Pbl Exam 3

Front 1

light forms an image on the ___ that is __ and __

Back 1

retina...inverted...reversed

Front 2

info from upper visual space is projected to ___ retina, and right visual space projects to ___

Back 2

lower....left

Front 3

central fixation point for the eye falls onto ___, does this have high or low acuity? This accounts for __ to __ degrees, and is innervated by ___ of the nerves. It is surrounded by __ (which accounts for about __ degrees)

Back 3

fovea...high....1-2.....half....macula...5

Front 4

About __ degrees from fovea in the __ direction is the __.

Back 4

15....medial...optic disk

Front 5

there are __ rods for every cone... rods are useful in __ conditions.

Back 5

20...low light

Front 6

receptor in the outermost layer (furthest from lens) is ___

Back 6

photoreceptors

Front 7

photoreceptors synapse onto __ cells (travels by ___) which synapse onto __ cells (travels by ___) which synapse onto ___ (travels by ___)

Back 7

bipolar...electrical conduction..ganglion...electrical conduction...optic nerve....action potentials

Front 8

There are also __ and __ cells that have for ___. The two types are ____ (excited by light in center of receptive field and inhibited by light in surrounding area) and ___ (opposite)

Back 8

horizontal....amacrine...center surround.....on-center... off-center

Front 9

Parasol cells (P__) are ___ cells that have ___ cell bodies, ___ receptive/dendritic fields, and respond best to __stimulus/movement. Projects to _ layers of __ nucleus of thalamus

Back 9

A....ganglion....large...large....gross....magnocellular.... lateral geniculate

Front 10

Midget cells (P__) are ___ cells that have ___ cell bodies, ___ receptive/dendritic fields, and respond best to __stimulus/movement. Projects to _ layers of __ nucleus of thalamus

Back 10

B...ganglion....small....small....fine....parvocellular ....
lateral geniculate

Front 11

parasol vs midget: which one is more numerous?

Back 11

midget

Front 12

Main pathway: Lateral geniculate nucleus projects to ___ . Minor pathway LGN projects to ___ and ___ (for ___ reflex). Both minor pathways are important for responding to ___ and therefore project to ___ cortex and ___.

Back 12

primary visual cortex...superior colliculus...pretectal area.... pupillary light.... visual stimuli.....association.... brainstem

Front 13

LGN has 6 layers (1-6 from __ to __).. first two are ___, and the rest are ___

Back 13

ventral to dorsal....magnocellular...parvocellular

Front 14

some LGN neurons, particularly in ___ layers are ___ cells in order to detect ___

Back 14

magnocellular....on/off...change

Front 15

From LGN to primary visual cortex, axons fan out (this is called ___). When they fan out to temporal lobe, they are called ___. Lesions here cause __lateral homonymous ___ quadrantanopia

Back 15

optic radiations....meyer's loop....contra....superior

Front 16

primary visual cortex lies along ___ fissure in the ___ lobe. Above the fissure is ___, below the fissure is ___. Most "distal" part is for ___

Back 16

calcarine...occipital...cuneus...lingula...fovea

Front 17

Most input goes to cortical layer __, which is divided into __, __, __, __. Stria of Gennari is layer ___. Primary visual cortex is Brodman's area __ and is often called ___

Back 17

4....4A, 4B, 4C-alpha, 4C-beta.....4B....17....striate cortex

Front 18

gross spatial movements go to ___ layer of LGN, and project to cortex layer ___ and then to __ and then by the __ stripe in visual assoc cortex (layer 18)

Back 18

magnocellular....4C-alpha...4B.....thick

Front 19

fine spatial info go to ___ layer of LGN, which go to layer ___, and then to layer 2, 3 ___ and then to ___ stripe

Back 19

parvocellular...4C-beta...interblobs...pale

Front 20

color goes to ___ layer of LGN, which go to layer ___, and then layer 2, 3 ___, and then to ___ stripe

Back 20

parvocellular...4C-beta...blobs....thin

Front 21

dorsal pathways project to _____, and answer the question ___

Back 21

parieto-occipital association cortex....where

Front 22

ventral pathways project to _____, and answer the question ___

Back 22

occipitaltemporal association cortex....what

Front 23

simple cells respond to lines or edges that occur at a ____, complex cells respond to lines or edges that occur at ____

Back 23

specific location....any location

Front 24

a complete sequence of both ocular dominance and orientation columns are known as ___

Back 24

hypercolumns

Front 25

regions of absent vision are usually r/t ___ lesions, while black/brown/purple scotomas are usually r/t ___ lesions

Back 25

central visual pathway....retinal

Front 26

retinal detachment often makes the pt see ___

Back 26

light flashes

Front 27

acute glaucoma often makes the pt see ___

Back 27

rainbow halos

Front 28

migraine often causes ___

Back 28

fortification scotomas

Front 29

occipital seizures often causes __

Back 29

pulsating colored lights (or moving geometric shapes)

Front 30

formed visual hallucinations arise from lesions in the ____

Back 30

inferior temporo-occipital visual association cortex

Front 31

___ is when pt w/ visual deprivation see objects/people/animals in the area of vision loss

Back 31

release phenomenon

Front 32

normal visual field extends about __ degrees. Can be tested with ___

Back 32

60.....Goldmann perimetry

Front 33

monocular scotoma is r/t lesion of

Back 33

retina

Front 34

elevated intracranial pressure causes

Back 34

constricted visual field

Front 35

retina receives blood supply from ___ artery. 3 main causes of vascular impairment are ____

Back 35

opthalmic....emboli, stenosis, vasculitis

Front 36

if you lose upper/lower half of vision it is an

Back 36

altitudinal scotoma

Front 37

impaired blood supply to anterior optic nerve is called ___

Back 37

AION

Front 38

anterior optic nerve is supplied by

Back 38

short posterior cilliary arteries

Front 39

arteric AION is r/t

Back 39

temporal arteritis

Front 40

LGN is supplied by ___, ___, ___

Back 40

anterior/posterior choroidal, thalamogeniculate

Front 41

optic radiations can be damaged by infarcts of parietal lobe (__ artery) and temporal lobe (__ artery)

Back 41

superior MCA....inferior MCA

Front 42

inferior occipitotemporal visual association cortex is supplied by ___, while the lateral parieto-occipital visual association cortex lies in ______

Back 42

PCA...MCA-PCA watershed

Front 43

optic neuritis is similar to __, often causes __ and ___. Rx w/ ___

Back 43

MS...eye pain.... central scotoma...steroids

Front 44

prolonged visual evoked potential indicates

Back 44

demyelination

Front 45

the superior oblique originates from __ and passes through the __ to cause ___

Back 45

sphenoid...trochlea...intorsion

Front 46

inferior oblique causes

Back 46

extorsion

Front 47

when the eye is abducted, the __ cause pure depression, but when it adducted, the ___ causes pure depression

Back 47

inferior rectus....superior oblique

Front 48

ciliary muscle is for

Back 48

focusin the lens

Front 49

oculomotor nerve splits into 2 branches after ___. Superior innervates ___ and ___. Inferior division innervates ____ and ___

Back 49

entering the orbit...superior rectus....levator palpebrae superioris.... all other muscles....parasympathetics

Front 50

occulomotor nuclei are located in ___ at the level of superior colliculi and red nuclei

Back 50

upper midbrain

Front 51

Edinger-Westphal nucleus contains ___ fibers. It is susceptible to compression by ___ aneurysms. CNIII enters ___ and enters orbit by ___

Back 51

preganglionic parasympathetic.... PComm... cavernous sinus.... superior orbital fissure

Front 52

lesions of oculomotor nucleus does not cause ___, ___, ___

Back 52

unilateral ptosis, unilateral dilated pupil, unilateral superior rectus palsy

Front 53

trochlear nuclei are located in ___. Trochlear nerves are the only CN that ext the brain ___. Can be compressed by ___ tumors

Back 53

lower midbrain....dorsally...cerebellar

Front 54

abducens nuclei lie on the floor of the __. It exits the dura to enter ____, susceptible to downward traction injury caused by ____

Back 54

4th ventricle...dorello's canal...elevated intracranial pressure

Front 55

large nerve fibers usually have a resting potential of ___.. this is largely maintained by ___

Back 55

-90 mV....K

Front 56

cells have electrogenic pump that pumps out ___ and allows ___ in

Back 56

3 Na....2 K

Front 57

depolarization starts with increased permeability to __, which makes the potential slightly positive (this is ___), then there is increased permeability to __.

Back 57

Na...overshoot...K

Front 58

voltage gated Na channel has 2 gates: __ and __. Normal resting state has which gate open? Which one is slower? The inactivation gate will not open again until ____

Back 58

activation...inactivation....inactivation...inactivation.... membrane potential returns to normal

Front 59

calcium channels are ___ than sodium channels

Back 59

slower

Front 60

a deficit of calcium in extracellular fluid makes sodium channels ____

Back 60

more premeable

Front 61

threshold for initiating action potential is usually ___, which is where more Na channels are opened by ___. The direction of propagation is ___.

Back 61

-65...positive feedback...away from stimulus

Front 62

the Na-K ATPase pump is strongly activate when there is excess ___

Back 62

Na inside the cell

Front 63

plateaus in heart muscle action potentials are due to

Back 63

slow calcium channels

Front 64

rhythmic potentials are generated due to ____ as well as fluctuating ___

Back 64

inherent leakiness to Na/Ca.....K permeability

Front 65

saltatory conduction is impt for 3 reasons

Back 65

faster, conserves energy, quicker repolarization

Front 66

local anesthetics like procaine and tetracaine act to _____

Back 66

stabilize sodium channels

Front 67

the pigment layer in the back of the __ contains ___ and ___

Back 67

retina...melanin...vitamin A

Front 68

entire inner layer of retina is supplied by ___, whereas outer layers get diffusion from ___

Back 68

central retinal artery....choroid

Front 69

rods have __ (made of __ and ___ (which changes from __ to ___ when light hits it)) and degrades in response to light. Reforms, using energy and catalyzed by ___

Back 69

rhodopsin....scotopsin....retinal...cis...trans...retinal isomerase

Front 70

Vitamin A can be used to form new ___. Is this reversible?

Back 70

retinal....yes

Front 71

Rod exposure to light causes ___ of membrane by decreasing ___ via ____

Back 71

hyperpolarization....sodium conductance...cGMP

Front 72

Rods are extremely sensitive via __

Back 72

positive feedback

Front 73

cones have photochemicals made up of __ and ___. The colors they can sense are __, __, __

Back 73

photopsins...retinal....red, blue, green

Front 74

After a long time in bright conditions, the photochemicals in rods/cones degrade into __ and __. Furthermore, a lot of the __ will be converted into __

Back 74

opsins....retinal....retinal...vitamin A

Front 75

Adapting to dark: __ adapt faster, __ are more sensitive. Also there is __ and ___

Back 75

cones....rods....pupil size change....neural adaptation

Front 76

loss of red cones is ___, loss of green cones is ___. This is an ___ trait

Back 76

protanope...deuteranope....X-linked

Front 77

horizontal cells work in ___ layer, and amacrine cells work in ___ layer

Back 77

outer plexiform...inner plexiform

Front 78

rods and cones use the neurotransmitter ___

Back 78

glutamate

Front 79

why do visual neurons use electrotonic conduction?

Back 79

it can scale

Front 80

horizontal cells are always

Back 80

inhibitory

Front 81

bipolar cells are (depolarizing/hyperpolarizing?)

