Blood testing in suscipicion of celiacs
- blood test for:
- IgA anti-endomysial
- Iga anti-tissue transglutaminase
- IgA anti-endomysial
- Iga anti-tissue transglutaminase
Transmural inflammation of arteries w/fibrinoid necrosis ==> dx?
- polyarteritis nodosa
Characteristics of polyarteritis nodosa
- segmental, fibrinoid necrosis of small-med arteries
- Sx
- fever
- abdominal pain
- peripheral neuropathy
- weakness
- weight loss
- assoc. w/hep B in 10-30% of cases
- fever
- abdominal pain
- peripheral neuropathy
- weakness
- weight loss
Most common point of occurence of intusseception
ileocecal jxn
Characteristics of a transaminase reaction
- reaction between amino acid and an alpha-keto acid
- e.g. glutamate & oxaloacetate
- often occur to allow amino acids to enter TCA cycle/Urea cycle
- Vit B6 (Pyroxidine) = cofactor for transaminase and decarboxilation reactions
- e.g. glutamate & oxaloacetate
TH1 cytokines (+ purpose) =
TH2 cytokines (+ purpose) =
- interferon-gamma, IL-2 ==> activate macs & attract CD8+ t cells
- TH2 ==> stimulate B cells [adaptive immunity]
- IL4 + IL13 ==> IgE from B cells
- IL5 ==> IgA + eosinophil
- IL4 + IL13 ==> IgE from B cells
- IL5 ==> IgA + eosinophil
"Red neurons" on histo section of brain
- ischemia/infaction within the past 12-24 hrs
Characteristics of lynch syndrome
- hereditary nonpolyposis colon cancer
- due to defect in mismatch repair
- AD
- due to mutations @
- MSH2 ==> MutS
- MLH1 ==> MutL
- MSH2 ==> MutS
- MLH1 ==> MutL
a. that runs with the radial n.
deep brachial
anatomic structure that runs through the hepatoduodenal ligament
- portal triad = hepatic artery, portal vein, common bile duct
Mechanism of relaxation of cardiac muscle
- calcium efflux preceeds relaxation
- accomplished via:
- Ca2+ ATP pump
- Na/Ca exchanger
- Ca2+ ATP pump
- Na/Ca exchanger
Most common cause of bronchiolitis + tx
- RSV
- 1st line = O2 or IV fluids
- in @ risk for progression, can give ribavirin:
- nucleoside analog
- active against RSV and hep C
- nucleoside analog
- active against RSV and hep C
K+ in DKA
- total body decrease in K+
- decreased intracell stores of K+
- normal to increased serum K+
- K+ drawn out in exchange for H+; low insulin levels
- increased if hypovolemic
- K+ drawn out in exchange for H+; low insulin levels
- increased if hypovolemic
HCV vs. HBV most common transmission
- HCV
- most common = blood transfusion or IV drug use
- possible, but less common = sexual transmission
- HBV
- blood contact (transfusion, needle stick, IV drug use) OR unprotected sex
- most common = blood transfusion or IV drug use
- possible, but less common = sexual transmission
- blood contact (transfusion, needle stick, IV drug use) OR unprotected sex
Strep infections that lead post-strep syndromes
- Impetigo (step skin infect) OR strep pharyngitis ==> APSGN
- ONLY strep pharyngitis ==> rheumatic fever
Common cause of fluid filled cavity in liver + fever chills
- dx = hepatic abcess
- underdeveloped countries ==> parasitic infection (entamaeba histolytica)
- developed countries ==> bacterial infection
- biliary tract infection (asc. cholangitis)
- portal vein pyremia (bowel or peritoneal sources e.g. appecitis, peritonitis, enteric pathogens)
- hepatic artery (hemat spread from distant site)
- penetrating injury or trauma
- biliary tract infection (asc. cholangitis)
- portal vein pyremia (bowel or peritoneal sources e.g. appecitis, peritonitis, enteric pathogens)
- hepatic artery (hemat spread from distant site)
- penetrating injury or trauma
ST elevation @ V1-V3 ==> dx?
occlusion at left anterior descending coronary artery
Riboflavin biochemical role
- Riboflavin + Pi ==> FMN = coenzyme
- FMN + Pi ==> FAD (i.e. FAD+) ==> oxidation/reduction reaction
- e.g. @ TCA cycle: succinate + FAD+ ==> fumarate + FADH2
- e.g. @ TCA cycle: succinate + FAD+ ==> fumarate + FADH2
Palpaple, nontender gallbladder + jaundice ==> dx?
