Flashcards in UWorld_2.11 Deck (17)
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1
Botulism mechanism of infection
- main kinds: food-borne, wound, infant (honey)
- food-borne:
- spores grow intracellularly
- autolysis ==> release of neurotoxin into food (NOT actively secreted)
- toxin can be destroyed by heating, but if food is not cooked well, toxin will exert its effects
- neurotoxin ==> blocking of ACh release from nerve terminals @ NMJ ==> flaccid paralysis
- spores grow intracellularly
- autolysis ==> release of neurotoxin into food (NOT actively secreted)
- toxin can be destroyed by heating, but if food is not cooked well, toxin will exert its effects
- neurotoxin ==> blocking of ACh release from nerve terminals @ NMJ ==> flaccid paralysis
2
Clinical presenation of botulism
- "three 'Ds'":
- diplopia
- dysphagia
- dysphonia
3
Characteristics of Digeorge Syndrome
- CATCH-22
-
Cardiac abnormality (especially tetralogy of Fallot)
-
Abnormal facies
-
Thymic aplasia ==> T-cell dysfxn
-
Cleft palate
-
Hypocalcemia/Hypoparathyroidism
-
22q11.2 deletion
4
Characteristics of tuberous sclerosis
- AD
- cutaneous angiofibromas (adenoma sebaceum)
- seizures
- mental disability
- pathology
- CNS hamartomas and benign neoplasma
- renal/visceral cysts
- cardiac rhabdomyomas
- CNS hamartomas and benign neoplasma
- renal/visceral cysts
- cardiac rhabdomyomas
5
Characteristisc of Marfan syndrome
- AD
- Mutation @ FBN1 gene @ chromosome 15 ==> connective tissue glycoprotein defect
- associated sx:
- tall stature
- cystic medial necrosis ==> aortic dissection
- lens dislocation
- narrow face
- tall stature
- cystic medial necrosis ==> aortic dissection
- lens dislocation
- narrow face
6
Major fxns of stomach
- Protein digestin
- parietal cells ==> HCl
- chief cells ==> pepsinogen
- pepsinogen ==> pepsin ==> degrades proteins
- IF secretion ==> absorption of vitamin B12
- Gastric resevoir = slow emptying into small bowel
- parietal cells ==> HCl
- chief cells ==> pepsinogen
- pepsinogen ==> pepsin ==> degrades proteins
7
Tx/recommendations after total gastrectomy
- parental B12
- to avoid dumping syndrome (colicky ab pain, nausea, diarrhea)
- small meals
- low dietary intake of simple sugars
- small meals
- low dietary intake of simple sugars
8
Identify: A-H
- A = Corpus Callosum
- B = Lateral Ventricle
- C = Caudate
- D = Internal capsule
- E = Putamen
- F = Globus Pallidus
- G = Amygdaloid nuclei
- H = Internal Capsule
9
Cystic degeneration of putamen ==> dx?
Wilson's disease
10
Presentation of GVHD
- most common afer allogeneic bone marrow transplant or organs rich in lymphocytes (e.g. liver) or transfusion of non-irradiated blood
- T cells @ donor tissue recognize host MHC antigens and attack
- both CD4+ and CD8+ cells
- skin, liver, and GI tract are generally most affected
- Sx/Labs
- w/in one week of transplant
- liver damage ==> jaundice + elevated LFTs (ALT, AST, alk phos, bilirubin)
- GI damage ==> diarrhea, intestinal bleeding, ab cramping, ileus
- [severe cases] ==> skin desquamation
- both CD4+ and CD8+ cells
- w/in one week of transplant
- liver damage ==> jaundice + elevated LFTs (ALT, AST, alk phos, bilirubin)
- GI damage ==> diarrhea, intestinal bleeding, ab cramping, ileus
- [severe cases] ==> skin desquamation
11
Meckel diverticulum characteristics
- blind pouch connected to ileum <== incomplete obliteration of onphalomesenteric duct (connects midgut lumen and yolk sac cavity in fetal life)
-
ectopy ==> gastric, pancreatic and other types of cells/mucosa that may be found at meckel diverticulum
- presentation
- commonly ==> painless melana
- may become infected/inflamed ==> ~appendicitis presentation
- commonly ==> painless melana
- may become infected/inflamed ==> ~appendicitis presentation
12
Ectopy definition
- microscopically and functionally normal cells/tissue found in an abnormal location due to embryonic maldevelopment
13
Valsalva maneuver impact on venous return/heart murmurs
- ==> decreased venous return
- mitral valve prolapse & hypertrophic cardiomypathy ==> more audible
- aortic stenosis ==> less audible
14
Common heart murmur in CHF
- S3 = "ventricular gallop" <== blood rushing into partially filled ventricle or into a stiff ventricle
- best heard w/bell of stethoscope @ apex in L lateral decubitus position + patient completely exhales (==> heart closer to chest wall)
15
Characteristics of duodenal lining
- villi covered by simple columnar epithelium w/brush border
- goblet cells ==> mucous secretion
- APUD = amine precursor uptake and decarboxylation cells
- @ lamina propria = crypts of lieberkuhn ==> deliver secretion to intervillar spacese
- submucosa is deep to muscular mucosae
- Brummer's glands ==> alkaline mucous
- goblet cells ==> mucous secretion
- APUD = amine precursor uptake and decarboxylation cells
- Brummer's glands ==> alkaline mucous
16
Characteristics of jejunal villi
- more goblet cells vs. duodenal villi
- crypts of Lieberkuhn persist; open into intervillar space
- heavy lymphocytic infiltrate of lamina propria is common
17
Characteristics of ileum
