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284 Cards in this Set

  • Front
  • Back
Inadequate oxygenation is called _
HYPOXIA
Most common cause of hypoxia is _
Coronary artery atherosclerosis
CO and CN both inhibit _
Cytochrome oxidase
How do you treat CO poisoning ?
100% O2
Most adversely affected cell in tissue hypoxia _
NEURONS
What do you see on ECG in subendocardial ischemia
ST segment depression
Cytochrome C activates _
Apoptosis
Most common cause of drug induced fulminant hepatitis
ACETAMINOPHEN
Reperfusion injury can be caused by ?
O2 and increase in cytosolic Ca
What is the difference between dystrophic and metastatic calcification
Dystrophic calcification - calcification of necrotic tissue

Metastatic calcification - calcification of normal tissue
Decrease in size of tissue or organ is called _
ATROPHY
Increase in cell size is called _
HYPERTROPHY
Increase in number of cells _
HYPERPLASIA
One cell type replaces another - this is called _
METAPLASIA
Disordered cell growth is called _
DYSPLASIA
In cerebral infarction - what type of necrosis?
LIUEFACTIVE (NOT coagulative)
Most common cause of caseous necrosis
Tuberculosis
What type of necrosis in acute pancreatitis
Enzymatic fat necrosis
Programmed cell death is called _
Apoptosis
Name apoptosis gene
BAX
Name anti apoptosis gene
BCL2
These cells release preformed histamine
Mast cells
Primary leukocytes in acute inflammation
Neutrophils
Responsible for "rolling" of neutrophils
Selectins
Neutrophil adhesion molecules
Beta 2 integrins
Directed migration of neutrophils is called _
CHEMOTAXIS
Name 2 opsonins
IgG and C3b
In Butons agammogloblinemia there is a defect in _
OPSONIZATION
In Chediak Higashi syndrome patient cannot form _
PHAGOLYSOSOMES
Most potent microbicidal system
O2 dependent MPO system
End product of O2 dependent MPO system
BLEACH
In chronic granulomatous disease there is absent _
NADPH OXIDASE AND RESPIRATORY BURST
Most important chemical mediator of acute inflammation
HISTAMINE
Most common cause of skin abscess
Staph aureus
Most common cause of chronic inflammation
INFECTION
Primary leukocytes in chronic inflammation
Monocytes and macrophages
Granulation tissue is converted to _
Scar tissue
Key adhesion glycoprotein in ECM
Fibronectin
cell types in granuloma
macrophages and CD4 helper T cells
Macrophages activated by gamma interferon from CD4 Th cells are called _
Epithelioid cells
Most variable stage in cell cycle
G1
Most critical phase in cell cycle
G1 to S
Genes controlling G1 to S phases of cell cycle
RB and TP53
Key adhesion glycoprotein in basement membrane
LAMININ
IN Ehlers Danlos syndrome which collagen is defective
Type I and type III
Cofactor in collagenase
Zn
Most common cause of impaired wound healing
Infections
In which vitamin defficiency is there decreased cross linking of collagen
Vitamin C defficiency
Which drugs prevent scar formation
Glucocorticoids
In keloids which type collagen is in excess
type III
In lung injury which cell is repair cell
TYPE II PNEUMOCYTE
What happens in brain with injury
Proliferation of astrocytes and microglial cells
With peripheral nerve transection which cell is key cell in reinnervation
Schwann cell
Predominant immunoglobulin in acute inflammation
IgM
Predominant immunoglobulin in chronic inflammation
IgG
Corticosteroid effect in blood
Increased neutrophils

Decreased lymphocytes and eosinophils
Marker of necrosis and disease activity
CRP
Marker of acute inflammation
IgM
Sign of chronic inflammation
Polyclonal gammopathy, increased IgG
Large granular lymphocytes in peripheral blood
Natural killer cells
When does IgM and IgG synthesis begin
After birth
Class I MHC is present on which cells
All nucleated cells
Name antigen presenting cells
B cells

