Flashcards in uworld assessment block #4 4.15 Deck (109)
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)
differentiate infectious arthritis from reactive arthritis 'reiter's'
infectious arthritis: gonorrhea, s. aureus, strep
reactive arthritis: nongonococcual urethritis (chlamydia) and GI bugs (campylobacter, salmonella, shigella, yersinia)
infectious: tenosynovitis, synovitis, dermatitis
reactive: conjunctivitis, seroneg arthritis, urethritis
symmetric polyarticular disease. associated w/ parvovirus, hep B, hep C, rubella, alphavirus
neonatal hypotonia, extreme hyperphagia, morbid obesity, ultimately DM type II, short, small hands & feet, hypogonadism, characteristic facies.
pathophysiology of prader-willi
normal: mom's gene 15q11 region SILENT. express ONLY PAPA.
(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.
pathophysiology of angelman's syndrome
normal: papa's gene is normally SILENT. express ONLY MOM.
(1) delete mom's gene
(2) 5% uniparental disomy. (only inherit papa's imprinted gene)
presentation of angelman's syndrome
inappropriate laughter "happy puppet", seizure, ataxia, severe intellectual disability
inversions of chromosomal DNA in one arm of chromosome not including centromere
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.
Ab found in celiac's disease
anti-transglutaminase, anti-gliadin, anti-endomysial
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
normal thickness of right ventricle? left ventricle?
left: 1 cm
layers of epidermis
describe stratum corneum
15-20 layers of dead squamous cells that lack nuclei.
generally thickest in regions exposed to friction (soles of feet)
painless thickening of stratum corneum, at locations of repeated of external pressure / friction
essential characterestics of PCOS
amenorrhea, obesity, hirsuitism, virilization, peripheral insulin resistance, dyslipidemia
ovaries in PCOS
bilateral enlargement and smooth thickened capsules.
subcapsular follicles in diff stages of atresia.
hyperplastic theca stroma cells rim arrested follicles
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.
lesch-nyhan inheritance? presentation?
self-mutilating behavior, mild mental retardation, involuntary movement, delayed motor development, nephrolithiasis, gout
FROST on skin under diaper --> hyperuricuria
convert hypoxanthine and guanine to inosine monophosphate (IMP) and guanine mono phosphate (GMP).
absence: increased purine synthesis, hyperuricemia, hyperuricuria
impt for purine catabolism. deficiency: build up dATP, inhibit ribonucleotide redutase, inhibit DNA synthesis.
adenine phosphoribosyltransferase (APRT)
involved in purine salvage. converts adenine to AMP.
deficiency: hyperuricemia and adenine stone urolithiasis.
autosomal recessive. no neurological symptoms
erythromyocin drug effect
prevent tRNA release from donor site after peptide bond formation. 50S.
chloramphenicol drug effect
bind to 50S
block peptidyltransferase action
aminonucleoside, structure analogus to aminoacyl-tRNA.
leads to premature release of unfinished polypeptide chains and polypeptidyl-puromycin derivatives.
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.
cytokine vs. growth factor
growth factor = type of cytokine. stimulate GROWTH and DIFFERENTIATION of various lines. regulates synthesis of transcription factor.
timolol for glaucoma?
block b2 receptor mediated secretion of aqueous humor from ciliary epithelium
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