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218 Cards in this Set
- Front
- Back
Rx for serotonin syndrome
|
Cryproheptadine
|
|
Rx for neuroleptic malignant syndrome
|
Dantrolene
or agonists, e.g. bromocriptine |
|
Ragged red fibers indicate
|
Mitochondrial myopathy
|
|
Blotchy red muscle fibers on Gomori trichrome stain indicate
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Mitochondrial myopathy
|
|
Key sign of mitochondrial myopathy
|
Ragged red muscle fibers!
|
|
Treatment for orotic aciduria?
|
Oral uridine administration (feedback inhiibits CPS 2 --> decreased orotic acid)
|
|
Normal CFTR protein ____ Cl from sweat an _____ Cl in lungs and GI tract
|
Reabsorbs from sweat
Actively secretes in lungs/ GI tract |
|
Three stop codons
|
UAG
UGA UAA |
|
Mucicarmine stain
|
Cryptococcus
(detects polysaccharide capsule) (also methenamine silver) |
|
Mechanism of Shiga-toxin
|
Inactivates 60S ribosomal subunit --> inhibition of protein synthesis
|
|
Two bacteria that inhibit EF-2
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C. diphtheriae
Pseudomonas |
|
Rx Legionnaire's disease
|
Erythromycin
|
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Two bugs with cold agglutinins
|
Mycoplasma pneumoniae
EBV |
|
Bronchiolitis obliterans
|
Chronic rejection with lung transplant is from inflammation/ fibrosis of bronchiolar walls (NOT vascular, as in most chronic rejection)
|
|
Respiratory distress, diffuse neurological impairment, and upper body petechial rash within several days of severe long bone fractures?
|
Fat embolism syndrome
|
|
Effect on which murmurs, and why:
inspiration |
R-sided murmurs louder
|
|
Effect on which murmurs, and why:
expiration |
L-sided murmurs louder
|
|
Effect on which murmurs, and why:
Valsalva/ standing |
Decreased venous return --> must murmurs softer, except HCM and MVP
|
|
Effect on which murmurs, and why: squatting/ passive leg raise
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Increased TPR --> most murmurs louder, except HCM and MVP
|
|
Effect on which murmurs, and why: handgrip
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Increased afterload --> MR, VSD, and AR become louder; HCM softer
|
|
How do you differentiate CML from a leukemoid reaction?
|
Leukocyte alkaline phosphatase:
Decreased in CML Normal/ elevated in leukemoid rxn |
|
Precocious puberty, paralysis of conjugate vertical gaze, and obstructive hydrocephalus
|
Germinoma in the pineal gland
(Parinaud syndrome is paralysis of conjugate vertical gaze due to lesion in superior colliculi) |
|
Intestinal biopsy in lactase deficiency shows
|
Normal appearing villi
|
|
Foamy enterocytes on intestinal biopsy indicates
|
Abeta-lipoproteinemia
|
|
Meiosis I is arrested in?
|
PrOphase until Ovulation
|
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Meiosis II is arrested in?
|
METaphase until fertilization (when egg met a sperm)
|
|
somatomedin C is also known as
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Insulin-like growth factor 1 (IGF-1)
|
|
A lesion to which hypothalamic nucleus --> anorexia?
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Lateral
|
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A lesion to which hypothalamic nucleus --> hyperphagia
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Ventromedial
|
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Leptin inhibits which hypothalamic nucleus?
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Lateral (which causes hunger)
|
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Leptin stimulates which hypothalamic nucleus?
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Ventromedial
|
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Which brain tumor commonly destroys the ventromedial hypothalamic area?
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Craniopharyngioma
|
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Hemolytic anemia, hypercoagulable state, and decreased blood counts
|
Paroxysmal nocturnal hemoglobinuria
|
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Deficiency of CD 55 and CD 59 is diagnostic of?
|
Paroxysmal nocturnal hemoglobinuria
|
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PNH is caused by impaired synthesis of?