Macrophages

Dendritic cells
Which HLA protein is associated with ankylosing spondylitis
HLA B27
IgE activation of mast cells happens in which type of hypersensitivity
Type I
Name potentially fatal type I hypersensitivity reaction
Anaphylactic shock
Antibody dependent cytotoxic reactions are what type of hypersensitivity
Type II
Activation of compliment by circulating antigen-antibody complexes is what type of hypersensitivity
Type III
Name antibody activated hypersensitivity reactions
Type I, II, III
Which type of hypersensitivity has to do with cellular immunity
Type IV
What is the most important requirement for successful transplantation
ABO blood group compatibility
Type of transplant with best survival rate
Autograft (self to self)
Hyperacute rejection of transplant - is it reversible? what type of hypersensitivity?
Irreversible, type II hypersensitivity
Most common type of transplant rejection - what typ of hypersensitivity?
Acute rejection - type IV and type II hypersensitivity
Is chronic rejection of transplant reversible
Irreversible
What are symptoms and signs of graft versus host reactions
Jaundice

Diarrhea

Dermatitis
Most common cardiac finding in SLE
Fibrinous pericarditis with effusion
Most common drug associated with drug induced lupus
Procainamide
What type of antibodies are present in drug induced lupus
Antihistone antibodies
What two tests can confirm SLE
Anti double stranded DNA

Anti Smith antibodies
In systemic sclerosis there is excess _
Collagen deposition
Most common initial sign of systemic sclerosis
Raynaud phenomenon
What type of antibodies are present with systemic sclerosis
Anti-topoisomerase antibodis
What does CREST syndrome stand for
Calcinosis

Raynauds phenomenon

Esophageal dysfunction

Sclerodactyly

Telangiectasia
In dermatomyositis and polymyositis there is increased _
Serum creatine kinase
Im MCTD (mixed connective tissue disease) what kind of antibodies are present
Anti RNP antibodies
Most common congenital immunodefficiency
IgA defficiency
Most common acquired immunodefficiency disease worldwide
AIDS
Pediatric AIDS is mostly due to _ transmission
Vertical (mother to child)
HIV is cytotoxic to what type of cells? which immunity is lost?
CD4 T cells

Loss of cell mediated immunity
Which protein is detected in ELISA test screen for HIV
anti gp 120
Which test confirms HIV
Western blot
Which cells are reservoir cells for HIV
Follicular dendritic cells in lymph nodes
Most common CNS fungal infection in AIDS
Cryptococcosis
Most common malignancy in AIDS
Kaposis sarcoma
Most common cause of blindness in AIDS
CMV
In hereditary angioedema there is defficiency of what?
C1 esterase inhibitor
Which protein exhibits apple green birefringence in polarized light
Amyloid
Which protein is associated with Alzheimers disease in Down syndrome
Beta amyloid
Major cation of extracellular fluid
Na
Major cation of intracellular fluid
K
Water movement between extracellular and intracellular fluid compartments is called? What is it controlled by?
OSMOSIS - controlled by serum Na
Formula for calculating serum Na
Total body Na/ Total body water
What is the sign of volume depletion
Decreased total body Na
In which conditions would you see increase in total body Na
Pitting edema

Body cavity effusions
What happens to Na in isotonic loss or gain
Serum Na normal
What two signs describe hypotonic disorders
Hyponatremia

ICF expansion
In which conditions would you see pitting edema
Right sided heart failure

Cirrhosis

Nephrotic syndrome
Which signs describe hypertonic disorders
Hypernatremia or hyperglycemia

