USMLE3

• Alveolar collapse due to deficiency in type II pneumocytes.
• Decreased in pulmonary surfactant -> Decreased surface tension -> alveolar collapse
• Seen in neonatal respiratory distress syndrome

• Atelectasis- alveolar collapse due to decreased surface tension
• Seen in neonatal respiratory distress syndrome

• 1. Mucosa
• 2. Submucosa
• 3. Muscularis
• May contain ectopic acid- secreting gastric mucosa and/or pancreatic tissue.
• Ectopic acid can cause ulceration of adjacent mucosa and lower GI bleeding.

• 1. Mucosa
• 2. Submucosa

• Meckel's diverticulum
• a.k.a vitelline duct

Chédiak-Higashi syndrome

Chédiak-Higashi syndrome

Chédiak-Higashi syndrome

Chédiak-Higashi syndrome

• Recurrent pyogenic infections by staphylococci and streptococci- skin, respiratory
• Albinism- light skin, silvery hair
• Peripheral neuropathy
• Progressive neurodegeneration- nystagmus

• Mitochonrdrially inherited diseases which may be expressed differently.
• Presence of both normal and inherited mtDNA.

• Mitochondrial myopathies
• Present with myopathy, lactic acidosis and CNS disease.
• Secondary to failure in oxidative phosphorylation.
• Muscle biopsy often shows “ragged red fibers.”
• HETEROPLASMY-  Variable expression in mitochondrially inherited disease.

• 1 = Abdominal Aorta
• 2 = Duodenum
• 3 = Gallbladder
• 4 = Head of Pancreas
• 5 = Inferior Vena Cava
• 6 = Left Kidney
• 7 = Left Renal Vein
• 8 = Liver
• 9 = Psoas Muscle
• 10 = Right Kidney
• 11 = Stomach
• 12 = Superior Mesenteric Artery
• 13 = Tail of Pancreas
• 14 = Transverse Colon

Erector spinae muscle

• Echinococcus granulosus- cestodes (tapeworms)
• Hydatid cysts in liver- causing anaphylaxis if antigens released.

• Compares the exposure of people to the disease (cases) to the exposure of people without the disease (control).
• Measured by ODDS RATIO:  Odds that the group with the disease was exposed to risk factor/ ordds that group without the disease were exposed.

• 1. FSH stimulates follicle to form in ovary.
• 2. FSH stimulates estrogen production from ovaries.
• 3. Increased estrogen stimulates LH.
• 4. LH causes ovulation.
• 5. Progesterone production increase with formation of corpus luteum.
• 6. Progesterone maintains endometrium to allow for implantation.
• 

• Handgrip increases afterload
• So it increases the intensity of backflowing murmurs: MR, AR, VSD
• It decreases the intensity of hypertrophic cardiomyopathy murmur (any maneuver that increases preload/afterload decreases this type of murmur because increased LV by these parameters reduce the LV outflow tract obstruction)

• D- complement binding (located on Fc portion, closer to hinge region)
• A&B- hypervariable regions of Fab (antigen binding fragment)
• E- macrophage binding

• AChE inhibitor
• Alzheimers disease

• NMDA receptor antagonist; helps prevent excitiotoxicity (mediated by Ca2+)
• Alzheimer's disease

• Mood stabilizing agents: 
• Lithium
• Valporate
• Carbamazepine
• + Atypical antipsychoitc

• Increase NE and dopamine
• Depression and Smoking addiction

• Maculopapular rash that resolves in 3-5 days.
• Spreads from head -> Trunk -> extremities.
• Occipital/ postauricular lymphadenopathy.

• Fever
• Sore throat
• Diffuse erythematous rash with numerous small papules "sandpaper-like"
• S.pyogenes (group
• A)

HSV-6/ HSV-7

High fever that lasts for 3-5 days, which resolves following the appearance of a maculopapular rash/ diffuse macular rash that starts on the trunk and spreads peripherally.

Roseola

Rubella

Erythema infectiosum (fifth disease)

• Scarlet fever
• S.pyogenes

• Bleeding (in ventricle) usually originates from the germinal matrix whcih is  highly vascularized and where neurons and glial cells migrate out during brain development.
• 

• Subdural hematoma
• 

Rupture of bridging veins.

• Normal tissues/ cells found in an abnormal loaction due to embryonic maldevelopment.
• Meckel diverticulum-  ectopic acid secreting gastric mucosa and/ or pancreatic tissue

• Decrease in number of cells resulting in decreased volume/ size of organ.
• e.g. Renal hypoplasia.

Increase in number of cells.

Increase in size of cells.

Replacement of one cell type by another.

• Abnormal growth with loss of cellular orientation, shape and size in comparison to normal tissue maturation. 
• Commonly preneoplastic.

• Innervated by group 1b sensory axons.
• Maintains MUSCLE TENSION- When a muscle exerts too much force, the golgi tendon organs inhibit contraction of the muscle, causing sudden muscle relaxation.
• Note: THEY ARE INSENSITIVE TO MUSCLE STRETCH!

