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811 Cards in this Set
- Front
- Back
- 3rd side (hint)
Term
|
Association
|
Notes
|
|
Orientia tsutsugamushi
|
black eschar, rash on trunks that spreads to extremities, chigger borne
|
Formerly Rickettsia tsutsugamushi
|
|
Chlamydia trachomatis
|
cell wall lacks muramic acid
|
|
|
Reiter's Syndrome
|
Urethritis, conjunctivitis/uveitis, arthritis
|
|
|
Yersinia pestis
|
antiphagocytic components F1 and VW
|
F1 and VW are active at 37C, which is why they are not virulent in the flea vector (25C)
|
|
Type 3 Secretion System (T3SS)
|
sensory probes used to detect presence of eukaryotic organisms, help bacteria infect
|
Shigella, Salmonella, Yersinia, Chlamydia, Pseudomonas, EHEC
|
|
Red man syndrome
|
Vancomycin
|
also ciprofloxacin, amphotericin B
|
|
sporotrichosis
|
rose thorns, gardeners
|
subcutaneous nodules that ulcerate and travel along lymphatics
|
|
Histoplasma
|
bird and bat droppings in mississippi and ohio
|
granulomas with calcifications on CXR
|
|
Progressive supranuclear palsy
|
widespread neuronal loss and gliosis in subcortical sites
|
|
|
Middle meningeal artery
|
found in middle cranial fossa
|
|
|
Toxoplasmosis
|
poorly cooked pork
|
|
|
Mucor and Rhizopus
|
>90 degree branching, ketoacidotic diabetics
|
|
|
Buproprion
|
seizures in bulimic or anorexic patients
|
|
|
Torticollis
|
involuntary twisting or devation of the neck, neck pain, sensory tick, abnormal head posture
|
acute or delayed complication of dopamine antagonist therapy (antipsychotics)
|
|
Organ of Corti
|
Contains hair cells that can be damaged by loud sounds
|
|
|
Atherosclerosis of brain vessels
|
commonly found in circle of willis, NOT in penetrating smaller arteries
|
|
|
Subdural hematoma
|
negative initial workup at time of trauma, delayed onset of symptoms (2 weeks), originates from bridging veins
|
|
|
Internal branch of superior laryngeal nerve
|
supplies sensory innervation to laryngeal mucosa above vocal cords
|
runs with superior laryngeal artery
|
|
Subacute sclerosing panencephalitis
|
caused by perinatal measles (rubeola) infection, manifests in childhood, teenager and leads to death
|
|
|
Prions
|
acute presentation of progressive ataxia and dementia, spongiform change
|
encephalopathy with axonal degneration, neuronal loss, gliosis, astrocytic proliferation
|
|
Cushing reflex
|
HTN and bradycardia due to increased ICP
|
autonomic response triggered by changes in the arterial-to-intracranial pressure gradient
|
|
xerostromia
|
Dry mouth
|
|
|
Amide analgesics
|
Have 2 "I's" in name
|
|
|
Trihexyphenidyl
|
muscarinic antagonist
|
used as adjunctive therapy in Parkinson disease
|
|
Amitriptyline
|
Strong anticholingergic effects
|
useful in depression and parkinsons
|
|
vincristine
|
peripheral neuropathy
|
|
|
anterior ear canal innervation
|
auriculotemporal nerve
|
|
|
posterior half of ear canal innervation
|
auricular branch of vagus
|
|
|
both surfaces of lower auricle
|
great auricular nerve
|
|
|
cranial surface of upper auricle
|
lesser occipital nerve
|
|
|
viral encephalitis
|
arthropod transmission during summer
|
|
|
Blowout fracture
|
maxillary sinus blood
|
|
|
Prosopagnosia
|
can't recognize faces
|
|
|
cryptococcus
|
latex particle agglutination
|
|
|
nerve growth
|
1 mm/day
|
|
|
Lithium
|
hypothyroidism
|
check TSH every 1 to 2 months
|
|
Vecuronium
|
ACh antagonist
|
reverse blockade with neostigmine
|
|
Ki-67
|
stains astrocyte neoplasms
|
|
|
acanthamoeba
|
free living amoeba that infects brain, usually in immunosuppressed
|
|
|
cyclobenzaprine
|
centrally acting skeletal muscle relaxant
|
structurally related to TCAs, has anticholingergic side effects
|
|
schwann cells
|
axonal regeneration
|
|
|
toxoplasmosis
|
ingestion of cysts in meat
|
|
|
Pick's disease
|
