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284 Cards in this Set
- Front
- Back
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Inadequate oxygenation is called _
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HYPOXIA
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Most common cause of hypoxia is _
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Coronary artery atherosclerosis
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CO and CN both inhibit _
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Cytochrome oxidase
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How do you treat CO poisoning ?
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100% O2
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Most adversely affected cell in tissue hypoxia _
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NEURONS
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What do you see on ECG in subendocardial ischemia
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ST segment depression
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Cytochrome C activates _
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Apoptosis
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Most common cause of drug induced fulminant hepatitis
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ACETAMINOPHEN
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Reperfusion injury can be caused by ?
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O2 and increase in cytosolic Ca
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What is the difference between dystrophic and metastatic calcification
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Dystrophic calcification - calcification of necrotic tissue
Metastatic calcification - calcification of normal tissue |
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Decrease in size of tissue or organ is called _
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ATROPHY
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Increase in cell size is called _
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HYPERTROPHY
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Increase in number of cells _
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HYPERPLASIA
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One cell type replaces another - this is called _
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METAPLASIA
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Disordered cell growth is called _
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DYSPLASIA
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In cerebral infarction - what type of necrosis?
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LIUEFACTIVE (NOT coagulative)
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Most common cause of caseous necrosis
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Tuberculosis
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What type of necrosis in acute pancreatitis
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Enzymatic fat necrosis
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Programmed cell death is called _
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Apoptosis
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Name apoptosis gene
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BAX
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Name anti apoptosis gene
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BCL2
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These cells release preformed histamine
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Mast cells
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Primary leukocytes in acute inflammation
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Neutrophils
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Responsible for "rolling" of neutrophils
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Selectins
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Neutrophil adhesion molecules
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Beta 2 integrins
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Directed migration of neutrophils is called _
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CHEMOTAXIS
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Name 2 opsonins
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IgG and C3b
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In Butons agammogloblinemia there is a defect in _
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OPSONIZATION
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In Chediak Higashi syndrome patient cannot form _
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PHAGOLYSOSOMES
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Most potent microbicidal system
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O2 dependent MPO system
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End product of O2 dependent MPO system
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BLEACH
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In chronic granulomatous disease there is absent _
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NADPH OXIDASE AND RESPIRATORY BURST
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Most important chemical mediator of acute inflammation
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HISTAMINE
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Most common cause of skin abscess
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Staph aureus
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Most common cause of chronic inflammation
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INFECTION
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Primary leukocytes in chronic inflammation
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Monocytes and macrophages
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Granulation tissue is converted to _
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Scar tissue
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Key adhesion glycoprotein in ECM
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Fibronectin
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cell types in granuloma
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macrophages and CD4 helper T cells
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Macrophages activated by gamma interferon from CD4 Th cells are called _
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Epithelioid cells
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Most variable stage in cell cycle
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G1
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Most critical phase in cell cycle
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G1 to S
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Genes controlling G1 to S phases of cell cycle
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RB and TP53
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Key adhesion glycoprotein in basement membrane
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LAMININ
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IN Ehlers Danlos syndrome which collagen is defective
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Type I and type III
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Cofactor in collagenase
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Zn
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Most common cause of impaired wound healing
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Infections
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In which vitamin defficiency is there decreased cross linking of collagen
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Vitamin C defficiency
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Which drugs prevent scar formation
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Glucocorticoids
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In keloids which type collagen is in excess
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type III
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In lung injury which cell is repair cell
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TYPE II PNEUMOCYTE
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What happens in brain with injury
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Proliferation of astrocytes and microglial cells
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With peripheral nerve transection which cell is key cell in reinnervation
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Schwann cell
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Predominant immunoglobulin in acute inflammation
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IgM
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Predominant immunoglobulin in chronic inflammation
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IgG
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Corticosteroid effect in blood
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Increased neutrophils
Decreased lymphocytes and eosinophils |
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Marker of necrosis and disease activity
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CRP
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Marker of acute inflammation
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IgM
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Sign of chronic inflammation
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Polyclonal gammopathy, increased IgG
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Large granular lymphocytes in peripheral blood
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Natural killer cells
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When does IgM and IgG synthesis begin
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After birth
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Class I MHC is present on which cells
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All nucleated cells
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Name antigen presenting cells
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B cells
Macrophages Dendritic cells |
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Which HLA protein is associated with ankylosing spondylitis
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HLA B27
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IgE activation of mast cells happens in which type of hypersensitivity
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Type I
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Name potentially fatal type I hypersensitivity reaction
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Anaphylactic shock
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Antibody dependent cytotoxic reactions are what type of hypersensitivity
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Type II
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Activation of compliment by circulating antigen-antibody complexes is what type of hypersensitivity
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Type III
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Name antibody activated hypersensitivity reactions
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Type I, II, III
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Which type of hypersensitivity has to do with cellular immunity
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Type IV
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What is the most important requirement for successful transplantation
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ABO blood group compatibility
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Type of transplant with best survival rate
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Autograft (self to self)
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Hyperacute rejection of transplant - is it reversible? what type of hypersensitivity?
