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319 Cards in this Set
- Front
- Back
- 3rd side (hint)
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hypoxia
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inadequate oxygentation of tissue
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need 02 for...
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oxidative phosphorylation
to make... |
ATP
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where in the mitcho is the ETC?
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inner mitcho memb
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02 is an electron donor or receptor?
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receptor
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in which form is iron to carry o2
+2 or +3 |
+3
what type of iron is that? |
ferrous
+3=ferric |
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hypoxemia
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decreased partial p of 02 in the arterial plasma
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what happens to PO2 when you have a respiratory acidosis
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you get a decrease in PO2 and therefore you get...
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hypoxemia
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what is the equivalent of adult resp distress syndrome in kids
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hyaline memb dz
it is an issue with? |
ventilation defect (no ventilation but perfusion)
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Perfusion without ventilation is known as
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SHUNT
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How to dx SHUNT?
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give them 100% O2 and if the Pa02 doesnt improve then it is SHUNT
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#1 perfusion issue
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PE
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Increased V (ventilation) without Q (perfusion) is known as
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DEAD SPACE
dx? |
give 100% 02, Pa02 will improve (since not all vessels are under perfused)
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what causes diffusion issues in the lungs?
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fibrosis (oxygen cant get to alveoil)
name 2 dz that cause: |
Sarcoidosis
Pulm Edema (HF) |
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is there a decrease in Pa02 in anemia?
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NO, not hypoxemia
but they do have... |
tissue hypoxia (exerctional dyspnea) (exercise intolerance)
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causes for carbon monoxide
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room heater, housefire
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House fire exposures:
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CO and cyanide
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CO poisoning messes with
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02 saturation (decreased)
presents as... |
cyanosis (decrease 02 saturation) BUT CO poisioning leaves person looking red so wont look blue even though they are cyanotic
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Tx for CO poisoning
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100% 02
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#1 complaint of CO poisoning
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HA
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Methemoglobin type iron is....
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is Iron +3
otherwise known as.. |
ferrous
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Methemoglobin poisoning
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messes with oxygen saturation (Decreased)
(since oxygen cant bind to the iron since +3 |
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what does blood look like with methemoglobin
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chocolate colored (since no oxygen on heme)
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What is normal and abnl with Methemoglobin poisoning
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Pa02=nl
Hb=nl O2 sat= decreased |
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What causes methemoglobin?
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-Dapsone
-Mtn water with nitrates -Sulfa drugs what else can these drugs cause? |
G6PD
HA |
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Tx of methemoglobin
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methylene b
(vit. c is second line) 02 doesnt fix cyanosis |
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What is dapsone used to treat?
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leprosy
what type of drug is it? |
sulfa
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Methemoglobin seen with HIV, why?
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due to Bactrim
to treat |
PCP
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What type of curve shift to normal people want their Hb to be?
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right shift
what does that mean? |
Hb less affinity for o2 and more likely to release it
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Causes of right-shift of Hb 02-dissociation
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Inc 2,3BPG-bisphoglycerate
low pH fever high altitude |
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Causes of left-shift of Hb 02-dissociation
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CO
Methemoglobin Hb F Dec 23BPG Alkylosis |
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Cytochome Oxidase inhibited by
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cyanide & Co
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Uncoupling Agents
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salicylates
alcohol what do they do: |
causes protons to go thru membrane without making ATP
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What results with loss of protons
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NADH and FADH try to ramp up production to compensate for loss of protons out of the mitcho membrane (loss of oxidative phosphorylation)
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increasing rate of a chem rxn leads to what temp change
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hyperthermia
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acute resp acidosis
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Hb- nl
Pa02- dec 02 Sat- dec |
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anemia
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hb-low
Pa02- nl 02 Sat-nl 02 Sat: |
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C0
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Hb- nl
Pa02- nl 02 Sat- low |
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what is the end product of anaerob metabolism
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lactic acid (from pyruvate)
requires NAD to make NADH for the cycle |
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what type of metab do you use with tissue hypoxia
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anaerobic glycolysis
makes how many ATP per glucose |
2
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what does digitalis do?