similar to AD, but with frontotemporal atrophy
|
|
|
REM sleep decrease
|
medication that causes decrease in ACh
|
|
|
piriform cortex
|
primary olfactory cortex
|
receives neurons from olfactory bulb
|
|
Glaucoma (closed angle)
|
painful, bluurred vision w/ halos around eyes
|
treat with IV acetazolemide
|
|
Y. pestis
|
prophylaxis is doxycycline, treatment is streptomycin or gentamycin
|
|
|
lymphogranuloma venerum
|
C. trachomatis L1-L3, fluctuant draining nodules
|
|
|
Thiamine deficiency
|
Wernicke-Korsakoff, Dry beriberi (polyneuritis), wet beriberi (cardiomyopathy)
|
|
|
HIV encephalitis
|
multinucleated giant cells
|
|
|
S. pneumoniae attachment
|
IgA protease cleaves IgA into Fc, which attaches to bacterium and allows attachment to Fc receptors on mucosal cells
|
|
|
Phenylethanolamine=N-methyltransferase (PMNT)
|
converts NE to E
|
|
|
Halothane
|
hepatitis w/ focal massive necrosis
|
|
|
Cowdry Type A inclusions
|
HSV-1 encephalitis, intranuclear viral inclusion bodies
|
|
|
HSV-1
|
most common cause of fatal, sporadic encephalitis cases in US
|
|
|
area postrema
|
floor of 4th ventricle, responds to chemical signals, vomit center
|
|
|
Alar plate
|
dorsal spinal cord
|
sensory or afferent portion
|
|
basal plate
|
ventral part of spinal cord
|
motor or efferent portion
|
|
AChE inhibitors
|
carbamylate AChE
|
often combined w/ prednisone to treat severe MG
|
|
Pinealoma
|
Parinaud syndrome (epward gaze palsy, light and accomodation deficit, failure of convergence
|
|
|
Herpes zoster encephalitis
|
Encephalitis + shingles
|
resistant to acyclovir
|
|
General paresis
|
general paraylsis of the insane, includes mental deterioration that precedes motor system deterioration
|
late sequela of syphilitic infection
|
|
sagittal sinus thrombosis
|
associated with hypercoagulable states
|
increased frequency during prego/postpartum
|
|
Taenia solium
|
cysticercosis, can invade CNS (neurocysticercosis)
|
parasitic infection by ingesting eggs in pork, found in south america and central america
|
|
Cerebellar abscess
|
otitis media is #1 cause
|
|
|
Pituitary surgery
|
approach via the sphenoid sinus transnasally
|
|
|
Thyroglossal duct
|
thyroid gland
|
failure of the duct to degenerate may lead to a thyroglossal duct cyst or a median cervical cyst
|
|
Retinal angiomas
|
Von hippel-lindau disease
|
|
|
Nerve in tonsillar fossa
|
glossopharyngeal nerve
|
|
|
Bartonella henselae
|
cat-scratch disease
|
stellate granulomas w/ central necrosis and gram neg organisms
|
|
Target cells
|
thalassemia, hemoglobin C disease, liver disease
|
|
|
Reed-sternberg cell
|
somatic hypermutation, CD15, CD30
|
|
|
Nodular sclerosis hodgkin's lymphoma
|
fibrotic bands
|
|
|
Mast cells
|
release histamine, serotonin, leukotrienes, platlet aggregating factor (PAF)
|
Giemsa stain = metachromasia of cytoplasm, granular cytoplasm
|
|
Lines of Zahn
|
cell-rich layers found in a thrombus that forms pre-mortem
|
post-mortem clots will not have lines of zahn
|
|
Spontaneous bleeding
|
20,000 platelet count
|
|
|
E. coli K1 capsule
|
neonatal meningitis
|
Listeria and GBS are other common causes of neonatal meningitis
|
|
Hepatocellular carcinoma
|
erythropoietin overproduction -> polycythemia
|
increased EPO is also associated with RCC and hemangioblastoma
|
|
Burkitt Lymphoma
|
t(8;14), t(8;22), t(2;8)
|
|
|
Febuxostat
|
xanthine oxidase inhibitor
|
given in conjunction with chemotherapy for leukemias and lymphomas to prevent hyperuricemia
|
|
Sulfa drugs + hemolytic anemia
|
G6PD
|
|
|
Schuffner dots
|
multiple brick-red dots in Romanovsky-stained blood smears
|
P. vivax occurs in western hemisphere
|
|
Clarithromycin
|
inhibits hepatic enzymes
|
if given with warfarin, enhances activity and may lead to anticoag and hematuria
|
|
G6PD hemolytic drugs
|
antimalarials, dapsone, sulfonamides
|
|
|
