Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
88 Cards in this Set
- Front
- Back
|
Net yield ATP for acetyl CoA and pyruvate
|
acetyl CoA- 12
pyruvate 15 fatty acid can yield lots... 129 |
|
|
Key enzymes of carbohydrate metabolsm
1. glycolysis 2. gluconeogenesis |
gluconeogenesis- activated by phosphorylation, fructosedipohospahtase inhibited b AMP, fructose 2,6, dp, ATP activates
glycolysis- PFK1- inhibited by ATP, citrate, activated by AMP, fructose 2,6 dp, PFK2 inhibited by phopsohrylation |
|
|
Essential enzymes for fat metabolism
1. lipolysis 2. fat mobilization 3. lipid synthesis 4. cholesterol snthesis |
carnitine acyltransferase- inhibited by malonyl CoA
hormonse sensitive lipase- activated by phosphorylation AcetylCoA carboxylase- inhibited by phos, activated by citrate 4. cholsesterol synthesis, HMG CoA reductase |
|
|
Key enzyme of citric acid cycle
|
pyruvate dehydrogenase, inhibited by Aceryl CoA and NADH, inhibited by phos
citrate synthase- acetyl CoA, ATP, NADH inhibit |
|
|
Build up of 17-ketosteroids (androsenedione) w/ this deficiency
|
11-hydroxylase, 21-hydroxlase, Cushing syndrome androgen producing adrenal or gonad tumors
|
|
|
excess of cortisol metabolites seen w/
|
11-hydroxylase deficiency, Cushing's syndrome
|
|
|
17-alpha hydroxylase deficiency leads to...
|
overproduction of mineralocorticoids, decreased glucocortidcoids and androgens
|
|
|
ovarian theca cells and granulosa cell produce what?
|
theca cells produce androgens
granulosa cells convert androgens to estrogens in the periphery the estrigens are converted to estriol vs. in males testosterone converts to DHT |
|
|
17 alpha hydroxylase deficit presentation in males and females
|
males- ambiguous genitalia
females- amennorhea at puberty can't produce glucorticoids or androgens |
|
|
21-alphja hydroxylase deficiency, male, female and salt wasting
|
male- precocious puberty, increased DHEA
female- ambiguous genitalia salt wasting- 50% can't prodcue aldosterone |
|
|
11B-hydroxyalse in males and femals
|
males- precocious pubery, ambiguous genitalia in femalse
causes HTN and hypokalmeia, deoxycorticosterone more potent than aldosterone, still can't make cortisol |
|
|
Cortisol MOA
|
causes lysis and redistrubtion of fat, inhibits uptake of sugar, stimulates gluconeogenesis and glycogen syntehesis, build up stores of glycogen at expese of protein and fat
|
|
|
MOA of zidovudine
|
has a crazy amine thing where an OH should be at the 3' position, so no further elongation of HIV DNA, win!
|
|
|
5 fluorouracil
|
inhibits thymidine synthesis once converted to 5-FdUMP
|
|
|
Bacterial DNA stuff
1. operon 2. promoter 3. operator 4. repressor 5. regulator |
1. either on or off, includes promoter, operator and one or more strucutral genes
2. promoter- RNA polymerase binding site, located at 5' end of operon 3. operator- located between promoter and structural gene, binding site of repressors 4. repressor is protein- binds operator and prevents transcription 5. regulator- codes for repressor |
|
|
In Eukaryotes
1. transcription factor 2. inducer 3. enhancer |
no operons, each gene has its own promoter, regulation bind to several promoters, transcription regulated by combos
TF- binds to TATAbox, RNA polyemrase can't recognize w/o inducers- bind nuclear receptor protein, bind DNA to activate gene enhacncers- regulatory DNA sequence, can be far away, loops in DNA bring enhancers near promoter |
|
|
Clinical presentation of PCOS
|
infertility, amenorrhea, or oligomenorrhea, acne and heisutism, possile obesity and type II betes
overstimulation w/ LH causes theca cells to overproduceandrogens, converted to estrone in adipose tissue which inhibits FSH |
|
|
Patient presents with bloody and serous discharge from nips, dx and px?