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stop atp-ase pumps
to do what? |
to allow Na to get into heart musc to open calcium channels to increase force of contraction
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lactic acid build-up leads to
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metabolic acidosis in tissue hypoxia
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increased acid in cells leads to
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denaturation of proteins and enzymes (cant auto-digest)
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tissue hypoxia leads to what type of necrosis?
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coagulation necrosis
in or out of the cell? |
inside the cell (infarct)
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what two parts of the cell are most affected by hypoxia
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cell membrane and mitcho
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lipofuscin
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composed of lipid-containing residues of lysosomal digestion (lipids you cant break down). It is considered one of the aging or "wear-and-tear" pigments, found in the liver, kidney, heart muscle, adrenals, nerve cells, and ganglion cells.
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ROS made up of...
lead to.. |
02, H2O2,
lead to protein and DNA fragmentation |
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Neutralization of ROS...
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O2-----> H202 via SOD (antioxidant enzyme)
H202----->OH- + H2o via Glutathione peroxidase |
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Discoupling agents ex.
do what? |
alcohol
ASA casues proteins to go thru membrane without ATP production |
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why are alcohols susceptible to heat stroke
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mitcho are messed up from uncoupling
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why do you need NAD for the glycolytic cycle?
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to make 2 ATP in anaerobic glycolysis (for each 1 glucose mol)
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do RBC do anaerobic glycolysis?
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yes
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anaerobic glycolysis leads to
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lactic acidosis
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increase acid in cell..
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denatures proteins and enzymes (so cant auto digest)
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Anaerobic metabolism can lead to what type of necrosis..
where |
coagulation
in the cell |
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tissue hypoxia leads to .....
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decreased atp
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Decreased ATP leads to NA influx which leads to
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swelling (since water follows Na)
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In tissue hypoxia, what does Calcium do?
what does it do? |
enters the cells easily
activates phospholipase (attacks cell membrane) and other enzymes that destroy nucleus and mitcho |
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hypercalcemia does what to the pancreas
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activates enzymes and get acute pancreatitis
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where is lipofucin seen in the cell
what else can it look like? |
It is specifically arranged around the nucleus
hemosiderin/hemochromatosis |
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Free radical
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unpaired electron, unstable and damaging
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#1 CA due to radiation?
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Leukemia (hydroxyl free radicals formed)
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UV light is
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non-ionizing radiation
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Fenton Rxn
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tissue iron leading to hydroxyl free radicals that dammage tissue (cirrhosis, restrictive cardiomyopathy, DM)
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what can liver p450 do to drugs that is bad
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metabolizes drugs to ROS
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which drug leads to the most free radicals..
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acetaminophen
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Drug used for acetaminophen overdose
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acetyl-cysteine (n-acetyl cysteine)
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what neutralizes oxygen free radicals
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SOD, glutathione peroxidase
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n-acetyl cysteine does what..
what else does it do? |
replenishes glutathione to neutralize hydrogen peroxide
anti-mucous |
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what do you give with MTX to stop folate deficiency
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leucovorin
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acetaminophen + aspirin over time lead to....
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kidney
tylenol-> free radicals kill medulla, tubules asprin->kills vasodilator PGE so Angiotensin 2 (vasocontstrictor) dominates |
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Which P450 in the liver is very important for things like alcohol, acetaminophen and Ccl4
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CYP 2E1
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mullerian structures..
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uterus, upper 1/3 vagina, cervix
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wolffian structures..
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epidydimis, seminal vesicle, vas deferens
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thymic aplasia seen in which dx
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Di George
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councilman body
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eosinophil w/o nucleus, due to apopotosis via caspase (dont see inflammatory cells around them)
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Bcl-2
p53 Bax |
Bcl-2: inhibits apoptosis
BAX: facilitates apoptosis p53 facilitates apoptosis primarily by increasing BAX |
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popliteal artery sclerosis leads to
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gangrene (in diabetics)
coagulative necrosis |
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2 most common causes of SB infarction
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#1-adhesions from a previous surgery
#2-trapped in an indirect inguinal hernia |
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knife like pain with inspiration
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pleuritis
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what kind of infarct of the brain..
