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166 Cards in this Set
- Front
- Back
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What type of epithelium in ovary?
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simple cuboidal
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Fallopian tube lining
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simple columnar
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HLA class II antigens are
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DP, DQ, DR
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HLA Class I antigens are
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HLA B27
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in anklyosing spondilitis what is the pathophysiology that appears in their genotype?
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too much HLA b27
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twin studies show that 80% genetics for
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bone mass density
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Older pt w bone pain, increase in serum alkaline phosphate, cement lines showing a mosaic lamellar bone pattern what does this indicate?
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Paget's disease of the bone, starts w a marked incr in ostereoclasts which incr osteoblasts...eventually see an incr in fibrous deposition, vascular proliferatin, fibroblasts & endothelial cells
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carbohydrate-rich mucus, edematous stroma, torturous spiral arteries in the endometrium indicate what phase?
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Secretory phase of menstrual cycle (day 15-28) stimulated by progesterone
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What happens in the proliferative phase of the menstrual cycle
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day 1-15, highly proliferative endometrium by estrogen, glan:stroma= <1:1
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Giving estrogen to some rats increases their RANK-ligand expression what does this mean?
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inreased bone resorption= releasing more calcium and breaking more bones (osteoclasts activated)
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14yo boy presents w delayed puberty, short heigh, loss of smell, & no scondary sexual developement what are you thinking?
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call-me-maybe? Kallman's syndrome!
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What is the defect with kallman's syndrome?
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the GnRH cells fail to migrate and form the olfactory bulbe which causes adecr in GnRH synthesis in the hypothalamus, anosmia, lack of 2nd sex characteristic, decr GnRH, FSH, LH, test, sperm count
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What is an example of a hypogonadotropic hypogonadism?
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Kallman's syndrome
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What does FSH stimulate in males?
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the seminiferous tubules--> inhibin which turns off FSH
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16yo female no menstrual cycle, decrease sexual characteristics, small elongated ovaries your thinking?
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turner syndrome XO
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What happens to the heart in turner syndrome?
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coarctation of the aorta & bicuspid aortic valve
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What do the ovaries appear like in XO?
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"streak" ovaries, small and elongated
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What kind of genetic abnormality is turner's syndrome?
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Aneuploid, one parental X lost in mitosis aka meotic nondisjunction
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What is an example of uniparental disomy?
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Angelman's syndrome & Prader Willi, only get one copy of maternal/paternal on chrom 15
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What do the synaptic vesicles in a motor neuron pre-synaptic contain?
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Ach
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What stimulates the release of Ach from the vesicles in pre-synaptic?
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Ca, action potential depolarizes the membrane causing extracellular Ca to influx into the synaptic membrane
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Name the boxes and the middle area of the figure
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Adrenal gland
zona glomerulosa zona fasiculata zona reticularis and adrenal medulla w chromaffin cells |
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Describe the mechanism of release catcheolamines and why is it different in the adrenal medulla?
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Everywhere else in the body all preganglioninc sympathetic neurons release ACH which activates nicotin, Ach R on post ganglions. Post ganglions release--> NE on target peripheral
medulla is an exception bc it does 80% epi, 20% NE direct to blood sweat glands also an exception bc postgangl--> ACh |
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What is negative predictive value?
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the probability of not having a disease, someone w a high chance of getting the disease will have a low NPV
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Which hormone will have a higher ratio after the LH surge than before the LH surge? Ad vice versa?
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progesterone
estrogen |
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K+ is more a _______ ion
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intracellular
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What is the RMP for K+? so what likely happens when channels open?
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-80mV, so when channels open it goes out (bc less is there) causing inside to become more negative
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What about Na+ it is found more____-
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extracellular
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Resting MP of Na+? so where would it go if channels opened?
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+60Mv , likely to go inside to make the RMP more positive
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Ca is mostly found ____
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extracellular, so would influx in a negative potential
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Who has lower bone denisty mass, caucasions or african americans?
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caucasians
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Does a low BMI or high BMI have a lower bone density mass?
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Low BMI
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glucocorticoids incr or decr Bone mass denisty?
