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UWSA 1 Flashcards

1
Q

Where is AV node anatomically located?

A

Intratrial septum near tricuspid valve

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2
Q

Where is SA node anatomically located?

A

RA near SVC

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3
Q

What is order of length of conduction from fastest to slowest?

A 
PAVA
Purkinje fibers (bundle of HIS) 2.2m/sec
Atrial muscle 1.1 m/s
Ventricular muscle 0.3 m/sec
AV node (slowest at 0.05 m/s)
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4
Q

What bone condition is associated with Paget’s disease?

A

Osteosarcoma. Lysis and sclerosis of bone, focal periosteal elevation, Codman’s triangle, subburst pattern of soft tissue adjacent to bone

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5
Q

Which vitamin is teratogenic in 1st trimester?

A

Vit A- spontaneous abortion and fetal defects, cardiac anomalies, microcephaly, early epiphyseal closure, growth retardation

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6
Q

MOA oseltamivir?

A

Inhibits neuraminidases that inhibit cleaving of sialic acid and release of viral particles

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7
Q

What is DNA laddering?

A

Appearance of DNA fragments on gel electrophoresis. Malignant cells overexpress BCL2 antiapoptotic protein and so their endonucleases don’t work- the fragments will remain uncleaved

***DNA laddering –> BCL2 –>Evasion of apoptosis

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8
Q

What does Ach do to smooth muscle in lungs? Which receptors are activated?

A

Causes contraction via stimulation of M3 receptors

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9
Q

MOA physiostigmine?

A

AchE inhibitor - will increase levels of Ach and cause bronchoconstriction

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10
Q

Which drug blocks the action of M3 receptors in lung?

A

Atropine - competitive muscurinic receptor antagonist

Will act as anticholinergic agent and decrease the effects of Ach (decreased smooth muscle constriction)

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11
Q

What are SE of benzos? Who gets them

A

Elderly people who have slower CYP hepatic oxidative reduction

Confusion, anterograde amnesia, falls, ataxia

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12
Q

What are signs of anticholingergic toxicity?

A

Mad as a hatter, hot as a hare, blind as a bat, red as a beet, dry as a bone, full as a flask, fast as a fiddle

Mydriasis, urinary retention, dry, flushed skin, confusion/hallucinations, tachycardia, hyperthermia, decreased sweat and salivation

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13
Q

Which drugs cause anticholingeric toxicity?

A

Jimson weed (seeds)

Atropine (M3 antagonist), scopolamine, hyoscyamine

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14
Q

If genetic mutation is present in offspring, but not in parents, what occurred?

A

Germline mosaicism

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15
Q

What will you see on smear for AML?

A

Auer rods

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16
Q

What is translocation in AML?

A

15;17

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17
Q

What is Tx for AML?

A

All trans-retonoic acid

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18
Q

What are initial symptoms of AML?

A

Pancytopenia- weakness, fatigue, bleeding gingiva, easy bruising

DIC

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19
Q

Which cells secrete IL-2? What is function?

A

T-cells that have been activated by antigens

IL-2 stimulates growth of other white cells- NK cells, B cells, T cells, macrophages

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20
Q

What transmembrane proteins are used for epithelial cells to adhere to one another?

A

Cadehrins- form desmosomes and adherens junctions. They are calcium-dependent & will not adhere without extracellular Ca2+

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21
Q

What will you see on histology for molluscum contagiosum (pox virus)?

A

Cytoplasmic inclusion bodies- eosinophilic cytoplasmic inclusion bodies made of viral particles

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22
Q

What stimulates bile and bicarbonate release?

A

Low duodenal pH

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23
Q

What muscles are near the popliteal artery?

A

Adductor magnus and soleus

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24
Q

Sublimation? (psych)

A

Channelling impulses into socially acceptable behaviors ( never drinking because your dad drank)

