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118 Cards in this Set
- Front
- Back
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recurrent sinusitis, bronchiectasis, male infertility
genetics? |
Kartagener(dynein microtubule defect)
autosomal recessive |
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Tuberous Sclerosis
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autosomal dominant
adenoma sebaceum SEIZURES mental retardation CNS hamartomas cardiac rhabdomyomas ash leaf spots renal angiomyolipoma |
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Friedrich's Ataxia
genetics and presentation |
Autosomal Recessive - trinucleotide(GAA) repeat in frataxin gene
spinal ataxia - staggering gait, hammer toes, etc. kyphoscoliosis in child |
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Neural input to adrenals
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one neuron -- ACh
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neural input to sweat glands
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2 neurons -- ACh
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20% ether is effective at destroying?
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enveloped viruses
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How do you destroy non-enveloped viruses
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boil in water 1 minute
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snRNP
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small nuclear ribonucleoproteins
participate in the formation of spliceosomes |
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what is the resistance of a vessel determined by?
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viscosity*length/radius^4
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how do you calculate flow in a blood vessel?
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change in pressure / Resistance
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pemphigus vulgaris
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IgG antibody vs desmosomes(anti-epithelial cell antibody)
"Nikolsky's Sign" positive -- skin peels off light rubbing |
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acantholysis
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loss of intercellular connections
a/w pemphigus vulgaris |
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bullous pemphigoid
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IgG antibody against HEMIdesmosomes(epidermal basement membrane..."bullow" the membrane)
eosinophils with tense blisters |
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spares oral mucosa
Nikolsky's sign? bullous pemphigoid vs pemphigus vulgaris |
bullous pemphigoid
negative |
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Dermatitis herpetiformis a/w
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celiac disease
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Deposits of IgA at tips of dermal papillae leading to pruritic papules and vesicles
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Dermatitis herpetiformis
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anti-desmoglein antibodies
Nikolsky sign? |
pemphigus vulgaris
positive |
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pemphigus vulgaris hypersensitivity
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Type II
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Calcium dependent adhesion molecules
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Cadherins
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Epithelial Junctions
types and associated protein |
Zona Occludens(tight) - claudins/occludins
Zona adherens - actin/cadherins Macula adherens(desmosome) - IMF/cadherins Hemidesmosome - integrins bind laminin in BM |
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sensory nerve to pinky area
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C8
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sensory nerve to deltoid area
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C4
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sensory nerve to middle finger area
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C7
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sensory nerve to thumb area
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C8
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sensory nerve to proximal arm(humerus) area
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C5
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draw brachial plexus
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draw
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long thoracic nerve innervates
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serratus anterior
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rotator cuff muscles
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SItS
Supraspinatus Infraspinatus teres minor Subscapularis |
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pudendal nerve landmark
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ischial spine
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lumbar puncture landmark
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iliac crest
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promotes migration and proliferation of smooth muscle cells into intima of blood vessels
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PDGF
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promotes migration of smooth muscle cells
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TGF-Beta
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men who engage in anal intercourse are at risk for urethritis by what organism?
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E. coli
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purulent, yellow-green urethral discharge from a male
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gonorrhea
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Describe process of Type IV hypersensitivity
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Dendritic cells process antigen and present it on MHC II receptors to Th1 cells which secrete IFN-gamma to recruit macrophages
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What cells produce factors that cause atheroma production?
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monocytes and platelets
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where are pericytes most populated in the vasculature?
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post capillary venules
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What antibiotic fights chlamydia?
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Azithromycin(Macrolide)
or Doxycycline(Tetracycline) |
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Alternative treatment for gonorrhea?
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Fluoroquinolone
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What type of hypersensitivity is granulomatous inflammation?
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Type IV
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What cytokine important for Type IV hypersensitivity?
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IFN-gamma released by Th1
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Octreotide
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Somatostatin analog
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What MOA does octreotide treat diarrhea?
