Board Review Day 14

Front 1

Calcium Pyrophosphate Crystals

Back 1

Rhomboid Crystals with Positive Birefringence

pseudogout aka Calcium Pyrophosphate Depsoition Dz CPDD:

NB: usually presents Knee >> Foot

Tx: NSAIDs [Steroids, & Colchecine]

Front 2

NF- κB

Back 2

transcription factor which induces cytokine prodxn in response to microbial infx

Hint 2

#immunology #molecules

Front 3

NOD2

Back 3

[Nucleotide Binding Oligomerization Domain]

intracellular microbial receptor which which triggers NF- κB transcription factor → cyokine prodxn

Hint 3

#immunology #molecules

Front 4

Pseudogout

Back 4

aka Calcium Pyrophosphate Depsoition Dz CPDD:

Inflammed Knee, aspirate of PMNs + Rhomboid Crystals with Positive Birefringence

NB: usually presents Knee >> Foot

Tx: NSAIDs [Steroids, & Colchecine]

Front 5

Galactosyl β-1,4 - glucose

Back 5

aka Lactose

Hint 5

#biochemistry #molecules

Front 6

↑ pH ↑ HCO3 ↑ pCO2
↓ Urinary Cloride, Hypovolemic

Back 6

Saline Responsive Metabolic Alkalosis

3 Causes of Metabolic Alkalosis

1. "Saline Responsive" 2° to loss of Gastric Contents (vomitting) + volume contraxn → maintain HCO3 to retain volume
↓ Urine Chloride, Volume Depleted
Tx: Normal Saline

2. "Contraction Alkalosis" Diuretic → Na delivered to distal collecting duct → Na/H+ antiporter
↑ Urine Chloride, Volume Depleted

3. "Saline Resistant" Conn Sro or Mineralcorticoid Excess: Aldosterone upregulates Na/H+ antiporter
↑ Urine Chloride, Hypervolemic

Front 7

Thalamic Nuclei

Back 7

VPL
--incoming from Spinothalamic (pain & temp) tract and Medial Lemniscus (position, proprioception),
---relays to Somatosensory Cortex (Brodman's areas 1-3)

VPM Ventral Posteromedial Nucleus
---incoming from Trigeminal & Gustatory pathways
---relays to same

Lateral Geniculate
--Relay for Vision

Medial Geniculate: relay for audition
--input from superior olivary nucleus & inferior colliculus

NB: smell not relayed through thalamus

Hint 7

#neurology #cns #anatomy

Front 8

↑ pH ↑ HCO3 ↑ pCO2
↑ Urinary Cloride, Hypovolemic

Back 8

Contraction Alkalosis

3 Causes of Metabolic Alkalosis

1. "Saline Responsive" 2° to loss of Gastric Contents (vomitting) + volume contraxn → maintain HCO3 to retain volume
↓ Urine Chloride, Volume Depleted
Tx: Normal Saline

2. "Contraction Alkalosis" Diuretic → Na delivered to distal collecting duct → Na/H+ antiporter
↑ Urine Chloride, Volume Depleted

3. "Saline Resistant" Conn Sro or Mineralcorticoid Excess: Aldosterone upregulates Na/H+ antiporter
↑ Urine Chloride, Hypervolemic

Front 9

VPL Nucleus

Back 9

Thalamic Nucleus

--incoming from Spinothalamic (pain & temp) tract and Medial Lemniscus (position, proprioception),
---relays to Somatosensory Cortex (Brodman's areas 1-3)

NB: does not relay face/pharynx that is VPM

Hint 9

#neurology #cns #anatomy

Front 10

↑ pH ↑ HCO3 ↑ pCO2
↑ Urinary Cloride, Hypervolemic

Back 10

Saline Resistant Metabolic Alkalosis

3 Causes of Metabolic Alkalosis

1. "Saline Responsive" 2° to loss of Gastric Contents (vomitting) + volume contraxn → maintain HCO3 to retain volume
↓ Urine Chloride, Volume Depleted
Tx: Normal Saline

2. "Contraction Alkalosis" Diuretic → Na delivered to distal collecting duct → Na/H+ antiporter
↑ Urine Chloride, Volume Depleted

3. "Saline Resistant" Conn Sro or Mineralcorticoid Excess: Aldosterone upregulates Na/H+ antiporter
↑ Urine Chloride, Hypervolemic

Front 11

Adult Brain Tumors by Frequency

Back 11

1. Glioblastoma multiform (Grade 4 Astrocytoma)
--Astrocytes which strain for GFAP
--Pseudopalisading borders around necrosis
--Bad Px

2. Meningioma
--Arachnoid cells
--Psammoma bodies
--Benign
--Surgically Resectable

3. Schwannoma
--Cerebellopontine Angle, S100+

4. Oligodendroma
--Indolent "Fried Eggs" Chicken wire capillaries & calcifications

5. Pituitary adenoma

Front 12

VPM Nucleus

Back 12

Ventral Posteromedial Nucleus iof the Thalamus

---incoming from Trigeminal & Gustatory pathways
---relays to Somatosensory Cortex (Brodman's areas 1-3)

Hint 12

#neurology #cns #anatomy

Front 13

Glioblastoma Multiform

Back 13

Most common adult brain tumor

Grade 4 Astrocytoma
--Astrocytes which strain for GFAP
--Pseudopalisading borders around necrosis
--Bad Px

Front 14

Lateral Geniculate Nucleus

Back 14

Thalamic Nucleus Responsible for Vision

Hint 14

#neurology #cns #anatomy

Front 15

Brain Tumor stains for GFAP

Back 15

Glioblastoma Multiform
Grade 4 Astrocytoma
--Astrocytes which strain for GFAP
--Pseudopalisading borders around necrosis
--Bad Px

Most common adult brain tumor

Front 16

Medial Geniculate Nucleus

Back 16

Thalamic Nucleus Responsible for Audition

input from superior olivary nucleus & inferior output to temporal lobe

Hint 16

#neurology #cns #anatomy

Front 17

Adult tumor of Astrocytes

Back 17

Glioblastoma Multiform
Grade 4 Astrocytoma
--Astrocytes which strain for GFAP
--Pseudopalisading borders around necrosis
--Bad Px

Most common adult brain tumor

Front 18

Phenoxybenzamine

Back 18

long acting α blocker used in pheos

Hint 18

#pharmacology #autonomics #drugs

Front 19

Ephedrine

Back 19

sympatheticomimentic

Hint 19

#pharmacology #autonomics #drugs

Front 20

Meningioma

Back 20

2nd most common adult brain tumor

(Gioblastoma Multiform > Meningioma > Schwannoma)

--Arachnoid cells
--Psammoma bodies
--Benign
--Surgically Resectable

Front 21

Adult tumor of Arachnoid Cells

Back 21

2nd most common adult brain tumor

(Gioblastoma Multiform > Meningioma > Schwannoma)

--Arachnoid cells
--Psammoma bodies
--Benign
--Surgically Resectable

Front 22

oxybutynin

Back 22

anticholinergic agent used for overactive bladder

does not affect nicotininc receptors

Hint 22

#pharmacology #autonomics #drugs

Front 23

Adult Brain Tumor of "Fried Egg" Cells

Back 23

Oligodendroma
--Indolent "Fried Eggs" Chicken wire capillaries & calcifications

Front 24

phentolamine

Back 24

α1, 2 antagonist

Hint 24

#pharmacology #autonomics #drugs

Front 25

Brain Tumor with Psammoma Bodies

Back 25

Meningioma


2nd most common adult brain tumor

(Gioblastoma Multiform > Meningioma > Schwannoma)

--Arachnoid cells
--Psammoma bodies
--Benign
--Surgically Resectable

Front 26

ergonovine

Back 26

α + 5HT stimulator

constricts VSMCs

used to prevent post-partum bleed out

used diagnostically to induced prinzmetal's angina

Hint 26

#pharmacology #autonomics
#cardiovascular #pathology #reproductive #diagnostics #drugs

Front 27

Parvovirus B19 loves which cells

Back 27

erythroid precurosors

[esp pronormoblasts and normoblasts]

Hint 27

#microbiology

Front 28

thiolase

Back 28

enzyme which conjugates 2 acetyl-CaA → acetoacetyl-CoA

the necessary substrate for HMG CoA Synthase in the formation of cholesterol

Hint 28

#biochemistry #molecules #cardiovascular

Front 29

DOC: Heparin OD

Back 29

Protamine

aka protamine sulfate

binds to heparin to form inactive complex

Hint 29

#pharmacology #drugs #toxicities

Front 30

Protamine Sufate

Back 30

ie protamine

DOC: Heparin OD

binds to heparin to form inactive complex

Hint 30

#pharmacology #drugs #toxicities

Front 31

Aminocaproic Acid

Back 31

inhibits plasminogen activation

used to inhibit fibrinolysis
ie tPA or streptokinase OD

[sibling Rx: tranexamic acid]

Hint 31

#drugs #pharmacology #cardiovascular

Front 32

Tranexamic Acid

Back 32

inhibits plasminogen activation

used to inhibit fibrinolysis
ie tPA or streptokinase OD

[sibling Rx: Aminocaproic Acid]

Hint 32

#drugs #pharmacology #cardiovascular

Front 33

DOC: tPA overload

Back 33

Aminocaproic Acid or Tranexamic Acid

inhibits plasminogen activation

used to inhibit fibrinolysis
ie tPA or streptokinase OD

Hint 33

#drugs #pharmacology #cardiovascular

Front 34

The Absorption of B12

Back 34

1. Salivary Glands Secrete R protein haptocorrin which binds B12 to prevent acid denaturation in Stomach

2. stomach parietal cells (located midway down gastric pits) secrete intrinsic factor

R factor binds B12 in stomach once released from food by Acid

3. Pancreatic proteases cleave R factor which is immediately bound by intrinsic factor (to prevent degredation in SI by pancreatic enzymes)

4. IF-B12 complex abosrbed in distal ileum by IF specific receptor

Hint 34

#biochemistry #nutrition #gastrointestinal

Front 35

Haptocorrin

Back 35

R factor

secreted by salivary glands
binds to B12 to prevent hydrolysis by gastric acidity

degraded by pancreatic proteases

(where IF binds to prevents proteolytic degradation of B12)

Hint 35

#biochemistry #nutrition #gastrointestinal

Front 36

Elderly Patient with Anemia and negative Fecal Occult Blood

Back 36

Probably B12 deficiency 2° aging → gastric atrophy → [relative] achlorhydria → poor B12 release from eaten foods

Hint 36

#biochemistry #nutrition #gastrointestinal #hematology

Front 37

Neuroblastoma

Back 37

N-myc Amplification
medullary adrenal mass: small round blue cells
displaces kidney, causes anorexia

2 yo presents with paraneoplasic "Opsoclonus-Myoclonus Sro"

Opsoclonus: Non-rhythmic conjugate eye movements in various directions (ie not nystagmus)

Px: better w/ younger age (<1) and fewer N-mycs

Hint 37

#pathology #neoplasia

Front 38

Toddler with spontaneous bursts of non-rhythmic eye movement and occasional myoclonus

Back 38

Neuroblastoma

N-myc Amplification
medullary adrenal mass: small round blue cells
displaces kidney, causes anorexia

2 yo presents with paraneoplasic "Opsoclonus-Myoclonus Sro"

Opsoclonus: Non-rhythmic conjugate eye movements in various directions (ie not nystagmus)

Px: better w/ younger age (<1) and fewer N-mycs

Hint 38

#pathology #neoplasia

Front 39

N-myx

Back 39

Neuroblastoma

N-myc Amplification
medullary adrenal mass: small round blue cells
displaces kidney, causes anorexia

2 yo presents with paraneoplasic "Opsoclonus-Myoclonus Sro"

Opsoclonus: Non-rhythmic conjugate eye movements in various directions (ie not nystagmus)

Px: better w/ younger age (<1) and fewer N-mycs

Hint 39

#pathology #neoplasia

Front 40

Toddler presents with palpable flank mass

Back 40

Wilm's Tumor

Histologically: primitive metanephric ts (primtive nephrons)

Malignant

WT1 is a tumor suppressor gene
Chrom 11p

[WAGR: Wilm's Tumor, Aniridia, GU Malformation, MR]

Hint 40

#pathology #neoplasia #nephrology #childhood

Front 41

Wilm's Tumor

Back 41

Toddler presents with palpable flank mass

Histologically: primitive metanephric ts (primtive nephrons)

Malignant

WT1 is a tumor suppressor gene
Chrom 11p

[WAGR: Wilm's Tumor, Aniridia, GU Malformation, MR]

Hint 41

#pathology #neoplasia #nephrology #childhood

Front 42

WT1

Back 42

WT1 is a tumor suppressor gene
Chrom 11p

WAGR: Wilm's Tumor, Aniridia, GU Malformation, MR

Hint 42

#pathology #neoplasia #nephrology #childhood

Front 43

WAGR

Back 43

WT1 is a tumor suppressor gene
Chrom 11p

WAGR: Wilm's Tumor, Aniridia, GU Malformation, MR

Hint 43

#pathology #neoplasia #nephrology #childhood #syndromes

Front 44

BP 180/70

Back 44

isolated systolic hypertension 2° age related aortic stiffening

also seen in panic attacks

Hint 44

#cardiovascular #pathology #geriatrics

Front 45

isolated systolic hypertension

Back 45

isolated systolic hypertension 2° age related aortic stiffening

common in elderly

also seen in panic attacks

Hint 45

#cardiovascular #pathology #geriatrics

Front 46

Haptoglobin Levels

Back 46

Haptoglobin Binds Free Hemoglobin within Blood Vessels

Complexed Hemoglobin-Haptoglobin is phagocytized by Spenic M∅

↓ serum haptoglobin levels ≈ intravascular hemolysis

normal serum haptoglobin levels rules out intravascular hemolysis (ie extravascular = direct splenic phagocytosis)

Hint 46

#hematology #diagnostics #molecules

Front 47

Differentiating Intravascular from Extravascular Hemolysis

Back 47

Haptoglobin Levels

Haptoglobin Binds Free Hemoglobin within Blood Vessels

Complexed Hemoglobin-Haptoglobin is phagocytized by Spenic M∅

↓ serum haptoglobin levels ≈ intravascular hemolysis

normal serum haptoglobin levels rules out intravascular hemolysis (ie extravascular = direct splenic phagocytosis)

NB: Extravascular includes Splenic Phagocytosis

Hint 47

#hematology #diagnostics #molecules

Front 48

Rhomboid Crystals with Positive Birefringence from Inflammed Knee Aspirate

Back 48

Calcium Pyrophosphate

pseudogout aka Calcium Pyrophosphate Depsoition Dz CPDD:

NB: usually presents Knee >> Foot

Tx: NSAIDs [Steroids, & Colchecine]

Hint 48

#pathology #crystals #inflammation #joints

Front 49

DOC: anaphylaxis

Back 49

Epinephrine

Hint 49

#pharmacology #immunology

Front 50

Pathogenesis Presbyopia

Back 50

age related lens sclerosis → ↓ elasticity

Hint 50

#geriatrics #pathology #eye

Front 51

Myasthenia Gravis vs Lambert Eaton Sro

Back 51

MG:
Begins with Optic Muscles
Worsens at End of Day & after effort
Risk of Thymoma
Anti-ACh receptor antibodies
Edrophonium improves weakness
Nerve Stimulation → decrementalresponse

LE:
Begins with proximal muslces
improves through day & w/ exercise
2° to an already existing malignancy
Anti-Pre-Synaptic Ca2+ channel Antibodies
Edrophonium does not improve
Nerve Stimulation → incremental response

Hint 51

#neurology #neoplasia #pathology

Front 52

Danger of appetite suppressants

Back 52

Fenfluramine or Phentermine

↑ 5-HT release

↑ risk pulmonary htn after 3 mo → sudden cardiac death

Hint 52

#pathology #nutrition #pulmonology

Front 53

Phentermine

Back 53

appetite suppressent

↑ 5-HT release
like fenfluramine

↑ risk pulmonary htn after 3 mo → sudden cardiac death

Hint 53

#pathology #nutrition #pulmonology #drugs

Front 54

Fenfluramine

Back 54

appetite suppressant

↑ 5-HT release
like phentermine

↑ risk pulmonary htn after 3 mo → sudden cardiac death

Hint 54

#pathology #nutrition #pulmonology #drugs

Front 55

Endomysial Inflammatory Infiltration

Back 55

characteristic of polymyositis

progresssive symmetrix proximal muslce weakness

Path: CD8 vs myofibers
Findings: ↑ CK, ↑ aldolase, muscle weakness

most often involves shoulders

Similar to Dermatomyositis (∅ shoulders, ✓ Grotton/Heliotrope/perifasicular atrophy)

Hint 55

#pathology #rheumatology

Front 56

Diarrhea, Weight Loss, Arthralgia

Back 56

Whipple's Dz

"Foamy" PAS+ M∅

Mn: CAN of Whipped Cream

Cardiac Sx
Arthralgias
Neurologic Sx

Hint 56

#gastrointestinal #microbiology #pathology

Front 57

Acute Stress Ulcers

Back 57

Trauma/Shock/Burns

Curling Ulcers: duodenal 2° to hypoxia
Cushing Ulcers: Esophagus, Stomach, Duodenum 2° to ↑ ICP → Vagal Stim → H+ hypersecretion; prone to perforate

Hint 57

#gastrointestinal #pathology #ulcers

Front 58

Curling Ulcers

Back 58

duodenal ulcers 2° to shock hypoxia

NB: not Cushing Ulcers: Esophagus, Stomach, Duodenum 2° to ↑ ICP → Vagal Stim → H+ hypersecretion; prone to perforate

Hint 58

#gastrointestinal #pathology #ulcers

Front 59

Cushing Ulcers

Back 59

Esophageal, Gastric, Duodenal Ulcers

2° to ↑ ICP → Vagal Stim → H+ hypersecretion; prone to perforate

NB: not Curling Ulcers: duodenal ulcers 2° to shock hypoxia

Hint 59

#gastrointestinal #pathology #ulcers

Front 60

Mannitol OD

Back 60

excessive volume depletion → hypernatremia

even worse
rapid administration rapidly draws fluid from interstitial → vascular compartment, ↑ hydrostatic pressure in lungs → pulmonary edema & death

[Mannitol used for ↑ ICP/Cerebral Edema]

Hint 60

#pharmacology #toxicities

Front 61

DOC: ↑ ICP/Cerebral Edema

OD?

Back 61

Mannitol

overaggressive → excessive volume depletion → hypernatremia

even worse
rapid administration rapidly draws fluid from interstitial → vascular compartment, ↑ hydrostatic pressure in lungs → pulmonary edema & death

Hint 61

#pharmacology #toxicities #drugs

Front 62

Bumetanide

Back 62

Loop Diuretic like Furosimide

[Loop Diuretic toxicities:
Ototixicity, Hypokalemia, Dehydration, Allergic Rxn, Interstitial Nephritis, Gout
Mn: OH DANG!]

Hint 62

#pharmacology #nephrology #cardiovascular

Front 63

c-myc fnx

Back 63

nuclear transcription factor

Hint 63

#molecules #pathology #neoplasia

Front 64

Radius vs Resistance

Back 64

R = viscosity * length / radius ^4

NB: ^4

Hint 64

#physiology
#cardiovascular

Front 65

DOC: Refractorily High LDL

Back 65

First Line Drug: Statin
Competitively (vs Mevalonate) inhibits HMG CoA Reductase
Hepatocytes ↑ LDL receptors to compensate
Tox: Hepatotixic, Rhabdotoxic

Refractory: Add Ezetimibe
Inhibits Brush Border Cholesterol Resorption
Tox: Rare, hepatotoxic

Hint 65

#pharmacology #cardiovascular #lipids

Front 66

DOC: Refractorily High TAGs

Back 66

First Line Drug: Fibrates
↑ LPL
Tox: Hepatotoxic, Rhabdotoxic, Gallstones

Refractory: Add Niacin
Inhibits TAG synthesis & VLDL secretion
Tox: Hyperglycemia, Hyperuricemia

Hint 66

#pharmacology #cardiovascular #lipids

Front 67

DOC: Refractorily Low HDL

Back 67

Niacin:
Inhibits TAG synthesis & VLDL secretion
Tox: Hyperglycemia, Hyperuricemia

No 2ndry Drug

Hint 67

#pharmacology #cardiovascular #lipids

Front 68

TGFα mutation

Back 68

oncogene

astrocytoma, hepatocellular carinoma

Hint 68

#pathology #neoplasia #molecules

Front 69

Periacinar v Centriacinar Emphysema

Back 69

Periacinar: air trapped in terminal bronchioles before acini
α1 anti-trypsin deficiency
lower lung fields worse: ↑ perfusion = ↑ PMN's

Centriacinar: air trapped in acini after TB's
smoking
upper fields worse: ↓ perfusion = ↓ α1 anti-trypsin

Hint 69

#pathology #pulmonology

Front 70

Diathesis Panel
Laboratory Abnormality of HUS

Back 70

↑ Bleeding Time from Platelet consuming thrombi

oddly no ↑ PT, or PTT

Shiga toxin producing Shigella or E Coli O157H7

Hint 70

#microbiology #pathology #hematology

Front 71

Pentazocine

Back 71

opiod partial agonist

will precipitate withdrawal in dependents

sibling: buprenorphine

Hint 71

#pharmacology #drugs #analgesia

Front 72

Buprenorphine

Back 72

opiod partial agonist

will precipitate withdrawal in dependents

sibling: Pentazocine

Hint 72

#pharmacology #drugs #analgesia

Front 73

Opiod Partial Agonists

Back 73

Pentazocine and Buprenorphine


will precipitate withdrawal in dependents

Hint 73

#pharmacology #drugs #analgesia

Front 74

Levorphanol

Back 74

an opioid

Hint 74

#pharmacology #drugs #analgesia

Front 75

continuous murmur heard best at left infraclavicular regioj

Back 75

PDA

Hint 75

#cardiovascular #pathology
#anatomy

Front 76

How do OCP's inhibit ovulation

Back 76

1° by inhibiting the LH spike

also
thickened cervical mumus plug

Hint 76

#pharmacology #endocrine #reproductive

Front 77

Warfarin Necrosis

Back 77

Proteins C & S are natural anticoagulants

Protien C is vitamin K dependent and has much shorter λ than factors 2, 7, 9 and X.

Rare complication: in pts w/ already defective Protein C, warfarin creates a transient hypercoagulable state

Tx: Vitamin K + FFP

Hint 77

#hematology #pharmacology #toxicity

Front 78

What part of airways are attacked in lung transplant rejexn

Back 78

small airways

Hint 78

#pathology #pulmonology

Front 79

Rofecoxib

Back 79

a selective COX2 inhibitor

Hint 79

#pharmacology #drugs #analgesics

Front 80

Why does systemic granulomatous dz → hypercalcemia

Back 80

↑ M∅ 1-α hydroxylase

apparently activated M∅ just naturally convert vitamin D to active form

Hint 80

#pathology #chemistry

Front 81

TNF α inhibitors by name

Back 81

infliximab, etanercept, adalimumab

Hint 81

#pharmacology #drugs

Front 82

new onset aortic stenosis in 50 yo

Back 82

bicuspid aortic valve


recently calcificied

Hint 82

#pathology #cardiovascular

Front 83

Ehrlichia

Back 83

zoonotic infx from amblyoma lone star

obligate intracellular inhibits phagolysosomal fusion

a rickettsia

Hint 83

#microbiology

Front 84

Obligate intracytoplasmic bacterieria

Back 84

chlamydia and rickettsia

NB: only these survive intracytoplasmically outside of phagosomes

Hint 84

#microbiology

Front 85

Causes of LV dilation

Back 85

CAD
Valvular Heat Dz
Dilated Cardiomyopathy
Arrhytmias

Hint 85

#pathology #cardiovascular

Front 86

Preventing Morbidity of Subarachnoid Hemorrhage

Back 86

Calcium Channel Blockers

Nimodipine

prevents vasospasm → ischemia, the real cause of morbidity

Hint 86

#neurology #pharmacology

Front 87

Nimodipine

Back 87

calcium channel blocker

used both for hypertension and uniquely used to prevent mobidity following SubArachnoid Hemorrhage

Hint 87

#neurology #cardiovascular #pharmacology

Front 88

The polyol pathway

Back 88

Aldose Reductase
Glucose → Sorbitol

Sorbitol Dehydrogenase
Sorbitol → Fructose

Hint 88

#biochemistry #energymetzm

Front 89

Bile Soluble Streptococci

Back 89

ie cannot grow in presence of bile

all non enterococcal strep

Hint 89

#microbiology

Front 90

What is the main mechanism for regulating iron stores?

Back 90

Hepatically produced Hepcidin produced by liver binds ferroportin and causes its degradation

[Ferroportin is basolateral iron transporter on gut epithelium. No ferroportin → iron lost in gut shedding]

Hepcidin prodxn ↑ w/ high [iron] or inflammation

Hint 90

#nutrition #biochemistry #molecules

Front 91

Hepcidin

Back 91

Hepatically produced Hepcidin produced by liver binds ferroportin and causes its degradation

[Ferroportin is basolateral iron transporter on gut epithelium. No ferroportin → iron lost in gut shedding]

Hepcidin prodxn ↑ w/ high [iron] or inflammation

Main mechanism of iron regulation

Hint 91

#nutrition #biochemistry #molecules

Front 92

Erosions vs Ulcers

Back 92

Erosions do not cross muscularis mucosa

Hint 92

#pathology #gastrointestinal

Front 93

Antipsychotic associated with retinitis pigmentosa

Back 93

Thioridazine

Mn: thior-eye-disease

NB: Chlorpormazine ≈ corneal deposits

Hint 93

#pharmacology #toxicity

Front 94

Toxicity of Thioridazine

Back 94

retinitis-pigmentosa like retinal deposits

Mn: Thior-eye-disease

NB: Chlorpormazine ≈ corneal deposits

Hint 94

#pharmacology #toxicity

Front 95

Antipsychotic assocaited with corneal deposits

Back 95

Chlorpromazine

NB: Thioridazine ≈ Retinal Deposits

Hint 95

#pharmacology #toxicity

Front 96

Toxicity of Chlorpromazine

Back 96

Corneal Deposits

NB: Thioridazien ≈ Retinal Deposits

Hint 96

#pharmacology #toxicity

Front 97

most important strx/molecular defects in Alzhemiers

Back 97

↓ ACh in Nucleus Basalis and Hippocampus

Hint 97

#pathology #neurology #dementia

Front 98

Hemangiomas:

Strawberry, Cherry, Cavernous

Back 98

Benign vascular tumors

Strawberry: infantile
few weeks of rapid growth → regression in elementary school

Cherry: senile
↑ # w/ age, ∅ regress

Vacernous: blue palpable masses
assoc. w/ VHL Dz
may also exist in viscera and CNS as well as dermally

Hint 98

#pathology #dermatology

Front 99

Eicosonoid responsible for PMN chemotaxis

Back 99

LTB4

Hint 99

#pathology #inflammation

Front 100

LTB4

Back 100

Eicosonoid responsible for PMN chemotaxis

Hint 100

#pathology #inflammation

Front 101

Hemosiderin

Back 101

aggregation of ferritin micelles

maker of iron accumulation

golden yellow brown pigment

indicative of chronic iron overload/hemolytic anemia

Hint 101

#pathology #molecules #diagnostics #hematology

Front 102

Pigment found in chronic iron overload

Back 102

Hemosiderin

aggregation of ferritin micelles

golden yellow brown pigment

indicative of chronic iron overload/hemolytic anemia

Hint 102

#pathology #molecules #diagnostics #hematology

Front 103

Cause of Death: Hypertrophic Cardiomyopathy

Back 103

Mitral Valve leaflets get sucked into the outflow tract

Hint 103

#pathology #cardiovascular

Front 104

The first portion of the brain damaged during global ischemia

Back 104

The Hippocampus goes first, within 5 minutes

Then watershet ischemia follow LATER

Hint 104

#neurology #pathology #shock

Front 105

3-Hydroxy-3-methylglutaryl- lyaseCoA

Back 105

HMG CoA Lyase

responsible for ketogenesis from HMG CoA (which itself is produced yby degradation of leucine or synthesis via HMG coA synthase)

Hint 105

#biochemistry #molecules

Front 106

Reid Index

Back 106

Submucosal Gland thickness/ thickenss of wall from epithlium to cartilage (not including cartilage)

normally 0.4

higher index ≈ severity/duration of chronic bornchitis

Hint 106

#pathology #pulmonology #diognostics

Front 107

Pemphigus Vulgaris

Back 107

anti-desmoglein IgG

Flaccid Bullae

Asboe-Hansen sign: bullae spread laterally w/ pressure

Nikolsky Sign: new bullae form with gentile traction

Reticular Immunofluorescence

Hint 107

#dermatology #pathology #rheumatology

Front 108

Skin covered with Blisters which spread laterally with pressure

Back 108

Asboe-Hansen sign of Pemphigus Vulgaris

anti-desmoglein IgG

Flaccid Bullae

Reticular Immunofluorescence

also: Nikolsky Sign: new bullae form with gentile traction

Hint 108

#dermatology #pathology #rheumatology

Front 109

Skin Covered with Blisters, New Blisters formed with Gentle Traction

Back 109

Nikolsky's Sign of Pemphigus Vulgaris

anti-desmoglein IgG

Flaccid Bullae

Reticular Immunofluorescence

also: Asboe-Hansen sign: bullae spread laterally w/ pressure

Hint 109

#dermatology #pathology #rheumatology

Front 110

Skin Covered with Blisters, Immunofluorescence shows Reticular Pattern of IgGs

Back 110

Pemphigus Vulgaris; anti-desmoglein IgG

Flaccid Bullae

Reticular Immunofluoresence

may affect oral mucosa

Asboe-Hansen sign: bullae spread laterally w/ pressure

Nikolsky Sign: new bullae form with gentile traction

Hint 110

#dermatology #pathology #rheumatology

Front 111

Blistering Skin Dz which Also Affects Oral Mucosa

Back 111

Pemphigus Vulgaris; anti-desmoglein IgG

Flaccid Bullae

Reticular Immunofluoresence

may affect oral mucosa

Asboe-Hansen sign: bullae spread laterally w/ pressure

Nikolsky Sign: new bullae form with gentile traction

Hint 111

#dermatology #pathology #rheumatology

Front 112

Bullous Pemphigoid vs Pemphigus Vulgaris

Back 112

Pemphigus Vulgaris:
anti-desmosomal IgG → flaccid blisters & reticular immunofluorescence
may affect oral mucosa
Positive Nikolsky Sign: new bullae form with gentile traction

Bullous Pemphigoid
anti-hemidesmosomal IgG → tense blisters & linear IF w/ oral sparing & negative Nikolsky's sign

Hint 112

#dermatology #pathology #rheumatology

Front 113

Skin Covered with Blisters, New Blisters do not formed with Gentle Traction

Back 113

Bullous Pemphigoid

anti-hemidesmosomal IgG

spares oral mucosa

tense bullae

linear immunofluorescence
(contrast to PV: reticular)

NB: negative Nikolsky's sign (new blisters formwith gentle traction, indicative of Pemphigus Vulgaris anti-desmoglein IgG)

Hint 113

#dermatology #pathology #rheumatology

Front 114

Skin Covered with Blisters, Immunofluorescence shows Linear Pattern of IgGs

Back 114

Bullous Pemphigoid

anti-hemidesmosomal IgG

spares oral mucosa

tense bullae

linear immunofluorescence
(contrast to PV: reticular)

NB: negative Nikolsky's sign (new blisters formwith gentle traction, indicative of Pemphigus Vulgaris anti-desmoglein IgG)

Hint 114

#dermatology #pathology #rheumatology

Front 115

Bullous Pemphigoid

Back 115

Bullous Pemphigoid

anti-hemidesmosomal IgG

spares oral mucosa

tense bullae

linear immunofluorescence
(contrast to PV: reticular)

NB: negative Nikolsky's sign (new blisters formwith gentle traction, indicative of Pemphigus Vulgaris anti-desmoglein IgG)

Hint 115

#dermatology #pathology #rheumatology

Front 116

↑ Lipase & Amylase → Dyspnea

Back 116

Acute Pancreatitis → ARDS

Hint 116

#pathology #pulmonology

Front 117

Councilman Bodies

Back 117

acidophilic bodies within apoptitic hepatocytes

Hint 117

#pathology #hepatobiliary

Front 118

acidophilic bodies within insulted hepatocytes

Back 118

Councilman bodies indicative of apoptosis

Hint 118

#pathology #hepatobiliary

Front 119

Blue Babies

Back 119

5 T's

Tetrology of Fallot (most common)
Transposition fo GReat Vessels
Trucus Arteriosus (persistent, non-divided)
Tricuspid Atresia: hypoplastic RV + ASD + VSD
Total anamalous bulmonary venous return (2 systems)

Hint 119

#pathology #cardiovascular #neonatology

Front 120

New Onset Cyanosis in Children

Back 120

Eisenmenger

By Freq:
1. VSD
2. ASD (fixed split S2)
3. PDA

Hint 120

#pathology #cardiovascular

Front 121

DOC: Nitroprusside OD

Back 121

Nitroprosside: Ca2+ blocker which acts on both arteries an veins

Cyanide Toxicity

DOC: Sulfur ie Sodium Thiosulfate

provides extra substrate for liver rhodanase to form thiocyanate

Hint 121

#pharmacology #cardiovascular #toxicity

Front 122

Calcification is indicative of what

Back 122

prior cell death

Hint 122

#pathology

Front 123

Toxicity of Hydrocyhloroquine

Back 123

retinal damage

Hint 123

#pharmacology #antimicrobial #toxicity

Front 124

electrolyte abnormality following massive packed RBC transfusion

Back 124

Hypocalcemia

Packed RBC's contain citrate anticoagulant

citrate chelates calcium

Hint 124

#pathology #electrolytes #hematology

Front 125

nasal transepithelial potential difference

Back 125

a sensitive test for Cystic Fibrosis (more sensitive than Cl- sweat test)

test is positive if difference is more negative

CFTR both secretes chloride and inhibits Na+ secretion

reduced CFTR fnx → ↓ Cl- secretion ↑ Na+ secretion

more negative nasoepithlial surface

NB: sweat glands are the only glands where CFTR fnx to resporb Cl-

Hint 125

#pathology #molecules #diagnostics #geneticdzs

Front 126

HIV gp41

Back 126

gp41 is fusion protein allows entry into cell after adherence

[gp120 allows adherence to CD4]

both cleaved from gp160 from env gene

Hint 126

#HIV #microbiology

Front 127

HIV gp120

Back 127

gp120 allows adherence to CD4

[gp41 is fusion protein allows entry into cell after adherence]

both cleaved from gp160 from env gene

Hint 127

#HIV #microbiology

Front 128

How does mom's blood type determine whether the baby could suffer from hemolytic dz?

Back 128

Blood Types A & B usually have IgM anti-B & anti-A

Mom w/ Blood Type O often has IgG anti-A and anti-B

Mom with blood type O more likely to have hemolytic dz for baby than otherwise

Hint 128

#pathology #reproductive #immunology

Front 129

DOC: acute gout

Back 129

first line Rx is NSAID

glucocorticoid close 2nd

Hint 129

#pharmacology #analgesia

Front 130

Heparin vs LMWH

Back 130

enoxapren = LMWH

both activate AT3 to bind Factors 9 X & 2

Only require pentasaccharide to bind AT3 & ↑ affinity

Heparin has >18 sacchardies, allowing it to wrap around AT3 and form a stable bond with factor 2 (ie thrombin)

LMWH cannot and thus has higher affinity for X than 2

Hint 130

#pharmacology #hematology

Front 131

What is a good mini-mental status test for concentration

Back 131

reciting months of the year backwards, counting down from 100 by 7's or spelling world backward

Hint 131

#psychology

Front 132

First sign of uncal herniation

sequelae thereof

Back 132

ipsilateral dilated pupil from compression of CN3

sequelae:
down & out eye
PCA compression → homonymous hemianopia
contralateral cerebral peuncle → ipsilateral hemiparesis
alternatively isilateral " " → contralateral
brainstem duret hemorrhages 2° rupture of basilar artery → fatal

Hint 132

#neurology #pathology

Front 133

unilateral dilated pupil

Back 133

uncal herniation compressing CN3

Hint 133

#neurology #pathology

Front 134

epigastric pain following food after ~30 min → weight loss

no abnormalities on scope

Back 134

chronic mesenteric ischemia 2° to atherosclerotic narrowing of Celiac Trunk, SMA or IMA

microscopy would reveal atrophy

Hint 134

#gastrointestinal #pathology

Front 135

Calcium stones

Frequency, Radiography, Microscopy, Causes

Back 135

Calcium Stones

Caclium Phosphate or Caclium Oxalate

Frequency: Majority of all Stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: octahedrons (square w/ cross hitching in 2d)
Causes: hypercalcemia; calcium oxalate stones may form from ethylene glycol/methanol or vitamin C abuse

Hint 135

#pathology #nephrology #neprholithalisis

Front 136

Stones from Vitamin C Abuse

Back 136

Caclium Oxalate

Frequency: Majority of all Stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: octahedrons (square w/ cross hitching in 2d)
Causes: hypercalcemia; calcium oxalate stones may form from ethylene glycol/methanol or vitamin C abuse

Hint 136

#pathology #nephrology #neprholithalisis

Front 137

Most common Nephrolithiasis

Back 137

Calcium Stones

Caclium Phosphate or Caclium Oxalate

Frequency: Majority of all Stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: octahedrons (square w/ cross hitching in 2d)
Causes: hypercalcemia; calcium oxalate stones may form from ethylene glycol/methanol or vitamin C abuse

Hint 137

#pathology #nephrology #neprholithalisis

Front 138

Struvite Stones

Frequency, Radiography, Microscopy, Causes

Back 138

Struvite Stones

Ammonium Magnesium or Phosphate
Freq: uncommon, 2nd most common to calcium stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: "coffin lid" rectuangular prism
Causes: bugs: Proteus, Staph, Kleb
Worsened by Alkalinuria

Hint 138

#pathology #nephrology #neprholithalisis

Front 139

octahedron nephrolithaisis

Back 139

Calcium Stones

Caclium Phosphate or Caclium Oxalate

Frequency: Majority of all Stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: octahedrons (square w/ cross hitching in 2d)
Causes: hypercalcemia; calcium oxalate stones may form from ethylene glycol/methanol or vitamin C abuse

Hint 139

#pathology #nephrology #neprholithalisis

Front 140

Ammonium Stones

Back 140

Struvite Stones

Ammonium Magnesium or Phosphate
Freq: uncommon, 2nd most common to calcium stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: "coffin lid" rectuangular prism
Causes: bugs: Proteus, Staph, Kleb
Worsened by Alkalinuria

Hint 140

#pathology #nephrology #neprholithalisis

Front 141

Rectangular Prism Stones

Back 141

Struvite Stones

Ammonium Magnesium or Phosphate
Freq: uncommon, 2nd most common to calcium stones
Radiography: all stones radioopaque except uric acid stones
Microscopy: "coffin lid" rectuangular prism
Causes: bugs: Proteus, Staph, Kleb
Worsened by Alkalinuria

Hint 141

#pathology #nephrology #neprholithalisis

Front 142

Uric Acid Stones

Radiography, Microscopy, Causes

Back 142

Radiography: THE ONLY RADIOLUCENT KIDNEY STONE
Microscopy: Rhombus
Causes: uric acidemia (gout, leukemia etc)

Hint 142

#pathology #nephrology #neprholithalisis

Front 143

Radiolucent Kidney Stones

Back 143

Uric Acid Stones


Radiography: THE ONLY RADIOLUCENT KIDNEY STONE
Microscopy: Rhombus
Causes: uric acidemia (gout, leukemia etc)

Hint 143

#pathology #nephrology #neprholithalisis

Front 144

Cysteine Kidney Stones

Radiography, Microscopy, Causes

Back 144

Radiography: all kidney stones are radiopaque except uric acid stones
Microscopy: flat hexagons
Causes: cysteinuria; tx w/ alkalinization

Hint 144

#pathology #nephrology #neprholithalisis

Front 145

Hexagonal Kidney Stones

Back 145

Cysteine Stones

Radiography: all kidney stones are radiopaque except uric acid stones
Microscopy: flat hexagons
Causes: cysteinuria; tx w/ alkalinization

Hint 145

#pathology #nephrology #neprholithalisis

Front 146

"Hotdog" looking inclusions in eosinophils

Back 146

Major Basic Protein

Kills helminths
damages epithlium

Hint 146

#immunology
#hematology

Front 147

Cauliflower mass in sigmoid colon causing mucoid diarrhea

Back 147

villous adenoma

NB: carcinoid tumors also cause diarrhea, but not polypoid (?)

Hint 147

#pathology #gastrointestinal #neoplasia

Front 148

HBV vs HCV
& Hepatocellular CA

Back 148

HBV: integrates into genomes
HBx protein encodes for growth promoting and p53 inactivating proteins

HCV induces hepatocellular cancer simply through chronic inflammation, does not encorporate into genome, no specific pro-CA molecules

Hint 148

#pathology #microbiology #neoplasia

Front 149

what dz is assoc. w/ polyarteritis nodosum

Back 149

[fibrinoid necrosis of small/medium vessels]

HBV in some not all

Hint 149

#pathology #cardiovascular

Front 150

Zenker Diverticulum

Back 150

Esophageal Diverticium 2° inncreased pressure 3* to crichopharyngeal hypertony

crichopharyngeal muscles don't relax, more force required to push food → outpouching

retained food, regurgitation, aspiration all complications

Hint 150

#pathology #gastrointestinal

Front 151

the pathology of 3* syphilis

Back 151

obliteration of vasa vasorum

Hint 151

#microbiology

Front 152

Bosentan

Back 152

endothelin-receptor antagonist

prevents vasoconstriction and endothelial proliferation

DOC: pumonary artery hypertension

Hint 152

#pharmacology #pulmonology

Front 153

DOC: pulmonary artery hypertension

Back 153

Bosentan

endothelin-receptor antagonist

prevents vasoconstriction and endothelial proliferation

Hint 153

#pharmacology #pulmonology

Front 154

Cause of Death:
Acute Rheumatic Fever

Back 154

Myocarditis

NB: mitral stenosis req's years to dvlp

Hint 154

#microbiology #pathology

Front 155

HIV gp24

Back 155

gp24 and gp7 are nucleocapsid proteins encoded by gag

Hint 155

#HIV

Front 156

HIV gp7

Back 156

gp24 and gp7 are nucleocapsid proteins encoded by gag

Hint 156

#HIV

Front 157

HIV gag

Back 157

encodes nucleocapside proteins gp24 and gp7

Hint 157

#HIV

Front 158

HIV nef

Back 158

downregulates CD4 and MHC 1

↑ virlence

Hint 158

#HIV

Front 159

HIV rev

Back 159

faciliates transport of unspliced viral transcripts from nucleus

Hint 159

#HIV

Front 160

HIV tat

Back 160

Transcription AcTivator

↑ virulenc

Hint 160

#HIV

Front 161

Anastrozole

Back 161

aromatase inhibitor

useful v estrogen dpt breast tumors

anastrozole, letrozole, exemestane

Hint 161

#pharmacology #neoplasia #endocrine

Front 162

Letrozole

Back 162

aromatase inhibitor

useful v estrogen dpt breast tumors

anastrozole, letrozole, exemestane

Hint 162

#pharmacology #neoplasia #endocrine

Front 163

Exemestane

Back 163

aromatase inhibitor

useful v estrogen dpt breast tumors

anastrozole, letrozole, exemestane

Hint 163

#pharmacology #neoplasia #endocrine

Front 164

aromatase inhibitors

Back 164

anastrozole, letrozole, exemestane

useful v estrogen dpt breast tumors

Hint 164

#pharmacology #neoplasia #endocrine

Front 165

Double Barrel Aorta

Back 165

Aortic Dissection

Begins as an intimal tear

Hypertension is the most important risk factor

Hint 165

#pathology #cardiovascular

Front 166

Timeline for correcting B12 deficiency

Back 166

Immediate ↑ Reticulocyte Count, drops off again

slow ↑ hemoglobin

Hint 166

#nutrition #hematology

Front 167

Refractory PUD
Gastric Hypertrophy 2° to ?

Back 167

Gastrin (ZE)

Hint 167

#pathology #gastrointestinal

Front 168

Buspirone vs BZD's

Back 168

selective gor 5HT1A

no muscle relaxn
no anticonvulant
greatly ↓ addxn potential

Hint 168

#pharmacology

Front 169

Source of ↑ AP

Back 169

Largely from OsteoBlast activity and Liver

--Differentiatable by elecctrophoresis, specific antibodies and boiling
--Bone specific AP easily denatured in heat (Bone = Boil)


Follow-Up test for ↑ AP is γ Glutamyl Transpeptidase (GGTP):
Hepatobiliary Specific

Hint 169

#pathology #diagnostis #bone #hepatobiliary

Front 170

Urinary product of osteoclastic activity

Back 170

deoxypyridinoline --most specific

tartrate resistant acid phosphatase --specific but cross reacting with other acid phosphatases

urinary hydroxyproline present but non-specific

Hint 170

#pathology #diagnostis #bone

Front 171

urinary deoxypyridinoline

Back 171

the most specific marker of osteoclastic activity

other markers:



tartrate resistant acid phosphatase --specific but cross reacting with other acid phosphatases

urinary hydroxyproline present but non-specific

Hint 171

#pathology #diagnostis #bone

Front 172

tartrate resistant acid phosphatase

Back 172

tartrate resistant acid phosphatase --specific but cross reacting with other acid phosphatases

most specific: urinary deoxypyridinoline

Hint 172

#pathology #diagnostis #bone

Front 173

How is glycogen synthase activated

Back 173

Insulin → tyrosine kinase → protein phosphatase-1 →

dephosphyrlates glycogen synthase (activating)

also

dephosphorylates Fructose 1,6 bisphosphatase, inactivating and inhibiting gluconeogeneis

Hint 173

#biochemistry #energymetzm #molecules

Front 174

protein phosphatase-1

Back 174

Insulin → tyrosine kinase → protein phosphatase-1 →

dephosphyrlates glycogen synthase (activating)

also

dephosphorylates Fructose 1,6 bisphosphatase, inactivating and inhibiting gluconeogeneis

Hint 174

#biochemistry #energymetzm #molecules

Front 175

Transporter Defect in Cysteinuria

Back 175

Dibasic Cation Transporter

COAL
Cystine
Ornithine
Arginine
Lysine

Hint 175

#pathology #nephrology #nephrolithiasis #molecules

Front 176

What is the Nitrogen Source for the Urea Cycle?

How does that molecule originally get its nitrogen?

Back 176

Nitrogen Source for Urea Cycle is Aspartate (combines with Citrate to form arginosuccinate)

Oxaloacetate + NH3 = Asparatate

The NH3 for that reaction comes from Glutamate via B6

(NB: Glutamate losing NH3 becomes α-ketoglutarate)

And how does glutamate get its NH3+ you ask?

