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36 Cards in this Set
- Front
- Back
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K cells |
in small intestine secrete GIP (gastric inhibitory peptide or glucose dependent insulinotropic peptide) glucose related function is that oral glucose load is used more rapidly than the equivalent given by IV due to GIP secretion |
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when is motillin secreted |
during fasting, caused MMCs, stimulated by erythromycin |
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vagus acts on G cells via _______? On parietal cells via_______? |
G cells: Gastrin Releasing Peptide parietal: Ach |
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pancreatic secretions are_____(tonicity)? Low flow vs high flow composition. |
pancreas isotonically secretes Na-bicarb, but at low flow (when pancreas isn't stimulated, ie between meals, we don't need the extra bicarb in the intestine, so it is replaced w/ Cl-) At high flow (during active digestion) the bicarb is needed to neutralize the acidic chyme. |
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rate limiting step of bile synthesis |
cholesterol 7alpha hydroxylase |
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salivary tumors (painless masses) pleomorphic adenoma warthin tumor mucoepidermoid CA |
pleomorphic adenoma: irregularly shaped makes excision tricky warthin tumor: benign w/ germinal centers mucoepidermoid CA: malignant with muco and sq. epith. components |
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Whipple dz |
"Foamy Whipped cream in a CAN" Foamy PAS+ macs in lamina propria Whipple dz (gram +) Cardiac sx Arthralgias Neuro sx |
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Celiac sprue HLA assoc? Ab to? histologic feature? assoc. w/? tmt? |
HLA DQ2 and DQ8 antiendomysial, antiTTG, anti gliadin blunting of villi and increased lymphocytes in lamina propria assow w/ dermatitis herpetiformis (Ig deposits at tips of dermal papillae causing herpes-like vesicles) increased risk of CA tmt is gluten free diet |
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"current jelly" stools |
classic sign of intussusception
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location of volvulus in kids and adults |
cecum in children sigmoid in seniors |
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hirschprung dz association |
RET gene and down synd |
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necrotizing enterocolitis |
necrosis of intestinal mucosa w/ possible perf. most likely in neonates (especially in preemies (due to decreased immunity)) can see air in the bowel wall |
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2 CRC pathways |
Microsatellite instab. pathway (hereditary nonpolyposis colorectal cancer) problem w/ DNA mismatch repair R-sided exophytic mass bleeds APC/beta-catenin (chromosomal instability pathway). More common. Can be due to FAP, which is mutation of APC gene on chrm.5 ("polyp"). Order of events is "AK53": loss of APC (decreased cellcell adhesion and increased prolif) KRAS mutation (unregulated intracellular signal transduction) loss of p53 |
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tumor marker for CRC vs HCC |
CRC: CEA HCC: AFP (AFP is fetal form of albumin so that makes sense it's being made by less differentiated cells of the liver) |
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hepatic ademoma angiosarcoma |
hepatic ademoma: oral contraceptives or anabolic steroids angiosarcoma: pvc or arsenic |
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what causes PAS+ globules in the liver |
a1 antitrypsin def. |
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wilson dz pathophys and sx and tmt |
ATP7B mutation on chrm13 less cu incorporation into cerulopl. more cu in tissues and shorter t1/2 of cerulopl. Damage due to reactive O2 species. cu deposition in liver (cirrhosis and HCC), brain (basal ganglia), kidney, eye (KF rings), and joints. Hemolytic anemia due to reactive O2 species formed. chelation with penicillamine or trientine |
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Hemochromatosis genetic associations |
HLA-A3 HFE ("HFE and A3") C282Y and H63D mutations |
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1 biliary cirrhosis vs 1 sclerosing cholangitis |
1 biliary cirrhosis: middle aged female assoc. w/ other AI conditions. Mitoch. Ab. lymphocytic infiltrate + granulomas-> INTRAlobular bile duct destruction 1 sclerosing cholangitis: youg male w/ UC onion skin fibrosis -> beading intra and EXTRA hepatic bile ducts increased cholangioCA risk |
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porcelain gallbladder |
calcified gallbladder due to chronic cholecystitis remove prophylactically due to inc. risk of gallbladder CA |
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side fx of cimetidine |
inhib p450 antiandrogenic (gynicomastia, impotence, dec. libido) crosses BBB-> dizziness, confusion crosses placenta |
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mast cell markers? membrane stabilizer? |
CD11 and tryptase cromolyn |
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B cell markers |
CD 19, 20 CD21 (EBV binds this) As APC has MHCII and B7 (B7 provides second sig. to cd4 Th cells via CD28 on T cell) CD40 for class switching (binds CD40L on Tcells) |
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basophilic stippling assoc. conditions |
"Basically, ACiD alcohol is LeThal" Basophilic stippling Anemia of Chronic Dz Alcohol Lead poisoning Thalassemias |
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target cell assoc .conditinos |
caused by increased membrane to cytoplasm ratio -> target cells "HALT" when you reach the target HbC dz Asplenia Liver dz Thalassemia Sickle cell dz Iron def. anemia |
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alpha thalassemia 4 allele deletion and 3 allele deletion |
alpha thalassemia is alpha globin gene deletions 4 deletion: no alpha globulin. excess gamma forms Hb Barts tetramers. Fatal. "barts is bad" 3 deletion: excess B chain forms HbH tetramers. |
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causes of non-megaloblastic macrocytic anemias |
liver dz alcoholism reticulocytosis |
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Pmns w/ bilobed nuclei connected by thin chromatin filament |
myelodysplastic syndrome (pre leukemic condition marked by cytopenias and <20% blasts in the bone marrow) |
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heparins from low mw to high mw. T1/2 order? Reversal? |
all potentiate antithrombin III, and as such, are rapid acting and used where immediate anticoag is needed: PE, ACS, MI, DVT fondaparinux (Xa inhib), enoxaparin and dalteparin (mostly Xa inhib), and heparin (IIa and Xa inhib) Hep has the shortest t1/2 and can be reversed by protamine sulfate (+ charged molecule binds - charged hep) Hep can cause osteoporosis |
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HIT what drugs are used instead of hep in this situation |
IgG Ab against Hep-PF4 complex leads to thrombocytopenia and thrombosis (activates platelets) use argatroban, bivalirudin, dabigatran (direct thrombin inhibitors) in circumstances of HIT "Arg, pirates are rude" |
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Acute intermittent porphyria vs porphyria cutanea tarda |
Acute intermittent porphyria: def porphobilinogen deaminase "6 P's" porphobilinogen deaminase painful abdomen purple urine polyneuropathy psych disturbances precipitated by drugs, etoh, and starvation porphyria cutanea tarda (pct): def UROD most common porphyria blistering photosensitivity tmt for both is glucose and heme (inhibit ALAsynthase) |
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phosphodiesterase III inhibitors |
cilostazol, dipyridamole increase cAMP in platelets, inhibiting aggregation. Also act as vasodilators (thus dipyridamole is used in stress testing to induce coronary steal) |
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mtx |
antimetabolite (s phase specific) folic acid analog inhibits dihydrofolate reductase toxicity: "the M's" myelosuppression macrovesicular fatty change of liver mucositis murders babies (teratogen) sfx reversible w/ leucovorin (folinic acid) |
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hydroxyurea |
inhibits ribonucleotide reductase leads to dec. DNA synt (s phase specific) used as antineoplastic and also in sickle cell dz to inc. HbF |
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tamoxifen vs raloxifene |
both est antagonists on breast both est agonists on bone tamox agonist in uterus (inc. risk of endometrial CA) ralox antagonist in uterus |
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BRAF inhibitor |
vemurafenib |