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25
What does ligand binding to tyrosine kinase receptor do?
Causes **dimerization* of two identical receptor subunits that then undergo conformational change to expose tyorsine kinase active sites
26
MOA phosphodiestrase-5 inhibitors?
Increase cGMP and cause SM vasodilation in corpora cavernosa
27
What muscle is paralyzed in winged scaupla? Innervation?
Serratus anterior, rotates scapula upward | Long thoracic nerve. Lymph node dissection or chest tube placement can sometimes damage nerve
28
What does pancreas secrete in response to secretin?
Bicarbonate
29
As flow rate increases, what electroyltes are secreted from pancreas?
Bicarbonate and Na+ Bicarb and Cl have inverse flow relationship due to Cl-/HCO3- exchanger
30
Duration of acute stress disorder vs PTSD?
ASD = 3 days to 1 month | PTSD > 1 month
31
What are categories in punnet square for determining TP, TN, FP, FN?
Diseased and non-diseased | vs + test and - test
32
Equation for false positive rate?
(1-specificity)
33
How do you calculate RR?
RR = (diseased/total in group A)/(diseased/total in group B)
34
Equation NNT?
1/ARR
35
Calculation for ARR?
Control Event rate - experimental event rate
36
Patient with port wine colored urine, abdominal pain, n/v, peripheral neuropathy. What is it?
Porphobilinogen deaminase deficiency Acute intermittent porphorya (defective heme synthesis No skin photosensitivity* Usually occurs after oxidative stress (medications)
37
How is retinoblastoma caused by hereditary disease?
2 hit hypothesis RB1 gene already mutated A second mutation causes the disease from spontaneous somatic mutation Bilateral mutlifocal retinoblastoma + osteosarcoma
38
Most common cuase of septic arthritis?
Staph aureus & N gonorrhea
39
What are WCC like for people with digeorge? Which infections will they get
Dysplastic thymus --> Abnormally low T cells (CD3+) but normal B cells Fungal infections - Candida and P Jirovecii
40
What is chiari malfomation I?
Displacement of cerebellum through foramen magnum | Occipital headaches, ataxia, worse with physical activity
41
46XY with female karyotype. Vagina ends in blind pouch. What is it?
Complete androgen insensitivity syndrome
42
What are labs in 5-alpha reductase deficiency? Presentation?
Ambiguous genetalia | Testosterone/DHT ratio elevated
43
What receptors are found in adrenal medulla?
Alpha1 and Beta 1 (responsible for catecholamine release and HTN)
44
MOA Phenoxybenzamine? When do you use it?
Irreversible Alpha-1 inhibitor. Before pheochromocytoma surgery to avoid hypertensive crisis Don't give beta-blockers because they increase the action of Alpha-1 receptors in periphery
45
What structure in the brain is responsible for neonatal IV hemorrhage?
Germinal matrix (dense cellular and vascular layers where neurogenesis occurs). Bleeds into ventricles
46
What does amiodarone do to lung?
Interstitial pneumonitis
47
What is misoprostol used for? MOA?
Prostaglandin E1 analogue, decreases gastric acid secretion. Can treat peptic ulcers Cervical ripening in pregnancy
48
How do NSAIDs lead to asthma and respiratory disease?
Inhibit COX pathway and cause increased production of leukotrienes
49
Where do squamous cell carcinomas due to smoking occur in head/neck?
Ventral tongue, floor of mouth, lower lip, soft palate, gingiva. Mets to submandibular area
50
Effect of nitrates on HR and end diastolic volume?
Decreased EDV, increased HR (due to reflex tachycardia)
51
What is electrolyte composition in sweat and mucous for CF patients?
High Cl in sweat | Low Cl and Na in mucous
52
What are the stages of mRNA processing?
5' capping - stabilizes 5' mRNA in cytosol PolyA trail addition- stabilizes 3- in cytosol Splicing out of introns (causing DNA loops) by snRNPs***
53
What is allelic heterogeneity?
Same disease, but different genes causing it
54
Man with hyperpigmentation, derranged LFTs, arthralgia, Diabetes, cardiomyopathy. what is it?
Hemochromatosis- autosomal recessive disease of excess iron stores. Excessive GI absorption of iron
55
How does cirrhosis cause splenomegaly?
Portal venous system congestion, increased backpressure into splenic vein (valveless system)
56
Burn victim with yellow crusting on wound. What is organism?
Staph or strep- impetigo- yellow crust
57
What is cell mechanism for multidrug resistance?
Bacterial antibiotic efflux pumps using ATP, proton electrochemical gradients, and sodium gradients**
58
Which gene is affected in achondroplasia?
FGFR3 - restricted chondrocyte proliferation
59
What are White cells like in X-linked burton agammalobinemia?
No B cells, present T cells | Intracellular messaging abnormality
60
Where do insulin N-terminal peptide sequence proteins accumulate in someone with diabetes?
Proteins accumulate in cytosol. Normally translated -->ER cleaves preproinsulin into proinsulin-->Golgi-->cleavage of proinsulin--> exocytosis of insulin and C peptide
61
What accumulates in maple syrup urine disease?
Branched chain amino acids
62
What enzyme and vitamin is deficient in MSU disease?
``` Alpha ketoacid dehydrogenase Requires B1 (thiamine) as a cofactor ```
63
What type of cells secrete andorgen binding protein in males? Why is this important?
Sertoli cells secrete them in order to maintain high concentrations of testosterone in epydidymis and seminiferous tubules so that spermatogenesis can occur
64
Signaling path for glucagon?
