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89 Cards in this Set
- Front
- Back
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Modification of proteins targeted for lysosomes |
Golgi body phosphotransferase enzyme phosphorylation of mannose residues |
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Where else condylomata acuminatum likes to affect besides GU |
true vocal cords -stratified squamous epithelium |
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Trigger for neoplastic change in HBV cirrhosis to hepatocellular carcinoma |
integration of the viral DNA into host genome -inhibits Insulin like growth factor -inhibits p53 |
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Cause of death in TCA OD |
inhibit reuptake of NE & serotonin -inhibit fast Na2+ channel conduction -> slow down myocardial depolarization -> arrythmia others -refractory hypotension resulting from decreased contractility and direct peripheral vasodialation |
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Cardiac tissue conduction velocity from fastest to slowest |
Perkinje system Atrial muscle ventricular muscle av node "park at venture avenue" |
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When is pulmonary vascular resistance lowest |
at FRC increased volume = increase peripheral vascular ressitance -longitudinal stretch of alveolar capillaries by expanding alveoli decreased volume = aslo = increased PVR -decreased radial traction from adjacent tissues on the large extraalveolar vessels - |
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Functions of angiotensin II |
1. systemic vasoconstriction 2. constriction of efferent arteriole 3. increased aldosterone secretion |
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cellular interactions that occur due to HbS glutamic acid for valine switch |
hydrophobic interactions (-) AA changed for neutral AA lead to aggregation of the molecules under low O2 conditions & RBC sickling |
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what does the empty can test, test? |
supraspinatus |
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On auscultation best indicator for the severity of mitral stenosis |
Length of time between A2 component of S2 (aortic valve closure) and the opening snap (OS) -due to abrupt tensing of mitral leaflets as left atrial pressure increases the A2-OS period shortens = more severe |
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varenicline |
partial agonist of the nicotinic receptor stimulated by smoking -leads to decreased withdrawl symptoms -less reward pathway stimulation |
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Silicosis on histology |
calcification of hilar lymph nodes (egg shell) birefringent silica particles surrounded by fibrosis |
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DOC in treatment resistant Schizophrenia |
Clonzapine |
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Histologic changes associated with chronic bronchitis |
-thickened bronchial walls -lymphocytic infiltrate -increased number of mucus cells (with increased mucus production) -patchy squamous metaplasia |
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wide fixed S2 split that does not vary with inspiration |
ASD |
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wiscott-aldrich syndrome |
1. eczema 2. recurrent infections 3. thrombocytopenia mutation on x chromosome - x linked -only affects males immunodeficiency = combined B and T cell |
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characteristics of cocaine withdrawal |
depression fatigue hypersomnia hyperphagia vivid dreams |
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babesiosis defining feature |
maltese cross on histology -tick born (ioxedes) |
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when to use NaHCO3 in TCA OD |
widened QRS ventricular arrythmia affects the cardiac fast Na channels |
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major side effect of trazodone |
priapism |
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when nitrate poisoning what part of the blood gas analysis will stay the same |
partial pressure of O2 is unchanged -also unchanged in CO poisoning, anemia & polycythemia |
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what is the nitroblue tetrazolium test for |
catalase + bugs |
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what is responsible for the green color of pus and sputum in bacterial infections |
myeloperioxidase made by neutrophils -heme based pigment -make hypochlorous acid from chloride and H202 for the burst |
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what bug is associated with reactive arthritis |
chlamydia |
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how does radiation therapy work |
1. DNA double strand breakage 2.ROS generation |
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Histological description of mesothelioma |
Endotheliod-type cells joined by desmosomes abundant tonofilaments studded with very long microvilli Presentation =hemorrhagic pleural effusion + pleural thickening |
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blood supply to the femoral head (cut off = necrosis in hip fractures) |
medial circumflex artery |
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a fib EKG |
irregularly irregular NO P WAVES |
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holiday heart syndrome |
a fib -precipitated by acute systemic illness or large EtOH indulgence |
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desmopressin use in bleeding disorders |
increased circulating factor VII or endothelial secretion of vWF to stop bleeding |
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cytokine involved in asthma |
eosinophillic bronchitis by activated eosinophils respond to allergen activated Th2 cells secreting IL-5 |