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GPI anchor, which is necessary for attachment of CD55/CD59, the "decay accelerating factor" that inhibits complement on RBC membrane
|
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Homogenous sheets of cells with translucent cytoplasm on renal biopsy
|
RCC (clear cell)
|
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Opsoclonus, myoclonus, truncal ataxia
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Paraneoplastic syndrome in neuroblastoma
|
|
Aniridia, GU malformations, and mental- motor retardation are associated with which childhood tumor?
|
Wilms' tumor
|
|
What can cause hepatic adenoma to regress?
|
Cessation of OCPs
|
|
Characteristics of polymyalgia rheumatica
|
Neck, torso, shoulder, and pelvic girdle pain + morning stiffness
Fatigue, fever, and weight loss |
|
Alport's Syndrome causes defects in these three organs
|
Kidneys (progressive nephritis), ears (deafness), eyes
|
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ADPKD is associated with these three complications
|
Polycystic liver disease
Berry aneurysms Mitral valve prolapse |
|
Guillain-Barre Syndrome has a ___ inflammatory infiltrate
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Endoneural
|
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Bell's Palsy is a complication of these diseases
|
ALexander graHam BELL w/ STD
AIDS Lyme disease Herpes zoster Sarcoidosis Tumors Diabetes |
|
ADPKD is carried by a mutation on chromosome?
|
16
|
|
RFs for esophageal squamous cell cancer
|
Alcohol
Achalasia Cigarettes Diverticula (e.g. Zenker's) Esophageal web (Plummer-Vinson) Esophagitis |
|
Iron-deficiency anemia, atrophic glossitis (beefy red tongue), esophageal web
|
Plummer-Vinson Syndrome
|
|
Werdnig-Hoffman disease presents similarly to?
|
Poliomyelitis (LMN lesions from destruction of anterior horns --> flaccid paralysis)
|
|
Inheritance of Werdnig-Hoffman?
|
AR (death at 7mo)
|
|
Hemochromatosis is caused by a mutation on chromosome?
|
6 (mutant HFE gene can't detect circulating iron levels, so keeps expressing iron uptake proteins --> increased GI absorption)
|
|
Degeneration of this part of the brain occurs in Wilson's disease
|
Basal ganglia (specifically putamen)
|
|
When should supplementary O2 be used in COPD?
|
Very rarely! These pts have adjusted to hypercapnia, so they depend instead on hypoxia for respiratory drive–increasing their oxygen could decrease that drive.
|
|
Three diseases on chromosome 7
|
Ehlers-Danlos
Osteogenesis imperfecta CF |
|
3 structural changes in the heart with aging
|
Lipofuscin deposits
Decreased LV cavity size Sigmoid-shaped ventricular septum blocking LV outflow tract |
|
Chemo agents: ____ is given with doxorubicin to prevent _____
|
Dexrazoxane (iron chelating agent)
Cardiotoxicity |
|
Chemo agents: ____ is given with cyclophosphamide or ifosfamide to prevent _____
|
Mesna (has a thiol group that binds toxic metabolite, acrolein)
Hemorrhagic cystitis |
|
Chemo agents: ____ and ____ are given with cisplatin and carboplatin to prevent ____ and _____
|
Amifustine (thiol-based cytoprotective free-radical scavenger)
Hydration (IV saline --> chloride diuresis --> cispaltin stays in nonreactive state) Nephrotoxicity and acoustic nerve damage |
|
Serum levels of ceruloplasmin are increased/ decreased in Wilson's?
|
Decreased
|
|
Rx for Wilson's
|
Penicillamine (chelator)
|
|
Rx for hemochromatosis
|
Deferoxamine (chelator) and phlebotomy
|
|
Tension pneumothorax: ____ breath sounds and ____ to percussion
|
Absent
Hyperresonance |
|
Fever, rash, oliguria, and eosinophilia 1-2 wks after started a new med
|
Acute interstitial nephritis
|
|
2 reasons the kidney is susceptible to emboli?