Decreased ESR
|
sickle-cell, polycythemia, CHF
|
|
|
Increased ESR
|
increased antibody formation: cancer, infection, prego, connective tissue diseases
|
|
|
Smudge cells
|
CLL
|
older individuals, indolent
|
|
cirrhosis and coag factors
|
If d-dimer is increased, that means that fibrin is still being made and that the real reason for a decrease in coag factors is consumption and not the cirrhosis
|
|
|
FDPs vs. d-dimer
|
FDP can be generated from degradation of fibrinogen or fibrin, while D-dimer derives exclusively from fibrin
|
FDP can be elevated due to plasmin-mediated breakdown of fibrinogen (primary fibrinolysis). Elevated FDP isn't enough for DIC. You must also have and increased D-dimer. People with cirrhosis can have decreased plasmin inhibiting proteins and this would lead to an increased FDP, which could incorrectly be diagnosed as DIC
|
|
DIC
|
exposure to lots of tissue factor over a brief period of time
|
|
|
Celecoxib
|
COX-2 inhibitor
|
used for pain management, contraindicated in sulfa allergy and coronary disease
|
|
Pirioxicam
|
indicated for moderate to severe pain associated with inflammatory disease
|
|
|
TdT (terminal deoxynucleotidyl transferase)
|
mediates N-nucleotide addition to junctions in gene segments
|
very primitive cell marker that is active when VDJ rearrangement occurs
|
|
Cytoplasmic mu chains
|
positive cells have completed VDJ rearrangement
|
|
|
Babesia microti
|
causes babesiosis transmitted by the Ixodes tick
|
B. burgdorferi and Ehrlichia phagocytophila are also trasnmitted by the Ixodes scapularis tick
|
|
P-450 inducers
|
quinidine, barbiturates, St. John's wort, Phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use
|
Queen Barb Steals Phen-phen and Refuses Greasy Carbs Chronically
|
|
P-450 inhibitors
|
sulfonamides, isoniazid, cimetidine, ketoconazole, erythromycin, grapefruit juice, acute alcohol use
|
Inhibit yourself form drinking beer from a KEG because it makes you Acutely SICk
|
|
Epstein-Barr virus
|
infects B-cells by attaching to CD21 receptor
|
cells that predominate in the blood during a EBV infection are CD8+ T-cells
|
|
Chloroquine
|
contraindicated in malarial patients with psoriasis
|
may lead to chloroquine retinopathy
|
|
Malaria treatment
|
Chloroquine is first choice, atovaquone/proguanil is alternative treatment
|
|
|
Eosinophil granules
|
crystalline core contains major basic protein (destroys parasites)
|
light component around the dense crystalline core contains histaminase, arylsulfatase, and other enzymes
|
|
Gamma-carboxyglutamate residues
|
vitamin K deficiency prevents gamma-carboxyglutmation and thus a deficiency in clotting factors
|
|
|
Brushfield's spots
|
white speckling of the iris
|
associated with Down Syndrome. Down syndrome also increases risk of VSD, ASD, ALL, Alzheimer's, duodenal atresia
|
|
TGF-β
|
stimulates production of basophils and suppresses production of eosinophils
|
|
|
Neurofibromin gene (chromosome 17)
|
inhibits p21 ras oncoprotein
|
mutation leads to neurofibromatosis type 1
|
|
Merlin gene (chromosome 22)
|
regulator of contact-dependent inhibition of proliferation
|
mutation leads to neurofibromatosis type 2
|
|
Downey Type II Cells
|
large, basophilic, vacuolated T-cells
|
associated with EBV
|
|
Bone marrow expansion in calvarium
|
sickle-cell, thalassemia
|
|
|
Treatment of neonatal jaundice
|
Phototherapy (light decomposes bilirubin) and riboflavin
|
|
|
Warfarin overdose
|
Both extrinsic and intrinsic pathways are affected
|
normally, during warfarin treatment, only PT is prolonged because factor VII is the only factor that is decreased enough to impair coag
|
|
Streptokinase
|
binds to and activates plasminogen
|
|
|
DiGeorge Syndrome
|
Patients present with tetany (hypocalcemia due to hypoPTH), recurrent infections, lack of type IV hypersensitivity