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decrease it
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Anovulation is normal in
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first 7 yrs after first menarche, and 10 yrs before menopause
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an increased FSH assoc with
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menopause; lose feedback so keeps increasing
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Define capitation?
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physicians get a fixed amount no matter what, therefore likely to do more preventative medicine to keep their patients healthier
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2yo w black tarry stool, her 99mm-tc-ppetechnetate for RLQ is positive what are you thinking?
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meckels diverticulum
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What happens in Meckel's diverticulum?
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failure to close the omphoalomesenteric duct causing ectopi acid secreting gastric mucosa and or pancreatic tissue
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what are the five 2's assoc w meckels diverticulum
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2 inches long, 2 feet from ileocecal valve, 2% population, 2 first years of life, 2 type of epithelia (gastric/pancreatic)
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What is the most common presentation of Meckel's diverticulum?
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Lower Gi bleeding
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failure of ventral & dorsal pancreatic buds forms
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fusion of pancreas divisum= asymptomatic
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hindgut gives primitibe rise to
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distal 1/3 transverse colon, descending, sigmoid, and upper colon
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abnormal midgut rotation around SMA causes
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intestinal malorotation w adhesive bands and intestinal obstruction
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failure of neural crest would cause
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hirschsprungs disease
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6 month old baby comes in with diarrhea, resetlessness, failure to breathe, otitis and + pneumocytisis
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SCID causes recrrent infections of bacteria- hypoplasia of T and B lymphocytes
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what is agamaglobulinemia and common conditions seen w it?
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Be cell deficiency you see recurrent respiration infections
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Deificiency in 11-beta-hydroxylase causes?
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increase aldosterone & androgens, virilization in females
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Deficiency in 17-hydroxylase cause?
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increased aldosterone only & no virilization in girls
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Deficiciency in 21 hydroxylase causes
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excess of androgens only! virilization in fm
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Candida test is given to a mother and a bump is formed what is this made of?
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macrophages, Cd4, T lymphocytes, and CD8 T lymphocytes, NK, macrophages
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what type of reaction does the candida skin test measure?
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type IV delayed-hypersensitivity
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What do eosinophils do
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innate mimmune more for defending parasites
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study this remmeber the radial question
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AHH
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What is a depolarizing neurmuscular junction blocker?
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succinylcholine
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what is succinylcholine used for
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induction and intubation you use a train of 4 to assess muscle movement, acetylcholinesterases can block the block though
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32 yo pt w DS starting to lose all cognitive capabilites what would you most likely see on a CT?
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neurofibrillary triangles- likely associated w Alz. disease
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what do kinesin do?
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they use ATP to anterograde walk on microtubules and carry vesicles from cell body to nerve terminal
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What would be absent in a toxin that targeted kinesin?
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cargo delivered to end of microtubule tracks- that swhat kinesin does- delivers vesicles etc. atnerograde (- --> +)
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calculating risk of diseease (incidence)
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take amount disease over total number in that category (same levels of low comparing normal and diseased)
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environmental risks of diabetes II
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High BMI, lack of physicial activity (visceral fat not subcutaenous)
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Diseases associated with DS (5)
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acute leukemias (AML/ALL), congenital heart endocardial cushion (VSD/ASD), Gi duodenal atresia, Hirschsprungs, &Alzheimer's dz
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what 2 things are psammoma bodies often seen in?
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meningioma & papillary thyroid cancer
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27 yo female w epilepsy on valproate, wants to know risks of fetus if she gets pregnant?
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neural tube defects, likely to get spina bifida/meningioceles
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coartation of the aorta in fetus is associated with?
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turner syndrome see a bicuspid aortic valve
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Potter syndrome in a fetus is associated with
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renal agenesis
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Atrialized RV and tricuspid valve located down seen w pregnant moms on lithium is?
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Ebstein's
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an increase of AFP or acetylcholinesterase in the amniotic fluid indictes?
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neural tube defect
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Low levels of AFP in the amniotic fluid indicates?
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down syndrome
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which toxin commonly found in fish, binds to Na+ and prevents the influx?