ICF conraction
What happens to Posm and Na in hyperglycemia
Increased Posm

Decreased serum Na
What happens to K in alkalosis
Shifts into cell
What happens to K in acidosis
Shifts out of cell
Most common cause of hypokalemia
Loop and thiazide diuretics
What does ECG show in hypokalemia
U wave
Most common cause of hyperkalemia
Renal failure
What does ECG show in hyperkalemia
Peaked T waves
What does PaCO2 have to be to diagnose respiratory acidosis
>45 mm Hg
What does PaCO2 have to ne to diagnose respiratory alkalosis
< 33 mmHg
What happens in increased anion gap metabolic acidosis
Anions of acid replace HCO3
What happens in normal anion gap metabolic acidosis
Cl anions replace HCO3
What is the level of HCO3 have to be to diagnose metabolic acidosis
< 22 mE/L
Most common cause of metabolic alkalosis
Loop and thiazide diuretics
What does HCO3 have to be to diagnose metabolic alkalosis
> 28 mEq/L
With _ intoxication there is often mixture of primary metabolic acidosis and primary respiratory alkalosis
SALICYLATE
Excess fluid in interstitial space is called _
EDEMA
Protein poor and cell poor fluid is called _
TRANSUDATE
Protein rich and cell rich fluid is called _
EXUDATE
Is there transudate or exudate in pitting edema? What happens to hydrostatic and oncotic pressures?
Transudate

Increased hydrostatic pressure

Decreased oncotic pressure
Most common site for venous thrombosis
Deep vein of lower extremity under knee
Name anticoagulants that are used for prevention of venous thrombosis
Warfarin and Heparin
Prevents formation of arterial thrombi
Aspirin
How do you prevent mixed thrombus
Aspirin + anticoagulant therapy
Majority of pulmonary thromboembolism originate in _
Femoral veins
Majority of systemic embolisms originate in _
Left side of the heart
Most common cause for fat embolism
Fracture of long bones
Signs and symptoms of amniotic fluid embolism
Abrupt onset dyspnea

Hypotension

Bleeding (DIC)
What happens in decompression sickness
Nitrogen gas bubbles occlude vessel lumens
Two serious potential complications of scuba diving
Pneumothorax and pulmonary embolism
Most common cause of hypovolemic shock
Blood loss
Most common cause of cardiogenic shock
acute MI
What happens to cardiac output in hypovolemic shock? Cardiogenic shock? septic shock?
Hypovolemic shock - decreased CO

Cardiogenic shock - decreased CO

Septic shock - increased CO
What happens to left ventricular end-diastolic pressure in hypovolemic shock? cardiogenic shock? septic shock?
Decreased in hypovolemic and septic shock, increased in cardiogenic shock
What happens to peripheral vascular resistance in hypovolemic shock? cardiogenic shock? septic shock?
Increased in cardiogenic and hypovolemic shock, decreased in septic shock
Most common cause of death in shock
Multiorgan failure
What type of mutation occurs with sickle cell disease/trait
Missense mutation
With beta thalassemia major what type of mutation
Nonsense mutation with stop codon
In Tay Sachs disease what type of mutation
Frameshift mutation
Additional trinucleotide repeats increases disease severity in future generations - this is called _
ANTICIPATION
Most common type of mendelian disorder
Autosomal recessive
Both parents must have mutant gene - what type of inheritance
Autosomal recessive
Enzyme defficiencies disorders usually involve what type of inheritance
AR
In PKU what is increased and what is decreased
Phenylalanine increased

Tyrosine decreased
What is defficient in Von Gierkes disease
Glucose 6 phosphatase
Most common AR disorder
Hemochromatosis
Heterozygotes with dominant mutant gene express disease - type of inheritance
AD
Individual with mutant gene doesnt express disease - this is called
Reduced penetrance
Most common AD disorder
Von Willebrand disease
Asymptomatic female carrier transmits mutant gene to 50% of sons - what type of inheritance
XR
Most common x linked disorder
Fragile X syndrome
In which x linked inheritance femaler carriers are symptomatic
XD
Number of Barr bodies?
Number of chromosomes - 1
Unequal separation of chromosomes in meiosis is called _
Nondisjunction
Nondisjunction of chromosomes in mitosis is called _
Mosaicism
Which chromosomal defect is present in cri du chat syndrome
Deletion short arm chromosome 5
Most cases of Down syndrome occur due to _
Nondisjunction
Most common genetic cause of mental retardation
Down syndrome
Most important risk factor for bearing offspring with trisomy syndromes
Advanced maternal age
45, x caryotype is present in which condition
Turner syndrome
Most common genetic cause of primary amenorrhea
Turners syndrome
"Menopause before menarche"
Turners syndrome
Which hormones are decreased and which are increased in Klinefelters syndrome
Testosterone and inhibin decreased