• Fast, myelinated fibers whose free nerve endings detect temperature and nociceptive (pain) stimuli.
• Associated with acute (sharp) pain that mediates reflex withdrawal from a noxiois stimuli (e.g retracting hand away from hot stove)

Free nerve endings- A-delta

• Innervated by group Ia and group II sensory axons.
• Sensitive to changes in muscle length (resists muscle stretch)

• Open K+ channels: INCREASING K+ EFFLUX
• Close Ca2+ channels: DECREASE Ca2+ INFLUX

Part of the exposure-disease relationship can be explained by another variable.

• UGA
• UAA
• UAG
• They DO NOT code for amino acids.
• Releasing factors stimulate release of the formed polypeptide chain from the ribosome and dissociated from the ribosome-mRNA complex

Splicing- removes introns from pre-mRNA/ hnRNA

Recognize stop codons (UGA, UAA, UAG) to terminate protein synthesis.

Facilitates tRNA binding and translocation.

S.sanguinis makes dextrans, which bind to fibrin-platelet aggregates on damaged heart valves.

• Hydatid cyst in liver (can cause anaphylaxis if antigens released).
• Echinococcus granulosus- ingestion of eggs from dog faeces. Sheep are intermediate host.
• Tx: Abendazole

• Anaphylaxis if antigens released.
• Hydatid cyst injected with ethanol or hypertonic saline to kill daughter cysts before removal.

Released by eosinophils to kill helminths. Also contribute to bronchial epithelial damage in atopic asthma.

• Heparin (anticoagulant)
• Histamine (vasodilator)
• Leukotreines

• 1. Pseudostratified columnar ciliated epithelium
• 2. Goblet cells
• 3. Submucosal mucoserous glands
• 4. Cartilage

• Trachea + Bronchi
• Goblet cells and cartilage extend to end of bronchi

• Trachea + Bronchi
• Goblet cells and cartilage extend to the end of bronchi

• 1. Pseudostratified ciliated columnar epithelium
• 2. Smooth muscle

• 1. Ciliated simple cuboidal cells
• 2. Smooth muscle

• Trachea + Bronchi + Bronchioles
• They extend to the beginning of the terminal bronchioles, then transition to cuboidal cells

Trachea + Bronchi + Bronchioles + Terminal bronchioles

• Fever
• Hepatospenomegaly
• Pharyngitis
• Posterior cervical lymphadenopathy
• Caused by EBV (+Monospot) and CMV

• Mononucleosis
• Posterior cervical lymphadenopathy, fever, pharyngitis, hepatosplenomegaly

• Atypical lymphocytes- reactive cytotoxic T cells (CD8)
• Mononucleosis- EBV

CD14- on macrophages.

Less than a month

1-6 months

lasting> 2 weeks

More than 6 months.

Unique, false beliefs about oneself or others that persist despite the facts.

• Desmosine crosslinking involving lysine.
• The crosslinking is accomplised by the action of lysl hydroxylase.

C8-T1

• Sensory innervation to the fifth digit and the medial half of the fourth digit (palmar and dorsal surfaces)
• 

Ulnar nerve

Ulnar nerve

• Fracutre of medial epicondyle of humerus
• Fracure of hook of hamate
• Gyuon's canal

• Ulnar nerve
• 

• Median nerve
• Difficulty in fine motor control of thumb.
• 

• Axillary nerve
• Fractured surgical neck of humerus
• Anterior dislocation of humerus
• 

• Axillary nerve
• Fracture of surgical neck of humerus
• Anterior dislocation of humerus
• 

• Fracture of surgical neck of humerus
• Anterior dislocation of humerus

Axillary

• 1. Flattened deltoid
• 2. Loss of arm abduction at shoulder
• 3. Less of sensation over deltoid muscle and upper lateral arm

• The patient consumes C-labeled urea and his breath is then monitored for the presence of C-labeled carbon dioxide, which would indicate the presence of H.pylori product urease in the stomach.
• Used in DUODENAL ULCERS

• Inhibit maternal folate absorption
• Neural tube defects: Spina bifida, Meningocele, Meningomyelocele

• Turner syndrome
• Bicuspid aortic valve
• Aortic narrowing near insertion of ductus arteriosus
• 

Coarctation of the aorta.

• Bilious vomiting- usually 1st day of life
• Proximal stomach distention (double-bubble)
• Associated with Down Syndrome

• Duodenal atresia
• Double bubble - proximal stomach dilation

Duodenal atresia

Failure of small bowel recanalization.

Pulmonary hypoplasia

• ARPKD
• Obstructive uropathy e.g. Posterior urethral valves
• Bilateral renal agenesis

• Characterized by "atrialized right ventricle" because of a downward displacement of the tricuspid valve.
• Associated with the use of lithium during pregnancy.

• Edwards syndrome (trisomy 18)
• Pataus syndrome (trisomy 13)