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liquefactive NOT coagulative
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fibroblast of the brain....
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astrocyte
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two types of coagulative necrosis
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pale
hemorrhagic |
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Pale infarct
Hemorrhagic Infarct |
kidneys, spleen, heart, foot
BLT: bowel, lung, testicle |
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neutrophils job is to...
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liquefy, seen a lot in inflamm/infection
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what bacteria seen in lung abscess
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S. pneumo
see liquefactive necrosis |
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IL-12 and Th1 seen in
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granulomatous/caseous necrosis
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2 dz with non-caseating granulomas
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sarcoidosis
Crohns |
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Enzymatic Fat necrosis seen in..
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pancreas (unique to pancreas due to enzyme breaking down pancreas)-soap but see CALCIFICATIONS
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Traumatic Fat necrosis..
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seen in women who run without enough support, can look like CA
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blue discoloration on histology think..
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calcium, seen in pancreas due to alcohol consumption
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where is amylase produced
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-parotid glands
-fallopian tubes |
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what type of vasculitis is palpable purpura
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small vessel
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what type of hypsersens rxn is palpable purpura
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Type 3 hypersens [Ag-Ab deposits]
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what does the alternate complement pathway activate...
what is .....chemotactic to? |
C5a
Neutrophils |
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3 sinusoid organs
what are sinusoids |
spleen,liver,BM
areas where blood gets dumped into |
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RHF leads to congestion where in the liver
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centrilobular
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yellow fever bacteria
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aedes egypti
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which part of the kidney get more blood flow
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cortex (90%)
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where does fatty change happen most
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around central vein (alcohol)
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two types of metabolic acidosis seen in alcoholic?
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lactic acidosis
b-hydroxy butyric acid (ketone) |
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what type of _DL does the liver endogenously make?
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VLDL, from Fatty Liver
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Kwashikor:
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calories okay, just missing protein
see: anemia, ascites, fatty liver, decreased cellular immunity, |
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what is the sign of decreased Copper
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read hair
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Marasmus:
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total calorie deprivation, muscle wasting
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when you want to get VLDL out of the liver what do you put around it?
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apolipoprotein, helps it get into blood stream, make it water soluble
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alcohols have increased synthesis of...
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VLDL
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in Kwashiokor, fatty liver due to..
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inability to excreate VLDL
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ferritin is..
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circulating iron
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is hemosiderin soluble?
what stain do you use to see? |
no
prussian blue (for iron) |
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dystrophic calcifation seen in...
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enzymatic fat necrosis (chalky calicum)
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what dz is most likely to cause hypercalcemia in nl people?
people in the hosptial? |
primary hyperparathyroidism
due to CA |
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what is bad about high phosphate levels?
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drives calcium into tissues
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if no central pallor, think...
RBC lack what? |
hereditary spherocytosis
lack of spectrin (cant form a biconcave disk) |
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what type of protein is ubiquitin?
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stress
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ubiquitinated keratin leads to..
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mallory bodies in the
think alcoholic hepatitis |
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what other dz forms neurofib tangles besides alzheimers?
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creutzfeldt-jacob
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what is tau protien?
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ubiquitinated neurofilaments
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Nf tangles are intra/extracell?
Amyloid plaques are intra/extracell? |
intra
extra |
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Parkinsons due to:
see: |
Dopamine deficiency
see pale substantia nigra |
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What three areas in the body have labile/stem cell replication?
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BM, crypts in the small intestine, basement membrane of skin
in the cell cycle the most |
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permant cells cant undergo...
can undergo |
hyperplasia (more copies)
hypertrophy (bigger) |
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can stable undergo hypertrophy or hyperplasia?
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yes, both
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only muscle that isn't permanent?
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smooth muscle
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which phase is more variable, proliferative or secretory?
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proliferative, like G1 of cell cycle
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glucagon is a
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phosphorylater and activates catabolic enzymes (since P activates)
insulin dephosphorylates to activate anabolic enzymes |
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Rb suppressor gene on chromo
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13, makes Rb protein
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what step needs to happen to get from G1- S phase?
