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145 Cards in this Set
- Front
- Back
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How is hnRNA processed before it leaves the nucleus?
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5' cap
3' Poly-A tail Splicing out of introns Left with mRNA that leaves nucleus |
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What structures run through the cavernous sinus?
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Oculomotor: CNIII
Trochlear: CN IV Abducens: CN VI Opthalmic division of CN V Maxillary division of CN V |
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How do cardiac output, blood pressure, GFR, and thyroid hormone change during pregnancy?
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CO increases by 30-50%
BP decreases in early pregnancy, nadirs at 16-20 weeks, returns to pre-pregnancy levels by term GFR increases assocd w/inc plasma volume and preload, thus BUN/Cr decrease T4 unchanged TBG increases Total T3/T4 increases TSH, free T4, free T3 normal |
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Which neoplasm:
ACTH-->Cushing's Syndrome |
Small cell lung cancer
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Which neoplasm:
PTH-related peptide-->hypercalcemia |
Squamous cell cancers lung, head, neck)
Renal cell carcinoma Breast cancer |
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Which neoplasm:
EPO-->polycythemia |
RCC
Hemangioblastoma |
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Which neoplasm:
ADH-->SIADH |
Small cell lung cancer
CNS disorder--stroke, infection, trauma, tumor |
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What are the stages of behavioral change?
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Precontemplation
Contemplation Preparation/determination Action Maintenance (hopefully not relapse) |
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Describe following levels in primary hyperparathyroidism:
Serum Ca Serum Phos Alk Phos PTH |
Ca high
Phos low Alk phos high PTH high |
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Describe following levels in Paget's Disease of Bone:
Serum Ca Serum Phos Alk Phos PTH |
Ca nl
Phos nl Alk phos high PTH nl |
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Describe following levels in Vitamin D toxicity:
Serum Ca Serum Phos Alk Phos PTH |
Ca high
Phos high Alk phos nl PTH low |
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Describe following levels in renal insufficiency:
Serum Ca Serum Phos Alk Phos PTH |
Ca low
Phos high Alk phos nl PTH high |
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Which skin disorder:
Pruritic, purple, polygonal papules |
Lichen PLanus
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Which skin disorder:
Pruritic vesicles a/w celiac disease |
Dermatitis herpetiformis
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Which skin disorder:
Thickened scar esp. around face/chest |
Keloid
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Which skin disorder:
Parakeratotic scaling |
Psoriasis
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Which skin disorder:
Keratin-filled cysts |
Sbeorrheic keratosis
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Which skin disorder:
Skin rash and proximal muscle weakness |
Dermatomyositis
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Which skin disorder:
Honey crusting lesions common about the nose and lips |
Impetigo
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Which skin disorder:
Hyperkeratosis and koilocytosis |
Verruca of HPV, i.e., WART
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What portion of the spinal cord is affected by tabes dorsalis?
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Dorsal columns (gracilis, cuneatus)-->poor sensation, positive Rhomberg
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What portion of the spinal cord is affected by polio?
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Anterior horn MN's--West Nile also affects this area
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Treatment:
Trichomonas vaginalis |
Metronidazole
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Treatment:
Trypanosoma cruzi |
Nifurtimox
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Treatment:
Plasmodium vivax |
Chloroquine + Primaquine
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Treatment:
Leishmania donovani |
Sdoium stibogluconate
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Treatment:
Entamoeba histolytica |
Metro + Iodoquinol
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Treatment:
Toxoplasma gondii |
Sulfadiazine + Pyrimethamine
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What enzyme is responsible for tRNA charging?
What enzyme catalyzes peptide bond formation? |
Aminoacyl tRNA synthetase
Peptide bond formation via peptidyl transferase |
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Which skin disorder:
Hyperkeratosis and koilocytosis |
Verruca of HPV
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What portion of the spinal cord is affected by tabes dorsalis?