Back 81

both

Front 82

amacrine cells are ___ that basically work to ___ visual signals before they leave the retina

Back 82

interneurons....analyze

Front 83

3 types of ganglion cells: W for __ vision, X for ___ vision, and Y cells for ____

Back 83

rod....color...rapid change

Front 84

ganglion cells transmit signals by

Back 84

action potentials

Front 85

LGN "filters" signals via inhibitory signals that are ___ or from ___

Back 85

corticofugal...reticular area of mesencephalon

Front 86

simple cells are located in layer

Back 86

IV

Front 87

interconnections among brain stem nuclei is by ____

Back 87

medial longitudial fasiculus

Front 88

two parts of fixation movements: voluntary to ___ (located in ___), and involuntary to ___ (located in ___)

Back 88

find object...premotor cortex...lock on...secondary visual area of occipital cortex

Front 89

eyes have 3 types of constant movement: ___, ___, ___. These are provided by ___

Back 89

tremor...slow drift...flicking...superior colliculi

Front 90

rapid jumps fixating on diff objects are ____ (this is ___ movement)

Back 90

saccades....opticokinetic

Front 91

turning towards a stimulus is done by ____ using ___ fibers. Also by ___, whole head turns

Back 91

superior colliculi...Y fibers....medial longitudinal fasiculus

Front 92

if 2 eyes report signals that aren't in sync, ___ between neurons of cortex correct eye position

Back 92

interference excitation

Front 93

accommodation is achieved by ___ mechanisms. Specifically it does it by chromatic aberration (using ___), because convergence ____, because the fovea is slightly ___, and because the lens ___ all the time

Back 93

negative feedback....color....always causes lens to thicken... deeper.... oscillates (in degree of contraction)

Front 94

Argyll Robertson pupil is when the pupil responds to ___ but not ___

Back 94

accommodation....light

Front 95

a block of ___ in brainstem can cause a failure of pupillary light reflex

Back 95

pretectal region

Front 96

Horner's syndrome causes what 3 effects

Back 96

ptosis, miosis, anhydrosis

Front 97

babies are sterile at birth b/c ___ is a barrier and we don't get antigens from ___

Back 97

placenta....mother

Front 98

colonization is ___ of microorganism, and does not necessarily mean ___

Back 98

presence....infection

Front 99

ingress of microorganism means entering a space that is ____. Opposite is ___

Back 99

continuous with outside....penetration

Front 100

to prevent against inhaled pathogens, respiratory tract has ___ that sweep ___

Back 100

cilia...upwards

Front 101

macrophages in lungs (___) can phagocytose pathogens and bring them into body (this is ___)

Back 101

dust cells,,,cell mediated entry

Front 102

inoculum is

Back 102

# of invading organisms

Front 103

spread can be 2 things: spread to adjacent areas (___) or spread to distant sites (___)

Back 103

lateral propagation...dissemination

Front 104

children get ear infections either because their eustachian tubes are more ___, and do not __

Back 104

horizontal...drain well

Front 105

incubation period is the time needed for infectious agents to ___ and ___. This period is ____

Back 105

overcome early defense...build up numbers...asymptomatic

Front 106

complement: classic pathway is ___ binding (can cause ___). Alternative is activated in presence of ___

Back 106

antigen-antibody....glomerulonephritis...microorganisms

Front 107

cell mediated immunity is associated with ___ inflammation. Can cause __ or ___

Back 107

chronic inflammation...tubercles or granulomas

Front 108

cell mediated immunity is associated with ___ inflammation. Can cause __ or ___

Back 108

pathogen...host response

Front 109

colonization is __ but not ___ for disease

Back 109

necessary....sufficient

Front 110

blood, CSF, synovial fluid, and deep tissues are usually ___, so presence of pathogens is ____

Back 110

sterile...significant

Front 111

to colonize, microorganisms must be able to ___ and ___

Back 111

resist host defense....compete successfully

Front 112

preferences of infection sites are known as

Back 112

tropism

Front 113

normal flora can cause disease when it ____

Back 113

goes somewhere it isn't supposed to

Front 114

virulence is not intrinsic to microorganism, but also depends on

Back 114

immune competence of host

Front 115

IgA are secreted through

Back 115

mucous membrane

Front 116

antibodies to ABO antigens can arise from

Back 116

cross-reaction from intestinal flora

Front 117

Normal flora can keep invaders out by producing ___, they can also create vitamins like ___

Back 117

bacteriocins...vitamin K

Front 118

Most of normal flora are ___ ____

Back 118

anaerobic bacteria

Front 119

most people's intestinal flora is (constant/variable?).. this means they are good at ___

Back 119

constant...resisting colonization

Front 120

Prokaryotes vs eukaryotes. Which one is diploid? Which one has many chromosomes? Which one has translation coupled to transcription?

Back 120

eukaryotes....eukaryotes....prokaryotes

Front 121

dental plaque (AKA ___) is composed of ___ from ___

Back 121

biofilm...polysaccharides...bacteria

Front 122

small size of microbes means ___ diffusion, ___ surface to volume ratio, ___ metabolic rates

Back 122

easier....higher....higher

Front 123

the strongest antibody responses are usually directed at antigens located where?

Back 123

surface

Front 124

Gram negatives are ___, gram positives are ___

Back 124

red...purple

Front 125

gram positive bacteria have a thick ___ composed of ___ (AKA ___).. this works to ___ and protect against ___. The shapes can be rods (__), spheres (___), or helices (___)

Back 125

cell wall....murein....peptidoglycan...limit shape...osmotic pressure.....bacilli....cocci....spirilla

Front 126

the cell wall can be removed with ___, which causes the cell to become __ in isoosmotic fluid

Back 126

lysozyme....spherical

Front 127

the cell wall also impedes passage of ___ compounds

Back 127

hydrophobic

Front 128

gram negative bacteria have a ____ located ___. It has __ layers and the outside layer has ___ (composed of ___, ___ and ___). The outside layer is permeable to ___ compounds

Back 128

outer membrane...outside murein....2....LPS.... Lipid A.... Core..... O antigen...hydrophilic

Front 129

between the 2 membrane of gram negative bacteria is ___ that has ___ and ___

Back 129

preiplasm....enzymes....binding protein

Front 130

fever and inflammation can be r/t which component of gram negative bacteria? It is AKA ___

Back 130

lipid A....endotoxin

Front 131

Acid-fast staining bacteria have cell walls made up of

Back 131

waxes

Front 132

penicillins, cephalosporins, and carbapenems (____) act by ____

Back 132

beta-lactams....inhibit murein synthesis

Front 133

Murein synthesis requires a lipid carrier (inhibited by ___) and disaccharide linkage to growing murein chain (inhibited by ___). Final step is transpeptidation (blocked by ___)

Back 133

bacitracin...vancomycin...penicillin

Front 134

Penicillin only lyses cells that are ___. Penicillin resistance are r/t bacteria deficient in ___

Back 134

growing....autolysin

Front 135

penicillin resistant bacteria that have no murein are

Back 135

mycoplasmas

Front 136

bacteria have ___ proteins to help transport. Are they energy dependent?

Back 136

permeases....yes

Front 137

active transport for bacteria is driven by ___

Back 137

proton motive force

Front 138

gram negatives concentrate stuff in periplasm using

Back 138

binding proteins

Front 139

bacteria requires ___ for growth. They get it by secreting ___

Back 139

iron....siderophores

Front 140

baccterial DNA is coiled into a __ that is twisted into __. This is done by __ and undone by __

Back 140

nucleoid...supercoils...DNA gyrase...topoisomerase I

Front 141

one of the only drugs that can disrupt bacterial DNA replication

Back 141

metronidazole

Front 142

bacterial mostly synthesize ___. Rifampin inhibits __ of this

Back 142

protein...first step

Front 143

chloramphenicol and macrolides (like __) works to block ___. These aren't bactericidal, but __

Back 143

erythromycin....formation of peptide bonds....bacteriostatic

Front 144

__ like sterptomycin, gentamicin, and neomycin bind to __ ribosomal subunit. Bacteriocidal?

Back 144

aminoglycosides....30S

Front 145

some bacteria has outer capsule, which is ___ and ___

Back 145

slimy and shiny

Front 146

flagella are for ___, but pili are for ___

Back 146

movement....attachment

Front 147

chemotaxis is ___, and can be towards attractant (mostly ___ by ___ of flagella) or away from repellent (mostly ___ by ___ of flagella)

Back 147

swimming....counterclockwise....tumbling...clockwise

Front 148

pili expression can change, like in the disease ___. This is called ___

Back 148

salmonella...phase variation

Front 149

most important class of bacteria? (strict aerobes vs strict anaerobes vs facultative anaerobes)

Back 149

facultative anaerobes

Front 150

___ is when a culture's growth stops. This can initiate ___ which can release toxins

Back 150

stationary phase...sporulation

Front 151

Damage to DNA of a bacteria causes ___

Back 151

SOS response

Front 152

bacteria can adapt by using ____ (bacteria don't make they don't need)

Back 152

parsimony

Front 153

genes enzymes of a metabolic pathway are strung together into an ____. An enzyme that is made on demand is ____ and one which must be made all the time is ____

Back 153

operon....inducible...constitutive

Front 154

meningoencephalitis is diff from meningitis in that there is also inflammation of

Back 154

brain parenchyma

Front 155

hematogenous spread is entry to CNS by ___

Back 155

blood vessels

Front 156

acute pyrogenic meningitis: LP yields __ protein, ___ glucose, __ appearance.

Back 156

high...low...cloudy

Front 157

acute aseptic meningitis is from ___ origin, and CSF is ___

Back 157

viral...sterile

Front 158

brain abscess can be r/t ___ and is characterized by ____ necrosis. CSF pressure is ___

Back 158

bacterial endocarditis...liquefactive...elevated

Front 159

subdural empyema is r/t ___ or ___ infection and causes __ effect and ___ dura

Back 159

bacterial...fungal...mass....thickened

Front 160

extradural abscess is associated with ___ and can cause ____

Back 160

osteomyelitis...spinal cord compression

Front 161

TB can cause ___, resulting in ___ and a ___. Most serious complication is ___ or ___

Back 161

meningoencephalitis...endarteritis....teberculoma.. hydrocephalus... infarct

Front 162

Neurosyphilis involves mostly __ of brain, and can damage sensory nerves in dorsal roots (__)

Back 162

base...tabes dorsalis

Front 163

lyme disease can show up as ___ meningitis and ____

Back 163

aseptic...facial nerve palsies

Front 164

arboviruses are carried by __ and are characterized by ____. Microglial cells can form ___

Back 164

bugs..lymphocytic meningoencephalitis..microglial nodules

Front 165

HSV-1 can cause encephalitis that mostly involves __ and __ regions of temporal lobes as well as ___ of frontal lobes

Back 165

inferior and medial.....orbital gyri

Front 166

cytomegalovirus tends to occur in people that are

Back 166

immunosuppressed

Front 167

poliomyelitis affects _____

Back 167

anterior motor neurons of spinal cord

Front 168

rabies causes neuronal degen in ___ and can cause ___ bodies. Causes foaming and ___

Back 168

brainstem....negri....sensitivity

Front 169

HIV tends to cause ___ in microglial nodules

Back 169

multinucleated giant cells

Front 170

cryptococcal meningitis is a __ infection that can cause ____

Back 170

fungal....hydrocphalus

Front 171

prions can cause disease by changing ___ to ___. Changes cortex into ___

Back 171

alpha PrP to beta PRP.........spongiform

Front 172

MS is an ___ ____ r/t polymorphisms in __ and __ receptor genes. It is initiated by ___ T cells

Back 172

autoimmune demyelinating......IL2...IL7....CD4

Front 173

shadow plaques appear in ___ and has a ____ border

Back 173

MS...poorly defined

Front 174

MS usually presents with ____ involvement. Can also produce CN signs r/t ___ involvement

Back 174

optic nerve....medial longtidinal fasciculus

Front 175

MS presents with elevated __ in CSF, that elecgtrophorese into ___.

Back 175

IgG...bands

Front 176

neuomeylitis optica is a demyelinating disease. Presents with antibodies to ___, harming ___

Back 176

aquaporins...BBB

Front 177

Central pontine melinolysis is characterized by myelin loss of ___ and parts of ___

Back 177

basis pontis....pontine tegmentum

Front 178

acute disseminated encephalomyelitis causes ___ and appears after ___

Back 178

demyelination...viral infection

Front 179

penicillin is a ___ antagonist

Back 179

GABA-a

Front 180

nerve has a refractory period from ___ and ___ mediated ___

Back 180

Na channel activation...K channel .. hyperpolarization

Front 181

neural networks use ___ that use the neurotransmitter ___ to cause ___ (prevents seizures)

Back 181

interneurons....GABA...surround inhibition

Front 182

focal seizures are those that are ____. Often initiated by PDS (___)

Back 182

restricted to 1 hemisphere... paroxysmall depolarizing shift

Front 183

extracellular K makes seizures more likely by blunting

Back 183

K channel mediated hyperpolarization

Front 184

b/c of surround inhibition, local discharges are contained in a ___. These are seen as ____

Back 184

focus..interictal spikes

Front 185

Repetitive firing causes more ___, opens ___, and accumulates ___

Back 185

extracellular K...NMDA channels....Ca (in synaptic terminals)

Front 186

during spread to neighboring area, pt may experience __

Back 186

aura

Front 187

seziures can start in hand and progress to arm and then leg. This is

Back 187

Jacksonian march

Front 188

focal seizures can spread along diffuse connections to involve both hemispheres. This is ____ (most common is ___). ___ connect various regions of cortex. ___ connects hemispheres. ___ connect cortex to other parts of brain.