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phosphorylation of Rb protein
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p53 suppresser gene on chromo
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17
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HPV's E6 and E7 knock off what?
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E6--p53
E7- RbR |
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Rb suppressor gene associated with?
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Retinoblastoma
Ostegeogenic Sarcoma (sunburst on x-ray, Codmans triangle-tumor that raises the periosteum) |
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how many n in G1
how many n in S |
2
4 |
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p53 does what to Rb
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makes a protein that inhibits the protein kinase that activates Rb so cell doesnt go into S
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G2 phase does what:
blocked by: |
tubulin/mitotic spindles
etoposide and bleomycin |
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Alkaloids block the ....phase
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M
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MTX blocks which phase?
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S (DHF reductase inhib)
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hydronephrosis due to what growth alteration?
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atrophy, stone blocks the cell so cortex thins due to ischemia (increased P)
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azheimer is what growth alteration?
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Atrophy
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Renal Artery stenosis is what growth abnl?
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atrophy due to ischemia, low renin
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psoriaisis is what type of growth abnl
tx? |
hyperplasia
MTX (treats extra stratum corneum) |
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BPH
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hyperplasia not hypertrophy
(all hormone-stim glands undergo hyperplasia) prostate hyperplasia causing bladder to hypertrophy |
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what does viral RNA do to get the host to replicate it?
how? |
disguises itself as mRNA
makes itself look single stranded and positive sense |
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what kind of virus is rhinovirus?
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single stranded and pos sense
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Non-enveloped virus:
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enteroviruses (polio, coxsack, echo, hepa A), rotavirus, Norwalk
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HIV is a ...
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retrovirus, enveloped, SS+ RNA, packed with reverse transcriptase [RNA dependent DNA polymerase]
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which type of naked virus can be infectious?
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single-stranded positive sense RNA
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What does beta-lactamase do?
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disrupts the beta-lactam ring of penicillins and cephalosporins making them ineffective
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why are third generation cephalosporins improved?
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they can prevent beta-lactamase destruction
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examples of beta-lactamase inhibitors:
are these ABX? |
clavulonic acid, sulbactam, tazobactam
no |
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how are penicillins and aminoglycosides synergistic?
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penicillins inhibit peptioglycan cell wall synthesis so that aminoglycosides can get in and act on the 30S subunit
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how to macrolides work?
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they inhibit p-450 systems so they increase the conc of other drugs that use this pathway
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cystic dilations of the medullary collecting ducts should make you think of...
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medullary sponge kidney
renal cortex is spared, prone to kidney stones, hematuria, UTI |
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relationship btwn alcohol and GABA?
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binds GABA receptors and potentiates its effect leading to sedation.
long-term use leads to down-reg of receptors |
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alcohol and catecholamines?
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increases catecholamine synthesis leading to tolearance
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Alcohol withdrawl timeline
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5-10 hrs, start of symptoms
2-3 days, most intense 4-5 days, less severe |
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besides the shakes what else do you see with withdrawl?
|
inc HR,
Inc respriation Inc body temp GI distress Insomnia, agitation |
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DTs
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fluctuant arousal levels
-48-72 hrs after last drink -formication, hallucinations, sweating, confusion |
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COPD
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hyperinflated lungs
flat diaphragm decreased expiratory air flow decreased elastic recoil decreased forced vital capacity |
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barrel-shaped chest
|
emphysema, also see decreased breath sounds
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what measurements increase with COPD?
|
TLC, RV, FRC due to
1. destruction of alveoli walls 2. diminished elastic recoil-->air trapping [inc expiratory reserve] |
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what is FRC equal to?
|
ERV + RV
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how does iron get absorbed via?
how does iron enter the circulation? how is iron transported in circ? |
DMT-1 transporter in SI
Ferroportin in enterocyte transportin |
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how is iron stored in the enterocyte?
what reg how iron is routed? |
ferritin (intracell binding protein)
hepcidin |
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to ways to excrete iron?
|
blood loss
epithelial cell loss |
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How does hepcidin affect absorption of iron?