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tetradoxin
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What is length constant?
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how far along an electric can impulse down an axon
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what increase and stabilizes the length constant and reduces the time constant?
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myelin
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demylination is bad bc?
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decr the length constant and increases the time constant
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SRy gene on Y chromosome is the
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testes determining factor
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testes produce sertolie cells and
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leydig cells
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sertoli cells make
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mullerian inhibitory factor which kills female internal genitalia
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testosterone creates
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DHT
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DHT causes
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genital tubercle, urogenital sinus...male external genitalia prostate
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What muscles are innervated by the recurrent laryngeal nerve?
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thyroartyenoid, lateral cricoarytenois, posterior crycoartyenoid, aryepiglotticus
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What nerve are you at risk of excising during a thyroidectomy?
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external branch of the superior laryngeal nerve
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know it
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What 3 things make a neurovascular triangle and travel superior to the thyroid gland
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superior thyroid artery, superior thyrdoi vein, superior larngeal nerve
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What lies deep to the superior thyroid artery
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external branch of the superior laryngeal nerve
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Southern blot experiment techqnique is comparable to
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alternative splicing
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what is alternative splicing
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a lot of pre-mRNA cut and re-sealed together to produce whats needed
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what is southern blot
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DNA sample electrophoresed on gel and transferred to a filter, then soak in denaturant and expose to radiolabeled DNA probe recognizes and anneals complimentary strand...result double-stran labeled DNA visualized when filter expose to film
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What is nothern blot
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same thing as southern but for RNA
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young child with Aplastic anemia should make you think of?
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someone with parvovirus B19, sickle cell anemia, or immunocompromised
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young child with Coronary artery anyeursm should make you think of
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Kawasaki's, feber, strawberry tongue, & rash
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child with dore throat, fever, rash, gray-white tonsillar exudates whats the worst complication from this?
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scarlet fever
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little kid with measles virus you're worried about
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encephalitis
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orchitis is complication from
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mumps
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T-cell precursor is made in the
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bone marrow
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when does the T-cell move to to the thymus
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1st trimester moves into thymus for positive and negative selectivity
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describe positive selection of Tcells
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in thymic cortex T cells w TCRs capable of binding self MHC molecules survive
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Describe negative selection of T cells
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in medulla T cells expressing TCRs w high affinity for self antigens undergo apopotosis
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what is the point of positive and negative T cell selection
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rid the overly autoreactive against self- antigens
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where do B cells undergo affinity maturation?
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germinal centers of the lymph nodes
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what cells undergo isotype switching and when?
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B lymphocytes and after exposure to an antigen
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21yo male vision impairment bilateral lens opacity what enzyme is causing the onset of these issues?
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aldose reductase- cataracts
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what happens w people that are galactokinase deficiency?
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appear with benign cataracts without hepatocellular manifestations...you get a built up of galactes which aldose reductase will keep converting to galactitiol (causes cataracts)
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scarring on the LV of a person shown here, what kind of collagen would make up this?
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type I (MI 1 osteogenisis imperfecta 1)
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1, 2, 3, 4 collagen name the pneumonic
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strong, slippery, bloody, BM
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What are Langherhan Cells?
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dendritic cells "professorial antigen presenters" so obvioulsy interact w T lymphocytes a lot...find in skin & mucous- contain Birbeck granules giving the tennis-racquet shape
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what gives this unique shape?
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Birbeck granules
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what cell line do Langherhan cells come from?
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myeloid cell line
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What are Kupffer cellS?
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macrophages of the liver..found in hepatic sinusoids and phagocytose everything there!
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What are Merkel cells?
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neuroendocrine cells- move to basal epidermis, for perceptoin touch nerve projection
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What are melanocytes?
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neural crest cells move to basal layer epidermis in embryogenesis ...no dendritic processes, give the diff shades of color
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Neurofibromatosis type 1, describe the common findings
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cafe au-lait spots, lisch nodules (pigment in hamartomas of the iris) can lead to tumors meningioma/pheochromocytoma
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what kind of genetic inheritance is this? Pt. presents w headache & left leg pain
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autosomal dominant...other symptoms probably bc of meningioma
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A study that lost 1200 of the 2500 population is at risk for?