Back 188

secondary generalized seizure....tonic-clonic.... U fibers... corpus callosum.... thalamocortico projections

Front 189

Tonic-clonic- tonic is r/t ____, and clonic is r/t ____ at the same time that __ and ___ mediated excitation oscillates

Back 189

loss of GABA-input......GABA-input starts.... AMPA... NMDA

Front 190

primary generalized seizures emanates from ____ and spreads to ___. Classic type is ___ seizure, which is where pt has interruptions in ___ along with ___ stare and ____ symptoms. These are r/t abnormal synchronizations of ___ and ___ cells

Back 190

central brain regions....both hemispheres.... absence seizure..... consciousness....blank...motor.... thalamocortical and cortical

Front 191

Relay neurons connect ___ to ___. In awake state, they ___. During sleep, ___ channels alter the signal to make a _______ readout on EEG. This is SWS. In absence seizures, ____ is activated. This can open happen when the cell is ___, occurs r/t increased ___, or increased ___ or loss of ____

Back 191

thalamus....cortex.....transmit info..... T-type Ca..... spike and wave.....T-type Ca channels....hyperpolarized....K.... GABA....excitation

Front 192

Drugs that enhance Na Channel-mediated inhibition are specific for ___ and ___ seizures. Specifically targets neurons that ____. Not much effect on ____

Back 192

focal... secondary generalized seizures... fire fast.... absence seizures

Front 193

Phenytoin acts to ____. Inactivated by ___

Back 193

slow Na Channel recovery......P450

Front 194

Carbamazapine works to ____. Drug of choice for ___. __ drug interactions

Back 194

slow Na channel recovery....focal seizures... not much

Front 195

Lamotrigine works to ____, but surprisingly is effective for ___

Back 195

slow Na channel recovery.... absence seizures

Front 196

Lacosamide works to ____

Back 196

slow Na channel recovery

Front 197

Ethosuximide works to ____, first in line for ___

Back 197

inhibit T-type Ca channel....absence seizures

Front 198

Valpric acid works to ___ and ___. Good for ___

Back 198

inhibit T-type Ca channel....slow Na channel recovery... mixed seizures

Front 199

Gabapentin, and pregabalin are both ____ that works to ___

Back 199

GABA analogues....inhibit HVA calcium channel

Front 200

Benzodiazapines increase affinity of __ for ___ receptor, thereby increase ___ influx. Good rx for ___ and ___ seizures. Clonazepam is unique b/c it inhibits ____

Back 200

GABA....GABA-a .... Cl.....focal... tonic-clonic..... T-type Ca channel

Front 201

Barbituates act on ____, and exacerbates ___

Back 201

all GABA-a receptors.....absence

Front 202

vigabatrin is a ___ that also irreversibly ____

Back 202

GABA analogue....GABA transaminase

Front 203

Felbamate works to ____. Rufinamide does same as well as ___

Back 203

inhibit NMDA receptors....slow Na channel recovery

Front 204

Dominant vs nondominant: handedness is ___, skilled complex motor tasks ___, language __, visual-spatial skills ___, analytical calculating skills ___, music appreciation ____, emotion __, big picture ___, understanding tone of voice ___

Back 204

dominant, dominant, dominant
nondominant, dominant, nondominant, nondominant
nondominant, nondominant

Front 205

heteromodal association cortices has connections from

Back 205

more than one modality

Front 206

generally, brain functions are ___ in posterior, ___ in anterior

Back 206

sensory....motor

Front 207

wernickes area is brodmann area ___, broca's area is ___ and ___. They communicate with each other using the ___

Back 207

22....44...45....arcuate fasciculus

Front 208

syntax depends critically on ___ stuctures

Back 208

frontal

Front 209

___ areas contain ___, which is impt to map sounds to meaning for comprehension/speaking

Back 209

posterior...lexicon

Front 210

does aphasia affect spoken or written language? acute onset of aphasia is usually r/t ___

Back 210

both....stroke

Front 211

broca's aphasia is usually r/t ___ infarct. More __ words than __ words. Phrases are __. Decreased prosody (___). ___ difficulties

Back 211

MCA....content...function...short...melody....naming

Front 212

broca's aphasia is related to __ sided hemiparesis affecting ___/___ more than ___

Back 212

right.....arm/face....leg

Front 213

Wernicke's aphasia has impaired ___ and speech is ___. Might say "ink" instead of "pen" (____), or "pish" instead of "fish" (____). Often unaware of their deficit.

Back 213

comprehension....meaningless....semantic paraphasias... phonemic paraphasias.

Front 214

In ___ aphasia, often patient is frustrated, in ___ aphasia, often doctor is frustrated

Back 214

broca...wernicke

Front 215

3 cells in cortex: granular (__ axons, act as __, can be both __) and __ and __ (both are for __)

Back 215

short...interneurons...excitatory/inhibitory... fusiform... pyramidal... output

Front 216

Cortex layers: most input goes to layer __, and ouptut leaves through __and __. Large fibers to brainstem/cord arise in layer __. Output to thalamus arise from layer __. Intracortical association is from __, ___, ___. Short horizontal connections by __ and ___

Back 216

IV.....VI and V......
V.....VI.....
I, II, III.....II and III

Front 217

secondary areas are there to ____

Back 217

make sense of signals in primary areas

Front 218

Parieto-occipitotemporal assoc. area is bounded by __ anteriorly, __ posteriorly, __ laterally. It contains __ area and is impt for __ coordination, __ objects, and __ for reading

Back 218

somatosensory....visual cortex....auditory cortex... wernicke.. spatial....naming....angular gyrus

Front 219

Prefrontal assoc area helps in ___ and is connected to ____ area. This contains ___ area

Back 219

motor planning....parieto-occipitotemporal....broca

Front 220

Prosopagnosia is ___, and is r/t damage to __ __ of occipital lobes and ____ of temporal lobes

Back 220

inability to recognize faces.... medial underside.. medioventral

Front 221

Wernicke's area is impt for memory b/c

Back 221

sensory experience is converted into language

Front 222

prefrontal area is for ____ and uses ___

Back 222

elaboration of thought...working memory

Front 223

___ connects bilateral amygdalas as well as ____ parts of ___ lobes

Back 223

anterior commissure....anterior....temporal lobes

Front 224

corpus callosum function is to make ___ of ___ available to ___

Back 224

stored info....1 hemisphere....other hemisphere

Front 225

memory traces are

Back 225

new or facilitated pathways

Front 226

most memory is ___ and results from ___. Important memory is ___ and results from ___

Back 226

negative....inhibition.....positive....facilitation

Front 227

declarative memory is memory of ___, skill memory is ____

Back 227

details...learned skills

Front 228

intermediate long-term memory requires ___ by stimulus of ____. This works by neurotransmitter ___, which uses ___ to activate a ___ to block ___

Back 228

habituation...facilitator terminal....serotonin...cAMP... protein kinase.... K channel

Front 229

long term memory results from

Back 229

structural changes

Front 230

during brain devpt, if axons don't connect to target, it ___

Back 230

dissolves

Front 231

short term memory can be converted into long term memory by ___ (____). During this process, it is ___ which is basically when it is ___

Back 231

consolidation....repeated activation.... codified... sorted

Front 232

Hippocampus (in ___ part of __ lobe) is impt for memory. Lesion here causes ___ loss but not ___ loss. Hippocampus is also impt for ___

Back 232

medial...temporal....declarative....skill...reward/punishment

Front 233

Hippocampus lesion causes ___ amnesia, but thalamic area causes ___ amnesia

Back 233

anterograde AND retrograde......retrograde

Front 234

cerebral part of brain is activated by ___ and ____

Back 234

direct stimulation and neurohormones

Front 235

central driving force of awakefulness is __ substance of __ and __, which also regulates ___ and sends signals through ___.

Back 235

reticular....midbrain...pons...posture...thalamus

Front 236

level of activity of excitatory area in brainstem is determined by how much ___ brain gets

Back 236

sensory signals

Front 237

if brainstem is transected above ___, coma results

Back 237

CN V

Front 238

neurohormonal control of brain activity: ___ (excitatory), ___ (inhibitory), ___ (can vary). Which one affects entire brain? Which 2 affect only specific areas?

Back 238

norepi...serotonin...dopamine....norepi....dopamine/ serotonin

Front 239

Locus ceruleus is located at junction of __ and __. Secretes ___ and is involved in ___

Back 239

pons...mesencephalon....norepi....REM sleep

Front 240

paleocortex is a ring that serves for communication between ___ and ___

Back 240

neocortex...lower limbic structures

Front 241

communication between limbic system and brainstem is mainly by ____

Back 241

medial forebrain bundle

Front 242

hypothalamus has 2-way communication with all levels of ___. __ and ___ hypothalamus increas BP/HR, while ___ has opposite effects. ___ regulates body temp, and ___ area has the thirst/hunger center. ___ has satiety center. ____ has fear/punishment.

Back 242

limbic....posterior and lateral
preoptic....preoptic....lateral
ventromedial nuclei.....periventricular nuclei

Front 243

major reward center of hypothalamus is ___ and ___

Back 243

lateral area....ventromedial nuclei

Front 244

which one is stronger? punishment or reward?

Back 244

punishment

Front 245

rage is usually inhibited by ___ of hypothalamus

Back 245

ventromedial nuclei

Front 246

if experience doesn't elicit reward/punishment, there will be ___. If it does, it will be ___

Back 246

habituation...reinforced

Front 247

hippocampus is on ___ of ___ ventricle. Activated by any ___ experience. Communicates through ___. Loss of this causes an inability to ___. It also turns ___ into ___.

Back 247

ventral....lateral....sensory...fornix...learn....short term memory... long term memory

Front 248

Amygdala is ___ of hippocampus. Related to sense of ___. Loss causes ___, which is where you have __ fear, ___ curiosity, ___ memory, tries to __ everything, ___ horny

Back 248

window...smell....Kluver-Bucy....
less...more...worse...eat...more

Front 249

first hr of sleep is usually ___, with __ occurring every __ min

Back 249

SWS...REM

Front 250

In SWS, BP/RR/metabolism will ___. In REM, muscle tone ___, but muscle movements __, and person is harder to ___

Back 250

decrease....decreases....increases...arouse

Front 251

sleep is caused by an

Back 251

active inhibitory process

Front 252

Sleep is characterized by more ___. More __ can cause REM sleep

Back 252

serotonin...acetylcholine

Front 253

Alpha waves are during __ ___ and are most intense in __ region. ____ connections

Back 253

quiet wakefulness....occipital....cortico-thalamic

Front 254

Beta waves occur during __ ___ and are most intense in __ and __ parts of brain

Back 254

alert wakefulness...parietal...frontal

Front 255

theta waves are associated with ___

Back 255

emotional stress

Front 256

delta waves are associated with ___. ____ connections. Associated with stage __ sleep

Back 256

deep sleep...intercortical....4

Front 257

during high mental activity, waves become ___, so EEG voltages ___

Back 257

asynchronous...fall

Front 258

Petit mal epilepsy is characterized by ___ pattern on EEG

Back 258

spike and dome

Front 259

depression is r/t too little ___ or ___ or both

Back 259

norepi...serotonin

Front 260

____ like imipramine and amitriptyline work to prevent ____

Back 260

TCA antidepressants....norepi/serotonin reuptake

Front 261

schizophrenia is possibly r/t too much ___. ___ is often reduced in size

Back 261

dopamine...hippocampus

Front 262

Alzheimer's commonly presents with neuronal loss of __ pathway. Often presents with __+__

Back 262

limbic...HTN...atherosclerosis

Front 263

70% of childhood CNS tumors arise in ___

Back 263

posterior fossa

Front 264

80% of adult primary brain tumors are ____. Grade I is ___, II is ___, III is ___, IV is ___ (here, tumor cells can collect along edges of necrotic regions... this is ___)

Back 264

infitrating astrocytoma.... pilocytic....diffuse.... anaplastic... glioblastoma....pseudopalisading

Front 265

pleomorphic xanthoastrocytoma occurs most often in

Back 265

temporal lobe

Front 266

ependymoma can present with ___and can cause ___ if it occurs in posterior fossa

Back 266

pseudorosettes....hydrocephalus

Front 267

___ can metastasize to cauda equina... this is ___

Back 267

medulloblastoma....drop metastases

Front 268

primary CNS lymphoma can occur in people that are ___. Most are from ___ origin

Back 268

immunosupressed...B-cell

Front 269

5 most common sites of metastases:

Back 269

lung, breast, skin, kidney, GI tract

Front 270

Schwannomas all have loss of ___. Antoni A has ___ bodies, Antoni B is less ___

Back 270

merlin...verocay....dense

Front 271

Neurofibroma can be ___ (most common) or ___ (affects large nerve trunks mostly)

Back 271

cutaneous...plexiform

Front 272

Tuberous sclerosis is characterized by ___ development

Back 272

hamartomas

Front 273

Dilute urine: kidney reabsorbs __ without reabsorbing __.. this occurs in ___ parts of nephron

Back 273

Na...water...distal

Front 274

in proximal tubule, urine stays ___

Back 274

isosmotic

Front 275

ascending loop of Henle: Na/K/Cl are ___, water is ___

Back 275

actively reabsorbed...impermeable

Front 276

Regardless of ADH presence, fluid is ___ when leaving the early distal tubule

Back 276

hypo-osmotic

Front 277

obligatory urine volume is

Back 277

0.5L/day

Front 278

the more concentrated the urine, the ___ the specific gravity

Back 278

higher

Front 279

2 things required for concentrated urine:

Back 279

ADH...hyperosmotic renal medulla

Front 280

water is carried away from renal medulla by

Back 280

vasa recta

Front 281

___ is how renal medulla becomes hyperosmotic. Major factors contributing to this are ion buildup from ___ and ___, as well as urea buildup from ___

Back 281

countercurrent mechanism...thick part of ascending loop of Henle...collecting duct...collecting duct

Front 282

water reabsorption generally goes into ___

Back 282

cortex

Front 283

UTA1 and UTA3 transport urea from __ into __....which one is ADH activated?