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artery damaged in a mid shaft humerus fracture |
deep brachial artery |
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chromosomal mutation that results in VHL |
deletion or mutation of VHL tumor supressor gene on chromosome 3p |
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where is c-myc located & what is it associated with |
chromosome 8 Burkitt Lymphoma Diffuse large B cell lymphoma |
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where is RB gene located and what is it associated with |
chromosome 13 retinoblastoma osteosarcoma |
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WT-1 gene is located where and what is it associated with |
chromosome 11 wilms tumor |
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what muscles displace the clavicle after fractured |
SCM - medial segment goes superior Pec major & gravity (arm) pull the lateral fragment inferior & anterior |
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thoracic outlet syndrome |
compresses brachial plexus, subclavian A and subclavian V. occurs in scalene triangle -anterior scalane -middle scalene -first rb |
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fendolopam |
short acting dopa 1 receptor agonist +adenylyl cyclase and increases cAMP = vasodialation of arterioles = decreased BP +renal vasodialation -> increased perfusion, diuresis and natriuresis this is used in pts in an hypertensive emergency with acute kidney injury |
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substances used to maintain capillary patency and normal blood flow |
Prostacyclin - inhibits platelet aggregation & vasodialates Thromboxane A2 - enhances platelet aggregation and vasoconstricts the two together keep vessels good |
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tryptase |
released by mast cells (specific) elevated levels used to determine anyphylaxis |
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neonate recieves no vaccines and has an intracranial bleed---why |
no vitamin K at birth |
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changes on spirometry due to obesity |
most common indication = reduced expiratory reserve volume --max amount blown out after normal tidal inhale decreased FRC is also noticed due to ERV reduction |
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most common organisms to affect someone with CGD |
Staph aureus Burkholderia cepacia serratia marcescens nocardia aspergillus |
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what you expect to see on histology after correcting microcytic hypochromic anemia with iron |
Reticulocytes:immature RBC -retain basophillic retwork of residual RNA -appear blue with wright giemsa stain -they mature within a day |
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classic presentation of legionella infection |
very high fever smoker diarrhea confusion cough |
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what lung syndrome has a normal capillary wedge pressure |
ARDS |
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histology changes of calcified aortic valve |
necrosis -> dystrophic calcification |
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what is lead time bias |
artificial increase in survival time among tested patients who actually have an unchanged prognosis -ie the disease was caught earlier than it would have been so they appear to live longer -common in screening tests |
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cilostazol |
phosphodiesterase inhibitor that stops platelet aggregation and acts as a direct arterial vasodialator -used in pts with PAD |
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clinical presentation of typhoid fever |
week 1: Rising fever, bacteremia, bradycardia week 2: abdominal pain & rose spots on trunk week 3: hepatosplenomegaly + GI bleeding, perforation |
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digoxin role in afib |
slows rate via enhancing vagal tone |
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uremic syndrome and bleeding |
uremic toxins from kidney failure impair platelet aggregation and adhesion = prolonged bleeding time PT and PTT are normal |
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what does bcl-2 do |
inhibits apoptosis of tumor cells -follicular lymphoma |
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permissiveness |
one hormone allows another to exert maximal effect example- cortisol primes vasculature so that NE will have a maximal vasoconstrictive effect |
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Jervell and Lange neilsen syndrome |
prologed QT AR accompanied with neurosensory deafness |
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what causes DIC in placental abruption |
tissue factor (thromboplastin) being released from the placenta |
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Trisomy 21 causes an increased risk of what blood born cancer |
acute lymphoblastic leukemia |
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transthyretin |
protein produced by the liver that carries thyroxine and retinol mutaions lead to amyoid protein and can be seen int he myocardium = infiltrative cardiomyopathy = diastolic heart failure due to decreased ventricular compliance |
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lab findings associated with diastolic heart failure |
increased LV end diastolic pressure normal LV end diastolic volume normal LV ejection fraction |
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Heart condition associated with diGeroge |
Tetrology of fallot interupted aortic arch |
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heart condition associated with freidreich ataxia |
hyprtropic cardiomyopathy |