Substrate specific transaminases like AST and ALT (the two most significant):
Alanine → Pyruvate
Aspartate → Oxaloacetate

Hint 176

#biochemistry #energymetzm #molecules

Front 177

homogenous hyalinization vs onion skinning of arteries

Back 177

hyaline: low level Htn

onion skinning: malignant htn

Hint 177

#pathology #cardiovascular

Front 178

describe mechanism of hearing in the inner ear

Back 178

3 chambers: scala vestibuli: Na+ rich, onnected to oval window
scala media: K+, organ of corti
basilar membrane separates media from tympani
scala tympani: Na+: connected to round window

scala vestibuli and scala tympani meet at helicotremma at top

low freq's cause vibration at top near helicotremma
high freqs at base near oval window

Hint 178

#neurology #physiology

Front 179

immunolytic effects of corticosteroids

Back 179

inhibit PLA2
inhibit phagocytosis
inhibit IL1 prodxn

Hint 179

#pharmacology #immunology

Front 180

Leucovorin

Back 180

N5 Formyl THF

Rescules MTX toxicity

potentiates 5FU effectiveness

5FU binds THF & Thymidilate Synthase in stable intermediate state

Hint 180

#pharmacology #chemotheraputics

Front 181

Gemcitabine

Back 181

pyrimidine analogue

-abine = dNTP analogue

Hint 181

#pharmacology #chemotheraputics

Front 182

Cytarabine

Back 182

pyrimidine analogue

-abine = dNTP analogue

Hint 182

#pharmacology #chemotheraputics

Front 183

Fludarabine

Back 183

purine analogue

used v CLL

-abine = dNTP analogue

Hint 183

#pharmacology #chemotheraputics

Front 184

Loss of FAS → SLE

pathogenesis?

Back 184

impaired "Clonal deletion" of activated T's by CTL's in peripheral ts

Hint 184

#pathology #hematology #immunology

Front 185

Most common cause of superior vena cava sro?

Back 185

1. bronchogenic carcinoma

esp 20 years after asbestos exposure

Hint 185

#pathology #pulmonology

Front 186

Sodium Cyanide Nitroprusside Test for Nephrolithasis

Back 186

If urine becomes red-purple then you are looking at cystine stones

Cyanide converts cystine → cysteine
Nitroprusside + Cysteine → Blue Molecule

Dibasic AA transporter

Cystine
Ornithine
Arginine
Lysine

Tx: alkalinize the urine

Hint 186

#pathology #diagnostics #nephrology #nephrolithaisis

Front 187

Confirmatory Test for Cystine Cyrstaluria

Back 187

Sodium Cyanide Nitroprusside Tes

If urine becomes red-purple then you are looking at cystine stones

Cyanide converts cystine → cysteine
Nitroprusside + Cysteine → Blue Molecule

Dibasic AA transporter

Cystine
Ornithine
Arginine
Lysine

Tx: alkalinize the urine

Hint 187

#pathology #diagnostics #nephrology #nephrolithaisis

Front 188

Cystic pancreatic lesion 3 weeks post pancreatitis

Back 188

pancreatic pseudocyst 2° pancreateic enzymatic degradation of pancreas

not a true cyst, lined by fibrosis and granulation ts, no epithlelium

most commonly lesser peritoneal sac posterior to stomach

Hint 188

#pathology #gastrointestinal

Front 189

Mifepristone

Back 189

progesterone antagonist abortificant

NB: often combined with misoprostol

5x affinity for progesterone receptor as progesterone

Hint 189

#pharmacology #reproductive

Front 190

fetus no longer has a heartbeat

Back 190

dead

risk of DIC

monitor fibrinogen closely

Hint 190

#pathology #reproductive

Front 191

Cystic degeneration of putamen likely 2° to

Back 191

Wilson's Dz

Hint 191

#pathology #neurology

Front 192

What blotting technique should you use to determine if a gene is being transcribed

Back 192

Northern blot for mRNA

Hint 192

#diagnostics

Front 193

Medullary Sponge Kidney

Back 193

common benign disorder
linear dilations of medullary collecting ducts w/ cortical sparing

incidental finding
majority of pts will dvlp kidney stones
10% of all kidney stones 2° to MSK

NB: not medullary cystic kidney dz
fibrosis → inability to concentrate urine → end stage renal dz

Hint 193

#pathology #nephrology

Front 194

Kidney with cystically dilated medullary collecting ducts

Back 194

Medullary Sponge Kidney
common benign disorder
linear dilations of medullary collecting ducts w/ cortical sparing

incidental finding
majority of pts will dvlp kidney stones
10% of all kidney stones 2° to MSK

NB: not medullary cystic kidney dz
fibrosis → inability to concentrate urine → end stage renal dz

Hint 194

#pathology #nephrology

Front 195

Most common Amino Acid in Collagen

Back 195

Glycine every 3rd position

Strx is always
(Gly-X-Y)x333

Proline also essential, but not as frequent

Hint 195

#biochemistry #molecules

Front 196

Gestational Diabetes

Back 196

human placental lactogen hPL from syncytiotrophoblasts induces insulin resistance to provide glucose for baby

if maternal insulin prodxn overwhelmed → gestational diabetes

Hint 196

#endocrine #reproductive #physiology

Front 197

Cromolyn

Back 197

Inhibit mast cell degranulation

useful in tx of asthma

sibling: nedocromil

Hint 197

#pharmacology #pulmonology

Front 198

Nedocromil

Back 198

Inhibit mast cell degranulation

useful in tx of asthma

sibling: cromolyn

Hint 198

#pharmacology #pulmonology

Front 199

inhibitors of mast cell degranualtion

Back 199

cromolyn and nedocromil

useful vs asthma

Hint 199

#pharmacology #pulmonology

Front 200

Recurrent Bacterial and Viral Infx

Back 200

indicative of combined T and B cell deficiency (SCID)

Hint 200

#immunology #pathology

Front 201

The progression of lobar pneumonia

Back 201

First 24h: Congestion
macro: red, heavy boggy
micro: vascular dilation, bacteria rich exudate

d2-3: Red hepatization
macro: red, firm
micro: RBC, PMN & fibrin infiltrate

d4-6: Grey hepatization
macro: grew brown & firm
micro: PMN's & Fibrin

resolution
macro: normal architecture
enzymatic degradation of exudate

Hint 201

#pathology #pulmonology

Front 202

Akathisia

Back 202

side effect of anti-psychotics

anxiety, restlessness

timeline
4h: dystonia
4d: parkinsonianism
4wk: akathisia
4mo: tardive dyskinesia

Hint 202

#pharmacology #toxicity

Front 203

anti-Mtb Rx most active in acidic environment

Back 203

pyrazinhamide

ie within phagolysosomes

unknown mechanism of action

Hint 203

#pharmacology #antimicrobials

Front 204

Pick's Dz: brain region

Back 204

frontotemoral specificty

inappropriate behavior and speach decline

unknown genetic basis

Hint 204

#neurology #pathology

Front 205

Conoloscopy Findings:

protuberant mass

Likely Dz?

Back 205

adenocarcinoma

biopsy: dysplastic mucosa w/ gland formation

Hint 205

#pathology #gastrointestinal

Front 206

Conoloscopy Findings:

multiple ulcers and mucosal erosions

Likely Dz?

Back 206

CMV

Hint 206

#pathology #gastrointestinal

Front 207

Conoloscopy Findings:

nonulcerative inflammation

Likely Dz?

Back 207

cryptosporidium

biopsy: basophilic clusters seen on surface of intestinal mucosal cells

Hint 207

#pathology #gastrointestinal

Front 208

Conoloscopy Findings:

numerous discrete flash-shaped ulcerations

Likely Dz?

Back 208

entamoeba histolytica

biopsy: trophozoites contianing RBC's

Hint 208

#pathology #gastrointestinal

Front 209

Conoloscopy Findings:

violet flat maculopaular lesions & hemorrhagic nodules

Likely Dz?

Back 209

Kaposi's sarcoma

HHV-8

biopsy: spindle shpaed tumor cells w/ small vessel proliferation

Hint 209

#pathology #gastrointestinal

Front 210

Biopsy Findings:

dysplastic mucosa w/ gland formation



Likely Dz?

Back 210

adenocarcinoma

Hint 210

#pathology #gastrointestinal

Front 211

Biopsy Findings:

basophilic clusters seen on surface of intestinal mucosal cells

Likely Dz?

Back 211

cryptosporidium

nonulcerative inflammation

Hint 211

#pathology #gastrointestinal

Front 212

Biopsy Findings:

trophozoites containing RBC's

Likely Dz?

Back 212

entamoeba histolytica

numerous flask shaped uilcerative lesiosn

Hint 212

#pathology #gastrointestinal

Front 213

Biopsy Findings:

spindle shaped tumor cells with small vessel proliferation

Likely Dz?

Back 213

Kaposi's sarcoma

HHV-8

Hint 213

#pathology #gastrointestinal

Front 214

HCV v HBV: which more likely from sexual transmission

Back 214

HBV

Hint 214

#pathology #micobiology #hepatobiliary

Front 215

DOC: AML

Back 215

t(15:17) RAR-PML

DOC: all-trans-retinoic acid
induces remission in 90% of pts

Hint 215

#hematology #pharmacology #chemotheraputic #neoplasia #pathology

Front 216

Murmurs v Respiration

Back 216

Inspiration induces/increases Right Sided Murmurs

Expiration induces/increases Left Sided Murmurs

Hint 216

#pathology #cardiovascular #diagnostics

Front 217

Murmurs v Valsalva Maneuver

Back 217

same as standing

Most murmurs diminish except for

Hypertrophic Cardiomyopathy and Mitral Valve Prolapse

NB: these also the only mumurs to become quieter with passive leg raise/squatting

Hint 217

#pathology #cardiovascular #diagnostics

Front 218

Murmurs v Standing

Back 218

same as valsalva maneover

Most murmurs diminish except for

Hypertrophic Cardiomyopathy and Mitral Valve Prolapse

NB: these also the only mumurs to become quieter with passive leg raise/squatting

Hint 218

#pathology #cardiovascular #diagnostics

Front 219

Mumurs v Squatting

Back 219

same as passive leg raising

most murmurs become louder except hypertrophic cardiomyopathy and mitral valve prolapse

NB: these are also the only murmurs to become louder with valsalva maneuver/standing

Hint 219

#pathology #cardiovascular #diagnostics

Front 220

Murmurs v Passive Leg Raise

Back 220

same as passive leg raising

most murmurs become louder except hypertrophic cardiomyopathy and mitral valve prolapse

NB: these are also the only murmurs to become louder with valsalva maneuver/standing

Hint 220

#pathology #cardiovascular #diagnostics

Front 221

Murmurs v Handgrip

Back 221

MR, VSD, and AR become Louder

Hypertrophic Cardiomyopathy murmur becomes queiter

Hint 221

#pathology #cardiovascular #diagnostics

Front 222

many immature myelogenous cells on blood smear

Back 222

Not AML: would be "blast cells" rather than immature cells (bands, metamyelocytes, myelocytes)

either CML t(9:22) or leukemoid rxn (ie infx)

depends on AP

low AP: CML
normal or high: leukemoid rxn

Hint 222

#pathology #diagnostics #hematology #neoplasia

Front 223

D-glutamate capsule

Back 223

The primary virulence factor of Bacillus anthracis, required for pathogenicity, uniquely does not contain polysaccharide

"wool-workers dz"

grows "medusa head" colonies on media

spores grow once ingested by alvoelar M∅ → mediastinal lymkph nodes → hemorrhagic mediastinitis → septic shock and death

anthrax toxin

Hint 223

#microbiology #pulmonology

Front 224

Wool Worker with Widened Mediastinum

Back 224

Bacillus anthracis --"wool workers dz"

spores grow once ingested by alvoelar M∅ → mediastinal lymkph nodes → hemorrhagic mediastinitis → septic shock and death

D-glutamate capsule is the The primary virulence factor of Bacillus anthracis, required for pathogenicity, uniquely does not contain polysaccharide

grows "medusa head" colonies on media

anthrax toxin

Hint 224

#microbiology #pulmonology

Front 225

"medusa head" colonies on agar

Back 225

Bacillus anthracis --"wool workers dz"

spores grow once ingested by alvoelar M∅ → mediastinal lymkph nodes → hemorrhagic mediastinitis → septic shock and death

D-glutamate capsule is the The primary virulence factor of Bacillus anthracis, required for pathogenicity, uniquely does not contain polysaccharide

anthrax toxin

Hint 225

#microbiology #pulmonology

Front 226

Drug Interaxns of Niacin

Back 226

Potentiates Anti-Hypertensives

Induces Insulin Resistance

also causes hyperuricemia

Hint 226

#pharmacology #cardiovascular #toxicity

Front 227

Diphenoxylate

Back 227

opiod used motility diarrhea

often combined with atropine as lomotil

Hint 227

#pharmacology #drugs #gastrointestinal

Front 228

Desmopressin

Back 228

aka DDAVP

ADH analogue

used for central diabetes insipidus

and also coagulopathies
→ induces release of vWF & Factor 8 from endothelial cells (where they are produced and stored)

Hint 228

#pharmacology #drugs #hematology #nephrology

Front 229

DDAVP

Back 229

aka Desmopressin

ADH analogue

used for central diabetes insipidus

and also coagulopathies
→ induces release of vWF & Factor 8 from endothelial cells (where they are produced and stored)

Hint 229

#pharmacology #drugs #hematology #nephrology

Front 230

Daptomycin

Back 230

Rx v MRSA

Mech: creates transmembrane channels → electrolyte flow → depolarization → proteins now nonfnx

Limitation: cannot get through to inner membrane of gram negatives; also inactivated by pulmonary surfactant

Side Effects: Myopathy ( ↑ CPK)

Hint 230

#pharmacology #drugs #antimicrobials

Front 231

MRSA Rx

non-fnx vs pneumonia

Back 231

Daptomycin

Mech: creates transmembrane channels → electrolyte flow → depolarization → proteins now nonfnx

Limitation: cannot get through to inner membrane of gram negatives; also inactivated by pulmonary surfactant

Side Effects: Myopathy ( ↑ CPK)

Hint 231

#pharmacology #drugs #antimicrobials

Front 232

MRSA Rx:

depolarizes cellular membrane

Back 232

Daptomycin

Mech: creates transmembrane channels → electrolyte flow → depolarization → proteins now nonfnx

Limitation: cannot get through to inner membrane of gram negatives; also inactivated by pulmonary surfactant

Side Effects: Myopathy ( ↑ CPK)

Hint 232

#pharmacology #drugs #antimicrobials

Front 233

MRSA Rx:

↑ CPK

Back 233

Daptomycin

Mech: creates transmembrane channels → electrolyte flow → depolarization → proteins now nonfnx

Limitation: cannot get through to inner membrane of gram negatives; also inactivated by pulmonary surfactant

Side Effects: Myopathy ( ↑ CPK)

Hint 233

#pharmacology #drugs #antimicrobials #toxicity

Front 234

Linezolid

Back 234

good Rx v MRSA

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro

Hint 234

#pharmacology #drugs #antimicrobials

Front 235

MRSA Rx:

Binds 23S

Back 235

Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro

Hint 235

#pharmacology #drugs #antimicrobials

Front 236

MRSA Rx:

Thrombocytopenia

Back 236

Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro

Hint 236

#pharmacology #drugs #antimicrobials #toxicity

Front 237

MRSA Rx:

Optic Neuritis

Back 237

Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro

Hint 237

#pharmacology #drugs #antimicrobials #toxicity

Front 238

MRSA Rx:

5HT Sro

Back 238

Linezolid

binds 23S portn of 50S

Toxicities:
Thrombocytopenia
Optic neuritis
5HT Sro

Hint 238

#pharmacology #drugs #antimicrobials #toxicity

Front 239

rT3

Back 239

rT3 is nonfnx product of peripheral T4 conversion

T4 can be converted to T3 or rT3

NB: T3 cannot be converted to T4 or rT3

Hint 239

#physiology #endocrine

Front 240

Libman-Sacks Dz

Back 240

Libman Sacks Endocarditis of SLE

sterile endocarditis

likely IC deposition

may progress to regurgitation or stenosis

Hint 240

#pathology #cardiovascular #rheumatology

Front 241

Frequency:
Esophageal Cancers

Back 241

Adenocarcinoma > Squamous Cell Carcinoma

People are fatter and smoking less

Hint 241

#neoplasia #pathology #gastrointestinal

Front 242

Dressler's Dz

Back 242

autoimmune myocarditis which follows MI by months

Hint 242

#pathology #rheumatology #cardiovascular

Front 243

autoimmune myocarditis which follows MI by months

Back 243

Dressler's Dz

Hint 243

#pathology #rheumatology #cardiovascular

Front 244

Relative Conduction Speeds Throughout the Heart

Back 244

Purkinje
Atrial Muscle
Ventricular Muscle
AV Node

Mn: Park At VENTura AVenue

Hint 244

#physiology #cardiovascular

Front 245

Cholelithiasis 2° to Cholecystitis

Back 245

Brown Pigment Stones

Infx → β-glucuronidase spillage → deconjugates bilirubin → Cholelithiasis

Esp E Coli, Ascaris Lumbricoides or Opisthorchis sinesis

Elderly Women in Rural Asia

Hint 245

#pathology #hepatobiliary

Front 246

Cholelithiasis in Rural Central Asia

Back 246

Brown Pigment Stones

Infx → β-glucuronidase spillage → deconjugates bilirubin → Cholelithiasis

Esp E Coli, Ascaris Lumbricoides or Opisthorchis sinesis

Elderly Women in Rural Asia

Hint 246

#pathology #hepatobiliary

Front 247

Brown Pigment Stones

Back 247

Infx → β-glucuronidase spillage → deconjugates bilirubin → Cholelithiasis

Esp E Coli, Ascaris Lumbricoides or Opisthorchis sinesis

Elderly Women in Rural Asia

Hint 247

#pathology #hepatobiliary

Front 248

Cause of Death: CF

Back 248

Pneumonia

Hint 248

#pathology #geneticdzs

Front 249

anti-PLAR2 IgG

Back 249

PLAR2 = transmembrane phsopholipase A2 receptor abundant on podocyutes

ideopathic membranous nephropathy

neophrotic sro)

Hint 249

#pathology #nephrology

Front 250

ideopathic membranous nephropathy

Back 250

nephrotic sro 2° to anti-PLAR2 IgG

PLAR2 = transmembrane phsopholipase A2 receptor abundant on podocyutes

ideopathic membranous nephropathy

NB: not the same as 2° membranous nephropathy (SLE)

Hint 250

#pathology #nephrology

Front 251

Most reliable prognostic indicators for liver damage

Back 251

PT and albumin

NB: AST & ALT only indicative of damage, not of outcome

Hint 251

#pathology #diagnostics #hepatobiliary

Front 252

Anti-depressant which causes priapism

Back 252

Trazodone

contraindicated in adolescent boys

Hint 252

#pharmacology #toxicities #drugs

Front 253

DOC: DKA

Back 253

regular insulin

oddly not rapid acting insuilins (lispro aspart)

Hint 253

#pharmacology #DOCs #endocrine

Front 254

HNPCC adenocarcinoma vs Sporadic Adnocarcinoma

Back 254

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Sporadic
>50 yo
left sided
single
arise from adenomatous polyps
genetics: adenoma → CA sequence: APC, K-ras, p53 & finally DCC

Hint 254

#pathology #neoplasia #genticdzs #gastrointestinal

Front 255

Right Sided Adenocarcinoma

Back 255

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Hint 255

#pathology #neoplasia #genticdzs #gastrointestinal

Front 256

MLH1

Back 256

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Hint 256

#pathology #neoplasia #genticdzs #gastrointestinal

Front 257

MLH2

Back 257

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Hint 257

#pathology #neoplasia #genticdzs #gastrointestinal

Front 258

MSH6

Back 258

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Hint 258

#pathology #neoplasia #genticdzs #gastrointestinal

Front 259

PMS2

Back 259

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Hint 259

#pathology #neoplasia #genticdzs #gastrointestinal

Front 260

Colonic Adenocarcinoma in a 30 yo

Back 260

HNPCC
<50 yo
right sided
multiple
arise from apparently normal ts
caused by DNA mismatch repair gene mutations: MLH1, MLH2, MSH6 and PMS2

Hint 260

#pathology #neoplasia #genticdzs #gastrointestinal

Front 261

Colonic Adenocarcinoma in a 70 yo

Back 261

Sporadic
>50 yo
left sided
single
arise from adenomatous polyps
genetics: adenoma → CA sequence: APC, K-ras, p53 & finally DCC

Hint 261

#pathology #neoplasia #gastrointestinal

Front 262

Digoxin: mechanism of action

Back 262

1. Blocks NaK ATPase → ↑ [Ca2+]

2. ↑ PSNS tone → ↓ AV node condxn

Hint 262

#pharmacology #cardiovascular

Front 263

S3 indicative of

Back 263

stiff or partially filled

best heart in left lateral decupitus position at ventricular apex at end of expiration

Hint 263

#cardiovascular #pathology #diagnostics

Front 264

Gastric Adenocarinomas

Back 264

2 variants

signet ring: do not form glands, contain mucin
diffusely involve stomach wall, often infiltrate cause "leather bottle" linitis plastica

intestinal type resemble colon cancers: grow as well demarcated masses of well formed glands

Hint 264

#pathology #gastrointestinal #neoplasia

Front 265

Rugal thickening of stomach

Back 265

indicative of ZE sro

Hint 265

#pathology #gastrointestinal #neoplasia

Front 266

"leather bottle" stomach

Back 266

signet rinng gastric adenocarcinoma: do not form glands, contain mucin
diffusely involve stomach wall, often infiltrate cause "leather bottle" linitis plastica

Hint 266

#pathology #gastrointestinal #neoplasia

Front 267

linitis plastica

Back 267

signet rinng gastric adenocarcinoma: do not form glands, contain mucin
diffusely involve stomach wall, often infiltrate cause "leather bottle" linitis plastica

Hint 267

#pathology #gastrointestinal #neoplasia

Front 268

What good is HMP shunt?

Back 268

does not produce ATP

produces 2 NADPH's

Required for
--FA, cholesterol & steroid synthesis
--Rx metzm

Hint 268

#biochemistry #energymetzm

Front 269

Reyes Sro

Back 269

Child c Fever + Aspirin

Hepatic Failure → Acute Encephalopathy

Biopsy: microvesicular steatosis (yes, there was a question on this) No necrosis or inflammation

all LFT's ↑
cerebral edema

Hint 269

#pathology #hepatobiliary

Front 270

DOC: anti-depressant with least sexual side effects

Back 270

Burproprion does not cause sexual dysfnx

DA NE RI

does cause seizures and insomnia

Hint 270

#pharmacology #physciatric

Front 271

NE activates which receptors

Back 271

both α and β1

little effect on β2

Hint 271

#pharmacology #autonomic

Front 272

What signals drive angiogenesis

Back 272

VEGF: endothelial cell motility and proliferation

FGF: also contributes

Hint 272

#physiology #cardiovascular

Front 273

Pathogenesis of Crohn's Nephrolithiasis

Back 273

normally dietary Ca2+ binds dietary Oxalate → insoluble salts → oxalate excretion

Crohns: loss of bile acids → impaired fat absorption → Ca2+ FA Soap formation → excretion → unbound oxalate taken up → Calcium Oxalate Stones

Radiopaque Octahedrons

Hint 273

#pathology #gastrointestinal #nephrology #nephrolithiasis #inflammation

Front 274

Fever, GI distress, Hepatosplenomegaly, Periumbilical Rose Spots

Back 274

Salmonella typhi

Hint 274

#microbiology #gastrointestinal #hepatobiliary #pathology

Front 275

Adrenal Cortex Dz's caused by Hypertrophy and Hyperplasia

Back 275

Hypertrophy: Conn

Hyperplasia: Cushing

Hint 275

#endocrine #pathology

Front 276

Histology of Conn & Cushing Sros

Back 276

Conn: Hypertrophy

Cushing: Hyperplasia

Hint 276

#endocrine #pathology

Front 277

Signal which gathers Myofibroblasts at wound

Back 277

MMP's gather myofibroblasts at wound edges

Hint 277

#physiology #molecules

Front 278

DIC vs TTP vs HUS

Back 278

DIC:
Pts bleed
Activated Coagulation Cascade
↑ PT & ↑ PTT
↓ fibrinogen, ↑ FDP (D-dimer)

TTP-HUS
usually do not bleed
Only Platelets activated
normal PT, PTT, fibrinogen, ∅ FDP

Hint 278

#hematology #pathology

Front 279

Rectal Prolapse in Children

Back 279

CF

Hint 279

#pathology #geneticdzs #gastrointestinal

Front 280

Osmotic Laxitives

Back 280

Polyethylene Glycol
& Magnesium Chloride

Hint 280

#pharmacology #gastrointestinal

Front 281

Microbe: produce diarrhea with small innoculum

Back 281

Entamoeba Histolytica (1)
Giardia (1)
Shigella (10)
Campylobacter jejuni (500)

Hint 281

#microbiology #gastrointestinal

Front 282

Dilated Cardiomyopathies

Back 282

90% of cardiomyopathies are dilated cariomyopathies

Pathogenesis: ↑ End Diastolic Volume
→ Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 282

#pathology #cardiovascular

Front 283

Alcoholic Cardiac Abnormality

Back 283

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 283

#pathology #cardiovascular

Front 284

Thiamine Deficiency Cardiac Abnormality

Back 284

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 284

#pathology #cardiovascular

Front 285

Coxsackie Cardiac Abnormality

Back 285

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 285

#pathology #cardiovascular

Front 286

Doxorubicin Cardiac Abnormality

Back 286

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 286

#pathology #cardiovascular

Front 287

Hemochromatosis Cardiac Abnormality

Back 287

May be Dilated or Restrictive Cardiomyopathy!

Dilated:
↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx
All chambers dilated, valvular insufficiencies, heart failure

Restrictive:
↓ compliance → diastolic dysnfx heart failure

Hint 287

#pathology #cardiovascular

Front 288

Cocaine Cardiac Abnormality

Back 288

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 288

#pathology #cardiovascular

Front 289

Chagas Cardiac Abnormality

Back 289

Dilated Cardiomyopathy

↑ End Diastolic Volume → Eccentric Hypertrophy → Systolic Dysfnx

All chambers dilated, valvular insufficiencies, heart failure

90% of cardiomyopathies are dilated cariomyopathies
Etiologies:
Mn: ABCCCD (-PH)
Alcohol, Beriberi
Coxsackie B, Cocaine, Chagas
Doxorubicin/Daunorubicin
Post Partum
Hemochromatosis (may be restrictive)

Hint 289

#pathology #cardiovascular

Front 290

Restrictive Cariomyopathy

Back 290

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes:
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 290

#pathology #cardiovascular

Front 291

Amyloidosis Cardiac Abnormality

Back 291

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes:
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 291

#pathology #cardiovascular

Front 292

Radiation Induced Cardiac Abnormality

Back 292

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes:
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 292

#pathology #cardiovascular

Front 293

Pompe's Dz Cardiac Abnormality

Back 293

deficiency of Lysosomal α 1,4 glucosidase (aka acid maltase)

restrictive cardiomyopathy
↓ compliance → diastolic dysnfx heart failure

Causes of Restrictive Cardiomyopathy
1. Amyloidosis
2. Post-surgical fibrosis
3. Radiation-induced Fibrosis
also Genetics: pompe's dz, hemochromatosis (may also be dilated)
Metastatic Cancers, Genetic abnormalities
childhood fibroelastosis

Hint 293

#pathology #cardiovascular

Front 294

Px of ITP

Back 294

Ideopathic thrombocytopenic purprua

Bleeding from platelet destrx

Chidlren: acute and self-limited

Adults: insidious and chronic

Hint 294

#pathology #hematology #rheumatology

Front 295

Best test to monitor for HCC recurrence

Back 295

Hepatocellular Carcinoma:

Alpha fetoprotein

Hint 295

#pathology #neoplasia #diagnostics

Front 296

Vitamin K deficiency

Back 296

Bleeding

Extremely unlikely in adults as colonic bacteria produce vitamin K

Hint 296

#pathology #nutrition

Front 297

Nails which bow in and bend out

Back 297

Spoon nails aka Koilonychia
specific for iron deficiency anemia

___________________

Plummer Vincent Sro: Triad of

Iron Deficiency Anemia
Glossitis
Esophageal Webbing (Dysphagia)

Hint 297

#pathology #hematology

Front 298

Plummer Vincent Sro

Back 298

Triad of

Iron Deficiency Anemia (Spoon Nails aka Koilonychia)
Glossitis
Esophageal Webbing (Dysphagia)

Hint 298

#pathology #hematology #gastrointestinal

Front 299

Anemia + Dysphagia

Back 299

Plummer Vincent Sro

Triad of

Iron Deficiency Anemia (Spoon Nails aka Koilonychia)
Glossitis
Esophageal Webbing (Dysphagia)

Hint 299

#pathology #hematology #gastrointestinal

Front 300

Spoon Nails + Dysphagia

Back 300

Plummer Vincent Sro

Triad of

Iron Deficiency Anemia (Spoon Nails aka Koilonychia)
Glossitis
Esophageal Webbing (Dysphagia)

Hint 300

#pathology #hematology #gastrointestinal

Front 301

Spoon Nails

Back 301

aka Koilonychia

Specific for Iron Deficiency Anemia

___________________

Plummer Vincent Sro: Triad of

Iron Deficiency Anemia
Glossitis
Esophageal Webbing (Dysphagia)

Hint 301

#pathology #hematology

Front 302

Koilonychia

Back 302

aka spoon nails

Specific for Iron Deficiency Anemia

___________________

Plummer Vincent Sro: Triad of

Iron Deficiency Anemia
Glossitis
Esophageal Webbing (Dysphagia)

Hint 302

#pathology #hematology

Front 303

B6 deficiency anemia

Back 303

required for first step of heme synthesis

microcytic hypochromatic B6 responsive anemia

same morphology as X linked Sideroblastic Anemia, but B6 responsive

Hint 303

#pathology #nutrition #hematology

Front 304

Neutral Aminoaciduria

Back 304

Hartnup Dz

Defective Neutral AA transporters in both Kidneys and Intestine

Tryptophan is the only essential AA,
necessary for (BH4 dpt) 5HT and (B6 dpt) Niacin synth

mostly aSx, though som pts present with pelagra:
Diarrhea
(Photosensative) Dermatitis
Dementia (Ataxia)

These pts benefit from Niacin supplementation

Hint 304

#pathology #geneticdzs #nutrition

Front 305

Ataxia + Photosensitive Skin Lesions + Loose stools

Back 305

Pellagra 2° to Niacin Deficiency
Diarrhea, Dermatitis, Dementia

causes:
Corn Based Diets
Carcinoid Tumor (uses up all the 5HT)
Hartnup Dz: defective transport of neutral AA's in intestine and nephrons → no Tryptophan absorption → no Niacin prodxn

Hint 305

#pathology #nutrition #neoplasia #geneticdzs

Front 306

Pellagra

Back 306

Diarrhea,
(Photosenstive) Dermatitis
Dementia (Ataxia)

causes:
Corn Based Diets
Carcinoid Tumor (uses up all the 5HT)
Hartnup Dz: defective transport of neutral AA's in intestine and nephrons → no Tryptophan absorption → no Niacin prodxn

Hint 306

#pathology #nutrition #neoplasia #geneticdzs

Front 307

Tocopherol

Back 307

Vitamin E

Hint 307

#nutrition #molecules

Front 308

Vitamin E molecule name

Back 308

Tocopherol

Hint 308

#nutrition #molecules

Front 309

E Coli & Sorbitol

Back 309

Most E coli Strains ferment sobitol Rapidly

Most EHEC O157H7 cannot ferment sorbitol

Hint 309

#micriobiology #diagnostics

Front 310

Test for EHEC from other E coli

Back 310

Sobitol Containin McConkey's Agar

Most E coli Strains ferment sobitol Rapidly

Most ETEC O157H7 cannot ferment sorbitol

Hint 310

#micriobiology #diagnostics

Front 311

Cause of Death: TCA OD

Back 311

Fast Na+ Channel inhibition → slowed conduction + prolonged QRS → fatal arrhytmias

else

↓ CO (arrthmias) + α blockade → Refractory Hypotension

Hint 311

#pharmacology #toxicity

Front 312

Rapid Lactose Fermenters

Back 312

Kleb: Citrate + Urease +
Enterobacter: Citrate + Urease Neg
E Coli: Citrate, Urease Double Neg

Hint 312

#microbiology #diagnostics

Front 313

Biochemical Profile of Kleb

Back 313

Rapid Lactose Fermenter
Citrate +
Urease +

Hint 313

#microbiology #diagnostics

Front 314

Biochemical Profile of Enterobacter

Back 314

Rapid Lactose Fermenter
Citrate +
Urease Neg

Hint 314

#microbiology #diagnostics

Front 315

Biochemical Profile of E coli

Back 315

Rapid Lactose Fermenter
Citrate Neg
Urease Neg

Hint 315

#microbiology #diagnostics

Front 316

Biochemical Profile of Shigella

Back 316

Oxidase Negative
Lactose Nonfermenter
Which does not produce H2S on TSI Agar

Hint 316

#microbiology #diagnostics

Front 317

Biochemical Profile of Salmonella

Back 317

Oxidase Negative Lactose Nonfermenter
Which Produces H2S on TSI Agar

Identical Profile to Proteus

Hint 317

#microbiology #diagnostics

Front 318

Biochemical Profile of Proteus

Back 318

Oxidase Negative Lactose Nonfermenter
Which Produces H2S on TSI Agar

Identical Profile to Salmonella

Hint 318

#microbiology #diagnostics

Front 319

Biochemical Profile of Pseudomonas

Back 319

Oxidase Positive Lactose Nonfermenter

Hint 319

#microbiology #diagnostics

Front 320

Gram Negative Rod
Which Ferments Lactose Slowly

Back 320

Both Citrobacter and Serratia

Hint 320

#microbiology #diagnostics

Front 321

Urease + Citrate +
Rapid Lactose Fermenting
Gram Negative Rod

Back 321

Kleb

Hint 321

#microbiology #diagnostics

Front 322

Urease Neg Citrate +
Rapid Lactose Fermenting
Gram Negative Rod

Back 322

Enterobacter

Hint 322

#microbiology #diagnostics

Front 323

Urease Neg Citrate Neg
Rapid Lactose Fermenting
Gram Negative Rod

Back 323

E coli

Hint 323

#microbiology #diagnostics

Front 324

Oxidase Negative Lactose Non-Fermenting
Gram Negative Rod
Which Does Not Produce H2S on TSI Agar

Back 324

Shigella

Hint 324

#microbiology #diagnostics

Front 325

Oxidase Negative Lactose Non-Fermenting
Gram Negative Rod
Which Produces H2S on TSI Agar

Back 325

Either Salmonella or Proteus

Hint 325

#microbiology #diagnostics

Front 326

Oxidase Positive
Lactose Non-Fermenting
Gram Negative Rod

Back 326

Pseudomonas

Hint 326

#microbiology #diagnostics

Front 327

Lactose Non Fermenting
Oxidase Negative
Gram Negative Rod

Back 327

TSI Agar:

∅ H2S Prodxn: Shigella

H2S Prodxn: Salmonella or Proteus

Hint 327

#microbiology #diagnostics

Front 328

Maltose Fermenting
Gram Negative Cocci

Back 328

N meningitidis

NB: Maltose Non-Fermenting = N gonorrhoeae

Hint 328

#microbiology #diagnostics

Front 329

Maltose Non-Fermenting
Gram Negative Cocci

Back 329

N gonorrhoeae

NB: Maltose Fermenting = N meningitidis

Hint 329

#microbiology #diagnostics

Front 330

ANS innervation of the Uterus

Back 330

beta 2 causes relaxation

beta 2 agonists used to defer premature labor:
ritodrine, terbutaline
allows time for cortisol to work

Hint 330

#pharmacology #autonomics #reproductive

Front 331

Ritodrine

Back 331

beta 2 agonist

used to relax the uterus and defer labor
allowing time for cortisol to work

Hint 331

#pharmacology #autonomics #reproductive #drugs

Front 332

Terbutaline

Back 332

beta 2 agonist

used to relax uterus and defer labor
allowing time for cortisol to work

Hint 332

#drugs #pharmacology #autonomics #reproductive

Front 333

deferring labor

Back 333

beta 2 agonists

ritodrine and terbutaline
allowing time for cortisol to work

Hint 333

#drugs #pharmacology #autonomics #reproductive

Front 334

Kussmaul's Sign

Back 334

normally JVP decreases with inspiration

Kussmaul's sign is an increase in JVP w/ inspiration

indicative of constrictive pericarditis

-Kussmaul's Sign
-Pericardial Knock (earlier than S3 which normallly indicates rapid filling from dilated/weak ventricle)
-Pulsus Paradoxus

Hint 334

#cardiology #pathology #diagnostics

Front 335

Increase in JVP on inspiration

Back 335

normally JVP decreases with inspiration

Kussmaul's sign is an increase in JVP w/ inspiration

indicative of constrictive pericarditis

-Kussmaul's Sign
-Pericardial Knock (earlier than S3 which normallly indicates rapid filling from dilated/weak ventricle)
-Pulsus Paradoxus

Hint 335

#cardiology #pathology #diagnostics

Front 336

Decrease in JVP on inspiration

Back 336

Physiologic
_________________________
Kussmaul's sign is an increase in JVP w/ inspiration

indicative of constrictive pericarditis

-Kussmaul's Sign
-Pericardial Knock (earlier than S3 which normallly indicates rapid filling from dilated/weak ventricle)
-Pulsus Paradoxus

Hint 336

#cardiology #pathology #diagnostics

Front 337

Pericardial Knock

Back 337

Heart Sound heard before S3 indicative of extremely restricted filling

Restrictive Pericarditis
--Kussmaul's increase in JVP on inspiration
--Pericardial Knock
--Pulsus Paradoxus

Hint 337

#cardiology #pathology #diagnostics

Front 338

Heart sound immediately following S2

Back 338

Pericardial Knock

before S3 (ventricular splash from dilation)

indicative of restrictive pericarditis
--Kussmaul's increase in JVP on inspiration
--Pulsus Paradoxus
--Pericardial Knock

Hint 338

#pathology #cardiovascular #diagnostics

Front 339

Small Cell Lung Cancer

Risk Factors, Histology, Location, Behavior/Px, Genetics, Staining, PNP Sros, Tx

Back 339

Histology: Kulchitsky cells: Small Dark & Blue beneith intact epithelium
Arises Centrally
Px: Very Aggressuve, Mets Early & Widely
Genetics: c-myc
Stains: chromogranin, synaptophysin, CD56, neuron specific enoslase
Risks: Smoking
Tx: Chemo

Many PNP Sros: Cushing, Lambert Eaton, SIADH

Hint 339

#pathology #neoplasia #pulmonology

Front 340

Bronchial Adenocarcinoma

Risk Factors, Histology, Location, Behavior/Px, Genetics, Staining, PNP Sros, Tx

Back 340

Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 340

#pathology #neoplasia #pulmonology

Front 341

Bronchioalveolar Carcinoma

Risk Factors, Histology, Location, Behavior/Px

Back 341

Risk Factors: not assoc. with smoking
Histology: lepidic growth w/o invasion
Location: Periphery, Terminal broncheolavoli
Behavior/Px: Aerogenous Seeding, Death from Suffox → consolidatn

Hint 341

#pathology #neoplasia #pulmonology

Front 342

Squamous Cell Carcinoma of the Lung

Risk Factors, Histology, Location, Behavior/Px, PNP Sros

Back 342

Risk Factors: Males, Smoking
Histology: Cavitating; Keratin Pearls & Intracellular Bridges
Location: Central (Bronchus/Hilar Mass)
Behavior/Px: Large & Slow, Late Mets
PNP Sros: PTHrP induced Hypercalcemia

Hint 342

#pathology #neoplasia #pulmonology

Front 343

Methylene Blue

Back 343

Antidote for methemoglobin

reduces iron Fe3+ to Fe2+

Front 344

Antidote for poisoned pt with garlic breath

Back 344

Dimercaprol

Antidote for acute arsenic poisoning.

Note: garlic odor.

Displaces Arsenic ions from sulfhydryl groups.

Side effects of antidote: nephrotoxic & hypertension

Front 345

Large Cell Lung Cancer

Histology, Location, Behavior/Px, Genetics, Staining, PNP Sros, Tx

Back 345

Histology: Highly anaplastic: large cells with large nuclei
Location: Peripheral
Behavior/Px: Extensive Local Growth
PNP Sros: Gynecomastia, Galactorrhea
Tx: non responsive to chemotheray

Hint 345

#pathology #neoplasia #pulmonology

Front 346

Antidote for Acute Lead Poisoning

Back 346

Antidote for Acute Lead and Mercury Poisoning. Forms complexes with mono, di, and trivalent ions.CaNa2EDTA

Front 347

Antidote for Acute Mercury Poisoning

Back 347

Antidote for Acute Lead and Mercury Poisoning. Forms complexes with mono, di, and trivalent ions.CaNa2EDTA

Front 348

Lung Cancer:

Dark Blue Cells

Back 348

Small Cell Lung Cancer

Histology: Kulchitsky cells: Small Dark & Blue beneith intact epithelium
Arises Centrally
Px: Very Aggressuve, Mets Early & Widely
Genetics: c-myc
Stains: chromogranin, synaptophysin, CD56, neuron specific enoslase
Risks: Smoking
Many PNP Sros: Cushing, Lambert Eaton, SIADH
Tx: Chemo

Hint 348

#pathology #neoplasia #pulmonology

Front 349

Antidote for Iron Poisoning

Back 349

Deferoxamine

most common after multiple blood transfusions

facilitates urinary excretion

Front 350

Lung Cancer:

C-Myc

Back 350

Small Cell Lung Cancer

Histology: Kulchitsky cells: Small Dark & Blue beneith intact epithelium
Arises Centrally
Px: Very Aggressuve, Mets Early & Widely
Genetics: c-myc
Stains: chromogranin, synaptophysin, CD56, neuron specific enoslase
Risks: Smoking
Many PNP Sros: Cushing, Lambert Eaton, SIADH
Tx: Chemo

Hint 350

#pathology #neoplasia #pulmonology

Front 351

Antidote for Cyanide Poisoning

Back 351

Amyl Nitrite

Forms methemoglobin that binds cyanide, distracting it from binding to mitochondiral enzymes

Front 352

Lung Cancer:

TTF-1 positive Stain

Back 352

Bronchial Adenocarcinoma
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 352

#pathology #neoplasia #pulmonology

Front 353

Antidote for methemoglobin

Back 353

Methylene Blue

reduces iron Fe3+ to Fe2+

Front 354

Destroying Hep A

Back 354

Boiling for to 85* for 1 min

Chlorination
Bleach,
Formalin
UV Rad

Front 355

Female Child with Ambiguous Genitalia

Hyponatremia, Hyperkalemia, Hypotension

Back 355

21β hydroxylase deficiency

↓corticosteroids & mineralcorticoids
↑ testosterone

Front 356

Lung Cancer

CEA positive Stain

Back 356

Bronchial Adenocarcinoma
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 356

#pathology #neoplasia #pulmonology

Front 357

Female Child with Ambiguous Genitalia

Hypertension

Back 357

11β hydroxylase deficiency

↓ cortisol, aldosterone

↑11-deoxycorticosteone (weak mineralcorticocoid)

↑ testosterone

Front 358

Male child with female genitalia

Hypertension

Back 358

17α hydroxylase deficiency

↑ mineralcorticoids

↓ sex hormones and corticosteroid

fluid and salt retention

Front 359

Lung Cancer

Hypertrophic Osteoarthropathy

Back 359

Bronchial Adenocarcinoma
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Bronchioalveolar Carcinoma
Risk Factors: not assoc. with smoking
Histology: lepidic growth w/o invasion
Location: Periphery, Terminal broncheolavoli
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Behavior/Px: Aerogenous Seeding, Death from Suffox → consolidatn

Hint 359

#pathology #neoplasia #pulmonology

Front 360

21β hydroxylase deficiency

Back 360

↓corticosteroids & mineralcorticoids
↑ testosterone

Ambiguous Genitalia in Females

Hyponatremia, Hyperkalemia, Hypotension

Front 361

11β hydroxylase deficiency

Back 361

↓ cortisol, aldosterone
↑11-deoxycorticosteone (weak mineralcorticocoid)
↑ testosterone

Ambiguous Genitalia in Females
fluid and salt retention → hyeprtension

Front 362

Lung Cancer: EGFR

Back 362

Bronchial Adenocarcinoma
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 362

#pathology #neoplasia #pulmonology

Front 363

17α hydroxylase deficiency

Back 363

↑ mineralcorticoids

↓ sex hormones and corticosteroid

all patients phenotypically female
fluid and salt retention → hypertension

Front 364

What blood has the lowest oxygen content in the body

Back 364

blood in the coronary sinus

myocardium extracts 80% of all O2 normally, 90% when stressed, consuming 5% of all CO

Front 365

Pt treated for depression

↓ BP, ↑ HR, ↑ QRS, & PVC's

What is wrong?
How do you treat?

Back 365

TCA overdose
quinidine like effect: inhibition of fast Na+ channels

most effective tx: NaHCO3

Front 366

Describe the perfusion of the Heart

Back 366

Left and Right Coronary Arteries

Left becomes Left Anterior Descending and Circumflex Arteries, supplies the anterior and left lateral surfaces of heart

Right gives rise to Posterior Descending Artery which supplies most of the inferior wall of the left ventricle including the diaphragmatic surface of the heart, as well as the SA and AV node arteries.

In 10% of pts the Left Circumflex artery gives rise to the posterior descending arteries.

