uworld assessment block #4 4.15 Flashcards Preview

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Flashcards in uworld assessment block #4 4.15 Deck (109)
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1

infectious arthritis causes? presentation

most common (1) n. gonorrhea (disseminated). can also be (2) s. aureus (2) streptococcus

STD triad: synovitis (arthralgia, knee), tenosynovitis (hand), dermatitis

(note, no eye symptoms. compared to reiter's -- conjunctivitis)

2

differentiate infectious arthritis from reactive arthritis 'reiter's'

infectious agents:

infectious arthritis: gonorrhea, s. aureus, strep
reactive arthritis: nongonococcual urethritis (chlamydia) and GI bugs (campylobacter, salmonella, shigella, yersinia)

eye involvement:
infectious: tenosynovitis, synovitis, dermatitis
reactive: conjunctivitis, seroneg arthritis, urethritis

3

viral arthritis

symmetric polyarticular disease. associated w/ parvovirus, hep B, hep C, rubella, alphavirus

4

prader-willi presentation

neonatal hypotonia, extreme hyperphagia, morbid obesity, ultimately DM type II, short, small hands & feet, hypogonadism, characteristic facies.

5

pathophysiology of prader-willi

imprinting.
normal: mom's gene 15q11 region SILENT. express ONLY PAPA.

disease:
(1) delete papa's gene
(2) 25% uniparental disomy (only inherit mom's imprinted gene)

would detect microdeltion of papa's chr 15 on FISH. if FISH is normal = uniparental disomy.

6

pathophysiology of angelman's syndrome

imprinting
normal: papa's gene is normally SILENT. express ONLY MOM.

disease:
(1) delete mom's gene
(2) 5% uniparental disomy. (only inherit papa's imprinted gene)

7

presentation of angelman's syndrome

inappropriate laughter "happy puppet", seizure, ataxia, severe intellectual disability

8

paracentric inversions

inversions of chromosomal DNA in one arm of chromosome not including centromere

9

GI presentation of celiac's disease

(1) blunting of villi (2) lymphocytes in lamina propria (3) hyperplasia of crypts

CD8+ T cells infiltrate surface epithelilum, while CD4+ in lamina propria.

distal duodenum

10

Ab found in celiac's disease

anti-transglutaminase, anti-gliadin, anti-endomysial

11

presentation of dermatitis herpatiformis? pathophysiology?

PRUITIC erythematous urticarial plaques on extensor surfaces of elbow, knee, buttocks, back.

caused by CROSS-REACTION of gliadin IgG and IgA with RETICULIN

--> component of fibrils that anchor the epidermal basement membrane to superficial dermis.

neutrophils at dermal tips --> microabscesses --> subepidermal blisters

12

normal thickness of right ventricle? left ventricle?

right: 3-4mm
left: 1 cm

13

layers of epidermis

corneum
lucidium
granulosum
spinosum
basale

14

describe stratum corneum

15-20 layers of dead squamous cells that lack nuclei.

generally thickest in regions exposed to friction (soles of feet)

15

callus

painless thickening of stratum corneum, at locations of repeated of external pressure / friction

16

essential characterestics of PCOS

amenorrhea, obesity, hirsuitism, virilization, peripheral insulin resistance, dyslipidemia

17

ovaries in PCOS

bilateral enlargement and smooth thickened capsules.

subcapsular follicles in diff stages of atresia.

hyperplastic theca stroma cells rim arrested follicles

18

hormone imbalance in PCOS

elevation in everything EXCEPT FSH

think: high LH makes theca cells produce more androgens.

FSH is diminished, so granulosa cells can't make as much estrogen.

19

lesch-nyhan inheritance? presentation?

X-linked recessive.

self-mutilating behavior, mild mental retardation, involuntary movement, delayed motor development, nephrolithiasis, gout

FROST on skin under diaper --> hyperuricuria

rx: allopurinol

20

HGPRT fxn

purine salvage.
convert hypoxanthine and guanine to inosine monophosphate (IMP) and guanine mono phosphate (GMP).

absence: increased purine synthesis, hyperuricemia, hyperuricuria

21

ADA deficiency

impt for purine catabolism. deficiency: build up dATP, inhibit ribonucleotide redutase, inhibit DNA synthesis.

22

adenine phosphoribosyltransferase (APRT)

involved in purine salvage. converts adenine to AMP.

deficiency: hyperuricemia and adenine stone urolithiasis.

autosomal recessive. no neurological symptoms

23

erythromyocin drug effect

block translocation.

prevent tRNA release from donor site after peptide bond formation. 50S.

24

chloramphenicol drug effect

bind to 50S

block peptidyltransferase action

25

puromycin

aminonucleoside, structure analogus to aminoacyl-tRNA.

leads to premature release of unfinished polypeptide chains and polypeptidyl-puromycin derivatives.

26

differentiation of a cell primarily depends on

transcription factor: favors expression of only those genes required for cell to perform function.

specific for each individual tissue.

27

cytokine vs. growth factor

growth factor = type of cytokine. stimulate GROWTH and DIFFERENTIATION of various lines. regulates synthesis of transcription factor.

28

timolol for glaucoma?

block b2 receptor mediated secretion of aqueous humor from ciliary epithelium

29

what GI hormone would be elevated in a patient with pernicious anemia?

GASTRIN. autoimmune destruction of parietal cells.

parietal cells secrete instrinic factor (bind to b12) AND HCl!

low HCl will prompt Gastrin secretion

30

pernicious anemia

results in atrophic gastritis w/ profound hypochloridia and increased serum gastrin levels