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heart conditions associated with marfan syndrome |
cystic medial necrosis -aortic dissection -aneurism mitral valve prolapse |
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heart condition associated with tuberous sclerosis |
valvular obstruction due to cardiac rhabdomyoma |
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heart conditions associated with turner syndrome |
coarctation of aorta bicuspid aortic valve |
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heart conditions associated with downs |
endocardial cusion -ASD - ostium primum regurgantant valves |
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Elastin formation |
1.tropoelastin is made by mRNA 2. secreted into ECM 3.it interacts with microfibrils called fibrillin that function as the scaffold 4. lysyl oxidase (+ Cu2+) creates desmosine cross links |
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cystic medial degeneration |
fragmented elastic tissue (basket weave appearance) -described as myxomatous degenratoni with pooling of proteoglycans in the medial layer of arteries -associated with aortic aneurisms -associated with marfan syndrome |
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what is net filtration pressure calculatoin |
NFP = (Pc - Pi) - (Oc-Oi) |
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AD PKD presents |
in the 50-60s normal kidneys at birth |
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side effect of ethambutol |
TB drug = optic neuopathy |
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right vs left frontal lobe lesions |
right = disinhibition left = apathy |
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Dohle bodies |
basophillic peripheral granules (blue) in neutrophils -due to ribosomes bound to RER -seen in systemic toxic illnesses -burns -meylodysplasia |
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POL Gene mutation result in an HIV+ pt |
Pol gene mutations are responsible for changes in HIV proteases resulting in protease inhibitors POL gene can also cause mutations in structure of HIV-1 reverse transcriptases -resistance to standard NRTI's and NNRTI's |
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pathophysiology of hemochomatosis |
mutation in HFE protein -interacts with transferrin receptor that endocytoses the iron/transferrin complex -without it it makes the enterocytes and hepatocytes to think they have a falsely low iron content -> accumulation of iron in body 1. enterocytes increase apical expression of divalent metal transporter 1 (DMT1) 2. hepatocytes decrease hepcidin synthesis ---increase ferroportin on basolateral surface of enterocytes ---increased iron sercretion into circulation |
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transesophageal US faces ant and post - what is it looking at |
anterior = Left Atrium posterior = descending aorta |
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cytokine associated with giant cell arteritis |
IL-6 corolates with the severity of the disease drug that can be used is a monoclonal Ab against IL-6 -tocilizumab |
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lynch syndrome -gene mutation & cancers |
Gene: MSH2, MSH6, MLH1, PMS2 Cancers -colorectal -endometrial -ovarian AD causing inactivation of tumor supressors + second hit- loss of heterozygosity |
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Familial adenomatous polyposis -gene mutation & cancers |
APC Cancers -colorectal -desmoids & osteomas -brain tumors AD inactivatoin of tumor supressor +second hit - loss of heterzyogosity |
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Von-hipple lindeau syndrome -gene mutation & assocaited cancers |
VHL cancers -hemangioblastoma -clear cell renal carcinoma -pheochromocytoma AD inactivation of tumor supressor +second hit = loss of heterozygosity |
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Li Fraumeni syndrome -gene mutation & associated CA |
TP53 mutation Cancers -sarcoma -breast cancer -brain tumors -adrenocortical carcinoma -leukemia |
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MEN type 1 -gene mutation & associated cancers |
MEN1 cancers -parathyroid adenoma -pituitary adenoma -pancreatic adenoma AD - mutation inactivates tumor supressor -second hit = loss of heterozygosity |
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MEN type 2 -gene mutation & associated cancers |
RET cancers -Medullary thyroid cancer -pheocrhomocytoma -parathyroid hyperplasia AD - activating mutation (gain of function) ---> proto-onco gene -continuous stimulation of cell division promotes tumor growth |
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Gene mutation in pulmonary arterial hypertension |
inactivation of BMPR2 -AD -dysfunctional smooth muscle cell proliferation |
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type 1 muscle fiber composition |
high myoglobin (O2 stores) high mitochondrial (ETC) used for low level resistance like postural maintenance |
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renal ammoniagenesis |
acidosis stimulates this -renal tubular cells metabolize glutamin to glutamate -makes ammonium that can be excreted in urine & bicarb is reabsorbed |
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C1 inhibitor deficiency |
(C1INH) -prevents the C1 mediated cleavage of C2 and C4 -limits complement cascade also - inhibits kallikrien induced conversion of kininogen to bradykinin increased bradykinin -bradykinin associated angioedema |
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rituximab |
monoclonal antibody used in lymphoma that specifically targets cd20 |
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function of adding activated protein C to plasma |
change in PTT -causes an antithrombotic effect of protein C -resistance leads towards a mutation in factor V gene |
