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71 Cards in this Set

  • Front
  • Back
What part of the brain is hyperactive in a person with OCD?
Caudate nucleus and prefrontal cortex
Presentation: chronic musculoskeletal pain that improves with exercise, chronic fatigue, sometimes severe headaches; painful trigger points include palpation of trapezius and lateral epicondyle of elbow; no signs of inflammation
Fibromyalgia (fibrositis); tx with TCA like amitriptyline or skeletal muscle relaxants like cyclobenzaprine
Presentation: xanthomas on Achilles tendon and arcus lipoides (opaque rings in the eye); elevated LDL
Familial hypercholesterolemiia;
tx aimed to increase ApoB-100 receptors
Name 6 GI diseases/issues associated wih arthropathy
Crohns, ulcerative colitis, bypass surgery, whipple disease, behcet syndrome and celiac disease
What muscles does the recurrent laryngeal nerve supply?
All intrinsic muscles of the larynx, except the cricothryoid (A pancoast tumor of the apical portion of the upper lobe of the lung may cause Horner's syndrome)
Presentation: Old man with heavy history of drinking, appears confused, ataxic, sluggish pupils, denies recent intoxication; one week later, calm and alert with pupils normal and ataxia gone, however he's confused and has severe recent memory loss
Wernicke-Korsakoff; due to thiamine deficiency; may lead to dry beriberi (polyneuritis) or wet beriberi (dilated cardiomyopathy)
Name the highly conserved splice sites on an intron
5' end has G-T, 3' end has A-G
Why does hypertension occur in the case of ADPK Disease?
The cysts cause impingement on glomeruli, decreasing perfusion --> increase in Renin; tx with ACE inhibitor
Presentation: development of acute renal failure, fever, maculopapular rash, eosinophilia, periorbital edema, wheezing.
What treatment caused this?
This is acute interstitial nephritis due to one of the following: NSAIDs, beta-lactam Abiotics, sulfonamides, diuretics (furosemide, thiazides), phenytoin, cimetidine, and methyldopa
In a reflex arc, what structure senses tension within the muscle?
Golgi tendon apparatus (it produces inhibitory feedback to alpha motor neurons to relieve the tension)
What brings efferent signaling in a reflex arc?
alpha motor neurons
Upon muscle stretch, what sends afferent information via Ia nerves?
intrafusal fibers
What's the major and minor criteria for Rheumatic Fever?
Major: carditis, migratory polyarthritis, subcutaneous nodules, Sydenham's chorea, and erythema marginatum
Minor: fever, arthralgia, elevated acute phase reactants, and prolonged PR interval
Metabolically what happens in a chronic alcoholic, with regard to NADH/NAD, lactate/pyruvate, gluconeogenesis, formation of G3P & DHAP, and fatty acid oxidation
Increase NADH/NAD ratio
Favors G3P formation over DHAP
Favors Lactate over Pyruvate (glycolysis)
Inhibits Fatty acid oxidation and gluconeogenesis
Most common cause of chromosomal abberation resulting in spontaneous abortion?
1) trisomy 16
2) triploidy
3) Turners?
what adrenergic receptors can be found in uterine smooth muscle?
alpha 1 and beta 2
What does the Glosspharyngeal nerve innervate?
Stylopharyngeus (M), posterior 1/3 tongue (S), mucosa of pharynx (S)
How does calreticulin recognize misfolded proteins within the RER?
It is a chaperone protein in the RER that binds to misfolded MEMBRANE proteins in the RER and prevents them from entering the Golgi (Calnexin does similarly, but for SOLUBLE proteins). They both recognize oligosaccharides containing terminal glucose residues that are added if abnormal folding is detected
What is bacillary angiomatosis?
Vascular proliferative disease involving skin, bone, and subQ tissues in immunocompromised patients, due to B. henselae and B. quintana.
What causes Oroya Fever and Verruga?
Bartonella bacilliformis (Verruga is chronic cutaneous form of Oroya Fever, an acute febrile illness with severe anemia)
Name the function for the following hypothalamic nuclei:
1) ventromedial nucleus
2) lateral nucleus
3) septal nucleus
4) suprachiasmatic nucleus
5) supraoptic nucles
1) satiety
2) hunger
3) control of aggression (destroy it --> aggressive!)
4) controls circadian rhythms (input from retina)
5) regulates water balance and produces ADH and oxytocin (along with periventricular nucleus)
Presentation: skin in armpits and groin gets darker, velvety brown and warty skin in axilla and groin, variably hyperplastic epidermis with many sharp peaks and valleys
Acanthosis nigricans -- seen in obesity, diabetes, and in patients with underlying visceral carcinoma (like adenocarcinomas of chest/abdomen). Lesions are not malignant or premalignant
The use of which antibiotic treatment in a patient with G6PD deficiency could result in hemolytic anemia?