|
intraductal papilloma, benign
|
|
|
Lobular carcinoma
|
never forms calcifications, signet ring cells, diffusely invasive in breast, detection is difficult
Single file arrangement of neoplastic cells |
|
|
Paget's disease of the nipple
|
form of ductal carcinoma in situ extends from nipple dcts into the skin, palpable mass present in breast, get fissured, uclerated, oozing, hyperemic, edematous nipple
|
|
|
Findings on mammography
|
density- spiculated density- invasive ductal or tublar breast cancer, cyst or finroadenoma have circumscribed smooth borders
Architectural distortion- lobular carcinoma, distortion without a discrete density calcifications- malignant lesion, small, irregular and clustered or linear branching are seen |
|
|
Cheilosis is associated with what vit deficiency?
|
drying and scaling of lips with fissured corners in vitamin B2 deficiency
|
|
|
Chronic gastritis type A vs. B
|
B- h. pylori- affects antrum, chronic irritation leads to eventual atrophy and metaplasia leading to carcinoma
Type A- fundus- autoimmune agianst gastric glands, parietal cells and intrinsic factor -> pernicious anemia, assocaited with other autoimmune diseases |
|
|
Addison's dz
|
autoimmune destruciton of adrenal, can;t produce aldosterone -> hylperkalemia, hyponatremia, increased ACTH prodcution and therefore POMC leading to darkened pigmentation
|
|
|
ADenomatous polyps
|
neoplastic, arise from prolierative dysplasia of epitehlial cells lining the ocolon
tubula- comprised of tubular epithelial glands villous adenoma- villous progenstion >4cm in diameter, poyps with the highest risk for malignant transformation, most common to the rectum and rectosigmoid colon, hypokalemia tubulovillous adenoma- somewhere in the middle |
|
|
Peutz Jegher's syndrome
|
AD, hamartomatous polyp- overgrowth of mature tissue from gland malformation, low cancer potential, , spotted hjyperpigmentaiton of lips, palms and soles
|
|
|
Gene defect associated with familial adenomatous polyposis? Gardner vs. Turcot
|
APC, all are autosomal dominant
Garner includes skin and bone tumors Turcot- includes CNS tumors All high risk to almost 100% getting colon cancer |
|
|
Hereditary nonpolyposis colorectal cancer
|
AD, defect in DNA mismatch repair genes, increases risk of colon and other CA, does not arise from polyps can either be APC inactivation or K-Ras oncogene and p53 suppression
|
|
|
Difference betweem right and left colon CA
|
Right causes iron deficicency anemia, + hemoccult
left causes hemoocult, change in bowel habits, crampy LLQ pain, pencil stools |
|
|
Diverticular disease
|
high pressure greatest risk is in sigmoid colon, most vulnerable where vessel penetrate
Diverticulosis- gross bleeding, blood vesssels at site are more exposed, painfless, diagnosed with barium enema or colonoscopy Diverticulitis- inflammation of diverticuli, onjects lodgin in diverticular origice trapping bacteria, LLQ pain, fevere, diarreha and drop in hct, diagnosed onf CT tx is cipro and metronidzole |
|
|
Crohn's vs. Ulcerative colitis
|
crohn's- skip lesions, ileum, granulomas, crypt abcesses, + string sign, tx is sulfasalazine plus roids immunosupresents, transmural
Ulcerative colitis- progresses from rectum continuously, nongranulomatous, pseudopoylms, lead pipe colon, hig risk of CA and toxic megacolon,more bleeding than pain, sulfasalazine, +/- immunosuppressives |
|
|
+ schilling test indicates
|
decreased B12 absorption with and w/o intrinisc factor, rules out pernicious anemia
chronic pancreatitis, bacterial overgrowth, diseas e of ileum |
|
|
Findings in celiac sprue, tropical sprue and Whipple's dz
|
celiac sprue- anti-gluten, flat villi, affects small intestine, dematitis herpetiformis, inceased risk of malt lymphoma, weheat, rye and barley
Tropical sprue- infectious, chronic diarreha, stearotrhea, weight, lowss Whipples- steatorrhea, arthralgia, fevere, TMP/SMX is tx, tropheryma whippeli (a type of actinomyces +macs in mucosa on PAS) |
|
|
Cholecystitis-
|
gall bladder infection, fever, RUQ pain, Murphy's sign, NV, elevated PMNs and alakaline phos
|
|
|
Choledocholithiasis
|
obstruction of bile duct, RUQ pain, jaundice, tea colored urine, elevated alk phos and conjugated bile duct, dilated bile duct on US