where made? |
negatively affected
binds to ferroportin and causes its degradation liver |
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two jobs of hepcidin:
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release of iron from macroph
blocks ferroportin |
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what delivers iron to the BM to make new RBC?
|
transferrin
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fungal branching, septate hyphae that branch at acute angles in v-shapes?
grows where? |
aspergillus [only in mold form]
decomposing vegetables |
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neutropenia in leukemia/lymphoma think
tx of aspergillus |
aspergillus
amphotericin B |
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where does aspergillus have an affinity for?
how does it travel? enjoy what kind of areas |
BV
hematagenously old lung cavities (from TB or bronchiectasis) "fungus balls", can remove via surgeryh |
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Mucor causes
who gets mucor: look like: |
mucormycosis
paranasal infection in Dm patient broad, non-septate hyphae branch at rt angles |
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what is unique about blasto, histo and cocci as fungus?
|
dimorphic
grow as mold but exist as yeast in the body |
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hyphae only seen in..
|
mold
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what does crypto cause in AIDS in patients
|
meningitis, lung infection
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hashimoto's thyroiditis
|
AI process leading to hypothy {destroys thyroid cells] seen more in women
|
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which affects TSH secretion more, T3 or T4?
|
T3
|
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which is TH has the highest quanity?
Which is the most active? Which is inactive? |
T4
T3 rT3 |
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what does T4 get converted to?
which TH has the longest half-life? |
T3 or rT3 via deiodinase
T4 |
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exogenous T3 leads to..
|
decreased TSH, decreased T4 from thyroid, decrease rT3
|
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radial nerve branches...
damage causes damage due to |
C5-T1
weakness of foream, wrist and finger extensors (wrist drop) crutches |
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bilateral cateracts think...
|
galactokinase deficiency (form of galactosemia)
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fibrilin forms a sheet around?
|
elastin fibers
|
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three ossicles in the ear?
2 muscles? |
malleus, incus, stapes
tensor tympani and stapedius (smallest striated muscle) |
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tensor tympani innervation
stapedius innervation |
trigeminal (CN V3)-mandibular
facial (CN 7) |
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ADE of niacin?
what causes it? |
flushing, warmth itching
prostaglandins |
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Substance P?
|
pain neurotransmitter in the periph and CNS
regulates mood, anxiety, stress |
|
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what food can block Substance P in the PNS?
|
hot peppers, capsaicin
|
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what is the time frame for acute rejection?
what do you see histo? |
2-4 weeks post-transplant
dense infiltrate of monomuclear cells (t-cells) |
|
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to prevent GVHD?
|
tx is immunosuppresion
|
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what is the uptake mxn in the thyroid?
|
sodium iodide symporter (NIS)
|
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what is propylthiouracil (PTU) used for?
|
hyperthyroidism, decreases formation of thyroid hormonse by inhibiting thyroid peroxidase
|
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levothyroxine
|
synthetic t4, tx for hypothyroidism
|
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lymphogranuloma venereum:
|
pain in the inguinal region
show mixed granulomas with neutrophilic inflammation, stellate abscesses of necrosis |
|
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inclusion bodies think..
|
chlamydia
|
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|
|
Serotypes of Chlamydia:
A-C D-K L1-L3 |
ocular infection [trachoma]
urogenital infection + conjunctivitis lymphogranuloma venereum |
|
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chancre=
|
treponema pallidum (syphillis)
|
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typical FF=
FF is calculated via? |
.20
GFR/RPF |
|
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bacteria behind BV?
what happens? |
gardnerella vaginalis
loss of lactobacilli |
|
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|
clue cells...
|
BV
|
|
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|
which can you view on gram stain:
ghonorrhea or chlamydia? |
gonorrhea
|
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|
how does telomerase work?
what type of enzyme is it? |
synthesizes ssDNA from ssRNA (template)
reverse transcriptase |
|
|
|
what does telomerase do/
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adds TTAGGG to the 3' end of DNA at the end of chromo (telomere)
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which cells express telomerase?