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decreases secretions
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diphenoxylate
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opiate related to meperidine that reduces gastric motility
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Cri-du-chat syndrome
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5p deletion
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Paternal vs Maternal inheritance of Huntington's Disease
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Maternal inheritance will not exhibit anticipation. This is because the expansion of trinucleotide repeats occurs during spermatogenesis.
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neuraminidase cleaves what molecule?
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Sialic Acid
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What is necessary to be mindful of for nitrate administration
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tolerance development in repeated usage
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"Monday disease" or heart palpitations and flushing in an industrial worker
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Nitrate occupational exposure
Develops tolerance over the week and then upon rexposure experiences reflex symptoms to the vasodilatory effects of the nitrate. |
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Nitroglycerin MOA
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NO release in smooth muscle causing increase in cGMP.
Venodilatory |
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Phase 1 vs Phase 2 metabolism
old people lose what first? |
Phase 1 - P-450
Phase 2 - Glucuronidation, Acetylation, Sulfation(GAS) OLD PEOPLE HAVE GAS geriatrics lose Phase 1 |
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P-450 inducers
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Quinidine
Barbiturates St. John's Wart Phenytoin Rifampin Griseofulvin Carbamazepine Chronic Alcohol Use |
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P-450 inhibitors
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MAGIC RACKS
Macrolides Amiodarone Grapefruit Juice Isoniazid Cimetidine Ritonavir Acute Alcohol Abuse Ciprofloxacin Ketoconazole Sulfonamides |
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Carbamazepine
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Anti-epileptic for partial seizures
Mood stabilizer for bipolar disorder |
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Describe an instance of pharmacodynamic drug antagonism
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A non-selective beta blocker(labetalol, carvedilol) will block the effects of catecholamines by preventing them from binding
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What do you coadminister with nitrates?
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Beta blockers to try to prevent reflex tachycardia
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Marker for immunity vs Hep B
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Anti-HBsAg
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Window period of Hep B infection
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period between loss of HBs Ag in blood and appearance of Anti-HBsAg in bloodI
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IgM Anti-HBc
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important SPECIFIC marker for acute Hep B infection
Will be present during window period. |
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IgG Anti-HBc
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will be present in resolved infection as well as chronic infection but be ABSENT in vaccinated individuals.
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Marker of acute infection of Hepatitis A
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Anti-HAV IgM
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Chronic Obstructive Pulmonary Disease
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Emphysema
Chronic Bronchitis |
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Cystic fibrosis patients classically have what lung disorder
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COPD - bronchiectasis
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QRS complex corresponds to...?
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ventricular depolarization
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Which phases do anti-arrhythmics not work on?
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1 and 4
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Which class are K+ modulators anti-arrhythmics? What phase do they work on?
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Class III
Phase 3 |
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Which class are Ca+2 modulators anti-arrhythmics? What phase do they mostly work on?
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Class IV
Phase 2 |
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Ventricular repolarization correlates to what phase?
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Phase 0, the immediate incline
Phase 4 is the flat plateau before the next AP Phase 2 is the depolarized plateau. |
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What substance is neither secreted nor absorbed in kidney?
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Inulin
100% of inulin is excreted |
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What substance is almost completely excreted in kidneys?
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Paraaminohippuric Acid(PAH)
90% of filtered PAH is EXCRETED |
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What substance is almost completely reabsorbed in kidneys?
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Sodium
99% of filtered sodium is reabsorbed |
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Describe absorption/secretion of urea in kidney...
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About 55% of filtered urea is excreted
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GFR is dependent on what factors?
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oncotic pressure difference and hydrostatic pressure difference between Bowman's Capsule and Renal Arteriole.
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How does a bladder neck obstruction influence FF?
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It increases Bowman's Space Hydrostatic Pressure pushing fluid back into arteriole, thereby decreasing GFR.
Doesn't change RPF, so net decrease in FF |
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How does constriction of afferent arteriole change FF?
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It doesn't change FF
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How does dilation of efferent arteriole change FF?
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It decreases FF via increase in RPF and decrease in GFR(decreased renal capillary hydrostatic pressure)
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aseptic meningitis with oral ulcers on the back of the mouth
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coxsackie A
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Slow progression of hemiparesis, visual field defects(hemianopsia), cognitive impairment.
