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62 Cards in this Set
- Front
- Back
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Gastric erosion vs ulcer?
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Erosion does NOT penetrate the muscularis mucosae
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Clinical picture and histology of PBC?
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Clinical: female with pruritis, fatigue, pale stool, xanthelasma
Histo: granulomatous inflammation ("florid duct infiltrate") w/ heavy portal tract inflammation |
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What is a xanthelasma?
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Lesions often on eyelids (in superficial dermis), lipid-laden macs (foam cells), due to high cholesterol (often associated with PBC)
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Causes of acute erosive gastritis?
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NSAIDs, head trauma, burns, alcohol, tobacco, acute stress, bacterial infection
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Abdominal pain with GU symptoms --> think...
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PID! (either GC or CT)
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Why is there low or no sperm production in cryptorchidism (undescended testes)?
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Temperature is too high for sperm production. The seminiferous tubules atrophy, which also decreases production of inhibin, leading to high FSH levels (Leydig cells, testosterone, and LH are normal).
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Which type of kidney stone is radiolucent?
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Uric acid stones are radiolucent (can be detected on abdominal ultrasound or CT but NOT on x-ray)
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What's the most common cause of calcium stones?
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>50% are due to idiopathic hypercalciuria (normal serum Ca, high urine Ca) (other causes: hyperoxaluria, hyperuricosuria, low urinary volume, hypocitraturia)
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What do each of the pharyngeal pouches?
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1: auditory tube, 2: palatine tonsil, 3: thymus and inferior thyroid, 4: superior parathyroid, ultimobranchial body
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Malformation vs agenesis ve deformation vs disruption vs sequence?
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Malformation (primary defect in the cells or tissues that form an organ (like holoprosencephaly), agenesis (organ not made), deformation (mechanical forces), disruption (previously normal), or sequence (single primary defect leads to others)
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What kind of structure are the kidney, pancreas, abdominal aorta, and adrenal gland (and others)?
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Retroperitoneal!
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What do "spoon nails," koilonychia, and dysphagia indicate?
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Iron deficiency anemia
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#1 cause of iron deficiency anemia?
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Blood loss
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Side effect of halogenated anesthetics?
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Massive hepatic necrosis
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Phenoxybenzamine vs phentolamine?
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Phenoxybenzamine: nonselective, irreversible alpha 1 and 2 antagonist, Phentolamine: competitive alpha antagonist
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What is dexrazoxane?
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An iron chelator that prevents cardiotoxicity with daunorubicin.
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Drugs that cause seizures?
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Bupropion, INH, Imipenem
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What does cisplatin do and how can its toxicity be decreased?
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ROS cause DNA cross-links. Decrease toxicity with Amifostine (scavenges free radicals). Can also prevent nephrotoxicity with chloride diuresis (high Cl inactivates Cisplatin).
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How can you determine the presence of a confounding factor?
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You can run separate analyses for what you think might be the confounding factor (stratified analysis) to disclose the true, unconfounded relative risk.
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What is the cause of splenomegaly in PK deficiency?
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Work hypertrophy
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What are causes of passive congestion splenomegaly?
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CHF, splenic vein thrombosis, portal HTN
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What is tryptase a marker of?
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Mast cell activation
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What stimulates the hepatic production of acute phase reactants (fibrinogen, CRP, serum amyloid A/P, complement, ferritin)?
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IL-1, IL-6, and TNF-alpha. Lead to erythrocytes forming stacks, which increases ESR.
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What is McArdle's syndrome?
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Deficient myophosphorylase --> muscle can't break down glycogen --> cramps with exercise, myoglobinuria
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What is the direct result of the HbS mutation (glu --> val)?
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It allows a hydrophobic interaction of the beta with alpha chains.
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Where is the enzyme transketolase located?
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Cytoplasm
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Where is HMGCoA lyase located?
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mitochondria
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Which enzymes does lead inhibit?
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D-aminolevulinic acid Dhase (needs zinc also) and ferrochelatase
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Which amino acid is most abundant in collagen?
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Glycine! (Formula = (Gly-X-Y)333 (X and Y are often pro, lys)
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What is the relationship of acetyl CoA and gluconeogenesis?
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It is an allosteric activator of gluconeogenesis.
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What compound is needed to activate CPS 1 (urea cycle)?
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N-acetylglutamate
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Which enzymes convert propionyl CoA to methylmalonyl CoA and then methylmalonyl CoA to succinyl CoA?
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Propionyl CoA CARBOXYLASE and then methylmalonyl CoA MUTASE (an isomerase)
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Where does the energy (phosphate group) for gluconeogenesis come from?
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GTP comes from the succinyl CoA --> succinate reaction and is used for OAA --> PEP
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Which enteric organism causes bacteremia and endocarditis and is associated with GI malignancy (colon cancer)?
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Strep. bovis
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Which beta hemolytic strep is sensitive to bacitracin?