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Irreversible, type II hypersensitivity
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Most common type of transplant rejection - what typ of hypersensitivity?
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Acute rejection - type IV and type II hypersensitivity
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Is chronic rejection of transplant reversible
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Irreversible
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What are symptoms and signs of graft versus host reactions
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Jaundice
Diarrhea Dermatitis |
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Most common cardiac finding in SLE
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Fibrinous pericarditis with effusion
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Most common drug associated with drug induced lupus
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Procainamide
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What type of antibodies are present in drug induced lupus
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Antihistone antibodies
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What two tests can confirm SLE
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Anti double stranded DNA
Anti Smith antibodies |
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In systemic sclerosis there is excess _
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Collagen deposition
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Most common initial sign of systemic sclerosis
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Raynaud phenomenon
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What type of antibodies are present with systemic sclerosis
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Anti-topoisomerase antibodis
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What does CREST syndrome stand for
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Calcinosis
Raynauds phenomenon Esophageal dysfunction Sclerodactyly Telangiectasia |
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In dermatomyositis and polymyositis there is increased _
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Serum creatine kinase
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Im MCTD (mixed connective tissue disease) what kind of antibodies are present
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Anti RNP antibodies
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Most common congenital immunodefficiency
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IgA defficiency
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Most common acquired immunodefficiency disease worldwide
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AIDS
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Pediatric AIDS is mostly due to _ transmission
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Vertical (mother to child)
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HIV is cytotoxic to what type of cells? which immunity is lost?
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CD4 T cells
Loss of cell mediated immunity |
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Which protein is detected in ELISA test screen for HIV
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anti gp 120
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Which test confirms HIV
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Western blot
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Which cells are reservoir cells for HIV
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Follicular dendritic cells in lymph nodes
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Most common CNS fungal infection in AIDS
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Cryptococcosis
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Most common malignancy in AIDS
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Kaposis sarcoma
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Most common cause of blindness in AIDS
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CMV
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In hereditary angioedema there is defficiency of what?
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C1 esterase inhibitor
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Which protein exhibits apple green birefringence in polarized light
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Amyloid
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Which protein is associated with Alzheimers disease in Down syndrome
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Beta amyloid
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Major cation of extracellular fluid
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Na
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Major cation of intracellular fluid
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K
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Water movement between extracellular and intracellular fluid compartments is called? What is it controlled by?
