uWorld 24 Flashcards
low bone density is a well known complication of hyperprolactinemia. What causes this
GnRH suppression from the hypothalamus leading to HYPOGONADISM, anovulation, and amenorrhea
if untreated the LOW ESTROGEN (hypogonadism) causes accelerated bone loss (same process as postmenopausal osteopenia/osteoporosis
also see vaginal dryness (low estrogen)
amniocentesis performed on a pregnant women; amnionic fluid bilirubin levels check for what
erythroblastosis fetalis
HIGH ANDROGEN levels and LOW ESTROGEN with CLITOROMEGALY and AMIGUOUS GENITALIA in a female fetus MATERNAL VIRILIZATION (HIRSUTISM and VOICE DEEPENING) during pregnancy
AROMATASE deficiency
at puberty: amenorrhea, osteoporosis, and tall stature (low estrogen delays fusion of the epiphyses
male fetuses with aromatase deficiency have what
tall stature and osteoporosis
no genital abnormalities
what is peripheral tolerance
T cell anergy- functional inactivation of T-cells that are reactive to self antigens
what is central tolerance
acquired within the fetal thymus during negative selection
what is the most common cause of CORONARY SINUS DILATION
elevated RIGHT-SIDED HEART PRESSURE secondary to PULMONARY HYPERTENSION
also: anomalous venous drainage into the coronary sinus, including persistent left superior vena cava and total anomalous pulmonary venous return
what can cause MEDICATION-INDUCED IgE-INDEPENDENT mast cell activation
OPIOIDS (MORPHINE)
RADIOCONTRAST AGENTS
some antibiotics (VANCOMYCIN)
activation of PROTEIN KINASE A and PI3 KINASE
release of histamine, bradykinin, heparin, and a number of enzymes and chemotactic factors
DIFFUSE ITCHING and PAIN, BRONCHOSPASM, and localized swelling (URTICARIA)
what takes over the role of fructose metabolism in fructokinase deficiency
HEXOKINASE
what happens to T3 levels in hashimotos
stays relatively normal until late in the disease then it drops
what is alirocumab
monoclonal antibody against PCSK9 that blocks this effect, resulting in increased availability of LDL receptors on hepatocyte membranes and subsequently increased clearance of LDL from the blood
as the testicles descend what two things they pass through
DEEP INGUINAL RING (TRANSVERSALS FASCIA)- the transversus abdomens muscle laterally and the inferior epigastric vessels medially
testis then passes anteromedially to exit the canal via the SUPERFICIAL INGUINAL RING, which is formed by an opening in the EXTERNAL OBLIQUE MSUCEL APONEUROSIS above and medial to the pubic tubercle
what is the conjoint tendon
common tendon of the transversals abdomens and internal oblique muscle
forms part of the posterior wall of the inguinal canal
the internal oblique aponeurosis contributes to what
formation of the conjoint tendon and rectus sheath
FREE ribosomes remain floating in the cytosol throughout protein synthesis. What are they responsible or translating
proteins found in the: CYTOSOL NUCLEOSOL PEROXISOME matrix NUCELAR-ENCODED MITOCHONDRIAL proteins
ATTACHED ribosomes bind to the RER after protein translation begins. what do they syntehsize
most SECRETORY proteins
the integral membrane proteins of the NUCLEUS and CELL MEMBRANE
proteins within the ER, GOlGI NETWORK, LYSOSOMES
how do ribosomes attach to the RER
TRANSLOCON- protein complex continuing ribophorins that bind the large 60s subunit
in what tow parts of the cell is ATP made
cytosol- glycolysis
mitochondria- oxidative phosphorylation
proteins in both these cellular compartments come from FREE ribosomes in the cytosol
steroid hormone synthesis and drug detoxification are performed by various proteins found in what
smooth ER
SEE does not bind ribosomes b/c it lacks the translocon complex
aging is associated with increased ARTERIAL STIFFNESS caused by what
endothelial dysfunction and a change in extracellular matrix composition (decreased elastin, increased collagen deposition)
this leads to decreased compliance of the aorta and major peripheral arteries, causing elevated pressures during systole- ISOLATED SYSTOLIC HYPERTENSION
what are some causes of isolated systolic hypertension
arterial stiffness (aging) severe aortic regurgitation systemic causes (anemia, hyperthyroidism)
celiac disease is a chronic malabsorptive disorder caused by hypersensitivity to gluten, a protein found in wheat, barley, and rye
what is seen on histology
VILLOUS ATROPHY
CRYPT HYPERPLASIA
INTRAEPITHELIAL LYMPHOCYTE INFILTRATION
DUODENUM and JEJUNUM fucked the most
when does celiac disease present and what screening can be done for it
6-24 months after the introduction of gluten into the diet w/ symptoms of malabsportion (diarrhea, flatulence, steatorrhea, nutrient deficiencies, weight loss)
IgA anti-endomysial antibodies
IgA anti-tissue transglutaminase antibodies
what is the most effective preventative intervention in almost all patients (and especially true in those with diabetes)
SMOKING cessation
what is the most common primary cerebral neoplasm in adults
GLIOBLASTOMA
arises from ASTROCYTES and is typically located within the CEREBRAL HEMISPHERES
can cause mass effect within midline shift and can CROSS CORPUS CALLOSUM (“butterfly glioma”)
on gross exam: soft and poorly defined with area of NECROSIS and HEMORRHAGE
highly malignant- poor prognosis
what does oligodendroglioma look like on gross exam
well-circumscribed gray masses with calcification
slow growing tumors of adults typically in white matter of cerebral hemispheres
what does primary central nervous system lymphoma present as
most often seen in the immunocompromised
multiple brain lesions involving the sep gray matter, while matter, and cortex
what lymph nodes are found bounded by the inguinal ligament, sartorious muscle, and adductor longs muscle and overlie the femoral nerve, artery, and vein
what do they drain
SUPERFICIAL INGUINAL LYMPH NODES
drain all CUTANEOUS lymph from the UMBILICUS DOWN- including external genitalia and the anus (BELOW the DENTATE LINE)