Front 367

Lung Cancer: Kras

Back 367

Bronchial Adenocarcinoma
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 367

#pathology #neoplasia #pulmonology

Front 368

Describe the K+ distribution in DKA

describe the causes

Back 368

↓ total body K+
↓ intracellular [K]
↑ extracellular [K]

2° to
-osmotic loss
-acidosis pulls K from intracellular to extracellular
-lack of insulin which normally promotes cellular influx of K

Front 369

Lung Cancer:

Gyneocomastia

Back 369

Large Cell Lung Cancer
Histology: Highly anaplastic: large cells with large nuclei
Location: Peripheral
Behavior/Px: Extensive Local Growth
PNP Sros: Gynecomastia, Galactorrhea
Tx: non responsive to chemotheray

Hint 369

#pathology #neoplasia #pulmonology

Front 370

Progressive weakening with repeated use

Back 370

the hallmark of myasthenia gravis

Front 371

Amino Acids with Titratable Protons

Back 371

Bases:

H Histidine
R Arginine
K Lysine

Acids:
D Aspartic Acid
E Glutamic Acid

Neutral:
C Cysteine (-SH)
Y Tyrosine (-OH)

Front 372

2 most common causes of focal brain lesions in HIV+ pts

Back 372

Toxoplasmosis

Lymphoma esp 2° to EBV

Front 373

Lung Cancer:

Galactorrhea

Back 373

Large Cell Lung Cancer
Histology: Highly anaplastic: large cells with large nuclei
Location: Peripheral
Behavior/Px: Extensive Local Growth
PNP Sros: Gynecomastia, Galactorrhea
Tx: non responsive to chemotheray

Hint 373

#pathology #neoplasia #pulmonology

Front 374

Phenytoin

Back 374

DOC: partial seizures and tonic clonic seizures

blocks sodium channels

↑ CYP

Front 375

DOC: tonic clonic seizures

Back 375

Phenytoin
also for partial seizures

blocks sodium channels
↑ CYP450

Front 376

Peripheral Lung Cancers

Back 376

Bronchial & Bronchioalveolar Adenocarcinoma
Large Cell Lung Cancer

Hint 376

#pathology #pulmonology #neoplasia

Front 377

Anti-seizure drug which blocks sodium channels

Back 377

phenytoin
carbamazepine
lamotrigine
valproic acid-also blocks NDMA receptors in hippocampal neurons

Front 378

Central Lung Cancers

Back 378

Small Cell & Squamous Cell Carcinomas

Hint 378

#pathology #pulmonology #neoplasia

Front 379

Anti-seizure drug which blocks calcium channels in the thalamus

Back 379

Ethosuximide

first line tx for absence

Front 380

Lung Cancer:

Non-smoking Women

Back 380

Bronchial Adenocarcinoma
_____________________
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 380

#pathology #pulmonology #neoplasia

Front 381

Anti-seizure drug which ↑ Cl- flow

Back 381

Benzos, Barbituates, ETOH, enhance inhibitory action of GABA on GABAa and thus ↑ Cl- flux

Front 382

Anti-seizure drug which blocks NMDA receptors in hippocampal neurons

Back 382

Valproic acid
also has some sodium channel blocking effect

Front 383

DOC partial seizures

Back 383

carbamazepine

blocks Na+ channels

↑ CYP450

Front 384

Ethosuximide

Back 384

Anti-seizure drug which blocks calcium channels in the thalamus

first line tx for absence

Front 385

Lung Cancer

Definitively Not Caused by Smoking

Back 385

Bronchioalveolar Carcinoma
____________________________
Risk Factors: not assoc. with smoking
Histology: lepidic growth w/o invasion
Location: Periphery, Terminal broncheolavoli
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Behavior/Px: Aerogenous Seeding, Death from Suffox → consolidatn

Hint 385

#pathology #pulmonology #neoplasia

Front 386

DOC: Absence Seizures

Back 386

Ethosuximide

blocks calcium channels in the thalamus

Front 387

Lung Cancer

Slow Growth
Early Mets

Back 387

Bronchial Adenocarcinoma
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 387

#pathology #pulmonology #neoplasia

Front 388

Sertaline

Back 388

Zoloft, an SSRI

Front 389

Phentolamine

Back 389

competitive αantagonist

Front 390

Labetalol

Back 390

competitive antagonist of α1 and β1 with partial agonism at β2

Front 391

Lung Cancer

Fast Growth
Early Mets

Back 391

Small Cell
Large Cell
_____________________

Small Cell Lung Cancer
Histology: Kulchitsky cells: Small Dark & Blue beneith intact epithelium
Arises Centrally
Px: Very Aggressuve, Mets Early & Widely
Genetics: c-myc
Stains: chromogranin, synaptophysin, CD56, neuron specific enoslase
Risks: Smoking
Many PNP Sros: Cushing, Lambert Eaton, SIADH
Tx: Chemo


Large Cell Lung Cancer
Histology: Highly anaplastic: large cells with large nuclei
Location: Peripheral
Behavior/Px: Extensive Local Growth, Early Mets
PNP Sros: Gynecomastia, Galactorrhea
Tx: non responsive to chemotheray

Hint 391

#pathology #pulmonology #neoplasia

Front 392

Phenoxybenzamine

Back 392

nonselective, irreversible α1 and 2 antagonist

Front 393

Pramipexole

Back 393

a non-ergot dopamine agonist

sibling to rppinerole

Front 394

Lung Cancer

Slow Growth
Late Mets

Back 394

Squamous Cell
________________________
Risk Factors: Males, Smoking
Histology: Cavitating; Keratin Pearls & Intracellular Bridges
Location: Central (Bronchus/Hilar Mass)
Behavior/Px: Large & Slow, Late Mets
PNP Sros: PTHrP induced Hypercalcemia

Hint 394

#pathology #pulmonology #neoplasia

Front 395

ropinerole

Back 395

a non-ergot dopamine agonist

Front 396

Lung Cancer

Hypercalcemia

Back 396

Squamous Cell Carcinoma
___________________________
Risk Factors: Males, Smoking
Histology: Cavitating; Keratin Pearls & Intracellular Bridges
Location: Central (Bronchus/Hilar Mass)
Behavior/Px: Large & Slow, Late Mets
PNP Sros: PTHrP induced Hypercalcemia

Hint 396

#pathology #pulmonology #neoplasia

Front 397

non-ergot DA agonists

Back 397

pramipexole and ropinerole

Front 398

ergot DA agonists

Back 398

bromocriptine, pergolide

Front 399

Lung Cancer

Mucin Producing Glands

Back 399

Bronchial Adenocarcinoma
_____________________
Risk Factors: most common non-small cell cancer
non-smoking females at sites of scarring
Histology: Glandular differentiation with mucin prodxn
Location: Peripheral
Behavior/Px: Slow & Small but with Early & Wide Mets
Genetics: EGFR overexpression, Kras mutation
Staining: TTF-1, CEA
PNP Sros: Clubbing, Hypertrophic Osteoarthropathy
Tx: Surg

Hint 399

#pathology #pulmonology #neoplasia

Front 400

bromocriptine

Back 400

an ergot DA agonist

like pergolide

Front 401

pergolide

Back 401

an ergot DA agonist like bromocriptine

Front 402

tirhexyphenidyl

Back 402

anticholinergic

Front 403

benztropine

Back 403

anticholinergic

Front 404

Lung Cancer

Cavitating

Back 404

Squamous Cell Carcinoma
_____________________
Risk Factors: Males, Smoking
Histology: Cavitating; Keratin Pearls & Intracellular Bridges
Location: Central (Bronchus/Hilar Mass)
Behavior/Px: Large & Slow, Late Mets
PNP Sros: PTHrP induced Hypercalcemia

Hint 404

#pathology #pulmonology #neoplasia

Front 405

Amantadine

Back 405

primarily an anti-flu agent

indirect and direct dopaminergic agent used initially in parkinsons

Front 406

Lung Cancer

Intercellular Bridges

Back 406

Squamous Cell Carcinoma
_____________________
Risk Factors: Males, Smoking
Histology: Cavitating; Keratin Pearls & Intracellular Bridges
Location: Central (Bronchus/Hilar Mass)
Behavior/Px: Large & Slow, Late Mets
PNP Sros: PTHrP induced Hypercalcemia

Hint 406

#pathology #pulmonology #neoplasia

Front 407

Auer Rods

Back 407

Stain for peroxidase

inducative of AML t(15:17) Retinoic Acid Receptor α + Promylogenous Leukemia

RARα-PML

bone marrow repalcement produces anemia, thrombocytopenia and neutropenia

Front 408

Major Basic Protein

Back 408

found in eosinophil granules, used against parasites

Front 409

Terminal deoxynucleotidyl transferase

Back 409

adds nucleotides to V D and J regions

makrer of immature lymphocytes as seen in ALL

mainly affect children

Front 410

Acyclovir v Herpesviruses

Back 410

Guanosine Analogue

must be converted to acyclovir monophosphate by virally encoded Thymidine Kinase before being incorporated (rate limiting step)

HSV-1 & VZV produce thymidine kinase

EBV and CMV do not
[some fnxality at extremely high concentrations]

Hint 410

#pharmacology #microbiology #antimicrobials

Front 411

Tartarate resistant Acid PHosphatase

Back 411

Stain for Hairy Cell Leukemia

CD20+ B cell precursors

splenomegaly, fatigue, pancytopenia

Front 412

Peroxidase Stain in Leukemia

Back 412

detects Auer Rods

Stain for peroxidase

inducative of AML t(15:17) Retinoic Acid Receptor α + Promylogenous Leukemia

RARα-PML

bone marrow repalcement produces anemia, thrombocytopenia and neutropenia

Front 413

platelet derived growth factor receptor mutations

Back 413

Chronic myelomonocytic leukemia

Front 414

Pure Red Cell Aplasia

Pathogenesis

Back 414

Parvovirus B19

or

Thymoma

Hint 414

#pathology #hematology #microbiology #noplasia

Front 415

p27

Back 415

protein cell cycle inhibitor which acts to inhibit cyclin depdent kinases from allowing G1-G2 crossing

Front 416

Rb's job

Back 416

binding E2F, the transciption factor necessary for G1 → S transition

Cyclin D, E and CDK4 and 6 hyperphosphyrlate Rb to relase EF2

Front 417

Fnx of Nucleolus

Back 417

Synthesis of rRNA

Hint 417

#biochemistry

Front 418

Bacterial DNA polymerases

Back 418

I: the only bacterial DNA polymerase with exonuclease activity

Front 419

Cystic Fibrosis and Sweating

Back 419

sweat is produced isotonic to plasma

it is the CFTR channels which reabsorb Chloride and Sodium.

CF pts secrete high sodium high cloride sweat and thus experience hypovolemia

Front 420

relationship of λ, CL and Vd

Back 420

λ = (Vd * 0.7)/CL

Hint 420

#pharmacology #pharmacokinetics

Front 421

Azole antifungals & CYP450

Back 421

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 421

#pharmacology #pharmacodynamics

Front 422

What part of the brain does Huntington's Damage and how

Back 422

NMDA receptors bind gluatamate and cause NMA associated toxicity and neuronal death in the caudate nucleus and putamen

Chrom 4

Decreases ACh, GABA and Substantce P in caudate nucleus and putamen

Front 423

Ethnicity and Bone Mass

Back 423

African American Women have better bone mass than Caucausian Women

Caucasian race assoc with ↓ bone mass

Front 424

Delta Nerve endings

Back 424

Thing myelinated

Acute pain and temp, contribute to reflex withddrawal

Front 425

Grapefruit Juice & CYP450

Back 425

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 425

#pharmacology #pharmacodynamics

Front 426

Pacinian corpuscels

Back 426

rapidly adapting mechanoreceptors


like Ruffini's end organs(slowly adapating), mediate touch, proprioception and virbratory sensation

myelinated A β fibers

Front 427

Ruffini's end organs

Back 427

slowly adapting mechanoreceptors

like Pacinian (rapidly adapating), mediate touch, proprioception and virbratory sensation

myelinated A β fibers

Front 428

Isoniazid & CYP450

Back 428

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 428

#pharmacology #pharmacodynamics

Front 429

MAP Kinase Pathway

Back 429

RTK autophosphorylation
SOS
Ras GTPase
Raf Kinase
MAP Kinase Kinase
MAP Kinase (Mitogen Activated Protein Kinase) enters nucleus and influences gene granscription

Front 430

Hemoglobin which does not bind 2,3-BPG

Back 430

Fetal Hemoglobin
HbF 2α2γ

Production begins around 2nd trimester
Majority of Hb at time of birth
Slowly drops off to zero by 6 mo

Lack of interaction with 2,3 BPG accounts for stronger affinity for oxygen than maternal hemoglobin

Charged Histidine in β subunit responsible for 2,3 BPG interaction

Front 431

Alcoholic excreting fat in feces

Back 431

pancreatic insufficiency

Front 432

Ritonavir & CYP450

Back 432

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 432

#pharmacology #pharmacodynamics

Front 433

Azithromycin

Back 433

Chalmydia
Mycoplasma
H influenza
Moraxella

Front 434

CYP450 inducers

Back 434

CYP450 Inducers

Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Griseofulvin

Hint 434

#pharmacology #pharmacodynamics

Front 435

S-100

Back 435

Neural Crest Derivative Marker
Schwannoma & Melanoma

Front 436

Intracranial mass with mixed areas: some densely cellular, some sporatically cellular

Back 436

Antoni pattern of schwannoma

Antoni A Pattern is density
Antoni B Pattern is sporatic

S-100+
(also S-100+: melanoma)

Front 437

urinary trends in DKA

Back 437

excess H+ excreted
Bicarbonate retained in exchange for Na+
titratable acids excreted
H2PO4- and NH4+

Front 438

CYP 450 inhibitors

Back 438

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 438

#pharmacology #pharmacodynamics

Front 439

Male
Recurrent infections
Induration vs Skin Challenge (TB, Candida, etc)

Back 439

Bruton's X linked agammaglobulinemia

B lymphocyte maturation defect

[Induration = Fnx T cells]

Front 440

Carbamazepine & CYP450

Back 440

CYP450 Inducers

Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Griseofulvin

Hint 440

#pharmacology #pharmacodynamics

Front 441

Tetrology of Fallot

Back 441

VSD
Overriding Aorta
Pulmonary Stenosis
RV Hypertrophy

Initially acts as a left to right shunt, but progressive increase in pulmonary hypertension leads to shunt reversal with increase in cyanotic sx releived by increasing systemic pressure (squatting)

Problem is with abnormal migration of neural crest cells which form the aorticopulmonary septum

may manifest cyanosis at birth

Front 442

Endocardial cushion defects

Back 442

acyanotic left-too-right shunt → pulmonary hypertesnion → shunt reversal (Eisenmenger Sro) → cyanosis

will NOT manifest cyanosis at birth

Front 443

southwestern blot

Back 443

identify and isolate proteins that bind to DNA

Front 444

jun

Back 444

DNA binding protein
proto-oncogene
will show up via southwestern blot (DNA binding proteins)

Front 445

pigmented spots on trunk, headaches, ruberry cutaneous tumors

Back 445

Neurofibromatosis Type 1
cafe-au-lait macules
gliomas
neurofibromas of Schwann Cells

Front 446

Phenobarbitol & CYP450

Back 446

CYP450 Inducers

Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Griseofulvin

Hint 446

#pharmacology #pharmacodynamics

Front 447

Renal Failure: Calcium Status

Back 447

no renal 1-α-hydroxylase → no 1,25-dihydroxy vitamin D → no gut Ca2+ absorption

↓ renal flow → ↑ phosphate retention → calcium binding

↓ serum [Ca2+]

compensatory ↑ [PTH]

2° hyperparathyroidism

Front 448

Insulin & Glucagon

Back 448

Insulin decreases Glucagon secretion

[Glucagon does not decrease Insulin Secretion--right?]

Front 449

What are the major factors affecting coronary blood flow

Back 449

Coronary blood flow almost entirely controlled by local metabolites

almost no input from nervous system

NO: arteries
adenosine: arterioles

Front 450

Phenytoin & CYP450

Back 450

CYP450 Inducers

Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Griseofulvin

Hint 450

#pharmacology #pharmacodynamics

Front 451

DOC: Tic Douloureaux

Back 451

Carbamazepine

like phenytoin, inhibits Na+ channel recovery following discharge, inhibiting high frequency signalling

may cause aplastic anemia
powerful CYP450 inducer

Front 452

What is the major mechanism by which hormones/cytokines induce insulin resistance

Back 452

TNFα, catecholamines, glucocorticoids and glucagons

all activate serine kinase which phosphorylates serine and threonine residues on insulin receptor

normally insulin receptor RTK phosphorylates tyrosines

phosphorylating serines/threonines inhibits phosphorylation of tyrosines and inhibits downstream signalling.

Front 453

Competant Bacteria

Back 453

can uptake DNA for transformation

Strep pneumo
H influenzae
N meningitidis

Front 454

Rifampin & CYP450

Back 454

CYP450 Inducers

Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Griseofulvin

Hint 454

#pharmacology #pharmacodynamics

Front 455

Acid Fast Stain

Back 455

Analine dye (carbolfuscion)
Hydrochloric Acid (dissolves outer membranes)
Counter stain: methylene blue

Stains mycolic acid

Mycoplasma: Acid Fast
Nocardia: Weakly acid fast

Front 456

Griseofulvin & CYP450

Back 456

CYP450 Inducers

Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Griseofulvin

Hint 456

#pharmacology #pharmacodynamics

Front 457

Oral Thrush, Interstitial Pneumonia, Severe Lymphopenia during first year of life

Back 457

HIV+ maternal → fetal transmission

prevent with zidovudine nucleoside analogue RTI

Front 458

DOC: Serotonin Sro

Back 458

Cyproheptadine

antihistamine with anti-serotonergic properties

Front 459

Cimetidine & CYP450

Back 459

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 459

#pharmacology #pharmacodynamics

Front 460

Inheritence pattern of G6PD

Back 460

X linked

Front 461

Cirpofloxacin & CYP450

Back 461

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 461

#pharmacology #pharmacodynamics

Front 462

Fx at hook of hamate: neurologic consequence?

Back 462

Ulnar nerve injury

passes btw hook of hamate and pisiform bone in Guyon's fibroosseus tunnel

Dysesthesias on ulnar side of hand and weakness of intrinsic mucles of the hand

Front 463

dysthesias on ulnar side of hand and weakness of intrinsic mucles of the hand

Back 463

Fx at hook of hamate: Ulnar nerve injury

passes btw hook of hamate and pisiform bone in Guyon's fibroosseus tunnel

Front 464

Erythromycin & CYP450

Back 464

CYP450 Inhibitors

Cimetidine
Ciprofloxacin
Erythromycin
Azole antifungals
Grapefruit Juice
Isoniazid
Ritonavir/Protease Inihbitors

Hint 464

#pharmacology #pharmacodynamics

Front 465

Fx at Radeal head:
neurologic consequence?

Back 465

radial nerve innervates muscles of the extensor compartment of the upper arm, passes through lateral epicondyle and divides into superficial and deep branches.

superficial branch: sensory innervation to dorsal half of hand, radial side.

Damage to radial nerve injury at radial head (including subluxation) damages deep branch: wakenss of forarm extensors with wrist drop

Front 466

Radial nerve

Back 466

radial nerve innervates muscles of the extensor compartment of the upper arm, passes through lateral epicondyle and divides into superficial and deep branches.

superficial branch: sensory innervation to dorsal half of hand, radial side.

Damage to radial nerve injury at radial head (including subluxation) damages deep branch: wakenss of forarm extensors with wrist drop

Front 467

Aspirin Induced Kidney Damage

Back 467

Chronic Interstital Nephritis

Hint 467

#pharmacology #toxicity #pathology #nephrology

Front 468

Fx at the surgical neck of the humerus

Back 468

axillary nerve damage

paralysis of deltoid and teres major muscles, loss of sensation to lateral upper arm

Front 469

paralysis of deltoid and teres major muscles, loss of sensation to lateral upper arm

Fx?

Back 469

surgical neck of humerus

Front 470

Coracobrachialis

adjacent strx,
innervation

Back 470

overlies median nerve and brachial artery

innervated by musculocutaneous nerve.

Front 471

Vitamin E deficiency

Back 471

anti-oxidant which preserves cell membranes

most affected:
neurons (large surface area)
RBC's (poor antioxidant fnx)

manifestation:
Friederick's ataxia-like neuropathy w/ ataxi a & loss of proprioception and vibration +
hemolytic anemia

Hint 471

#pathology #nutrition #neurology #hematology

Front 472

Hibernating Myocardium

Back 472

repetitive ischemia of myocytes or persistent hypoperfusion → chronic but reversible loss of contractile fnx "hibernation"

Repetitive "stunning" (mild <30 min ischemic episodes) can result in hibernation

Front 473

Myocardial stunning

Back 473

mild ischemia induced reversible loss of contractile function

Repetitive Stunning can lead to hibernation
<30 min
full recovery w/in days

Front 474

Compare Subclasses of Class I antiarrhytmics

Back 474

1A (DQP)
prolonged QRS
intermediate inhibition of phase 0

1B
Shortened QRS
Weak inhibition of Phase 0

1C
∅Δ QRS
Strong inhibition phase zero

Hint 474

#cardiovascular #pharmacology

Front 475

Ischemic preconditioning

Back 475

cardiac myocytes which develop resistence to infarction via non-lethal ischemia

sub-lethal ischemia protect myocardium vs later ischemic events

Front 476

Chronic reversible loss of cardiomyocyte contractile fnx

Back 476

Hibernating myocardium

repetitive ischemia of myocytes or persistent hypoperfusion → chronic but reversible loss of contractile fnx "hibernation"

Repetitive "stunning" (mild <30 min ischemic episodes) can result in hibernation

Front 477

Short term reversible loss of cardiomyocyte contractile fnx

Back 477

Myocardial Stunning

mild ischemia induced reversible loss of contractile function

Repetitive Stunning can lead to hibernation


NB: ischemic preconditioning = cardiac myocytes which develop resistence to infarction via non-lethal ischemia

sub-lethal ischemia protect myocardium vs later ischemic events

Front 478

Teardrop RBC's

Back 478

indicative of myelofibrosis or metastatic cancer

RBC's which had had to squeeze through fibrous strands

(not sliced like schistocytes)

Hint 478

#hematology #pathology #diagnostics

Front 479

Sequelae of sublethal ischemia on myocardium

Back 479

ischemic preconditioning
cardiac myocytes which develop resistence to infarction via non-lethal ischemia

sub-lethal ischemia protect myocardium vs later ischemic events

Front 480

Pantothenic Acid

Back 480

actively transported into the cell and then ATP-dependently phosphorylated to become Coenzyme A

particularly important for first step of TCA cycle: binds with oxaloacetate to form citrate and then succinyl-CoA

also important in the syntehsis of vitamin A, D, cholesterol, steroids, heme A, fatty acids, amino acids and proteins

Deficiency rare, severley malnourished with "burning feet" paresthesias and GI distress

Front 481

Acanthrocytosis

Back 481

indicative of abetalipoproteinemia
or liver dz

no fat absorption
(no vitamin E absorption)

Hint 481

#hematology #pathology #diagnostics

Front 482

Spur cells

Back 482

extreme form of acanthrocytosis
or liver dz

indicative of abetalipoproteinemia

Hint 482

#hematology #pathology #diagnostics

Front 483

Most common location of colon cancer

Back 483

rectosigmoid colon

Hint 483

#pathology #neoplasia #gastrointestinal

Front 484

anatomic landmarks of ureters to bladder

Back 484

start retroperitoneally on top of psoas

pass under gonadal vasculature

cross over the common or external illiac arteries (depending on laterality)

stay laterl to internal ilac vessels and medial to gonadal vessels before entering uterosacral ligament and gaining access to bladder

Hint 484

#anatomy #genitourinary

Front 485

Helmet Cell

Back 485

Schistocyte
ie mechanical trauma

Hint 485

#hematology #pathology #diagnostics

Front 486

Most Likely Outcomes:

Acute Hep B and C

Back 486

Hep B: Complete Resolution

Hep C: Chronic Stable Hepatitis

Hint 486

#microbiology #hepatobiliary #pathology

Front 487

Ki 67

Back 487

protein expressed in S phase

maker for proliferation

near 100% in cancers

Hint 487

#pathology #neoplasia #molecules #diagnostics

Front 488

Familial QT prolongation

Back 488

predisposes to TdP

accompanied by neurosensory deafness

Hint 488

#pathology #cardiovascular #neurology #geneticdzs

Front 489

Familial Neurosensory Deafness

Likely Accompanying Condition?

Back 489

Familial QT prolongation

predisposes to TdP

Hint 489

#pathology #cardiovascular #neurology #geneticdzs

Front 490

Pathogenesis of aortic aneurysm

Back 490

myxomatous changes in media of large arteries 2* gragementation of elastic ts

may be caused by marfan sro
β-aminopropionitrile (sweat peas) inhibits lysyl oxidase which cross links elastin

Hint 490

#pathology #cardiovascular

Front 491

SERM: agonist in bones antagonist in breast and uterus

Back 491

Raloxifene

Hint 491

#pharmacology #endocrine #neoplasia

Front 492

Raloxifene

Back 492

SERM: agonist in bones antagonist in breast and uterus

Hint 492

#pharmacology #endocrine #neoplasia

Front 493

Uremia v. Hemostasis

Back 493

only ↑ Bleeding Time

∅Δ platelet count

just makes platelets non-fnx

Hint 493

#pathology #henmatology #nephrology

Front 494

azoospermia

Back 494

not having measurable sperm in semen

think CF bilateral absence of vas deferens

Hint 494

#pathology #reproductive #geneticdzs

Front 495

bilateral absence of vas deferens

Back 495

CF

Hint 495

#pathology #reproductive #geneticdzs

Front 496

Cutoff for Sweat Chloride Test

Back 496

above 60 mM/L is diagnostic

Hint 496

#pathology #geneticdzs #diagnostics

Front 497

Thiazide Diuretics
and
Serum Constituents

Back 497

Causes Hyper
-Uricemia, Calcemia, Glycemia, Lipidemia
"GLUC"
Hypo
Kalmia & Tension

Hint 497

#pharmacology #toxicity

Front 498

Heart Abnormality of DiGeorge Sro

Back 498

Tetrology of Fallot

Hint 498

#pathology #cardiovascular #geneticdzs

Front 499

Heart Abnormality of Down Sro

Back 499

Endocardial Cushion Defects:
--ASD
--Regurgitant AV vales

Hint 499

#pathology #cardiovascular #geneticdzs

Front 500

ApoA

Lipoproteins
Fnx
Dysfnx manifestation

Back 500

ApoA1

Present on Chylomicrons and HDL's
(not Chylomycron Remants interestingly)

LCAT activation induces cholesterol esterification

Dysnfx: not a clinical entity

Hint 500

#biochemistry #energymetzm #lipids

Front 501

Apolipoprotein: LCAT Activation

Lipoproteins, Dysnfx

Back 501

ApoA1

Present on Chylomicrons and HDL's
(not Chylomycron Remants interestingly)

LCAT activation induces cholesterol esterification

Dysnfx: not a clinical entity

Hint 501

#biochemistry #energymetzm

Front 502

ApoB-48

Lipoproteins
Fnx
Dysfnx manifestation

Back 502

ApoB-48

Present on Chylomicrons and CM Remnants

Fnx: Chylomicron assembly and secretion by small intestine

Dysnfx: not a clinical entity

Hint 502

#biochemistry #energymetzm

Front 503

Apolipoprotein: Chylomicron assembly and secretion

Lipoproteins, Dysnfx

Back 503

ApoB-48

Present on Chylomicrons and CM Remnants

Fnx: Chylomicron assembly and secretion by small intestine

Dysnfx: not a clinical entity

Hint 503

#biochemistry #energymetzm

Front 504

ApoB-100

Lipoproteins
Fnx
Dysfnx manifestation

Back 504

ApoB-100

Present on VLDL, IDL and LDL

Binds LDL receptor

Dysnfx: inherited overexpression = Type 2b combined familial hyperlipidemia

HyperTAGemia + Hypercholesterolemia c high [LDL] and [VLDL]

∅xanthoma
✓ ↑ CVD Risk
Tx: aggressive lifestyle modification + Rx's

Hint 504

#biochemistry #energymetzm

Front 505

Apolipoprotein which binds LDL receptor

Lipoproteins, Dysnfx

Back 505

ApoB-100

Present on VLDL, IDL and LDL

Binds LDL receptor

Dysnfx: inherited overexpression = Type 2b combined familial hyperlipidemia

HyperTAGemia + Hypercholesterolemia c high [LDL] and [VLDL]

∅xanthoma
✓ ↑ CVD Risk
Tx: aggressive lifestyle modification + Rx's

Hint 505

#biochemistry #energymetzm

Front 506

HyperTAGemia + Hypercholesterolemia c ↑ LDL & VLDL

Back 506

ApoB-100

Present on VLDL, IDL and LDL

Binds LDL receptor

Dysnfx: inherited overexpression = Type 2b combined familial hyperlipidemia

HyperTAGemia + Hypercholesterolemia c high [LDL] and [VLDL]

∅xanthoma
✓ ↑ CVD Risk
Tx: aggressive lifestyle modification + Rx's

Hint 506

#biochemistry #energymetzm

Front 507

ApoC-II

Lipoproteins
Fnx
Dysnfx

Back 507

ApoC-II: Lipoprotein lipase activation

Lipoproteins: HDL, CM, VLDL

Dysnfx:
Type I Familial Chylomicronemia
--identical to LPL deficiency

Isolated HyperTAGemia c ↑ CM & Normal VLDL
Xanthoma, Pancreatitis, Hepatosplenomegaly
Presentation: Abdominal Pain 2° Acute Pancreatitis

NB: No Tendinous Xanthomas, Xanthelasmas, or ↑ CVD (all from cholesterol)

Hint 507

#biochemistry #energymetzm

Front 508

Apolipoprotein:
Activates Lipoprotein Lipase

Lipoproteins
Dysnfx

Back 508

ApoC-II: Lipoprotein lipase activation

Lipoproteins: HDL, CM, VLDL

Dysnfx:
Type I Familial Chylomicronemia
--identical to LPL deficiency

Isolated HyperTAGemia c ↑ CM & Normal VLDL
Xanthoma, Pancreatitis, Hepatosplenomegaly
Presentation: Abdominal Pain 2° Acute Pancreatitis

NB: No Tendinous Xanthomas, Xanthelasmas, or ↑ CVD (all from cholesterol)

Hint 508

#biochemistry #energymetzm

Front 509

Isolated HyperTAGemia c ↑ CM & Normal VLDL

Back 509

ApoC-II: Lipoprotein lipase activation

Lipoproteins: HDL, CM, VLDL

Dysnfx:
Type I Familial Chylomicronemia
--identical to LPL deficiency

Isolated HyperTAGemia c ↑ CM & Normal VLDL
Xanthoma, Pancreatitis, Hepatosplenomegaly
Presentation: Abdominal Pain 2° Acute Pancreatitis

NB: No Tendinous Xanthomas, Xanthelasmas, or ↑ CVD (all from cholesterol)

Hint 509

#biochemistry #energymetzm

Front 510

Type I Familial Chylomicronemia

Back 510

ApoC-II: Lipoprotein lipase activation

Lipoproteins: HDL, CM, VLDL

Dysnfx:
Type I Familial Chylomicronemia
--identical to LPL deficiency

Isolated HyperTAGemia c ↑ CM & Normal VLDL
Xanthoma, Pancreatitis, Hepatosplenomegaly
Presentation: Abdominal Pain 2° Acute Pancreatitis

NB: No Tendinous Xanthomas, Xanthelasmas, or ↑ CVD (all from cholesterol)

Hint 510

#biochemistry #energymetzm

Front 511

Type 2b combined familial hyperlipidemia

Back 511

ApoB-100

Present on VLDL, IDL and LDL

Binds LDL receptor

Dysnfx: inherited overexpression = Type 2 combined familial hyperlipidemia

HyperTAGemia + Hypercholesterolemia c high [LDL] and [VLDL]

∅xanthoma
✓ ↑ CVD Risk
Tx: aggressive lifestyle modification + Rx's

Hint 511

#biochemistry #energymetzm

Front 512

ApoE (3 & 4)

Lipoproteins
Fnx
Dysnfx

Back 512

ApoE3 & ApoE4

CM CMR, VLDL, IDL (not LDL or HDL)

VLDL and Chylomicron remnant uptake by liver cells

Dysnfx: Type III Hyperlipidemia Dysbetalipoproteinemia

mostly manifests as poor clearance of IDL

Combined HyperTAGemia + Hypercholesterolemia with ↑ IDL

Xanthoma and ↑ RIsk CVD

Hint 512

#biochemistry #energymetzm

Front 513

Apolipoprotein: Hepatic Remanant Clearance

Lipoproteins, Dyfnx

Back 513

ApoE3 & ApoE4

CM CMR, VLDL, IDL (not LDL or HDL)

VLDL and Chylomicron remnant uptake by liver cells

Dysnfx: Type III Hyperlipidemia Dysbetalipoproteinemia

mostly manifests as poor clearance of IDL

Combined HyperTAGemia + Hypercholesterolemia with ↑ IDL

Xanthoma and ↑ RIsk CVD

Hint 513

#biochemistry #energymetzm

Front 514

Combined HyperTAGemia + Hypercholesterolemia with ↑ IDL

Back 514

ApoE3 & ApoE4

CM CMR, VLDL, IDL (not LDL or HDL)

VLDL and Chylomicron remnant uptake by liver cells

Dysnfx: Type III Hyperlipidemia Dysbetalipoproteinemia

mostly manifests as poor clearance of IDL

Combined HyperTAGemia + Hypercholesterolemia with ↑ IDL

Xanthoma and ↑ RIsk CVD

Hint 514

#biochemistry #energymetzm

Front 515

Type III Hyperlipidemia Dysbetalipoproteinemia

Back 515

ApoE3 & ApoE4

CM CMR, VLDL, IDL (not LDL or HDL)

VLDL and Chylomicron remnant uptake by liver cells

Dysnfx: Type III Hyperlipidemia Dysbetalipoproteinemia

mostly manifests as poor clearance of IDL

Combined HyperTAGemia + Hypercholesterolemia with ↑ IDL

Xanthoma and ↑ RIsk CVD

Hint 515

#biochemistry #energymetzm

Front 516

Isolated Hypercholesterolemia c ↑ LDL

Back 516

Type IIa Familial Hypercholesterolemia

Isolated Hypercholesterolemia c ↑ LDL

Deficiency of LDL receptor

Xanthomas, Corneal Arcus, ↑ Risk CVD

Hint 516

#biochemistry #energymetzm

Front 517

Corneal Arcus

Back 517

Type IIa Familial Hypercholesterolemia

Isolated Hypercholesterolemia c ↑ LDL

Deficiency of LDL receptor

Xanthomas, Corneal Arcus, ↑ Risk CVD

Hint 517

#biochemistry #energymetzm

Front 518

Deficiency of LDL receptor

Back 518

Type IIa Familial Hypercholesterolemia

Isolated Hypercholesterolemia c ↑ LDL

Deficiency of LDL receptor

Xanthomas, Corneal Arcus, ↑ Risk CVD

Hint 518

#biochemistry #energymetzm

Front 519

Type IIa Familial Hypercholesterolemia

Back 519

Type IIa Familial Hypercholesterolemia

Isolated Hypercholesterolemia c ↑ LDL

Deficiency of LDL receptor

Xanthomas, Corneal Arcus, ↑ Risk CVD

Hint 519

#biochemistry #energymetzm

Front 520

Isolated Hypertagemia c ↑ VLDL

Back 520

Type IV Familial HyperTAGemia

Isolated Hypertagemia c ↑ VLDL

VLDL over-expression

↑ Risk of CVD

Hint 520

#biochemistry #energymetzm

Front 521

VLDL overexpression

Back 521

Type IV Familial HyperTAGemia

Isolated Hypertagemia c ↑ VLDL

VLDL over-expression

↑ Risk of CVD

Hint 521

#biochemistry #energymetzm

Front 522

LPL deficiency

Back 522

ApoC-II: Lipoprotein lipase activation

Lipoproteins: HDL, CM, VLDL

Dysnfx:
Type I Familial Chylomicronemia
--identical to LPL deficiency

Isolated HyperTAGemia c ↑ CM & Normal VLDL
Xanthoma, Pancreatitis, Hepatosplenomegaly

NB: No Tendinous Xanthomas, Xanthelasmas, or ↑ CVD (all from cholesterol)

Hint 522

#biochemistry #energymetzm

Front 523

Type IV Familial HyperTAGemia

Back 523

Type IV Familial HyperTAGemia

Isolated Hypertagemia c ↑ VLDL

VLDL over-expression

↑ Risk of CVD

Hint 523

#biochemistry #energymetzm

Front 524

Tubular Xanthomas

Back 524

aka Tendinous Xanthomas

the hallmark of type 2a familial hypercholesterolemia

Type IIa Familial Hypercholesterolemia
Isolated ↑ LDL 2° to LDL receptor deficiency
Xanthomas, Corneal Arcus, ↑ Risk CVD

Type 2 B
ApoB-100 (binds LDL receptor)
overexpression = HyperTAGemia + Hypercholesterolemia c high [LDL] and [VLDL]
∅xanthoma, ✓ ↑ CVD Risk
Tx: aggressive lifestyle modification + Rx's

Hint 524

#biochemistry #energymetzm

Front 525

Tendinous Xanthomas

Back 525

aka Tuberous Xanthomas

the hallmark of type 2a familial hypercholesterolemia

Type IIa Familial Hypercholesterolemia
Isolated ↑ LDL 2° to LDL receptor deficiency
Xanthomas, Corneal Arcus, ↑ Risk CVD

Type 2 B
ApoB-100 (binds LDL receptor)
overexpression = HyperTAGemia + Hypercholesterolemia c high [LDL] and [VLDL]
∅xanthoma, ✓ ↑ CVD Risk
Tx: aggressive lifestyle modification + Rx's

Hint 525

#biochemistry #energymetzm

Front 526

What should you monitor when giving Lithium?

Back 526

T3 and T4

Hint 526

#pharmacology #toxicities

Front 527

What should you monitor when giving Amiodarone?

Back 527

PFT's: Pulmonary Fibrosis
LFT's
TFTs

Hint 527

#pharmacology #toxicities

Front 528

What should you monitor when giving INH?

Back 528

LFT's

Hint 528

#pharmacology #toxicities

Front 529

What should you monitor when giving Carbamazapine?

Back 529

LFT's

Hint 529

#pharmacology #toxicities

Front 530

For what drugs should you monitor thyroid hormone levels?

Back 530

Lithium
Amiodarone (LFT, PFT, TFTs)

Hint 530

#pharmacology #toxicities

Front 531

For what drugs should you vigilently monitor LFT's?

Back 531

INH
Carbamazapine
Amiodarone (LFT, PFT, TFTs)

Hint 531

#pharmacology #toxicities

Front 532

Which heart chamber is closest to the esophagus?

Back 532

left atrium makes up the majority of heart's posterior surface

RA makes up the right border of X-ray
LV makes up the left border and paex
RV is the front of the heart and inferior border on X ray

Hint 532

#anatomy #cardiovascular

Front 533

Why doesn't blood flow back into lungs during atrial systole?

Back 533

cardiac muscle in proximal few cm of pulmonary veins fnx like sphincters

Hint 533

#phsyiology #cardiovascular

Front 534

5' 3'

3' 5'

which way does DNA polymerize?

Back 534

DNA adds onto the 3' end
the 3' end is out front and then the next piece clips a 5' onto that

5' → 3'

Hint 534

#biochemistry #DNA

Front 535

3' 5'

5' 3'

which way does DNA polymerize?

Back 535

DNA adds onto the 3' end
the 3' end is out front and then the next piece clips a 5' onto that

5' → 3'

Hint 535

#biochemistry #DNA

Front 536

bisphosphoglycerate mutase

Back 536

bisphosphoglycerate mutase
present only in RBC's & Placenta
alternative glycolytic pathway which produces no ATP

BPG mutase: 1,3 BPG → 2,3 BPG

Phosphatase: 2,3 BPG → 3 Phosphoglycerate

Bypasses one step by Phosphoglycerate kinase which would have produced ATP

2,3 BPG allosterically induces a right shift → O2 dumping

[I guess BPG mutase fnx is upregulated by hypoxia]

Hint 536

#biochemistry #hemoglobin #molecules #energymetzm

Front 537

1,3 BPG → 2,3 BPG

Back 537

bisphosphoglycerate mutase
present only in RBC's & Placenta
alternative glycolytic pathway which produces no ATP

BPG mutase: 1,3 BPG → 2,3 BPG

Phosphatase: 2,3 BPG → 3 Phosphoglycerate

Bypasses one step by Phosphoglycerate kinase which would have produced ATP

2,3 BPG allosterically induces a right shift → O2 dumping

Hint 537

#biochemistry #hemoglobin #molecules #energymetzm

Front 538

2,3-bisphosphoglycerate

Back 538

bisphosphoglycerate mutase
present only in RBC's & Placenta
alternative glycolytic pathway which produces no ATP

BPG mutase: 1,3 BPG → 2,3 BPG

Phosphatase: 2,3 BPG → 3 Phosphoglycerate

Bypasses one step by Phosphoglycerate kinase which would have produced ATP

2,3 BPG allosterically induces a right shift → O2 dumping

Hint 538

#biochemistry #hemoglobin #molecules #energymetzm

Front 539

Factors which induce K+ secretion in the proximal tubule

Back 539

Dietary K
Aldosterone
Alkalosis
K non sparing diuretics.

Hint 539

#physiology #nephrology

Front 540

CD55

Back 540

Paroxysmal Nocturnal Hemoglobinuria
Neither Paroxysmal nor Nocturnal
Constant w/ ↑ visualization in first urine of day

mutation in PIG-A gene which codes for glycosylphosphatidylcholine (GPI) anchor necessary for CD55 and CD59 attachment

CD55 & 59 important to inactivate complement

a disorder of the stem cells → pancytopenia

chronic hemolysis → recurrent venous thromboses

>>deficiency of CD55 and CD59 diagnostic of PNH<<

Hint 540

#pathology #hematology

Front 541

Paroxysmal Nocturnal Hemoglobinuria

Back 541

Paroxysmal Nocturnal Hemoglobinuria
Neither Paroxysmal nor Nocturnal
Constant w/ ↑ visualization in first urine of day

mutation in PIG-A gene which codes for glycosylphosphatidylcholine (GPI) anchor necessary for CD55 and CD59 attachment

CD55 & 59 important to inactivate complement

a disorder of the stem cells → pancytopenia

chronic hemolysis → recurrent venous thromboses

>>deficiency of CD55 and CD59 diagnostic of PNH<<

Hint 541

#pathology #hematology

Front 542

CD59

Back 542

Paroxysmal Nocturnal Hemoglobinuria
Neither Paroxysmal nor Nocturnal
Constant w/ ↑ visualization in first urine of day

mutation in PIG-A gene which codes for glycosylphosphatidylcholine (GPI) anchor necessary for CD55 and CD59 attachment

CD55 & 59 important to inactivate complement

a disorder of the stem cells → pancytopenia

chronic hemolysis → recurrent venous thromboses

>>deficiency of CD55 and CD59 diagnostic of PNH<<

Hint 542

#pathology #hematology

Front 543

Mycoplasma v Mycobacterium

Species, DOC's

Back 543

Mycobacterium: tuberculosis, leprosy, M avium
Mycolic acid cell wall: acid fast
INH (B6 analogue) inhibits mycolic acid synth


Mycoplasma: M pneumo & ureaplasma urealyticam
single cell membrane composed of cholesterol containing pospholipid bilayer
DOC: erythromycin or tetracycline

Hint 543

#microbiology #antimicrobials #pharmacology

Front 544

ACEI's → ↑ Cr

Back 544

Slight ↑ Cr physiologic 2° to ↓ Renal Filtration

(relaxed efferent arteriole)

Hint 544

#pharmacology #toxicities #nephrology

Front 545

Renal damage from heroine

Back 545

focal segmental glomeruloscelrosis

same as pamidronate

Hint 545

#pharmacology #toxicities #nephrology

Front 546

Renal damage from pramidronate

Back 546

focal segmental glomeruloscelrosis

same as heroin

Hint 546

#pharmacology #toxicities #nephrology

Front 547

Renal damage from Gold

Back 547

membranous nephropathy

Hint 547

#pharmacology #toxicities #nephrology

Front 548

Renal damage from Sulfonamides

Back 548

precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene

Hint 548

#pharmacology #toxicities #nephrology

Front 549

Acid-Base State of Pulmonary Ebolus Pt

Back 549

Respiratory Alkalosis

PE → V/Q mismatch → hypoxia → hyperventilation → ↓ pCO2

Hint 549

#pathology #pulmonology

Front 550

Renal damage from MTX

Back 550

precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene

Hint 550

#pharmacology #toxicities #nephrology

Front 551

Renal damage from acyclovir

Back 551

precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene

Hint 551

#pharmacology #toxicities #nephrology

Front 552

What Amino Acid is essential in PKU

Back 552

Tyrosine

Hint 552

#biochemistry #pathology

Front 553

Crescenteric Glomerulonephritis:

what could you stain for?

Back 553

Monocytes, M∅& fibrin

as it progresses ↑ sclerosis: mroe and mroe fibrin

if and only if goodpasture
IgG & C3

Hint 553

#pathology #diagnostics #nephrology

Front 554

Renal damage from triamterene

Back 554

precipitation in renal tubules → failure

sulfonamides, MTX, acyclovir, triamterene

Hint 554

#pharmacology #toxicities #nephrology

Front 555

Renal damage from foscarnet

Back 555

drug induced tubular necrosis

aminoglycosides, radiocontrast media, cisplatin, amphotericin B, foscarnet

Hint 555

#pharmacology #toxicities #nephrology

Front 556

Varicose Veins: most problematic complication

Back 556

skin

thrombi do occur, but no thromboemboli

all PE's from deep veins of leg (sic: DVT)
varicosities occur in superficial veins

Hint 556

#cardiovascular #pathology

Front 557

Mechanism of Action: NO

Back 557

primarily a venodilator

↓ preload → ↓ cardiac O2 demand


large doses can affect arterioles → HA, flushing

Hint 557

#pharmacology #cardiovascular

Front 558

phlegmaisa alba dolens

Back 558

painful white leg

ilofemoral venous thrombosis which occurs in peripartum women 2° uterus pressure on deep pevic veins + hypercoagulaable state

non-ischemic state

if superficial flow lost also "Phlegmasia cerulea dolens"→ ischemia & gangrene

Hint 558

#reproductive #pathology #cardiovascular

Front 559

Flunisolide

Back 559

inhaled glucocorticoid
prophylaxis vs bronchial asthma

DOC vs bronchial asthma for anti-inflam effects

Hint 559

#pharmacology #pulmonology

Front 560

Regulation: precapillary sphincters

Back 560

pericytes

location dpt response to NE & E
dilate irt histamine, ↓ O2, ↑ CO2, ↓ pH

Hint 560

#physiology #cardiovascular

Front 561

Palpable But Non-Tender Gallbladder

Back 561

Courvoisier Sign

indicative of adenocarcinoma of head of pancreas compressing bile duct

Biggest environmental contributor: smoking

Hint 561

#pathology #gastrointestinal
#neoplasia

Front 562

Theophylline

Back 562

Methylxanthines: theophylline & aminophylline

phosphodiesterase inhibitor, increases [cAMP] → bronchodilation

also block adensoine receptors

Hint 562

#pharmacology #pulmonology

Front 563

aminophylline

Back 563

Methylxanthines: theophylline & aminophylline

phosphodiesterase inhibitor, increases [cAMP] → bronchodilation

also block adensoine receptors

Hint 563

#pharmacology #pulmonology

Front 564

Low Fiber Diet v CA

Back 564

Colonic Adenocarcinoma

Hint 564

#pathology #gastrointestinal
#neoplasia

Front 565

"Starry Sky" Lymphoma

Back 565

Burkitt's Lymphoma

appearance from M∅ &apoptotic bodies

almost all assoc. w/ c-MYC translocations on chrom 8 usually w/ Ig on 14 t(18;14)

Hint 565

#pathology #neoplasia #hematology

Front 566

Phosphodiesterase Inhibitors vs Asthma

Back 566

Methylxanthines: theophylline & aminophylline

phosphodiesterase inhibitor, increases [cAMP] → bronchodilation

also block adensoine receptors

Hint 566

#pharmacology #pulmonology

Front 567

Most common cause of asthma

Back 567

inhaled allergens like animal dander >> other stuff like cold air & exercise

Hint 567

#pathology #pulmonology

Front 568

What does intracellular [citrate] affect?