SMX-TMP (other drugs that cause HA too: sulfonamides, nitrofurantoin, dapsone, primaquine, quinine)
Presentation: monoclonal gammopathy with high serum levels of IgM and hyperviscosity
Waldenstrom's macroglobulinemia (a type of NHL)
What cell types will be found surrounding lesions in a patient with MS?
CD4+ Th1 cells that react against self-myelin and secrete IFN-gamma to recruit macrophages (therefore its technically type IV hypersensitivity)
what's the landmark for a pudendal nerve block
the ischial spine (which along with the sacrospinous ligament, separates the greater and lesser)
How can you locate the sciatic nerve in the gluteal region?
Midpoint between greater trochanter and the ischial tuberosity
Which polymerase is specific to the nucleolus?
RNA polymerase I (II and III can be found there, but also elsewhere in the nucleus); it is responsible for forming rRNA (18S, 28S, 5.8S)
Which type of cancer are albinos MOST at risk for?
SCC (#2 is basal cell)
where is somatostatin released from? What does it inhibit?
hypothalamus, pancreas, and GI mucosa; inhibits TSH, GH, Insulin, Glucagon, and Gastrin release (and really, all GI hormones and gastric H+ secretion, in response to low pH)
Presentation: large meningioma involving parasagittal region and falx cerebri. What neuro deficits result?
*think FOREBRAN...NOT cranial nerves of the brainstem; it could compress sensory (postcentral gyrus) or motor cortex (precentral gyrus) supplying the lower extremities
Presentation: EEG shows recurrent bursts of high voltage slow waves, rapidly worsening dementia, motor dysfunction (general hypertonicity and profound dysarthria), death within 6-12months
Creutzfeldt-Jakob disease (diffuse spongiform change)
Presentation: intracellular bacterium, morulae (berry-like clusters), fever, joint pain, muscle pain, headache, photophobia, nausea, vomiting; NO ulcers, rashes, or petechiae; leukopenia, thrombocytopenia, increased serum transaminases
Ehrlichia phagocytophila, transmitted via the Ixodes tick (also responsible for Borrelia burgdorferi and Babesia microti). It basically looks like RMSfever without the rash.
How did MRSA spread?
generalized transduction
How did H.influenza ampicillin-resistance and S.aureus vanco-resistance happen?
conjugation to pass plasmid-encoded resistance (vanco then makes ligase enzyme that changes cell wall pentapeptides to foil binding)
How did beta-lactamase N.gonorrhea happen?
conjugation using non-conjugative plasmids (needs another plasmids tra operon to make bridge)
How did S.pneumo develop resistance to pBps?
chromosomal genes incorporated via transformation
Explain hypokalemic periodic paralysis
presentation: sporadic episodes of severe muscle weakness, particularly after severe exercise, rich meal of CHO, tension, anxiety, habitual high salt diet; nighttime atacks
Autosomal dominant, manifests 10s-20s; primary defect in calcium channels; tx with Potassium supplementation acutely, and prophylax with acetazolamide, triamterene, amiloride, or spironolactone
Which bacteria undergo natural transformation?
Haemophilus, Strep, N.gonorrhea, and H.pylori
Presentation: ovarian mass, resected to show lymphoma composed of small lymphocytes with interspersed macrophages surrounded by clear spaces
Burkitts lymphoma (that was the starry sky pattern described); c-myc activation by t(8,14)
What cancer is caused by t(14,18)?
Follicular lymphoma (bcl-2 activation)
If a mother is infected by L.monocytogenes, what happens to the fetus? To the mother?
potentially fatal granulomas (granulomatosis infantiseptica) to fetus; mom will complain of fever, weakness, and diarrhea or may be asymptomatic - may cause premature labor
What does radioactive iodine uptake demonstrate?
TSH levels? (high uptake -- high TSH levels and vice versa)
In rickets, where do most bony changes occur?
At lower ends of radius and ulna, where diaphyseal ends becom fuzzy, cup-shaped and may develop spotty rarefaction; due to vit. D deficiency
What can octreotide be used for?
Control diarrhea and control variceal bleeding
Presentation: 54 y.o. man, headaches, elevated Hct (62%), normocellular erythrocytes, with increased reticulocyts and nucleated RBCs; increased erythrocytic precursors;
Diagnosis? Organ involved
Erythrocyosis due to abnormal erythropoietin secretion by RCC (paraneoplastic syndrome in kidney), hyoxia, other tumors (meningioma, pheochromocytoma, cerebellar hemangioblastoma, adrenal adenoma), androgen therapy, Bartter's syndrome, or polycythemia vera.
SE profile of Thiazide diuretics?