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Dorsal columns (gracilis, cuneatus)-->poor sensation, positive Rhomberg
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What portion of the spinal cord is affected by polio?
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Anterior horn MN's--West Nile also affects this area
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Treatment:
Trichomonas vaginalis |
Metronidazole
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Treatment:
Trypanosoma cruzi |
Nifurtimox
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Treatment:
Plasmodium vivax |
Chloroquine + Primaquine
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Treatment:
Leishmania donovani |
Sdoium stibogluconate
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Treatment:
Entamoeba histolytica |
Metro + Iodoquinol
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Treatment:
Toxoplasma gondii |
Sulfadiazine + Pyrimethamine
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What enzyme is responsible for tRNA charging?
What enzyme catalyzes peptide bond formation? |
Aminoacyl tRNA synthetase
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What are the characteristic features of HELLP syndrome?
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HTN
Elevated LFTs Low PLTs Pallor, jaundice |
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What is the pathway of sperm during ejaculation?
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SEVEN UP
Seminiferous tubules Epididymis Vas Deferens Ejaculatory Duct (Nothing) Urethra Penis |
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Erection:
ANS Branch and nerve Describe steps required to achieve erection (molecular) Describe steps to achieve detumescence |
Parasymp via Pelvic Nerve (Point)
NO-->Inc cGMP-->SM relax-->vasodilation-->proerection NE-->Inc'd Ca2+ intracell-->SM contraction-->vasoconstriction-->antierectile |
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What is emission? ANS branch? Nerve?
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Emission = movement of sperm toward prostatic urethra
SYmpathetics--Hypogastric nerve |
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Ejaculation:
ANS branch Nerve |
Sympathetic (shoot)
Pudendal nerve |
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Sildenafil:
MOA AE |
Inhibit cGMP PDE causing inc'd cGMP-->inc'd SM relaxation in corpus cavernosum
sildenaFIL FILls the penis AE: HA, flushing, dyspepsia, blue-green vision, hypotn w/nitrates (***lifethreatening) |
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Spermatogonia:
Function Location |
Maintain germ pool and produce spermatocytes
Line seminiferous tubules |
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Sertoli cells:
Function Location |
Secrete inhibin ot inhibit FSH
Secrete androgen-binding Protein to maintain testosterone levels Support and nourish developing spermatozoa Line seminiferous tubules (Sertoli cells Support Sperm Synthesis) |
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What is the blood-testis barrier?
Where is it found? |
Tight jns between adjacent Sertoli cells; isolate gametes from autoimmune attack
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Leydig cells:
Function Location |
Secrete testosterone
Located in interstitium |
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Describe the hyothalamic-gonadal axis in males.
Begin with GnRH release. |
Hthal: GnRH
Ant Pituitary: FSH, LH FSH-->Sertoli Cells-->ABP, Inhibin Inhibin-->inhibits ant pituitary release of FSH LH-->Leydig Cells-->Testosterone-->(+)Sperm production, (-) GnRH/LH release |
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Spermatogenesis:
Meiosis I vs Meiosis II-- Products Diploid/Haploid |
Meiosis I: Primary spermatocytes (4N)-->Secondary spermatocytes (2N)
Meiosis II: Secondary spermatocyte (2N)-->Spermatid (N) }Note: both 2N and N = haploid |
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Testosterone:
Function |
1. Differentiation of epididymis, vas def, SVs (internal genitalia EXCEPT prostate)
2. Growth spurt: Penis, SVs, sperm, muscle, RBCs 3. Deepening of voice 4. CLosure of epiphyseal plates via E2-->T conversion 5. Libido |
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DHT:
Function |
Early--diff of penis, scrotum, prostate
Late--prostate growth, balding, sebaceous gland activity |
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DHT:
Potency (vs other androgens) Production |
Potency: DHT> T> Androstenedione (adrenal T)
TEstosterone converted to DHT via 5-alpha reductase (inhibited by finasteride) |
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Which androgens are converted to estrogen? Where and how?