Back 568

↑ Acetyl CoA carboxylase (FA synth)
↓ Posphofructokinase 1 (Glycolysis)

Hint 568

#bicohemistry #energymetzm

Front 569

DOC: Mac

Back 569

clarithormycin or azithromycin + others

Hint 569

#antimicrobials #pharmacology #microbiology

Front 570

To where is blastomyces native

Back 570

Mississippi River & Great Lakes regions

Hint 570

#microbiology

Front 571

DOC: kaospi's sarcoma

Back 571

IFN α (roferon)

Hint 571

#antimicrobials #pharmacology #microbiology

Front 572

Flecainide

Back 572

IC antiarrhytmic

blocks sodium channels and primarily acts by slowing phase 0 depolarization
no effect on duration of QT

contrast to
IA: Qunidine, Procainimide, Disopyramide
blocks K channels ↑ QT

IB: Lidocaine, Mixiletine, Tocainide
shortens QT by ↓ Funny Current (Background Na)

Hint 572

#drugs #cardiology #pharmacology

Front 573

DOC: Pneumocystis pneumonia

Back 573

pentamidine

also for tyrpanosoma brucei

Hint 573

#antimicrobials #pharmacology #microbiology

Front 574

Dofetilide

Back 574

Class III antiarrhthmic

blocks K⁺ channels

dofetilide, ibutilide, amiodarone, sotalol

Hint 574

#drugs #cardiology #pharmacology

Front 575

Ibutilide

Back 575

Class III antiarrhthmic

blocks K⁺ channels

dofetilide, ibutilide, amiodarone, sotalol

Hint 575

#drugs #cardiology #pharmacology

Front 576

pentamidine

Back 576

DOC: Pneumocystis pneumonia & Tyrpanosoma brucei

[unknown mech]

Hint 576

#antimicrobials #pharmacology #microbiology

Front 577

Major causes of Hepatocellular Carcinoma

Back 577

Hep B, Hep C, Chronic EtOH, Afloatoxins

Hint 577

#pathology #neoplasia #hepatobiliary

Front 578

Mutations in the HIV genome which enhance its virulence/survival

Back 578

pol genes: resistance to HIV reverse transcriptase inhibitors & other antiretroviral drugs (reverse transcriptase inhibitor)

env: escape host neurtalizing antibodies (codes glycoproteins)

Hint 578

#microbiology #resistance

Front 579

Ticlopidine

Back 579

Ticlopidine
ADP antagonist like Clopidogrel

2nd line drug for pts who are allergic to clopidogrel

serious side effects: neutropenia → fever & mouth ulcers

Hint 579

#pharmacology #cardiovascular #toxicities

Front 580

Why inverted nipple w/ breast ca?

Back 580

suspensory ligament infiltration

Hint 580

#pathology #diagnostics #reproductive #neoplasia

Front 581

Best Diagnostic Test for Distended, Tympanic Abdomen

Back 581

Potential Toxic Megacolon

Flat Plain X Ray

Anything that invades (scope, enema) may induce perforation

Hint 581

#pathology #diagnostics #gastrointestinal

Front 582

Pt on Rx after TIA dvlps fever & oral ulcers

Back 582

Ticlopidine
ADP antagonist like Clopidogrel

2nd line drug for pts who are allergic to clopidogrel

serious side effects: neutropenia → fever & mouth ulcers

Hint 582

#pharmacology #cardiovascular #toxicities

Front 583

Most cardioselective calcium channel blocker

Back 583

Verapamil

Hint 583

#cardiovascular #pharmacology

Front 584

Pt cannot clear Giardia infx

Back 584

IgA deficiency

Hint 584

#microbiology #immunology #gastrointestinal

Front 585

anti-arrhythmic which ↑ PR & QT intervals

Back 585

Sotalol

Class II: β1 blockade ↑ PR
Class III: K+ blockade ↑ QR

uniquely so

Hint 585

#pharmacology #cardiovascular

Front 586

Where are ulcers not likely to be malignant

Back 586

Vast Majority of Ulcers Duodenal

Even when H pylori induced, not likely malignant

Esewhere assoc. w/ malignancy
Stomach: adenocarcinoma, maltoma
Esophagus: adenocarcinoam
Colon: annular "napkin rings" or UC (still ↑ risk)

Hint 586

#neoplasia #pathology #gastrointestinal

Front 587

Hydrocephalus, Intracranial Calcifications, Chorioretinitis

Back 587

Classic Traid of Congenital Toxoplasmosis

1st exposed when pregnant

Hint 587

#pathology #neonatology #microbiology

Front 588

Layers of the Gastric Mucosa

Back 588

Surface: simple columnar epithelium which secretes mucus to protect lining

Gastric Pits short things

Midway down Gastric PIts:
parietal Cells: HCl & Intrinsic Factor

Botton of the PIts: Cheif Cells: Pepsinogen

Hint 588

#physiology #gastrointestinal

Front 589

Congential Toxoplasmosis

Back 589

Classic Triad:

Hydrocephalus
Intracranial Calcifications
Chorioretinitis

1st exposed when pregnant

Hint 589

#pathology #neonatology #microbiology

Front 590

Neurophysiology of Urination

Back 590

Sacrial mMicturation center S2-4

Pontine center: coordinates sphincter relaxn

Cerebral corteex: inhibits sacral center

normal pressure hydrocephalus (elderly) ↑ ventricular area stretches descending cortical fibers → urinary incontenence

Hint 590

#neurology #physiology

Front 591

Pt presents with bruised looking eyes and grey scaling papules on extensor surfaces of hands

Back 591

Dermatomyositis

↑ CK, ↑ aldolase, muscle weakness

Heliotrope Rash: bruised looking eyes
Grotton's Papules: grey scaling papules on extensor surfaces of hands

Path: CD8 vs myofibers

Dx: perifasicular atrophy on muscle biopsy

positive ANA, anti-Jo-1

Similar to Polymyositis (∅ Grotton/Heliotrope, ✓ shoulders)

Hint 591

#pathology #rheumatology

Front 592

Urinary incontenence of demention: pathophysiology

Back 592

Sacrial mMicturation center S2-4

Pontine center: coordinates sphincter relaxn

Cerebral corteex: inhibits sacral center

normal pressure hydrocephalus (elderly) ↑ ventricular area stretches descending cortical fibers → urinary incontenence

Hint 592

#neurology #pathology

Front 593

anti-Jo-1

Back 593

Dermatomyositis or Polymyositis

Path: CD8 vs myofibers
Findings: ↑ CK, ↑ aldolase, muscle weakness
positive ANA, anti-Jo-1

Dermatomyositis
Heliotrope Rash: bruised looking eyes
Grotton's Papules: grey scaling papules on extensor surfaces of hands
Dx: perifasicular atrophy on muscle biopsy


Polymyositis
∅ Grotton/Heliotrope/perifasicular atrophy
Mostly affects shoulders

Hint 593

#pathology #rheumatology

Front 594

Size cutoff:
mucociliary elevator vs M∅

Back 594

>2.5 mucociliary elevator
≤2mm Alveolar M∅

[Pneumoconiosis = interstital lung fibrosis 2° to M∅ stimulation & growth factor prodxn]

Hint 594

#physiology #pulmonology

Front 595

perifasicular atrophy on muscle biopsy

Back 595

Dermatomyositis

Heliotrope Rash: bruised looking eyes
Grotton's Papules: grey scaling papules on extensor surfaces of hands

Path: CD8 vs myofibers
Findings: ↑ CK, ↑ aldolase, muscle weakness
positive ANA, anti-Jo-1

Dx: perifasicular atrophy on muscle biopsy


Similar to Polymyositis (∅ Grotton/Heliotrope/perifasicular atrophy, ✓ shoulders)

Hint 595

#pathology #rheumatology

Front 596

Primary biliary cirrhosis: primary pathology

Back 596

antimitochondrial antibody

Hint 596

#pathology #hepatobiliary

Front 597

Dermatomyositis

Back 597

Dermatomyositis

Heliotrope Rash: bruised looking eyes
Grotton's Papules: grey scaling papules on extensor surfaces of hands

Path: CD8 vs myofibers
Findings: ↑ CK, ↑ aldolase, muscle weakness
positive ANA, anti-Jo-1

Dx: perifasicular atrophy on muscle biopsy

Similar to Polymyositis (∅ Grotton/Heliotrope/perifasicular atrophy, ✓ shoulders)

Hint 597

#pathology #rheumatology

Front 598

serum marker of chronic alcoholism

Back 598

elevated gamma glutamylthransferase (GGT)

NB: the whole ALT/AST > 2:1 thing is for alcoholic hepatitis, not chronic alcoholism

Hint 598

#pathology #diagnostics

Front 599

Coronary Steal Effect

Back 599

Vessels in Ischemic Regions are often maximally dilated

addition of adenosine and dipyridamole (coronary-selective vasodilators) may dilate surrounding vessels and divert flow away from ischemic areas.

Hint 599

#pharmacology #cardiovascular #toxicity

Front 600

Polymyositis

Back 600

progresssive symmetrix proximal muslce weakness

Path: CD8 vs myofibers
Endomysial Inflammatory Infiltration
Findings: ↑ CK, ↑ aldolase, muscle weakness

most often involves shoulders

Similar to Dermatomyositis (∅ shoulders, ✓ Grotton/Heliotrope/perifasicular atrophy)

Hint 600

#pathology #rheumatology

Front 601

dipyridamole

Back 601

a coronary-selective vasodilator like adenosine

also inhibits thromboxane synthesis and prevents platelet thrombus formation

Hint 601

#pharmacology #cardiovascular

Front 602

progressive weakness of proximal shoulder muscles

↑ CK aldolase

Back 602

progresssive symmetrix proximal muslce weakness

Path: CD8 vs myofibers
Findings: ↑ CK, ↑ aldolase, muscle weakness

most often involves shoulders

Similar to Dermatomyositis (∅ shoulders, ✓ Grotton/Heliotrope/perifasicular atrophy)

Hint 602

#pathology #rheumatology

Front 603

Polymyalgia Rheumatica

Back 603

Pain and stiffness of axillary muscles w/o weakness

>50yo, occurs in 1/2 of pts w/ temporal arteritis

↑ ESR, normal CK

Tx: prednisone

Hint 603

#pathology #rheumatology

Front 604

Pulmonary perfusion

Back 604

Left and Right Bronchial Arteries arise from Descending Aorta.

These perfuse the areas which would not be perfused by simple flow of pulmonary arteries.

Majority drains into the Right atrium → RA blood is less oxygenated than blood from pulmonary veins.

Hint 604

#physiology #anatomy #pulmonology

Front 605

DOC: Listeria

Back 605

Ampicillin

(& Aminoglycosides)

Hint 605

#microbiology #antimicrobials #pharmacology

Front 606

elderly pt with stiffness & pain in neck, pelvis, shoulders

Back 606

Polymyalgia Rheumatica

Pain and stiffness of axillary muscles w/o weakness

>50yo, occurs in 1/2 of pts w/ temporal arteritis

↑ ESR, normal CK

Tx: prednisone

Hint 606

#pathology #rheumatology

Front 607

Emperical Treatment for Meningitis

Back 607

Ceftriaxone + Ampicillin

Ceftriaxone:
-Neisseria
-Strep pneumo
-Strep pyo
-H influenzae

Ampicillin
-Listeria Monocytogenes

Hint 607

#microbiology #antimicrobials #pharmacology

Front 608

Fibromyalgia

Back 608

Diffuse muscle Pain
Pinpoints
Insomnia
Δ emotional

Hint 608

#pathology #rheumatology

Front 609

Distinguishing causes of metabolic alkalosis

Back 609

Urine Chloride + Volume Status

1. "Saline Responsive" 2° to loss of Gastric Contents (vomitting) + volume contraxn → maintain HCO3 to retain volume
↓ Urine Chloride, Volume Depleted
Tx: Normal Saline

2. "Contraction Alkalosis" Diuretic → Na delivered to distal collecting duct → Na/H+ antiporter
↑ Urine Chloride, Volume Depleted

3. "Saline Resistant" Conn Sro or Mineralcorticoid Excess: Aldosterone upregulates Na/H+ antiporter
↑ Urine Chloride, Hypervolemic

Hint 609

#pathology #nephrology #diagnostics

Front 610

The initial lesion of atherosclerosis

Back 610

Intimal Streak

NB: not intimal tear
this is the initial lesion of dissecting aortic aneurysm

Hint 610

#pathology #cardiovascular

Front 611

Pathogenesis of Aortic Aneurysms

Back 611

Atherosclerotic Atheroma: wall swells with fat until it is too weak to handle the pressure

Initial Lesion is Intimal Streak

NB: not intimal tear
this is the initial lesion of dissecting aortic aneurysm

Hint 611

#pathology #cardiovascular

Front 612

Vaccine from recombinant outer surface protein

Back 612

Borrelia burgdorferi

Hint 612

#microbiology #vaccines

Front 613

46XY neonate with functional gonads but female genitals

Back 613

5α reductase deficiency

No DHT

may only present as small phallus/hypospadias

Hint 613

#pathology #neonatal #urgoenital

Front 614

Brief uncontrollable jerky movements which occur episodically

Back 614

Myoclonic Seizures

DOC: Valproate

Hint 614

#neurology #pharmacology

Front 615

46XY neonate with functional gonads but small phallus and hypospadias

Back 615

5α reductase deficiency

No DHT

may present as female at birth will masculinize at puberty

Hint 615

#pathology #neonatal #urgoenital

Front 616

DOC: Tourettes

Back 616

Haloperidol

Hint 616

#neurology #pharmacology

Front 617

Pulmonary infarction:

what kind of necrosis?

Back 617

almost always hemorrhagic thanks to dual blood supply (pulmonary and bronchial arteries)

Hint 617

#pathology #pulmonology

Front 618

Drug using population:
what organisms cause endocarditis

Back 618

1. Staph aureus
2. Pseudomonas aeruginosa

NB: Tricuspid endocarditis,
septic emboli to lungs → hemorrhagic necrosis

Hint 618

#microbiology #pulmonology

Front 619

Attachment Molecule for CMV

Back 619

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 619

#microbiology

Front 620

Attachment Molecule for EBV

Back 620

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 620

#microbiology

Front 621

Attachment Molecule for HIV

Back 621

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 621

#microbiology

Front 622

Attachment Molecule for Rabies

Back 622

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 622

#microbiology

Front 623

Attachment Molecule for Rhinovirus

Back 623

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 623

#microbiology

Front 624

Virus Which attaches to Cellular Integrins

Back 624

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 624

#microbiology

Front 625

Virus Which attaches to CD21

Back 625

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 625

#microbiology

Front 626

Virus Which attaches to DR2

Back 626

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 626

#microbiology

Front 627

Virus Which attaches to ICAM1

Back 627

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 627

#microbiology

Front 628

Virus Which attaches to CD54

Back 628

CMV: Cellular Integrins
EBV: DR2 (CD21)
HIV: CD4, CXCR4 & CXCR5
Rabies: Nicotinic ACh receptor
Rhinovirus: ICAM1 (CD54)

Hint 628

#microbiology

Front 629

Basement Membrane Splitting

Back 629

Alport Sro: Deafness, Ocular Problems

or

Membranoproliferative Glomerulonephritis type 1
granular IF, mesangial proliferation on LM

Hint 629

#nephrology #pathology

Front 630

Octreotide

Back 630

Somatostatin analogue

Hint 630

#pharmacology #drugs

Front 631

Inferior wall STEMI

which artery?

Back 631

Right Coronary Artery

Sinus Bradycardia

Hint 631

#cardiovascular #pathology #diagnostics

Front 632

Anterior Wall STEMI

which artery?

Back 632

Left Anterior Descending

also supplies interventricular septum

Mobitz Type 2, 2° or 3° possible

Hint 632

#cardiovascular #pathology #diagnostics

Front 633

Left Lateral Wall STEMI

Which artery

Back 633

Left Circumflex

Hint 633

#cardiovascular #pathology #diagnostics

Front 634

Right Coronary Artery Ischemia: EKG Findings

Back 634

Inferior wall MI

Sinus bradycardia

Hint 634

#cardiovascular #pathology #diagnostics

Front 635

Left Anterior Descending Ischemia: EKG Findings

Back 635

Anterior Wall MI

also supplies interventricular septum:

Mobitz Type 2, 2° or 3° possible

Hint 635

#cardiovascular #pathology #diagnostics

Front 636

Left Circumflex Artery Ischemia: EKG Findings

Back 636

Left Lateral Wall MI

Hint 636

#cardiovascular #pathology #diagnostics

Front 637

High Arginine Levels

What Enzyme Deficiency?

Back 637

arginase

progressive spastic paralysis releived by arginine free diet

Hint 637

#biochemistry #energymetzm

Front 638

Atrial Myxoma

Back 638

pedunculated gelatenous masses

scattered cells w/in mucopolysaccharide stroma

large amts of VEGF and IL6 produced
→ intrapeduncular hemorrhaging
→ constitutional sx

either embolize or obstruct valves

dyspnea improves lying down

most common cardiac neoplasm

Hint 638

#pathology #cardiology #neoplasia

Front 639

systemic inflammatory response, mid-diastolic murmur at apex, dyspnea which improves when supine

Back 639

pedunculated gelatenous masses

scattered cells w/in mucopolysaccharide stroma

large amts of VEGF and IL6 produced
→ intrapeduncular hemorrhaging
→ constitutional sx

either embolize or obstruct valves

dyspnea improves lying down

most common cardiac neoplasm

Hint 639

#pathology #cardiology #neoplasia

Front 640

Dysphagia 2° to Cardiac Hypertrophy,

which chamber?

causes?

Back 640

Left Atrium

mitral stensosis or ↑ Left Ventricular Pressure

Hint 640

#cardiology #pathology

Front 641

Preventhing Calcium renal stones without diuretics

Back 641

1. Increase Fluid intake (& thus outgo)
2. Citrate (eg in the form of Potassium Citrate) will bind calcium and prevent it from precipitating with oxalate or phosphate
3. Preventing ↓ pH

Hint 641

#pathology #nephrology

Front 642

Hyperthyroidism with Pain in Neck following Flu like Sx

Back 642

de Quervain's subacute thyroiditis

Granulomatous Inflammation
Early stages = Hyperthyroidism
--release of stored hormones from local destrx
↑ ESR, Jaw Pain, Tender Thyroid

Progresses to Hypothyroidism
usually make complete recovery in months

NB: no antithyroid peroxidase Ab

Hint 642

#pathology
#endocrine
#thyroid

Front 643

De Quervain's Dz

Back 643

de Quervain's subacute thyroiditis

Granulomatous Inflammation following flulike illness

Early stages = Hyperthyroidism
--release of stored hormones from local destrx
↑ ESR, Jaw Pain, Tender Thyroid

Progresses to Hypothyroidism
usually make complete recovery in months

NB: no antithyroid peroxidase Ab

Hint 643

#pathology
#endocrine
#thyroid

Front 644

subacute thyroiditis

Back 644

de Quervain's subacute thyroiditis

Granulomatous Inflammation following flulike illness

Early stages = Hyperthyroidism
--release of stored hormones from local destrx
↑ ESR, Jaw Pain, Tender Thyroid

Progresses to Hypothyroidism
usually make complete recovery in months

NB: no antithyroid peroxidase Ab

Hint 644

#pathology
#endocrine
#thyroid

Front 645

Riedel's Dz

Back 645

Riedel's Thyroiditis

Hypothyroidism

Thyroid Replaced by Fibrous Ts

Rock Hard, Painless Goiter

Hint 645

#pathology
#endocrine
#thyroid

Front 646

Thyroid Replaced by Fibrous Ts

Back 646

Riedel's Thyroiditis

Hypothyroidism

Thyroid Replaced by Fibrous Ts

Rock Hard, Painless Goiter

Hint 646

#pathology
#endocrine
#thyroid

Front 647

Hypothyroidism w/ Rock Hard, Painless Goiter

Back 647

Riedel's Thyroiditis

Hypothyroidism

Thyroid Replaced by Fibrous Ts

Rock Hard, Painless Goiter

Hint 647

#pathology
#endocrine
#thyroid

Front 648

Vessels Spared by PAN

Back 648

Pulmonary Arteries & Bronchial Arteries

Chronically ongoing inflammation of medium & small arteries

Presents as livedo reticularis (purple network) or palpable purpura, propensity for bead like aneurysm

Segmentally distinct acute inflam → Mixed WBC infiltrate → Fibrinoid necrosis
(Contrast Mixed WBC Infitlrate to eosinophil dominated Churgg-Strauss, and PMN dominanted -ie leukocytoclastic- Microscopic polyangitis)

Histology: thick hyalinosis in adventitia

All stages concurrent around the body
(Contrast to Kawasaki's lock-step progression)

Not assoc with ANCA's
(Contrast to Wegener's and Microscopic Polyangitis)

Fatal if UnTx
Rx: immunosuppressents

Hint 648

#pathology #cardiovascular

Front 649

Intestinal Invasion: Agents

Back 649

Salmonella
Shigella
EIEC
Campylobacter jejunu

Entamoeba histolitica

Hint 649

#microbiology #gastrointestinal

Front 650

"Stacked Brick" Intestinal Bacterial Adhesions

Back 650

Enteroaggregative E coli EAEC

Hint 650

#microbiology #gastrointestinal

Front 651

Where do the respiratory drive signals originate

Back 651

Hypercapnea (normal individuals):
-Medulla detects pH

Hypoxia (<60 mmHg or chronic hypercapnics)
-Chemoreceptors in aotic arch and carotid bodies via CN9

Hint 651

#cardiovascular
#pulmonary
#neurology
#physiology

Front 652

Accute Intermittent Porphyria

Back 652

Deficiency of HMB synthase (Uroporphyrinogen I Synthase)

responsible for condensing 2 PBG's → HMB aka uroporphyrinogen 1

1. Abodminal Pain, Neurologic Sx w/o Photosensitivity
2. Urine Darkens on standing
3. ALA & PBG-uria

precipitated by EtOH, Barbituates, Hypoglycemia, Phenytoin & Griseofulvin
relieved by: heme, glucose

Hint 652

#pathology #biochemistry #hematology

Front 653

HMB synthase

Back 653

responsible for condensing 2 PBG's → HMB aka uroporphyrinogen 1

Deficiency: Acute Intermittent Porphyria

1. Abodminal Pain, Neurologic Sx w/o Photosensitivity
2. Urine Darkens on standing
3. ALA & PBG-uria

precipitated by EtOH, Barbituates, Hypoglycemia, Phenytoin & Griseofulvin
relieved by: heme, glucose

Hint 653

#pathology #biochemistry #hematology

Front 654

Hormones which signal via cAMP 2nd Messengers

Back 654

Mn: FLATCHAMP Good Guy Craig

all the releasing hormones except GnRH & TRH (IP3)

FSH
LH
ACTH
TSH
CRH
hCG
ADH -V2 in the Kidney
MSH
PTH
Calcitonin
GHRH
Glucagon

[Non endocrine:
Gs: β's, D1, H2, V2 ↑ cAMP
Gi: M2 α2 D2 ↓ cAMP]

Hint 654

#endocrine #physiology

Front 655

Hormones which signal via IP3 2nd Messengers

Back 655

GnRH, Oxytocin, ADH V1, TRH, H1 AT2, Gastrin

GOAT HAG


[Non-endocrine: H1, α1, V1, M1, M3]

Hint 655

#endocrine #physiology

Front 656

Hormones which signal via Cytosolic Steroid Receptors

Back 656

Vitamin D, Estrogen, Testosterone, Cortisol, Aldosterone, Progesterone

Mn: VET CAP

Think Adrenal Hormones and Vitamin D

Hint 656

#endocrine #physiology

Front 657

Hormones which signal via Nuclear Steroid Receptors

Back 657

T3 & T4 only

Hint 657

#endocrine #physiology

Front 658

Hormones which signal via RTK/MAP pathway

Back 658

Insulin, IGF-1, FGF, PDGF

Think Growth Factors (but not growth hormone)

Hint 658

#endocrine #physiology

Front 659

Hormones which signal via RTK/JAK-STAT

Back 659

Prolactin
Cytokines - eg IL2, IL6 etc
GH

Mn: Jack Stacked Pigs

Hint 659

#endocrine #physiology

Front 660

Sequence of Ig Isotype Switching

Back 660

Requires interaction of B cell CD40 and T cell CD40L (CD154)

Once you go on to the next you cannot come back

M D G E A

Hint 660

#hematology #immunology

Front 661

Drugs implicated in Serotonin Syndrome

Back 661

Anti-Depressants
--SSRI's
--SNRI (Venlafaxine)
--MAOI's
--TCA's

Analgesics
--Tramadol

Anti-Emetics
--Ondansetron (5HT3 antagonist)

Antibiotics
--Linezolid (Vancomycin resistant enterococcus, MRSA)

Neuropsychiatrics
--Triptans

Hint 661

#pharmcology
#toxicities

Front 662

Antidepressents implicated in Serotonin Sro

Back 662

Anti-Depressants
--SSRI's
--SNRI (Venlafaxine)
--MAOI's
--TCA's

Hint 662

#pharmcology
#toxicities

Front 663

Analgesics implicated in Serotonin Sro

Back 663

Tramadol

Hint 663

#pharmcology
#toxicities

Front 664

Anti-emetics implicated in Serotonin Sro

Back 664

Ondansetron (5HT3 antagonist)

Hint 664

#pharmcology
#toxicities

Front 665

Antibiotics implicated in Serotonin Sro

Back 665

Linezolid (Vancomycin resistant enterococcus, MRSA)

Hint 665

#pharmcology
#toxicities

Front 666

Headache Medicine implicated in Serotonin Sro

Back 666

Triptans

Hint 666

#pharmcology
#toxicities

Front 667

Mononucleus like Sro with negative monospot test

Back 667

CMV HHV-6 Toxoplasmosis

Hint 667

#microbiology

Front 668

Differentiating Septate Hyphae

Back 668

V-branching: Aspergillus
Right Angle: Mucor/Rhizapus

Hint 668

#microbiology

Front 669

Epinephrine Dosing

Back 669

always activates β1

systolic responds to α1 stimualtion

diastolic more β2 > α2 at low doses

α1 overwhelms β2 at high doses → vasoconstrx

Hint 669

#physiology #pharmacology
#ans

Front 670

phentolamine vs phenylephrine

Back 670

phenylephrine is α agonist
phetolamine is α blocker

Hint 670

#physiology #pharmacology #ans

Front 671

Horner's Sro + UE LMN signs

Back 671

pancoast tumor esp adenocarcinoma from apex of lung

Hint 671

#pathology #neurology #neoplasia

Front 672

Elevated Creatine Kinase from a Drug

Back 672

Lipids: Statins, Fibrates, Niacin

Hydroxychloroquine

Glucocorticoids

Colchecine

IFN α

Penicillamine

Hint 672

#pharmacology #tocities

Front 673

Kyphoscoliosis and a High Foot Arch

Back 673

Frederick's Ataxia

AR ↑ tinucleotide repeats in "Frataxin" Chrom 9, improtant for Mitochondrial Fnx

--Hypertrophic Cariomyopathy
--Kyphoscoliosis & Pes Cavus
--Degeneration of Dorsal Root Ganglia & Columns → loss of position & vibration sensation
--Degeneration of Ascending & Decending Spinocerebellar Tracts → Ataxia
--DM

Hint 673

#pathology #genetics

Front 674

Frederick's Ataxia

Back 674

Frederick's Ataxia

AR ↑ tinucleotide repeats in "Frataxin" Chrom 9, improtant for Mitochondrial Fnx

--Hypertrophic Cariomyopathy
--Kyphoscoliosis & Pes Cavus
--Degeneration of Dorsal Root Ganglia & Columns → loss of position & vibration sensation
--Degeneration of Ascending & Decending Spinocerebellar Tracts → Ataxia
--DM

Hint 674

#pathology #genetics

Front 675

Topoisomerase I vs II

Back 675

1: single stranded nicks to relieve supercoiling

2: transient doublestranded breaks

Topoisomerase II is the target of etoposide and podophyllin
etoposide esp useful for testicular cancer and small cell lung cancer

Hint 675

#molecules #pharmacology #neoplasia

Front 676

Dihydropyridine Clalcium Channels

Back 676

L type calcium channels goddamn it

Hint 676

#molecules #physiology #pharmacology

Front 677

Heart Medicine which causes and AV block

Back 677

Class IV: Ca2+ channels

Verapamil, Diltiazem

non-dihydropyridine

↑ PR interval

Hint 677

#pharmacology #cardiovascular

Front 678

Dimeric IgA

Back 678

only found in secretions never in blood

Hint 678

#immunology #hematology

Front 679

Mitotane

Back 679

adrenocorticolytic used for adrenocortical carcinoma

Hint 679

#pharmacology #endocrine

Front 680

DOC: Hirsutism

Back 680

Spirolactone

Else
--Flutamide: testosterone receptor antagonist
--Finasteride 5 α Reductase inhibitor

Hint 680

#pharmacology #endocrine

Front 681

Organ of Corti

Back 681

The actual part of the inner ear that takes mechanical sound and turns it into energy signals

Hint 681

#neurology

Front 682

Cupula of the Cochlea

Back 682

the very apex of the cochlea

houses the cells that sense rotation

Hint 682

#neurology

Front 683

Carpal Bones

Back 683

Front 684

Renal Tubule Osmolarity

Back 684

Proximal Convoluted: 300
Loop of Henle: gets up to 1200
Distal Convoluted: 100 NB Lowest Osmolarity
Collecting Duct: 100-1200

Hint 684

#physiology #nephrology

Front 685

Sunlight and Vitamin D

Back 685

UVB ( λ ≈ 320 )
7-dehydrocholesterol → Cholecalciferol which may enter circulation

NB: Cholecalciferol is the form of Vitamin D absorbed by the Gut

Hint 685

#physiology #vitamins #endocrine

Front 686

Activation of Vitamin D

Back 686

First step
Cholecacliferol → 25 hydroxy vitaminD
p450 not regulated

1-α- hydroxylase in Kidney creates active 1,25 dihydroxyD
↑ by PTH
↓ by Ca2+ or Phospahte

NB 24 hydroxylase will create 24, 25 dihydroxyD which is inactive

Hint 686

#physiology #vitamins #endocrine #renal

Front 687

Where is tetrahydrobiopterin actually used?

Back 687

by phenylalanin hydroxylase in the production of tyrosine

by tyrosine hydroxylase in the prodxn of DOPA

and also by tryptophan hydroxylase in teh prodxn of 5HT

defective dihydrobiopterin reductase (needed to regenerate BH4 from BH2) causes rare form of PKU

Hint 687

#biochemistry #pathology

Front 688

measles-like rash, recurrent respiratory infx in neonate

supplement?

Back 688

Vitamin A deficiency

night/complete blindness, xeropthalmia
Bitot's spots, corneal perforation, keratomalacia
immunosuppression via phagocytes and T's

Research has shown that vitamin A effective in treatment of measles

Hint 688

#pathology #vitamins

Front 689

Back 689

Hint 689

#renal #physiology

Front 690

transposition of the great vessels is a failure of

Back 690

septation

Front 691

Reactive Arthritis
Urethritis
Conjunctivitis

Back 691

Reiter's Sro
HLA B27

assoc w/ infx of :
Chlamydia
Shigella, Salmonella, Yersinia
Campylobacter

Hint 691

#microbiology #pathology

Front 692

Reiter's Sro

Back 692

Reactive Arthritis
Urethritis
Conjunctivitis

HLA B27


assoc w/ infx of :
Chlamydia
Shigella, Salmonella, Yersinia
Campylobacter

Hint 692

#microbiology #pathology

Front 693

Anatomy of the Eye Socket:
What comes out which hole?

Back 693

Superior orbital fissure: CN3, 4 & 6 + Nasociliary branch of facial nerve,
Lesion: lack of EOM's & corneal reflex

Optic Canal: CN2 & Ophthalmic Artery

Inferior Orbital Fissure: V2, Infraorbital vessels, branches of sphenopalatine ganglion; Do not enter orbit!

Front 694

What is absorbed in the duodenum?

Back 694

Iron

Hint 694

#physiology #gastrointestinal

Front 695

Blue sclera

Back 695

osteogenesis imperfecta

Front 696

Fried Egg sign on Facial Blisters

Back 696

Impetigo

NB may be either staph or strep!

also note: while APSGN may follow strep impetigo, Rheumatic Fever will not! Rheumatic Fever ONLY assoc w/ throat infx

Hint 696

#microbiology

Front 697

Know table 5-1 listing autosomal dominant diseases

Back 697

Nervous System: Huntingtons 4p, Neurofibromatosis 17q, Myotonic dystrophy
Tuberous Sclerosis

Urinary: Polycystic Kidney Disease (Adult) 4q, Wilm's Tumor 11p, GI familial polyposis coli 5q

Musculoskeletal: Marfan's, Ehler-Danlos (some), Osteogenesis Imperfecta 1-4, Achondroplasia

Metabolic: Familial hypercholesterolemia, Acute intermittent porphyria

Hematopoietic: Hereditary Spherocytosis, Von Willebrand's Disease

Front 698

Terbinafine mechanism of action

Back 698

inhibition of squaline epoxidase necessary for ergosterol synthesis

Hint 698

#microbiology #pharmacology #antimicrobials

Front 699

Anti-fungal: inhibits squalline epoxide

Back 699

Terbinafine

prevents ergosterol synth

Hint 699

#microbiology #pharmacology #antimicrobials

Front 700

Know table 5-1, autosomal recessive disorders

Back 700

---Metabolic: CF, Phenylketonuria, Galactosemia, Homocystinuria, Lysosomal Storage Dz's, alpha1 anti-trypsin deficiency, Wilson's disease, Hemochromatosis, Glycogen storage disease
--Hematopoietic: Sickle Cell Anemia, Thalassemias
--Endocrine: Congenital adrenal hyperplasia
--Skeletal: Ehelrs Danlos (some), Alkaptonuria
--Nervous: Neurogenic muscular atrophies, Friedreich ataxia, spinal muscular atrophy

Front 701

Gram + Catalase + Coagulase + Organism

Back 701

Staph Aureus

also β hemolytic
produces a yellow pigment

Hint 701

#microbiology

Front 702

Autosomal Recessive Disorder Characteristics

Back 702

low frequency likely consanguinous marriages
high frequency likely confers disease resistance

expression within kindred is uniform (no variable expressivity)
complete penetrance is common
onset usually early in life
sporadic new mutations not readily manifested
usually enzymatic defects

Front 703

Gram +
Catalase +
Coagulase --
Novobiocin Sensitive
Bacterium

Back 703

Staph epidermidis

1. Prosthetic valve endocarditis
2. Catheter Related Infx
3. Prosthetic Joint Septic Arthritis

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 703

#microbiology

Front 704

Gram +
Catalase +
Coagulase --
Novobiocin Resistant
Bacterium

Back 704

Staph saprophyticus

UTI's in sexually active young women

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 704

#microbiology

Front 705

Know table 5-3, list of X-linked recessive disorders.

Back 705

Musculoskeletal: Duchenne Muscular Dystrophy, Becker Musculodistrophy

Blood: Hemophilia's A & B, Chronic granulomatous disease, G-6-P dehydrogenase deficiency

Immune: Bruton's Agammaglobulinemia, Wiskott-Aldrich Syndrome, SCID

Metabolic: Diabetes insipidus, Lesch-Nyhan Syndrome

Nervous: fragile X syndrome

Reproductive: Testicular Feminization

Misc: Hunter's Syndrome, Fabry's Disease

Front 706

Major Resistance of the bronchial tree

Back 706

there are 23 generations total

major resistance from first 10 generations (>2mm), peaking at 5th gen

↑ cross sectional area after 10th generation

Front 707

Gram + Catalase + Organism

assoc. w/ UTI's in sexually active young women

Back 707

Staph saprophyticus

Coagulase Negative
Novobiocin Resistant

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 707

#microbiology

Front 708

Rx: ↑ HgF synthesis

Back 708

HgF = α2γ2

hydroxyurea

used for sickle cell anemia

Front 709

Gram + Catalase + Organism

assoc. w/ Prosthetic Valve Endocarditis

Back 709

Staph epidermidis

Coagulase negative
Novobiocin sensitive

1. Prosthetic valve endocarditis
2. Catheter Related Infx
3. Prosthetic Joint Septic Arthritis

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 709

#microbiology

Front 710

Childhood Brain Tumors by Frequency

Back 710

1. Pilocytic Astrocytoma
Usually cerebellum
Appearance: Solid (white on MRI) and Cystic (dark no MRI)
Histology: pilocytic astrocytes with rosenthol fibers (pink corkscrews)
Px: Low Grade, Good Px

2. Medulloblastoma
Most Common Malignant Brain Tumor in Childhood
Appearnce: Solid, Uniform Appearance
Always in cerebellum
Histology: Small blue cells (hyperchromatic nuclei, scant cytoplasm)
Px: Bad

3. Ependymoma
Presentation: Hydrocephalus
Histology: Rosettes: glandlike structures w/ ependymal processes
Psuedorosettes: glandlike strx around blood vessel

Front 711

Gram + Catalase + Organism

assoc. w/
catheter related infx

Back 711

Staph epidermidis

Coagulase negative
Novobiocin sensitive

1. Prosthetic valve endocarditis
2. Catheter Related Infx
3. Prosthetic Joint Septic Arthritis

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 711

#microbiology

Front 712

Childhood Brain Tumors with Small Blue Cells

Back 712

Hyperchromatic Nuclei, Scant Cytoplasm: Medulloblastoma

2nd most common brain neoplasm in children (to pilocytic astrocytoma),
Most common malignant neoplasm

Always in cerebellum
Histology: Small blue cells (hyperchromatic nuclei, scant cytoplasm)
Px: Bad

Front 713

Gram + Catalase + Organism

assoc. w/

prosthetic joint septic arthritis

Back 713

Staph epidermidis

Coagulase negative
Novobiocin sensitive

1. Prosthetic valve endocarditis
2. Catheter Related Infx
3. Prosthetic Joint Septic Arthritis

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 713

#microbiology

Front 714

Gram + Catalase + β Hemolytic Organism

Back 714

Staph aureus

Coagulase +
produces a yellow pigment

Hint 714

#microbiology

Front 715

Most common brain neoplasm in children

Back 715

1. Pilocytic Astrocytoma
Usually cerebellum
Appearance: Solid (white on MRI) and Cystic (dark no MRI)
Histology: pilocytic astrocytes with rosenthol fibers (pink corkscrews)
Px: Low Grade, Good Px

Front 716

Staph epidermidis

Back 716

Staph epidermidis

Gram + Catalase +
Coagulase negative
Novobiocin sensitive

1. Prosthetic valve endocarditis
2. Catheter Related Infx
3. Prosthetic Joint Septic Arthritis

Coagulase Negative Staph part of normal flora
Infx = special circumstances

Hint 716

#microbiology

Front 717

Staph saprophyticus

Back 717

Gram + Catalase +
Coagulase Negative
Novobiocin Resistant

Assoc w/ UTI's in sexually active young women

Hint 717

#microbiology

Front 718

Childhood Brain Tumor
Histology: cells that look like fibers with dark pink corkscrews

Back 718

Pilocytic (fibrous) Astrocytoma with Rosenthal Fibers

Usually cerebellum
Appearance: Solid (white on MRI) and Cystic (dark no MRI)
Histology: pilocytic astrocytes with rosenthol fibers (pink corkscrews)
Px: Low Grade, Good Px

Front 719

DOC: Loss of Consciousness 2° to hypoglycemia

Back 719

Non medical setting: IM glucagon

Medical Setting: IV Dextrose

Hint 719

#pharmacology #endocrine

Front 720

What exacerbates Multiple Sclerosis?

Back 720

heat leads to worsening fatigue and deficits

heat = ↓ axona transmission

Hint 720

#pathology #neurology

Front 721

Childhood Brain Tumor with glandlike Strx around blood vessels, with cytoplasmic processes directed towards wall of vessel

Back 721

psuedorosettes of Ependymoma

3rd most common Brain neoplasm in children

Presentation: Hydrocephalus
Histology: Rosettes: glandlike structures w/ ependymal processes
Psuedorosettes: glandlike strx around blood vessel

Front 722

neurologic condition worsened by heat

Back 722

Multiple Sclerosis

heat = ↓ axona transmission

Hint 722

#pathology #neurology

Front 723

describe the pathogenesis of HBV assoc hepatocellular carcinoma

Back 723

viral integration into host genome
viral protein HBx activates both synthesis of IGF-II and IGF-I-R

Hint 723

#pathology #neoplasia #microbiology

Front 724

Genetics of Sexual Differentiation

Back 724

Y chromosome determines male sex regardless of number of X chroms
SRY: Sex Determining Region in Y is in the short arm of the chrom and includes translational activator SIP-1 for dvlpt of male phenotype
SRY mutations/translocations → XY females, XX males

Lyon Hypothesis: Inactivation of either paternal or maternal X chromosome happens randomly in each cell at gestation day 16; all females are mosaics.

XIST gene inactivates one X chrom by coating it with non-coding RNA;

Pseudoautosomal region: 25% of X genes remain active on both chroms: these have normal, non-sex determining functions & a homologous region on Y.

Front 725

What kind of necrosis occurs with a spider bite?

Back 725

Liquifactive Necrosis

ie characterized by preservation of cell outlines

eosinophilic cytoplasm w/ protein denatuation
nucleus pyknocytosis and haryorrhexis
lysis

Hint 725

#pathology

Front 726

what enzyme converts benz(o)pyrine into a carcinogen

Back 726

most inactive metabolites converted to carcinogens are converted by the p450 microsomal monoogenase system.

Front 727

Factor XIII deficiecy

Back 727

clot instability, recurrent bleeding after trauma

extremely rare condition

does not manifest hemophilia like bleedin

Front 728

Moldy Grain mutates p53 causes

Back 728

Aflotoxin G to T mutation causes Hepatocellular Carcinoma

Hint 728

#neoplasia #microbiology #pathology

Front 729

Galactose Metzm & Disorders

Back 729

Galactokinase(Galactose → Galactose-1-P)

Galactose-1-Phosphate Uridyltransferase( galactose -1-P → glucose-1-P)

Aldose Reductase (Galactose → Galactitol)

Galactokinase deficiency: AR; galactitol accumulates → cataracts, galactosuria.

G1P Uridyltransferase deficiency: AR: accumulation of galactitol and toxic Galactose-1-P → Failure to thrive, cataracts, MR, jaundice, hepatomegaly
Tx: exclude galactose & lactose

Front 730

Subacute Sclerosing Panecephalitis

Back 730

Complication of Measles which lacks the M protein

No protein, no good antigen for clearing

cough coryza conjunctivitis koplic's spots

Hint 730

#microbiology

Front 731

Where is IGF-1 produced

Back 731

The liver

also some IGF-1 from hypothalamus, but that regulates CNS activity, not linear growth

Front 732

DOC: Gestational Diabetes

Back 732

Insulin

Hint 732

#pharmacology #endocrinology #pregnancy

Front 733

Ketogenic vs. Glucogenic Amino Acids

Back 733

Exclusively Ketogenic: Leucine & Lysine

Ketogenic and Glucogenic: Phenylalanine, Isoleucine, Tryptophan

Front 734

inv(16)

Back 734

inversion of chrom 16

M3Eo (eosinophilic subtype) of AML

Hint 734

#neoplasia #pathology #genetics

Front 735

genetics: M3Eo AML

Back 735

inv(16)
inversion of chrom 16

M3Eo (eosinophilic subtype) of AML

Hint 735

#neoplasia #pathology #genetics

Front 736

Rining Ears, Dizziness, and Difficulty Hearing

Back 736

Meniere's Dz: failure to resporb endolymph

Hint 736

#pathology #neurology

Front 737

Inhibin B

Back 737

produced by Sertoli Cells allows for negative feedback of FSH

Front 738

Community Acquired Pneumonia with high fever and nothing on gram stain

Back 738

legionella

Tx: floroquinolones or azithromycin

Front 739

Failure to resporb endolymph in the inner ear

Back 739

Meniere's Dz:

Triad of Tinnitus, Vertigo and Hearing Loss

Hint 739

#pathology #neurology

Front 740

IFNα & IFNβ

Back 740

produced by many cells in resposne to ifnection

stimulates neighbors to synthesize antiviral proteins to inhibit viral mRNA translation (without affecting eukaryotic mRNA translation)

Front 741

NF-2

Back 741

Autosomal Dominant

Tumor suppressor gene merlin on chrom 22

--bilateral accoustic shwannomas
--few cutaneous signs

Hint 741

#pathology #neurology #neoplasia

Front 742

merlin protein

Back 742

Autosomal Dominant

NF-2

Tumor suppressor gene merlin on chrom 22

--bilateral accoustic shwannomas
--few cutaneous signs

Hint 742

#pathology #neurology #neoplasia

Front 743

Where should you do IM injxns into the buttock and why

Back 743

Inject into the superolateral corner to avoid superior gluteal nerve (superomedial) and Sciatic Nerve (Medial Half)
Many muscles of the gluteal regions have tendinous insertinos in the inferolateral quadrant

Front 744

Fructose 2, 6 Bisphosphate

Back 744

ATP dpt prodxn from F6P by PFK-2 in the presence of insulin

Positive Influence on PFK-1: helps drive Glycolysis

Hint 744

#biochemistry #energymetzm

Front 745

Differentiating Causes of Esophagitis in AIDS pts

Back 745

3 main Causes

Candida albicans: pseudomembranes

HSV-1: vesicles → ulcers; esoinophilic intranuclear inclusions (Cowdry bodies) in multinuclear squamous cells at margins of ulcers

CMV: linear ulcerations, intranuclear and cytoplasmic inclusions

Front 746

PFK-1

Back 746

Fructose 6 phosphate to Fructose 1,6 bisphophate

an irreversible forward reaction in glycolysis
(circumvented by Frictose bisphosphatase 1, FBP1)

↑ fnx by Fructose 2,6 Bisphosphate
(produced from F6P in presence of Insulin by PFK2)

↓ fnx by citrate and ATP

Hint 746

#biochemistry #energymetzm

Front 747

Hemiballism

Back 747

unilateral flinging limbs contralateral to injury in/around subthalamic nucleus

Front 748

Neurons with eosinophilic cytoplasm, no nisssl substance, and pyknosis of nucleus

Back 748

Red Neuron

Transient Severe Insult which Will Result in Death

Hint 748

#pathology #neurology

Front 749

New Mother Feels Depressed Since Birth

Tx?