LH and FSG increased
Which chromosome determines genetic sex of individual
Y chromosome
Most common cause of pseudohermaphroditism? What is defficient in this disease?
Testicular feminization

Androgen receptors
Most common pathogen causing congenital infection
CMV
Name TORCH infections
Toxoplasmosis

Other agents

Rubella

CMV

Herpes simplex
Most common cause of stillbirth
Abruptio placentae
Common cause of spontaneous abortions
Trisomy 16
Most common cause for large for gestational age babies
Maternal diabetes
Most common cause of neonatal morbidity/mortality
Prematurity
Triple marker for Down syndrome
Decreased AFP

Increased hCG

Decrease in unconjugated urine
Most important preventable cause of disease and death in US
Smoking
Do women or men have less gastric alcohol dehydrogenase and therefore reach hight alcohol levels
Women
Most common cause of thiamine defficiency
Alcohol abuse
Increased anion gap metabolic acidosis is caused by _
Lactic acid and beta-hydroxybutyric acid
Most common systemic complication of intravenous drug use
Hepatitis B
Oral contraceptives decrease risk for which cancers
Endometrial and ovarian
Most common cause of hypertension in young woman
Oral contraceptives
Most common cause of death in burn victims
sepsis caused by Pseudomonas
Least sensitive tissue to radiation
Bone
First hematological sign of total body radiation
Lymphopenia
Most frequent type of cancer caused by radiation
Acute leukemia
Which UV light is most damaging and how
UVB - increase in pyrimidine dimers distorts DNA helix
Most common UVB related skin cancer
Basal cell carcinoma
Where does carbohydrate digestion begin
Mouth
Where does protein digestion begin
Stomach
Where does fat digestion begin
Small intestine
What is characteristic feature of kwashiorkor
Pitting edema
What is characteristic feature of marasmus
Extreme muscle wasting
Most common cause of death in anorexia nervosa
Ventricular arrythmia
What is the complication caused by vomitting in bulimia nervosa
Hypokalemic metabolic alkalosis
Which gene is usually defective in obesity
Leptin gene
First sign of vitamin A defficiency
Night blindness
Most common cause of vitamin D defficiency
Renal failure
Vitamin E toxicity causes _
Decreased synthesis of vitamin K dependent coagulation factors
Most common cause of vitamin K defficiency in hospital
Broad spectrum antibiotics
Rat poison contains _ derivatives
Coumarin
People on corn based diets are defficient in _
Tryptophan and niacin
Three D's of pellagra
Dermatitis

Diarrhea

Dementia
Most common cause of vitamin B12 defficiency
Perncious anemia
Most common cause of folate defficiency
Alcohol abuse
Defficiency of ascorbic acid is called _
Scurvy
Poor wound healing, poor taste and perioral rash are signs of what defficiency
Zn
Iodide defficiency results in _
Multinodular goiter
Benign tumors are of what origin
Epithelial or connective tissue
Tumor that has derivatives of ectoderm, endoderm and mesoderm is called_
Teratoma
Carcinomas derive from?
Squamous

Glandular (adenocarcinoma)

Transitional epithelium
Sarcoma derives from?
Connective tissue
Non neoplastic overgrowth of tissue is called _
Hamartoma
Which cancer invades tissue but doesnt metastasize
Basal cell carcinoma of skin
Which metastasis have greater prognostic significance - nodal or extranodal
Extranodal (liver, etc)
Name 3 routes of metastasis
Lymphatic

Hematogenic

Seeding of body cavities
2 types of bone metastasis
Osteoblastic (radiodense)

Osteolytic (radioluscent)
Most common cause of cancer deaths in adults
Lung cancer
Precursor of squamous cell carcinoma
Actinic (solar) keratosis
How can you reduce risk for developing gastric lymphoma and adenocarcinoma
Treat H pylori
Most common type of mutation in cancer
Point mutation
Which genes protect from unregulated cell growth? Which are involved in normal growth and repair?
Suppressor genes