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OSMOSIS - controlled by serum Na
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Formula for calculating serum Na
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Total body Na/ Total body water
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What is the sign of volume depletion
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Decreased total body Na
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In which conditions would you see increase in total body Na
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Pitting edema
Body cavity effusions |
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What happens to Na in isotonic loss or gain
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Serum Na normal
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What two signs describe hypotonic disorders
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Hyponatremia
ICF expansion |
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In which conditions would you see pitting edema
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Right sided heart failure
Cirrhosis Nephrotic syndrome |
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Which signs describe hypertonic disorders
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Hypernatremia or hyperglycemia
ICF conraction |
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What happens to Posm and Na in hyperglycemia
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Increased Posm
Decreased serum Na |
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What happens to K in alkalosis
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Shifts into cell
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What happens to K in acidosis
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Shifts out of cell
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Most common cause of hypokalemia
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Loop and thiazide diuretics
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What does ECG show in hypokalemia
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U wave
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Most common cause of hyperkalemia
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Renal failure
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What does ECG show in hyperkalemia
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Peaked T waves
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What does PaCO2 have to be to diagnose respiratory acidosis
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>45 mm Hg
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What does PaCO2 have to ne to diagnose respiratory alkalosis
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< 33 mmHg
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What happens in increased anion gap metabolic acidosis
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Anions of acid replace HCO3
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What happens in normal anion gap metabolic acidosis
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Cl anions replace HCO3
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What is the level of HCO3 have to be to diagnose metabolic acidosis
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< 22 mE/L
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Most common cause of metabolic alkalosis
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Loop and thiazide diuretics
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What does HCO3 have to be to diagnose metabolic alkalosis
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> 28 mEq/L
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With _ intoxication there is often mixture of primary metabolic acidosis and primary respiratory alkalosis
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SALICYLATE
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Excess fluid in interstitial space is called _
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EDEMA
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Protein poor and cell poor fluid is called _
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TRANSUDATE
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Protein rich and cell rich fluid is called _
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EXUDATE
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Is there transudate or exudate in pitting edema? What happens to hydrostatic and oncotic pressures?
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Transudate
Increased hydrostatic pressure Decreased oncotic pressure |
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Most common site for venous thrombosis
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Deep vein of lower extremity under knee
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Name anticoagulants that are used for prevention of venous thrombosis
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Warfarin and Heparin
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Prevents formation of arterial thrombi
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Aspirin
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How do you prevent mixed thrombus
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Aspirin + anticoagulant therapy
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Majority of pulmonary thromboembolism originate in _
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Femoral veins
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Majority of systemic embolisms originate in _
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Left side of the heart
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Most common cause for fat embolism
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Fracture of long bones
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Signs and symptoms of amniotic fluid embolism
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Abrupt onset dyspnea
Hypotension Bleeding (DIC) |
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What happens in decompression sickness
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Nitrogen gas bubbles occlude vessel lumens
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Two serious potential complications of scuba diving
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Pneumothorax and pulmonary embolism
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Most common cause of hypovolemic shock
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Blood loss
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Most common cause of cardiogenic shock
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acute MI
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What happens to cardiac output in hypovolemic shock? Cardiogenic shock? septic shock?
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Hypovolemic shock - decreased CO
Cardiogenic shock - decreased CO Septic shock - increased CO |
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What happens to left ventricular end-diastolic pressure in hypovolemic shock? cardiogenic shock? septic shock?
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Decreased in hypovolemic and septic shock, increased in cardiogenic shock
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What happens to peripheral vascular resistance in hypovolemic shock? cardiogenic shock? septic shock?
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Increased in cardiogenic and hypovolemic shock, decreased in septic shock
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Most common cause of death in shock
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Multiorgan failure
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What type of mutation occurs with sickle cell disease/trait
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Missense mutation
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With beta thalassemia major what type of mutation
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Nonsense mutation with stop codon
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In Tay Sachs disease what type of mutation
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Frameshift mutation
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Additional trinucleotide repeats increases disease severity in future generations - this is called _
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ANTICIPATION
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Most common type of mendelian disorder
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Autosomal recessive
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Both parents must have mutant gene - what type of inheritance
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Autosomal recessive
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Enzyme defficiencies disorders usually involve what type of inheritance
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AR
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In PKU what is increased and what is decreased
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Phenylalanine increased
Tyrosine decreased |
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What is defficient in Von Gierkes disease
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Glucose 6 phosphatase
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Most common AR disorder
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Hemochromatosis
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Heterozygotes with dominant mutant gene express disease - type of inheritance
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AD
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Individual with mutant gene doesnt express disease - this is called
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Reduced penetrance
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Most common AD disorder
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Von Willebrand disease
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Asymptomatic female carrier transmits mutant gene to 50% of sons - what type of inheritance
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XR
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Most common x linked disorder
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Fragile X syndrome
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In which x linked inheritance femaler carriers are symptomatic
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XD
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Number of Barr bodies?