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stem cells, cancer cells
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what is this triad indicitive of?
anemia, thrombocytopenia (including eosinophils), absent hematopoietic cells |
aplastic anemia, results in increase in EPO
iron is NORMAL |
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loss to follow-up leads to..
study design flaws lead to.. recall bias |
selection error
observation bias misclassification of the exposure status |
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what type of ldl do statins lower?
ADE? |
LDL
myopathy and hepatitis |
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risk of myopathy with statins increases when used with?
why? |
fibrates....gemfibrozil or fenofibrate [cause myopathy on their own]
increase the conc of the statins |
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why cant you give chloestyramine at the same time as statins/
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bile acids sequestrant reduce absorption of statin
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what drug is best post-mi to fight arrhythmias?
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lidocaine (depresses conduction in depolarized cardiac cells
amiodarone better for ventricular tachycardia |
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what is verapamil used for?
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treats atrial tachyarrythmias, slow conduction thru AV node
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what is adenosine used for?
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paroxysmal supraventricular tachycardia
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what does digoxin do?
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slows conduction thru AV node, good for atrial fib
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signs of tension pneumothorax:
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tachycardia, hypotension, tachypnea, hypoxia and no breath sounds, hyperresonnace to percussion
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ansa cervicalis roots..
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C1-C3 (inner muscles of the anterior neck)
injury above cricoid cartilage w |
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what muscles does the accessory nerve innervate?
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sternocleidomastoid and trapezius m.
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what bone are the carotid bodies below?
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hyoid bone
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risk of myopathy with statins increases when used with?
why? |
fibrates....gemfibrozil or fenofibrate [cause myopathy on their own]
increase the conc of the statins |
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why cant you give chloestyramine at the same time as statins/
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bile acids sequestrant reduce absorption of statin
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what drug is best post-mi to fight arrhythmias?
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lidocaine (depresses conduction in depolarized cardiac cells
amiodarone better for ventricular tachycardia |
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what is verapamil used for?
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treats atrial tachyarrythmias, slow conduction thru AV node
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what is adenosine used for?
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paroxysmal supraventricular tachycardia
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what does digoxin do?
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slows conduction thru AV node, good for atrial fib
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signs of tension pneumothorax:
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tachycardia, hypotension, tachypnea, hypoxia and no breath sounds, hyperresonnace to percussion
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ansa cervicalis roots..
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C1-C3 (inner muscles of the anterior neck)
injury above cricoid cartilage w |
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what muscles does the accessory nerve innervate?
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sternocleidomastoid and trapezius m.
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what bone are the carotid bodies below?
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hyoid bone
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def of efficacy:
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the intrinsic ability of a drug to elict an effect
ie loop diuretics are better at diuresis than HCTZ, regardless of dose |
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def of potency:
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dose of a drug that is need to accomplish a desired effect.
affected by its affinity for a receptor |
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how to compare drug potencies:
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the potency of diff agents can be compared by determining the dose required to produce 50% the desired response
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which is better after an MI:
cardiac catheterization or tPA? |
CC
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what is the most common side effect of streptokinase?
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hemorrhage
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polyuria, polydipsia and fruity odor due to:
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DKA
kassmaul respirations |
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purpose of kussmaul respriations:
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CNS is trying to mitigate the metabolic acidosis by a compensatory respiratory alkalosis
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how to know if there is a respiratory acidosis and resp failure superimposed on the metabolic acidosis:
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PaCO2=1.5 (bicarb value) +8
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how to compensate for metabolic acidosis?
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hyperventilation
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how to know if a patient has ATN
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elevated SERUM creatinine
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what determines if you develop testes:
testes-different. factor or testosterone? |
TDF
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paramesonephric=
mesoneprhic= |
mullerian
wolffian |
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order of sexual differentiation:
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gonadal
genital duct external genitalia |
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what two things does the SRY gene on chormo Y do>
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1. tells gonads to secrete T via leydig
2. AMF from sertoli cells |
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radiation has 2 effects:
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Free radicals and 2B strand breaks
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AMH:
Testosterone: |
regression of mullerian duct
development of male internal genitalia/DHT does external genitalia |
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what does the sciatic nerve divide into?