Back 283

collecting duct...medulla....UTA3

Front 284

rate of urea excretion depends on 2 things:

Back 284

urea concentration in plasma....GFR

Front 285

UTA2 transports urea from ___ into ___

Back 285

medulla...thin loop of Henle

Front 286

2 features of renal medulla that helps keep concentration high:

Back 286

low medullary blood flow....vasa recta

Front 287

medullary blood flow increases when there is

Back 287

high BP

Front 288

65% of filtered electrolytes is reabsorbed in

Back 288

proximal tubule

Front 289

central DI is ___ and is treated with ___. Nephrogenic DI is r/t ___ and is treated with ___

Back 289

not enough ADH....desmopressin....kidney doesn't respond... thiazides

Front 290

high concentration in blood excites ___ near ___ in __ hypothalamus

Back 290

osmoreceptors...supraoptic nuclei....aneterior

Front 291

____ of 3rd ventricle is ___ region. It has ___ on top and ____ on bottom. These are circumventricular and are the "thirst centers" and also causes ADH secretion

Back 291

anteroventral....AV3V....subfornical organ.... organum vasculosum

Front 292

Effects on ADH: nausea __ it, nicotine __ it, morphine __ it, alcohol __ it, HTN __ it

Back 292

increases...increases...increases...decreases...decreases

Front 293

angiotensin II ___ thirst, hypovolemia __ thirst, gastric distention __ thirst, HTN __ thirst

Back 293

increases....increases....decreases....decreases

Front 294

angiotensin II and aldosterone have little effect on ___

Back 294

Na concentration

Front 295

Potassium uptake into cells: Insulin ___ it, Aldosterone __ it, Sympathetics __ it, acidosis __ it

Back 295

increases...increases....increases....decreases

Front 296

Cell lysis causes increased ___ K concentration. Strenous exercise can cause __-kalemia

Back 296

extracellular....hyper

Front 297

K secretion regulation is mostly by ___ cells. It secretes ___ while uptaking ___ from urine. Then it has a normal ___ with interstitial fluid. This is stimulated by ____ and decreased by ___. K can then be reabsorbed by ___

Back 297

principal....K....Na.....Na-K ATP-ase.....aldosterone... acidosis......intercalated cells

Front 298

Addison's disease is

Back 298

no aldosterone

Front 299

increased distal tubular flow rate stimulates

Back 299

K secretion

Front 300

acidosis causes ___ K (unless it is ___)

Back 300

more....chronic

Front 301

pt with __ are more susceptible to hypocalcemic tetany

Back 301

alkalosis

Front 302

most Ca reabsorption is in ___ by ___ route.

Back 302

proximal tubule...paracellular

Front 303

half of Ca reabsorption in ___ occurs by transcellular route. This requires ___

Back 303

thick ascending...PTH

Front 304

safety factor against edema is lost once tissues become ____

Back 304

highly compliant

Front 305

high ADH can cause really low ___

Back 305

extracellular sodium

Front 306

nephrotic syndrome is when kidney leaks ___, causing low ___ pressure, causing ___. This can also be caused by ____, which causes ___

Back 306

protein....colloid...edema....cirrhosis....ascites

Front 307

pH livable range:

Back 307

6.8 to 8

Front 308

3 primary systems of pH regulation:

Back 308

buffer, respiration, kidneys

Front 309

buffer most effective when pH is near the buffer's ___

Back 309

pKA

Front 310

phosphate buffer important for ___ as well as kidneys for 2 reasons:

Back 310

intracellular....phosphate more concentrated, lower pH

Front 311

really important buffer inside cells is ___, only __ diffuses rapidly

Back 311

protein...CO2

Front 312

effectiveness of respiratory control on H+ concentration:

Back 312

50-75%

Front 313

emphysema causes pt to lean towards

Back 313

acidosis

Front 314

volatile acids include ___, and is defined as one that can be ___

Back 314

H2CO3...exhaled

Front 315

H+ __ and bicarb ___ occurs in all parts of nephrons except for ____

Back 315

secretion...reabsorption...descending/ascending thin loops

Front 316

Early part of nephron: ____ helps reabsorb sodium. The pushed out __ forms ___/___ which is reabsorbed and uses carbonic anhydrase to make ___/___. __ goes to blood, __ is reused

Back 316

Na/H antiport....H....CO2/H2O.....H/bicarb....bicarb....H

Front 317

Intercalated cells: absorb CO2, makes H/bicarb, and then ___, and trades bicarb for ___

Back 317

actively pumps out H...Cl

Front 318

Whenever H secreted and combined to a non-bicarb buffer, ____

Back 318

bicarb is added to blood

Front 319

ammonium is made from ___. Results in reabsorption of ___ . This is increased during ___

Back 319

glutamine....2 bicarbs...chronic acidosis

Front 320

aldosterone causes pt to lean towards ___ b/c of increased action of ____

Back 320

alkalosis...intercalated cells

Front 321

extracellular volume depletion stimulates ____ which increases ____ causing ___

Back 321

angiotensin II....Na/H antiport....alkalosis

Front 322

diarrhea causes ___, vomiting of intestines causes ___, vomiting of gastric causes ___, diuretics cause ___, aldosterone causes ___

Back 322

acidosis....acidosis...alkalosis....alkalosis...alkalosis

Front 323

large anion gap means a big disparity between measured __, __, and __

Back 323

Na, bicarb, chloride

Front 324

Loop diuretics like ___ block the ___ cotransporter in ____. Works by 2 ways:

Back 324

lasix...1 Na - 2 Cl - 1 K....thick ascending part of loop.... prevent water reabsorption...disrupt countercurrent

Front 325

thiazides work in ___ to block ___ cotransporter

Back 325

early distal....NaCl

Front 326

Acetazolamide inhibits ___, prevents __ reabsorption in ___. This disrupts ____ antiport

Back 326

carbonic anhydrase...bicarb...proximal tubule....Na-H

Front 327

spironolactone/eplerenone are ___ antagonists and are __ sparing

Back 327

aldosterone...K

Front 328

amiloride/triamterene blocks __ channels in ___. ___ sparing

Back 328

sodium...collecting ducts....K

Front 329

acute renal failure can be prerenal (often ___), intrarenal (___), or postrenal (___). These can cause ___ of nephrons. Also toxins can cause this. Causes __, ___, ___

Back 329

ischemia...infection...obstruction...plugging up... edema, HTN, hyperkalemia

Front 330

chronic renal failure is often due to ___ or ___

Back 330

sclerosis...infection

Front 331

Loss of some nephrons still allows function of __/___ excretion, but impairs __/__ excretion

Back 331

water/electrolytes......urea/creatine

Front 332

isothenuria is the inability of kidneys to

Back 332

concentrate or dilute urine

Front 333

Renal failure can cause ___, ___, ___ waste buildup (AKA ___), anemia from lack of ____, secondary ___, and ___ from lack of vitamin D, and also metabolic ___

Back 333

HTN...edema...nitrogen...azotemia...erythropoetin... hyperparathyroidism....osteomalacia...acidosis

Front 334

Patchy renal damage vs complete renal damage: which one causes HTN?

Back 334

patchy

Front 335

fanconi's syndrome is when the kidney can't reabsorb

Back 335

anything

Front 336

bartter's syndrome is when the kidney can't reabsorb

Back 336

Na/Cl/K

Front 337

Gitelman's syndrome is when the kidney can't reabsorb __ from ___

Back 337

NaCl ... distal tubules

Front 338

Liddle's syndrome is when the kidney retains too much ___ from defect in ___

Back 338

Na....ENaC

Front 339

Benign nephrosclerosis is associated with renal artery ___ and ___ of parenchyma. There is a reduction in ____. Two processes here: __/__ thickening and ___ deposition

Back 339

sclerosis...focal ischemia...functional renal mass.... medial/intimal.... hyaline

Front 340

malignant HTN have high levels of __, and there is __ necrosis of arterioles along with ___ r/t intimal thickening

Back 340

renin.....fibrinoid....onion skinning

Front 341

unilateral renal stenosis is rx w/ ___, and Goldblatt showed that if constriction of 1 renal artery causes ___ HTN. Most commonly r/t ___

Back 341

surgery...proportional...atheromatous plaque

Front 342

thrombotic microangiopathies often present with schistocytes (___). Can be Typical HUS (with ___) or nontypical HUS (often ___ causes), or TTP (most common symptom is __ involvement)

Back 342

fragmented RBC's....diarrhea...genetic....CNS

Front 343

diffuse cortical necrosis often occurs after ___ emergency or ___

Back 343

OB...septic shock

Front 344

renal infarcts often are ___ because blood supply is ___

Back 344

white...end-organ

Front 345

low pressure volume sensors (like __ and ___) causes ___ secretion as well as increased ____. High-pressure volume sensors (like ___ and __) do opposite

Back 345

atria and pulmonary vasculature...ADH...sympathetics... JG apparatus and carotid sinus

Front 346

JG apparatus ultimately causes __ secretion. Works by 3 mechanisms: sensory from ___ arteriole, ___ adrenergic signalling, and osmoreceptors in ___ nephron

Back 346

renin...afferent arteriole...beta1....distal

Front 347

angiotensinogen is made by ___. ACE also breaks down ___

Back 347

liver....bradykinin

Front 348

Rx nephrogenic DI w/ ___

Back 348

thiazides

Front 349

Angiotensin II causes 4 responses: ___ secretion, increased ___ reabsorption in ___, central stimulation of __ and ___, and ____ of ___

Back 349

aldosterone...NaCL...proximal tubule....thirst....ADH... vasoconstriction...arterioles

Front 350

ANP is released by ___, BNP is released by ___, CNP is released by ___. ANP and BNP bind to ___. CNP binds to ___. NPR-C is a ___

Back 350

atria...ventricles...endothelium....NPRA....NPRB....decoy

Front 351

cardiovascularly, ANP relaxes vascular smooth muscle by increasing ___. It also increases capillary ___. In kidney, ANP antagonizes ___ and increases ___.

Back 351

cGMP....permeability....ADH....GFR

Front 352

ADH works by V1 for ___, and V2 which uses a ___ protein to increase ___ to activate ___ to transport the water channel ___

Back 352

vasoconstriction....Gs....cAMP....protein kinase A.... aquaporin 2

Front 353

renal sympathetics decrease GFR by constricting ___

Back 353

afferent arteriole

Front 354

most of water reabsorption across proximal tubule is

Back 354

trancellular

Front 355

Principal cells reabsorb Na by ___ and secretes ___

Back 355

ENaC....K

Front 356

2 types of intercalated cells: Type A secrete __ and reabsorb ___. Type B is opposite. Both reabsorb ___.

Back 356

protons....bicarb....K

Front 357

pathophysiology of transudative edema always requires an element of pathalogic ____

Back 357

Na retention

Front 358

In heart failure, diuretics are used in ___ settings, but they can cause ___

Back 358

acute...hypotension

Front 359

Cirrhosis causes edema by 2 models: Underfill (___) and overfill (causes ____)

Back 359

portal HTN.....primary renal Na retention

Front 360

Aliskiren is a ___

Back 360

renin inhibitor

Front 361

Vasoconstrictive effects of angiotensin II occur primarily at

Back 361

efferent arteriole

Front 362

ACE inhibitors: Captopril is administered as an ___ drug and converted into an active metabolite. Enalapril and ramipril are given as a ____, Lisinopril is administered as a ___ drug

Back 362

active....prodrug....active

Front 363

Side effects of ACE inhibitors: ___ and ___ from bradykinin, ___, renal failure (so it isn't for people with ____), and ___ from decreased aldosterone

Back 363

cough...angioedema....hypotension...bilateral renal artery stenosis..... hyperkalemia

Front 364

Losartan and Valsartan block ___ which is __ effective than ACE inhibitor.

Back 364

AT1 receptors....more

Front 365

Nesiritide is recombinant ___, and given to manage ____ heart failure

Back 365

BNP....decompensated

Front 366

demeclocycline is rx for ___ . Conivaptan vs Tolvaptan: Which one is V2 selective?

Back 366

SIADH....tolvaptan

Front 367

Acetazolamide is a ____ and can cause ___, but helps with ___. Works on __ parts of nephron

Back 367

carbonic anhydrase inhibitor...acidosis...glaucoma...distal

Front 368

mannitol is often used to rx ___

Back 368

increased intracranial pressure

Front 369

loop diuretics block the ____ transporter of ___. Can cause ___, __ sparing, decreases ___

Back 369

Na-2Cl-K...thick ascending...alkalosis...Ca...K

Front 370

Thiazides inhibit NaCL reabsorption in ___. ___ sparing, can cause ___, not for pt w/ ___.

Back 370

distal convoluted tubule...Ca...alkalosis...arrhythmia

Front 371

Spironolactone and eplerenone inhibits ___ in ___ cells. Amiloride and triamterene inhibits ___ of ___ cells. These are all ___ sparing and can cause ___. Often used with ___.

