USMLE12

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rere_girl4ever
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USMLE12
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2015-01-18 14:02:45
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  1. What is the Margination step in inflammatory leukocyte adhesion?
    • Neutrophils pushed to the periphery.
    • ↑Contact of neutrophils with endothelial lining.
  2. How do neutrophils roll?
    • Via the binding of Sialyl-Lewis X/ P-Selectin glycoprotein 1 (PSGL-1) to E-selectin and P-selectin
    • GlyCAM-1, CD34 to L-selectin
  3. What is the importance of Sialyl-Lewis X in leukocyte extravasion?
    • Margination and rolling
    • Via the binding of Sialyl-Lewis X/ P-Selectin glycoprotein 1 (PSGL-1) to E-selectin and P-selectin
  4. What is the importance of  P-Selectin glycoprotein 1 (PSGL-1) in leukocyte extravasion?
    • Margination and rolling
    • Via the binding of Sialyl-Lewis X/ P-Selectin glycoprotein 1 (PSGL-1) to E-selectin and P-selectin
  5. What is the importance of E/P/L-selectin in leukocyte extravasion?
    • Margination and rolling
    • Via the binding of Sialyl-Lewis X/ P-Selectin glycoprotein 1 (PSGL-1) to E-selectin and P-selectin.
    • GlyCAM-1, CD34 to L-selectin
  6. What is the importance of GlyCAM-1 in leukocyte extravasion?
    • Margination and rolling
    • Via the binding of Sialyl-Lewis X/ P-Selectin glycoprotein 1 (PSGL-1) to E-selectin and P-selectin.
    • GlyCAM-1, CD34 to L-selectin.
  7. What is the importance of CD34 in leukocyte extravasion?
    • Margination and rolling
    • GlyCAM-1, CD34 to L-selectin.
  8. How does tight binding occur in leukocyte extravasation?
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
    • VCAM-1 (CD106) to VLA-4 integrin
  9. What is the importance of CD54 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  10. What is the importance of ICAM-1 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  11. What is the importance of CD11 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  12. What is the importance of CD18 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  13. What is the importance of LFA-1 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  14. What is the importance of Mac-1 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  15. What is the importance of ICAM-1 in leukocyte extravasion?
    • Tight-binding
    • ICAM-1 (CD54) to CD11/18 integrins (LFA-1, Mac-1)
  16. What is the importance of VCAM-1 in leukocyte extravasion?
    • Tight binding
    • VCAM-1 (CD106) to VLA-4 integrin
  17. What is the importance of CD106 in leukocyte extravasion?
    • Tight binding
    • VCAM-1 (CD106) to VLA-4 integrin
  18. What is the importance of VLA-4 integrin in leukocyte extravasion?
    • Tight binding
    • VCAM-1 (CD106) to VLA-4 integrin
  19. What is the importance of PECAM-1 in leukocyte extravasion?
    • Transmigration/ Diapedesis
    • PECAM-1 (CD31) to PECAM-1 (CD31)
  20. What is the importance of CD31 in leukocyte extravasion?
    • Transmigration/ Diapedesis
    • PECAM-1 (CD31) to PECAM-1 (CD31)
  21. What is Diapedesis/ Transmigration in leukocyte extravasion? How does it occur?
    • Transmigration/ Diapedesis - WBCs travel between endothelial cells and exist blood cells.
    • PECAM-1 (CD31) to PECAM-1 (CD31)

  22. What is Leukocyte adhesion deficiency type 1?
    • Defect in LFA-1 (Leukocyte function associated antigen) integrin (CD18) on phagocytes.
    • Impaired Tight adhesion.
    • Absent pus formation
    • Delayed separation of umbilical cord
    • Impaired wound healing
  23. How do we calculate net filtration pressure?
    Hydrostatic pressure gradient (Pc-Pi)- (πc - πi) Oncotic pressure gradient
  24. Describe the nondisjunction seen the restriction fragment length polymorphysm analysis.
    • Maternal Meiotis I
  25. Describe the nondisjunction seen the restriction fragment length polymorphysm analysis.
    • Maternal Meiosis II
  26. Describe the nondisjunction seen the restriction fragment length polymorphysm analysis.
    • Paternal meiosis I
  27. Describe the nondisjunction seen the restriction fragment length polymorphysm analysis.
    • Paternal meiosis II
  28. Describe the pathophysiology of addison's disease.
    • Adrenal atrophy/ destruction (autoimmune, TB, metastasis)
    • Deficiency of aldosterone and cortisol production. 
    • Loss of cortisols negative feedback on pituitary leads to increased ACTH and MSH.
    • Decreased aldosterone results in ↓Na+ reabsorption, ↓K+ and H+ excretion and a compensatory ↑ in Cl- retention.
  29. What are the toxicities caused by the use of lithium?
    • Tremors, ataxia, twitching, neuromuscular agitation.
    • Polyuria (causes nephrogenic DI)
    • Ebstein anomaly
  30. Which drugs are contraindicated in the use of lithium?
    • Most Lithium is reabsorbed at PCT with Na+
    • 1. Thiazides- work in DCT and impair Na+ reabsorption. Kidney tries to compensate by ↑
    • Na+ reabsorption in PCT.
    • 2.ACE inhibitors
    • 3.NSAIDS
  31. What happens if there is a mutation in a splice site?
    • Results in the production of larger proteins (↑amino acid residues) that are nonfunctional but have preserved immune reactivity (binding to antibodies)
    • Only exons contain proper base pairs in correct order that will result in functional protein.
  32. What is the enzyme deficient in Cori disease?
    Deficiency of debranching enzyme (alpha 1,6-glucosidase)
  33. Describe the findings in Cori disease.
    • Alpha 1 -6 glucosidic branch points cannot be degraded, so small chain dextrin-like material accumulates within cytosol of hepatocytes.
    • Hypoglycemia
    • Hypertriglyceridemia
    • Ketoacidosis
    • Hepatomegaly
  34. What is the function of the Accessory nerve? Which muscles does it innervate?
    • Head turning, shoulder shrugging
    • Innervates the Sternocleidomastoid and Trapezius.
  35. Patient faints during the procedure of ear examination. What nerve causes this?
    • Vasovagal syncopial episode
    • Temporary loss of consciousness/ fainting. Results from stimulation of vagus nerve, leads to decrease in blood pressure and heart rate.
  36. Salmon-colored rose spots on abdomen are characteristic of?
    Salmonella typhi
  37. How does Salmonella penetrate the gut mucosa?
    Via transporters on enterocytes and via phagocytosis by M cells in Peyers patches.

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