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S. pyogenes
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Distinguish S. viridans vs pneumoniae?
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Both are alpha hemolytic, but strep pneumo is optochin sensitive, bile solubile, but can't grow in bile.
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What Abs are made in response to the Hib vaccine?
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Abs against polyribosyl-ribitol-phosphate (PRP) (component of the capsule). The compound is conjugated to diphtheria or tetanus toxin and is given at 2mo.
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What happens if an echinococcus liver cyst is disrupted?
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It can cause anaphylaxis if the cyst is aspirated and gets into the body. Normally it is a unilocular with a thick fibrous cap (with eggshell calcifications).
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Which cells prevent against candida infection?
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T cells prevent against superficial infection (oral, cutaneous, vulvovaginitis). Neutrophils prevent against hematogenous spread.
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When do you treat for prevention of neonatal GBS infection?
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INTRAPARTUM penicillin (or ampicillin). Treatment with abx too early in pregnancy isn't effective for prophylaxis.
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What can allergic bronchopulmonary aspergillosis lead to?
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Bronchial infiltrates can lead to bronchiectasis. Also see high IgE, eosinophilia, and IgE/IgG Abs to aspergillus.
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What is the effect of lack of proofreading on the Hep C virus?
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There are over 6 genotypes and lots of antigenic variation. Abs against Hep C are neutralizing.
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What is the main virulence factor of E. coli?
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K1 capsular antigen (present in 20-40% of intestinal E. coli and most all strains that cause neonatal meningitis). It allows the bacteria to spread hematogenously and infect the meninges.
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Classic triad of congenital toxoplasmosis?
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Hydrocephalus, Intracranial calcifications, and Chorioretinitis
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What is the most common neurological complication of VZV infection?
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Post-herpetic neuralgia (continued pain in area)
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How can Candida albicans be separated from other Candida infections?
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It forms "germ tubes" at 37 degrees C. It is a common contaminant of sputum cultures but doesn't necessarily indicate disease caused by it.
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CD4 cutoff for immunocompetency?
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CD4 > 400. In HIV patients with CD4 > 400 the most common cause of CAP is still S. pneumoniae.
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What do cord factor and sulfatides do?
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Both are virulence factors of M. tb. Cord factors allows growth in a serpentine, cord-like pattern (necessary for neutrophil inactivation, mito damage, and TNF alpha release). Sulfatides inhibit fusion of phagosome with lysosome and allow living inside of macrophages.
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Primary route of entry of cryptococcus?
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Lungs (often asymptomatic infection). Can spread to CSF in immunocompromised patients.
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Aspergillus vs mucor/rhizopus?
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Aspergillus forms septate hyphae at acute angles. Mucor/rhizopus form non-septate hyphae at wider (>90 degree) angles.
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Acid stability of rhinoviruses vs enteroviruses?
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Engeroviruses are acid STABLE. Rhinoviruses are acid LABILE (don't infect GI tract).
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What medication are chlamydia, U. urealyticum, Mycoplasma, and Trichomonas NOT susceptible to?
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Penicillin or other cell wall synthesis inhibitors. No PDG cell wall.
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How does an acid fast stain work?
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Stain with aniline dye (carbolfuchsin: red). Mycolic acid takes it up. Treat with HCl and EtOH (dissolve outer membrane of non-TB bacteria). Counterstain with methylene blue (taken up by decolorized bacteria).
--> Red = acid fast, blue = non acid fast. |
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What does isoniazid do?
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Inhibit mycolic acid synthesis.
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What does ethambutol do?
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Inhibit carbohydrate polymerization needed for mycobacterial cell wall synthesis. AE is optic neuritis.
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What different genes does HBV make?
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3 antigens (HbSAg is noninfective, forms spheres and tubules 22mm in diameter), DNA Pol, and transcriptional transactivator from X region (de-regulates hepatocyte proliferation)
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What is Ebstein's anomaly?
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Atrialization of RV, apical displacement of tricuspid valve leaflets, and decreased RV volume. Due to lithium use during pregnancy.
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What cardiac defects are seen in DiGeorge syndrome?
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Tetralogy and abnormal aortic arch.
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Origin of cardiac defects in Down syndrome?
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Endocardial cushion defects.
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Describe myxomatous changes.
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Fragmentation of elastic tissue, seen in cystic medial necrosis. Predispose to aortic aneurysm/dissection. Associated with Marfan syndrome.
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Sequence of light microscopy findings after MI?
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0-4 hours (normal).
4-12 hrs (edema, coag necrosis) 12-24 hrs (contraction bands). 1-5d: neutrophils 5-10d: macs. 10-14d: granulation tissue, neovasc 2wks-2yrs: scar |
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Normal changes with aging heart?
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Decrease in LV chamber size, S (sigmoid) shaped ventricular septum, myocyte atrophy with interstitial fibrosis, lipofuscin accumulation.
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