|
CATCH-22: Cardiac abnormality, Abnormal facies, Thymic aplasia, Cleft palate, Hypocalcemia, deletion on chromosome 22
|
|
Cat-scratch fever
|
painful, enlarged lymph node w/o fever
|
biopsy of node shows granulomas with necrotic debris
|
|
Uterine leiomyomas
|
blood loss during menstruation leads to iron deficiency anemia
|
|
|
extracellular bacterial infection
|
high white count with left shift
|
|
|
Birbeck granules
|
Langerhans cell histiocytosis
|
|
|
Heterophile antibody test
|
diagnostic test for EBV/mononucleosis
|
another word for monospot
|
|
EBV
|
nasopharyngeal carcinoma, African form of Burkitt lymphoma, B-cell lymphoma
|
|
|
French-American-British classification
|
L for lymphoblastic, M for myeloblastic
|
1 for small uniform nuclei and scant cytoplasm, 2is variable lymphoblasts with irregular nuclei and more cytoplasm
|
|
Hemoglobin A2
|
B-thalassemia minor
|
|
|
ABO incompatibility
|
Mother is O and infant is A or B. Normally, IgM is produced by mother, but rarely, IgG can be produced and can cross the placenta
|
mild anemia, jaundice, + coombs test
|
|
ticlopidine
|
severe bone marrow toxicity
|
same mechanism as clopidogrel (inhibit ADP receptor)
|
|
Polycythemia vera
|
can progress to essential thrombocytosis and myelofibrosis, but does not progress to CML
|
|
|
ergonavine
|
triggers vasospasm in susceptible patients, use with angiography to diagnose prinzmetal angina
|
|
|
baclofen
|
treat spasticity
|
used in dystonia, symptomatic MS
|
|
Waldenstrom's macroglobulinemia
|
cancer of lymphocytes
|
IgM spike, no bone lytic lesions, hyperviscosity syndrome
|
|
Xanthoma
|
lipid laden histiocytes seen in hyperlipidemia (Touton cells)
|
|
|
Variceal rupture
|
engorgement of the azygos vein and the left gastric vein
|
|
|
Atropine
|
leads to rapid pulse with no change in blood pressure
|
|
|
Lyme disease
|
AV block
|
|
|
Temporal arteritis
|
focal granulomatous inflammation
|
|
|
Coarctation
|
rib notching, hypertension due to underperfused kidneys (RAAS activation)
|
occurs distal to the left subclavian artery near the region of the ductus arteriosus
|
|
Loeffler endocarditis
|
restrictive cardiomyopathy, prominent eosinophilic infiltrate
|
|
|
Isolated elevated AST
|
myocardial infarction
|
|
|
Transposition of great vessels
|
keep PDA open with PGE1 analog like alprostadil or misoprostal
|
PDA shunt must be open to keep oxygenated blood circulating
|
|
VEGF
|
secreted under hypoxic conditions by cells, such as muscle during exercise
|
levels rise to high levels within an hour after exercising
|
|
Arteriolar rarefaction
|
loss of arterioles (decreased arteriolar density) seen in severe hypertension
|
|
|
Capillary wall-to-lumen ratio
|
never changes because capillaries don't have smooth muscle in their walls
|
|
|
Tenecteplase, alteplase
|
tPA
|
|
|
Beta thalassemia major
|
large numbers of transfusions lead to iron overload and hemosiderosis, which eventually leads to cardiac failure
|
|
|
Medial umbilical arteries
|
arise from internal iliac arteries
|
|
|
Guarnieri bodies (type B inclusions)
|
diagnostic for poxvirus
|
poxvirus is the only DNA virus to replicate entirely in the cytoplasm
|
|
koilocytic atypia
|
squamous epithelial cells with characteristic cytoplasmic vacuoles
|
HPV
|
|
Severing of IX and X
|
tachycardia w/ hypertension
|
illusion that the patient has lost all blood pressure leads to increase in sympathetic stimulation
|
|
Propranolol
|
blunt or prevent the premonitory signs and symptoms (hunger, tachycardia, fatigue, tremors) or hypoglycemia
|
nonselective beta-blockers may even potentiate insulin-induced hypoglycemia
|
|
hyperplastic arteriolosclerosis
|
"onion-skinning" in vessel walls due to progressive laying down of fibrotic tissue by smooth muscle cells
|
|
|
Procainamide
|
reversible SLE, prolonged QT