Back 749

Postpartum "Blues"
--majority of women, resolves within 10 days
Tx: reassurance, schedule reevaluation in 2 weeks

Postpartum Depression:
--10% of women, >2 weeks
Tx: Antidepressants, psychotherapy

Postpartum Psychosis
--Rare
Tx: Antipsychotics, Antidepressants, Hospitalization

Front 750

Neuron with enlarged body, dispersed nissl substance, and eccentric nucleus

Back 750

Axonal Reaction, about to regrow axon

Hint 750

#pathology #neurology

Front 751

Borders of the Lungs and Pleura

Back 751

Pleura
Midclavicular Line: 7th Rib
Midaxillary Line: 10th Rib
Paravertebral Line: 12th Rib

Lung is 2 spaces above pleural border

Front 752

Pt treated for hyperthyroidism presents with fever and sore throat

Back 752

agranulocytosis (PMN <500) rare but serious complication of thyrolytics

PTU - DOC in pregnants

Methimazole - DOC in nonpregnants, teratogenic

both are thionamide class
inhibit thyroid peroxidase which is resposnbiel for I- → I0 and coupling of iodotyrosines

Hint 752

#pharmacology #toxicity

Front 753

Toxin Route:

Wound → Motor Neurons → Spinal Cord

Toxin

Back 753

Tetanus Toxin

NB: Not the Bacterium

Front 754

methimazole

Back 754

thyrolytic doc for non-pregnant hyperthyroidism,

teratogenic
thionamide class
inhibit thyroid peroxidase which is resposnbiel for I- → I0 and coupling of iodotyrosines

assoc with agranulocytosis

Hint 754

#pharmacology #drugs

Front 755

Toxin Route:

Fibrinous Exudate → Systemic Circulation → Cortical Neurons

Toxin

Back 755

diphtheria

attacks cardiac and cerebral cortical ts

Front 756

Calymmatobacterium inguinal

Back 756

donovanosis

unTx → elephantiasis

papule → ulcer → soft exophytic w/ indurated boarders

Hint 756

#microbiology

Front 757

Meningitis

Food → Systemic Circulation → Meninges

Back 757

Listeria monocytogenes

Front 758

Genital papule ulcerates and produces grey-yellow exudate

Back 758

H ducreyi

regional LN's swell and may become chronic ulcers themselves

Hint 758

#microbiology

Front 759

Toxin Route:

Food → Systemic Circulation → Peripheral Nerves

Toxin

Back 759

Botulism Toxin

Front 760

Arteriovenous Concentration of an Inhaled Anesthetic

Back 760

A large gradient means that the tissue is absorbing it and not being saturated = Slower onset of action

Front 761

Regulation of ACE's

Back 761

Apparently the lung endothelium upregulates ACE's when BP is low I don't know I don't think that's true

Hint 761

#physiology #cardiovascular

Front 762

Selective Albuminuria following upper respiratory tract infection

Back 762

Loss of sialic acid (polyanion) → loss of electrical barrier to albumin without damage to GBM

Minimal change dz

most common nephrotic sro in children

Front 763

Tryptase

Back 763

Indicative of Mast Cell Degranulation

Hint 763

#physiology #hematology

Front 764

Three phases of stomach activity

Back 764

Stimulation of H+ secretion
Cephalic phase: Vagal ACh triggered by percception of food
Gastric Phase: gastrin stimulates histamine secretion
Intestinal phase: protein containing food enters duodenum (minor)

Inhibition:
Intestinal influences Major influence is Peptide YY from ileum and colon binds Enterochromaffin-like cells (↓ Histamine release)
Also Somatostatin & Prostaglandins

Front 765

Blood Product indicative of Mast Cell Degranulation

Back 765

Tryptase

Hint 765

#physiology #hematology

Front 766

Purine Salvage Pathways

Back 766

90% of purines salvaged

avoids spending 6ATP & 2x 510-formyl-THF's

HGPRT: major enzyme
Guanine + PRPP → GMP
Hypoxanthine + PRPP → IMP

HGPRT KO: no salvage, Lesch-Neyhan
→ massive urate prodxn → severe gout, MR, self mutilation

Front 767

Acute onset chest pain relieved by sitting up

Back 767

pericarditis

friction rub, sero-firbinous exudate

Hint 767

#pathology #cardiovascular

Front 768

Neurologic consequence: anterior dislocation of the humerus

Back 768

axillary nerve: deltoid and teres minor, provides sensory innervation to skin over deltoid

Front 769

Patholophysiologic of a Lung Abscess with Air Fluid Levels

Back 769

Release of PMN & M∅ lysosomal contents into the parenchyma: fnx is to fight bacteria and chemotactic for PMN's & M∅, but creates abscess

Hint 769

#pathology #pumonary

Front 770

BUN and Cr

Back 770

Both freely filtered

BUN reabsorbed some in the proximal tubule
Cr not really absorbed or secreted

↓ GFR will slow down the flow through the proximal tubule, allow more time for reabsoprtion of BUN

↓ kidney function will affect both BUN & Cr equally

>15:1 ratio = pre-renal azotemia (decreased
<15:1 ratio = kidney problem

Front 771

Vasopressin

Back 771

V1: vascular smooth muscle contraction and what not

V2 receptor mediated increase in both permeability to water and urea in luminal membrane of medullary collecting duct (MCD)

Front 772

unwanted sustained muscle contractions + cataracts

Back 772

Myotonic Dystrophy

CTG trinucleotide expansion within myotponia protein kinase

AD inheritance

Cataracts & Myotonia
Myotonia: unwanted sustained muscle contractions
--cannot release doohandles
Type 1 fibers more affected

Also: frontal balding & gonadal atrophy

differentiate from Duchenne: Myotonic Dystrophy does not have necrosis of muscle fiber sand fibrofatty replacement

Front 773

Pleural Pressure Through Inspiration and Expriation

Back 773

always negative (collapses pleural space)

-8 at fully inspired
-5 at fully expired

Hint 773

#physiology #pulmonology

Front 774

CTG trinucleotide expansion

Back 774

Myotonic Dystrophy

CTG trinucleotide expansion within myotponia protein kinase

AD inheritance

Cataracts & Myotonia
Myotonia: unwanted sustained muscle contractions
--cannot release doohandles
Type 1 fibers more affected

Also: frontal balding & gonadal atrophy

differentiate from Duchenne: Myotonic Dystrophy does not have necrosis of muscle fiber sand fibrofatty replacement

Front 775

Duchenne's Muscular Dystrophy

Back 775

X linked frameshift → nonsense mutation within dystrophin gene

dystrophin anchors skeletal and muscle fibers → accelerated muscle breakdown

starts in pelvic girdle → progresses superiorly

Onset <5yo
pseudohypertrophy of calves 2° fibro-fatty replacement
Gower's sign: coming to a stand via spreading legs apart and "walking" backwards on their hands so as not to need lower extremities

Dx: ↑CPK and muscle biopsy: necrosis and fibrofatty replacement

Front 776

CREST Sro

Back 776

CREST Sro

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Anti-centromere antibodies are very Specific for CREST

Hint 776

#pathology #rheumatology

Front 777

OTC Rx resitant heartburn + finger ulceration

Back 777

CREST Sro

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Anti-centromere antibodies are very Specific for CREST

Hint 777

#pathology #rheumatology

Front 778

Why does Hepatitis C become chronic

Back 778

no proofreading 3' → 5' exonucease activity within the RNA-dependent-RNA polymerase

hypervariable region of envelope glycoprotein

dozens of subspecies of HepC in each pt's blood at any given time

Front 779

Which virus is enveloped in nuclear membrane

Back 779

herpesviruses
-HSV 1 & 2
-HHV 6 - 8
-EBV
-CMV
-VZV

Front 780

Virulence Factors of Strep Pyogenes

Back 780

M protein: >100 antigenic forms
--protects cell from phagocytosis & inhibits complement
--is the epitope to which human antibodies eventually bind

Protein F: binds fibronectin
LTA: attaches to pharyngeal epithelium

Capsule of hyaluronic acid: immunologic hiding

Streptolysin O: Oxygen labil: β hemolysis (& destroys RBC's)
Streptolysin S: induced by being in serum β hemolysis " "

C5a peptidase

Streptodornase- allows mvmt
Streptokinase- breaks down clots to allow mvmt

Front 781

Barium Swallow: dilated esophagus, no peristalsis

Back 781

CREST Sro

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Anti-centromere antibodies are very Specific for CREST

Hint 781

#pathology #rheumatology

Front 782

Specificity vs. Sensitivity

Back 782

Sensitivity:
True Test Positives/All Actual Positives

Specificity:
True Test Negatives/All Actual Negatives

Front 783

Rathke's Cysts

Back 783

occur in vestigial intermediate lobe of pituitary gland between adenohypophysis and neurohypophysis

Front 784

Anti-centromere antibodies

Back 784

CREST Sro

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Anti-centromere antibodies are very Specific for CREST

Hint 784

#pathology #rheumatology

Front 785

The most common cause of E coli sepsis

Back 785

UTI

Front 786

Anti-Topoisomerase antibodies

Back 786

Highly specific for diffuse scleroderma form of systemic sclerosis (other form is CREST Sro, anti-centromere antibodies)

Hint 786

#pathology #rheumatology

Front 787

Concommittent treatment to aerosolized corticosteroids for athsma

Back 787

oral rinsing to avoid candidiasis

Front 788

Anti-dsDNA antibodies

Back 788

SLE

Hint 788

#pathology #rheumatology

Front 789

Which organs cannot survive on ketones

Back 789

RBC's and Liver

RBC's done have the mitochondria
Liver doesn't have the enzyme

Front 790

Anti-histone antibodies

Back 790

Drug induced Lupus

Procainamide
Hydralazine
Isoniazid
Penicillamine

Hint 790

#pathology #pharmacology #toxicity

Front 791

Lymphadenopathy and Serum Sickness from an Anti-Siezure Drug

Back 791

Phenytoin
hirsutism
gingival hypertrophy

Hint 791

#pharmacology #toxicities

Front 792

During an action potential when is K+ conduction highest

Back 792

during the repolarization

NB: not during the overshoot, K+ is close to equilibrium at the overshoot and thus not rushing in anymore

Front 793

Esophageal Neoplasm with Keratin Pearls

Back 793

Squamous Cell Carcinoma

EtOH & Tob

Poor Px

Hint 793

#pathology #neoplasia #gastrointestinal

Front 794

Gastrin secreting tumors

Back 794

Zollinger Ellison Sro

↑ histamine release from enterochromaffin like cells → ↑ ↑ H+ prodxn by parietal cells

multiple ulcers in odd places
diarrhea 2° to inactivated pancreatic enzymes

Hint 794

#pathology #neoplasia #gastrointestinal

Front 795

Slowly growing mass following oral trauma which drains yellow pus through Skin

Back 795

Actinomyces israelii

Gram positive member of oral flora

growth pattern looks mycelial (reason for name)

"Sulfur Granules" are yellow aggregations of actinomyces bound by proteins (not sulfur)

Tx: surgical debridement & penicillin

Front 796

Calculating Maintenance Dose for Steady State given Vd and clearance

Back 796

Maintenance Dose = interval* [Rx]ss * CL/F

Hint 796

#pharmacology

Front 797

Lac Operon

Back 797

i is a regulatory region
p is a promotor
o is the operator
z y and are fnx genes

Glucose decreases adenylyl cyclase
↓ glucose → ↑ cAMP
cAMP binds CAP Catabolite Activator Protein
cAMP-CAP complex binds to upstream promtor region and increases lac operon expression

i is upstream of everything and encodes a repressor protein which will bind to o and prevent RNApol from passing O

o is upstrem of z, y & a
lactose will bind the repressor and prevent it from binding o

z codes for βgalactosidase (hydrolysis of lactose)
y gene for permease (lets lactose in)
a for βgalactoside transacetylase, unecessary for metzm

this arrangement is "polycistronic" one mRNA for several proteins

Hint 797

#genetics #microbiology

Front 798

Actinomyces israelii

Back 798

Slowly growing mass following oral trauma which drains yellow pus through Skin

Gram positive member of oral flora

growth pattern looks mycelial (reason for name)

"Sulfur Granules" are yellow aggregations of actinomyces bound by proteins (not sulfur)

Tx: surgical debridement & penicillin

Front 799

Fnx Mitral Regurgitation

Back 799

Mitral Regurgitation which dissappears upon reduction of afterload

Hint 799

#cardiovascular #pathology

Front 800

Pudendal Nerve Block

Back 800

Intravaginal injection near tip of ischeal spine

S2-S4 → Innervates perineum and genitals of both sexes

given if woman has progressed too far to receive epidural

Front 801

Myocardial Granulomas

Back 801

Aschoff bodies indicative of acute rheumatic carditis

plump M∅ w/ abundant cytoplasm and slender ribbons of chromatin = Anitschkow Cells (within Aschoff bodies)

Hint 801

#cardiovascular #pathology #microbiology #rheumatology

Front 802

Genitofemoral Nerve

Back 802

L1-L2

courses over psoas muscle to innervate scrotum or labia majora and femoral triangle cutaneously

Front 803

DOC: febrile seizures

Back 803

>40 C = hyperpyrexia
>42 = Neurologic Sequelae
43 = dead

Cooling blankets, cool saline bags in groin and axilla, water enemas

THEN follow with oral antipyretics, NSAIDs, acetaminophen --these take time to act and you don't have it

Hint 803

#pharmacology

Front 804

Intravaginal Lidocaine next to Ischial Spines

Back 804

Pudendal Nerve Block

S2-S4 → Innervates perineum and genitals of both sexes

given if woman has progressed too far to receive epidural

Front 805

What is the most common cause of Native Valve Bacterial Endocarditis

Back 805

Mitral valve prolapse

rheumatic dz less common

Hint 805

#microbiology #pathology

Front 806

Fixed splitting of S2

Back 806

A-V defect

Left-to-Right Shunt:
RA pressure normally <8
LA pressure up to 12

Abnormally large blood volume in RV → delays emptying

Eisenmenger Sro:
Left-to-Right Shunt → ↑ Pulmonary Flow → Pulmonary Hypertension → Right-to-Left Shunt

Hint 806

#cardiology #pathology

Front 807

Low Grade Fever and Skin Rash Beginning on Face and Spreading down to the rest of the body

Back 807

Either Measles (Rubeola) or German Measles (Rubella)

Differentiate via Post-Auricular Lymphadenopathy, present in Rubella

Rubella = Togavirus

Rubeola = Paramyxovirus

Front 808

Acyclovir Toxicity

Back 808

Crytalline Nephropathy if dehydrated

Hint 808

#pharmacology #toxicity #antimicrobials

Front 809

Small Bluish Lesion under the Fingernail

Back 809

May be either glomus tumor (glomangioma) or subungual melanoma

Glomangioma = benign tumor of modified smooth muscles cells

Glomus body small encapsulated neurovascular organs found in dermis of nail beds, digit pads, and ears. Senses temperature to shunt blood away from skin during cold temperatures and into the skin during hot temperatures

Front 810

Encapsulated Bacterial Organisms

Back 810

Pneumococcus
Meningococcus
H influenzi
S typhi
Group B Strep agalactae

Hint 810

#microbiology #agents

Front 811

Glomus body

Back 811

small encapsulated neurovascular organs found in dermis of nail beds, digit pads, and ears. Senses temperature to shunt blood away from skin during cold temperatures and into the skin during hot temperatures

Glomangioma = benign blue tumor beneith nails

DDx: melanoma

Front 812

Sickler with Macrocellular Anemia

Back 812

Folic Acid Deficiency 2° to ↑ Bone Marrow Turnover

Hint 812

#pathology #hematology

Front 813

Anormal embryologic rotation of midgut

Back 813

intestinal malrotation
→
intestinal obstruction due to compression by adhesive "Ladd's" bands between cecum and duodenum or midgut volvulus

Front 814

Stages of acute Tubular Necrosis

Back 814

Initiation: Ischemic Injury

Maintenence: oliguria, hypervolemia, ↑ BUN & Cr, HyperKalemia
retention of H+ & Anions → high metabolic gap acidosis
↓ Na, Ca, PO4
Muddy Brown casts, low urine osmolarity high Fractioanl sodium excretion
Most Serious complication: HyperKalemia

Recovery: Body rapidly diuresing, but tubules not yet recovered enough to resporb things properly
↓ K, Mg, PO4, Ca

Most serious complciation: Hypokalemia

Hint 814

#pathology #nephrology

Front 815

Cecum fixed in Right Upper Quadrant of Vomitting Neonate

Back 815

midgut malrotation
→
intestinal obstruction due to compression by adhesive "Ladd's" bands between cecum and duodenum or midgut volvulus

Front 816

p vs Confidence interval

Back 816

if confidence interval does not include null hypothesis then p<0.05

if confidence interval includes null hypothesis then p >0.5

Hint 816

#biostats

Front 817

Small Bluish Lesion under the Fingernail

Back 817

May be either glomus tumor (glomangioma) or subungual melanoma

Glomangioma = benign tumor of modified smooth muscles cells

Glomus body small encapsulated neurovascular organs found in dermis of nail beds, digit pads, and ears. Senses temperature to shunt blood away from skin during cold temperatures and into the skin during hot temperatures

Front 818

Vi antigen

Back 818

virulence angiten of salmonell the capsule which protects it from opsonization

Hint 818

#microbiology

Front 819

Glomus body

Back 819

small encapsulated neurovascular organs found in dermis of nail beds, digit pads, and ears. Senses temperature to shunt blood away from skin during cold temperatures and into the skin during hot temperatures

Glomangioma = benign blue tumor beneith nails

DDx: melanoma

Front 820

Cardiac Ischemia:

How long until Contraxns Stop?
When does Injury Become Irreversible?

Back 820

Contraxn stops w/in first minute

damage permenant after 30 min

Hint 820

#pathology #cardiovascular

Front 821

Young Child with Thromboembolitic Infarcts in Various stages of healing

Back 821

Homocysteinuria: Cystathionine synthase deficiency
Marfanoid Habitus and Thromboemboli

--Homocysteine produced as end product of SAM usage
--Methionine Synthase aka Homocysteine methyltransferase[B12] (Homocysteine + N5-methyl-THF → Methionine)
--Methionine + ATP → SAM
--Methyltransferase(SAM → S-adensoyl homocysteine + methyl group on other subtrate)
--Unimportant enzyme (SAH → Homocysteine & Adenosine)
--at this point Homocysteine may be recycled or

Cystathione synthetase[B6](Homocysteine + Serine → Cystathione
Csystathionase[B6](Cystathione → Cysteine)

1/2 of pts respond positively to B6 supplementation
(↑ functionality of poorly functioning cystathione synthetase)

Front 822

Abnormal Breathing Pattern

Back 822

Cheyne-Stokes Breathing of Advanced CHF

delayed feedback to hypercapnea

start breathing hard to blow off CO2 → suppress drive

cyclic variation in tidal volume with periods of apnea

contrast to OSA which has on-off phenomenon not cyclic variation in tidal volume

Hint 822

#pathology #cardiovascular

Front 823

Li Frauman Sro

Back 823

p53 KO

Breast, Brain Adrenal Cortex

Sarcomas Leukemias

Hint 823

#genetics #pathology #neoplasia

Front 824

Anormal embryologic rotation of midgut

Back 824

intestinal malrotation
→
intestinal obstruction due to compression by adhesive "Ladd's" bands between cecum and duodenum or midgut volvulus

Front 825

Cancer 2° to EBV

Back 825

Hodgkin's Lymphoma
Non-Hodgkin's Lymphoma
Nasopharyngeal Carcinoma esp in China & Africa
Burkitt's Lymphoma in Africa & new Guinea

Hint 825

#pathology #neoplasia #microbiology

Front 826

The end result of Fabry's Dz

Back 826

Renal failure

Hint 826

#pathology #genetics #biochemistry

Front 827

Cecum fixed in Right Upper Quadrant of Vomitting Neonate

Back 827

midgut malrotation
→
intestinal obstruction due to compression by adhesive "Ladd's" bands between cecum and duodenum or midgut volvulus

Front 828

Where do aspirations go?

Back 828

superior regions of lower lobes
posterior regions of upper lobes

Hint 828

#pathology #pulmonology

Front 829

Odds ratio of event x happening in population y vs population z

Back 829

AD/BC

Technically:
(A/C)/(B/D)

NB: not the same as relative risk [a/(x)] / [c/(y)]

Front 830

Why do we get wrinkles in our skin?

Back 830

↓ collagen synth

→

net loss of dermal collagen & elastin

Hint 830

#pathology #skin

Front 831

Trihexyphenidyl

Back 831

Muscarinic Antagonist

Hint 831

#pharmacology

Front 832

DOC: catheter endocarditis

Back 832

Staph epidermidis

Gram + Catalase +
Coagulase Neg Novobiocin Sensitive

Usually MRSE start with Vancomycin

Hint 832

#microbiology #pathology #cardiovascular #pharmacology #antimicrobials

Front 833

Anti-epileptic drug metzd to barbituate

Back 833

Primidone

metabolized to phenobarbital and PEMA (phenylethylmalonamide)

All 3 compounds are anticonvulsants

Hint 833

#pharmacology #seizures #neurology

Front 834

Primidone

Back 834

Anti sieizure drug Primidone

metabolized to phenobarbital and PEMA (phenylethylmalonamide)

All 3 compounds are anticonvulsants

Hint 834

#pharmacology #seizures #neurology

Front 835

Cyproterone

Back 835

prevents interaxn of DHT and receptors

like flutamide and spirolactone (NB spirolactone also decreases leydig synth of T)

Hint 835

#pharmacology #endocrinology #reproductive

Front 836

Naked Viral RNA can be processed by human Ribosomes

Back 836

must be single stranded and positive sense

Hint 836

#microbiology #molecules

Front 837

Satellite Phenomenon on Sheep Plate

Back 837

Blood Agar Plate

Beta hemolytic organism like Staph aureus allows permissive growth of H influenzae which needs NAD+ & Hementin from blood

Hint 837

#microbiology

Front 838

Electrolyte balance of ACEI's

Back 838

Sodium wasting
K retaining

so check K levels before and during

NB: other side effects
--angioedema
--cough
--first dose hypotension

Hint 838

#pharmcology #toxicities

Front 839

Amiloride

Back 839

an ACEI

Hint 839

#pharmacology #drugs

Front 840

Pt started on antibiotic

2 weeks later dvlps fever, rash, & oliguria

Back 840

Drug Induced Acute Interstitial Nephritis

Fever, Maculopapular Rash, Oliguria a few weeks after starting a new drug

β-Lactams, sulfas, rifampin, or diuretics

interstital damage and WBC infiltrate,
usu. Eosinohpils

Resolves if Med Terminated

Hint 840

#pharmacology #pathology #nephrology

Front 841

Drug Induced Interstitial Nephritis

Back 841

Drug Induced Acute Interstitial Nephritis

Fever, Maculopapular Rash, Oliguria a few weeks after starting a new drug

β-Lactams, sulfas, rifampin, or diuretics

interstital damage and WBC infiltrate,
usu. Eosinohpils

Resolves if Med Terminated

Hint 841

#pharmacology #pathology #nephrology

Front 842

Lipid containing cells 1 week post stroke

Back 842

M∅'s arrive day 3-5

Hint 842

#pathology #neurology

Front 843

Killed vaccines generate what kind of response and why?

Back 843

humoral response instead of T cell response because they can't actually infect cells, so they never get expressed on MHC I so they never induce mCD8T's

Hint 843

#microbiology #immunology

Front 844

What part of the testicles are sensitive to heat?

Back 844

The sertoli cells

which are responsible for producing inhibin

leydig cells keep chugging
thus no lack of sexual dvlpt in cryptorchidism but ↑ risk of testicular cancer

Hint 844

#anatomy #physiology #endocrine #reproductive

Front 845

Sudden Cardiac Death:

pathogenesis

Back 845

Majority due to Coronary artery desiease

acute plaque rupture & thrombus → ischemia

ischemia → arrhytmias → ventricular fibrillation

Hint 845

#pathology #cardiovascular

Front 846

Heart Drug

Visual changes and GI disturbances

Back 846

Digoxin toxicity

Hint 846

#cardiovascular #pharmacology #toxicity

Front 847

haptoblogin

Back 847

a plasma protein which binds free hemoglobin in order to prevent its renal excretion

5d λ of haptoglobin alone
1h λ bound to heme

↓↓↓ in hemolytic anemias

Hint 847

#molecules #biochemistry

Front 848

a plasma protein which binds free hemoglobin

Back 848

haptoblogin

a plasma protein which binds free hemoglobin in order to prevent its renal excretion

5d λ of haptoglobin alone
1h λ bound to heme

↓↓↓ in hemolytic anemias

Hint 848

#molecules #biochemistry

Front 849

ARDS

Back 849

diffuse injury to endothelium or epithelium
→ ↑ permeability → interstitial & alveolar edema, inflam, hyalin membranization
↓ compliance, ↑ workload ↓ diffusion

severe involvment or atalectasis will cause V/Q mismatch

requires an absence of cardiogenic ie hemodynamic causes ie wedge pressures, atrial pressures should not be hchanged

Hint 849

#pathology #pulmonlogy

Front 850

define bioavailability

Back 850

Area under [route] curve divided by area under IV curve

IV bioavailability always 100%

Hint 850

#pharmacology

Front 851

Laplace's law

Back 851

Pressure necessary to distend a hollow organ is directly proprtional to the tension and inversely proprortional to the radius

P = 2T/r

assuming constant surface tension, sphere with smaller radius will have higher distending pressure requirement

thus will want to collapse when in communication with a larger sphere of the same surface tension


(ergo we need surfactant)

Hint 851

#physiology #pulmonology

Front 852

How does nitroglycerin help the heart?

Back 852

cGMP → venodilation → decreased preload

nitrates do dilate the coronary arterioles, but this is not where the bulk of their effectiveness comes from, the bulk of the effectiveness comes from venorelaxn

Hint 852

#pharmacology #cardiovascular

Front 853

CD40

Back 853

CD40 is a receptor on the B cell for CD154 aka CD40L on T cells

This interaction allows for class switching to occur

Hint 853

#immunology

Front 854

Most likely organisms within hair follicles

Back 854

Follicullitis: S aureus & P aeruginosa

Furuncles/Carbuncles: S aureus

Hint 854

#microbiology #skin

Front 855

Which part of HAART is responsible for the cushing-like presentation?

Back 855

Protease inhibitors
-navirs

lipodystrophy, hyperglycemia, and p450 inhibition

Hint 855

#microbiology #pharmacology #antimicrobials #toxicities

Front 856

What reactions is necessary for the primary catabolized amino acid to enter Gluconeogeneis/Glycogenoslysis

Back 856

one step reversible transamination by alanine aminotransferase
B6 dependent
alanine → pyruvate

amino group transfered to α-ketoglutarate to form glutamate

glutamate cleaved by glutamate dehydrogenase → α ketoglutarate + NH3

Hint 856

#biochemistry #energymetzm

Front 857

Compare Crohn's to UC in terms of

Involvement, Cheif Complaint and Complications

Back 857

Crohns: anywhere along gut w/ skip lesions
inflammation of entire thickness w/ linear ulcerations & granulomas
CC: abdominal pain>diarrhea
Complications: Fistulas & Strictures

UC: Starting from the rectum w/ continous progression
only mucosal/submucosal only (thus no fistulas)
CC: Bloody Diarrhea
Complixn: Toxic Megacolon

Hint 857

#pathology #gastrointestinal

Front 858

Caspofungin

Back 858

an echinocandin

inhibits glucan synthesis

like micafungin

Hint 858

#microbiology #pharmacology #antimicrobials

Front 859

Micafungin

Back 859

an echinocandin

inhibits glucan synthesis

like caspofungin

Hint 859

#microbiology #pharmacology #antimicrobials

Front 860

What biologically active molecules are derived from Pheynylalanine?

Back 860

BH4 dpt conversion to Tyrosine

Tyrosine may be converted to Thyroxine or DOPA*

[DOPA may be converted to dopamine^ or melanin]

*also req BH4
^B6 dpt

Hint 860

#biochemistry #molecules

Front 861

What biologically active molecules are derived from Tryptophan?

Back 861

B6 dpt conversion to Niacin
→ NAD+ and NADP+

BH4 dpt conversion to Serotonin
→ Melatonin

Hint 861

#biochemistry #molecules

Front 862

What biologically active molecules are derived from Glycine?

Back 862

B6 dpt combination with Succinyl CoA to dALA

Hint 862

#biochemistry #molecules

Front 863

What biologically active molecules are derived from Arginine?

Back 863

Creatinine
Urea
& NO

Hint 863

#biochemistry #molecules

Front 864

What biologically active molecules are derived from Glutamate?

Back 864

Glutathione
B6 dpt conversion to GABA

Hint 864

#biochemistry #molecules

Front 865

What is the necessary precursor molecule for DOPA synthesis?

Back 865

Tyrosine

BH4 dpt conversion to DOPA

Hint 865

#biochemistry #molecules

Front 866

What is the necessary precursor molecule for Tyrosine synthesis?

Back 866

Phenylalanine

BH4 dpt conversion to Tyrsoine


Tyrosine may be converted to Thyroxine or DOPA*

[DOPA may be converted to dopamine^ or melanin]

*also req BH4
^B6 dpt

Hint 866

#biochemistry #molecules

Front 867

What is the necessary precursor molecule for Niacin synthesis?

Back 867

Trytpophan

B6 dpt conversion to Niacin
necessary for NAD+ & NADP+

Tryptophan may also undergo BH4 dpt conversion to Serotonin

Hint 867

#biochemistry #molecules

Front 868

What is the necessary precursor molecule for Serotonin synthesis?

Back 868

BH4 dpt conversion of Tryptophan

necessary for Melanonin prodxn

Tryptophan may also be converted to Niacin (w/ B6)

Hint 868

#biochemistry #molecules

Front 869

What is the necessary precursor molecule for NO synthesis?

Back 869

Arginine

Hint 869

#biochemistry #molecules

Front 870

What is precursor molecule to Urea prodxn?

Back 870

Arginine

also precursor to NO & Creatinine

Hint 870

#biochemistry #molecules

Front 871

What is the precursor molecule to Creatinine prodxn?

Back 871

Arginine

also precursor to NO & Urea

Hint 871

#biochemistry #molecules

Front 872

What is the necessary precursor molecule for GABA synthesis?

Back 872

Glutamate & B6

Glutamate also precursor to Glutathione

Hint 872

#biochemistry #molecules

Front 873

What is the necessary precursor molecule for Glutathione synthesis?

Back 873

Glutamate

Glutamate also precursor to GABA (w/ B6)

Hint 873

#biochemistry #molecules

Front 874

In pulmonary edema what accounts for dyspnea?

Back 874

↓ lung compliance from interstitial fluid

Hint 874

#pathology #pulmonology

Front 875

How does folate deficiency cause anemia?

Back 875

decreased thymidine synthesis

Hint 875

#biochemistry #vitamins #pathology

Front 876

Brown Pigment Stones vs Black Pigment Stones

Back 876

black: hemolysis
brown: biliary tract infx

Hint 876

#gastrointestinal #pathology

Front 877

HLA
class I vs class II

Back 877

HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 877

#rheumatology #immunology

Front 878

HLA Class 2

Back 878

HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Front 879

HLA Class 1

Back 879

HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Front 880

HLA associated with Hemochromatosis

Back 880

HLA A3

____________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 880

#pathology #rheumatology

Front 881

HLA associated with Psoriasis

Back 881

HLA B27

assoc. w/ Psoriasis, Ankylosing Spondylitis, Inflmmatory Bowel Dz & Reiter's Sro

____________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 881

#pathology #rheumatology

Front 882

HLA associated with Ankylosing Spondylitis

Back 882

HLA B27

assoc. w/ Psoriasis, Ankylosing Spondylitis, Inflmmatory Bowel Dz & Reiter's Sro

____________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 882

#pathology #rheumatology

Front 883

HLA associated with Inflammatory Bowel Dz

Back 883

HLA B27

assoc. w/ Psoriasis, Ankylosing Spondylitis, Inflmmatory Bowel Dz & Reiter's Sro

____________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 883

#pathology #rheumatology

Front 884

HLA associated with Reiter's Sro

Back 884

HLA B27

assoc. w/ Psoriasis, Ankylosing Spondylitis, Inflmmatory Bowel Dz & Reiter's Sro

____________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 884

#pathology #rheumatology

Front 885

HLA associated with Grave's Dz

Back 885

HLA B8

____________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 885

#pathology #rheumatology

Front 886

HLA associated with Multiple Sclerosis

Back 886

HLA DR2

assoc. with multiple Sclerosis, Hay Fever, SLE and Goodpasture's
____________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 886

#pathology #rheumatology

Front 887

HLA associated with Hay Fever

Back 887

HLA DR2

assoc. with multiple Sclerosis, Hay Fever, SLE and Goodpasture's
____________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 887

#pathology #rheumatology

Front 888

HLA associated with SLE

Back 888

HLA DR2

assoc. with multiple Sclerosis, Hay Fever, SLE and Goodpasture's
____________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 888

#pathology #rheumatology

Front 889

HLA associated with Goodpasture

Back 889

HLA DR2

assoc. with multiple Sclerosis, Hay Fever, SLE and Goodpasture's
____________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 889

#pathology #rheumatology

Front 890

HLA associated with T1DM

Back 890

HLA's DR3 & DR4

DR4 also assoc w/ rheumatoid arthritis
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 890

#pathology #rheumatology

Front 891

HLA associated with Rheumatoid Arthritis

Back 891

HLA DR4

also associated with T1DM (which is also associated with HLA DR3)
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 891

#pathology #rheumatology

Front 892

HLA associated with Pernicious Anemia

Back 892

HLA DR5

also associated with Hashimoto's Thyroiditis

___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 892

#pathology #rheumatology

Front 893

HLA associated with Hashimoto's

Back 893

HLA DR5

also associated with Perniciosu Anemia
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 893

#pathology #rheumatology

Front 894

HLA associated with Steroid Responsive Nephrotic Sro

Back 894

HLA DR7
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 894

#pathology #rheumatology

Front 895

HLA DR7

Back 895

assoc. w/ steroid responsive nephrotic sro
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 895

#pathology #rheumatology

Front 896

HLA DR5

Back 896

Pernicious anemia and Hashimoto's
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 896

#pathology #rheumatology

Front 897

HLA DR4

Back 897

Rheumatoid Arthritis
& T1DM

NB: T1DM also assoc. w/ DR3
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 897

#pathology #rheumatology

Front 898

HLA DR3

Back 898

T1DM

NB:
NB: T1DM also assoc. w/ DR4 which is also assoc. with Rheumatoid Arthritis
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 898

#pathology #rheumatology

Front 899

HLA DR2

Back 899

Multiple Sclerosis, Goodpasture, Hay Fever, SLE
___________________
HLA Class II = MHC Class II
Equal sized α and βglobulins

Inclues HLA-DR, HLA-DP and HLA DQ

Hint 899

#pathology #rheumatology

Front 900

HLA B8

Back 900

Grave's Dz
________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 900

#rheumatology #pathology

Front 901

HLA B27

Back 901

Mn: PAIR

Psoraisis
Ankylosing Spondylitis
IBD
Reiter's Sro
________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 901

#rheumatology #pathology

Front 902

HLA A3

Back 902

Hemochromatosis
________________
HLA Class I = MHC Class I
large α, β2 microglobulin

Includes HLA-A, HLA-B & HLA-C

Hint 902

#rheumatology #pathology

Front 903

Rx: Alzhemier's Demetia

Back 903

Central acting Cholinergic enhancers:
Donepezil, Rivastigmin

NMDA antagonists: memantidine

Antioxidants: Eitamin E

Hint 903

#pharmacology #neurology

Front 904

Gibbs Free Energy & Keq

Back 904

Gibbs Free Energy
ΔG0 = -RlnKeq

Keq = products/reactants

if ΔG0 is negative Keq > 1 and products accumulate

if ΔG0 is positive than Keq <1 and substrates will accumualte

ΔG = 1 is steady state

ΔG = 0 is mathmatically impossible

Hint 904

#formulas

Front 905

What kind of heart damage doe doxorubicin & daunocrubicin produce?

Back 905

anthracyclines

dose dpt cardiact toxicity

swelling SR → loss of individual cardiomyocytes ("myofibrillar dropout" → dilated cariomyopathy

preventable with dexrazocane

Hint 905

#pharmacology #toxocities

Front 906

ACEI's vs Kidneys

what is contraindication

Back 906

renal artery stenosis

these people are depending on dilated efferent arteriole to decreases resistance and maintain glomerular filtration and interstitial perfusion

Hint 906

#pharmacology #toxicities

Front 907

Killed bacterial vaccines

Back 907

Cholera
Anthrax
Pertussis
Plague

Hint 907

#microbiology #immunology

Front 908

Live attenuated bacterial vaccines

Back 908

BCG: tuberculosis
thyphoid vaccine
Tularemia

Hint 908

#microbiology #immunology

Front 909

Capsular polysaccharide vaccines

Back 909

Pneumococcus
Hib
Meningococcus

Hint 909

#microbiology #immunology

Front 910

Ig which does not contribute to Neisseria killing

Back 910

IgA cannot trigger complement cascade

only IgM and IgG

too much IgA leaves pts vulnerable to Neisseria by blocking IgG and IgM from epitopes

Hint 910

#micobiology #immunology

Front 911

Lewy Bodies

Back 911

Parkinsons & Lewy Body Dementia

Hint 911

#pathology #neurology #dementia

Front 912

IL10

Back 912

produced by TH2 and inhibits the synthesis of IFNγ

Hint 912

#immunology

Front 913

S3 & S4

Back 913

S4 = Atrial Kick
NB: caused by non-compliant ventricle

S3 = Opening Splash
caused by ↑ Atrial Pressure or Dilated ventricles
ie ↑ mitral regurg or end stage CHF
physiologic in children & pregnants

Hint 913

#cardiology #pathology

Front 914

Heart Problems on a Med

Nausea, Vomiting, Confusion, Visual Changes

Back 914

Digoxin used for atrial fib w/ undelrying systolic dysnfx

Not only ↑ contractility, but also induces vagal stim of AV node

Toxicity:
Nausea/Vomitting/Anorexia/Diarrhea
fatigue/HA/Dizziness/Confusion/Delerium
Blurry Vision, Δcolor perception

Hyperkalemia

Tx: activated charcoal
insulin, kayexalate or hemodyalysis for hyperK
avoid Ca2+ gluconate
3. Fab

NB: hypokalemic state ↑ susceptibility to digoxin tocitity

Hint 914

#cardiology #pharmacology #toxicity

Front 915

Where do the testicular and adrenal veins drain?

Back 915

Right Adrenal drains via right suprarenal vein directly into IVC
Right Testical Drains directly into IVC

Both left Adrenal and Left Testical Drain into Left Renal Vein

Hint 915

#anatomy #cardiovascular

Front 916

Potassium perchlorate

Back 916

K Cl O4

Competitively inhibits Na+/I- symporter (NIS) on basolateral membrane of thyroid follicular cells

useful for decreasing radioactive iodine uptake

sibling drug: Pertechnetate TcO4-

Hint 916

#pharmacology #endocrine #thyroid

Front 917

Pertechnetate

Back 917

TcO4-

Competitively inhibits Na+/I- symporter (NIS) on basolateral membrane of thyroid follicular cells

useful for decreasing radioactive iodine uptake

sibling drug: Perchlorate (aka potassium perchlorate) K Cl O4-

Hint 917

#pharmacology #endocrine #thyroid

Front 918

Hypotonic Baby dies at 7 mo

Back 918

Werdnig Hoffman

infantile spinal muscular atrophy
AR degeneration of anterior horn cells
LMN involvment only

Floppy at birth, dies w/in year

Hint 918

#pathology #genetics #neurology

Front 919

Werdnig Hoffman

Back 919

Werdnig Hoffman

infantile spinal muscular atrophy
AR degeneration of anterior horn cells
LMN involvment only

Floppy at birth, dies w/in year

Hint 919

#pathology #genetics #neurology

Front 920

infantile spinal muscular atrophy

Back 920

Werdnig Hoffman

infantile spinal muscular atrophy
AR degeneration of anterior horn cells
LMN involvment only

Floppy at birth, dies w/in year

Hint 920

#pathology #genetics #neurology

Front 921

Alcohol detoxification process

Back 921

Most common manifestation is tremulousness "shakes" which start w/in 12 hours and peak at day 3 and subside by day 5

Delerium tremens peaks on the 3rd day: fluctuant level of arousal, hallucinations, SNS hyperactivity etc

only 1/4 will have vision disturbances

only 1/20 will actually undergo tonic clonic seizures

Hint 921

#pharmacology #alcohol

Front 922

Serum Creatine Kinase indicative of

Back 922

aka CPK

Muscle Cell membrane damage

gets out when membrane is damage

Hint 922

#pathology #diagnostics

Front 923

Potent CYP450 inducers and inhibitors

Top 12

Back 923

Inducors
Carbamazepine
Phenobarbital
Phenytoin
Reifampin
Griseofulvin

Inhibitors
Cimetidine
Ciprofloxavin
erythromycin
Azoles
Grape Fruit Juice
Isoniazid
Ritonavir & other protease inhibors

Hint 923

#pharmacology

Front 924

Best Diagnostic Test for Acute Cholecystitis

Back 924

Failed visualization of gallbladder on HIDA scan

Almost all acute cholecystitises 2° to gallstone obstrx of cystic duct

radiolabelled nucleotide uptaken by bladder excreted via biliary ducts but does not enter gallbladder w/in 4 h

indicates obstxn of cystic duct and therefore actue cholecystitis

Hint 924

#pathology #diagnostics #hepatobiliary

Front 925

HIDA scan

Back 925

Best Diagnostic Test for Acute Cholecystitis


Almost all acute cholecystitises 2° to gallstone obstrx of cystic duct

radiolabelled nucleotide uptaken by bladder excreted via biliary ducts but does not enter gallbladder w/in 4 h: indicates obstxn of cystic duct and therefore actue cholecystitis

Hint 925

#pathology #diagnostics #hepatobiliary

Front 926

"Normal" Cardiac Abnormality

Back 926

1/4 of adult population has a patent foramen ovale

normal atrial pressures keep it closed

problems arise if RA pressures > LA pressures

thromboses/strokes

Hint 926

#cardiovascular #pathology

Front 927

Ideopathic Pulmonary Artery Hypertension

Back 927

Ideopathic Pulmonary Hypertension

abnormal Bone Morphogenic Protein Receptor Type 2 BMPR2

30 yo women

↓ NO & Prostaglandins
↑ endothelin
↑ VSMC proliferation

Hint 927

#pathology #pulmonology

Front 928

BMPR2

Back 928

Ideopathic Pulmonary Hypertension

abnormal Bone Morphogenic Protein Receptor Type 2 BMPR2

30 yo women

↓ NO & Prostaglandins
↑ endothelin
↑ VSMC proliferation

Hint 928

#pathology #pulmonology

Front 929

Colonic Polyps

What features indicate malignant vs benign

Back 929

Non-neoplastic Polyps:

Hyperplastic (well differentiated w/ crypts and glands)
Hamartomatous: sporatic or Peutz-Jeghers and Juvenile Polyposis
Inflammatory: regenerating (Crohns)
Lymphoid: children

Neoplastic factors:
Degree of dysplasia
Villous>Tubular
Size esp >4

Hint 929

#pathology #gastrointestinal #neoplasia

Front 930

Carcinoid Tumor: Benign vs Metastatic

Back 930

5-hydroxyindolacetetic aciduria

Liver will metabolize any products normally

If there are systemic sx then it has metastesized to the liver already

Hint 930

#pathology #neoplasia

Front 931

Cardiovascular Defects of Turner Sro

Back 931

1. Bicuspid Aortic Valve <<most common
2. Coarctation of aorta

Hint 931

#pathology #genetics #cardiovascular

Front 932

FGF gene in embryogenesis

Back 932

produced at apical dermal ectodermal ridge (thickened ectoderm at distal end of each developin limb). Stimulates mitosis of underlying mesoderm responsible for lengthening limbs.

Hint 932

#embryology #molecules

Front 933

Wnt-7 gene

Back 933

produced at apical ectodermal ridge (thickened ectoderm at distal end of each developin limb). Necessary for proper organization along dorsal-ventral axis

Hint 933

#embryology #molecules

Front 934

Sonic Hedgehog Gene

Back 934

produced at base of limbs in zone of polarizing activity. involved in patternining along A-P axis

Hint 934

#embryology #molecules

Front 935

produced at base of limbs in zone of polarizing activity. involved in patternining along A-P axis

Back 935

Sonic Hedgehog Gene

Hint 935

#embryology #molecules

Front 936

produced at apical ectodermal ridge-- necessary for proper organization along dorsal-ventral axis

Back 936

Wnt-7 gene

ectodermal ridge: (thickened ectoderm at distal end of each developin limb

Hint 936

#embryology #molecules

Front 937

produced at apical dermal ectodermal ridge-- stimulates mitosis of underlying mesoderm responsible for lengthening limbs.