Back 371

Na channel synthesis...principal...ENaC....principal... K... acidosis...thiazides

Front 372

phosphates and proteins are mostly in ___ fluid

Back 372

intracellular

Front 373

transport proteins can be ___ (free movement) or ___ (require __ change to allow transport)

Back 373

channel....carrier...conformational

Front 374

simple vs facilitated diffusion: facilitated requires ___. Facilitated is capped at ___

Back 374

carrier protein....vmax

Front 375

GLUT4 is an example of ___ diffusion

Back 375

facilitated

Front 376

osmolality is osmoles per ___ of water. Osmolarity is osmoles per __ of water

Back 376

Kg...liter

Front 377

primary active transport gets energy from __. Secondary active transport gets energy from __

Back 377

ATP...pre-established gradient

Front 378

Na-K ATPase pumps __ Na for __ K...activated when the cell ___

Back 378

3...2...swells

Front 379

100-fold concentration requires __ x more energy than 10 fold concentration

Back 379

2

Front 380

local blood flow control: oxygen lack theory is that without O2, ___ won't function. Vasodilator theory states that decreased O2 causes release of vasodilators like ___

Back 380

precapillary sphincter....adenosine

Front 381

beriberi is r/t lack of ___ that cause ___

Back 381

vitamins....vasodilation

Front 382

reactive hyperemia occurs after ____. Active hyperemia occurs when ___

Back 382

blood supply is blocked....tissue is active

Front 383

Autoregulation: Metabolic theory is ____. Myogenic theory is reflex ___ in response to HTN

Back 383

washout of vasodilators....constriction

Front 384

Tubuloglomerular feedback: too much __ causes ___ of ___ arterioles

Back 384

filtrate....constriction...afferent

Front 385

NO works by ___ dependent ___. Sildenafil blocks ___ (especially ___)

Back 385

cGMP...kinase....cGMP degradation....PDE5

Front 386

___ is a powerful vasoconstrictor (blocking this can help treat __)

Back 386

endothelin...pulmonary HTN

Front 387

Metabolism of a tissue increases for a long time, ___ will result. Caused by ___, inhibited by ____. It is determined by _____ of tissue

Back 387

angiogenesis....VEGF...steroids...max blood flow need

Front 388

bradykinin is a ___ that is inactivated by ____ or ACE

Back 388

vasodilator...carboxypeptidase

Front 389

histamine is released by ___ or ___

Back 389

mast ells...basophils

Front 390

Ca causes __, K causes ___, Mg causes ___, H causes ___, Anions cause ___, CO2 causes ___

Back 390

constriction..dilation..dilation...dilation...dilation...dilation

Front 391

2 determinants of long term arterial pressure:

Back 391

salt/water intake, renal function

Front 392

pt w/ kidney injury or too much antinatriuretics are

Back 392

salt sensitive

Front 393

changes in ____ do not affect long term BP, if kidney function is normal

Back 393

total peripheral resistance

Front 394

renin is made by __ in __ arterioles

Back 394

JG....afferent

Front 395

1-kidney Goldblatt: 2 peaks, first by ___, second by ___

Back 395

constriction....long term control

Front 396

patchy kidney ischemia is r/t ___ and causes ___

Back 396

HTN...2-kidney Goldblatt

Front 397

coarction of aorta causes __

Back 397

1 kidney Goldblatt

Front 398

preeclampsia is r/t ___ that causes release of ___

Back 398

placenta ischemia....toxic factors

Front 399

Acute kidney injury causes decreased ___. Can be r/t ischemia (___ necrosis and casts in ____) or toxic (___ necrosis and casts in ___)

Back 399

renal function...patchy...distal nephron....continuous.... distal nephron

Front 400

___ are particularly sensitive to ischemia, which causes loss of ___ which means increased ___ to distal tubules, which causes ___ via ___, decreasing GFR

Back 400

tubular epithelial cells....polarity....Na delivery.... vasoconstriction...tubuloglomerular feedback

Front 401

AKI is characterized by 3 phases: initiation (slight ____), maintenance (___ decrease in urine output), and recovery (___ in urine output but also ___ and increased vulnerability to ___)

Back 401

decrease in urine output....sustained....increase... hypokalemia.... infections

Front 402

tubulointerstitial nephritis: acute ( ___ and ___ infiltration) or chronic (__ and __ infiltration). Causes ____

Back 402

edema...leukocyte...fibrosis...mononuclear leukocyte... inability to concentrate urine

Front 403

Pyelonephritis is most often r/t __ infection. Can be from lower urinary tract (____)

Back 403

E.Coli.....ascending infection

Front 404

Acute pyelonephritis is an acute ___ ___ inflammation. Causes ___ necrosis and ___

Back 404

patchy...suppurative...papillary....obstruction

Front 405

urine with leukocytes

Back 405

pyuria

Front 406

Chronic pyelonephritis vs chronic glomerulonephritis: which one is patchy and asymmetric?

Back 406

chronic pyelonephritis

Front 407

anlagesiscs can cause ___ and then ___ ___ nephritis r/t ___ urine flow

Back 407

papillary necrosis...cortical tubulointerstitial... impeded

Front 408

NSAIDs in particular can cause problems r/t decreased ___ that usually cause ___. Also can cause ___ and ___

Back 408

prostaglandins...vasodilation...nephrotic syndrome... hypersensitivity

Front 409

Urate nephropathy can be acute (___) or chronic (___) or ___

Back 409

uric acid crystal precipitation....gouty...stones

Front 410

Kidney stones can be r/t ____ and can cause ___

Back 410

hypercalcemia...inability to concentrate urine

Front 411

light-chain cast nephropathy (____ kidney) is r/t nonrenal ___. Most common is ____ which occurs b/c light chains are ___ to epithelial cells and b/c in ___ conditions, they can form __

Back 411

myeloma....tumors...Bence Jones...directly toxic.... acidic.. casts

Front 412

noscomial means

Back 412

hospital-acquired

Front 413

complicated urinary tract infections are r/t structural/functional abnormalities like

Back 413

post-void residual

Front 414

relapse (___) of UTI in older men is usually r/t ___

Back 414

same exact bacteria...chronic bacterial prostate infection

Front 415

___ helps bacteria stay in bladder. In men, this is often r/t ___

Back 415

turbulent urine flow...prostate hypertrophy

Front 416

hematogenous dissemination into urinary tract is often r/t ___

Back 416

abscesses

Front 417

Acute uncomplicated UTI is often r/t ___ that have ____. Acute pyelonephritis is often r/t ___ that have ___...these also have ___ (for iron) and __ (lyse host cells)

Back 417

E.Coli...FimH....E.Coli...P.fimbrae....aerobactin...hemolysin

Front 418

uncomplicated vs complicated UTI: which have pathogens of lower virulence? Which has more than one organism isolated from urine culture?

Back 418

complicated...complicated

Front 419

Urease-producing organisms have higher pathogenic potential, b/c they metabolize ___ into ___, which damages kidneys, and can also form ___

Back 419

urea..ammonia...stones

Front 420

You can be predisposed to uncomplicated UTI's if you don't secrete ___ or if you use ___, which kills ___ flora of vagina which maintains ___ environment

Back 420

ABH blood group antigens...spermicide...lactobacillus...acid

Front 421

Host response to UTI's often make which cytokines? Also __ antibodies for acute and __ for chronic

Back 421

IL6, IL8, IL10.....IgM....IgG (for lipid A)

Front 422

Uncomplicated UTI: you can give ___. Uncomplicated pyelonephritis: wait till ___

Back 422

Bactrim...cultures

Front 423

Asymptomatic Bacterinuria, usually not treated unless pt is ___ b/c of risk of ___

Back 423

pregnant...pyelonephritis

Front 424

sulfonamides inhibit ___. Starts working after __ generations

Back 424

folic acid synthesis...4

Front 425

broad spectrum antibiotics are for when you need to give rx before

Back 425

the bug is identified

Front 426

aminoglycosides are ineffective against

Back 426

anaerobes

Front 427

trimethoprim blocks ___

Back 427

folic acid function

Front 428

most common resistance mechanism is

Back 428

modification of target site

Front 429

beta lactams resistance by gram-positive bacteria via __, and by gram-negative bacteria via __

Back 429

extracellular beta lactamase....periplasm beta lactamase

Front 430

gonorrhea penicillin resistance is conferred to other strains by

Back 430

transposon

Front 431

MRSA is resistant because the antimicrobial targets, ___, are altered

Back 431

PBP

Front 432

Some strains of pneumococci and staph are inhibited, not killed by beta lactams. This is called ____ and is r/t the fact that these strains don't have enough ___

Back 432

tolerance...autolysin

Front 433

Vancomycin is good rx for ___ bacteria, and VRE has altered ___

Back 433

gram positive...peptidoglycan

Front 434

quinolones inhibit action of ___ including __ and ___. Resistance to it is by ___

Back 434

topoisomerases..DNA gyrase..topoisomerase 4..efflux pump

Front 435

antiribosomal antibiotics like __ and ___ are resisted by gram-negative bacteria by ____

Back 435

streptomycin...erythromycin...modifying enzymes

Front 436

tetracyclines are resisted by

Back 436

excretion

Front 437

macrolides are most often resisted by ___ of the ___ ribosomal RNA

Back 437

methylation...23s

Front 438

treat fungus with polyenes that bind to ___

Back 438

ergosterol

Front 439

synergistic combinations include bactrim (___ and ___)

Back 439

sulfamethoxazole...trimethoprim

Front 440

Tetracycline blocks ___, which is required for penicilin to cause lysis. This combination is ___

Back 440

protein synthesis....antagonism

Front 441

WBC moves to where it is needed by chemotaxis, which is attraction to which 4 things?

Back 441

toxins, complement, clotting, degen products

Front 442

Features that inhibit phagocytosis: ___ surface, protective __ coats, lack of ___

Back 442

smooth....protein...opsonization

Front 443

reticuloendothelial system is a reservoir of

Back 443

monocytes

Front 444

if a macrophage cannot digest it, it will become a ___

Back 444

giant cell

Front 445

macrophages in liver are

Back 445

kupffer cells

Front 446

Clotting during inflammation is so that toxin can be ___. Occurs proportional to degree of __

Back 446

walled off....tissue injury

Front 447

Neutrophil invasion: First, ___ and __ cause endothelium to make ___ that react to ___ on neutrophils. This is ___. Then the neutrophils go between endothelial cells (___)

Back 447

TNF...IL1....ICAM-1....integrins...margination...diapedesis

Front 448

___ work against parasites by releasing ___, ___, and larvacidal polypeptide called ___

Back 448

eosinophils...hydrolytic enzymes, ROS, MBP

Front 449

In allergies, mast cells and basophils cause __ to migrate their to ___

Back 449

eosinophils...stop the reaction

Front 450

Leukopenia is when there is ___ WBC's. Leukemia is when there is ___ WBC's. Can be ___ or ___. The more ___ the cell, the more acute is the leukemia. Effects include ___ bone, decreased ____, decreased ___, and increased usage of ___

Back 450

not enough....too much... lymphocytic...myelogenous... undifferentiated...weak...RBC...clotting....resources

Front 451

Antigens usually have ____ and have regularly recurring molecular groups (___)

Back 451

HMW...epitopes

Front 452

Most common antibody is ___. Primary response is usually ___

Back 452

IgG...IgM

Front 453

Classic pathway for complement: ___ binds with ___ and then activates ___.

Back 453

antibody...antigen...C1

Front 454

Complement: __ activates phagocytosis, ___ inittiates chemotaxis. __, __, __ activate mast cells and basophils

Back 454

C3b....C5a....C3a, C4a, C5a

Front 455

IL2 causes ___. IL__, __, ___ causes more B cells

Back 455

more CTL's....4,5, 6

Front 456

CTL's secretes hole-forming proteins called

Back 456

perforins

Front 457

Suppressor T cells's role is to

Back 457

surpress T cells

Front 458

Delayed reaction allergy is caused by ____. Urticaria is ___.

Back 458

T cells...hives

Front 459

Asthma is caused by what substance?

Back 459

slow reacting substance of anaphylaxis

Front 460

The TCR complex is made up of the ___, the ___, and the ___ (the latter two are for ___)

Back 460

TCR....zeta....CD3....signalling

Front 461

TCR's bind to ___:___ complexes with low affinity. Must bind for long time, done by ___. Major one for T cell is ___ which binds to ____. Full activation requires ___ such as B7-1 and B7-2, which binds to ___. This is increased by ___ on APC's that increase B7 costimulators

Back 461

peptide:MHC....integrins...LFA1....ICAM-1... costimulators... CD28...CD40

Front 462

Opposite of CD28 is ___ and PD1, which inhibit response

Back 462

CTL4

Front 463

CD8 T cell activation often requires ___ of ___

Back 463

costimulation...helper cells

Front 464

T cell activation: Multiple TCR's and other receptors come to the middle called ____, this activates ___ which phosphorylates ___ on CD3 and zeta. Activated zeta is called ____

Back 464

immunologic synapse....Lck...ITAMs....ZAP70

Front 465

ZAP70 has 2 signaling pathways: phospholipase C which makes ___ (mobilizes ___ to activate phosphatase ____ to release ___.. this is blocked by ____) and ___ (activates ___).