|
contraindicated in long QT syndrome
|
|
Charcot-Bouchard
|
intracerebral hemorrhage
|
mostly found in small perforating vessels of the brain (lenticulostriate)
|
|
Berry aneurysm
|
subarachnoid hemorrhage
|
blood metabolites can lead to vasospasm
|
|
valproic acid
|
hepatotoxicity, neural tube defects in fetus
|
|
|
Type II pneumocytes
|
lamellar bodies which contain the surfactant
|
|
|
Hemoptysis
|
rupture of bronchial veins due to left heart failure
|
|
|
Mucor
|
epistaxis, severe facial sinus infection, frontal lobe abscess
|
DKA and leukemia
|
|
Corynebacterium diptheria
|
grow on tellurite agar, look for gram positive rod with metachromatic granules
|
|
|
Hirano bodies
|
intracytoplasmic proximal dendritic eosinophilic inclusions composed of actin
|
seen in AD
|
|
Transposition of the great vessels
|
associated with maternal diabetes
|
|
|
Thiazide diuretics
|
drug-induced gout
|
|
|
Spironolactone
|
blocks androgen receptors, leading to gynecomastia (can use eplerenone instead, because it's a more specific aldosterone receptor antagonist)
|
potassium sparing duiretic that is a competitive inhibitor of aldosterone receptors in the DCT
|
|
Contractility of heart
|
demonstrated by slope of graph…
|
increased by beta-1 agonists
|
|
Muscarinic cholinergic receptor antagonist
|
increases heart rate without changes in MAP
|
|
|
Marfan
|
defect in fibrillin
|
|
|
ACE inhibitors
|
delay progression of CHF by protecting ventricles from remodeling
|
first line treatment for CHF, HTN w/ diabetes, renal problems
|
|
Indomethacin (NSAIDS)
|
precipitate acute renal failure
|
decrease prostaglandin synthesis, which primarily affects the afferent arteriorle, leading to vasoconstriction
|
|
beta blockers
|
can cause AV block
|
|
|
Rheumatic heart disease
|
fibrous bridging between valve leaflets and calcifcation, "fish-mouth" appearance
|
|
|
Calcification of mitral annulus
|
beadlike calcifications of the annulus in elderly individuals
|
|
|
Tiny vegetations along the line of closure of the valve leaflet
|
marantic (nonbacterial thrombotic) endocarditis
|
marantic endocarditis: sterile vegetations as a result of a pro-coag effect from tumors of the colon and pancreas
|
|
Indapamide
|
non-thiazide diuretic which acts like thiazide, lead to decreased Ca in urine
|
indapamide, hydrochlorothiazide, metolazone are used in volume overloaded states and HTN
|
|
Digoxin
|
life-threatening cardiac dysrhythmias (paroxysmal supraventricular tachycardia)
|
|
|
CHF
|
S3 sound on auscultation
|
|
|
Amlodipine
|
Ca-channel blocker, works on smooth muscle
|
used for treatment of mild to moderate HTN and angina
|
|
Left dominant coronary arteries
|
PDA is supplied by the left CFX
|
infarction leads to ischemia of the posterior septum and posterior left ventricle
|
|
Anemia
|
increased stroke volume and cardiac output to make up for the low levels of Hb
|
|
|
Neutrophil granule contents
|
myeloperoxidase, lactoferrin, hydrolytic enzymes
|
|
|
Granulomatosis infantisepticum
|
vaginal transmission of listeria to neonate leads to early-onset sepsis or neonatal meningitis
|
formation of fatal granulomas
|
|
Enterococcus faecium
|
More likely to be resistant to vancomycin, less common than E. faecalis
|
|
|
ethambutol
|
red-green color blindness
|
|
|
Isoniazid, pyrazinamide
|
must be activated by bacterial enzymes from prodrug form
|
|
|
Chlorthalidone
|
thiazide diuretic
|
|
|
Persistent truncus arteriosus
|
goes along with a VSD, because the conotruncal ridges that are malformed in the truncus also give rise to the interventricular septum
|
|
|
Adult polycystic kidney disease
|
Give ACE inhibitor to treat HTN
|
the cysts impair perfusion of glomeruli, which triggers the secretion of renin by the juxtaglomerular complexes
|
|
QRS complex prolongation
|