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tibial nerve and common peroneal nerve (m. injured in leg)
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common peroneal nerve damage present with:
sensory: |
inversion and plantarflexion
loss of sensation of ant leg due: damage to fibula |
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tibial nerve damage causes:
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dorsiflexion and eversion with loss of sensation on sole of foot
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sural nerve:
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only sensory, does the posterolateral leg and lateral foot
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obturator nerve injury leads to:
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spasms of the adductor musc of the thigh
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a point mutation is also known as...
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missense mutation
single base substitution, results in a codon change |
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Conservative mutation:
Silent mutation; |
results in an AA change, but the properties stay the same [type of missense-substitution]
the mutation codes for the same AA |
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how is surfactant released?
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via excytosis into alveolar space by ca dependent fusion of lamellar bodies with the membrane
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what are lamellar bodies:
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intracellular inclusions, membrane bound
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Signs of Pagets dz:
due to: |
pain and deformity in bones, hearing loss
excessive osteoclast action-->chaotic bone formation |
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what is differernt about osteoclasts in Pagets?
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they have many and large nuclei (up to 100)
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what determines osteoclast differentiation?
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M-CSF and RANK-L
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osteocalcin is..
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produced by osteoblasts, marker of bone formation
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Osteoclast come from..
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hematopoietic progenitor cells
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Pulsatile GnRH production regulates
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gonadtrophin (FSH and LH) release from pituitary gland
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what dominates the fight against TB?
what are they helped by? |
macroph
T helper cells (produce IFN-y which helps macroph mature and fight infection) |
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which cytokine is responsible for granuloma formation and caseous necrosis?
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IFN-y
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leukotriene, PAF and thromboxane are all:
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vasoconstrictors
Throm also does platelet-aggreg |
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what complement split product triggers mast cell histamine release?
histamine leads to: |
C3a
increase permeability and vasodilation |
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IL-4:
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converts Thelpers into Th-2, also helps with B-cell growth, isotype switching and IgE formation
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IL-5:
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bcell diff, activates eosinofils and increase IgA production
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actinic keratosis is a pre-cursor for?
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SCC
scrapes off and comes back |
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what degrades bradykinin?
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ace-inhib
so what is a side offect of ace-inhib? |
angioedema
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what is histamine's 3 jobs?
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vasodil arterioles
increase perm of venules redness/heat/swelling |
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how is neutrophil rolling done?
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e-selectin on edothelium binds to sialyl-lewis seg on leukocyte
how does tight binding work? |
Icam-1 on edothelium binds to LFA-1 on leukocyte
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what cant bruton agammaglobulinemia do?
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they cant phagocytose
why? what inheritance? |
cant make opsonizers (IgG) cause they cant generate mature bcells so they have no Ab
x-linked |
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how do you diagnose CGD?
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you do a nitroblue tetrazolium (NBT) test and if it is not blue you know there is no NADPH oxidase
what does nadph do? |
converts O2-->O2'
then SOD converts O2' to H2O2 and Cl- then MPO converts that to HOCl or bleach |
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where is myeloperoxidise contained?
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in lysosomes of neutrophils and monocytes (not macrophages)
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when you cant get rid of your umbilical cord you have?
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adhesion mol defect
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what stim mast cells to release histamine?
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C5a and C3a
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what does IL-1 cause and what does it tell the hypothal to do?
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fever
make PGs |
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are there more CD4 or CD 8 cells?
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cd4
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eccentric clock face nucleus?
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plasma cells
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who has major basic protein?
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eosinophils
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what CD is associated with ALL
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CD10
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What CD is associated with reed-sternberg cells?
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CD15, 30
what dz do you see them with? |
HL
lacunar histiocytes made giant cells |
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CD on Bcells
CD on all luekocytes? |
21 (where EBV attaches)
CD45 |
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how does osteomyelitis spread?
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hematogenously
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what is erysipelas?
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Acute streptococcus bacterial infection-upper dermis and superficial lymphatics.
other name for it? type of bacteria? |
st. anthony's fire
GAS |
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how does c. diphtheriae work?