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selection bias- loss to follow up creates this
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3yo w abdominal pain, rectal bleeding, laporotomy shows a blind pouch to th ileum with fibrous bands- end umbilicus what is this?
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Meckel's diverticulum, in early embryo theres a connection between the lumen midgut & yolk sac if it fails to seperate you get this
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Meckel's diverticulum causes
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rectal bleeding/intesting obstruction
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What kind of diverticulum is Meckel?
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true includes mucosa, submucosa, & muscularis...can also include ectopic tissue (gastric & pancreas)
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Coloni and Zenker diverticulums are examples of
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pseudodiverticlums zenker= upper esophagus
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rats w muscle rigidity werent able to respond to dopamine in substantia nigra- they injected dopamine but still no response why?
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bc of the tight junctions in BBB, no fenestrations or gap junctions doesnt allow anything to get by
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define each one
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tight junctions: zonula occludens, composed of claudins/occludins prevents any paracellular movement of solutes (BBB)
Desmosomes: anchors holds joining cells, macula adherhens- structural support via keratin Gap junctions: channel proteins called connexons permit electrical/chemical hemidesmosomes: keratin in basal cells to underlying BM integrin: membrane protein maintain integrity of BM binding of laminin in BM |
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Someone just received a bunch of blood transfused now have low Ca why?
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Citrate chelation of calcium
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What is added in stored blood?
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citrate
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what is the complication that can occur w citrate in blood transfusion?
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calcium chelator if give lots of blood 5-6L will cause hypocalcemia
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23yo fm immigrant w dry cough, and audio of a murmur in apex of heart, always had bilateral swelling of knees?
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MR: whoosing holosytici murmur- cardiac apex--> axilla
likely rheumatic heart disease bc of swelling |
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6yo eastern europe kid is having difficult breathing, hasnt been eating/drinking, fever, gray exudate what is the best thing to do?
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passive immunization, they have diptheria..by c. diptheriae-- since already infected give an antitoxin
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what does C. diptheria cause
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diptheria via exotoxing encoded by beta-prophage..inhibits protein synthesis via ADP-ribosylation of EF-2
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what are the symptoms of diptheria?
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pseudomembranous pharyngitis, lympahdenopathy, myocarditis, & arrythmias
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Someone who just had an MI, their tissue would have collagen the same as?
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bone, tendon, dermis type I
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virus A can not infect humans but after it's exposed to virus B it can infect humans...but the particles of it can not.. what is this called?
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phenotypic mixing...you get 2 viral strains and then mixing occurs... creating a difference not genotypic bc no mixing of cells
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what is incidence?
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the number of new cases out of the total population at risk , so the # of new cases/ total - the ones who already have it
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24 hrs of baby passes no meconium and has a dimple present instead of an anal opening...what other defects would you likely see?
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urinary tract defects
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what develops the anal canal below the pectinate line
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surface ectoderm
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What develops the anal canal above the pectinate line
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endoderm- hindgut
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What happens if theres failure to close the junction between the pectinates by the anal membrane?
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you can create a fistule and pass meconium through the urethra or vagina
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repurfusion arrythmias most likely caused by what kind of drugs?
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fibrinolytics- tpa, increase lyse of clot by increasing plasmin by plasminogen
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ketamine blocks tolerance development to morphine through what neurotransmitter?
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glutamate
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explain the process of tolerance with glutamate & morphine
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in morphine, seems like glutamate interferes w the opiod pathway to increase tolerance by binding NMDA receptor and increasing nitrous oxide (tolerance)
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pt comes in w glucose of 78 even after fasting, unable to eat N/V/fever, during fast liver converts pyruvate to make glucose what is the allosteric activator?