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Number of chromosomes - 1
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Unequal separation of chromosomes in meiosis is called _
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Nondisjunction
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Nondisjunction of chromosomes in mitosis is called _
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Mosaicism
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Which chromosomal defect is present in cri du chat syndrome
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Deletion short arm chromosome 5
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Most cases of Down syndrome occur due to _
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Nondisjunction
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Most common genetic cause of mental retardation
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Down syndrome
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Most important risk factor for bearing offspring with trisomy syndromes
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Advanced maternal age
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45, x caryotype is present in which condition
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Turner syndrome
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Most common genetic cause of primary amenorrhea
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Turners syndrome
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"Menopause before menarche"
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Turners syndrome
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Which hormones are decreased and which are increased in Klinefelters syndrome
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Testosterone and inhibin decreased
LH and FSG increased |
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Which chromosome determines genetic sex of individual
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Y chromosome
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Most common cause of pseudohermaphroditism? What is defficient in this disease?
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Testicular feminization
Androgen receptors |
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Most common pathogen causing congenital infection
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CMV
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Name TORCH infections
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Toxoplasmosis
Other agents Rubella CMV Herpes simplex |
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Most common cause of stillbirth
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Abruptio placentae
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Common cause of spontaneous abortions
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Trisomy 16
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Most common cause for large for gestational age babies
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Maternal diabetes
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Most common cause of neonatal morbidity/mortality
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Prematurity
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Triple marker for Down syndrome
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Decreased AFP
Increased hCG Decrease in unconjugated urine |
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Most important preventable cause of disease and death in US
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Smoking
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Do women or men have less gastric alcohol dehydrogenase and therefore reach hight alcohol levels
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Women
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Most common cause of thiamine defficiency
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Alcohol abuse
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Increased anion gap metabolic acidosis is caused by _
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Lactic acid and beta-hydroxybutyric acid
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Most common systemic complication of intravenous drug use
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Hepatitis B
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Oral contraceptives decrease risk for which cancers
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Endometrial and ovarian
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Most common cause of hypertension in young woman
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Oral contraceptives
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Most common cause of death in burn victims
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sepsis caused by Pseudomonas
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Least sensitive tissue to radiation
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Bone
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First hematological sign of total body radiation
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Lymphopenia
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Most frequent type of cancer caused by radiation
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Acute leukemia
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Which UV light is most damaging and how
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UVB - increase in pyrimidine dimers distorts DNA helix
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Most common UVB related skin cancer
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Basal cell carcinoma
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Where does carbohydrate digestion begin
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Mouth
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Where does protein digestion begin
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Stomach
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Where does fat digestion begin
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Small intestine
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What is characteristic feature of kwashiorkor
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Pitting edema
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What is characteristic feature of marasmus
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Extreme muscle wasting
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Most common cause of death in anorexia nervosa
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Ventricular arrythmia
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What is the complication caused by vomitting in bulimia nervosa
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Hypokalemic metabolic alkalosis
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Which gene is usually defective in obesity
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Leptin gene
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First sign of vitamin A defficiency
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Night blindness
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Most common cause of vitamin D defficiency
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Renal failure
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Vitamin E toxicity causes _
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Decreased synthesis of vitamin K dependent coagulation factors
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Most common cause of vitamin K defficiency in hospital
|
Broad spectrum antibiotics
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Rat poison contains _ derivatives
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Coumarin
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People on corn based diets are defficient in _
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Tryptophan and niacin
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Three D's of pellagra
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Dermatitis
Diarrhea Dementia |
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Most common cause of vitamin B12 defficiency
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Perncious anemia
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Most common cause of folate defficiency
|
Alcohol abuse
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Defficiency of ascorbic acid is called _
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Scurvy
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Poor wound healing, poor taste and perioral rash are signs of what defficiency
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Zn
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Iodide defficiency results in _
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Multinodular goiter
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Benign tumors are of what origin
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Epithelial or connective tissue
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Tumor that has derivatives of ectoderm, endoderm and mesoderm is called_
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Teratoma
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Carcinomas derive from?
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Squamous
Glandular (adenocarcinoma) Transitional epithelium |
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Sarcoma derives from?