Back 465

IP3....Ca....calcineuron....NFAT....cyclosporine....DAG.... protein kinase C

Front 466

Next pathway is ras/rac which activates ___. Another pathway is PIP3 activates ___ to promote survival

Back 466

MAPK.....Akt

Front 467

naive T cells have only __ of the 3 parts of IL-2 receptor. It is completed after T cell is ___

Back 467

2....activated

Front 468

Helper T cells use ___ to activate ___ and ___

Back 468

CD40 ligand...macrophages...B lymphocytes

Front 469

Classes of Helper T cells: TH1 (makes ___ to activate ___), TH2 (makes __ to make __ antibodies, __ to activate ___, and also activates macrophages to __) , TH17 (makes __ to __)

Back 469

IFN-gamma...macrophages...IL4...IgE...IL5...eosinophils... repair... IL17/IL22....mediate inflammation

Front 470

TH1 is made in response to ___ (from __) and ___ (from __). TH2 is made in response to ___. TH17 are made in response to __ and ___

Back 470

IL12...macrophages...IFN-gamma....NK....IL4.... IL6...IL1

Front 471

Memory T cells require __ to stay alive. During response, survival of T cells is maintained by costimulation from ___, and cytokines like ___, and the ___ itself

Back 471

IL7...CD28....IL2...antigen

Front 472

DNA becoming RNA is ___, RNA becoming protein is ___

Back 472

transcription...translation

Front 473

topoisomerases prevent DNA from forming ___. Type I form and reseal breaks to ___. Type II does this to ___. ____ is better target. 2 main types are ___ and ___

Back 473

supercoils...single stranded DNA...double stranded DNA.. Type II... DNA gyrase...topoisomerase IV

Front 474

Translation: ribosome is 70s. Made up of __ (for __) and ___ (for __). ___ is most active

Back 474

30S...decoding..50S...peptide bonds....rRNA

Front 475

Inhibitors of topoisomerases are ___. They end in ___. Resistance is by ____ or ___. Inhibits ____ in Gram negative, and inhibit ___ in gram positive. Given at high enough conc. to be ___

Back 475

quinolones..-floxacin..efflux..mutated topoisomerase.. DNA gyrase...topisomerase IV... bacteriocidal

Front 476

inhibitors of transcription are ___ derivatives. Good against ___. Stabilizes ____. Bacterio-___

Back 476

Rifampin....TB....RNA polymerase...bacteriocidal

Front 477

Inhibitors of translation are bacteriostatic except ___, which are used to treat ___ bacteria. They bind to ___ rRNA of ___ subunit. Kills because aberrant proteins create ___. Work well with ___. Resistance by ___, preventing ___, ____. Side effects include ___ and ___

Back 477

aminoglycosides...gram negative....16S...30S... membrane pores....beta-lactams....deactivation...entry...target mutation.. ototoxicity...acute renal failure

Front 478

__ binds to 16S rRNA subunit of 30S. Not bactericidal. Permits formation of 70S but inhibits _

Back 478

Spectinomycin...translocation

Front 479

Tetracyclines bind to __ of 30S. Mammals don't have the ___. Resistance by ___. Taken on ___

Back 479

16S....pump...efflux...empty stomach

Front 480

Macrolides have large ___ rings. Includes ___ and ___. Bacterio___. Targets ___ of ___. Resistance is by inactivation by ___. Can cause __ or __ problems. ___ cytochrome P450

Back 480

lactone....erythromycin...azithromycin...bacteriostatic... 23S ...50S....methylase...GI...liver...inactivates

Front 481

Chloramphenicol is a bacterio__ drug that binds to __. Resistance is via ___ that inactivate the drug. Can cause ___ syndrome

Back 481

static...23S....acetyltransferases....gray baby

Front 482

Clindamycin is a ___ that blocks ___ formation through both the __ site and __ site. Clearing out the local fauna can cause ___ infections like ___

Back 482

lincosamides...peptide bond...A...P....anaerobic....Cdiff

Front 483

Streptogramin's are made out of ___ and ___. It is bacterio___ usually. Binds to ___

Back 483

dalfopristin...quinupristin...bacteriocidal...50S

Front 484

Good rx against MRSA is ___ which is a ____

Back 484

linezolid...oxazolidinone

Front 485

mucus is made up of ___ and is hydro-___

Back 485

hydrophilic

Front 486

defensins are ___ rich peptides that are highly ___

Back 486

cysteine...cationic

Front 487

lysozyme hydrolyzes ___ (main component of cell walls) and acts mainly on ____ bacteria

Back 487

peptidoglycan....gram positive

Front 488

To detect microbes, body has ____ receptors. Most famous is ___ and ___. Some are intracellular like __ and protein kinase __

Back 488

pattern recognition...TLR....CD14....NOD...R

Front 489

complement nomenclature: C3 breaks down into C3a/C3b. "a" means ___. "b" binds to ___

Back 489

small/soluble...cell surfaces

Front 490

Complement proteins B, D, and P belong to ___ pathway. C3b belongs to ___ pathway

Back 490

alternative....all 3

Front 491

__ and __ are anaphylatoxins

Back 491

C3a....C5a

Front 492

C3b works to ___, and binds to ___ on phagocytic cells

Back 492

opsonize...CR1

Front 493

Classical pathway: __ is a most potent activator? It activates C1 to activate C2 and C4 into __ to activate C3

Back 493

IgM....C4b2a

Front 494

Lectin pathway: activated by ____, which is a __ analog

Back 494

mannose- binding lectin....C1q

Front 495

Alternative pathway works because usually a small amount of __ is constantly being cleaved.

Back 495

C3

Front 496

C5b is involved in making the ___

Back 496

membrane attack complex

Front 497

which complement is a major attractant for neutrophils and monocytes?

Back 497

C5a

Front 498

What part of bacterial protein formation is a big chemotaxin?

Back 498

clipped peptide

Front 499

Endothelial cells express __ for weak binding and __ for strong binding

Back 499

selectins....integrin ligands

Front 500

neutrophils recruit mononuclear cells by releasing ___

Back 500

azurocidin

Front 501

neutrophils move with __ and __ which is affected by ___. Downstream is __, upstream is __

Back 501

actin..myosin...gelsolin...uropod...lamellipodium

Front 502

lactoferrin is in __ granules

Back 502

secondary

Front 503

O2 dependent killing: need Phox __, __ to be inserted into vesicle to join Phox __ and __. Most mutations here involve Phox ___

Back 503

91...22...47...67...91

Front 504

Gram negative is more common in ___, and are readily killed by oxygen ___ mechanism

Back 504

gut...independent

Front 505

chemokines are classified as __ (chemotactic) and __ (pus)

Back 505

CC...CXC

Front 506

NK have 2 receptors: ___ that binds to ___, and ___ that bind to ___

Back 506

NKR...glycoproteins....KIR...self MHC I

Front 507

NK are stimulated by macrophage-derived ___ and ___, and in turn cause ___ production. They are also stimulated by __ from helper T cells, which cause __-__ binding to kill easier

Back 507

IL15....IL12....IFN gamma....IL2....CD2-CD58

Front 508

Antibody dependent cell-mediated cytotoxicity: NK's Fc-gamma-RIIIa binds to ___

Back 508

IgG

Front 509

B cells have ___ receptors for C3b

Back 509

CR2

Front 510

most common pyogenic (___) bacteria is ___. Can use ___ to bind fibrin and create abscesses

Back 510

pus forming...staph aureus...clumping factor

Front 511

Staph. aureus is a large gram __ coccus that grows in ___ clusters. S. saprophyticus causes only ___. S. lugdunensis can cause ___. S. aureus is distinguished using the ___ test

Back 511

positive...grape-like...UTI's....endocarditis...coagulase test

Front 512

Staph aureus have ____ binding proteins to attach to wounds.

Back 512

fibronectin

Front 513

abscess of skin is ___. diffuse inflammation of skin is ___

Back 513

furuncle...cellulitis

Front 514

teichoic acid is a ___ component that activates ___

Back 514

cell wall...complement

Front 515

____ incapacitates antibodies, and ___ converts hydrogen peroxide to water. ___ kills PMN's

Back 515

protein A....catalase...leukocidin

Front 516

Staph. aureus is a large gram __ coccus that grows in ___ clusters. S. saprophyticus causes only ___. S. lugdunensis can cause ___. S. aureus is distinguished using the ___ test

Back 516

positive...grape-like...UTI's....endocarditis...coagulase test

Front 517

___ hydrolyzes connective tissue. ___ protects S. aureus from penicillins

Back 517

hyaluronidase...PBP2a

Front 518

Staph aureus have ____ binding proteins to attach to wounds.

Back 518

fibronectin

Front 519

SSSS is when neonates's skin ___ r/t separation at ___

Back 519

sloughing off....desmosomes

Front 520

abscess of skin is ___. diffuse inflammation of skin is ___

Back 520

furuncle...cellulitis

Front 521

tampons cause toxic shock b/c it introduces ___ (required for toxin production)

Back 521

oxygen

Front 522

teichoic acid is a ___ component that activates ___

Back 522

cell wall...complement

Front 523

superantigens crosslink the beta chain of ___ with ___ on macrophages, causing massive cytokine release

Back 523

TCR...MHC class II

Front 524

____ incapacitates antibodies, and ___ converts hydrogen peroxide to water. ___ kills PMN's

Back 524

protein A....catalase...leukocidin

Front 525

Rx MRSA with ___ but there is some resistance now, so use ___

Back 525

vancomycin...clindamycin

Front 526

___ hydrolyzes connective tissue. ___ protects S. aureus from penicillins

Back 526

hyaluronidase...PBP2a

Front 527

SSSS is when neonates's skin ___ r/t separation at ___

Back 527

sloughing off....desmosomes

Front 528

tampons cause toxic shock b/c it introduces ___ (required for toxin production)

Back 528

oxygen

Front 529

superantigens crosslink the beta chain of ___ with ___ on macrophages, causing massive cytokine release

Back 529

TCR...MHC class II

Front 530

Rx MRSA with ___ but there is some resistance now, so use ___

Back 530

vancomycin...clindamycin

Front 531

Hematogenous osteomyelitis in kids is most often in __ of __. This is b/c of high vascular supply that causes ___, which retain and shields bacteria. In adults, it is most often in ___

Back 531

metaphysis...long bones....microclots....IV discs

Front 532

Most often pathogen is ___

Back 532

S. aureus

Front 533

Most often pathogen is ___

Back 533

subperiosteal abscess...involucrum

Front 534

In kids, a ___ can form which makes a piece of bone essentially into a ___

Back 534

sequestrum....FB

Front 535

In adults, a ___ can form or a ___ can form. Can be r/t spread via ___

Back 535

spinal epidural abscess...psoas abscess...Batson plexus

Front 536

Contamination from an open wound can often be due to the pathogen ____ which is gram __

Back 536

P. aeruginosa....negative

Front 537

Pt w/ DM can have osteomyelitis from ___ causes. Difficult to treat r/t ___. Rx often is ____

Back 537

polymicrobial...poor vascular supply...amputation

Front 538

synovial fluid normally should not ___. Distinguish between arthritis and infection by ___

Back 538

clot...WBC count (of aspirated fluid)

Front 539

Once activated, T cells in lymph nodes upregulate receptors for ___ to move into blood

Back 539

sphingosine 1-phosphate

Front 540

Endothelium in response to TNF/IL1, increase expression of __ and __ selectins, as well as integrins like __ (for __ on T cells) or __ (for __ on T cells)

Back 540

E...P....ICAM-1...LFA-1....VCAM-1....VLA4

Front 541

L-selectin is the one that keeps naive T cells in

Back 541

lymph nodes

Front 542

T cells stay at site of infection b/c of increase of ___ integrins.

Back 542

VLA

Front 543

Differentiated effector cells are not as dependent on

Back 543

costimulation

Front 544

TH1 can cause rxn in 1-2 days. This is __ and shows that pt has been __. It is r/t products of __

Back 544

DTH...previously exposed...macrophages

Front 545

TH1 cells that recognize macrophage-associated antigens activate antigens by __ and __. Results in increased production of ___. ___ can do this too

Back 545

CD40...IFN-gamma...lysosomal enzymes...CD8 T cells

Front 546

mycobacterial infections can cause

Back 546

granulomas

Front 547

CD8 CTL's recognize infected cells by ___ and ___. They then adhere by ___. They do not require costimulation if they are ___. Releases ___ (activate ___) and ___. These are both bound to ___. Minor pathway is by activating the cell's death receptor __

Back 547

TCR...CD8....integrins...differentiated...granzymes ...caspases.... perforins....serglycin...Fas

Front 548

inhibitory receptor on CD8 is

Back 548

PD-1

Front 549

class I MHC deficient cells are killed by

Back 549

NK

Front 550

Peptidoglycan is AKA

Back 550

murein

Front 551

beta lactams inhibit the ___ enzymes that mediate ____

Back 551

transpeptidase...peptide cross linking

Front 552

gram positives stain ___ , gram negatives stain ___.