|
|
|
Ascending cholangitis
|
infection of the common bile duct, complication of obstruction
RUQ pain, jaundice and fever, tea colored urine, clay stool elevated alk phos, conjugated bilrubin and PMNs |
|
|
Primary sclerosing cholangitis
|
non-infectious inflammaiton and sclerosis of bile ducts with eventual obliteration of all biliary ducts
pruritis, RUQ pain, jaudice and later scelrosois associated with ulcerative colitis see stuff associated with bile duct obstruction |
|
|
Primary biliary cirrhosis
|
autimmune destruction of bile dcts, pruritis, -> jaundice, steattorhea and xanthelasmas, +AMA (anti0mitochondrial antibody, associated with CREST, Sjogren's syndrome or Type I diabetes
|
|
|
MOA for steroids and inflammation
|
inhibt phospohlipase A2, prevent arachidonic acid production leading to decreased prostaglandins
|
|
|
MOA of D-penicaillamine and gold in RA
|
D-penicilmmaine- decreases rheumatoid factor, used now as a chel;ating aent d/t side effects
Gold- accumulates in synovial fluid and macrophages and decreased articular destruction, suppresiss lysomsal enzyme activt of phagocytes |
|
|
Infliximab and etanercept
|
infliximab is antibody against TNF, used in RA, UC and Crohn's can induce life threatiening sepsis, increased MS, optic neuritis
Etanercept is recombinant TNF receptor binds TNF in blood, similar probs, increased risk of infection |
|
|
Enzyme defect in Lesch-Nyhan
|
decreased HGPRT
|
|
|
Which ligament divides the greater and lesser sciatic foramen?
|
Sacrospinous, connects to sacrum and ischial spine
|
|
|
With weifht bearing on right leg where is the oblique sacral axis?
|
Right sacral oblique axis is engaged
|
|
|
Sacral-L5 rules
|
L5 rotation is oppsite of sacral rotation
L5 sidebending engages ipsalteral sacral oblique axis |
|
|
Causes of anterior and posterior innominates
|
anterior- tight quads
posterior- tight hamstrings |
|
|
Anterior vs. posterior sacrum
|
anterior is flexed and sidebend to opposite side of rotation
posterior is exteneded and sidebent to the opposite side of the rotation |
|
|
Antimicrosomal antibody associated with?
|
Hashimoto's...
|
|
|
What tumor suppressor gene most likely mutated in colon cancer?
|
p53, CEA is the marker to monitor
|
|
|
CAG repeats is associated with...
|
Huntington's
CCG = Fragile X |
|
|
Side effects of HCTZ
|
hyponatreia, hypercalcemia, hyperuricemia
blocks sodium uptake in DCT |
|
|
BB effect on kidneys
|
decrease renin production via RAAS decraeases blood volume
|
|
|
Contraindications for ACEIs?
|
renal stenosis, pregnancy (teratogenic)
|
|
|
Minoxidil is a vasodilator used for HTN, what't it's weird side effct?
|
Hypertrichosis- excess body hair
|
|
|
Essential HTN protocol
|
first step is lifestyle mods, target BP is 140/90 unless they have CAD, DM or MI hx (130/90)
first line is HCTZ except in diabetics and chronic renal disease ACEIs for angina and MI is BBs + ACEI use two drugs if 160/100 |
|
|
CHF HTN management
|
<120/80, BBs plus ACEIs plus a loop or thiazide, use of CCBS and alpha blockers is contraindicated
beta blockers must be discontinued w/ acute CHF |
|
|
side effects of spironolactone
|
kyperkalemia, metabolic acidosis, hormone related side effects act at collecting duct to antagonize aldosterone
|
|
|
Ergots and triptans treat migraines and cluster headaches
|
ergots act on 5HT1 (stimulates) and 2 (inhibits) serotonin recteptors to cause vasocontriciton don't want to give w/ hx of CAD
triptans= 5HT-1 agonists, don't use with SSRIS, SNRIs or MAOIs |
|
|
Odansteron and metoclopramide what do they have in common?
|
act on serotonin receptors
metoclopramide- 5HT4 agonist used as an anti-emetic, also increases GI motility, minimizing gastroparesis and vomiting odansteron- 5HT3 antagonists, prevent CNS driven vomiting |
|
|
lumbosacral spring tests positive in...
|
bilateral sacral extensions, pain worsens with forward bending
|
|
|
Forward sacral torsions
|
L on L or R on R, lumbar rotation is opposite directionof sacral rotation
|
|
|
Backward sacral torsion
|
L on R and R on L, L5 rotated to side contralateral to rotational component
|
|
|
With sacral dysfunction what must be assessed and treated first?