|
Receives 3-5x more blood flow
Few collaterals |
|
2 diseases that stain PAS+
|
Whipple's
alpha-1 antitrypsin deficiency |
|
Lipid drugs that can increase TG levels?
|
Bile acid resins
|
|
If alk phos is elevated, what test should be done next?
|
GGT (can distinguish etiology: alk phos is increased in both bone and hepatobiliary diseases, but GGT is specific for hepatobiliary disease)
|
|
Polyarteritis nodosa is associated with what infection?
|
HBV
|
|
Fever, ab pain, peripheral neuropathy, muscle weakness, weight loss
|
Polyarteritis nodosa
|
|
Vasculitis associated with antibiotic use (often penicillin)
|
Microscopic polyangiitis
|
|
Formation of microabscesses containing fibrin and neutrophils at the dermal papillae tips
|
Dermatitis herpetiformis (from IgA and IgG Abs cross reacting with reticulin, a BM anchoring fibril protein)
|
|
2 vitamins not in adequate amounts in breast milk?
|
Vita D and K
|
|
Mechanism of N-acetylcysteine in CF
|
Cleaves disulfide bonds within mucous glycoproteins --> loosens mucous plugs
|
|
5 drug classes with antimuscarinic effects
|
Atropine
TCAs H1 antagonists Neuroleptics Antiparkinsonian rugs |
|
Why do bile acid resins and fibrates increase the risk of gallstones?
|
Increase cholesterol synthesis and excretion
|
|
Initial injury in thoracic aortic aneurysms?
Initial injury in AAAs? |
Vaso vasorum obliteration
Intimal streak (atherosclerosis) |
|
Fulminant liver disease one week after open cholecystectomy
|
Halothane toxicity --> fulminant hepatitis
|
|
Why does central retinal artery occlusion present with a cherry red spot on the macula?
|
Macula has separate blood supply (choroid artery), so is not affected by retinal artery occlusion like the rest of the retina
|
|
Only lab abnormality of sickle cell trait?
|
Will sickle when sodiummetabisulfite is added
|
|
HFE gene is on the short arm of chromosome
|
6
|
|
Renal papillary necrosis is associated with these four conditions:
|
DM
Acute pyelonephritis Chronic phenacetin use (e.g. acetaminophen) SCD (or trait) |
|
Granular, muddy brown casts
|
Acute tubular necrosis
|
|
3 causes of papilledema
|
Malignant HTN
Communicating hydrocephalus Guillain-Barre |
|
Medial calcification
|
Monckeberg (asymptomatic)
|
|
Differential cyanosis
|
Cyanosis in lower, but not upper, extremities
Indicative of PDA |
|
Potency of inhaled anesthetic =
|
1/MAC
MAC = minimum alveolar concentration at which 50% of population is anesthetized |
|
Atypical lymphocyte
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EBV
|
|
Auspitz sign
|
Psoriasis (bleeding spots when scales are scraped off)
|
|
Acanthosis (increased stratum spinosum), parakeratosis, and decreased stratum granulosum
|
Psoriasis
|
|
Intraepidermal vesicles, hyperkeratosis, acanthosis, spongiosus, inflammation
|
Atopic dermatitis
|
|
Nitroprusside toxicity and treatment?
|
Cyanide toxicity (releases CN)
Rx: sodium thiosulfate (donates sulfur to liver rhodanase to enhance metabolism/ detox of cyanide --> thiocyanate) |
|
Pathogenesis of vitiligo vs. albinism?
|
Absent melanocytes
Poor melanin formation in melanocytes |
|
Melanosome aggregates within the cytoplasm of melanocytes manifests as
|
Cafe au lait spots
|
|
Councilman body
|
Apoptotic hepatocyte (acidophilic/ eosinophilic)
|
|
Secondary complication risk from subarachnoid hemorrhage?
|
Vasospasm 2-3 days later
|
|
Treatment/ prevention of SAH-associated vasospasm?
|
CCBs
|
|
Argatroban is a?