Back 937

FGF gene

ectodermal ridge: (thickened ectoderm at distal end of each developin limb

Hint 937

#embryology #molecules

Front 938

Electrolytes through the pancreatic ducts

Back 938

released isotonic to plasma

regulated by secretin from duodenal S cells in response to H+

HCO3 exchanged for Cl along the way

the more secretin, the more these exchange by the end, the more alkaline the secretions

Hint 938

#physiology #gastrointestinal

Front 939

Eplerenone

Back 939

Aldosterone antagonist useful in Conns

1/10th as many reports of gynecomastia with Eplerenone as Spirolactone

Hint 939

#pharmacology #drugs

Front 940

Cord factor

Back 940

mycoside: 2 mycolic acids molecules bound via disaccharide [trehalose]

Virulence factor of mycobacteria, mycobacteria which do not have cord factor are not infectious

allows Mtb to grow in thick serpeinte cords, inactivates PMN,s damages mitochondria and induces TNF prodxn

Hint 940

#microbiology

Front 941

sulfatides

Back 941

virulence factor of Mtb prevent fusion of lysosomes to phagosomes

Hint 941

#microbiology

Front 942

congenital inability to smell

Back 942

assoc w/ Kallman sro

hypogonadotrophic hypogonadism

GnRH releasing neurons do not travel from primitive olfactory bulb to hypothalamus

Hint 942

#pathology #endocrine

Front 943

Anti-hyperlipidemic agent which precipitates gouty attack

Back 943

Niacin

esp w/ initial threatment

also hyperglycemia and then hepatotoxicity at high doses

Hint 943

#drugs #toxicities

Front 944

HMP Shunt

Back 944

Irreversible Oxidative Rxns

G6PDehydrogenase
G6P + NADP → 6 Phosphogluconate + NADPH
Rate Limiting Step

6 Phosphogluconate Dehydrogenase
Phosphogluconate + NADP → Ribulose 5 Phosphate + NADPH

all subsequent rxns reversible

Transketolase
Ribose 5 Phsophate → Glyceraldehyde 3 Phosphate

Transaldolse
Glyceraldehyde 3 phsophate → Fructose 6 Phosphate

Hint 944

#biochemistry #energymetzm

Front 945

What Rx must be taken to eliminate the hepatic stages of malaria

Back 945

primaquin

Hint 945

#microbiology #antimicrobials #pharmacology

Front 946

Single lymph node grows and shrinks cyclically

Back 946

Follicular lymphoma

benign
most common non-hodgkin lymphoma in adult
t(14:28) Bcl2

Hint 946

#neoplasia #pathology

Front 947

Follicular lymphoma

Back 947

benign
most common non-hodgkin lymphoma in adult
t(14:28) Bcl2

Single lymph node grows and shrinks cyclically

Hint 947

#neoplasia #pathology

Front 948

Where do urate stones form and why

Back 948

collecting ducts due to low pH

uric acid pKa 5.4

Hint 948

#pathology #nephrology

Front 949

1° mtb infx

Back 949

Gohn focus: fibrotic focus in lower lobe of lung

Ispilateral hilar adenopathy (w/ calcification)

Gohn complex = both of those

aspiration of <2mm droplets → M∅ phagocytosis → intracellular proliferation → lymphatic cirulation → dissemination

Hint 949

#microbiology #pulmonology

Front 950

Gohn Focus vs Gohn Complex

Back 950

Gohn focus: fibrotic focus in lower lobe of lung

Ispilateral hilar adenopathy (w/ calcification)

Gohn complex = both of those

aspiration of <2mm droplets → M∅ phagocytosis → intracellular proliferation → lymphatic cirulation → dissemination

Hint 950

#microbiology #pulmonology

Front 951

Which antimicrobials should always be monitored with a complete blood count

Back 951

cloramphenicol: aplastic anemia
dapsone
TMP SMX: megaloblastic anemia

Hint 951

#antimicrobials #pharmacology #toxicity

Front 952

Which antimicrobials should always be monitored for LFT's

Back 952

INH, rifampin, pyrazinamide

Hint 952

#antimicrobials #pharmacology #toxicity

Front 953

subdural hematoma and bilateral retinal hemorrhages in an infant

Back 953

shaken baby sro

Hint 953

#pathology #ethics

Front 954

cardinal signs of shaken baby sro

Back 954

subdural hematoma and bilateral retinal hemorrhages in an infant

Hint 954

#pathology #ethics

Front 955

HIV proteins

Back 955

env: gp160
cleaved into gp120 & gp41
gp120: attachment to T cell
gp41: fusion & entry

gag (p24) capsid protein

pol: reverse transcriptase

Hint 955

#microbiology

Front 956

How can you diagnose a B12 deficiency (before empirically providing B12)

Back 956

serum methylmalonic acid level

Hint 956

#pathology #diagnostics

Front 957

low serum methylmalonic acid

Back 957

not a b12 deficiency

high would be a b12 deficiency

Hint 957

#pathology #diagnostics

Front 958

high serum methylmalonic acid

Back 958

B12 deficiency

Hint 958

#pathology #diagnostics

Front 959

Calories/Gram by Nutrient

Back 959

CHO & Proteins: 4

EtOH: 7

Fat: 9

Hint 959

#biochemistry #energymetzm

Front 960

Lambert-Eaton Sro is 2° to what?

Back 960

Classically Small Cell Lung Cancer

Hint 960

#pathology #neoplasia

Front 961

easy fatigability, constpitation, back pain and azotemia

Back 961

multiple myeloma

Bence Jones Light Chainse

Hint 961

#pathology #neoplasia #presentations

Front 962

Carcinoid Tumor which produces diarrhea

Back 962

WDHA
whatery Diarrhea Hypokalemia Achlorhydria

Vasoactive Peptide

relaces GI smm
inhbitis gastric H+
stims pancreatic bicarbonate

Hint 962

#pathology #neoplasia

Front 963

PI3K-ATK Pathway

Back 963

Too much time on graph, return to this

Front 964

PTEN mutations

Back 964

Endometrial Hyperplasia & Carcinoma
Melanoma

Cowden Sro: AD
Bannayan-Ruvalcaba-Riley Sro: AD
Both present with macrocephaly, intestinal hamartomous polyps and benign skin lesions: lipomas, hamngiomas & pigmented macules on penis

Cowden Sro: no ↑ risk of GI malignancy, yes ↑ risk breast, thyroid follicular and endometrial CA
Bannayan-Ruvalcaba-Riley: ↓ risk malignancy, yes dvlptl delays

Front 965

PIK3 & Malignancy

Back 965

Part of the PI3K-ATK pathway

PIK3CA is the catalytic subunit

amplification is involved in
-the invasiveness of endometrial cancers, esp those s PTEN mutations (not the hyperplasia)

also in follicular thyroid carcinoma
[FTC else RAS gain of fnx w/ PTE loss of fnx or q13p25 translocation PAX8 (thyroid) + PPARG

Front 966

MDM2

Back 966

anti-apoptotic 2nd messenger in PI3K-ATK pathway

promotes degradation of p53
mutated in 1/3 of sarcomas esp those s p53 KO's

Front 967

Surfactant Dynamics In Utero: Molecules, Timeline

Back 967

Sphingomyeline is a common membrane lipid, the relative concentration of sphingomyelin does not increase

Phosphatidyl glycoerol is a component of surfactant which rises after 36 weeks

Phosphatidylcholine aka lecithin is a component of pulmonary surfactant which increases sharply after 30 wks

a ratio of L/S of 2:1 by week 35 indicates fetal lung maturity

Front 968

How do you deal with a language barrier

Back 968

always use a trained interpreter, not a family member.

Even for sign language: writing and/or lip reading is not an good substitute as these are imperfect or abridged.

Front 969

What are the cells and hormonal dynamics of the maturing follicle

Back 969

Theca Interna: Leutinizing Hormone induces the production of Progesterone and Androgens

Theca Externa is a non-participatory layer of smm and fibroblasts

Granulosa Cells: FSH induces aromatase to convert the androgens into estradiol

Front 970

What Sro presents with Aortic Coarctation

Back 970

Turner Sro

Front 971

What sro Presents with Hypertrophic Cardiomyopathy

Back 971

Freidrick's Ataxia

Front 972

What Sro Presents with Situs Inversus

Back 972

kartagener's Sro

Front 973

What Sro may present with Atrial septal defect and a regurgitant AV valve

Back 973

Down Sro

Front 974

Mitochondrial Dz's

Back 974

3 types:

MERRF: Myoclonic Epilepsy with Ragged Red Fibers

MELAS: Mitochondrial Encephalopathy with Stroke Like Episodes and Lactic Acidosis

Leber Optic Neuropathy (Blindness)

Front 975

What are the stop codons

Back 975

UAA, UAG, UGA

Front 976

Orexin

Back 976

aka hypocretin, produced in lateral hypothalamus, maintains wakefulness

most common form of narcolepsy 2° to destrxn of orexin producing neurons

Front 977

hypocretin

Back 977

aka orexin, produced in lateral hypothalamus, maintains wakefulness

most common form of narcolepsy 2° to destrxn of orexin producing neurons

Front 978

CO: 2 formulas

Back 978

SV*HR
or O2 consumption/arteriovenous O2 difference

Front 979

Horseshoe Kidney

Back 979

1/500 people
get caught under IMA
cause UTI's & Obstrx

Front 980

T tubules

Back 980

invagination of extracellular memgrane between A & I

fnx: coordinated contraction

Front 981

Sarcomere Organization

Back 981

M line: Middle Line: attachment points of myosin
H band: Heller german for lighter, just myosin
A band: anisotropic: two types of things actin and myosin
I band: isotropic one type of thing: just actin
Z disk: attachments of actin

T tubules lay across the jnx of the A and I bands

Front 982

Dihydropyridine Receptors

Back 982

Voltage Gated Calcium Channels on Muscle Cell Membrane

Front 983

How could two non-virulent mutant strains of the same, non-segmented virus produce virulent progeny

Back 983

recomination

Front 984

viral phenotype mixing

Back 984

combination of cytopathic effects from coinfx of 2 viruses

eg
virus A acquires surface glycoproteins of virus B
virus A has ability to infect the cells for which B is tropic, but only for one generation

Front 985

Virus Interference

Back 985

Viral coinfex but one virus blocks the action of a 2nd.

Eg?

Front 986

Describe Excitation Signals in All Muscle Types

Back 986

SkM: Direct physical interaction exists btw sarcolemmal ca2+ dihydropyridine L type calclium channel and the Ryanidine Receptor. this induces immediate release of Ca2+ from within the cell. There is no significant influx of Ca2+ from the extracellular environment. Ergo calcium channel blockers have no effect on SkM

CrM: L type Ca2+ channels allow influx of Ca2+. Ca2+ then acts as a 2nd messenger to open the RyR2 channels and allow a Calcium dependent calcium release.

SmM: similar mechanism, however, Ca2+ does not act directly on the TroponinC. Ca2+ binds and activates calmodulin, which activates myosin light chain kinase allowing for the phosphorylation of myosin & excitation contraxn coupling.

Front 987

Respiratory Tree: Epithelium

Back 987

Pseudostratified columnar with goblet cells, basal cells, and submucosal glands from trachea to 3* bronchi

Bronchioles transition to cuboidal cells with clara cells and no longer contain submucosal glands [not part of question but the smooth muscle of the bronchioles is the primary site of bronchoconstriction]

Respiratory Bronchioles transition to squamous still with clara cells

Ciliation continues from trachea through respiratory bronchioles, only not present in alveoli

Front 988

Embryology Week 1

Back 988

d0: fertilization
d1: cleavage
d2: 8 cells, compaction
d3: morula
d4: enter uterus, blastocystic cavity appears
d6: hatches, implants
d6-8 trophoblast divides into two layers
d8: syncytiotrophoblast βHCG production begins

Front 989

Embryology Week 2

Back 989

d6-8 trophoblast divides into two layers
d8: syncytiotrophoblast βHCG production begins
embryoblast differentiates into epiblast and hypoblast
amnioblasts from epiblasts form rim of amniotic sac
d9: lacunar stage & formation of the primitive yolk sac
--hypoblast migrates around exocoelomic cavity to form primitive yolk sac (aka exocoeolemic) membrane
d11 & 12 uroplacental circulation begins, extraembryonic mesoderm forms
d13: extraembryonic coelem forms w/in extraembryonic mesoderm, new cells emegrate from hypoblast to form 2° yolk sac as 1° yolk sac pinches off; NB: 2° yolk sac ≠ extraembryonic coelem; NB: Chorion = trophoblast layers + extraembryonic (somatic) coelom

Weeks of twos:
2 germs layers
2 cavities form: amniotic and yolk sac
2 components of placenta: cytotrophoblast & syncytiotrophoblast
2 derivatives of extrembryonic mesoderm: somatopleure, splanchopleure

Front 990

Embryology Week 3

Back 990

Trilaminar Disc, gastrulation;

primitive streak, notochord, mesoderm and organization, and neural plate begin to form

Front 991

Embryonic Period

Back 991

Weeks 3-8
Neural tube formed by enuroectoderm and closes by week 4
Organogenesis
Extremely susceptible to teratogens

Front 992

Embryology Week 4

Back 992

4 heart chambers: heart begins to beat
4 limb buds begin to form

Front 993

Week 8

Back 993

fetal movement, fetus looks like a baby

Front 994

Weekk 10

Back 994

gentialia have male/female characteristics

Front 995

Alar plate

Back 995

primitive sensory neurons, dorsally oriented

Front 996

basal plate

Back 996

primitive motor neurons, ventrally oriented

Front 997

Notochord Development

Back 997

notochord formed from primitive streak on surface of epiblast invaginating and intercalating with hypoblast. cells proliferate and detach until forming definitive notochord.

Front 998

Pharyngeal Cleft Derivatives

Back 998

1: EAM
2-4: Persistent Cervical Sinuses

Front 999

Pharyngeal Pouch Derivatives

Back 999

1: IAM
2: Palatine Tonsil Lining
3: Dorsal: Inferior Parathyroid Glands
Ventral: Thymus
4: Superior Parathyroid Glands, Ultimobranchial body (neural crest) → calcitonin producing clear cells

Front 1000

Pharyngeal Arch I

Back 1000

Maxillary Division: V2, midface dermis, mucosa of nose & palate

Mandibular Division: V3, Meckel's cartilage → malleus & incus, mandible, most of temporal bone, sphenomandibular ligament

mucosa: anterior 2/3 of tongue + oral cavity
muscles: anterior belly of digastric, mylohyoid, tensor hypani, tenso verli palatini

1st aortic arch → part of maxillary artery

Front 1001

Pharyngeal Arch 2:

Back 1001

Richert's Cartilages: Stapes, Styloid Process, Lesser Horn of Hyoid, Stylohyoid ligament, top 1/2 of hyoid body

Muscles: Facial Expression, Stapedius, Stylohyoid, Posterior Belly of Digastric

Nerve: CN7

Aortic Arch → Stapedial Artery, regresses in humans

Front 1002

Pharyngeal Arch 3

Back 1002

Greater Horn of Hyoid & Lower 1/2 of body

Mucles: Stylopharygeus

Mucosa: Orophayrnx, posterior 1/3 of tongue, posterior tongue taste buds

Nerve: CN9


Aortic Arch → Common & Proximal Internal Carotid

Front 1003

Pharyngeal Arch 4

Back 1003

Upper portn of thyroid cartilage & some laryngeal cartilage

mucosa: supperglottic laryngopharynx, epiglottic taste buds

Nerve: CNX via Superior Laryngeal Nerve & Pharyngeal Branch

Muscles: Pharyngeal Constrictors & Crichothyroid

Aortic Arch: Part of True Aorta & Subclavian

Front 1004

Pharyngeal Arch 5

Back 1004

Obliterated

Front 1005

Pharyngeal Arch 6

Back 1005

Lower Thyroid Cartilage, crichoid cartilage, some laryngeal cartilage

mucosa: infraglottic laryngeopharynx

CNX via Recurrent laryngeal N controlls all intrinsic muscles of the larynx except the crichothyroid

Aortic Arch: Pulmonary Arteries & Ductus Arteriosus

Front 1006

Aortic Arch Derivatices

Back 1006

1: Part of Maxillary Artery
2: Stapedial Artery (regresses)
3: Common & Proximal Internal Carotid
4: Part of True Aorta & Subclavian
5: Obliterated
6: Pulmonary arteries & Ductus Arteriosus

Front 1007

Nerve Injury

Sign: Wrist Drop

Nerve, Levels, Cause, Motor & Sensory Deficits?

Back 1007

radialnerve
C5-C8

Injury: Fx midshaft of humerus
"saturday night palsy" (compression on chair or crutches"

Motor: B.E.S.T. extensors

Brachioradialis, Extensors of Wrist & Fingers, Supinators, Triceps

Sensory Deficit: posterior arm + dorsal hand & thumb

Sign: Wrist Drop

Front 1008

Sign: Loss of opposability of thumb

Nerve, Levels, Cause, Motor & Sensory Deficits?

Back 1008

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1009

Sign: Ulnar deviation of wrist upon Flexion

Nerve, Levels, Cause, Motor & Sensory Deficits?

Back 1009

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1010

Sign: Claw Hand, Index & Middle Finger's Flexed

Nerve, Levels, Cause, Motor & Sensory Deficits?

Back 1010

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1011

Sign: Radial deviation of wrist upon flexion

Back 1011

Ulnar Nerve

Proximal Lesion; Fx of medial epicondyle "funny bone"
Motor: Medial finger flexion, wrist flexion
Sensory: medial 1.5 fingers & hypothenar eminence
Sign: radial deviation of wrist on flexion

Distal Lesion: Fx hook of hamate
Motor: Interossei (Ab/addxn), Addxn of thumb, lumbricals extension of 4th & 5th)
sign: ulnar claw hand "Pope's blessing"

Front 1012

Sign: claw hand of 4th & 5th digits

Back 1012

Ulnar Nerve

Proximal Lesion; Fx of medial epicondyle "funny bone"
Motor: Medial finger flexion, wrist flexion
Sensory: medial 1.5 fingers & hypothenar eminence
Sign: radial deviation of wrist on flexion

Distal Lesion: Fx hook of hamate
Motor: Interossei (Ab/addxn), Addxn of thumb, lumbricals extension of 4th & 5th)
sign: ulnar claw hand "Pope's blessing"

Front 1013

Injury: Fx surgical neck of humerus

Back 1013

Axillary Nerve
C5- C6

Injury: Fx surgical neck of humerus or dislocated humoral head

Motor: detloid
Sensory: skin over deltoid

Sign: Flattened Deltoid

Front 1014

Injury: Fx midshaft of humerus

Back 1014

Radial Nerve
C5-C8

Injury: Fx midshaft of humerus
"saturday night palsy" (compression on chair or crutches"

Motor: B.E.S.T. extensors

Brachioradialis, Extensors of Wrist & Fingers, Supinators, Triceps

Sensory Deficit: posterior arm + dorsal hand & thumb

Sign: Wrist Drop

Front 1015

Injury: Fx of supracondylar humerus

Back 1015

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1016

Injury: Carpal Tunnel

Back 1016

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1017

Injury: Dislocated Lunate

Back 1017

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1018

Injury: Fx of medial epicondyle

Back 1018

Ulnar Nerve

Proximal Lesion; Fx of medial epicondyle "funny bone"
Motor: Medial finger flexion, wrist flexion
Sensory: medial 1.5 fingers & hypothenar eminence
Sign: radial deviation of wrist on flexion

Distal Lesion: Fx hook of hamate
Motor: Interossei (Ab/addxn), Addxn of thumb, lumbricals extension of 4th & 5th)
sign: ulnar claw hand "Pope's blessing"

Front 1019

Injury: Upper Trunk Compression

Back 1019

Musculocutaneous Nerve
C5-C7

Injury: Upper trunk compression

Motor: Biceps, Brachialis, Coracobrachialis
Flexion of arm at elbow

Sensory: Lateral Forearm

Front 1020

Injury: Dislocated Humerus

Back 1020

Axillary Nerve
C5- C6

Injury: Fx surgical neck of humerus or dislocated humoral head

Motor: detloid
Sensory: skin over deltoid

Sign: Flattened Deltoid

Front 1021

Axillary Nerve

Back 1021

Axillary Nerve
C5- C6

Injury: Fx surgical neck of humerus or dislocated humoral head

Motor: detloid
Sensory: skin over deltoid

Sign: Flattened Deltoid

Front 1022

Radial Nerve

Back 1022

radialnerve
C5-C8

Injury: Fx midshaft of humerus
"saturday night palsy" (compression on chair or crutches"

Motor: B.E.S.T. extensors

Brachioradialis, Extensors of Wrist & Fingers, Supinators, Triceps

Sensory Deficit: posterior arm + dorsal hand & thumb

Sign: Wrist Drop

Front 1023

Median Nerve

Back 1023

Median Nerve

Proximal Lesion: Fx of supracondylar humerus
Motor: opposition of thumb
Sensory: lateral 3.5 fingers
Sign: "ape hand" thenar atrophy

Distal Lesion: Carpal Tunnel, Dislocated Lunate
Motor: Wrist & Lateral Finger Flexion
Sensory:Same
Sign: Claw hand, ulnar deviation of wrist upon flexion

Front 1024

Ulnar Nerve

Back 1024

Ulnar Nerve

Proximal Lesion; Fx of medial epicondyle "funny bone"
Motor: Medial finger flexion, wrist flexion
Sensory: medial 1.5 fingers & hypothenar eminence
Sign: radial deviation of wrist on flexion

Distal Lesion: Fx hook of hamate
Motor: Interossei (Ab/addxn), Addxn of thumb, lumbricals extension of 4th & 5th)
sign: ulnar claw hand "Pope's blessing"

Front 1025

Musculocutaneous Nerve

Back 1025

Musculocutaneous Nerve
C5-C7

Injury: Upper trunk compression

Motor: Biceps, Brachialis, Coracobrachialis
Flexion of arm at elbow

Sensory: Lateral Forearm

Front 1026

Back 1026

Front 1027

Brachial Plexus

Draw and Label

Back 1027

Front 1028

Leg numbness, slapping gait unable to evert

Back 1028

damage to common peroneal nerve:

equinovarus foot: plantarflexed & inverted

Front 1029

Sole numbness, dorsiflexion and eversion

Back 1029

Tibial Nerve Injury

Front 1030

Sensory loss in posterolateral leg and foot

Back 1030

Sural nerve injuury

Front 1031

Obturator nerve

Back 1031

adductor muscles of the thigh

Front 1032

Omalizumab

Back 1032

humanized anti-IgE IgG

DOC for recurrent IgE mediated anaphylaxis/severe asthma

Front 1033

DOC for recurrent IgE mediated anaphylaxis/severe asthma

Back 1033

Omalizumab

humanized anti-IgE IgG

Front 1034

Trastuzumab

Back 1034

anti-HER2/neu receptor
effective vs. breast cancer

Front 1035

Bortezomib

Back 1035

Prosteasome inhibitor used to treat multiple myelma and Waldenstrom macroglobinemia

Front 1036

Crigler Najjar Sro Type 1

Back 1036

AR lack of UGT (uridine diphsphate-glucouronyltransferase) in the ER

results in kernicterus

Front 1037

Dubin-Johson Sro

Back 1037

AR lack of MRP2 multidrug resistance protein 2 important in hepatocellular excretion of conjugated bilirubin

Liver becomes darkly pigmented, but sro is aSx

Front 1038

Rotor Sro

Back 1038

AR defects in hepatic uptake of conjugated bilirubin

Pt is jaundiced, but condition is benign

Front 1039

lack of UGT

Back 1039

Crigler Najjar Sro Type 1 (AR)

(uridine diphsphate-glucouronyltransferase) in the ER

results in kernicterus

Front 1040

defects in hepatic uptake of conjugated bilirubin

Back 1040

Rotor Sro (AR)

Pt is jaundiced, but condition is benign

Front 1041

lack of MRP2

Back 1041

Dubin-Johnson Sro

AR lack of MRP2 multidrug resistance protein 2 important in hepatocellular excretion of conjugated bilirubin

Liver becomes darkly pigmented, but sro is aSx

Front 1042

Floppy Baby, mild jaundice, enlarged tongue, umbilical hernia

Back 1042

Infantile hypothyroidism

except ASD/VSD's

T4 essential for myelination

Front 1043

Floppy Baby, Fed Honey

Back 1043

Botulism

Front 1044

Prolyl Hydroxylase

Back 1044

hydroxylation of proline on procollagen chains, important to form stable triple helix

Front 1045

Lysyl Oxidase

Back 1045

catalyzes conversion of lysine's amino terminus to aldehyde to stengthen collagen fibers

Front 1046

Procollagen peptidase

Back 1046

cleaves terminal regions of procollagen producing insoluble tropocollogen which may aggregate

deficient in Ehlers Danlos Sro: Stretchable Skin, Hypermobile Joints, Short Stature, CT defects

Front 1047

Ehelrs Danlos Sro

Back 1047

Procollagen peptidase cleaves terminal regions of procollagen producing insoluble tropocollogen which may aggregate

deficient in Ehlers Danlos Sro: Stretchable Skin, Hypermobile Joints, Short Stature, CT defects

Front 1048

Short Stature Stretchable Skin, Hypermobile Joints

Back 1048

Ehlers Danlos Sro: deficiency of Procollagen peptidase

Procollagen peptidase cleaves terminal regions of procollagen producing insoluble tropocollogen which may aggregate

Front 1049

Lipoic Acid

Back 1049

aka lipoate

essential cofactor in many steps of arobic metabolism
-trasfer of acyl group in 2 oxoacid dehydrogenase
-transfer of methylamine group in glycine cleavage complexes

also an antioxidant

Front 1050

Biotin

Back 1050

cofactor mecessary for many carboxylation enzymes

eg acetyl CoA Carboxylase
Pyrovate carboxylase

Front 1051

δ-ALA

Back 1051

δ Aminolevuloinic Acid

Glycine + Succinyl CoA → catalyzed by ALA synthase with Pyridoxal Phosphate cofactor → δ-ALA

the first, committing and rate limiting step of heme synthesis

occurs in mitochondria of liver and hematopoietic cells
subsequent steps in heme synthesis occur in cytosol

upregulated by EtOH, Barbituates and Hypoxia
downregulated by heme and glucose

2 forms of ALASynthase
only ALAS2 produced in hematopoietic cells
KO = X linked sideroblastic anemia

Front 1052

X linked Sideroblastic Anemia

Back 1052

Glycine + Succinyl CoA → catalyzed by ALA synthase with Pyridoxal Phosphate cofactor → δ-Aminolevuloinic Acid

the first, committing and rate limiting step of heme synthesis

occurs in mitochondria of liver and hematopoietic cells
subsequent steps in heme synthesis occur in cytosol

2 forms of ALASynthase
only ALAS2 produced in hematopoietic cells
KO = X linked sideroblastic anemia

Front 1053

What essential nutrients are not found in breast milk?

Back 1053

Vitamins K and D

Most infants given a shot of vitamin K at birth

Vitamin D produced by sun Exposure

African babies may need vitamin D supplements

Front 1054

Th1 cells

What cells induce Th1 differentiation via what signals?

What do Th1 cells produce and what do those signals do?

Back 1054

DC's & M∅: IL12
IL12 induces NK's & Th1 to produce IFNγ

IFNγ & IL12 both induce Th1 differentation

TH1's produce IL-2 which maintains the T cell population and
IFN γ which promotes
→ phagocytosis
→ class switching to phagocytosable Ig's (I assume IgG)
DC & M∅ expression of MHCII and B7 costimulators
[B7 costimulators necessary otherwise MHCII stimulation would drive T's into anergy]

Front 1055

Th2 cells

What cells induce Th2 differentiation via what signals?

What do Th2 cells produce and what do those signals do?

Back 1055

Exposure to antigens in absence of IL12 or IFNγ → autocrine IL4 production → Th2 differentiation

IL5: activates eosinophils and IgA prodxn
IL4: induces IgE prodxn, mucus secretion
IL13: Mucus secretion
IL4, 10, 13: Inhibit M∅ anti-microbial activity, focuses efforts on ts repair

Front 1056

Th17 cells

What cells induce Th17 differentiation via what signals?

What do Th17 cells produce and what do those signals do?

Back 1056

IL1: M∅ and endothelial cells
IL6: M, endothelial cells, and T cells
IL23: DC's and M∅
TGF β: Many Cells
→ Th17 differentiation


Th17 produce: IL17 and IL22: proinflammatory

Front 1057

IL12

Back 1057

produced by DC's and M∅
induces IFNγ prodxn from NK's & T's
induces Th1 differentiation of CD4

Front 1058

IFNγ

Back 1058

Produced by NK's in response to IL12 from M∅
Produced by Th1 CD4's

induces Th1 differentiation of CD4's

induces phagocytosis, IgG class switching, MHCII expression and B7 costimulator presentation on M∅ and DC's

Front 1059

IL4

Back 1059

Autocrine signal by CD4's in presence of antigenic stimulation with absence of IL12/IFNγ (normally direct Th1 differentation)

Induces class switching to IgE

Inhibits M∅ antimicrobial activity, focuses on ts repair (also has thsi fnx: IL's 10 and 13, also produced by Th2)

↑ mucus secretion (also has this fnx: IL13)

Front 1060

IL5

Back 1060

product of Th2

activates eosinophils and IgA class switching

Front 1061

IL17

Back 1061

proinflammatory cytokine of Th17

Front 1062

IL22

Back 1062

proinflammatory cytokine of Th17

Front 1063

IL23

Back 1063

product of M∅ and DC's
induces Th17 differentiation

Front 1064

Aspergillus filling a pre-existing lung cavity

Back 1064

common environmental fungus with septate hyphae with 45* V angle branching

colonizing aspergillosis

non-invasive, grows inside cavity forming a fungus ball

eg cavities left behind by tuberculosis, emphysema, or sarcoidosis

Front 1065

Forms of Aspergillosis

Back 1065

common environmental fungus with septate hyphae with 45* V angle branching

Colonizing aspergillosis: non-invasive, grows inside cavity forming a fungus ball
eg those cavities left behind by tuberculosis, emphysema, or sarcoidosis

ABPA: Allergic bronchopulmonary aspergillosis: hypersensitivity reaction produes asthma

Invasive aspergillosis only in immunosppressed; primarily lung invovlement,

Front 1066

Mucicarmine stain

Back 1066

used to reveal CHO capsule of cryptococcus; stains it red (india ink = negatively staining field)

Front 1067

Cimetidine

Back 1067

H2 receptor antagonist used for to ↓ gastric acid prodxn

inhibits CYP450, likely causes gynecomastia

Front 1068

What medicine likely decreases the efficacy of levodopa in parkinson's

Back 1068

OTC multivitamin containing B6 increases peripheral metzm of levodopa

Front 1069

LMN signs in UE's
UE loss of pain and Temp
UMN signs in LE's
scoliosis
progressive ataxia

Back 1069

Syringomyelia: central cystic degeneration of the cervical spinal cord

damages ventral white commissure and anterior horns

ventral white commissure site of decussation of spinothalamic tract neurons for pain and temp

most common at C8-T1, expansion produces LE UMN signs by damaging corticospinal tract

Front 1070

Syringomyelia

Back 1070

LMN signs in UE's
UE loss of pain and Temp
UMN signs in LE's
scoliosis

central cystic degeneration of the cervical spinal cord

damages ventral white commissure and anterior horns

ventral white commissure site of decussation of spinothalamic tract neurons for pain and temp

most common at C8-T1, expansion produces LE UMN signs by damaging corticospinal tract

Front 1071

Best way to prevent neonatal tetanus

Back 1071

maternal vaccination during pregnancy

IgG's will cross placenta

Front 1072

What determines blood flow to the brain

Back 1072

CO2

hypercapnia ↑ blood flow
hypocapnea ↓ blood flow

panic attacks ↓ cerebral perfusion
correct cerebral edema with hyperventilation

only sever hypoxia pO2<50mmHg leads to increased perfusion

Front 1073

Glycogen metzm in Muscles

Back 1073

Epinephrine or Glucagon bind Gs → ↑cAMP → activate PKA → activates phosphorylase kinase, deactivates glycogen synthase

phosphorylase kinase activates glycogen phosphorylase

Glycogen phosphorylase breaks down glycogen

>>Ca2+ directly ↑ functionality of phosphorylase kinase regardless of activation status<

[Glyogen phosphorylase activated by phosphorylase kinase, deactivated by phosphoprotein phosphatase]

Front 1074

Conn Sro

Back 1074

Hyperaldosteronism

Aldosterone produced by the zona glomerulosa, the outer layer of adrenal cortex

Renal Na+ retention and K+ wasting → hypertension, hypokalemia, metabolic alkalosis (why?)

hypokalemia → muscle weakness
hypokalemic alkalosis → parasthesias

Front 1075

Hyperaldosteronism

Back 1075

Conn Sro

Aldosterone produced by the zona glomerulosa, the outer layer of adrenal cortex

Renal Na+ retention and K+ wasting → hypertension, hypokalemia, metabolic alkalosis (why?)

hypokalemia → muscle weakness
hypokalemic alkalosis → parasthesias

Front 1076

Zona Glomerulosa

Back 1076

Produces Aldosterone

Overproduction: Conn Sro, Hyperaldosteronism

Aldosterone produced by the zona glomerulosa, the outer layer of adrenal cortex

Renal Na+ retention and K+ wasting → hypertension, hypokalemia, metabolic alkalosis (why?)

hypokalemia → muscle weakness
hypokalemic alkalosis → parasthesias

Front 1077

Zona Fasiculata

Back 1077

Cortisol Production

Front 1078

Zona Reticularis

Back 1078

Inner Layer
Adrenal Androgen Production

Dehydropeiandrosterone
Androstenedione

Front 1079

Which Adrenal Cortex Layer Produces Adrenal Androgens?

Back 1079

Zona Reticularis
Inner Layer
Adrenal Androgen Production

Front 1080

Which Adrenal Cortex Layer Produces Cortisol

Back 1080

Zona Fasiculata, Middle Layer

Front 1081

Which Adrenal Cortex Layer Produces Aldosterone

Back 1081

Zona Glomerulosa
Outer Layer

Overproduction: Conn Sro, Hyperaldosteronism

Aldosterone produced by the zona glomerulosa, the outer layer of adrenal cortex

Renal Na+ retention and K+ wasting → hypertension, hypokalemia, metabolic alkalosis (why?)

hypokalemia → muscle weakness
hypokalemic alkalosis → parasthesias

Front 1082

What physiologic aspect of neuronal transmission is affected in MS?

Back 1082

the space constant

myelin increases the space constant

Front 1083

Lung Mass + Hyponatremia

Back 1083

SIADH paraneosplastic sro of small cell carcinoma

Water Retention suppresses RAAS system → Water Loss → Euvolemia Hyponatremia

hyponatremia → seizures

Front 1084

SIADH

Back 1084

SIADH paraneosplastic sro of small cell carcinoma

Water Retention suppresses RAAS system → Water Loss → Euvolemia Hyponatremia

hyponatremia → seizures

Front 1085

probability that the child of the sister of someone with an X linked dz will have that dz?

Back 1085

1/8

1/2 probability that sis is a carrier
1/2 probability that sis will contribute defective gene
1/2 probability that child will be a girl

Front 1086

Selegiline

Back 1086

MAOB inhibitor

used to delay prorgression of parkinson's to avoid untoward GI side effects of levodopa

Front 1087

Carbidopa

Back 1087

Dopa-decarboxylase inhibitor

prevents peripheral conversion of levodopa to dopamine

this conversion responsible for the intense nausea and vomitting caused by monotherapy of levodopa

∅xBBB

Front 1088

MAOB inhibitor

Back 1088

Selegiline

used to delay prorgression of parkinson's to avoid untoward GI side effects of levodopa

Front 1089

Dopa-decarboxylase inhibitor

Back 1089

Carbidopa

prevents peripheral conversion of levodopa to dopamine

this conversion responsible for the intense nausea and vomitting caused by monotherapy of levodopa

∅xBBB

Front 1090

Pergolide

Back 1090

Dopamine Agonist which directly simulates D2 receptors

only modest improvement in Parkinson's, but may delay use of levodopa and thus the intense nausea and vomitting assoc. w/ levodopa

Front 1091

Managing initial onset dopamien

Back 1091

many neurologists favor the use of selegiline (MAOB inhibitor), anticholinergics, and amantadine until they no longer provide control of Sx

only then is levodopa/carbidopa combo introduced (intense N/V)

Front 1092

Blood/Gas Coefficient

Back 1092

highly soluble drugs have a high blood/gas coefficient

their partial pressure rises slowly and they take a long time before they can act

Front 1093

PT, PTT, Coagulation Pathways

Back 1093

PT: extrinsic system: 7XV2
PTT: intrinsic system 12-11-9-XV2

Front 1094

Neurovasculature of the Ovary

Back 1094

arrives via the suspensory ligament

Front 1095

Round ligament of the Uterus

Back 1095

courses through inguinal canal to extenral genitalia

contains the artery of sampson

Front 1096

ALA dehydratase

Back 1096

dALA + dALA → pyrrole porphobilinogen (PBG)

the 2nd step in porphyrin production after ALA synthase (Succinyl CoA + Glucose → dALA)

occurs in cytoplasm
contains zinc

along with Ferrochelatase (Protoporphyrin 9 + Fe2+ → heme)[mitochondria], one of two enzymes in heme synthesis inhibited by lead

Front 1097

Ferrochelatase

Back 1097

Protoporphyrin 9 + Fe2+ → heme

occurs in mitochondria

along with ALA dehydratase(dALA + dALA → pyrrole porphobilingoen {PBG})[cytosol], one of two enzymes in heme synthesis inhibited by lead

Front 1098

Lead poisoning and heme synthesis

Back 1098

2 enzymes affected

ALA dehydratase(dALA + dALA → pyrrole PorphoBilinoGen {PBG})--cytosolic

contains zinc

Ferrochetolase(Protoporphyrin 9 + Fe2+ → heme) --mitochondrial

in lead poisoning dALA and protoporphyrin 9 accumulate

microcytic hypochromic anemia

Front 1099

Type I, Type II errors

Back 1099

Type I: rejecting the null hypothesis when you shouldn't
ie- find a connection that doens't exist

Type II: failing to reject the null hypothesis when you should
ie- ignore a connectino that is true

on that note:
α is the maximum probability of making a type I error, usually 0.05
β the maximum probability of making a type II error, usually 0.2

1-β (one minus β) is the probability of rejecting the null hypothesis when it is truly fasle. Tyically 0.8 and depends on sample size and relative difference between outcomes

Front 1100

α, β

(biostats)

Back 1100

Type I: rejecting the null hypothesis when you shouldn't
ie- find a connection that doens't exist

Type II: failing to reject the null hypothesis when you should
ie- ignore a connectino that is true

on that note:
α is the maximum probability of making a type I error, usually 0.05
β the maximum probability of making a type II error, usually 0.2

Front 1101

1-β

(biostats)

Back 1101

Type II: failing to reject the null hypothesis when you should
ie- ignore a connectino that is true

β the maximum probability of making a type II error, usually 0.2

1-β (one minus β) is the probability of rejecting the null hypothesis when it is truly fasle. Tyically 0.8 and depends on sample size and relative difference between outcomes

Front 1102

Pyruvate kinase

Back 1102

enzyme which converts phosphoenolpyruvate to pyruvate producing 1 ATP

simulated to function by fructose 1,6 bisphosphate, a precursor within the glycolysis pathway

any deficiency in the glycolysis pathway will lead to insufficient ATP for RBC's to survive and splenic enlargement via work hypertrophy

Front 1103

Charcoal yeast extract supplemented with cysteine

Back 1103

growth medium for legionella

stains silver (Fungi also stain silver)

most likely from water system contamination

Front 1104

Chocolate Agar with Factors V and X

Back 1104

H influenzae
V = NAD+
X = hematin

Front 1105

Thayer-Martin Media

Back 1105

aka VPN
Vancomyxin, Polymixin, Nystatin

only allows for neisserial growth

Front 1106

VPN

Back 1106

aka Thayer-Martin Media
Vancomyxin, Polymixin, Nystatin

only allows for neisserial growth

Front 1107

Bordet Gengou Media

Back 1107

aka potato agar
Bordetella

Front 1108

Potato agar

Back 1108

aka Bordet Gengou Media
Bordetella

Front 1109

Lowenstein Jensen agar

Back 1109

M tb

Front 1110

Eaton's Agar

Back 1110

M pneumo

Front 1111

MacConkey's Agar

Back 1111

contains bile salts

lactose fermenting enterics
-Kleb
-Ecoli
-Enterobacter
-citrobacter
-Serratia
-et al

excludes shigella, salmonella, proteus, psuedomonas

Front 1112

Sabouraud's Agar

Back 1112

Fungi

Front 1113

blue black colonies with metallic sheen on eosin-methylene blue agar

Back 1113

E coli

Front 1114

Agar for Legionella

Back 1114

Charcoal yest extract buffered with cysteine and iron

Front 1115

Agar for Fungi

Back 1115

Sabouraud's Agar

Front 1116

Agar for Lactose Fermenting Enterics

Back 1116

MacConkey's Agar

contains bile salt

-Kleb
-Ecoli
-Enterobacter
-citrobacter
-Serratia
-et al

excludes shigella, salmonella, proteus, psuedomonas

Front 1117

Agar for M pneumo

Back 1117

Eaton's Agar

Front 1118

Agar for M tb

Back 1118

Lowenstein Jensen

Front 1119

Agar for C diphtheriae

Back 1119

Tellurite plate or Loffler's Media

Front 1120

Agar for B pertussis

Back 1120

Bordet Gengou (potato) agar

Front 1121

Agar for Neisseria

Back 1121

Thayer Martin (VPN) Agar
Vanxomycin (gram pos), Polymyxin (gram neg), Nystatin (fungi)

Front 1122

Agar for H influenzae

Back 1122

Chcolate agar w/ Factor V (NAD_ and X (hementin)

Front 1123

Loffler's Media

Back 1123

C diphtheria

also grows on Tellurite plate media

Front 1124

Tellurite Plate

Back 1124

C diphtheriae, also grows on Loffler's Media

Front 1125

In order of severity: what are the top 5 sites of atherosclerosis

Back 1125

1. Abdominal Aorta at major branching
2. Coronary Arteries
3. Popliteal Arteries
4. Internal Carotids
5. Circle of Willis

Front 1126

Old School Antihypertensive Med which causes Depression

Back 1126

Reserpine, irreversibly binds presynaptic vesicles and blocks transportation of monoamines into vesicles

Front 1127

Reserpine

Back 1127

irreversibly binds presynaptic vesicles and blocks transportation of monoamines into vesicles

Old School Antihypertensive Med which causes Depression

Front 1128

α-methyltyrosine

Back 1128

inhibits the coversion of tyrospine to DOPA by tyrosine hydroxylase

used in pheochromocytoma, not for hypertension

Front 1129

DOC: pheo
mechanism

Back 1129

α-methyltyrosine
inhibits the coversion of tyrospine to DOPA by tyrosine hydroxylase

Front 1130

Mechanism of Action penicillins

Back 1130

like cephalosporins, Irreversibly binds transpeptidases

Front 1131

mechanism of action cephalosporins

Back 1131

like penicillins, irreversibly binds transpeptidases

Front 1132

pain on deification with bright red blood

lesion character & location?

Back 1132

anal fissure 2° to low fiber diet & constipation

midline posterior, distal to dentate (aka pectinate) line (mucosa → skin like epithelium transition)

(midline posterior has worst perfusion)

may be assoc. w/ skin tag if chronic

Front 1133

t(15:17)

Back 1133

creates fusion of retinoic acid receptor α with promyelocytic leukemia gene producing PML-RARα fusion gene

drives Acute myelogenous leukemeia

abnormal retinoic acid receptor prevents differentiation of myeloblasts to granulocytes

myeloblasts replace bone marrow → anemia, thrombocytopenia, neutropenia

Front 1134

Rb gene mutation

Back 1134

retinoblastoma and osteosarcoma

Front 1135

Epidermal Growth Factor Gene mutation

Back 1135

multiple mutations

erbB1: non small cell lung Ca
erbB2 aka HER2/neu: breast CA
some ovarian and gastric tumors

Front 1136

Defective PDGF

Back 1136

chronic myelomonocytic leukemia

Front 1137

PML/RARα

Back 1137

t(15:17) creates fusion of retinoic acid receptor α with promyelocytic leukemia gene producing PML-RARα fusion gene

drives Acute myelogenous leukemeia

abnormal retinoic acid receptor prevents differentiation of myeloblasts to granulocytes

myeloblasts replace bone marrow → anemia, thrombocytopenia, neutropenia

Front 1138

AML

Back 1138

t(15:17) creates fusion of retinoic acid receptor α with promyelocytic leukemia gene producing PML-RARα fusion gene

drives Acute myelogenous leukemeia

abnormal retinoic acid receptor prevents differentiation of myeloblasts to granulocytes

myeloblasts replace bone marrow → anemia, thrombocytopenia, neutropenia

Front 1139

DOC: preventing DVT in non-ambulatory/surgical candidate pts

Back 1139

Heparin, LMW Heparin

binds to and ↑ the efficacy of AT3 in neutralizing thrombin

Front 1140

Progressive Ataxia and Dysarthria, Loss of Position and Vibratory Sensation

Degeneration of Posterior Columns and Spinocerebellar Tracts

Back 1140

Frederick's Ataxia

NB: closely mimicked by Vitamin E deficiency

Front 1141

Vitamin E deficiency

Back 1141

Progressive Ataxia and Dysarthria, Loss of Position and Vibratory Sensation

Identical presentation to Frederick's Ataxia

Front 1142

Freidericks' Ataxia

Back 1142

Progressive Ataxia and Dysarthria, Loss of Position and Vibratory Sensation

Degeneration of Posterior Columns and Spinocerebellar Tracts

NB: closely mimicked by Vitamin E deficiency

Front 1143

Anovulation on Antipsychotics

Back 1143

D2 blockade allows prolactin production

Porlactin inhibits release of GnRH

Front 1144

Premature menopause definition

Back 1144

Loss of ovarian function before age 35

Front 1145

Most common cause of elevated AFP

Back 1145

dating error, underestimation of fetal age

Front 1146

Best long term relief for gastric/duodenal ulcers

Back 1146

antibiotics v helicobacter pylori

Front 1147

Testing for Syphilis

Back 1147

Sensitive Test: RPR, VDRL
Rapid Plasma Reagin,
looking for antibodies vs cardiolipin, cholesterol, lecithin (cross react with treponema)

Confirm with FT0ABS look for treponema specific antibodies

Front 1148

RNA Polymerase I, II, & III

Back 1148

I: formation of rRNA w/in nucleolus
II:mRNA prodxn
III: short RNA molecules: tRNA and snRNA, 5S rRNA

Front 1149

ATM gene

Back 1149

Ataxia Telangiectasia Mutant

responsible for DNA break repair

classic triad:
cerebellar ataxia
telangiectasia
↑ risk sinopulmonary infx 2° IgA deficiency

predisposed to hematologic malignancies
hypersensitive to X rays

Front 1150

cerebellar ataxia
telangiectasia
↑ risk sinopulmonary infx

Back 1150

Ataxia Telangiectasia Mutant (ATM) gene

responsible for DNA break repair

classic triad:
cerebellar ataxia
telangiectasia
↑ risk sinopulmonary infx 2° IgA deficiency

predisposed to hematologic malignancies
hypersensitive to X rays

Front 1151

Lesch-Nyhan

Back 1151

X-linked recessive

HGPRT hypoxanthine-guanine phosphoribosyltransferase

leads to severe hyperuricemia and gout

classically: MR and self mutalting behavior, spastic and choreoathetoid movements

Front 1152

MR and self mutalting behavior, spastic and choreoathetoid movements

Back 1152

Lesch-Nyhan: X-linked recessive

HGPRT hypoxanthine-guanine phosphoribosyltransferase

leads to severe hyperuricemia and gout

Front 1153

Niemann-Pick

Back 1153

Defective sphingolipid degradation

AR defective spingomyelinase

death in early childhood

hepatosplenomegaly, anemia, motor neuropathy → hypotonia, areflexia, cherry red spot on macula

Front 1154

floppy toddler with hepatosplenomegaly, anemia, cherry red spot on macula

Back 1154

Niemann-Pick AR defective spingomyelinase

death in early childhood

hepatosplenomegaly, anemia, motor neuropathy → hypotonia, areflexia, cherry red spot on macula

Front 1155

PRPP synthetase

Back 1155

responsible for synthesis of activated ribose, necessary for de novo synth of nucleotides

Front 1156

CaNa2EDTA

Back 1156

Antidote for Acute Lead and Mercury Poisoning. Forms complexes with mono, di, and trivalent ions.

Front 1157

Dimercaprol

Back 1157

Antidote for acute arsenic poisoning.

Note: garlic odor.

Displaces Arsenic ions from sulfhydryl groups.

Side effects of antidote: nephrotoxic & hypertension

Front 1158

Amyl nitrite

Back 1158

Antidote for cyanide poisoning.