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Connective tissue
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Non neoplastic overgrowth of tissue is called _
|
Hamartoma
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Which cancer invades tissue but doesnt metastasize
|
Basal cell carcinoma of skin
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Which metastasis have greater prognostic significance - nodal or extranodal
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Extranodal (liver, etc)
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Name 3 routes of metastasis
|
Lymphatic
Hematogenic Seeding of body cavities |
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|
2 types of bone metastasis
|
Osteoblastic (radiodense)
Osteolytic (radioluscent) |
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|
Most common cause of cancer deaths in adults
|
Lung cancer
|
|
|
Precursor of squamous cell carcinoma
|
Actinic (solar) keratosis
|
|
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How can you reduce risk for developing gastric lymphoma and adenocarcinoma
|
Treat H pylori
|
|
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Most common type of mutation in cancer
|
Point mutation
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Which genes protect from unregulated cell growth? Which are involved in normal growth and repair?
|
Suppressor genes
Proto- oncogenes |
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What is the most effective host defense against cancer
|
Cytotoxic CD8 T cells
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|
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What is the most common cause of death in cancer
|
Gram negative sepsis
|
|
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What is the most common paraneoplastic syndrome
|
Hypercalcemia
|
|
|
Diet derived triglyceride
|
Chylomicron
|
|
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Liver derived triglyceride
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VLDL
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-transports cholesterol
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LDL
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|
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Removes cholesterol from plaques for disposal in the liver
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HDL
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|
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Pathognomonic lesion of atherosclerosis
|
Fibrous cap
|
|
|
Excellent marker of disrupted fibrous plaques
|
CRP
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|
|
Most common site for atherosclerosis
|
Abdominal aorta
|
|
|
2 conditions associated with hyaline arteriosclerosis
|
DM
Hypertension |
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Most common aneurysm in men>55 years of age
|
Abdominal aortic aneurysm
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|
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Rupture of aneurysm triad
|
Left flank pain
Hypotension Pulsatile mass |
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|
2 conditions of aortic arch aneurysm
|
Tertiary syphillis
Vasculitis of vasa vasorum |
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|
Most common cause of death in Marfan syndrome and EDS
|
Aortic dissection
|
|
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Most common cause of death with aortic dissection
|
Cardiac tamponade
|
|
|
Symptoms and signs of small vessel vasculitis
|
Palpable purpura
|
|
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Symptoms and signs of medium sized vessel vasculitis
|
Thrombosis
Aneurysm formation |
|
|
Most common type of hypertension
|
Essential hypertension
|
|
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Most common cause of secondary hypertension
|
Renovascular hypertension
|
|
|
Ventricular hypertrophy occurs due to_
|
Increased afterload or increased preload
|
|
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Pulmonary edema is seen in which heart failure
|
Left
|
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First cardiac sign of LHF
|
S3
|
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Increases intensity for left sided heart murmurs and abnormal heart sounds
|
Expiration
|
|
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Increases intensity of right sided heart murmurs and abnormal heart sounds
|
Inspiration
|
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Inrease in venous hydrostatic pressure occurs in which heart failure
|
Right
|
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|
Most common manifestation of CAD
|
Angina pectoris
|
|
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Subendocardial ischemia with ST segment depression is what type of angina
|
Stable
|
|
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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
|
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Serum ferritin is _ in ACD, iron overload disease
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Increased
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Serum iron is _ in iron defficiency, ACD
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Decreased
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Serum iron is _ in iron overload disease
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Increased
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If serum total iron binding capacity is decreased it means that transferin is _
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Decreased
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In microcytic anemia there is defect in _
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Synthesis of Hb (heme + globin chain)
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Iron defficiency most often caused by _
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Bleeding
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Most common anemia in hospitalized patients
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ACD - anemia of chronic disease
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With sideroblastic anemia there is defect in _
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Heme synthesis in mitochondria, ringed sideroblasts
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Most common cause of sideroblastic anemia
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Alcohol
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Most common cause of pyridoxine defficiency
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Isoniazid
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In lead poisoning where does lead deposit
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Epiphyses
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Most common cause of vitamin B12 defficiency
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Pernicious anemia
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Which drug inhibits intestinal conjugase
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Phenytoin
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Monoglutamate reabsorption is inhibited by _
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Alcohol and oral contraceptives
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Most common cause of folate defficiency
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Alcohol
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