|
Direct thrombin inhibitor
|
|
Which vasculitis extends into contiguous veins and nerves?
|
Buerger's disease (thromboangiitis obliterans)
|
|
Auer rods stain with?
|
Peroxidase
|
|
What substance mediates malignancy-associated hypercoagulability?
|
Thromboplastin
|
|
Firm and brown spleen in SCD pt
|
Autosplenectomy (occurs in all pts by 8-10yo); due to vascular occlusion from extensive ingestion of sickled cells by splenic macrophages
|
|
Port-wine stain is associated with these 3 other manifestations
|
Sturge-Weber disease:
Ipsilateral leptomeningeal angiomatosis (intracerebral AVM) Seizures Early-onset glaucoma |
|
Hemiballismus is usually due to a ____ near _____
|
Lacunar stroke
Subthalamic nucleus |
|
Potential complication of CMV retinitis
|
Retinal detachment
|
|
Two foods that don't contain gluten
|
Oats and rice
|
|
Abetalipoproteinemia is an inability to form
|
Chylomicrons
|
|
PE causes what acid/base disturbance?
|
Hyperventilation --> respiratory alkalosis
|
|
Most common cause of aortic aneurysms?
|
Atherosclerosis
|
|
How does HBC cause HCC?
|
Integrates into host DNA (vs. HCV: injury and inflammation --> genetic instability)
|
|
Waxing and waning lymphadenopathy
|
Follicular lymphoma
|
|
Hyperpigmented mouth
|
Peutz-Jeghers Syndrome (+ hamartomas throughout GI tract and increased risk of colon and other cancers)
- AD |
|
Weight loss drug?
|
Orlistat
|
|
Mechanism of Orlistat?
|
Intestinal lipase inhibitor
|
|
2 causes of renal artery stenosis
|
Atherosclerosis
Fibromuscular dysplasia (females) |
|
Bromocriptine: mechanism and 2 uses
|
Dopamine agonist
PD and hyperPRL |
|
How to prevent cyclosporine nephrotoxicity?
|
Mannitol diuresis
|
|
Complication of alkaptonuria?
|
Debilitating arthralgias
|
|
Transmembrane proteins are composed of?
|
Hydrophobic (nonpolar) aas
|
|
Cellular ischemia promotes influx of _____ and efflux of _____?
|
Na, Cl, H2O, and Ca
K+ and H+ |
|
Hallmark of ischemic injury?
|
Cytoplasmic Ca accumulation
|
|
Inferior mesenteric vein drains to the
|
Poral vein
|
|
GPCRs work via ____ hydrolysis
|
GTP
|
|
E6 ____, E7 _____
|
shuts off p53
shuts off Rb |
|
3-hydroxybutyrate, acetone, and acetoacetate are
|
Ketone bodies
|
|
____ soluble materials cross the placenta, while _____ don't
|
Lipid
Water |
|
Complication of mumps?
|
Sexual dysfunction
|
|
Genetic shift causes
|
Pandemics
|
|
Genetic drift causes
|
Epidemics
|
|
Antigenic drift is another way of describing
|
Random mutation
|
|
Genetic shift occurs due to
|
Genetic reassortment
|
|
No genetic exchange occurs with
|
Phenotypic mixing (just get surface proteins)
|
|
Thrombotic complication of mucormycosis?
|
Cavernous sinus
|
|
Sign of cavernous sinus thrombosis?
|
CN VI palsy (lateral gaze palsy)
|
|
Systemic Rx for psoriasis?
|
Retinoids
|
|
Galactosyl beta-1,4-glucose is also known as?
|
Lactose
|
|
Decreased intestinal lactose activity with age due to?
|
Decreased gene expression
|
|
Hyperorality, hyperphagia, hypersexuality, disinhibition
|
Kluver-Bucy Syndrome
|
|
Kluver-Bucy syndrome is due to lesion where?
|
Bilateral amygdala
|
|
Contraction alkalosis mechanism?