Forms methemoglobin that binds cyanide, distracting it from binding to mitochondiral enzymes

Front 1159

Deferoxamine

Back 1159

Antidote for iron poisoning, most common after multiple blood transfusions

facilitates urinary excretion

Front 1160

Nerve Damaged during Thyroidectomy

Back 1160

Superior Thyroid Artery & Vein run adjacent to External Branch of Superior Laryngeal nerve, responsible for crichothyroid muscle

Hint 1160

#anatomy #innervation

Front 1161

Laryngeal innervation

Back 1161

Vagus
--recurrent laryngeal nerve
------all laryngeal muscles except cricothyroid
------sensory innervation below vocal cords

--Superior Laryngeal NErve
------External Branch: Circothyroid Muscle
------Internal branch: Sensory Innervation above vocal cords

NB: Extenral Branch of Superior Laryngeal Nerve runs adjacent to Superior Thyroid Artery/Vein → likely to be damaged in thyroidectomy

Hint 1161

#anatomy #innervation

Front 1162

Theophylline

Back 1162

inhibits phosphodiesterase → ↑ cAMP → bronchodilation

✓ anti-inflam properties, but significantly < gluco-corticoid anti-inflam

Hint 1162

#drugs

Front 1163

Anti-asthma Rx:

acts as a phosphodiesterase

Back 1163

Theophylline

inhibits phosphodiesterase → ↑ cAMP → bronchodilation

✓ anti-inflam properties, but significantly < gluco-corticoid anti-inflam

Hint 1163

#drugs

Front 1164

Ipratropium

Back 1164

muscarinic antagonist → bronchodilation

↓ mucus production

4° Ammonium → ∅x Blood-Air Barrier

Hint 1164

#drugs

Front 1165

Anti-asthma Rx:

Muscarinic antagonist

Back 1165

Ipratropium
muscarinic antagonist → bronchodilation

↓ mucus production

4° Ammonium → ∅x Blood-Air Barrier

also Tiotropium (↑ λ = 1/d)

Hint 1165

#drugs

Front 1166

Nifedipine

Back 1166

Dihydropyridine calcium channel blocker

used to tx hypertension

also causes bronchodilation

Hint 1166

#drugs

Front 1167

Dihydropyridine calcium channel blocker used to tx hypertension

Back 1167

Nifedipine

also causes bronchodilation

Hint 1167

#drugs

Front 1168

Hib Vaccine

Back 1168

polyribosysl-ribitol-phosphate (PRP) - polysaccharide conjugated with protein toxoid from either diphtheria or tetanus

this allows for T cell processing and the production of memory humoral immunity in children under age 18 mo

may be given as early as 2 mo

Hint 1168

#immunology
#microbiology

Front 1169

Non-typable Haemophilus influenzae

Back 1169

unencapsulated

commensural

Hint 1169

#immunology
#microbiology

Front 1170

Most common bacterial causes of acute otitis media, sinusitis and bacterial conjunctivitis

Back 1170

1. Pneumococcus
2. Non-typable Hib
3. Moraxella catarrhalis

in that order for ALL infections

Hint 1170

#microbiology

Front 1171

PRP polysaccharide

Back 1171

capsular antigen of Hib

polyribosysl-ribitol-phosphate (PRP) - polysaccharide conjugated with protein toxoid from either diphtheria or tetanus

this allows for T cell processing and the production of memory humoral immunity in children under age 18 mo

may be given as early as 2 mo

Hint 1171

#microbiology
#immunology

Front 1172

Neuropathic Pain Med which worsens Urinary Retention

Back 1172

TCA's (muscarinic blockade)

Hint 1172

#drugs

Front 1173

Define the Parameters

Back 1173

Hint 1173

#physiology

Front 1174

Metronidazole

Mechanism of Action

Back 1174

Binds to DNA within Susceptible Cells, unravels helical strx and breaks the strands

Hint 1174

#pharm: antibiotics

Front 1175

Limiting factor of ACEI's

Back 1175

First dose hypotension
Risk factors: hyponatremia, diuretics, low BP, high renin, aldosterone levels, renail impairment, heart fialure

Hint 1175

#pharm: side effects

Front 1176

non-communicative pt who cannot make wishes known, no documentation

end life?

Back 1176

medical decision making falls to next of kin ie wife

Hint 1176

#ethics

Front 1177

Genetics of Down Sro

Back 1177

Vast Majority Trisomy 21, 2° to maternal non-disjnx

Unbalanced Robertsonian translocation

Mosaicism

Hint 1177

#pathology #genetics

Front 1178

Uniparental Disomy

Back 1178

fetus inherits two copies of homologous chroms from one parent, nothing from other parent

ie complete hydatiform mole

Hint 1178

#pathology #genetics

Front 1179

Why convert pyruvate to lactate in anaerobic conditions?

Back 1179

to regenerate NAD+ for the conversion of Glyceraldehyde-3-Phosphate to 1,3 BPG (the conversion of which creates NADH and depletes NAD+)

Hint 1179

#biochemistry #metabolism

Front 1180

FADH2 production

Back 1180

FADH2 produced by succinate dehydrogenase (succinate → fumarate) during TCA cycle

Hint 1180

#biochemistry #metabolism

Front 1181

Clostridium difficile

Agent, Toxin, Mechanism, Manifestation

Back 1181

toxin A: enterotoxin
mechanism: PMN chemoattractant → cytokine release → mucosal inflam & fluid loss

toxin B: cytotoxin
mechanism: depolymerizes actin filaments
result: mucosal cell death → bowel wall necrosis & pseudomembrane formation

Hint 1181

#microbiology #toxins

Front 1182

Toxin which depolymerizes actin filaments

Back 1182

Clostridium difficile toxin B: cytotoxin
mechanism: depolymerizes actin filaments
result: mucosal cell death → bowel wall necrosis & pseudomembrane formation

[toxin A: enterotoxin
mechanism: PMN chemoattractant → cytokine release → mucosal inflam & fluid loss]

Hint 1182

#microbiology #toxins

Front 1183

Toxin which attracts PMNs

Back 1183

Clostridium difficile toxin A: enterotoxin
mechanism: PMN chemoattractant → cytokine release → mucosal inflam & fluid loss

[toxin B: cytotoxin
mechanism: depolymerizes actin filaments
result: mucosal cell death → bowel wall necrosis & pseudomembrane formation]

Hint 1183

#microbiology
#toxins

Front 1184

Hereditary pancreatitis

Back 1184

rare disorder 2° to mutation in gene that encodes trypsin

not susceptible to inhibition by pancreatic secretory trypsin inhibitor (PSTI) or trypsin (which serves as its own inhibitor at high concentrations)

Hint 1184

#pathology #genetics

Front 1185

Korotkoff Sounds

Back 1185

The sounds you hear when taking blood pressure

Front 1186

pulsus paradoxus

Back 1186

>10 mmHG ↓ in systolic BP on inspiration

indicative of some pericardial problem: tamponade, constrictive pericarditis, restrictive cardiomyopathy, severe obstructive lung dz)

inspiration causes an ↑ in systemic return
with limited space for expansion interventricular septum bulges into LV 2° to ↑ RV filling during diastole → ↓ LV filling & stroke volume → ↓ systemic pressure

Hint 1186

#pathology

Front 1187

>10 mmHG ↓ in systolic BP on inspiration

Back 1187

pulsus paradoxus

indicative of some pericardial problem: tamponade, constrictive pericarditis, restrictive cardiomyopathy, severe obstructive lung dz)

inspiration causes an ↑ in systemic return
with limited space for expansion interventricular septum bulges into LV 2° to ↑ RV filling during diastole → ↓ LV filling & stroke volume → ↓ systemic pressure

Hint 1187

#pathology

Front 1188

Risks of IBD

Back 1188

Colorectal Carcinoma 10 years after onset of Colitis

most significant risk factors are duration and extent of colitis

compared to non-IBD pts:
-earlier
-higher histological grade
-more likely to originate in non-polypoid form
-mucinous or signet ring morphology
-p53 mutation early, APC late (opposite normal)
-proximal colon
-multifocal

Hint 1188

#pathology

Front 1189

Normal Pressures in each Chamber of Heart and Major Vessel

Back 1189

(Min-Max)
RA: 0-8
RV: 4-25
Pulm Art: 9-25
LA: 2-12
LV: 9-130
Aorta: 70-130

Hint 1189

#physiology #cardiovascular

Front 1190

pH > 7.4
PCO2 > 40 mmHG

Condition,
Causes

Back 1190

Metabolic Alkalosis w/ Respiratory Compensation
(Blowing off HCO3 in form of CO2)

Causes:
-Vomitting- direct loss of H+
-Diuretic use

Vomitting and diuretics both induce volume depletion. To correct for volume depletion the body resporbs as many osmotically active metabolites as possible, including HCO3

-Antacid Use- addition of HCO3
-Hyperaldosteronism: aldosterone directly ↑ H+ export pumps

Hint 1190

#physiology #acid-base

Front 1191

pH >7.4
PCO2 <40 mmHG

Condition,
Causes

Back 1191

Respiratory Alkalosis

Hyperventilation eg high altitude

Early toxicity of aspirin ingestion

Hint 1191

#physiology #acid-base

Front 1192

pH < 7.4
PCO2 > 40

Back 1192

Respiratory Acidosis 2* to hypoventilation of many causes:

Anatomic/Pathologic
Opioids, Narcotics, Sedatives

Hint 1192

#physiology #acid-base

Front 1193

pH < 7.4
PCO2 < 40

Back 1193

Step 1: Calculate Anion Gap
Na - (Cl + HCO3)

Normal Anion Gap <12 = diarrhea, glue sniffing, renal tubular acidosis, hyperchloremia

↑ anion Gap (>20): MUDPPIILES

Methanol ( → formic acid)
Uremia
DKA
Paraldehyde or Phenformin
Iron or INH
Lactic Acidosis
Ethylene Glycol (Oxalic Acid, Urine Oxalate Crystals)
(Late) Salycilate Poisoning (Aspirin)

Calculate Osmolar Gap =
measured osmolarity - [2*Na + BUN/2.8 + glucose/18]
(ie measured - calculated)
>10 ≈ methanol or ethylene glycol

Hint 1193

#physiology #acid-base

Front 1194

Liver Biopsy Shows Ballooning Degeneration

Back 1194

Hepatitis B

ground glass appearance

Hint 1194

#pathology #histology

Front 1195

Liver Biopsy Shows Lymphoid Aggregates within Portal Tracts

Back 1195

Hepatitis C

microvesicular steatosis

Hint 1195

#pathology #histology

Front 1196

Hepatitis B Histology

Back 1196

Ballooning Degeneration of Hepatocytes with Ground Glass Eosinophilic Cytoplasm

Hint 1196

#pathology #histology

Front 1197

Hepatitis C Histology

Back 1197

Lymphoid Aggregates within Portal Tracts

microvesicular steatosis

Hint 1197

#pathology #histology

Front 1198

GABAa
GABAb
GABAc

Back 1198

GABAa in brain Cl- Ion Channel

GABAb in brain G protein
K+ efflux
↓ Ca2+ influx
inhibis cAMP

GABAc in Retina
Cl- Ion Channel

Hint 1198

#biochemistry #pharmacology #neurology

Front 1199

GABA synthesis and metzm

Back 1199

Gluatamte Decarboxylase +B6 (Glutamate → GABA)

GABA transaminase +B6 (GABA → nonfnx something)

Hint 1199

#biochemistry #pharmacology #neurology

Front 1200

What normally protects against C. dif?

Back 1200

intestinal biomass

Hint 1200

#microbiology

Front 1201

Zoonotic Dysentery

Back 1201

Campylobacter

Gram negative rod with filament which allows it to move in corkscrew

watery diarrhea which becomes dysenteric

fecal-oral from
1. domestic animals
2. contaminated/undercooked/unpasturized food

Most common infectious agent assoc. with Guillaine-Barre

Hint 1201

#microbiology

Front 1202

Most common infectious agent assoc. with Guillaine-Barre

Back 1202

Campylobacter

Gram negative rod with filament which allows it to move in corkscrew

watery diarrhea which becomes dysenteric

fecal-oral from
1. domestic animals
2. contaminated/undercooked/unpasturized food

Most common infectious agent assoc. with Guillaine-Barre

Hint 1202

#microbiology

Front 1203

Campylobacter

Back 1203

Campylobacter

Gram negative rod with filament which allows it to move in corkscrew

watery diarrhea which becomes dysenteric

fecal-oral from
1. domestic animals
2. contaminated/undercooked/unpasturized food

Most common infectious agent assoc. with Guillaine-Barre

Hint 1203

#microbiology

Front 1204

DOC: Methotrexate OD

Back 1204

Leucovorin aka Folinic Acid

Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active

Hint 1204

#pharm #toxicology

Front 1205

Leucovorin

Back 1205

aka Folinic Acid

DOC: Methotrexate OD

Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active

Hint 1205

#pharm #toxicology

Front 1206

Folinic Acid

Back 1206

aka Leucovorin

DOC: Methotrexate OD

Functional Derivative of THF which does not req dihydrofolate reductase to become biologically active

Hint 1206

#pharm #toxicology

Front 1207

Filgrastim

Back 1207

recombinant G-CSF

↑ granulocyte proliferation

Hint 1207

#pharm #toxicology

Front 1208

recombinant G-CSF

Back 1208

Filgrastim

↑ granulocyte proliferation

Hint 1208

#pharm #toxicology

Front 1209

Fomepazole

Back 1209

competitive antagonist of alcohol dehydrogenase

DOC: methanol or ethylene glycol poisoning

(high anion gap + high osmolar gap metabolic acidosis)

Hint 1209

#pharm #toxicology

Front 1210

DOC: ethylene glycol poisoning

Back 1210

Fomepazole: competitive antagonist of alcohol dehydrogenase

also for methanol poisoning

Hint 1210

#pharm #toxicology

Front 1211

DOC: methanol poisoning

Back 1211

Fomepazole: competitive antagonist of alcohol dehydrogenase

also for methanol poisoning

Hint 1211

#pharm #toxicology

Front 1212

Dexrazoxane

Back 1212

iron-chelating agent used to reduce anthracycline induced (ie doxorubicin) cardiotoxicity

Hint 1212

#pharm #toxicology

Front 1213

DOC: doxorubicin cardiotoxicity

Back 1213

Dexrazoxane: iron-chelating agent used to reduce anthracycline induced (ie doxorubicin) cardiotoxicity

Hint 1213

#pharm #toxicology

Front 1214

Amifostine

Back 1214

free-radical scavenging agent used to ↓ nephrotoxicity 2° to platinum containing agents (cisplatin)

Hint 1214

#pharm #toxicology

Front 1215

DOC: cisplatin nephrotoxicity

Back 1215

Amifostine + aggressive hydration

establish chloride diuresis: cisplatin stays in a non-reactive state when in higher chloride concentration

Hint 1215

#pharm #toxicology

Front 1216

Insulin Types Durations

Back 1216

Long Acting
--Glargine 1/d, no peak (provides basal levels)
--NPH 2/d [neutral protamine hagedorn--not important]

Short acting
Regular insulin: peaks in 3 hours, lots of problems with post-prandial hypoglycemia
[delayed onset due to unwanted polymerization at injection site]

Rapid Onset: lispro, aspart: best for postprandial hypoglycemia

Hint 1216

#pharm
#diabetes

Front 1217

Insuline Glargine

Back 1217

1/d no peak
provides basal levels

Hint 1217

#pharm
#diabetes

Front 1218

NPH Insulin

Back 1218

2/d no peak, provides basal levels

replaced by long acting Insuline Glargine (1/d)

Hint 1218

#pharm
#diabetes

Front 1219

Regular insulin injx

Back 1219

peaks in 3 hours, lots of problems with post-prandial hypoglycemia
[delayed onset due to unwanted polymerization at injection site]

Hint 1219

#pharm
#diabetes

Front 1220

Lispro

Back 1220

rapid onset insulin: 15 min
1h duration
good for post-prandial needs on top of 1/d insulin glargine

similar to aspart

[regular insulin forms unnatural polymers at injx site, delays onset to 3 h]

Hint 1220

#pharm
#diabetes

Front 1221

Aspart

Back 1221

rapid onset insulin 15 min
1h duration
good for post-prandial needs on top of 1/d insulin glargine

similar to lispro

[regular insulin forms unnatural polymers at injx site, delays onset to 3 h]

Hint 1221

#pharm
#diabetes

Front 1222

How does a cholecystectomy affect lipid digestion/absorption

Back 1222

it does not affect where lipids are digested (duodenum) or absorbed (jejunum)

bile acids are still produced by the liver and released into entero-hepatic circulation

what changes is a ↓ tolerance for eating a lot of fat at one sitting because there is no storage

Hint 1222

#physiology
#gastrointestinal

Front 1223

Lipid Digestion and Absorption: Locations

Back 1223

Digestion: Dudoenum
Absorption: Jejunum

Hint 1223

#physiology
#gastrointestinal

Front 1224

Losartan

Back 1224

ARB: Angiotensin Receptor Blocker

all end in -artan

NB: similar effects to ACEI's w/o angioedema or dry cough

Hint 1224

#pharmacology
#cardiovascular

Front 1225

-artan

Back 1225

ARB: Angiotensin Receptor Blocker

all end in -artan (eg Losartan)

NB: similar effects to ACEI's w/o angioedema or dry cough

Hint 1225

#pharmacology
#cardiovascular

Front 1226

ARB's

Back 1226

ARB: Angiotensin Receptor Blocker

all end in -artan (eg Losartan)

NB: similar effects to ACEI's w/o angioedema or dry cough

Hint 1226

#pharmacology
#cardiovascular

Front 1227

Gluconeogenesis:
Converting Pyruvate to Fructose 1,6 Bisphosphate

Back 1227

Unidirectional Enzyme: Pyruvate Kinase: Phosphoenolpyruvate (PEP) → Pyruvate + ATP
Circumventing Process:

Pyruvate Carboxylase + Biotin: Pyruvate → Oxaloacetate
Mitochondrial of Liver & Kidneys
Allosterically activated by Acetyl-CoA

Mitochonrial Malate Dehydroganase: Oxaloacetate → Malate
Transport to Cytosol
Cytosolic Malate Dehydrognase: Malate → Oxaloacetate

PEPCK (PEP Carboxykinase) → GTP dependent Oxaloacetate → PEP

Reversible Reactions back to Fructose 1,6 Bisphosphate

Hint 1227

#biochemistry #energymetzm

Front 1228

Gluconeogenesis:
Phosphoenolpyruvate → Glucose-6-Phosphate

Back 1228

PEP → Fructose-1,6-Bisphophate via reversible reactions of glycolysis

Unidirectional Enzyme: Phosphofuctoskinase 1
Reverse Enzyme: Fructose Bisphosphatase 1

Regulation via both ATP/AMP levels and Glucagon

No Glucagon → no cAMP → no PKA activity → dephosphorylated PFK-2/FBP-2 enzyme: PFK2 active state on → promotes Phosphofructose Kinase

Glucagon → cAMP → PKA activity → phosphorylated PFK-2/FBP-2 enzyme: FBP-2 in active state → promotes Fructose Bisphosphatase 1

So Fructose 1,6 Bisphosphate → Fructose 6 P

conversion to Glucose 6 P via reversible process

Hint 1228

#biochemistry #energymetzm

Front 1229

Gluconeogenesis
Fructose 6 Phosphate to Extracellular Glucose

Back 1229

F6P → G6P via reversible process in cytosol

G6P translocate moves it into ER

Glucose-6-Phosphatase removes phosphate

NB: deficiency of Glucose 6 Phosphatase = Von Gierke Dz

Hint 1229

#biochemistry #energymetzm

Front 1230

negatively birifringent cyrstals in synovial fluid

Back 1230

Monosodium Urate

NB: not uric acid/urate alone

Hint 1230

#pathology

Front 1231

Cytoplasmic inclusions in oligodendrocytes

Back 1231

histology of progressive multifocal leukoenceophalopathy (PML)

Front 1232

Microglial Nodules and Multinucleated Cells within the CNS

Back 1232

characteristic for viral CNS infections esp HIV encephalopathy

Front 1233

Spongiform Transformation of Grey matter

Back 1233

Prion Dz: Cruetzfelt-Jakob, Bovine Spongiform Encephalopathy

PrP prior protein found in normal neurons has α helix. Conversion to β sheet = prion dz.

Front 1234

Histology of PML

Back 1234

progressive multifocal leukoenceophalopathy:

Cytoplasmic inclusions in oligodendrocytes

Front 1235

Histology of Crutzfelt-Jakob

Back 1235

PrP prior protein found in normal neurons has α helix. Conversion to β sheet = prion dz.

Spongiform Transformation of Grey matter (like mad cow)

Front 1236

Differentiate the MEN Sros

Back 1236

MEN1: diamond
Pituitary Adenoma, Parathyroid Tumors, Pancreatic Tumor

MEN2a: Square: Parathyroid Tumors and Pheos

MEN2B: Tall Thin Pentagon: Parathyroid Tumors, Oral Neurofibromas, Pheos, plus marfanoid habitus

Hint 1236

#pathology #syndromes

Front 1237

Thyroid Mass + Marfanoid Habitus

Back 1237

MEN1: diamond
Pituitary Adenoma, Parathyroid Tumors, Pancreatic Tumor

MEN2a: Square: Parathyroid Tumors and Pheos

MEN2B: Tall Thin Pentagon: Parathyroid Tumors, Oral Neurofibromas, Pheos, plus marfanoid habitus

Hint 1237

#pathology #syndromes

Front 1238

Histones

Back 1238

5 histones

2x of (H2A, H2B, H3 & H4) create 8 molecule nucleosome core

H1 bind segments between nucleosome cores and facilitate packing into more complex cois

Hint 1238

#biochemistry #DNA

Front 1239

Dermatitis herpetiformis 2° to GI pathology

Back 1239

Celiac Dz


Small pruritic vesicles on extensor surfaces 2° to IgA deposition at tips of dermal papillae

Hint 1239

#pathology #gastrointestinal #skin

Front 1240

Small pruritic vesicles on extensor surfaces in pt w/ GI problems

Back 1240

Dermatitis herpetiformis of Celiac Dz

Staining will demonstrate IgA deposition at tips of dermal papillae

Hint 1240

#pathology #gastrointestinal #skin

Front 1241

Ventral Spinothalamic Tract

Back 1241

Light Touch and Pressure Sensation

Hint 1241

#neurology

Front 1242

Part of Spinal Cord Responsible for Light Touch and Pressure Sensation

Back 1242

Ventral Spinothalamic Tract

Hint 1242

#neurology

Front 1243

Lateral Spinothalamic tract

Back 1243

Pain and Temperature Sensation

Hint 1243

#neurology

Front 1244

Pain and Temperature Sensation in the Spinal Cord

Back 1244

Lateral spinothalamic tract

Hint 1244

#neurology

Front 1245

cystic hygroma

Back 1245

posterior neck mass of cystic spaces separated by connective tissue in lymphoid aggregates

Turner's Sro

Hint 1245

#pathology #syndromes

Front 1246

posterior neck mass of cystic spaces separated by connective tissue in lymphoid aggregates

Back 1246

cystic hygroma of Turner's Sro

Hint 1246

#pathology #syndromes

Front 1247

Hemicholinum

Back 1247

blocks choline uptake into nerve terminal

Hint 1247

#pharm #drugs

Front 1248

Rx: blocks choline uptake into nerve terminal

Back 1248

blocks choline uptake into nerve terminal

Hint 1248

#pharm #drugs

Front 1249

Pt being treated for Tuberculosis has ataxia and ↓ pain sensation

Back 1249

B6 deficiency

INH is B6 analog, competes in the processes of neurotransmitter production and also ↑ renal excretion of B6

Treat with B6 supplementation

Hint 1249

#pharm #toxicities

Front 1250

Physiologic Pulmonary Dead Space Formula

Back 1250

Vd =

Vtotal x (PaCO2 - PexpiredCO2) / PaCO2

Hint 1250

#physiology
#pulmonology

Front 1251

Hereditary Angioedema: Contraindicated Rx

Back 1251

AD C1 esterase inhibitor deficiency

ACEI's (Captopril)
worsens angioedema

Hint 1251

#pharmacology #sideeffects

Front 1252

Liver Damage from Inhaled Anesthetics

Back 1252

Massive Liver Necrosis, centrilobular

rare but existant complication of Halothane Use

Halothane metabolites toxic to liver → autoantibodies against liver proteins

Hint 1252

#pharmacology #sideeffects

Front 1253

PABA

Back 1253

para-aminobenzoic acid

folic precursor in prokaryiotes

sulfas are PABA analogues

humans lack abilityt o convert PABA to folic acid, thus require folate

Hint 1253

#microbiology
#pharmacology #antibiotics
#biochemistry #molecules

Front 1254

CREST Sro

Back 1254

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Hint 1254

#pathology #syndromes

Front 1255

Barium Swallow: dilated esophagus, no peristalsis

Back 1255

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Hint 1255

#pathology #syndromes

Front 1256

OTC Rx resitant heartburn + finger ulceration

Back 1256

CREST Sro

Calcinosis
Raynauds (may present with ulceration)
Esophageal Dysmotility
Sclerodactyly
Telangeictasia

CD4 mediated hyperreactivity to unknown antigen → excessive tissue fibrosis

Barium swallow: dilated esophagus absent peristalsis.

Risk for barret's Esophagus → adenocarcinoma

Hint 1256

#pathology #syndromes

Front 1257

Duiretic whose efficacy is decreased by NSAIDs

Back 1257

furosimide

(Na-K-2Cl symporter inhibitor)

additionally stimualtes prostaglandins which ↑ renal blood flow and ↑ GFR

Front 1258

Stroke: ataxia-hemiplegia

Back 1258

base of pons

Hint 1258

#neurology #strokes

Front 1259

Stroke: dysarthria, clumsy hands

Back 1259

base of parns, or genu of internal capsule

Hint 1259

#neurology #strokes

Front 1260

Stroke: base of pons

Back 1260

ataxia-hemiplegia

or

dysarthria, clumsy hands (may be genu of internal capsule)

Hint 1260

#neurology #strokes

Front 1261

Stroke: genu of internal capsule

Back 1261

dysarthria, clumsy hands (may be base of pons)

Hint 1261

#neurology #strokes

Front 1262

Tissue Presentation Based on Time Since MI

Back 1262

0-4h: no change
4-12: early coagulation necorsis, edema, hemorrhage, wavy fibers
12-24: coagulation necrosis and marginal contraction band necrosis
1-5d: PMN infiltrate
5-10: M∅ phagocytosis
10-14: granulation ts and neovascularization
2 wks -2 mo: collogen deposition

Hint 1262

#pathology

Front 1263

Drugs likely to produce SLE

Back 1263

Hydralazine
Procainamide
Isoniazid

likely to have anti-histone antibodies but not anti-dsDNA antibodies

Hint 1263

#pathology
#pharmacology #toxicities

Front 1264

The carnitine shuttle

Back 1264

long chain fatty acids cannot enter the inner mitochondrial matrix alone

Short and Medium Chain Fatty Acids just diffuse into to inner mitochondrial membrane

In Cytosol Fatty Acids → Fatty Acyl-CoA by Thiokinase
Translocate to outer mitochondrial lumen
NB: inner mito membrane impermeable to CoA
Carnitine Palmitoyltransferase 1 (CPT1) removes CoA group and transfers Fatty-Acyl to Carnitine
Fatty Acyl-Carnitine Shuttled Across membrane by Translocase

CPT2 switches Carnitine back for a CoA inside the inner mitochondrial lumen

malonyl CoA inhibits CPT1 preventing β-oxidation of fatty acids while fatty acids are being synthed in the cytosl

carnitine may be synthed in liver and kidney, but all muscular carnitine must be dietary, from meat.

Hint 1264

#biochemistry #energymetzm

Front 1265

β-Oxidation of Fatty Acids

Back 1265

each removal of 2 carbons requires the addition of a CoA group but produces 2FADH2, 1 NADH, and Acetyl CoA (which may enter TCA cycle and produce 12 equivalents of ATP or become ketones)

Odd chained fatty acids end as Propionyl CoA → methylmalonyl coA → Succinyl CoA by proprionyl-CoA-carboxylase + biotin and methylmalonal CoA racemase/mutase with B12 respectively

Hint 1265

#biochemistry #energymetzm

Front 1266

Ketones

Back 1266

Produced by siphoning off Acetyl CoA

Thiolase
(Acetyl-CoA + Acetyl-CoA → Acetoacetyl-CoA + CoA)

HMG CoA Synthase
(Acetoacetyl CoA + Acetyl-CoA --> HMG CoA + CoA)

HMG CoA Lyase
(HMG CoA → Acetyl CoA + Acetoacetate)

Acetoacetate is a Ketone
which may spontaneously degrade to Acetone (another ketone)
or be upgraded via NADH to 3 hydroxybutryate (another ketone)

Hint 1266

#biochemistry #energymetzm

Front 1267

What is the HBVsAg

Back 1267

22 nn glycoprotein componenet of the envelope

NB: not the nucleocapsid

Hint 1267

#microbiology #virology

Front 1268

Distinguishing Neuroleptic Malignant Sro from Serotonin Sro

Back 1268

Serotonin Sro: Myoclonus

NMS: Rigidity s Myoclonus

Hint 1268

#pharmacology #toxicity
#neurology

Front 1269

Renal Papillary Necrosis

Back 1269

Assoc. w/
--Sickle Cell
--Analgesics (NSAIDs ↓ renal blood flow)
--DM
--Acute Pyelo or UT Obstrx

Infarct Necrosis
Acute onset hematuria and colicky flank pain

Hint 1269

#pathology #nephrology

Front 1270

α glucosidase inhibitor

Back 1270

α glucosidase inhibitors

acarbose, miglitol

↓ fnx of intestinal brush border disaccharidases

create osmotic bloating & malabsorption

Hint 1270

#pharmacology #diabetes
#energymetzm

Front 1271

acarbose

Back 1271

α glucosidase inhibitors

acarbose, miglitol

↓ fnx of intestinal brush border disaccharidases

create osmotic bloating & malabsorption

Hint 1271

#pharmacology #diabetes
#energymetzm

Front 1272

miglitol

Back 1272

α glucosidase inhibitors

acarbose, miglitol

↓ fnx of intestinal brush border disaccharidases

create osmotic bloating & malabsorption

Hint 1272

#pharmacology #diabetes
#energymetzm

Front 1273

route of median nerve

Back 1273

C6-T1

with brachial artery between biceps brachii and brachialis muscle

medial aspect of antecubital fossa

crosses between humeral and ulnar heads of pronator teres muscle

between flexor digitorum superficialis and flexor digitorum profundus muscles

enters hand within flexor retinaculum

denervation → thenar atrophy, ape hand deformity lost sensation on palmar surface of first 3.5 digits

Hint 1273

#anatomy #neurology

Front 1274

route of the ulnar nerve

Back 1274

between olecranon and medial epicondyle "funnybone" injury

between flexor carpi and flexor digitorum profundus

injury paralyses intrinsic muscles of hand → claw hand

Hint 1274

#anatomy #neurology

Front 1275

99mmTc-pertechnetate accumulation

Back 1275

detects presence of gastric mucosa

Hint 1275

#pathology #diagnostics

Front 1276

test to identify presence of gastric mucosa

Back 1276

99mmTc-pertechnetate scan

accumulates in gastric mucosa

Hint 1276

#pathology #diagnostics

Front 1277

Pathogenesis of Polyhydramnios

Back 1277

~1000 ml

either ↓ fetal swallowing or ↑ fetal urination

↓ swallowing from GI obstrx/atresia, anenecephaly (no brain → no swallowing)

↑ urination: high cardiac output 2° to anemia or twin-to-twin transfusion

Hint 1277

#pathology #embryology

Front 1278

the histology of chronic graft rejection of a kidney

Back 1278

years in delay

antibody mediated → obliterative vascular fibrosis

Hint 1278

#pathology #kidney

Front 1279

in which direction is mRNA transcribed

Back 1279

5' to 3'

Hint 1279

#biochemistry #DNA

Front 1280

Production, Storage and Secretion of Thyroid Hormones

Back 1280

Active Import of I- by Iodine Pump
--inhibited by thiocyanate, perchlorate anions and extremely high [I-]

Oxication of I- to I2 (dimer, not 2+ ion) by peroxidase enzyme
--inhibited by propylthiouracil

Tyrosine incorporated into thyrobluline by ribosomes, thyroglobulin packaged in golgi secretory vesiscle and excreted into lumen

Organifciation of I2: same peroxidase enzyme catalyzes formation of either Monoiodotyrosine or diiodotyrosine at jnx of follicular cells and lumen

MIT + DIT = T3
DIT + DIT =T4

When stimulated by TSH lysosomal enzymes digest thyroglobulline and release T3 and T4

leftover MIT and DIT deiodintated by thyroid deiodinase (deficiency mimics I2 deficiency)

NB: TSH upregulates all processes

Hint 1280

#physiology #endocrine

Front 1281

Thyroid Deiodinase

Back 1281

breaks I2 off of leftover MIT and DIT allowing for I2 recycling

deficiency of Thyroid Deiodinase mimics I2 deficiency

Hint 1281

#physiology #endocrine

Front 1282

Thyroid Peroxidase

Back 1282

Responsible for both conversion of I- into neutral I2 dimer and also for organification of I2 dimers into MIT or DIT at jnx of thyroid follicular cells and thyroglobulin containing lumen

Hint 1282

#physiology #endocrine

Front 1283

T3 v T4

Back 1283

more T4 is produced
T3 is more active

T4 converted to T3 or rT3 in peripheral tissues

T3 serves as feedback inhibition to pituitary

[rT3 is inactive]

Hint 1283

#physiology #endocrine

Front 1284

Thyroid Binding Globulin

Back 1284

Transports T3 and T4 in peripheral blood

hepatic failure ↓ TBG
pregnancy ↑ TBG

because any free T3 inhibits pituitary TSH prodxn, Δ TBG will ↑↓ total Thyroid Hormone in blood but does not ↑↓ Free Thyroid hormone in blood

Hint 1284

#physiology #endocrine

Front 1285

Systemic Mastocytosis

Back 1285

↑ Histamine Secretion leads to manifestations

↑ Gastric secretion inactivates pancreatic and intestinal enzymes → diarrhea & malabosprtion

↑ vasodilation → flushing, hypotension, tachycardia, syncope

urticaria/, pruritis, dematographism

Hint 1285

#pathology #hematology

Front 1286

Neonate born to HepB+ mother

Back 1286

HBeAg presence in serum indicative of virulence

usually acquired through birth canal
25% transmission from HBeAg- moms
almost 100% from HBeAg+ moms

Viral replication proceeds at high rate and almost all progress to chronic hepatitis

However, minimal changes in Liver because HepB not directly hepatotoxic and neonatal immune system not capable of responding

Hint 1286

#microbiology #virology

Front 1287

Preventing Thyroid Toxicity upon exposure to Radioactive materal

Back 1287

administer overwhelming amts of K+I- potassium iodide

competitively inhibit uptake of radioactive iodide into thyroid gland

Hint 1287

#pharmacology #toxicology

Front 1288

[CRH], [ACTH] c prednisone Tx

Back 1288

both ↓ ↓

Hint 1288

#physiology #endocrineology

Front 1289

Constrictive Pericarditis vs Cardiac Tamponade

Back 1289

Constrictive Pericarditis takes months to produce tamponade

Tamponade is an acute onset

Hint 1289

#physiology #cardiology

Front 1290

Amlodipine

Back 1290

Dihydropyridine calcium channel blocker

more selective for vasculature

relaxes arterioles to reduce TPR in angina pectoris

Hint 1290

#pharmacology #cardiology

Front 1291

Drugs which increase lithium levels

Back 1291

Li+ treated just like Na+

Thaizide Diuretics (NB: not loop)
Kidney attempts to compensate for Na+ loss by increasing uptake in proximal tubule, ends up reabosrbing Li+

ACEI's -unknown mech
NSAID's -unknown mech

Hint 1291

#pharmacology #toxicity

Front 1292

72 kD enzyme only present in inflammatory cells during inflammation

Back 1292

COX2

selectively upregulated during inflammation

Hint 1292

#biochemistry #pharmacology #inflammation

Front 1293

Depolarizing NMJ blocker

Back 1293

Succinylcholine

Hint 1293

#pharmacology #drugs

Front 1294

Non-depolarzing NMJ blocker

Back 1294

d-turbocurare
anything -curium or -curonium

Hint 1294

#pharmacology #drugs

Front 1295

Enzymatic Rxns which Require biotin

Back 1295

Acetyl-CoA carboxylase
acetyl-CoA → malonyl CoA in fatty acid prodxn

Pyruvate Carboxylase
pyruvate to oxaloacetate (gluconeogenesis)

Propionyl Carboxylase
Proprionyl CoA → methylmalonyl-CoA [→ Succinyl CoA]

methylcrotonyl CoA Carboxylase
part of breakdown of branched chain amino acidsinto acetoacetate
Leu Phe Tyr Trp, Lys

deficiency from eating raw egg whites

Hint 1295

#biochemistry #energymetzm

Front 1296

Gram positive rods found in CSF tap

Back 1296

Listeria monocytogenes

Hint 1296

#microbiology #neurology

Front 1297

Gram negative rods found in CSF tap

Back 1297

E coli

Hint 1297

#microbiology #neurology

Front 1298

DOC: preventing Ca2+ nephrolithiasis

Back 1298

Thiazide diruetics

inhibition of Na+/Cl- cotransporter in distal convoluted tubule ↑ Na+ charge in lumen and forces Ca2+ out

Hint 1298

#pharmacology #drugs

Front 1299

Normal molecular progression to colon cancer

Back 1299

Normal Epithlium
mutated APC → Early Adenoma
mutated K-RAS → late adenoma

mutation of p53 & DCC → malignant trnasformation

adenomas <1 cm unlikely to undergo malifnant transformation

>4cm likely → adenocarcinoma

Hint 1299

#pathology #neoplasia

Front 1300

Precocious puberty + Paralysis of Upward Gaze

Back 1300

Paralyzis of upward gaze = parinaud sro aka dorsal midbrain sro

consistent with tumor in pineal region and germinomas are most common tumor of pineal gland

precocious puberty induced by βHCG prodxn

may proceed to obstructive hydrocephalus

Hint 1300

#pathology #neoplasia #neurology

Front 1301

Pineal Tumor

Back 1301

germinomas are most common tumor of pineal gland

precocious puberty induced by βHCG prodxn

Paralyzis of upward gaze = parinaud sro aka dorsal midbrain sro consistent with mass occupying lesion

may proceed to obstructive hydrocephalus

Hint 1301

#pathology #neoplasia #neurology

Front 1302

Spontaeous Intraranial Hemorrhage in a young adult

Back 1302

likely cocaine (or sympatheticomimetics)

coarctation of aorta → berry aneurysm (htn)

[AV malformation]

Hint 1302

#pathology #cardiovascular #neurology

Front 1303

Hypervariable Pili

Back 1303

Virulence factor of Neisserias

Hint 1303

#microbiology

Front 1304

IgG binding outer membrane protein

Back 1304

protein A virulence factor of Staph aureus binds Fc region

Hint 1304

#microbiology

Front 1305

Antiphagocytic acpsule

Back 1305

Pneumococcosu
H influenzae
Neisseria

Hint 1305

#microbiology

Front 1306

Characterize eosinophil fnx

Back 1306

Antibody-dependent cytotoxicity

Eosinophils have an IgE Fx

degranulation releases major basic protein

eosinophils also contain histaminase which degraes histamine and decreases severity of atopy also leukotrienes and peroxidases which ↑ inflammation

Hint 1306

#immunology

Front 1307

Which strx are associated with which parts of the duodenum (specifically at risk for cancer invasion)

Back 1307

1st part: horizontal over L1, only part not retroperitoneal

2nd part: L1-L3 vertical; ampulla of vater

3rd: horizontal along L3 abromainal aorta and IVC close association with uncinate process and SMA/V high risk for invasion

4th superiorly L3 → L2

Ligament of Treitz defines Duodenum from jejunum

Hint 1307

#anatomy

Front 1308

Most common Cancers in Women and Men

Highest Death causing Cancers in women and men

Back 1308

Incidence
--Women: Breast > Lung > Colon/Rectum
--Men: Prostate > Lung > Colon/Rectum

Mortality
--Men: Lung > Prostate
--Women: Lung > Breast

Hint 1308

#pathology #neoplasia

Front 1309

Psammoma bodies

Back 1309

"Sand Bodies" laminated concentric calcific spherules seen in:

Papillary adenocarcinoma of Thyroid

Serous papillary cystadenocarcinoma of ovary

Meningioma

Malignant mesotheliuma

Mn: PSaMMoma
Pappilary, Serous, Meningioma, Mesothelioma

Hint 1309

#pathology #neoplasia

Front 1310

Vitamin D deficiency

[Ca2+], [Phosphorus], [PTH]

Back 1310

↑ PTH

↓ both Ca2+ and Phosphorus

vitamin D ↑ absorption of both

bones will release both in response to PTH, but not enough

Hint 1310

#physiology #endocrine

Front 1311

enoxaprin

Back 1311

LMW heparin

Hint 1311

#pharmacology #drugs

Front 1312

"Chloride Shift"

Back 1312

HCO3 produced in blood from CO2 diffuses out into blood, negative charge drives Chloride into RBC

Hint 1312

#phsyiology

Front 1313

late onset food poisoning

transient waterry diarrhea

Back 1313

c perfringes

toxin formed after ingestion & germination of spores

Hint 1313

#microbiology #toxins

Front 1314

how do cells die during menstraution

Back 1314

apparently apoptosis though I still think it's reperfusion injury

Hint 1314

#physiology #endocrine

Front 1315

Radial Traction in lungs means what

Back 1315

pulling inwards

Hint 1315

#pathology #pulmonology

Front 1316

Why is sputum green during pneumonia?

Back 1316

Myeloperoxidase is a blue green heme based pigmented molecule within the azurophilic granules of PMN's which catalyzes the prdxn of HOCl from h2O2

Hint 1316

#immunology

Front 1317

Ristocetin

Back 1317

activates GP Ib-IX receptors on platelets which bind vWF

good test to see if vWF deficient

Hint 1317

#pathology #diagnostics #hematology

Front 1318

prolonged PTT c prolonged bleeding time, same pathology

Back 1318

vWF deficiency

vWF binds Factor8 and marketly ↑↑ λ

Hint 1318

#pathology #hematology

Front 1319

Henoch Shonen Purpura

Back 1319

IgA immune complex deposition

affects:
GI tract:severe abdominal pain risk bleeding and intussicception
Kidneys: Burger's leukocytoclastic nephritis
Skin: Purpura
Joints: migratory arthirits

Hint 1319

#pathology #syndromes

Front 1320

Where is the urethra damaged in a pelvic fx

Back 1320

between prostatic urethra and pelvic diaphragm becasue it is firmly attached to both

Hint 1320

#anatomy

Front 1321

where is the urethra damaged 2° to blunt trauma to perineum w/o pelvic fx

Back 1321

blubous urehtra immediately after pelvic diaphragm

Hint 1321

#anatomy

Front 1322

Extremity Edema
↑ Cardiac Output
↓ Extremity Sensation

Back 1322

Wet Beriberi

neuropathy + cardiac involvement usually high output CHF

Thiamine deficiency

Hint 1322

#pathology #nutrition

Front 1323

Wet Beriberi

Back 1323

Wet Beriberi

neuropathic sensory-motor loss in distal extremities + cardiac involvement usually high output CHF

Thiamine deficiency

dry beriberi does not include Cardiac invovlement

Hint 1323

#pathology #nutrition

Front 1324

tRNA strx

Back 1324

acceptor stem includes
--5' terminal phosphate and
--3' CCA w/ terminal hydroxyl, this is added post transcriptionally in eukaryotes and then loaded with aminoacid by aminoacyl tRNA synthetase

T arm with TΨC Loop (Thymidine, Pseudouridine, Cytidine) necessary for binding to Ribosomes

D arm: numerous dihydrouracil residues faciliatates correct recognition by aminoacyl tRNA synthetase

anticodon site opposite acceptor stem

Hint 1324

#biochemistry #DNA

Front 1325

Primary Limitation of BZD's

Back 1325

Falling

Hint 1325

#pharmacology #toxicities

Front 1326

statins + fibrates

Back 1326

statin: HMG coA reductase inhibitor
potential toxicity: myopathy and hepatitis
simvastatin is worst

fibrates: ↑ LPL
--gemfibrozil increases the concentration of statins
--fenofibrate itself casues myopathy

Hint 1326

#pharmacology #toxicities

Front 1327

statin + bile acid resins

Back 1327

statin: HMG coA reductase inhibitor
potential toxicity: myopathy and hepatitis
simvastatin is worst

bile acid resins: cholestyramine, colestipol, colesevelam
↓ absorption of statins
4 hour separation

Hint 1327

#pharmacology #toxicities

Front 1328

fibrates + bile acid resins

Back 1328

fibrates: ↑ LPL
--gemfibrozil & fenofibrate

bile acid resins: cholestyramine, colestipol, colesevelam

combo: ↑ cholesterol concentration in bile → ↑ gallstones

Hint 1328

#pharmacology #toxicities

Front 1329

Main cause of sudden cardiac death in previously healthy young adults

Back 1329

Hypertrophic Cardiomyopathy

Autosomal Dominant: disoriented tangled cardiomyocytes

Dilated septum obstructs outflow tract → systolic murmur ↑ by ↓ venous return (standing, valsalva)

Main cause of sudden cardiac death in previously healthy young adults

assoc. c Friederick's ataxia
Tx: βblocker or non-dihydropyridine Ca2+ channel blocker, eg verpamil

Hint 1329

#pathology #cardiovascular

Front 1330

Hypertrophic Cardiomyopathy

Back 1330

Hypertrophic Cardiomyopathy

Autosomal Dominant: disoriented tangled cardiomyocytes

Dilated septum obstructs outflow tract → systolic murmur ↑ by ↓ venous return (standing, valsalva)

Main cause of sudden cardiac death in previously healthy young adults

assoc. c Friederick's ataxia
Tx: βblocker or non-dihydropyridine Ca2+ channel blocker, eg verpamil

Hint 1330

#pathology #cardiovascular

Front 1331

The only microbe which causes epiglottitis

Back 1331

Hib

Hint 1331

#microbiology

Front 1332

Amphotericin B
what should you monitor

Back 1332

Serum K+ and Mg++

nephrotoxicity is Amphotericin's limitation, most pts will need K+ and Mg++ supplementation

decreased EPO production may also lead to normocytic normochromatic anemia

Hint 1332

#pharmacology #toxicity #chemotheraputics

Front 1333

pancytopenia s hepatosplenomegaly

Back 1333

aplastic anemia
--severe B12 or folic deficiency
--aleukemic leukemia
--myelodysplastic sro

"dry tap" hypocellular marrow filled with fat & fibrotic stroma

Hint 1333

#pathology #hematology

Front 1334

Clue Cells

Back 1334

Gardenlla vaginalis

grey vaginal discharge c "fishy odor"

Tx: metronidazole

Hint 1334

#microbiology #genitalia

Front 1335

grey vaginal discharge c "fishy odor"

Back 1335

Gardenlla vaginalis

Clue Cells

tx: metronidazole

Hint 1335

#microbiology #genitalia

Front 1336

foamy yellow-green vaginal c foul smell

Back 1336

Trichomonas vaginalis

flagellated protozoan

Hint 1336

#microbiology #genitalia

Front 1337

purulent vaginal discharge

Back 1337

Gonorrhea or Chlamydia

Hint 1337

#microbiology #genitalia

Front 1338

Partial Mole v Complete Mole

Back 1338

Partial Mole: one ovum + 2 or more sperm → 69XXX or 69 XXY

Complete Mole: one sperm enters egg, duplicates its chromosomes while maternal chroms eliminated "androgenesis" almost always 46XX

Hint 1338

#pathology #embryology #neoplasia

Front 1339

From whence is saphenous vein harvested for a CABG

Back 1339

surgeons access the vein in the femoral triangle just below the pubic tubercle

why? because fuck you that's why. quit asking questions.