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ADP ribos. of EF-2 >Inhibits protein synthesis
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Dresslers syndrome?
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a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium
known as postmyocardial infarction syndrome[ what is the triad? |
fever, pleuritic pain and pericardial effusion.
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what metal is a cofactor in healing?
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zinc
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what is most affected by ehlers-danlos?
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bv instability
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heart issues in marfans:
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MV prolapse
aortic regurg aortic aneurysms (dissection) |
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what does vit.c do for collagen?
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hydoxylizes proline and lysine
necessary for triple helix formation |
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what does lysyl oxidase do?
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Lysyl oxidase is an extracellular copper enzyme catalyzes formation of aldehydes from lysine residues in collagen and elastin precursors
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what does granulation tissue have a lot of?
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BV
wound healing (Rich in plasma cells and fibroblasts) |
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who is genetic predisposed to keloid?
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AA
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burns often lead to .... after healing?
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keloid
can lead to... |
scc (scars in third degree burns)
think of in a chronically draining sinus track |
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pus/excudate: acute or chronic?
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acute
what is a granuloma, acute/chronic? |
chronic
pink, multi-nucleated |
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what does gamma-IFN do?
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activate macroph
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who is the macroph of the skin?
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langhans
what is their marker? |
CD1
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what do langhans take up in TB testing?
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the PPD fluid
what do they do next? |
present via MHC2 to Type 1 memory tcells
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why would a person with AIDS and TB have a neg. PPD?
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since they have no helper T cells
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what portion of the kidney most likely to scar?
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medulla since most susceptible to hypoxia?
what parts of the nephron most suscept to hypoxia? |
straight portion of the prox tubule
medullary segment of the TAL |
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what is the repair cell of the lung?
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type 2 pneumocyte
also makes |
surfactant
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repair cell of CNS?
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astrocyte
astrocyte proliferation known as |
gliosis
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rxn to injury in the PNA?
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wallerian degeneration
anterograde or retrograde? |
anterograde
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what is the analogous cell to the schwann (PNS) cell in the CNS?
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oligodendrocyte
both do... |
make myelin
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what is like a schwannoma that causes hearing issues?
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acoustic
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what disease is associated with schwannoma?
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nfibromatosis/ bilateral aneuromas
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what normally keeps RBC from sticking together?
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neg. charge
what facilitates them sticking together? |
IgM
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multiple myeloma you see Ig
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G
Reynauds you see Ig |
M
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IgM is hot or cold agglutination?
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cold
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cryoglobulinemia is associated with which Hep?
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C
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which IgG increase ESR?
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IgG
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greater than 10% in bands tells you
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there is a left shift
you also see an increased? |
ANC
absolute neutrophil count |
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most potent system for killing bugs?
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oxygen via myeloperoxidase
in where |
asurophilic granules ie lysosomes
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what do dohle bodies and toxic granulations signify?
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found in granulocytes, particularly neutrophils. Along with Dohle bodies and cytosolic vacuolation, toxic granulations are a peripheral blood film suggest an inflammatory process.
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What is Edema?
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excess fluid in interstitial space
extracell, outside vessel |
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the cephalic phase increases H= in the lumen leading to HCO3 in the blood and a
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metabolic alkylosis causing a left shift curve and refusal to let go of...
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02 leading to hypoxia
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compensation for a metab alkylosis is a resp. acidosis leading to
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hyperventilation which increases..
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pC02 and leading to more hypoxia
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HF lead to what type of edema?
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transduate
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bee sting swelling leads to..
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exudate
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managment of anaphylactic shock?
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check airway
tx is aqueous epinephrine |
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edema due to right heart failure is due to...
but if its due to cirrhosis? |
incresead hydrostatic P
decreased oncotic P |
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post-mod radical mastecotmy often leads to..
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lymphadema
in other countries what is the cause of lymphadema? |
w. bancrofti
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what three things contribute to plasma osmolality?
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Na (which you multiply by 2)
Glucose (which you divide by 18) BUN (which you divide by 3) double serum Na then add 2 |
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