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JC Virus
progressive multifocal leukoencephalopathy |
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Infectious causes of Hydrops Fetalis
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CMV, Syphilis, Parvovirus B19
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Rheumatic heart disease - which valves affected?
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80% only mitral valve
20% mitral and aortic valve |
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endocarditis a/w colonic malignancy
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strep bovis
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endocarditis a/w genitourinary procedures
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e. faecium, faecalis
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What does anergy to cutaneously applied candida antigen imply?
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decreased cell-mediated immunity(T-cell dependent)
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Which hypersensitivity is associated with a decrease in complement?
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Type III
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fever, urticaria, arthralgias, glomerulonephritis, lymphadenopathy, low C3 serum level
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serum sickness - Type III hypersensitivity
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watershed stroke
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most common in ant/middle
presents with upper arm/leg weakness, higher order visual processing |
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Possible method of drug resistance by tumor cells
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ATP dependent pump similar to bacteria
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MDR1 is a protein expressed by cancer cells that provides drug resistance. A protein similar to MDR1 is normally expressed in what tissue?
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intestinal, renal tubular cells, and vessels of blood brain barrier.
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Why is carbidopa administered with levidopa?
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When levidopa is converted to dopamine in peripheral tissues, it activates nausea/vomiting centers.
Carbidopa is a DDCI(Dopamine decarboxylase inhibitor) and it inhibits production of dopamine(from L-DOPA) in peripheral tissues(Carbidopa can't cross BBB), but not the brain. |
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What electrolyte imbalance usually causes parasthesias?
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Calcium
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What kind of gene is VHL? What disease is it associated with?
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Tumor Suppressor
Renal Cell Carcinoma |
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Where does intron splicing occur?
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nucleus
also, 5' cap and poly A tail 5' cap occurs in two steps--GTP added then methylated |
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describe process of adding poly A tail
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recognition of AAUAAA sequence, cleavage few residues downstream, addition of 20-250 Adenosine residues
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describe process of adding 5' cap
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5' cap occurs in two steps--GTP added then methylated
guanylyltransferase and guanine-7-methyltransferase |
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muscle provides support for abdominal contents
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transversus abdominus - it is not attached to ribcage, so supporting the abdominal viscera doesn't interfere with breathing
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atrophy/demyelination of posterior column of spinal cord and medial roots
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Tabes Dorsalis -- Tertiary Syphilis
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lupus anticoagulant prolongues what?
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PTT
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How do ACE inhibitors predispose to Acute Renal Failure?
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In Renal Artery stenosis, Renal perfusion is maintained via efferent arteriole constriction by Angiotensin II.
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Increased Afterload
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Increases Aortic Pressure
Decreases Stroke Volume Increases End Systolic Volume |
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Increased Preload
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Increased Preload
Increases Stroke Volume |
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Increased Contractility
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Increased Contractility
Increases Stroke Volume Increases Ejection Fraction Decreases End Systolic Volume |
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Increased Preload
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Increased Contractility
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Increased Afterload
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Heart sound a/w atrial kick is a/w what?
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S4
a/w ventricular hypertrophy |
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Wide Splitting
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Pulmonic stenosis, right bundle branch block
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Fixed splitting
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ASD
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Paradoxical Splitting
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Aortic stenosis, left bundle branch block
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Tetralogy of Falot caused by
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Anterior Superior displacement of infundibular septum
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Transposition of great vessels caused by
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failure of aorticopulmonary septum to spiral
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Mental retardation, mousy odor, eczema
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Phenylketonuria
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Thrombocytopenia, Eczema, recurrent infections
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Wiskott-Aldrich Syndrome
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Von-Hippel Lindau triad
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hemangioblastomas, clear cell renal carcinomas, pheochromocytomas
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Presents in childhood with kyphoscoliosis
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Friedrich's Ataxia
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tennis elbow
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lateral epicondylitis
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golf elbow
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medial epicondylitis
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What predisposes to winged scapula?
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mastectomy
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what cell associated with bullous pemphigoid?
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eosinophils
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