Hint 1339

#anatomy #clincial

Front 1340

When is pulmonary vascular resistance lowest

Back 1340

at the low volume end of normal tidal volume

above this the stretch in the wall squeezes the vasculature

below this muscular is placing pressure on the system

Hint 1340

#physiology #pulmonology

Front 1341

What will ↓ proptosis in graves dz?

Back 1341

only glucocorticoids by ↓ inflam

antithyroid drugs do not fight exopthalmos

Hint 1341

#pharmacology #pathology #endocrine

Front 1342

Post MI Ventricular WallRupture

Back 1342

10% of cases 3-7 days after MI when coagulative necrosis and PMN infiltrate have weakened most

LV hypertrophy prior to MI is rupture-protective

Hint 1342

#pathology #cardiovascular

Front 1343

Multiple Myeloma

Back 1343

Plasma Cell Neoplasia

Anemia → infx
Bone Resorption → hypercalcemia
AL amyloid "apple green" birefringence → renal failure → Bence Jones light Chains

Hint 1343

#pathology #neoplasia

Front 1344

Cladribine

Back 1344

Adenosine analogue, resistent to Adenosine deaminase → reaches high concentrations in cells

DOC for hairy cell leukemia → complete remissions

good CNS penetration, urinary excretion

Hint 1344

#pharmacology #chemotheraputics #neoplasia

Front 1345

Adenosine Deaminase Resistant Adenosine Analogue

Back 1345

Cladribine

Adenosine analogue, resistent to Adenosine deaminase → reaches high concentrations in cells

DOC for hairy cell leukemia → complete remissions

good CNS penetration, urinary excretion

Hint 1345

#pharmacology #chemotheraputics #neoplasia

Front 1346

DOC Hairy Cell Leukemia

Back 1346

Adenosine analogue, resistent to Adenosine deaminase → reaches high concentrations in cells

DOC for hairy cell leukemia → complete remissions

good CNS penetration, urinary excretion

Hint 1346

#pharmacology #chemotheraputics #neoplasia

Front 1347

Fludrabine

Back 1347

Purine analogue used in CLL

Hint 1347

#pharmacology #chemotheraputics #neoplasia

Front 1348

Sickle Celler Dies of Septic Shock

Back 1348

Pneumococcus or Hemophilus Influenzae
(no spleen, esp susceptible to encapsulated organisms)

Salmonella important for osteomyelitis, not for septicemia

Hint 1348

#pathology #microbiology

Front 1349

Charcot-Bouchard pseudoaneurysms v Berry Aneurysms

Back 1349

Charcot-Bouchard
Hypertension
Small arteries of basal ganglia & internal capsule
<1mm
sudden onset of focal deficits from intracerebral hemorrhage in basal ganglia, itnernal capsule, thalamus, and pons

Berry (saccular aneurysms)
ADPKD, Marfan, Ehlrs-Danlos sros
Circle of Willis, APC, or middle cerebral artery
Size variable 2-25 mm
sudden onset of headache and AMS from subarachnoid hemorrhage

Hint 1349

#pathology #neurology #strokes

Front 1350

CD14

Back 1350

Monocyte-M∅ lineage

Hint 1350

#immunology

Front 1351

Stop Codons

Back 1351

UAA UGA UAG

Hint 1351

#biochemistry #DNA

Front 1352

Aseptic Meningitis in Children

Back 1352

Most commonly Enteroviruses:

Coxsackie virus, echovirus, poliovirus and enterovirus

Hint 1352

#microbiology #neurology

Front 1353

PMH: Blunt Trauma to Abdomen c Emergent Surgery presents with Bacteremia

Back 1353

Splenectomy

vulnerable to encapsulated organisms

Pneumococcus
Meningococcus
H influenzae

Hint 1353

#microbiology #immunology

Front 1354

Hydroxyzine

Back 1354

First Generation Anti-histamine

blackade M, 5HT and α pathways

5HT blocakde stimualtes appetite
α: postural dizziness

lipophilic ✓xBBB → sedation

Hint 1354

#pharmacology #drugs

Front 1355

Promethazine

Back 1355

First Generation Anti-histamine

blackade M, 5HT and α pathways

5HT blocakde stimualtes appetite
α: postural dizziness

lipophilic ✓xBBB → sedation

Hint 1355

#pharmacology #drugs

Front 1356

Fexofenadine

Back 1356

2nd Generation Anti-Hitstamine do not have anti-muscarinic, anti-alpha or anti-5HT problems

∅xBBB → ∅sedation

Hint 1356

#pharmacology #drugs

Front 1357

Chlorpheniramine

Back 1357

First Generation Anti-histamine

blackade M, 5HT and α pathways

5HT blocakde stimualtes appetite
α: postural dizziness

lipophilic ✓xBBB → sedation

Hint 1357

#pharmacology #drugs

Front 1358

Diphenhydramine

Back 1358

First Generation Anti-histamine

blackade M, 5HT and α pathways

5HT blocakde stimualtes appetite
α: postural dizziness

lipophilic ✓xBBB → sedation

Hint 1358

#pharmacology #drugs

Front 1359

Electrolyte Balance in 1° Adrenal Insufficiency

Back 1359

↓Na, Cl, HCO3
↑K

NB: pts w/ 2° or 3° adrenal insufficiency ∅ → mineralcorticoid deficciency

Hint 1359

#physiology #endocrine

Front 1360

Baroreceptor Reflex Physiology

Back 1360

CN9
pressure ↑ firing rate → vagal discharge → ↑ AV reffractory preriod

Stimualtion good for Superventricular Tachycardia (AV reenterant tachycardias)

Hint 1360

#physiology #cardiology #autonomics

Front 1361

Factor V Leiden mutation

Back 1361

glutamine for arginine substrition near protein C cleavage site → not degraded

hypercoagulative

[activated protein C (APC) responsible for inactivating factors V & 7]

Hint 1361

#pathology #hematology

Front 1362

glutamine for arginine substrition near protein C cleavage site on Factor V

Back 1362

Factor V Leiden mutation → not degraded

hypercoagulative

[activated protein C (APC) responsible for inactivating factors V & 7]

Hint 1362

#pathology #hematology

Front 1363

Cidofovir

Back 1363

a nucleoside monophosphate

unlike acyclovir, vaalacyclocir, famciclovir or ganiciclovir (only nucleaoside analogues) Cidofovir does not need to be phosphorylated by infected cells to be effectve

good for thymidine kinase deficient (acyclovir resistent) herpesvirus often found in AIDS pts

Hint 1363

#pharmacology #chemotheraputics

Front 1364

DOC: acyclovir resistant herpes

Back 1364

Cidofovir: a nucleoside monophosphate

unlike acyclovir, vaalacyclocir, famciclovir or ganiciclovir (only nucleaoside analogues) Cidofovir does not need to be phosphorylated by infected cells to be effectve

good for thymidine kinase deficient (acyclovir resistent) herpesvirus often found in AIDS pts

Hint 1364

#pharmacology #chemotheraputics

Front 1365

Acute Infective Endocarditis

Back 1365

Staph aureus is most common cause

predisposed by undelrying host endotheial damage & fibrin/platelet deposition

Hint 1365

#microbiology #pathology #cardiovascular

Front 1366

Otherwise healthy pt unable to tolerate everyday sounds?
Which cranial nerve has been injured?

Back 1366

Faical: stapedius muscle paralysis → no mitigation of sound "hyperacusis"

Hint 1366

#pathology #neurology

Front 1367

Reed Sternberg Cells

Back 1367

ample cytoplasm
double/bi-lobed nuclei

indicative of Hodgkin's Lymphoma

Hint 1367

#pathology #neoplasia #hematology

Front 1368

Cell with double/bi-lobed nuclei and ample cytoplasm

Back 1368

Reed Sternburg Cells

pathognomic for Hodgkin's Lymphoma

Hint 1368

#pathology #neoplasia #hematology

Front 1369

Normal Location of Great Vessels

Transposition

Back 1369

Normal: aorta anterior and to the left of the pulmonary artery

Transposition: aorta lies anterior and to the right of the pulmonary artery

Front 1370

two cardiovascular abnormalities which present with cyanosis at birth

Back 1370

Tetrology of Fallot

Transposition of the Great Vessels:
--right side of heart + pulmonary = closed loop
--left side + systemic = closed loop
compatible with life via abnormal patency: PFO, VSD, PDA,

Front 1371

renal mass
3p deletion

Back 1371

renal cell carcinoma

assoc w/ 3p deletion = VHL KO → constitutive HIF expression (hypoxia induced factor ↑ VEGF)
half of all spontaneous RCC's ( & VHL Sro incl RCC)

Micro: "polygonal cells with abundant clear cytoplasm"
Grossly: CHO & Lipids = golden

mets to lungs & bones, (prefers lungs)

Wide Range of PNPSro's:
-EPO → polycythemia
-ACTH → cushing's
-PTHrP → hypercalcemia
-Prolactin → HPG suppression

Hint 1371

#pathology #syndromes #neoplasia

Front 1372

cerebellar hemangioblastomas
renal cell carcinomas & pheocytochromas

Back 1372

Von Hippel Landau Sro

usually 3p delection

AD Sro (Knudsons)
VHL KO → constitutive HIF expression (hypoxia induced factor ↑ VEGF)

allso accts for
half of all spontaneous RCC's

Hint 1372

#pathology #syndromes #neoplasia

Front 1373

Most common laboratory abnormality of Legionella pneumonia

Back 1373

hyponatremia

Hint 1373

#microbiology

Front 1374

Scopolamine

Back 1374

selective muscarinic antagonist

primarily used vs. motion sickness 2ndary to Dramamine/Antihistamines

may be used to reduce the ANS side effects of cholinesterase inhibitors prescribed for myasthenia gravis.

Hint 1374

#pharmacology #drugs #toxicities

Front 1375

TAG metzm

Back 1375

Glucagon, Epinephrine → Gs → cAMP → cAMP dpt Protein Kinase → activates Hormone Sensitive Lipase

Hormone Sensitive Lipase: TAG → Glycorol and Fatty Acids

Fatty Acids undergo β Oxidation

Glycerol diffuses to Liver

(Hepatic) Glyrocerol Kinase: Glycerol → Glycoerol 3 Phosphate

May be used to build another TAG or
G3P dehydratase (unimportant): G3P → DHAP

DHAP in equilibrium with both Glyceraldehyde-3-P and Fructose 1,6 Bisphosphate, may participate in either glycolysis of gluconeogenesis

Hint 1375

#biochemistry #energymetzm

Front 1376

Acetyl CoA Carboxylase

Back 1376

biotin dpt enzyme: first comitted step in Fatty Acid Synth

Acetyl CoA --> malonyl CoA

Hint 1376

#biochemistry #energymetzm

Front 1377

Drugs which may cause seizures

Back 1377

Buproprion- NE + DA reuptake inhibitor
Isoniazid (if given w/o B6)
Imipenem (Antibiotic)

Hint 1377

#pharmacology #toxicities

Front 1378

Gram positive rods found in CSF tap

Back 1378

Listeria Monocytogenes

Facultatively Intracellular

β hemolytic gram potisive

Tumbling Motility via "Actin Rockets"
Opportunistic Infection of Neonates and Immunocomp
--Septicemia or Meningitis
Access via Contaminated/Unpasturized Food,
for neonates transplacental or vaginally

Uniquely able to grow at 4*C

Hint 1378

#microbiology

Front 1379

Listeria Monocytogenes

Back 1379

Listeria Monocytogenes

Facultatively Intracellular
β hemolytic gram potisive

Tumbling Motility via "Actin Rockets"
Opportunistic Infection of Neonates and Immunocomp
--Septicemia or Meningitis
Access via Contaminated/Unpasturized Food,
for neonates transplacental or vaginally

Uniquely able to grow at 4*C

Hint 1379

#microbiology

Front 1380

Gram Positive Rod with Tumbling Motility

Back 1380

Listeria Monocytogenes

Facultatively Intracellular
β hemolytic gram positive


Tumbling Motility via "Actin Rockets"
Opportunistic Infection of Neonates and Immunocomp
--Septicemia or Meningitis
Access via Contaminated/Unpasturized Food,
for neonates transplacental or vaginally

Uniquely able to grow at 4*C

Hint 1380

#microbiology

Front 1381

Gram Positive Rod Grows in Refridgerator

Back 1381

Listeria Monocytogenes

Facultatively Intracellular

Tumbling Motility via "Actin Rockets"
Opportunistic Infection of Neonates and Immunocomp
--Septicemia or Meningitis
Access via Contaminated/Unpasturized Food,
for neonates transplacental or vaginally

Uniquely able to grow at 4*C

Hint 1381

#microbiology

Front 1382

Suppression
(Defense Mechanism)

Back 1382

Mature Defense Mechanism

Intentional with-holding of distressing thoughts.

Hint 1382

#ethics

Front 1383

BZD's vs Barbituates

Back 1383

BZD's ↑ freq of GABAa opening

Barbituates ↑ duration of GABAa opening

Hint 1383

#pharmacology #drugs #mechanisms

Front 1384

Inhibits DA + NE Reuptake

Back 1384

Burproprion "Wellbutrin"

NB: Risk Seizures

Hint 1384

#pharmacology #drugs #toxicities

Front 1385

Inhibits NE + 5HT Reuptake

Back 1385

TCA's

Also Venlafaxine and Desvenlafaxine (SIADH, ↑ BP)

Hint 1385

#pharmacology #drugs #mechanisms

Front 1386

Lecithinase

Agent, Mechanism

Back 1386

aka Phospholipase C aka α toxin

Produced by C perf

Hint 1386

#microbiology #toxins

Front 1387

Genetics of Type 1 Diabets

Back 1387

HLA-DQ and HLA-DR

Hint 1387

#pathology #genetics

Front 1388

Why amyloid in T2DM islets?

Back 1388

Islet Amyloid Polypeptide ie Amylin cosecreted with insulin.

Hint 1388

#pathology

Front 1389

anti-hyperlipidemic agent produces cutaneous flushing

Back 1389

niacin/nicotinic acid

prostaglandin mediated flushing may be inhibited by aspirin

mech: inhibits VLDL secretion, ↑ HDL secretion & LPL fnx

Hint 1389

#pharmacology #drugs #cardiovascular

Front 1390

Caspacin

Back 1390

topical analgesic which ↓ substance P

Hint 1390

#pharmacology #drugs #mechanism

Front 1391

Complete Mole v Partial Mole

Genetics, Sx, Appearnce, Risks

Back 1391

Partial Mole: one ovum + 2 or more sperm → 69XXX or 69 XXY
Sx: vaginal bleeding, abd cramping
Grosss: fetus, cord, amniotic membrane, enlarged villi
Risks: low rate conversion to malignancy

Complete Mole: one sperm enters egg, duplicates its chromosomes while maternal chroms eliminated "androgenesis" almost always 46XX
Sx: many: vaginal bleeding, enlargement, hyperemesis, pre-eclampsia, hyperthyroidism, theca-lutein cysts
Gross: Trophoblast only "bunch of grapes" enlarged villi
Risks: 1/4 → malignant trophoblast dz

Hint 1391

#pathology #reproductive

Front 1392

Lipoate Deficiency

Back 1392

Cofactor for 3 enzymes: Pyruvate Dehydrogenase, αKGDHC & branched chain ketoic acid dehdyrogenase (maple syrup dz)

Pyruvate Dehydrogenase: Pyruvate → Acetyl-CoA

All 3 have the same cofactors:
NAD, FAD, Thiamine, CoA & Lipoate

Lipoate deficiency blocks things up at pyruvate → lactic acidosis

Hint 1392

#biochemistry #energymetzm #vitamins

Front 1393

Maple Syrup Urine Dz

Back 1393

↓ α ketoacid dehydrogenase
→ ∅ AminoAcid debranching

Leucine, Isoleucine, Valine (esp Leu)

Involved in both the pathway which converts Leu to Acetyl-CoA &the pathway that converts Ile & Val to Proprionyl-CoA

Severe CNS defects → MR and Death

NB: cofactors same as Pyruvate dehydrogenase and αKGDHC

Hint 1393

#biochemistry #pathology #syndromes

Front 1394

α ketoacid dehydrogenase

Back 1394

AminoAcid debranching: Leucine, Isoleucine, Valine (esp Leu)

Involved in both the pathway which converts Leu to Acetyl-CoA &the pathway that converts Ile & Val to Proprionyl-CoA

↓ α ketoacid dehydrogenase → Severe CNS defects → MR and Death

NB: cofactors same as Pyruvate dehydrogenase and αKGDHC

Hint 1394

#biochemistry #pathology #syndromes

Front 1395

Mesna

Back 1395

antidote for hemorrhagic cystitis 2° to nitrogen mustard based chemothreapeutics eg cyclophosphamide or analoges (ifosfamide)

normally nitrogen mustards → acrolein → uroepithelial toxicity

mesna binds and inactivates metabolites

Hint 1395

#pharmacology #drugs #toxicities

Front 1396

Prophylaxis vs Hemorrhagic Cystitis in Anti-neoplastic chemotherapy

Back 1396

Mesna
hemorrhagic cystitis 2° to nitrogen mustard based chemothreapeutics eg cyclophosphamide or analoges (ifosfamide)

normally nitrogen mustards → acrolein → uroepithelial toxicity

mesna binds and inactivates metabolites

Hint 1396

#pharmacology #drugs #toxicities

Front 1397

Ondansetron

Back 1397

5-HT3 inhibitor used for nauesa/vomitting following chemoRx

Hint 1397

#pharmacology #drugs

Front 1398

5-HT3 inhibitor used for nauesa/vomitting following chemoRx

Back 1398

Ondansetron

Hint 1398

#pharmacology #drugs

Front 1399

CD31+ Tumor

Back 1399

PECAM1 used for leukocyte migration

tumor of vascular endothelial cells

Hint 1399

#pathology #neoplasia

Front 1400

Describe the neurologic pathway by which the eyes accomodate to light

Back 1400

optic nerve branches branches to ispilateral pretectal nucleus in superior colliculus

fibers project to both ipsilateral and cotnralateral Edinger-Westphal nuclei, the site of preganglionic PSNS neurons

neurons project out within CN3 to ciliary ganglion and then into the eye

Hint 1400

#neurology

Front 1401

Trypanosoma cruzi
neurologic sequelae

Back 1401

trypanosome (parasite) carried by Reduviid "Kissing" bug which lives in the walls of rural huts

destroys myenteric plexus & causes PSNS denervation

Hint 1401

#microbiology

Front 1402

16S rRNA

Back 1402

peice of the prokaryotic 30S which contains the Shine-Delagarno complememntnary sequence necessary for for binding

Hint 1402

#biochemistry #DNA

Front 1403

23S rRNA

Back 1403

part of 50S rRNA which facilitates peptide bind formation

Hint 1403

#biochemistry #DNA

Front 1404

APP gene on Chrom 21

Back 1404

Amyloid Precursor Protein

one of 3 genes assoc w/ early onset (<60) familial Alzheimers

(APP + Presenilin 1 on chrom 14 and Presenilin 2 on Chrom 1)

Hint 1404

#pathology #genetics

Front 1405

Genes assoc w/ Early Onset Alzheimers

Back 1405

Amyloid Precursor Protein (APP) on Chrom 21
Presenilin 1 on chrom 14
Presenilin 2 on Chrom 1)

NB: Late onset assoc. w/ ε4 allele of ApoE

Hint 1405

#pathology #genetics

Front 1406

ε4 ApoE

Back 1406

ε4 allele of Apolipoprotein E associated with late onset (>60 yo) Alzheimers

Hint 1406

#pathology #genetics

Front 1407

Genes assoc w/ Late Onset Alzheimers

Back 1407

ε4 allele of Apolipoprotein E associated with late onset (>60 yo) Alzheimers

Hint 1407

#pathology #genetics

Front 1408

Hypertrophic Cardiopmyopathy

Back 1408

Hypertrophic Cardiomyopathy

Autosomal Dominant: disoriented tangled cardiomyocytes, mostly from β-myosin heavy chain mutation

Dilated septum obstructs outflow tract → systolic murmur ↑ by ↓ venous return (standing, valsalva)

Main cause of sudden cardiac death in previously healthy young adults

assoc. c Friederick's ataxia
Tx: βblocker or non-dihydropyridine Ca2+ channel blocker, eg verpamil

Hint 1408

#pathology #syndromes #genetics

Front 1409

β-Myosin Heavy Chain Mutation

Back 1409

Hypertrophic Cardiomyopathy

Autosomal Dominant: disoriented tangled cardiomyocytes, mostly from β-myosin heavy chain mutation

Dilated septum obstructs outflow tract → systolic murmur ↑ by ↓ venous return (standing, valsalva)

Main cause of sudden cardiac death in previously healthy young adults

assoc. c Friederick's ataxia
Tx: βblocker or non-dihydropyridine Ca2+ channel blocker, eg verpamil

Hint 1409

#pathology #syndromes #genetics

Front 1410

Interactions between HPG and HPT axes

Back 1410

Estrogen ↑ Thyroglobulin Production

Δ[thyroglobulin] → stepwise Δ[T3, T4] w/o Δ[free T3, T4]

↑ in thyroid hormones thus seen in pregnancy, OCPs & HRT

Hint 1410

#physiology #endocrine

Front 1411

Hematologic/poietic Effects of Glucocorticoids

Back 1411

lyses lymphocytes, eosinophils and basophils, ↓ monocyte differentiation into M∅ (thus decreasing antigen presentation)

"↑" PMN's on CBC via demargination, does not actually ↑ # PMN

Hint 1411

#pharmacology #physiology #hematology

Front 1412

Dyspniac Lung Biopsy

Back 1412

Metastatic Renal Clear Cell Carcinoma
Most Common Renal Cell Carcinoma

assoc w/ 3p deletion = VHL KO → constitutive HIF expression (hypoxia induced factor ↑ VEGF)
half of all spontaneous RCC's ( & VHL Sro incl RCC)

Micro: "polygonal cells with abundant clear cytoplasm"
Grossly: CHO & Lipids = golden

mets to lungs & bones, (prefers lungs)

Wide Range of PNPSro's:
-EPO → polycythemia
-ACTH → cushing's
-PTHrP → hypercalcemia
-Prolactin → HPG suppression

Hint 1412

#pathology
#neoplasia

Front 1413

Normal Fractional Excretion of Sodium, Inulin, PAH, Urea

Back 1413

Sodium = <1%
NB: majority ALWAYS resporbed in proximal tubule

Urea: 55% consistently

Inulin: 100%, neither secreted nor resorbed

PAH: 100% secreted, secretion rate correlates to blood flow not filtration rates

Hint 1413

#physiology #renal

Front 1414

Uptake and Secretion of Bilirubin: which is ATP dependent

Back 1414

Organic Anion Transporting Peptide OAPT bring unconjugated bilirubin in via facilitated diffusion

MRP2 is ATP dependent excretion

impaired MRP2 will allow diffusion back out OATP

Hint 1414

#physiology #renal

Front 1415

Dubin Johnson vs Rotor Sro

Back 1415

Both have defective MRP2 excretion of conjugated bile

DJ: black pigmented liver, no (?) jaundice
Rotor: no pigmentation, definitely jaundiced

Hint 1415

#pathology #renal

Front 1416

DOC: narcolepsy

Back 1416

Modafinil
non-amphetamine stimulant

not sympatheticomimetic,
lower risk for dependency

Hint 1416

#pharmacology #drugs #neurology

Front 1417

Modafinil

Back 1417

DOC: narcolepsy
non-amphetamine stimulant

not sympatheticomimetic,
lower risk for dependency

Hint 1417

#pharmacology #drugs #neurology

Front 1418

DOC: Trigeminal Neuralgia

Back 1418

carbapamazine

Hint 1418

#pharmacology #drugs #neurology

Front 1419

CXR: pulmonary infiltrates far worse than expected from clincial presentation

Back 1419

M pneumoniae "walking pneumonia"

Hint 1419

#microbiology #pulmonology

Front 1420

Positive VLDR, Negative FTA Absorption

Back 1420

circulating anti-phospholipid antibodies

indicative of SLE w/ Lupus Anticoagulant, present in 1/4 of SLE

results in recurrent thromboemboli and fetal loss

Hint 1420

#pathology

Front 1421

SLE w/ ↑PTT

Back 1421

Lupus Anticoagulant present in 1/4 of SLE

results in recurrent thromboemboli and fetal loss

Hint 1421

#pathology #rheumatology

Front 1422

The pathology of heart failure cells

Back 1422

↑ Pulmonary BP → RBC extravasation → M∅ Hemoglobin ingestion → Hemosiderin Laden M∅

Hint 1422

#pathology #pulmonology

Front 1423

Artery Damaged with non-displaced crushing fx of femoral neck (eg 2° to osteoporosis)

Back 1423

Medial Circumflex Artery supplies majority of blood to the region and is vulnerable as it is closely associated with posterior neck

Hint 1423

#anatomy

Front 1424

DOC: Absence + Tonic-Clonic

Back 1424

Valproate

Ethosuximide DOC for Absence, but does not help Tonic CLonic

Hint 1424

#pharmacology #neurology

Front 1425

Meiosis Events and Non-Disjunction

Back 1425

Meiosis 1: Chromosomes separate by homologous pairings
Non-disjunction: trisomy with 3 different chromosomes

Meisosis 2: those separate
Non-disjunction: trisomy with 2 types of chromosomes: 1 from one parent and two identical chroms from other parent

Oocytes arrest at prophase of Meiosis I
LH surge induces Meiosis I to conclude
Enters Meiosis II but arrests at metaphase

Meiosis II completes upon fertilization

Hint 1425

#embryology

Front 1426

How do β-Blockers interact with Thyroid Hormones

Back 1426

Beta Blockers do 2 things:

1. block thyroid mediated SNS upregulation
2. ↓ peripheral T4 → T3

NB: β blockers do not prevent new thyroid hormone synthesis, thyroid hormone release or decrease immediate cellular responsiveness to thyroid hormene ( ↑ cellular metzm)

Hint 1426

#physiology #pharmacology #endocrinology

Front 1427

What is:
Sucrose, Lactose, Maltose

Back 1427

Sucrose: Glucose & Fructoose
Lactose: Glucose & Galactose
Maltose: 2 Glucoses

Hint 1427

#biochemistry #energymetzm

Front 1428

Number Needed To Harm

2 drugs

Back 1428

1/(difference in absolute risk)

Hint 1428

#biostats

Front 1429

What drugs will halt the progression of diabetic nephropathy

Back 1429

ACEI's & ARBs
--far beyond anything else

Hint 1429

#pharmacology #diabetes

Front 1430

What Drugs/Hormones/Molecules use cGMP as a 2nd messenger

Back 1430

ANP, NO, the Eye, [Embryonic Polarization of Pyramidal Cells], Olfactory Cells

Phosphodiesterase inhibitors (sildenafil)

Hint 1430

#pharmacology #physiology #biochemistry

Front 1431

Gut does not absorb cystine

Back 1431

shares common transporter with ornithine, lysine and arginine (dibasic amino acids)

cysteine can be produced from homocysteine, not deficient
(unlike homocysteinuria)

same transporter in gut in kidney → no renal cysteine absorption → cystinuria: AR disorder with recurrent renal stones

Hint 1431

#pathology #nephrology

Front 1432

Cystinuria

Back 1432

cysteine can be produced from homocysteine, not deficient
(unlike homocysteinuria)

same transporter in gut in kidney → no renal cysteine absorption → cystinuria: AR disorder with recurrent renal stones

[Cystine shares common transporter with ornithine, lysine and arginine (dibasic amino acids)]

will show ↓ gut absorption of ornithine, lysine, arginine and cystine

Hint 1432

#pathology #nephrology

Front 1433

Calculate A-a gradient

Back 1433

Normal Aa gradient <15

(Not 0 because ventilation better in apex and perfusion better in lower lobes = ventilation perfusion mismatch)

>15 means that the problem is definitely in the lungs: air is not exchanging appropriately

A-a = PAO2 - PaO2

and PAO2 ≈ 150 - (PaCO2/0.8)

Deriving the formula is complicated but the formula is not so just memorize this:

Hint 1433

#physiology #pathology #pulmonology

Front 1434

Recurrent Lobar Hemorrhagic CNS Strokes

Back 1434

Lobar = cerebral hemispheres ie not lacunar

most common presentation of cereberal amyloid angiopathy

low mortality rate

2° to β amyloid deposition, not related to systemic amyloidosis

NB: β amyloid is from amyloid precursor protein, cause of late onset alzhemiers

Hint 1434

#pathology #neurology #rheumatology

Front 1435

AL protein

Back 1435

Bence Jones Ig light chain of multiple myeloma

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Mn: aL = Light chain

Hint 1435

#pathology #rheumatology

Front 1436

AA protein

Back 1436

derived from Serum Associated Amyloid (SAA) protein

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Hint 1436

#pathology #rheumatology

Front 1437

Transthyretin

Back 1437

derived from AF protein

Senile Cardiac Amyloidosis

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Mn: aF = auld Farts

Hint 1437

#pathology #rheumatology

Front 1438

Amylin

Back 1438

Derived from AE

Amyloid 2° to T2DM

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Mn: aE = Endocrine

Hint 1438

#pathology #rheumatology

Front 1439

A-CAL deposition

Back 1439

derived from calcitonin

= amyloidosis 2° to medullary carcinoma of the thyroid

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Hint 1439

#pathology #rheumatology

Front 1440

β2 microglobulin deposition

Back 1440

derived from MHC class I proteins

dialysis associated amyloidosis

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Hint 1440

#pathology #rheumatology

Front 1441

Senile Cardiac Amyloidosis

Back 1441

Transthyretin amyloid deposition derived from AF protein

Senile Cardiac Amyloidosis

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Mn: aF = auld Farts

Hint 1441

#pathology #rheumatology

Front 1442

Amyoid 2° to TD2M

Back 1442

Amylin amyloid protein deposition Derived from AE

Amyloid 2° to T2DM

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Mn: aE = Endocrine

Hint 1442

#pathology #rheumatology

Front 1443

Amyloidosis 2° to Cancer

Back 1443

A-CAL deposition, derived from calcitonin

= amyloidosis 2° to medullary carcinoma of the thyroid

Amyloidosis: β pleated sheet w/ apple green birfringence under polarized light with Congo red stain

Hint 1443

#pathology #rheumatology

Front 1444

Cystic Fibrosis vs. SCID

Back 1444

CF presents with recurrent infx (strep, Hib, Morax), but not opportunistic pathogens (fungi, pneumocysticis)

Hint 1444

#pathology #microbiology

Front 1445

ACL vs PCL

Back 1445

ACL:
Tibia anterior midline → Femur Posterior Lateral

PCL:
Think Straight up and Down on the posterior aspect of both femur and tibia

Hint 1445

#anatomy

Front 1446

Budd Chairi Sro

Back 1446

Occlusion of IVC 2° to any of multiple causes

congestive liver dz → failure
portal hypertension

Hint 1446

#pathology #liver

Front 1447

Occlusion of the IVC

Back 1447

Budd Chiari Sro

Sro 2° to any of multiple causes

congestive liver dz → failure
portal hypertension

Hint 1447

#pathology #liver

Front 1448

What kind of vaccine is the rabies vaccine?

Back 1448

Killed

Hint 1448

#microbiology

Front 1449

Osteocalcin

Back 1449

non-collagenous protein secreted by osteoblast used as a marker of bone formation

Hint 1449

#physiology

Front 1450

Nephrotic Sro:
sequence of events

Back 1450

1. ↑ glomerular permeability
2. massive protein loss in urine
3. edema
4. Both ADH & RAAS activated → sodium and water retention which exacerbates edema
5. Compensatory ↑ in Hepatic Protein Prodxn, including lipoproteins
6. Lipiduria

Hint 1450

#pathology #nephrology

Front 1451

ACEI's vs Cr

Back 1451

ACEI's block AT2 from constricting the efferent arteriole

normal for Cr to increase 1/3 in first week

Hint 1451

#pharmacology #nehprology

Front 1452

URI's s Croup

Causes by Freq

Back 1452

1. Rhinovirus
2. Influenza
3. Coronavirus
4. Adeno
etc

Hint 1452

#microbiology #pulmonology

Front 1453

Eythrocyte transketolase

Back 1453

↑ activity after thiamin infusion diagonistic of thiamin deficiency

Hint 1453

#vitamins #molecules

Front 1454

Parkinsoner on levodopa carbidopa

some good days
some lock ups

wants better medicine routine

Back 1454

on-off phenomenon

unpredictable and dose independent

higher doses have no benefit, nor do drug holidays

best prevention: maintaining a constant dose

Hint 1454

#pharmacology #neurology

Front 1455

Parkinsoner

medicine not working as well as before

Back 1455

continued destruction of striatonigral DA neurons

Hint 1455

#pharmacology #neurology

Front 1456

DOC: Meningococcal Prophylaxis

Back 1456

Rifampin

NB: orange secretions & ↑ p450

Hint 1456

#pharmacology #chemotheraputics #microbiology

Front 1457

Lady treated for MI now has severe eye pain

Back 1457

glaucoma treated with atropine

Hint 1457

#pathology #pharmacology

Front 1458

Night Blindness DDx

Back 1458

Most common cause: hereditary retinitis pigmentosa

Acquired:
1. toxic retinopathy 2° phenothiazines or chloroquine
2. vitamin A deficiency
3. Congenital rubella, syphilis, or infx
4. diabets

Hint 1458

#pathology #neurology

Front 1459

Thiazide side effects

Back 1459

1. RAAS activation → hypokalemia & acidosis
2. hyponatremia
3. hypovolemia → ↑ metabolite absoprtion → hyperuricemia
4. ↑ plasma cholesterol & LDL
5. ↓ insulin & ts glucose hyptake → hyperglycemia

Hint 1459

#pharmacology #sideeffects

Front 1460

Severe hypothermia and oxygen dyssociation curve

Back 1460

left shift (does not release O2 into ts as well)

this is because the lungs are normally cooler than the tissues, helpful in normal physiologic state to load with more o2

Hint 1460

#biochemistry #hemoglobin

Front 1461

Dz: Fabry's Dz

Back 1461

(Lysosomal Storage Dz)
Presentation: Peripheral Acorneuropathy, angiokeratomas, Cardiovascular/Renal Dz
Deficiency: alpha galactosidase A
Accumulation: Ceramide tihexose
Inheritance: XR --NB the only X linked lysosomal storage dz

Hint 1461

#pathology #molecules #geneticdzs

Front 1462

Dz: Gaucher's Dz

Back 1462

(Lysosomal Storage Dz)
Presentation: HSM, Asepptic necorsis of femur; Gaucher's cells: macorphages that look like crumpled ts paper
Deficiency: Glucocerebrosidase
Accumulation: Glucocerebroside
Inheritance: AR (all but Fabry's & Hunters AR)
NB: most common Lysosomal stroage Dz

Hint 1462

#pathology #molecules #geneticdzs

Front 1463

Dz: Neimann-Pick

Back 1463

(Lysosomal Storage Dz)
Presentation: progressive neuodegeneration, cherry red spot on macula, foam cells, HSM (defining feature vs. Tay-Sach's)
Deficiency: sphingomyelinase
Accumulation: sphingomyelin
Inheritance: AR (All but Fabry's & Hunters AR)
Mn: Neiman picks his nose with hi-sphinger

Hint 1463

#pathology #molecules #geneticdzs

Front 1464

Dz: Tay-Sach's

Back 1464

(Lysosomal Storage Dz)
Presentation: Prgoressive neurodegeneration, cherry red spot on macula, lysosomes with onion skin, no HSM (defining feature vs. Niemann Pick)
Deficiency: Hexosaminidase A
Accumulation: GM2 ganglioside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1464

#pathology #molecules

Front 1465

Dz: Krabbe's Dz

Back 1465

(Lysosomal Storage Dz)
Presentation: Peripehral neuropathy, dvlptl delay, optic atrophy, globoid cells
Deficiency: beta galactocebrosidase
Accumulation: galactoserebroside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1465

#pathology #molecules

Front 1466

Dz: Hurler's

Back 1466

(Lysosomal Storage Dz)
Presentation: Dvlpt delay, gargolylism, ariway obstrx, corenal clouding, HSM
Deficiency: alpha L iduronidase
Accumulation: heparan sulfate, dermatan sulfate (same as Hurler's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1466

#pathology #molecules

Front 1467

Dz: Hunter's

Back 1467

(Lysosomal Storage Dz)
Presentation: aggressive behavior mild dvlpt delay, HSM
Deficiency: Iduronidate sulfatase
Accumulation: heparan sulfate, dermatan sulfate (same as Hurler's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1467

#pathology #molecules

Front 1468

Ashkenazi Jews

Back 1468

Dz: Gaucher's Dz
(Lysosomal Storage Dz)
Presentation: HSM, Asepptic necorsis of femur; Gaucher's cells: macorphages that look like crumpled ts paper
Deficiency: Glucocerebrosidase
Accumulation: Glucocerebroside
Inheritance: AR (all but Fabry's & Hunters AR)
NB: most common Lysosomal stroage Dz


Dz: Neimann-Pick
(Lysosomal Storage Dz)
Presentation: progressive neuodegeneration, cherry red spot on macula, foam cells, HSM (defining feature vs. Tay-Sach's)
Deficiency: sphingomyelinase
Accumulation: sphingomyelin
Inheritance: AR (All but Fabry's & Hunters AR)
Mn: Neiman picks his nose with hi-sphinger

Dz: Tay-Sach's
(Lysosomal Storage Dz)
Presentation: Prgoressive neurodegeneration, cherry red spot on macula, lysosomes with onion skin, no HSM (defining feature vs. Niemann Pick)
Deficiency: Hexosaminidase A
Accumulation: GM2 ganglioside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1468

#pathology #molecules

Front 1469

Deficiency: alpha galactosidase A

Back 1469

Dz: Fabry's Dz
(Lysosomal Storage Dz)
Presentation: Peripheral Acorneuropathy, angiokeratomas, Cardiovascular/Renal Dz
Deficiency: alpha galactosidase A
Accumulation: Ceramide trihexose
Inheritance: XR --NB the only X linked lysosomal storage dz

Hint 1469

#pathology #molecules

Front 1470

Deficiency: Glucocerebrosidase

Back 1470

Dz: Gaucher's Dz
(Lysosomal Storage Dz)
Presentation: HSM, Asepptic necorsis of femur; Gaucher's cells: macorphages that look like crumpled ts paper
Deficiency: Glucocerebrosidase
Accumulation: Glucocerebroside
Inheritance: AR (all but Fabry's & Hunters AR)
NB: most common Lysosomal stroage Dz

Hint 1470

#pathology #molecules

Front 1471

Deficiency: sphingomyelinase

Back 1471

Dz: Neimann-Pick
(Lysosomal Storage Dz)
Presentation: progressive neuodegeneration, cherry red spot on macula, foam cells, HSM (defining feature vs. Tay-Sach's)
Deficiency: sphingomyelinase
Accumulation: sphingomyelin
Inheritance: AR (All but Fabry's & Hunters AR)
Mn: Neiman picks his nose with hi-sphinger

Hint 1471

#pathology #molecules

Front 1472

Deficiency: Hexosaminidase A

Back 1472

Dz: Tay-Sach's
(Lysosomal Storage Dz)
Presentation: Prgoressive neurodegeneration, cherry red spot on macula, lysosomes with onion skin, no HSM (defining feature vs. Niemann Pick)
Deficiency: Hexosaminidase A
Accumulation: GM2 ganglioside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1472

#pathology #molecules

Front 1473

Deficiency: beta galactocebrosidase

Back 1473

Dz: Krabbe's Dz
(Lysosomal Storage Dz)
Presentation: Peripehral neuropathy, dvlptl delay, optic atrophy, globoid cells
Deficiency: beta galactocebrosidase
Accumulation: galactoserebroside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1473

#pathology #molecules

Front 1474

Deficiency: alpha L iduronidase

Back 1474

Dz: Hurler's
(Lysosomal Storage Dz)
Presentation: Dvlpt delay, gargolylism, ariway obstrx, corenal clouding, HSM
Deficiency: alpha L iduronidase
Accumulation: heparan sulfate, dermatan sulfate (same as Hurler's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1474

#pathology #molecules

Front 1475

Deficiency: Iduronidate sulfatase

Back 1475

Dz: Hunter's
(Lysosomal Storage Dz)
Presentation: aggressive behavior mild dvlpt delay, HSM
Deficiency: Iduronidate sulfatase
Accumulation: heparan sulfate, dermatan sulfate (same as Hurler's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1475

#pathology #molecules

Front 1476

Accumulation: Ceramide trihexose

Back 1476

Dz: Fabry's Dz
(Lysosomal Storage Dz)
Presentation: Peripheral Acorneuropathy, angiokeratomas, Cardiovascular/Renal Dz
Deficiency: alpha galactosidase A
Accumulation: Ceramide trihexose
Inheritance: XR --NB the only X linked lysosomal storage dz

Hint 1476

#pathology #molecules

Front 1477

Accumulation: Glucocerebroside

Back 1477

Dz: Gaucher's Dz
(Lysosomal Storage Dz)
Presentation: HSM, Asepptic necorsis of femur; Gaucher's cells: macorphages that look like crumpled ts paper
Deficiency: Glucocerebrosidase
Accumulation: Glucocerebroside
Inheritance: AR (all but Fabry's & Hunters AR)
NB: most common Lysosomal stroage Dz

Hint 1477

#pathology #molecules

Front 1478

Accumulation: sphingomyelin

Back 1478

Dz: Neimann-Pick
(Lysosomal Storage Dz)
Presentation: progressive neuodegeneration, cherry red spot on macula, foam cells, HSM (defining feature vs. Tay-Sach's)
Deficiency: sphingomyelinase
Accumulation: sphingomyelin
Inheritance: AR (All but Fabry's & Hunters AR)
Mn: Neiman picks his nose with hi-sphinger

Hint 1478

#pathology #molecules

Front 1479

Accumulation: GM2 ganglioside

Back 1479

Dz: Tay-Sach's
(Lysosomal Storage Dz)
Presentation: Prgoressive neurodegeneration, cherry red spot on macula, lysosomes with onion skin, no HSM (defining feature vs. Niemann Pick)
Deficiency: Hexosaminidase A
Accumulation: GM2 ganglioside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1479

#pathology #molecules

Front 1480

Accumulation: galactoserebroside

Back 1480

Dz: Krabbe's Dz
(Lysosomal Storage Dz)
Presentation: Peripehral neuropathy, dvlptl delay, optic atrophy, globoid cells
Deficiency: beta galactocebrosidase
Accumulation: galactoserebroside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1480

#pathology #molecules

Front 1481

Accumulation: heparan sulfate, dermatan sulfate

Back 1481

Dz: Hurler's
(Lysosomal Storage Dz)
Presentation: Dvlpt delay, gargolylism, ariway obstrx, corenal clouding, HSM
Deficiency: alpha L iduronidase
Accumulation: heparan sulfate, dermatan sulfate (same as Hunter's)
Inheritance: AR (All but Fabry's & Hunters AR)

Dz: Hunter's
(Lysosomal Storage Dz)
Presentation: aggressive behavior mild dvlpt delay, HSM
Deficiency: Iduronidate sulfatase
Accumulation: heparan sulfate, dermatan sulfate (same as Hurler's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1481

#pathology #molecules

Front 1482

Presentation: Peripheral Acorneuropathy, angiokeratomas, Cardiovascular/Renal Dz

Back 1482

Dz: Fabry's Dz
(Lysosomal Storage Dz)
Presentation: Peripheral Acorneuropathy, angiokeratomas, Cardiovascular/Renal Dz
Deficiency: alpha galactosidase A
Accumulation: Ceramide trihexose
Inheritance: XR --NB the only X linked lysosomal storage dz

Hint 1482

#pathology #molecules

Front 1483

Presentation: HSM, Aseptic necorsis of femur; macorphages that look like crumpled ts paper

Back 1483

Dz: Gaucher's Dz
(Lysosomal Storage Dz)
Presentation: HSM, Asepptic necorsis of femur; Gaucher's cells: macorphages that look like crumpled ts paper
Deficiency: Glucocerebrosidase
Accumulation: Glucocerebroside
Inheritance: AR (all but Fabry's & Hunters AR)
NB: most common Lysosomal stroage Dz

Hint 1483

#pathology #molecules

Front 1484

Presentation: progressive neuodegeneration, cherry red spot on macula, foam cells, HSM

Back 1484

Dz: Neimann-Pick
(Lysosomal Storage Dz)
Presentation: progressive neuodegeneration, cherry red spot on macula, foam cells, HSM (defining feature vs. Tay-Sach's)
Deficiency: sphingomyelinase
Accumulation: sphingomyelin
Inheritance: AR (All but Fabry's & Hunters AR)
Mn: Neiman picks his nose with hi-sphinger

Hint 1484

#pathology #molecules

Front 1485

Presentation: Prgoressive neurodegeneration, cherry red spot on macula, lysosomes with onion skin

Back 1485

Dz: Tay-Sach's
(Lysosomal Storage Dz)
Presentation: Prgoressive neurodegeneration, cherry red spot on macula, lysosomes with onion skin, no HSM (defining feature vs. Niemann Pick)
Deficiency: Hexosaminidase A
Accumulation: GM2 ganglioside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1485

#pathology #molecules

Front 1486

Presentation: Peripehral neuropathy, dvlptl delay, optic atrophy, globoid cells

Back 1486

Dz: Krabbe's Dz
(Lysosomal Storage Dz)
Presentation: Peripehral neuropathy, dvlptl delay, optic atrophy, globoid cells
Deficiency: beta galactocebrosidase
Accumulation: galactoserebroside
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1486

#pathology #molecules

Front 1487

Presentation: Dvlpt delay, gargolylism, ariway obstrx, corenal clouding, HSM

Back 1487

Dz: Hurler's
(Lysosomal Storage Dz)
Presentation: Dvlpt delay, gargolylism, ariway obstrx, corenal clouding, HSM
Deficiency: alpha L iduronidase
Accumulation: heparan sulfate, dermatan sulfate (same as Hunter's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1487

#pathology #molecules

Front 1488

Presentation: aggressive behavior mild dvlpt delay, HSM

Back 1488

Dz: Hunter's
(Lysosomal Storage Dz)
Presentation: aggressive behavior mild dvlpt delay, HSM
Deficiency: Iduronidate sulfatase
Accumulation: heparan sulfate, dermatan sulfate (same as Hurler's)
Inheritance: AR (All but Fabry's & Hunters AR)

Hint 1488

#pathology #molecules