|
Volume loss --> increased aldosterone --> decreased H+ and K+
|
|
Lumbar kyphosis: contracture of?
|
Anterior abdominal muscles
|
|
Lumbar lordosis: contracture of?
|
Hip flexors (weakness of hip extensors)
|
|
Antipsychotics are dopamine ____
|
Antagonists
|
|
2 lung volumes that increase in COPD?
|
RV > TLC
|
|
What are incretins (and one example)
|
GI hormones secreted by gut mucosa that stimulate insulin secretion in response to a sugary meal
GLP-1 |
|
Carbonic anhydrase actiivty in bone
|
Bone remodeling (osteoclast activity)
|
|
Negri bodies are _____ in the _____, pathognomonic for _____
|
Eosinophilic cytoplasmic inclusions
Hippocampal neurons Rabies virus |
|
Pharnygeal muscle spasms
|
Rabies
|
|
Path of rabies
|
Wound --> neuron axons --> salivary glands
|
|
Xanthogranulomatous pyelonephritis
|
Infectious renal phlegmon
|
|
GBS can be caught from
|
Mother's vagina
|
|
Kartagener's is a ____ defect
|
Dynein
|
|
Dynein moves ____
|
Retrograde
|
|
Kinesin moves ____
|
Anterograde
|
|
Achalasia has ___ pressure at the LES
|
High
|
|
Flask-shaped ulcer after submucosal abscess of colon ruptures
|
Entamoeba histolytica
|
|
Bloddy diarrhea or red-brown liver abscess
|
Entamoeba histolytica (amoebiasis)
|
|
Transmission of entamoeba histolytica
|
Cysts in water
|
|
Diagnosis of entamoeba histolytica
|
Serology or trophozoites or cysts in stool; RBCs in cytoplasm of entamoeba
|
|
Rx of amebiasis
|
Metronidazole and iodoquinol
|
|
Rx for Crigler-Najjar
|
Phenobarbital (increases liver enzyme synthesis), but only for Type II (less severe)
|
|
Defect in Crigler-Najjar
|
Absent UDP-glucuronyl transferase
|
|
What is kernicterus
|
Bilirubin deposition in brain
|
|
Two causes of elevated unconjugated bilirubin in newborns
|
Gilbert's (mildly decreased UDP-glucoronyl transferase or decreased bilirubin uptake)
Crigler-Najjaar |
|
Toxicity of amphotericin
|
Nephrotoxicity --> decreased GFR, dose dependent
Which also causes electrolyte abnormalities (hypokalemia and hypomagnesemia) Fever/ chills (infusion related) Arrhythmias (precipitated by hypokalemia) IV phlebitis Anemia (from decreased EPO) |
|
Preventive strategies for pts on amphotericin
|
Hydration (to reduce nephrotoxicity)
Supplement K and Mg |
|
Form of amphotericin that reduces toxicity
|
Liposomal
|
|
Drug that inhibits rental tubular secretion of penicillins/ cephalosporins?
|
Probenecid
|
|
What acts as a mineralocorticoid in the hypertensive CAHs?
|
11-deoxycorticosterone
|
|
Cough-induced syncope: typical pt and mechanism
|
Overweight male with COPD
Decreased venous return |
|
Mictruition syncope (when rising from bed to urine): mechanism
|
Orthostatic hypotension from peripheral pooling
|
|
Syncope from stimulation of _____ sinus?
|
Carotid (increases vagal tone --> bradycardia)
|
|
Ataxia telangiectasia is a defect in ___ gene that is important in ____
|
ATM gene
DNA repair |
|
Photosensitivity, short stature, erythema, telangiectasias (+ lymphoproliferative and GI malignancies
|
Bloom syndrome (defective DNA helicase)
|
|
Palmar erythema is a manifestation of
|
Hyperestrogenemia
|
|
NEurofibromas contain ____ cells
|
Schwann (+ fibroblasts)
|
|
NF-1 chromosome?
