UWorld_2.11 Flashcards Preview

• 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

• "three 'Ds'":
• diplopia
• dysphagia
• dysphonia

• CATCH-22
• Cardiac abnormality (especially tetralogy of Fallot)
• Abnormal facies
• Thymic aplasia ==> T-cell dysfxn
• Cleft palate
• Hypocalcemia/Hypoparathyroidism
• 22q11.2 deletion

• AD
• cutaneous angiofibromas (adenoma sebaceum)
• seizures
• mental disability
• pathology
  • CNS hamartomas and benign neoplasma
  • renal/visceral cysts
  • cardiac rhabdomyomas

• AD
• Mutation @ FBN1 gene @ chromosome 15 ==> connective tissue glycoprotein defect
• associated sx:
  • tall stature
  • cystic medial necrosis ==> aortic dissection
  • lens dislocation
  • narrow face

1. Protein digestin
   1. parietal cells ==> HCl
   2. chief cells ==> pepsinogen
   3. pepsinogen ==> pepsin ==> degrades proteins
2. IF secretion ==> absorption of vitamin B₁₂ 
3. Gastric resevoir = slow emptying into small bowel

• parental B₁₂
• to avoid dumping syndrome (colicky ab pain, nausea, diarrhea)
  • small meals
  • low dietary intake of simple sugars

• A = Corpus Callosum
• B = Lateral Ventricle
• C = Caudate
• D = Internal capsule
• E = Putamen
• F = Globus Pallidus
• G = Amygdaloid nuclei
• H = Internal Capsule

Wilson's disease 

• 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

• 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

• microscopically and functionally normal cells/tissue found in an abnormal location due to embryonic maldevelopment

• ==> decreased venous return
• mitral valve prolapse & hypertrophic cardiomypathy ==> more audible
• aortic stenosis ==> less audible

• 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)

• 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

• more goblet cells vs. duodenal villi
• crypts of Lieberkuhn persist; open into intervillar space
• heavy lymphocytic infiltrate of lamina propria is common