|
L5 dysfunction, may be the underlying cause
|
|
|
Functions of Polyemerase I, II and III
|
I- rRNA
II- mRNA III- tRNA mRNA processed in nucleus with intron splcing out, poly A tail, 5' cap |
|
|
Parental DNA strand is read in the
|
3'-5' direction, new strand produced in 5'-3' direction
|
|
|
Endonuclease, exonuclease and ligase
|
endonuclease- incision of DNA
exonuclease- removal of nucleotides from incised ends ligase- joins Okazaki fragments |
|
|
Primase in prokaryotes
|
copies paretntal strand and makes RNA primer, pol III is major DNA polyemerase it's gamma in humans
|
|
|
Ectoderm resposible for forming...
|
CNS (neural tube)
PNS (neural crest) placodes- sensory organs surfacce epithelium |
|
|
Yolk stalk results in this remnant that can cause probs
|
Meckel's diverticulum
|
|
|
Umbilical arteries and vein become
|
vein (1)- round ligament of liver
arteries 2- medial umbilical ligaments urachus - median umbilical ligament |
|
|
Association of each branchial arch
1-4 |
1- mandibular arch, incus, malleus, muscles of mastication facial arteries V3 nerves
2- stapes, styloid, muscels of facial expresion, external carrotid, CN VII 3- body of hyoid, stylopahrynegeal muscle,internal crotid, IX 4- larynx, pharyngeal muscles X |
|
|
Pharynegeal pounches
|
separate branchial arches disaappear if not become cervical cysts in anterolateral neck
I- TM, eustachian tunbe II- palantine tonsil III- thymus, inferior parathyroids IV- superior parathyroids V- ultimobranchial body, parafaolicular C cells of thyroid |
|
|
Male differentiation in 7th week
|
Wolffian duct (mesonephric) becomes epidydymis and vas deferens, ssstained by Leydig cells (T)
Mullerian (paramesoonpehric ) suppressed by mullerian inhbitory factor glycoprotein from sertoli cells (would form fallopian tubes, uterus, vagina) |
|
|
CN V branches exit through these foramens
|
V1- superior orbital fissue
V2- foramen rotundum V3- mandibular formane ovale CN IX, X, XI all through jugular foramen, hypoglossal canal is exit for CN XII |
|
|
upward motion of the eye
|
superior rectus up and nasal, inferior oblique up and temoral
|
|
|
Inferior rectus and superior oblique motion is..
|
comnbined fown, rectus is lateral, oblique is medial
paralysis of superior oblique results in slight vertical dipolplia |
|
|
muscles of pupil
|
dilator pupilae- sympathetic, Muller's muscle in eyelid
sphincter pupillae- parasympatthetic innervation ciliary muscle- accomodation Parasympathetic |
|
|
Damage to hypoglossal nerve results in tongue deviation...
|
towards the side of damage
|
|
|
Sensation of tongue
|
anterior 2/3- sensation V3, taste VII
posterior 1/3- CN IX |
|
|
Musces of mastication
|
lateralpteryogoid and diagstric open
masseter, medial pterygoid and temporalis close lateral- protudes mandible and lateral displacement |
|
|
Which musce of larynx is not innervated by the recurrent laryngeal nerve?
|
cricothyroid, superior laryngeal nerve
posterior and lateral cricoarytenoid, thyroarytenoid by recurrent, all sensation below glottis |
|
|
Left recurrent nerve wraps around...
|
aortic arch, right wraps around subclavian
unilateral damage leads to hoarseness |
|
|
Inward rotation of the shoulder is done by...
|
subscapular shares innervation with teres major which extends shoulder, external rotation by infraspinatus
|
|
|
upper brachial plexus injury from separtion of neck and shoulder
|
arm hangs in medial rotation, waiter's tip
|
|
|
lower brachial plexus injury forcefull pull of arm and shoulders
|
ulnar nerve injury, claw hand (no flexion 4th and 5th finger)
|
|
|
tennis elbow
|
repetive stress, inflammation of lateral epicondyle, extensor origin of the foerarm, does not involve elbow or olecranon
|
|
|
Position of leg after femoral neck fracture
|
abducted and externally rotated
|
|
|
Motions of the hip and primary muscles
1. outward roation 2. internal rotation 3. extension 4. flexion- iliopsoas and femoral n 5. abduction 6. adduction |
1 and 3. glut max, infer glut
2 and 5 gluteus medius, sup glut 6- adductor magnus/,inimus obturator |