Stimulates Gs -->adenylate cyclase-->cAMP--> | glygocenolysis & gluconeogenesis
65
What is signaling path for insulin?
Tyrosine kinase receptor ---> phosphoinositide 3-pathway --> increases glucose uptake in tissues, increasess glcogen synthesis, decreases gluconeogenesis
66
What type of collagen is affected in OA?
Type II collagen - haline cartilage
67
What is pathogenesis of OA?
Increased biomechanical stress and metalloprotease activity
68
What are clinical signs of pulmonary artery hypertension?
Pitting edema, RV hypertrophy, R ventricular heave Due to pulmonary endothelial dysfunction** hyperplasia of intimal layer
69
What enzyme is deficient in neonatal hypoketotic hypoglycemia?
Medium chain Acyl-CoA dehydrogenase deficiency. No formation of Acetyl-CoA to form ketone bodies. Fatty acids usually oxidized to form ketone bodies
70
What genes are associated with 2-hit hypothesis (tumor supressor genes?)
VHL, BRCA1/2, APC, TP53, RB, WT1
71
What genes are associated with gain of function (proto-oncogenes?)
RAS, MYC, ERBB1/2, HER2, ABL, BRAF
72
What are internal ribosome entry sites?
Part of programmed cell death when a specific nucleotide sequence (internal ribosome entry) will attract eukaryotic mRNA and allow it to be translated in middle of sequence
73
MOA piolitazone?
Thiazolidinediones (PPAR-y activators) | -Decrease insulin resistance by upregulating genes for GLUT4 and adiponectin (fatty acid oxidation)
74
SE of pioglitazone?
Fluid retention, weight gain | No hypoglycemia
75
MOA dapaglifozin?
SGLT-2 inhibitor- inhibits glucose reabsorption
76
MOA sulfonylureas (glyburide) and meglitinides (repaglinide)?
Block K+ ATPase in pancreatic beta cells, causing depolarization of L-type calcium cannels, releasing insulin
77
What is main treatment for hepatic encephalopathy?
Lactulose (intestinal acidification to create lactic acid and acetic acid)
78
Which antibiotic interacts w warfarin?
SMP-TMX, it inhibits CYP 450 which then increases effect of warfarin (must lower dose of warfarin if giving SMP-TMX)
79
What are second messengers for Alpha 1/2, Beta 1/2 receptors?
Alpha 1 - increases IP3 Alpha 2- decreases CAMP Beta 1 increases CAMP Beta 2 increases CAMP
80
What part of bone is affected in osteomalacia?
Decreased mineralization of OSTEOID** in Haversian canal
81
Early onset malignancies- sacoma, breast, brain, adrenal, leukemia. What happened to their genes?
p53 two hit hypothesis - inactivating mutation on an alelle
82
What does recurrent laryngeal nerve supply?
all intrinsic muscles except for cricothyroid (superior laryngeal nerve)
83
What type of thyroid condition causes huge germinal centers to appear?
Hashimoto thyroiditis
84
What type of inheritence is duchenne muscular dysrtrophy?
X linked recessive
85
What causes achalasia?
Absence of esophageal peristalsis in distal esophagus. Degeneration of inhibitory ganglion cells in myenteric plexus
86
Who gets G6PD?
Africans, asians, mediterranians
87
What type of neurons are unmyelinated?
Slow pain, heat, and olfaction. Post-ganglionic autonomic nerves
88
Describe antigen processing in APC cell process?
MHC II made of alpha and beta subunits These are brought together by *invariant chain* and they go through RER and Golgi body to form a new complex that can be presented to T cells
89
What are symptoms of iron deficiency anemia?
Glossal pain, dry mouth, tongue papillae atrophy, alopecia
90
What happens cellularly when cardiac hypertrophy occurs?
Increased rate of myosin mRNA suynthesis
91
What layer of skin thickens when you get a callous?
Stratum corneum
92
MOA doxycycline?
Tetracycline, inhibits 30S ribosomal unit
93
MOA eurythromycin?
Binds 50s subunit
94
what determines cellular differentiation and de-differentiation?
Transcription factors
95
What does cholingergic stimulation do to eye?
Muscurinic agonists. Pupillary constriction (pilocarpine is a cholinomimetic)
96
What is pernicious anemia? Result?
Autoimmune descruction of gastric mucosa. Hypochloridia, decreased gastric acid, increased gastrin levels, decreased intrinsic factor and B12
97
Does varicocele transilluminate?
No. Only bulges when standing up not lying down
98
What are heart abnormaliies in Digeorge syndrome?
ToF, TA, interrupted aortic arch
99
What is result of CD40L deficiency? What is inheritance pattern?
X linked recessive Inability to class switch, hyperIgM syndrome Low IgA, IgG, IgE Normal B and T cell count
100
Alpha 1 receptors peripherally have what type of messenger system?
Phosphatidylinositol 2nd messenger system Gq-->phospholipase C --> inositol triphosphate (IP3)*** release, DAG, IP3 liberates calcium in ER and leads to smooth muscle contraction
101
What substances use cGMP as a second messenger?
BNP, ANP, NO
102
What do etanercept and infliximab target?
Anti-TNF-alpha agents. Used in autoimmune conditions
103
What organism does methenamine silver stain look for?
Aspergillus. Broomlike appearance. fungus balls in lng cavities
104
What do HOX13 genes do?
Determine where hand-foot-genitals go. Deformity results in malformations
105
How does afterload affect contraction velocity?
Decrease in afterload increases contraction velocity
106
Where do the maxillary sinuses drain?
Middle nasal meatus
107
What part of the sarcomere lengthens and shortens during muscle contraction and relaxation?
I- band containing thin actin filaments (and Z line)

STEP 1 MIXED (13 decks)

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