Dit Part I: Week 2

Front 1

Why do kidneys retain fluid in heart failure pts?

Back 1

CHF pts have decreased CO, which reflexively causes kidneys to increase renin-AT-system, increasing Na retention, INCREASING WATER RETENTION (which increases preload and CO)

Front 2

In which glomerular disease would you expect to see the following changes?
- anti-GBM antibodies
- Kimmelsteil-Wilson lesions
- "spike and dome" appearance
- "tram track" of subendothelial humps
- subepithelial humps
- subendothelial "wire looping"

Back 2

- anti-GBM antibodies = Goodpasture syndrome
- Kimmelsteil-Wilson lesions = diabetic glomerulonephropathy
- "spike and dome" appearance = diffuse membranous glomerulopathy
- "tram track" of subendothelial humps = membrano-proliferative GN
- subepithelial humps = APSGN
- subendothelial "wire looping" = diffuse proliferative glomerulonephritis (DPGN)

Front 3

What is the rate-limiting enzyme for pyrimidine synthesis? For purine synthesis?

Back 3

1) carbamoyl phosphate synthetase 2
2) glutamine-PRPP amidotransferase

Front 4

Compare the mechanism of action of zileuton to that of zafirlukast

Back 4

they are both anti-leukotrienes

ZILEUTON = 5-lipoxygenase pathway inhibitor (AA -X-> leukotrienes)

ZAFIRLUKAST = blocks leukotriene receptor (good for aspirin induced asthma)

Front 5

Km is substrate concentration at one-half Vmax. Vmax is max velocity of a reaction. How does a competitive antagonist affect Km and Vmax? How does a noncompetitive antagonist affect Km and Vmax?

Back 5

1. inc Km, no change in Vmax
2. no change Km, dec Vmax

Front 6

What are the different types of epithelial cell junctions?

Back 6

1. zona occludens - tight junctions
2. zona adherens - (Ca-dependent) actin
3. macula adherens (desmosome) - desmoplakin, cadherin, keratin
4. Gap junction - connexin
5. hemidesmosomes - connects cells to ECM; integrin binds to laminin and maintains integrity of BM

Front 7

What structures are injured in an unhappy triad knee injury?

Back 7

1. LATERAL meniscus
2. medial collateral ligament
3. ACL

Front 8

What is the definition of low birth weight? What complications are a/w low birth weight?

Back 8

1. < 2500 g
2. - physical/emotional problems
- infection
- RDS
- NEC
- IUH
- persistent fetal circulation

Front 9

In which types of infections are macrolide antibiotics a good choice? What is the most common cause of non-adherence to macrolide antibiotics?

Back 9

macrolide abx = erythromycin, azithromycin, clarithromycin (binds 23s rRNA of 50s ribosomal subunit, inhibiting protein synthesis by block TRANSLOCATION)

1. -URI
- pneumonias
- STDs
- gram + cocci (strep), Legionella, Mycoplasma, Chlamydia, Neisseria

2. GI discomfort

Front 10

Which branchial pouch gives rise to the following mature structures?

- middle ear cavity and eustachian tube
- superior parathyroids
- inferior parathyroids
- thymus
- mastoid air cells
- epithelial lining of palatine tonsil

Back 10

- middle ear cavity and eustachian tube = 1st
- superior parathyroids = dorsal 4th
- inferior parathyroids = dorsal 3rd
- thymus = ventral 3rd
- mastoid air cells = 1st
- epithelial lining of palatine tonsil = 2nd

Front 11

What are the clinical manifestations of Addison's disease? What is the cause of Addison's disease?

Back 11

1. hyperpigmentation, HYPOtension, decreased cortisol (adrenal insufficiency = die if much stree)

2. primary adrenal insuffiency - adrenal atrophy or destruction (by TB, autoimmune, mets)

Front 12

Where would you expect to find type I collagen? Type II collagen?

Back 12

I - ("Be So Totally") = bone, skin, tendon

II ("Cool") = cartilage

III ("Read") = reticulin (skin, blood vessels, granulation tissue, uterus, fetal tissue)

IV ("Books") = BM

Front 13

What are the side effects of cGMP inhibitors (sildenafil, vardenafil, tadalafil)?

Back 13

hot and sweaty, but then, HA, Heartburn, Hypotension (from nitrates)

-also have impaired blue-green color vision

Front 14

What are 4 examples of obligate aerobic organisms?

Back 14

"Nagging Pests Must Breathe"

Nocardia
Pseudomonas
Mycobacerium TB
Bacillus

Front 15

What are the 3 symptoms of pellagra? What are the causes of pellagra?

Back 15

1. 3 Ds = Diarrhea, Dermititis, Dementia

2. mainly due to NIACIN (Vit B3) deficiency
- hartnup dz (dec tryptophan absorpton)
- malignant carcinoid syndrome (inc tryptophan metabolism)
- INH (dec Vit B6, pyridoxine)

ALL THESE HAPPEN BECAUSE NIACIN IS DERIVED FROM TRYPTOPHAN (SO IF YOU DEC TRYPTOPHAN, YOU HAVE A DEFICIENCY OF NIACIN!!)