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T and androstenedione converted to E in adipose tissue and Sertoli cells via aromatase
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Methyltestosterone:
MOA Use AE |
Agonist at androgen receptors
Treat hypogonadism and promote dev't of secondary sex chars Stimulate naabolism to promote recovery after burn/injury Treat ER-poz BrCa AE: masculinization in females, reduced intratestic testosterone in males by inhibiting release of LH->gonadal atrophy Premature closure of epiphyseal plates Inc'd LDL, dec'd HDL (UNFAVORABLE LIPID PANEL) |
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Finasteride:
MOA |
5-alpha reductase inhibitor to prevent T-->DHT
Useful in BPH, promote hair growth |
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Fulatmide:
MOA |
Competitive inhibotr of androgens at receptor.
Used in CaP |
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Why is ketoconazole used in PCOS?
AEs? What other drug has this effect? |
Inhibits steroid synthesis (inhibits desmolase) to prevent hirsutism. AE: gynecomastic, amneorrhea
Sprinolactone used too, but works by inhibiting steroid binding. |
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Tamsulosin:
MOA Use |
alpha-1 antagonist used to tx BPH by inhibiting smooth muscle contraction.
Selective for alpha1-A,D receptors found on prostate (vs vascular alpha1B receptors), so no hypotn. |
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Which cells are responsible for maintaining a high testosterone concentration in the seminiferous tubules?
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Leydig Cells secrete testosterone
Sertoli cells secrete androgen binding protein, which helps maintain testosterone concentration in the area |
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What is cryptorchidisim?
Presentation |
Undescended testis (one or both); lack of spermatogenesis due to inc'd body temp assocd w/inc'd risk germ cell tumor
Prematurity increases the risk of cryptorchidism |
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Which testicular tumor:
Composed of cytotrophoblasts and syncytiotrophoblasts |
Choriocarcinoma
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Which testicular tumor:
May present initially with gynecomastia |
Leydig Cell Tumors
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Which testicular tumor:
Elevated AFP |
Yolk Sac Tumor
Embryonal Carcinoma |
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Which testicular tumor:
Elevated beta-hCG |
Choriocarcinoma
Embryonal Carcinoma |
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Which testicular tumor:
Most common testicular tumor |
Seminoma
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Which testicular tumor:
Most common testicular tumor in infants and children up to 3 years of age |
Yolk Sac Tumor
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Which testicular tumor:
Most common testicular tumor in men over 60 |
Testicular Lymphoma
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Which testicular tumor:
Histologic appearance similar to koilocytes (cytoplasmic clearing) |
Seminoma
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Which testicular tumor:
Histologically may have alveolar or tubular appearance with papillary convolutions |
Embryonal carcinoma
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Which testicular tumor:
Composed of multiple tissue types |
Teratoma
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Which testicular tumor:
histologic endodermal sinus structures (Schiller-Duval bodies) |
Yolk Sac Tumor
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Which testicular tumor:
25% have cytoplasmic rod-shaped crystalloids of Reinke |
Leydig cell tumor
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Which testicular tumor:
Androgen producing and associated with precocious puberty |
Leydig cell tumor
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A 55 year-old man undergoing treatment for BPH has increased testosterone and decreased DHT as well as gynecomastia and edema.
