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ulcer in the proximal duodenal vs. distal duodenum
peptic ulcer vs. gastrinoma
mutations in B-thalessemia
change protein mRNA processing leading to deficiency in protein chains
histology of utricaria
- superficial dermal edema and lymphatic channel dilation
- no epidermal problems
(spongiosis = intercellular epidermal edema)
how do TCAs cause cardiotoxicity compared to seizures/tremors?
- inhibition of Na+ channels
- prevents reuptake of NE and 5HT
Bursitis from repeated kneeling
bursitis along the medial side of the knee
- anserine bursa
- seen in athletes and patients with heavy body habitus
repair of dsDNA breaks occurs after what damage
ionizing radiation via non-homologous end joining
* mutated in ataxia telangiectasias*
Stage of lobar pneumonia that contains vascular dilation, and alveolar exudate contains mostly bacteria
- (first 24 hours)
stage of lobar pneumonia with enzymatic digestion of the exudate
- restoration of normal architecture
myxomatous changes in the arteries predisposes to what conditions?
- mitral valve prolapse
- cystic medial degeneration --> aortic dissections and aneurysms
how does HBV cause hepatocellular Ca?
- integration of viral DNA into the host genome of host hepatocytes
- HBV also suppresses p53 genes
mechanism of pancytopenia in SLE
- autoAb formed against blood cells
- Type II HS
sickling conditions that cause Hb aggregation?
- decreased oxygen to bind to Hb (oxygen unloading)
- increased 2,3BPG
- low pH (e.g. altitudes)
deoxygenated HbS polymerizes causing anemia and veno-occlusive crisis
characteristics of Legionella pneumonia (seen in cruise ship/hotel stay patients)
- neuro: headaches and confusion
- watery diarrhea
- higy fever and bradycardia
- gram stain will show neutrophils but no organisms
10-year old child presenting with toe cyanosis and clubbing but no finger abnormalities
patent DA that has become Eisenmenger's sydrome
coarctation of the aorta causes cyanosis in infants, but not children/adults
how can a tumor producing B-hCG cause hyperthyroidism?
- has the same a-subunit structure as TSH, LH, and FSH
- can bind to the TSH receptor
Treatment for mucormycosis and adverse affects
- amphotericin B
- hypokalemia and hypomagnesiumia
- nephrotoxicity: renal vasoconstriction and reduction in GFR
- can also cause acute tubular necrosis
- Aortic root dilation
- seen with AR
how do patients with essential fructosuria metabolize fructose?
- from fructose to fructose-6-P via hexokinase
- not imp in normal individuals
Structure responsible for the morbidity and mortality associated with Neiss. meningitis?
- outer membrane lipo-polysaccharide (LOS)
- not the capsule
Pathway of N. meningitis
pharynx - invades mucosal epithelium and gains access to the bloodstream. from blood, spreads to choroid plexus and gains access to the CNS via BBB
virulence mechanism of S.epidermitis?
- biofilm production
- (synthesis of extracellular polysaccharide matrix)
adverse effects of longer-acting benzos (flurazepam, diazepam)
- greater sedation
- less withdrawal (slow clearance, low risk of physical dependance)
short acting: less sedation, rapid clearance, more withdrawal sx.
Classic presentation of primary biliary cirrhosis
female with long hx of pruritis and fatigue and now cholestasis (develops pale stools and xanthelesmas)
- bony prominence at costochondral junctions (rosary chest)
nasal ulcers and hematuria
- prolonged thrombin time
- elevated aminotransferase levels (normal AST and ALT)
active and passive processes of bilirubin uptake by the liver?
- passive: bilirubin uptake from the blood
- active: bilirubin secretion into the gut (when conjugated bilirubin exit is inhibited, bilirubin comes out in the urine and less is sent to the GI tract)
when a number of abnormalities result from the same defect (e.g. Potter's syndrome from oligohydramnios)
toxicity of valproate?
toxicity of phenobarbital?
toxicity of lamotrigine?
- precipitates acute intermittent porphyria
- H.S. skin rash (steven-johnson)
interferons that are virus-specific and how do they work?
- interferons a and B
- act as cytokines, stimulating them to inhibit viral protein synthesis
(IFN-gamma is used for T and NK cells)
how does elastin differ from collagen?
- does not form a triple helix like collagen
- no modifications
- cross-linking done by lysyl hydroxylase
drug that develops an arrythymia on re-perfusion with arterial re-opening
paraneoplastic syndrome associated with neuroblastoma
- associated with increased # of N-myc genes
BPH can cause reflux nephropathy (kidney damage). how?
due to increased pressure in the urinary tract
what classifies a lymph node as malignant?
- monoclonal gene rearrangement
- polyclonal associated with lymphoid hyperplasia
brief myocardial ischemic episodes reversed by reperfusion
- myocardial stunning:
- reversible loss of contractile function
- (full recovery within hours-days)
repetitive ischemia of cardiac myocytes or persistent hypoperfusion of myocytes = chronic but reversible loss of contraction
myelination does what to length and time constant
- increases length (space) constant
- decreases time constant
SVC syndrome = u/l or b/l
- b/l symptoms
- fusion of brachiocephalic veins
cryptochoridism decreases inhibin or FSH
inhibin (Sertoli cells are damaged)
2 phases of Hepatitis B infection
1. proliferative: HbsAg and HbcAg are expressed along with MHC-I = activates the CD8 T cells, which destroy the infected hepatocytes (virus has no direct cytotoxic affect)
2. integrative: those cells that survive invade the host genome. Infectivity and liver damage decreases, risk of HCC remains
fetal adrenal cortex cannot produce B-hydroxysteroid dehydrogenase and only makes DHEA. what is inhibited?
production of glucocorticoid and mineralocorticoid precursors (progesterone) from pregnelone
made into androgens and estrogens by placental tissue
Ca+2 channel blocker contraindicated in CHF
- negative ionotropic effects
Test used for interval data only
Test used for combination of interval and nominal data
- pearson correlation
live attenuated vaccines have what cell markers?
- cell-mediated immunity
- Th1 --> IL-2 which activates cytotoxic effects (CD8)
blowout fracture of the eye causes damage to what sinus?
- maxillary (floor of the orbit = roof of the maxillary sinus)
- blood drains from the sinus into the nasal cavity
widespread neuronal loss and gliosis in subcortical areas
- progressive supranuclear palsy
- extrapyrimidal sx with dystonias of the neck and paralysis of downward gaze
which cytokine can inhibit contact dermatitis?
- inhibits Th1 cells, which inhibits cell-mediated immunity (Type IV H.S. rxn)
mechanism contributing to muscle length during patellar reflex?
- muscle length stretch detected by spindle afferents (attached to intrafusal fibres)
- afferents synapse and activate the a-motor neurons that activate the muscle
- contraction initiated
* golgi tendon responsible for muscle tension - involved in fine control movement and control of posture