c that is when IMPLANTATION OCCURS
beta-hCG is produced by the SYNCYTIOTROPHOBLAST after implantation

detectible in urine 14 days after fertilization (less sensitive than serum pregnancy test)

3

what is a crossover study

subjects are randomly allocated to a sequence of 2 or more treatment given consecutively
simplest model is AB/BA type of study in which subjects are allocated to the AB study arm receive treatment A followed by treatment B and vice versa in the BA arm

allows PATIENTS TO SERVE AS THEIR OWN CONTROLS

4

what is a disadvantage of crossover studies and how is it limited

principle drawback is that effects of one treatment may "carry over" and alter the response to subsequent treatments
to limit this a washout (no treatment) period is often added b/w consecutive treatments

5

what is a case series

a descriptive study that tracts patients with a known condition (a particular exposure, risk factor, or disease) to document natural history or response to treatment
a qualifying study that cannot quantify statistical significance

6

a left shift in the hemoglobin curve causes what sequelae in the a patient

ERYTHROCYTOSIS (compensatory to maintain normal oxygen delivery)
hint: hypoxia (low tissue O2 from the left shift and less unloading at the tissues) causes ERYTHTROYCYTOSIS b/c the kidneys sense the low tissue O2 and synthesize ERYTHROPOIETIN

7

what is the pre-contemplation stage of change (transtheoretical) model

no thinking about behavior modification

denial

8

what is the contemplation stage of change (transtheoretical) model

thinking about behavior modification

acceptance

9

what is the preparation stage of change (transtheoretical) model

planning behavior modification

panning

10

what is the action stage of change (transtheoretical) model

putting plan into action

11

what is the maintenance stage of change (transtheoretical) model

maintaining new behavior

12

what kind of drug is fenoldopam and what is it used for

DOPAMINE-1-RECEPTOR AGONIST (little or no effect on alpha or beta-adrenergic receptors)

used in hypertensive emergency especially when there is ACUTE KIDNEY INJURY b/c fendolopam has prominent RENAL VASODILATION effects and thus INCREASES RENAL PERFUSION
INCREASES NATRIURESIS

13

what is homocysteinuria and what is the most common cause

condition that leads to HYPERCOAGULABILITY and THROMBOEMBOLIC OCCLUSION
premature acute coronary syndrome, ECTOPIA LENTIS (DOWN and OUT displacement), and INTELLECTUAL DISABILITY

MCC = CYSTATHIONE SYNTHASE defect

cysteine is essential in diet

14

what does IL-3 do

promotes growth and differentiation of bone marrow stem cells

15

what promotes class switching to IgE

IL-4
IL-13

16

what is seen histologically in high-grade CIN

expansion of immature basal cells to the epithelial surface

17

what cells in the bone form from mononuclear phagocytic cell lineage and are ultimately formed when several precursor cells fuse to create a multinucleated mature cell
what factors are essential for the differentiation of these cells

osteoclasts
macrophage colony-stimulating factor (M-CSF)

receptor for activated nuclear factor kappa-B ligand (RANK-L)

18

what is osteoprotegerin (OPG)

physiologic decoy receptor that decreases binding of RANK-L to RANK

19

middle meningeal artery is a branch off of what

MAXILLARY ARTERY

20

the PTH receptor and calcium-sensing receptors (CaSR) are what kind of receptors

transmembrane G-protein0 coupled (metabotropic) receptors

21

what use transmembrane ligand-gated ion channels (inotropic receptors)

acetylcholine
serotonin
NMDA
GABA

22

what use transmembrane receptors that recruit Janus Kinase

GH
prolactin
erythropoietin

23

true aneursyms of the ventricular wall are bound by scarred myocardium is seen when after a large transmural infarct

late complication (greater than 1 month)

can cause thrombus, arrhythmias, and HF but rarely rupture

24

what are signs and symptoms of ventricular free wall rupture seen within 5-14 days of an MI

hemoperricardium and cardiac tamponade
profound hypotension
shock
rapid progression to pulseless electrical activity and death

25

what causes an S4 in older adults

age-related decrease in left ventricular compliance (relatively benign finding)
the louder it gets the more pathologic it is- like left ventricular hypertrophy following prolonged hypertension or restrictive cardiomyopathy

26

what is the second most common cause of ring-enhancing lesions with mass effect (seizures) in HIV pts

Primary Central Nervous System Lymphoma (PCNSL)
b-cell origin from epstein-barr virus

27

lymphadenopathy behind the ears is indicative of rubella or rubeola

rubella
rash of rubella typically spreads faster and does NOT DARKEN or COALESCE

28

what drug competitively inhibits iodine transport

potassium perchlorate or pertechnetate

29

what TB drug requires intracellular catalase peroxidase activity to be activated

Isoniazid (INH)- inhibits mycelia acid synthesis but needs to be processed by mycobacterial catalase peroxide for the drug to be activated within the bacteria

30

how does cyanide work

potent mitochondria toxin that binds Fe3+ in CYTOCHROME C OXIDASE inhibiting the electron transport chain and halting aerobic respiration in the cell

31

tonofiliaments, long slender microvilli in proliferation of epithelioid-type cells that are joined by desmosomes is indicative of what lung cancer

mesothelioma
pancytokeratin immunohistochemical marker is helpful

32

what is seen in the bladder of a MS patient

bladder hypertonia w/ increased urinary frequency and urge incontinence

33

what characterizes primary biliary cirrhosis

chronic autoimmune liver disease
infiltrate of macrophages, lymphocytes, plasma cells, and eosinophils that results in granulomatous destruction of INTRAHEPATIC, INTERLOBAR BILE DUCTS ("florid duct lesion")

34

primary biliary cirrhosis presents in who

insidiously in middle-aged women
FATIGUE and PRURITITS (usually worse at night) are usually first symptoms
hepatosplenomegaly and CHOLESTASIS (jaundice, pale stool, dark urine)
XANTHELASMA formation

35

what is seen in disseminated HSV infection

primarily in immunocompromised ppl and presents with diffuse vesicles on an erythematous base
NO erythema multiform