What is his medication? |
Finasteride or other 5-alpha reductase inhibitor
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Flutamide vs Finasteride:
MOA Use |
Flutamide:
Inhibits at testosterone receptor level; treats CaP Finasteride: 5-alpha-reductase inhibitor; prevents conversion of T to DHT Used for BPH and male pattern baldness |
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Clomiphene:
MOA Use |
Used for infertility
Acts as agonist at pituitary-estrogen receptor to induce FSH secretion |
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Which pathology:
Most common breast mass in postmenopausal women |
Invasive ductal carcinoma
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Which pathology:
Most common form of breast cancer |
Invasive ductal carcinoma
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Which pathology:
Small, mobile, firm mass with sharp edges in 24 yr old woman |
Fibroadenoma
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Which pathology:
Multiple bilateral fluid-filled lesions with diffuse breast pain |
Fibrocystic breast disease
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Which pathology:
Firm, fibrous mass in a 55 yr old woman |
Invasive ductal carcinoma
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Sildenafil:
AE |
All due to vasodilation:
Flushing, HA< dyspepsia Impaired blue-green color vision (little blue pill) Life-threatening hypotn in pts taking nitrates |
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Role of Sertoli and Leydig cells in spermatogenesis.
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Leydig cells: stimulated by LH, produce testosterone
Sertoli cells: Stimulated by FSH, secrete ABP Maintains high concentration of T in seminiferous tubules Provides nutrients to spermatocytes |
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Androgen insensitivity vs 5-alpha-reductase deficiency:
Pathophys Presentation |
Androgen insensitivity:
Testicular feminization Defect in DHT-receptor; does not respond to stimulation Phenotypically nl females Elevated T, LH, Estrogen 5-alpha-reductase deficiency: Can't convert T-->DHT Early defect: ambig genitalia Puberty: nl male genitalia Nl T, E, LH |
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Most common:
Cause of DIC |
STOP Making New Thrombi
Sepsis, trauma, OB, pancreatitis Malignancy Nephrotic syndrome Transfusion |
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Most common:
Heart murmur |
MV prolapse
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Most common:
Coronary artery involved in thrombosis |
LAD
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Most common:
Cause of death in lupus patients |
Lupus nephropathy
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Most common:
Congenital heart anomaly |
VSD
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How many carbon molecules are found on testosterone and on androstenedione?
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19
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What structures develop from the mesonephric duct?
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SVs
Epididymis ED Ductus deferens |
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Male homologue:
Vestibular bulbs |
Corpus spongiosum
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Male homologue:
Labia minora |
Ventral shaft of penis
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Male homologue:
Bartholin glands |
Bulbourethral glands
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Male homologue:
Urethral and paraurethral glands |
Prostate
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Where does testicular cancer first metastasize?
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Para-aortic LNs
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Which drug(s) cause(s):
Gingival hyperplasia |
Phenytoin
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Which drug(s) cause(s):
Gout |
Furosemide
Thiazides |
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Which drug(s) cause(s):
Osteoporosis |
Corticosteroids, heparin
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Which drug(s) cause(s):
Photosensitivity |
SAT for a photo:
Sulfonamides Amiodarone Tetracycline |
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Which drug(s) cause(s):
Steven-Johnson Syndrome (rash) |
Ethosuximide
Lamotrigine Carbamazepine Phenobarbital Phenytoin Sulfa drugs PCN Allopurinol |
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Which drug(s) cause(s):
SLE-like syndrome |
It's not HIPP to have Lupus
Hydralazine Isoniazid Procainamide Phenytoin |
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Which drug(s) cause(s):
Tendonitis, tendon rupture, cartilage damage |
Fluoroquinolones
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Which drug(s) cause(s):
Fanconi syndrome |
Expired tetracycline
Note: Fanconi = disease of the proximal renal tubules of the kidney in which glucose, amino acids, uric acid, phosphate and bicarbonate are passed into the urine, instead of being reabsorbed |
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Which drug(s) cause(s):
Interstitial nephritis |
NSAIDs
Furosemide Methicillin |
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Which drug(s) cause(s):
Hemorrhagic cystitis |
Cyclophosphamide
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Which drug(s) cause(s):
Cinchonism |
Quinidine
Quinine Note: Cinchonism = Dizziness, HA, tinnitus |
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Which drug(s) cause(s):
Diabetes insipidus |
Lithium
Demeclocycline |
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Which drug(s) cause(s):
Parkinson-like Syndrome |
Haloperidol
Chlorpromazine Reserpine Metoclopramide |
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Which drug(s) cause(s):
Seizures |
Bupropion
Imipenem/cilastatin INH |
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Which drug(s) cause(s):
Tardive dyskinesia |
Antipsychotics
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Which drug(s) cause(s):
Disulfiram-like reaction |
Metronidazole
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Which drug(s) cause(s):
nephrotoxicity/neurotoxicity |
Polymyxins
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Which drug(s) cause(s):
Nephrotoxicity/ototoxicity |
Aminoglycosides
Vancomycin Loop diuretics Cisplatin |
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What medication causes cardiotoxicity and bone marrow suppression?