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acetyl coA
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What happens during fasting
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maintain plasma glucose by glycogenolysis (12-18 hrs) & gluconeogenesis (main one)
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phosphenolpyruvate conveted to pyruvate by
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pyruvate kinase (one-way)
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1st step for gluconeogenesis from pyruvate
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converts to oxaloacetate by pyruvate carboxylase which is allostericallyu activated w acetyl-coA
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Oxaloacetate is converted to phosphenylpyruvate
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by PEP carboxylase then phophenylopyruvate can convert to glucose
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Pt comes in with ptosis, horizontal & vertical diplopia, no constriction, and when asked to look ahead eye goes inferior and lateral..which muscle is intact?
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lateral rectus (VI) the superior oblique is allowing it to go down but lateral rectus is stronger pushing it out
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Which nerves are tested with the pupillary light-test
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PSNS which send signal on II, and signal comes out on III
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95% confidence levels, std dev= .5, and mean= 40 what is the range?
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39-41, 95% is 2 std deviations
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someone comes in after an accident w bruising a day later they turn green why?
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presenting a hematoma, green color comes from heme oxygenase- break down of heme-->protophoryin--> heme oxygenase--> biliverdin--> unconj bilirubin
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what does ferrochelatase do?
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enzyme in final step of heme anabolism, combines Fe+ protophoryin
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what is uroporphyrinage dcarboxylase involved in?
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heme anabolism its missing in PCT- porphyria cutanea tarda
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pt comes in w saddle anesthesia, loss of reflex, lower back pain with flexion of back and raising of legs probably problem in th?
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cauda equina
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S2-S4 is cauda equina and they do
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motor and sesnory nerve problems here shoe saddle anesthetic, loss of reflex, bladder dysfunction masive rupture of an intervetebral disc
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S1&s2 test
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achille's tendon, ankle-jerk reflex, sciatic nerve sensory of post thigh & leg
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What is minimal alevolar concentration
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the concentration of anesthetic for 50% patients to not feel pain, inverse relationship w potency
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how does the body get rid of extra iron and keep homeostasis?
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hepatic parenchymal cells aka hepcidin: acute phase reactant in the liver, keeps iron stored in macrophages keeps it in there
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what is ferroportin
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transports iron from the enterocytes to the blood
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what is transferring
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transports iron in the bloodstream
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baby w non-enveloped single stranded DNA virus likely to be?
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erythema infectiousum (fifth disease) comes from B19 virus, RBC destruction in fetus- leads to hydrops fetalis, death, slaped cheek rash
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what is thought to be the etiology of rheumatoid arthritis?
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rheumatoid factor igM antibodies to Fc portion of igG
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anti-mitochondria antibodies are found in
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primary biliary cirrhosis
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anti-centromere antibodies are found in
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CREST syndrome
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Anti-phospholipid antibodies are found in
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SLE and other
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Anti-ds DNA antibodies around found in
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specific for SLE
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baby that's flaccid, absent ankle reflexes, poor development of lumbar...what is the mom most likely at fault for?
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maternal diabetes causing caudal regression syndrome
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What all is seen w a fetus w maternal diabetes?
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congenital heart defects, neural tube defects, agenesis of sacrum/lumbar spine, flaccid paralysis
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What is seen in a fetus with the mom on vit A overdose?
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posterior CNS defects, auditory defects, spontaneous abortions, cleft palate, cardiac abnormalities, HOX gene problems
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Vegan diets are at risk for
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B12 defeiciency
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man comes in dizzy, fatigue, and w a mass in the lung wha his lab levels revewl hyponatremia and a low plasma osmolality what should you be thinking?
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SIADH, small cell lung carcinoma.. (oat cell) causes ectopic hormon production (ADH/ACTH) histo: Kulchitsky cell- small dark blue cells
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what are the common findings with SIADH?
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lung mass (small cell carcinoma) low Na+ in plasma, highly concentrated urine, low osmolality in plasma...BUT euvolemic bc you keeping peeing it out etc.
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IF someone w suspected SIADH has a urine osmolality <100 what are you thinking it is?
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polydypsia- their just drinking too much
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what is unique about the virluence of staph epidermis?
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ability to produce adherent biofilms, makes an extracellular matrix protects from all even T lymphocytes..eventually once mature can shoot out pathogenic seeds
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