|
17
|
|
Fexofenadine: class
|
2nd generation H1 antagonist (+ (des) loratidine, cetirizine
|
|
In ulcerative colitis, ______ (immune cell type) accumulate in the _____
|
Neutrophils
Crypt lumina (crypt abscess) |
|
Ovarian atresia occurs via
|
Apoptosis
|
|
Demeclocycline is used to treat?
|
SIADH
|
|
Mechanism of paclitaxel in coronary artery stents?
|
Inhibits intimal hyperplasia (Sirolimus also used)
|
|
Only 2 RNA viruses that replicate in the nucleus?
|
Retroviruses and influenza
|
|
Somatization disorders requires 4 ____ symptoms, 2 ___ symptoms, and 1 each of ___ and ____ symptoms
|
Pain
GI Sex Pseudoneurological |
|
Huntington's is an increase in ____ repeats (not CAG)
|
polyglutamine
|
|
Pseudodementia occurs in ____ pts
|
Psychiatric
|
|
CAH pts develop this acid-base abnormality
|
Metabolic alkalosis
|
|
Location of psoas abscess
|
Groin
|
|
MHC genes are on chromosome
|
6
|
|
HLAs are involved in
|
Antigen presentations
|
|
Minute ventilation =
|
Alveolar ventilation + dead space ventilation
|
|
Dysmenorrhea + dyspareunia
|
Endometriosis (+ infertility)
|
|
2nd most common CMV infection
|
Colitis
|
|
NRTIs and NNRTIs have no effect on cells that
|
Have already had HIV integrated into their genomes
|
|
LE edema can be caused by obstruction of
|
IVC
|
|
Glycogen storage disease caused by a defective lysosomal enzyme
|
Pompe's
|
|
Chronic HBV w/ high vs. low infectivity
|
HBeAg + vs anti-HBeAg _
|
|
Clopidogrel must he activated by
|
P450 system
|
|
As prevalence increases, what happens to PPV and NPV?
|
Both increase
|
|
Definition of low birth weight
|
<2500g
|
|
Normal grief lasts how long?
|
2 months
|
|
Why is imipramine used to treat enuresis?
|
Decreases Stage 4 sleep
|
|
Etiology of narcolepsy
|
Low levels of orexin (hypocretin)
|
|
Rx: of narcolepsy
|
stimulants and sodium oxybate (GHB)
|
|
Ethical situation with alcoholic
|
Temporary incapacitation, so can't make own health decisions
|
|
2 positively charged aas
|
Lysine and arginine (with histidine, are the basic aas)
|
|
Heterochromatin is formed by _____ while euchromatin is formed by _____
|
DNA methylation
Histone acetylation |
|
Rx of orotic aciduria
|
Uridine (causes feedback inhibiiton of CPS2)
|
|
Single stranded binding proteins
|
Prevent DNA strands from reannealing
|
|
DNA repair disease with hypersensitivity to ionizing radiation
|
Ataxia telangiectasia
|
|
Process of nucleotide excision repair
|
Endonucleases cleave oligonucleotide containing damaged bases; DNA polymerase and ligase fill and reseal the gap
|
|
alpha-amanitin inhibits ____ --> ____ failure
|
RNA Pol II
Liver |
|
What disease has antibodies to spliceosomal snRNPs?
|
Lupus
|
|
____ targets ribosomes to the RER
|
Signal recognition peptides
|
|
Addition to _____ to lysosomal proteins targets the protein to the lysosome
|
Mannose-6-phosphate
|
|
Disease with failure of addition of mannose-6-phosphate
|
I-cell disease
|
|
Coarse facial features, clouded corneas, restricted joint movement, hgh plasma levels of lysosomal enzymes
|
I-cell disease
|
|
Type III cartilage is called ____ and is found where?
|
Retiulin
Skin, vessels, uterus, fetal tissue |
|
Three complications of Ehlers-Danlos
|
Joint dislocation, berry aneurysms, organ rupture
|
|
Type of collagen most frequently affected in Ehlers-Danlos
|
Type III
|