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Doxorubicin, Duanorubicin
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A patient tries to commit suicide by overdosing on digitalis.
What is the most important step in the management of this pt? |
Stop digoxin
Give anti-digoxin antibody fragments Normalize K+ and Mg2+ |
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What drugs induce the P450 system, and what effect this will have on other drugs?
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Queen Barb takes Phen Phen and got RId of Grisy Carbs
Quinidine Barbiturates Phenytoin Rifampin Griseofulvin Carbamazepine (Chronic EtOH) |
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What drugs inhibit the P450 system, and what effect this will have on other drugs?
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PICK EGS
Protease Inhibitors INH Cimetidine Ketoconazole Erythromycin Grapefruit Juice Sulfonamides |
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An African-American male that goes to Africa develops anemia after taking prophylactic medicine for
primary disease prevention. What enzyme is this patient deficient in? |
G6PD deficiency
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A 65 year-old male patient taking multiple medications presents with gynecomastia.
What drug is most responsible for this pt's gynecomastia? |
Spironolactone
Ketoconazole (Some Drugs Cause Awesome Knockers) |
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A patient presents with tinnitus, dizziness, headaches, and Gl distress.
What drug is causing these symptoms? |
This is cinchonism; either quinine or quinidine
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What medications are known for causing drug-induced lupus?
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SHIPP
Sulfonamides Hydralazine INH Procainamide Phenytoin |
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Hereditary bleeding disorder
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von Willebrand's Dz
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Hereditary harmless jaundice
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GIlbert's syndrome (benign congenital unconj'd hyperebilirubinemia)
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HLA-B27
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Ankylosing spondylitis
Reiter's syndrome Ulcerative colitis Psoriasis |
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HLA-DR3/4
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DM I, RA, SLE
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Holosystolic murmur
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VSD, tricuspid regurg, mitral regurg
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Hypercoagulability, endothelial damage, blood stasis
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Vichow's triad--results in DVT
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Secondary hypertension
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Renal dz
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Hypoparathyroidism
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Thyroidectomy
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Hypopituitarism
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Pituitary adenoma (usually benign tumor)
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Infection secondary to blood transfusion
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HCV
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Kidney stones (types, appearance on x-ray)
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Calcium = radiopaque
Struvite (ammonium) = radiopaque; formed by urease-poz organisms such as Proteus vulgaris, or Staph Uric acid = radiolucent |
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Late cyanotic shunt
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Eisenmenger's syndrome (ASD, VSD, PDA); results in pulm HTN/polycythemia
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Malignancy associated with noninfectious fever
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Hodgkin's lymphoma
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Mental retardation
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Down Syndrome
Fragile X |
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Metastases to bone
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Breast, lung, thyroid, testes, prostate, kdiney
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Metastases to brain
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Lung, breast, skin (melanoma), kidney (RCC), GI
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Metastases to liver
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Colon, gastric, pancreatic, breast, lung
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Mitral valve stenosis
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Rheumatic heart dz
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Mixed motor neuron disease
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ALS (lou gherig's)
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Nephrotic syndrome (adults vs kids)
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Adults: membranous GN
Kids: minimal change dz (assocd w/infections/vaccinations; tx w/steroids) |
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Nosocomial pneumonia
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Klebsiella
Pseudomonas |
