forgetful4

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docdee
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forgetful4
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2012-11-26 12:37:10
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  1. ulcer in the proximal duodenal vs. distal duodenum
    peptic ulcer vs. gastrinoma
  2. mutations in B-thalessemia
    change protein mRNA processing leading to deficiency in protein chains
  3. histology of utricaria
    • superficial dermal edema and lymphatic channel dilation
    • no epidermal problems

    (spongiosis = intercellular epidermal edema)
  4. how do TCAs cause cardiotoxicity compared to seizures/tremors?
    • inhibition of Na+ channels
    • prevents reuptake of NE and 5HT
  5. Bursitis from repeated kneeling
    prepatellar bursa
  6. bursitis along the medial side of the knee
    • anserine bursa
    • seen in athletes and patients with heavy body habitus
  7. repair of dsDNA breaks occurs after what damage
    ionizing radiation via non-homologous end joining

    * mutated in ataxia telangiectasias*
  8. Stage of lobar pneumonia that contains vascular dilation, and alveolar exudate contains mostly bacteria
    • congestion
    • (first 24 hours)
  9. stage of lobar pneumonia with enzymatic digestion of the exudate
    • resolution
    • restoration of normal architecture
  10. myxomatous changes in the arteries predisposes to what conditions?
    • mitral valve prolapse
    • cystic medial degeneration --> aortic dissections and aneurysms
  11. how does HBV cause hepatocellular Ca?
    • integration of viral DNA into the host genome of host hepatocytes
    • HBV also suppresses p53 genes
  12. mechanism of pancytopenia in SLE 
    • autoAb formed against blood cells
    • Type II HS
  13. 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
  14. characteristics of Legionella pneumonia (seen in cruise ship/hotel stay patients)
    • neuro: headaches and confusion
    • watery diarrhea
    • higy fever and bradycardia
    • hyponatremia
    • gram stain will show neutrophils but no organisms
  15. 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
  16. 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
  17. 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
  18. how do patients with essential fructosuria metabolize fructose?
    • from fructose to fructose-6-P via hexokinase
    • not imp in normal individuals
  19. Structure responsible for the morbidity and mortality associated with Neiss. meningitis?
    • outer membrane lipo-polysaccharide (LOS)
    • not the capsule
  20. 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
  21. virulence mechanism of S.epidermitis?
    • biofilm production
    • (synthesis of extracellular polysaccharide matrix)
  22. 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.
  23. 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)
    • rickets
  24. nasal ulcers and hematuria
    wegener's
  25. halothane-induced hepatitis
    • prolonged thrombin time
    • elevated aminotransferase levels (normal AST and ALT)
    • eosinophilia 
  26. 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)
  27. when a number of abnormalities result from the same defect (e.g. Potter's syndrome from oligohydramnios)
    sequence
  28. toxicity of valproate?
    toxicity of phenobarbital?
    toxicity of lamotrigine?
    • hepatotoxicity
    • precipitates acute intermittent porphyria
    • H.S. skin rash (steven-johnson)
  29. 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)
  30. how does elastin differ from collagen?
    • does not form a triple helix like collagen
    • no modifications
    • cross-linking done by lysyl hydroxylase
  31. drug that develops an arrythymia on re-perfusion with arterial re-opening
    tPA
  32. paraneoplastic syndrome associated with neuroblastoma
    • opsoclonus-myoclonus
    • associated with increased # of N-myc genes
  33. BPH can cause reflux nephropathy (kidney damage). how?
    due to increased pressure in the urinary tract
  34. what classifies a lymph node as malignant?
    • monoclonal gene rearrangement
    • polyclonal associated with lymphoid hyperplasia
  35. brief myocardial ischemic episodes reversed by reperfusion 

    hibernating myocardium
    • 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
  36. myelination does what to length and time constant
    • increases length (space) constant
    • decreases time constant
  37. SVC syndrome = u/l or b/l
    • b/l symptoms 
    • fusion of brachiocephalic veins
  38. cryptochoridism decreases inhibin or FSH
    inhibin (Sertoli cells are damaged)
  39. 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
  40. 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
  41. Ca+2 channel blocker contraindicated in CHF
    • verapamil 
    • negative ionotropic effects
  42. Test used for interval data only
    Test used for combination of interval and nominal data
    • pearson correlation
    • t-test/ANOVA
  43. live attenuated vaccines have what cell markers?
    • cell-mediated immunity
    • Th1 --> IL-2 which activates cytotoxic effects (CD8)
  44. 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
  45. widespread neuronal loss and gliosis in subcortical areas
    • progressive supranuclear palsy
    • extrapyrimidal sx with dystonias of the neck and paralysis of downward gaze
  46. which cytokine can inhibit contact dermatitis?
    • IL-10
    • inhibits Th1 cells, which inhibits cell-mediated immunity (Type IV H.S. rxn)
  47. 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

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