Hyperuricemia, hypercalcemia, hypokalemia, hyponatremia, hypochloremia, hypomagenesemia, and glucose intolerance
Presentation: 28 y.o. pregnant woman, flu-like illness, fever, headache, myalgia, backpain, spontaneous abortion, abortus displays severe ammnionitis; OTHER: fatal to kids/adults secondary to septicemia or meningoencephalitis;
Dx and Tx?
Listeriosis; tx wih Ampicillin or penicillin, often in combo with AG or TMP-SMX if pen allergic.
Over a long period of time, what can polycythemia vera and CML progress to?
Myeloid metaplasia with myelofibrosis (MMM) - the hypercellular bone marrow burns out and is replaced by fibrosis, so hematopoiesis must take place somewhere else...e.g. spleen and liver
Myeloid disorder featuring maturation defects and ineffective hematopoiesis
Myelodysplastic syndrome (MDS)
Massive dilation of aortic root without atherosclerotic vessels suggests...
It's histologic hallmark is...
syphilitic aneurysm (tertiary syphillis); plasma cell lesion of the vasa vasorum (small blood vessels that supply the aorta) and obliterate the small vessel lumina. Wrinkling = tree-barking of aorta
Presentation: slowly progressive dementia, with language disturbances and behavioral changes eventually leading to mutism; histologically, ballooned neurons or cytoplasmic inclusions; on imaging, atrophic frontal and termporal lobes
Picks Disease
What is preeclampsia before the 20th week of pregnancy indicative of?
Hydatidiform mole
Pigment stones, composed of pure calcium bilirubinate, found in an Asian person are characteristic of what fluke infection?
Clonorchois sinensis (also can be due to hepatic cirrhosis, hemolytic anemia, Fasciola
What is the result of increasing cAMP in granular cells of the kidney
Increase renin secretion --> Increase angiotensin II levels
Most common cause of peritoneal carcinomatosis (transcoelomic spread of cancers located within the abdominal cavity)
Ovarian Carcinoma (#2 colon cancer)
what type of gall stones are patients with sickle cell anemia, liver cirrhosis and liver fluke infestation most likely to develop?
Calcium bilirubinate stones
Name the location of the common breakpoint in Fragile X. What complications is it associated with?
CGG at Xq27.3; MVP, SIDS, MR, ADD/autism, CT-disorder (lax skin and joints, flat feet, large ears), prominent jaw and nasal bridge, macroorchidism, aortic root dilatation.
Mechanism: mutation at 11q22-23, whcih codes for a DNA-dependent protein kinase (tumor suppressor gene) localized mainly to the nucleus; cells have increased sensitivity to ionizing radiation, defective DNA repair, and frequent chromosomal abnormalities -->high incidence of lymphoreticular malignancies
Ataxia-telangiectasia (they present with telangiectasias of skin and eyes, variable immunodeficiency, and progressive ataxia; wheelchair by adolescence
where does primary Tb usually strike first (what part of the lung)
lung subjacent to the pleura in either the lower part of the UPPER lobe or the upper part of the LOWER lobe of one lung, usuall involving the mediastinal nodes
What part of the lung does reactivation Tb usually target?
Reinfection site is usually the apex of the lung
what does elevation of alkaline phosphatase indicate?
Destruction of cellsi n the biliary tree (bile stones, cancer or other obstruction)
Define plasmacytoma
solitary myeloma, involves soft tissue (lungs, nasopharynx, nasal sinuses); resembles multiple myeloma without sign. mets
What can be seen microscopically in a patient with mycosis fungoides?
malignant-appearing T-lymphocytes in the epidermis and superficial dermis --> plaques and nodules; it is actually a cutaneous T cell lymphoma, NOT a fungal infection
Within an hour of exercise, what growth factor shows increased mRNA levels?
what helps to distinguish the diagnosis of medullary thryoid carcinoma?
the presence of amyloid; it is a tumor of neuroendocrine parafollicular cells of the throid which produce calcitonin; component of MEN II (parathryoid disewase, pheo, med. carcinoma) and MEN III (parathyroid disease, pheo, med. carcinoma, mucocutaneos ganglioneuromas, and Marfanoid habitus)
what is the difference between subacute granulomatous thryoiditis and subacute lymphocytic thyroiditis?
-both can cause transient hyperthyroidism, but subacute LMPHOCYTIC thyroiditis is characteristically painless, while GRANULOMATOUS (DeQuervain's) is painful
what is a serological marker for primary biliary cirrhosis?
antimitochondiral antibody
what gives rise to the philtrum?
the fusion of medial nasal processes
failure of what fusion results in a cleft lip?
maxillary and medial nasal processes
failure of what fusion results in cleft palate?
fusion between the palatine shelves of the maxillae and the nasal septum