- palpable, nontender gall = "Courvosier's sign"
- dx = adenocarcinoma of the head of the pancreas obstructing CBD
Presentation and risks for adenocarcinoma of the head of the pancreas
- ==> courvosiers sign (palpable, distended, nontender gallbladder) + anorexia + obstructive jaundice
- obstructive jaundice = jaundice + dark urine + pale stools
- risks
- age > 50
- smoking
- DM
- chronic pancretitis
- genetic predisposition: HNP, FAP, MEN
- obstructive jaundice = jaundice + dark urine + pale stools
- age > 50
- smoking
- DM
- chronic pancretitis
- genetic predisposition: HNP, FAP, MEN
Ondansetron: MOA, use
- MOA
- central = 5HT3 inhibitor @ chemoreceptor trigger zone (medulla) & solitary nuceus
- periphery = inhibit vagus-mediated nausea
- use: post-chemo anti-nausea
- central = 5HT3 inhibitor @ chemoreceptor trigger zone (medulla) & solitary nuceus
- periphery = inhibit vagus-mediated nausea
5HT3-inhibitors
- ondansetron
- granesetron
- dolasetron
Rapid and complete relief in RA [short-term]
glucocorticoids, e.g. prednisone
Methotrexate: MOA, use
- MOA: antimetabolite, antifolate
- use: RA, other autoimmune
Auer Rods ==> dx?
- AML (/PML)
Nevirapine: MOA, similar drugs
- NNRTI
- inhibits reverse transcription, doesn't need phosphorylation to be active
- other drugs
- efavirenz
- delaviridine
- efavirenz
- delaviridine
Canagiflozin: MOA, use, SE
- MOA
- oral anti-diabetic
- = SGLT2 inhibitor ==> decreased reabsorption of glucose @ proximal renal tubule
- ==> urinary glucose loss
- SE
- renal effects <== monitor Creatinine and BUN
- oral anti-diabetic
- = SGLT2 inhibitor ==> decreased reabsorption of glucose @ proximal renal tubule
- ==> urinary glucose loss
- renal effects <== monitor Creatinine and BUN
Lithium toxicity antidote
hydrocholorthiazide ==> trapping in urine
Cause of decreased gene transcription in Huntington's
- CAG repeats ==> gain of fxn ==> pathologic interactions w/trxn factors
- abnormal huntingtin ==> histone deacetylation ==> repressed trxn ==> decreased production of neurotrophic factors ==> impaired neuron survival
Causes of polyhydramnios
- decreased fetal swallowing
- intestinal atresia/obstruction
- anencephaly
- increased urine production
- twin-twin transfusion
- high CO due to anemia
- intestinal atresia/obstruction
- anencephaly
- twin-twin transfusion
- high CO due to anemia
Enhancer and inhibitor of morphine/opoid tolerance
- mechanism = ~ phosphorylation of receptors, increased cAMP
- glutamate ==> increased NMDA receptor activity ==> potentiation of tolerance
- ketamine ==I tolerance
RANK receptor fxn
- ==> formation and differentiation of osteoclasts ==> increased bone resorption
- ligands for RANK receptor =
- RANK ligand <== osteoblast-produced
- MSC <== osteoblast produced
- bone formation regulated by RANK/OPG (osteoprotegerin) balance
- OPG also produced by osteoblasts
- RANK ligand <== osteoblast-produced
- MSC <== osteoblast produced
- OPG also produced by osteoblasts
Location of PTH receptors in bone marrow
osteoblasts
Ras protein type & association