Proto- oncogenes
What is the most effective host defense against cancer
Cytotoxic CD8 T cells
What is the most common cause of death in cancer
Gram negative sepsis
What is the most common paraneoplastic syndrome
Hypercalcemia
Diet derived triglyceride
Chylomicron
Liver derived triglyceride
VLDL
-transports cholesterol
LDL
Removes cholesterol from plaques for disposal in the liver
HDL
Pathognomonic lesion of atherosclerosis
Fibrous cap
Excellent marker of disrupted fibrous plaques
CRP
Most common site for atherosclerosis
Abdominal aorta
2 conditions associated with hyaline arteriosclerosis
DM
Hypertension
Most common aneurysm in men>55 years of age
Abdominal aortic aneurysm
Rupture of aneurysm triad
Left flank pain

Hypotension

Pulsatile mass
2 conditions of aortic arch aneurysm
Tertiary syphillis

Vasculitis of vasa vasorum
Most common cause of death in Marfan syndrome and EDS
Aortic dissection
Most common cause of death with aortic dissection
Cardiac tamponade
Symptoms and signs of small vessel vasculitis
Palpable purpura
Symptoms and signs of medium sized vessel vasculitis
Thrombosis

Aneurysm formation
Most common type of hypertension
Essential hypertension
Most common cause of secondary hypertension
Renovascular hypertension
Ventricular hypertrophy occurs due to_
Increased afterload or increased preload
Pulmonary edema is seen in which heart failure
Left
First cardiac sign of LHF
S3
Increases intensity for left sided heart murmurs and abnormal heart sounds
Expiration
Increases intensity of right sided heart murmurs and abnormal heart sounds
Inspiration
Inrease in venous hydrostatic pressure occurs in which heart failure
Right
Most common manifestation of CAD
Angina pectoris
Subendocardial ischemia with ST segment depression is what type of angina
Stable
Vasospasm with transmural ischemia and ST segment elevation is what type of angina
Prinzmetals angina
Most common cause of death in acute MI
Ventricular fibrillation
Most common cause of death in CHF
Ventricular aneurysm
Gold standard for diagnosis of acute MI
Cardiac troponin I and T
ECG findings in acute MI
Inverted T waves, elevated ST segments, Q waves
Stimuli for EPO
Hypoxemia

Left-shifted OBC

High altitude
Where is EPO synthesized?
In endothelial cells of peritubular capillaries
Measure of effective erythropoiesis, corrected for the degree of anemia
Reticulocyte count
Extramedullary hematopoiesis most often occurs where?
In liver and spleen
What happens to Hb, Hct and RBC count in thalassemia
Hb, Hct decreased

RBC count increased
What happens to RDW in iron defficiency
Increased
End product of heme degradation in macrophage
Unconjugated bilirubin
What is the main source of energy in mature RBC
Anaerobic glycolysis
Serum ferritin is _ in iron defficiency anemia
Decreased
Serum ferritin is _ in ACD, iron overload disease
Increased
Serum iron is _ in iron defficiency, ACD
Decreased
Serum iron is _ in iron overload disease
Increased
If serum total iron binding capacity is decreased it means that transferin is _
Decreased
In microcytic anemia there is defect in _
Synthesis of Hb (heme + globin chain)
Iron defficiency most often caused by _
Bleeding
Most common anemia in hospitalized patients
ACD - anemia of chronic disease
With sideroblastic anemia there is defect in _
Heme synthesis in mitochondria, ringed sideroblasts
Most common cause of sideroblastic anemia
Alcohol
Most common cause of pyridoxine defficiency
Isoniazid
In lead poisoning where does lead deposit
Epiphyses
Most common cause of vitamin B12 defficiency
Pernicious anemia
Which drug inhibits intestinal conjugase
Phenytoin
Monoglutamate reabsorption is inhibited by _
Alcohol and oral contraceptives
Most common cause of folate defficiency
Alcohol