Back 552

purple...pink

Front 553

Gram negative intake water through ___, and has __ on outer leaflet

Back 553

porins...LPS

Front 554

Gram positive: has proteins on peptidoglycan layers attached by ___

Back 554

sortases

Front 555

3 basic stages peptidoglycan synthesis: ___, ___, ___

Back 555

monomer synthesis, glycan polymerization, cross-linking

Front 556

Monomer synthesis: ____ turns into ____ (AKA ___ nucleotide).. this takes place in ___. Then in ____of cytoplasmic membrane, it is made into a ___-___ disaccharide called ___

Back 556

UDP-NAG....UDP-NAM...Park...cytoplasm....inner surface.... NAM-NAG...Lipid II

Front 557

polymerization is catalyzed by

Back 557

PGT's

Front 558

Murien chains are then cross-linked by ____. First step is where the ____ amide bond of a stem peptide is attacked and then a free amino group attacks the intermediate

Back 558

transpeptidases ... D-Ala-D-Ala

Front 559

Penicillin mimics the ____ and binds to the active site of ___, thereby stopping cross-linking

Back 559

D-Ala-D-Ala....TP

Front 560

Mycobacteria have high __ and __ in their DNA. They have an outer membrane that forms a ____ layer that is resistant to ___. The cell envelope is impermeable to __ (hydrophilic/phobic). One example of mycobacteria is ___

Back 560

C...G...waxy...acid fast....both.....TB

Front 561

Cell walls have __ to help them break it down. Cephalexin makes bacteria think it is ___

Back 561

autolysin...growing

Front 562

Fosfomycin is __ analog (inhibits __). Enters cell through __ transporter. Good against gram __

Back 562

PEP...MurA...G6P....negative

Front 563

Cycloserine is rx for ___ and inhibits the ___ that converts __ to ___. Also inhibits the _____. Common side effect includes ___ problems

Back 563

Tb.....alanine racemase....L-Ala...D-Ala...D-Ala-D-Ala ligase... neuro

Front 564

Bacitracin interferes with ___ of ____, thus inhibit murein synthesis/export. It is unique in that its target is a ___. Can be given orally to treat __ and __

Back 564

dephosphorylation....bactoprenyl diphosphate...lipid... Cdiff... VRE

Front 565

Vancomycin and teicoplanin are ___ and telavancin is a ___. These work by binding to ____ of murein monomer unit, thereby inhibiting ____. Can cause "red man syndrome" from ___

Back 565

glycopeptides....lipoglycopeptide....D-Ala-D-Ala... polymerization....histamine release

Front 566

Broad spectrum Beta lactams are typically active against both gram positive/negative, but narrow spectrum beta lactams are typically active only against. Spectrum depends on ability to penetrate ____ and ability to ____. Hydro___ agents tend to have broader spectrum

Back 566

gram positive....penetrate outer membrane... inhibit specific transpeptidases.....hydrophilic

Front 567

Antibiotic resistance is by __(intrinsic) or __(extrinsic) genes. Penicillin resistance is mostly __

Back 567

chromosomal...acquired....plasmids

Front 568

Beta-lactamases are more powerful in ___ due to ____

Back 568

concentration

Front 569

Clavulanic acid, sulbactam, and tazobactam are ____

Back 569

beta lactamase inhibitors

Front 570

___ penicillins lack activity against Gram negative bacteria

Back 570

antistaphylococcal

Front 571

amino penicillins like ___ and ___ have a ___ charged amino group that enhances ___ and are good against gram ___ bacteria

Back 571

ampicillin...amoxicillin...positively....diffusion...positive

Front 572

ampicillin...amoxicillin...positively....diffusion...positive

Back 572

carboxyl...negative...beta lactamases

Front 573

___ penicillins like piperacillin and mezlocillin have both positive/negative charges on R chains

Back 573

ureido

Front 574

Cephalosporins have a __ membered accessory ring. Generally more resistant to ___

Back 574

6....beta lactamases

Front 575

aztreonam is a ___ that is only active against most gram ___ bacteria.

Back 575

monobactam....negative

Front 576

carbapenems are ___ spectrum and cover most gram ___ bacteria

Back 576

broad...both

Front 577

Daptomycin is a cyclic ___ antibiotic that integrates into membranes of gram __, and forms __

Back 577

lipopeptide...positive...pores

Front 578

Ethambutol (decreases ___ synthesis) , pyrazinamide (inhibits __), and isoniazid (both inhibits ___) are good to rx ___

Back 578

arabinogalactan....FAS1....FAS2....Tb

Front 579

arabinogalactan....FAS1....FAS2....Tb

Back 579

epitope

Front 580

antibody has two __ and two __ chains bound by ___ bonds. Each one has variable/constant regions. __ is a single epitope binding site. __ is the part that causes the action

Back 580

heavy...light...disulfide....Fab...Fc

Front 581

each light chain is a union of what 3 genes?

Back 581

V, J, C

Front 582

how each the gene for each part of antibody comes from only one parent

Back 582

allelic exclusion

Front 583

responsible for junctional diversity

Back 583

TdT

Front 584

___ are confined to blood. ___ can cross placenta. __ and __ can activate complement. __ is secreted

Back 584

IgM....IgG....IgM and IgG....IgA

Front 585

TCR: variable part of alpha is by __ and __ genes. Variable part of beta is by __, __, ___

Back 585

V...J.....V, D, J

Front 586

Chromosomal rearrangement: what do BCR's have that TCR's don't?

Back 586

small mutations

Front 587

pMHC class I is composed of what 3 things?

Back 587

beta2, MHC class I, peptide

Front 588

T cells: first __, then ___, the __ selection and then __ selection

Back 588

double negative, double positive, positive, negative

Front 589

B1 cells are for ___. They secrete ___. Which type of B cell has more gene rearrangements?

Back 589

self renewal...IgM...B2

Front 590

ProB cells produce recombination activation gene __ and ___. First __ and then both ___

Back 590

Rag1, Rag2.....IgM....IgM, IgD

Front 591

APC's can sample soluble molecules by ___ in which it uses ___

Back 591

macropinocytosis...cytoplasmic ruffles

Front 592

Direct sensing: recognizing ___. APC recognizing antibody/complement is ___

Back 592

PAMP....indirect sensing

Front 593

cytoplasmic proteins that are to be destroyed are tagged with __, broken down by ___, and taken to MHC I by __

Back 593

ubiquitin...proteasome....TAP

Front 594

TCR initially does not have ___, but ___ does

Back 594

ITAMs....CD3

Front 595

Initial encounter of T cells with antigen is __. Here, naive CD4 cells (___) become uncommitted ___ cells. If there is LPS, APC will secrete __, to make them ___. But __ will make them ___

Back 595

priming...Thp...Th0....IL12...TH1....IL4...TH2

Front 596

BCR often needs both __ and ___

Back 596

antigen...C3b

Front 597

affinity is ___ of antigen. Valnce is number of ___. Avidity is ___

Back 597

binding strength...epitope binding sites....collective affinity

Front 598

Neutralizing antibodies is where it prevents pathogen from ___. Usually ___ or ___

Back 598

bind to cells...IgG...IgA

Front 599

Phagocytes have FcR's for binding to ___ that have bound to ___

Back 599

antibodies...epitopes

Front 600

Complement is usually activated by ___ or ___

Back 600

IgM...IgG

Front 601

Granzymes from ___ cause suicide by ___

Back 601

CTL's....damaging DNA

Front 602

In primary responses, antibody is usually ___. Subsequently it is usually __, __, __

Back 602

IgM...IgG..IgA...IgE

Front 603

If a lymphocyte binds to a pMHC without costimulation, it will be in a state of __

Back 603

anergy

Front 604

Treg express __ and __ to inhibit autoimmune disease

Back 604

CD$...CD25

Front 605

Hypersensitivity: Type I is __ and is AKA __, usually r/t __ antibodies. Type II is by ___ via ___ pathway where antibodies bind to ___. Type III is by __ via __ pathway where antigens bind to ___. Type IV is ___ and usually ___

Back 605

quick...allergies...IgE....complement...classical... cell surfaces.... complement...classical... soluble molecules... cell mediated response....DTH

Front 606

what cell is often active in primary infections (initial exposure)

Back 606

CTL's

Front 607

when viruses have random mutation is ___. When viruses from diff sources combine is ___

Back 607

antigenic drift...antigenic shift

Front 608

Pneumococcus is a member of __, and is gram ___, catalase __. Has the toxin ___, and has a thick ___ (main antigen)

Back 608

strep...positive...negative....pneumolysin.. pneumolysin... capsule

Front 609

pneumonia often occurs in __ and ___ and often in the setting of ___

Back 609

winter...early spring...viral URI

Front 610

It commonly colonizes the ___ but it doesn't become a problem until it gets to normally ___

Back 610

nasopharynx....sterile parts of airway

Front 611

Pathogenesis: First stage is when alveoli fill with ___, which serves as a ___. Second stage is ____, which is characterized by infiltration by ___ and ___ and activation of ___. Third stage is ___, where neutrophils have __, but lungs become heavy (___). Fourth stage is ___

Back 611

serous fluid...culture....early consolidation... neutrophils... RBC's... complement...late consolidation... won..... hepatization.....resolution

Front 612

CRP binding to antigen activates

Back 612

classical pathway of complement

Front 613

Pneumococcal pneumonia is diff from other types in that ____

Back 613

recovery is complete (no necrosis)

Front 614

Infection of pleural space is

Back 614

empyema

Front 615

Dx when ___ has neutrophils and more than 10 ___ shaped gram ___ ___cocci

Back 615

sputum....lancet....positive....diplo

Front 616

On blood agar it causes __ hemolysis

Back 616

alpha

Front 617

Treatment is often with ___, but there is resistance by ___

Back 617

penicillin...mutated PBP

Front 618

Pharyngitis in school aged children. Most commonly r/t____ followed by ___. In adults, it is mostly r/t ___

Back 618

Group A streptococcus....virus....virus

Front 619

Infections of nasopharynx are mostly caused by ___, followed by ___

Back 619

rhinovirus....coronavirus

Front 620

Most serious form of URI is ___, which is bad because __ can cause death. Most common cause is ___

Back 620

acute epiglottitis...swelling...influenza B

Front 621

Larnygotracheitis (aka __) is sudden onset ___. Most often caused by ___

Back 621

croup...barking cough....parainfluenza

Front 622

Acute tracheobronchitis is very common. ____ can cause whooping cough. Most cases are ___. Can be common in pt with ___

Back 622

B. pertussis....viral...COPD

Front 623

Bronchiolitis is associated with

Back 623

respiratory syncytial virus

Front 624

Why do CF pt get pneumonia easily?

Back 624

low mucus clearance

Front 625

Protection from pneumonia includes vibrissae in __ to ___, as well as cilia to beat mucus that contains __, __, and ___. Also in alveoli there are ___, ___ and ___

Back 625

nose...filter large particles........lysozyme, lactoferrin, sIgA... IgA, complement, macrophages

Front 626

typical vs atypical pneumonia presentation, which one "appears" more mild?

Back 626

atypical

Front 627

Typical organisms that cause community acquired pneumonia are ___, ___, and ___

Back 627

S. pneumoniae, H. influenza, S. aureus

Front 628

___ from birds can cause pneumonia

Back 628

chlamydia psittaci

Front 629

Legionella pneumophila is usually acquired from

Back 629

contaminated water

Front 630

in children under 2 yrs of age, agents of acute pneumonias are often

Back 630

viruses

Front 631

S.pneuomoniae, K.pneumoniae, and infections caused by aspiration often show __ on CXR

Back 631

focal lobar consolidation

Front 632

M. pneumoniae, C. pneumoniae, and P. carinii often show ___ on CXR

Back 632

diffuse interstitial infiltrates

Front 633

Hospital acquired pneumonia is often from ___. Usual agents are ___ and enteric ___

Back 633

aspiration...S.aureus....gram negative

Front 634

vast majority of URI infections are caused by

Back 634

viruses

Front 635

community acquired acute pneumonia is most often r/t ____

Back 635

streptococcus pneumoniae

Front 636

haemophilus is a ___ gram __ organism. Can cause lower respiratory infection and ___ in kids. The bad kind is the ___ kind. Has ___ to adhere and has factor to degrade ___

Back 636

pleomorphic....negative...meningitis....encapsulated.... pili..... IgA

Front 637

Bacterial pneumonia in elderly is often r/t ____

Back 637

moraxella catarrhalis

Front 638

Gram negative bacterial pneumonia is often r/t ____ (especially in chronic ___)

Back 638

klebsiella pneuomonia....alcoholics

Front 639

____ is often a cause of pneuomonia in CF pt

Back 639

P. aeruginosa

Front 640

Lobular bronchopneuomonia is ___ and lobar pneuomonia is ___

Back 640

patchy...solid

Front 641

intrapleural fibrinosuppurative reaction is

Back 641

empyema

Front 642

Primary atypical pneuomonia is often r/t ___ and predominant histological pattern is edema within ___

Back 642

mycoplasma pneumoniae....walls of alveoli

Front 643

Which types of influenza show no antigenic drift or shift?

Back 643

B and C

Front 644

H5N1 is ___ and has increased tissue tropism due to unusual structure of its ___

Back 644

bird flu...hemagglutinin protein

Front 645

SARS is r/t a ___

Back 645

coronavirus

Front 646

patients on ___ are at high risk for hosptial acquired pneumonia

Back 646

mechanical ventilation

Front 647

lung abscess is when there is a ___ destruction of lung parenchyma with __ of lung tissue

Back 647

suppurative....necrosis

Front 648

___ can resemble TB. They grow as ___ in environment, but grow as ___ in lungs

Back 648

Fungi....hyphae....yeast

Front 649

Types of fungi: Histoplasmosis targets ___ and causes ___. Blastomycosis cause ___, Coccidioides causes ___

Back 649

macrophages...granulomas...suppurative granulomas.... DTH

Front 650

Pneumonia is a common cause of death in pt with __ and ___

Back 650

HIV....sickle cell

Front 651

in HIV pt, bacterial and tuberculosis is common at CD4+ counts of greater than __.

Back 651

200

Front 652

chronic rejection of lung transplant appears w/ ___ (partial occlusion of airways by fibrosis)

Back 652

bronchiolitis obliterans

Front 653

PKU is deficiency of ___ resulting in ___ because you can't convert ___ into ___. Pt will have ___ odor and can cause ___ and rx with __

Back 653

PAH...hyperphenylalainemia...phenylalanine...tyrosine... musty.... MR...diet

Front 654

Galactosemia is commonly r/t lack of ___ but rarely r/t lack of ___. Buildup of ___ causes damage to ___, ___ and ___.

Back 654

GALT....galactokinase....galactose-1-phosphate....liver, eyes, brain

Front 655

CF is from problem in ___ gene. Enhances ENaC in ___, but inhibits it elsewhere.

Back 655

CFTR....sweat glands

Front 656

CF: Class I is r/t defective ___, Class II is r/t defective ___, class III is r/t defective ___, Class IV is r/t decreased ___, and class V is r/t reduced ___, and class VI is r/t altered regulation of __

Back 656

synthesis...folding.....regulation....conductance.... abundance.... separate ion channels

Front 657

CF causes lack of __ in respiratory area, causing a defect in __ action. This creates a ___ environment where an ___ forms, which acts as a biofilm

Back 657

mucus....ciliary... hypoxic....anginate

Front 658

CF also causes ___ involvement, and stones in ___ glands and ___ ducts. Causes __ and __ malabsorption. Also causes ___ in males

Back 658

liver....salivary....bile....protein...fat...infertility

Front 659

Marcus gunn pupil is when there is ___ defect in one pupil. Light in good eye causes ___ in ___, then swing light to bad eye and you see dilation in __ eyes. R/t __ nerve damage

Back 659

afferent....constriction....both eyes....both ... optic

Front 660

In unilateral hearing loss. Weber test is where fork is on ___, lateralizes to good ear if it is ___ loss. Rinne's test is on mastoid, BC>AC indicates ___ loss

Back 660

top of head....sensory.....conduction

Front 661

Test for CN __ in which you get pt to view a bright red object through each eyes is ___

Back 661

II....red desaturation

Front 662

Use double simultaneous extinction test to test for

Back 662

hemineglect

Front 663

brief oscillation of pupillary size is ___

Back 663

hippus

Front 664

Pupillary light reflex tests ___ (afferent) and ___ (efferent)

Back 664

II....III

Front 665

Eye movements used to rapidly refixate from one object to another is

Back 665

saccades

Front 666

corneal reflex tests __ (afferent) and ___ (efferent)

Back 666

V...VII

Front 667

Jaw jerk tests __ (afferent) and ___ (efferent)

Back 667

V...V

Front 668

UMN lesion of facial weakness affects ___ face and spares ___. LMN causes ___ weakness

Back 668

contralateral...forehead...ipsilateral

Front 669

oculocephalic maneuver is AKA __ eyes. When moving head, eyes move in __ direction

Back 669

doll....same

Front 670

caloric testing is when ___

Back 670

cold water is poured in ear

Front 671

gag reflex tests __ (afferent) and ___ (efferent)

Back 671

IX...X

Front 672

fasciculations of tongue is

Back 672

spontaneous quivering motions

Front 673

Evoked potentials are for testing __ deficits in response to ___. Pathology will cause ___

Back 673

sensory...stimulus...long latency

Front 674

CSF is usually located in

Back 674

subarachnoid space

Front 675

in LP, pressure above __ is abnormal. If you draw fluid and pressure decreases, suspect ___

Back 675

20...spinal cord obstruction

Front 676

Cloudy CSF indicates ___, redness indicates blood. ICH vs traumatic puncture: ICF will not __

Back 676

infection....clot

Front 677

CSF with neutrophils indicates __ meningitis. CSF with lymphocytes indicates __ or __.

Back 677

bacterial....viral...tubercular

Front 678

___ means there is turbidity of CSF r/t increased cells

Back 678

pleocytosis

Front 679

CSF protein electrophoresis can show __ and __ in MS and other demyelinating diseases

Back 679

IgG...MBP

Front 680

bacterial meningitis will show up in CSF as __ glucose, __ lactic acid, __ CRP

Back 680

low...high...high

Front 681

glutamine in CSF indicates ___. The glutamine is made from ___

Back 681

hepatic failure...ammonia

Front 682

avonex is an __ that is used to treat __. It is same thing as ___

Back 682

interferon beta...MS....Rebif

Front 683

betaseron is an ___ that is used to treat __

Back 683

interferon beta...MS

Front 684

copaxone is a decoy of __ and is used to treat __

Back 684

MBP...MS

Front 685

prednisone is a

Back 685

glucocorticoid

Front 686

Brainstem is __, __, and __. Gives rise to most ___.

Back 686

midbrain, pons, medulla.....CN

Front 687

Neurons of ____ modulate pain.

Back 687

periaqueductal gray

Front 688

Locus ceruleus, raphe nucleus, and others comprise the ___ which is responsible for ___

Back 688

reticular activating system....consciousness

Front 689

CT is usually in __ plane. It is limited in its ability to display ___.

Back 689

axial...high contrast

Front 690

In trauma, use CT and look for blood (appears __). Lens shape is ____, concave is ___, diffuse in gyri is ___. Intra-axial means ____. Also look for __ especially ___ away from ___

Back 690

white....extradural....subdural...subarachnoid... mass effect... midline shift... bleed

Front 691

Another thing to look for in trauma is poor ____, which indicates ___

Back 691

border between white/gray matter.....edema

Front 692

head trauma: after CT use ___ to assess parenchymal injury

Back 692

MRi

Front 693

UBO is ___ on ___

Back 693

unidentified bright objects....MRI

Front 694

MRI, stroke shows up as ___

Back 694

edamatous blotch

Front 695

in adults brain tumors arise from ___. In children it is not true. Tumors show up in CT's well when using ___. Extra-axial tumors will show widest base at ___

Back 695

metastases....contrast.....brain surface

Front 696

hydrocephalus ex vacuo is where ventricles are ___ and gyri/sulci appear ___. This is r/t ______ which can also look like ____

Back 696

dilated....prominent.... multi-infarct dementia.... alzheimers

Front 697

EEG can show __ by rapid spiking waves. Cerebral lesions would show up as ___

Back 697

seizure focus....slow waves

Front 698

EEG during surgery can show

Back 698

ischemia

Front 699

EEG during surgery can show

Back 699

epileptogenic zones...directly on brain

Front 700

MEG is similar to EEG but by measuring __ using a ___

Back 700

magnetic fields...SQID

Front 701

EEG uses __ or more electrodes. You can "activate" the brain by ___ or light

Back 701

16....hyperventilation

Front 702

dexamethasone is a ___. It is 6.6x more potent than ___

Back 702

glucocorticoid....prednisone

Front 703

main lipid associated with CAD is ___, ___% of which is bound to LDL. Day to day values can vary by ___% and levels decrease in the ___ position. Decreased levels indicate ___

Back 703

cholesterol...75%.....15%....recumbent....liver disease

Front 704

Only cardioprotective HDL is ___. LDL = ___ - (__/5 - __). Worst LDL is __ and ___ (this is LDL pattern __)

Back 704

2b....total cholesterol .... triglycerides...HDL...IVa... IVb.... B

Front 705

triglycerides are transported mostly by ___ and ___

Back 705

VLDL...LDL

Front 706

Arteriography is putting in contrast into arteries while taking ___. ___ can be used as contrast, and ___ is where you take out bones. Renal angiography can differentiate between a ____ from ____. Highly vascular renal cancers appear ___

Back 706

Xrays....CO2....DSA....vascular renal cyst... hypervascular renal cancers....very bright

Front 707

Renin is released from __ in response to hyper__ or low volume. It converts ___ into ___

Back 707

JG....kalemia...angiotensinogen...angiotensin I

Front 708

In PRA, renin isn't actually measured but ____ generation is.

Back 708

angiotensin I

Front 709

In PRC, you measure ____

Back 709

maximum renin effect

Front 710

In primary hyperaldosternoism, renin will be __, in secondary hyperaldosteronism, renin is __

Back 710

low....high

Front 711

If HTN is r/t renal a. stenosis, the affected kidney should have a __ of __ times the other one

Back 711

PRA...1.4

Front 712

Renin stimulation test is bascially ___ renin test. You see a shift in ___ hyperaldosteronism

Back 712

orhostatic....secondary

Front 713

captopril test is when the __ is measured __ later

Back 713

PRA...60 min

Front 714

Aspirin is __, Atenolol is __, Atorvastatin is ___, Captopril is ___, Clonidine is ___, Furosemide is ___, HCTZ is ___, Nifedipine is ___, NTG is ____, KCl is ___

Back 714

NSAID...beta blocker....HMG-Coa reductase inhibitor... ACE inhibitor... alpha2 agonist...loop diuretic...Ca channel blocker... vasodilator....potassium supplement

Front 715

In CBC+Diff, normal diff count should be what pneumonic?

Back 715

never let monkeys eat bananas

Front 716

hyponatremia can cause ___ and later on ___ and ___. Hyponatremia is when Na is below __

Back 716

weakness....confusion and lethargy....125

Front 717

hypernatremia will eventually cause.

Back 717

seizures

Front 718

sodium is the main determinant of

Back 718

extracellular osmolality

Front 719

blood osmolal gap is when there is a diff between what you expect from __, __, and ___ and what is actually measured.

Back 719

BUN...Na....glucose

Front 720

urine osomolality better measure of _ than _. Normal urine osmolality:blood osmolality is __

Back 720

urine concentration....specific gravity.....1:3

Front 721

urine concentration....specific gravity.....1:3

Back 721

anterior pituitary....corticosteroids

Front 722

cisplatin is a drug for __ that causes ___ which triggers ___

Back 722

CA.....crosslinking of DNA.....apoptosis

Front 723

etoposide is a drug for ___ that exploits the normal action of

Back 723

cancer...topoisomerase II

Front 724

Tumor terminology. T0 is ___, TX is ____, TIS is ____

Back 724

no tumor....positive cytology....carcinoma in situ

Front 725

T1 is tumor < ___ diameter, no other involvement

Back 725

3m

Front 726

T2 is tumor < ___ diameter, involves ____ or >___ from ____

Back 726

3cm....visceral pleural....2cm....carina

Front 727

T3 is when tumor extends to __ or ___

Back 727

pleura...chest wall

Front 728

T4 is invasion of __, ___ or other major structures

Back 728

heart, great vessels

Front 729

N0 is ___, N1 is ___ or ___, N2 is ___ or ___. N3 is ___ or ___ or any ___/___ nodes

Back 729

no involvement....peribronchial....ipsilateral hilar..... ipsilateral mediastinal or subcarinal.....contralateral mediastinal or hilar........or supraclavicular/scalene

Front 730

M0 is ___, M1 is ___

Back 730

nothing...metastasis

Front 731

Meyer's loop is connected to the __ banks of calcarine fissure

Back 731

lower

Front 732

dark red urine indicates bleeding from ___, bright red urine indicates bleeding from ___

Back 732

kidney...lower urinary tract

Front 733

preeclampsia can present as

Back 733

protein in urine

Front 734

protein/creatinine ratio is usually less than

Back 734

0.15

Front 735

chronic renal diseases are associated with ___ specific gravity

Back 735

low

Front 736

bacteria can make reductase to turn urinary ___ into ___

Back 736

nitrates....nitrites

Front 737

urine sediment that contains ___ indicates stones may form. Parathyroid abnormalities or malabsorption states can cause __ and ___ crystals.

Back 737

crystals.....phosphate....calcium oxalate

Front 738

casts form when urine is __ and ___. Also associated with ___. Clear casts are ___

Back 738

acidic...concentrated....stasis.....hyaline

Front 739

granular casts are found after ___. Composed of disintegration of ___

Back 739

exercise...cellular material

Front 740

fatty casts are associated with ___ but also with ___

Back 740

nephrotic syndrome...fractures

Front 741

waxy casts are due to degeneration of ___. Occurs when ___

Back 741

granular casts....low flow

Front 742

___ casts are extremely suggestive of glomerulonephritis

Back 742

epithelial

Front 743

MacConkey agar tests for ___, especially of family ___ and ___. Red is by ___. Everything else is inhibited by bile salts and crystal violet

Back 743

gram negative....enterobacteriaceae...pseudomonas... fermented lactose

Front 744

UTI is dx by presence of 10^__ for asymptomatic bacteriuria, 10^__ for acute uncomplicated pyleonephritis, 10^__ for acute dysuria in women, and 10^__ for specimens by foley

Back 744

5.....5.....2.....2

Front 745

RDW is indication of _____. If it is off, pt has

Back 745

variation in RBC size.....anisocytosis

Front 746

high ESR means high __ in blood (esp ___) which means increased settling rate. Nonspecific

Back 746

protein....fibrinogen

Front 747

ciprofloxacin is a ___ that inhibits ___. It can exacerbate ___

Back 747

quinolone....topoisomerases....myathenis gravis

Front 748

bactrim is made up of 2 drugs that both work to inhibit

Back 748

folate synthesis

Front 749

catalase test is good to differentiate between ___ and ___. Positive means ___

Back 749

staph....strep....staph

Front 750

coagulase test is good to ID ___

Back 750

S. Aureus

Front 751

Cefazolin is a __ gen ___. It is a type of ___

Back 751

1st...cephalosporin....beta lactam

Front 752

Sweat Electrolyte test is not reliable in first few __ of life. Done in __ min using a ___

Back 752

weeks...90...electric current

Front 753

CF is ___ recessive. It is r/t a mutation of ___ on chromosome __ (most commonly ___)

Back 753

autosomal....CFTR...7....Delta AF508

Front 754

albuterol is a ___

Back 754

beta 2 agonist

Front 755

ceftriaxone is a ___

Back 755

3rd gen cephalosporin

Front 756

vancomycin is good for gram __ bacteria, works by preventing synthesis of __ and ___, and it also inhibits ____

Back 756

positive...NAM...NAG...cross-linking