can occur due to bundle branch block, which can be a result of coronary artery occlusion
|
|
|
Cystic hygroma
|
assoicated with Turner syndrome
|
Turner also associated with coarctation, aortic stenosis, webbed neck, lymphedema of the extremities, short stature, gonadal dysgenesis, hypothyroidism, and infertility
|
|
Rib notching
|
found in coarctation, due to anterograde flow through the intercostal artery via the subclavian (first intercostal artery) or internal thoracic artery (subsequent intercostal arteries)
|
|
|
Venous drainage of ovary
|
Right ovary: drain into pampiniform plexus, right gonadal (ovarian) vein, IVC
|
Left ovary: drain into pampiniform plexus, left gonadal (ovarian vein), left renal vein, IVC
|
|
Central hemorrhagic necrosis of hepatic lobules
|
CHF
|
mottled appearance (nutmeg liver)
|
|
Minoxidil
|
opens K-ATP channels and hyperpolarizes the membrane, resulting in relaxation of vascular smooth muscle
|
also hyperpolarizes pancreatic beta cells, leading to a decrease in insulin secretion in response to glucose
|
|
Aortic stenosis
|
increase in diastolic blood flow
|
AS causes an increase in systolic pressure in the LV, compressing the coronary arteries even further, thus making it necessary to increase blood flow during diastole even more so that in a normal heart
|
|
AA Amyloid
|
assoicated with chronic inflammatory disease
|
|
|
AE Amyloid
|
assoicated w/ medullary carcinoma of the thyroid and pancreatic islet cell adenomas
|
AE amyloid is not systemically distributed, but found directly in the neoplasm
|
|
AF Amyloid
|
assoicated w/ certain familial amyloidosis syndromes
|
distributed within peripheral nerves and kidney and senile cardiac amyloidosis in elderly
|
|
AL Amyloid
|
associated w/ myeloma and B-cell malignant lymphomas
|
produced by neoplastic cells which deposit in heart, GI, kidney, spleen, tongue
|
|
Septic pulmonary edema
|
due to increase vascular permeability
|
|
|
Peaked T-wave
|
hyperkalemia
|
|
|
Constrictive pericarditis
|
kussmaul sign, pericardial knock
|
usually due to TB or pyogenic staph infections
|
|
kussmaul sign
|
increase in systemic venous pressure on inspiration, due to impaired filling of the right ventricle
|
|
|
Long QT syndrome
|
don't use drugs that prolong QT, cause hypokalemia, or hypomagnesemia
|
agents that prolong QT include procainamide, sotalol, amiodarone, disopyramide, dofetilide, phenothiazines, and TCAs
|
|
patent ductus arteriosus
|
indomethacin to close, alprostadil (prostaglandin) to keep open
|
|
|
Complete heart block (third degree heart block)
|
ventricles beat independently of SA node activity and do not correspond to P waves
|
heart rate is usually 30-40 bpm. Stroke volume is increased so that CO remains constant to keep a constant BP, but pulse pressure still goes up a bit because SV increases
|
|
Paraganglioma
|
most often found in adrenal glands (pheochromocytoma), but most common extra-adrenal is carotid body tumor
|
catecholamines are the major secretory products (norepinephrine for non-adrenal, epinephrine for adrenal)
|
|
Carotid body hyperplasia
|
people living at altitude/high mountains
|
|
|
Congenital rubella
|
triad of PDA, cataracts, sensorineural deafness
|
Prego mother with rubella has classic postauricular and suboccipital lymphadenopathy
|
|
Coxsackievirus A
|
herpangina (mouth blisters), acute hemorrhagic conjunctivitis, hand-foot-mouth disease
|
both Coxsackie A and B cause aseptic meningitis and the common cold
|
|
Coxsackievirus B
|
myocarditis, pericarditis, pleurodyna, Bornholm disease (Devil's grip), hepatits
|
both Coxsackie A and B cause aseptic meningitis and the common cold
|
|
Bornholm disease
|
pleurodyna, often caused by coxsackie B, where there is severe pain in the lower chest, often on a specific side
|
|
|
Reovirus
|
only double stranded RNA virus (dsRNA)
|
|
|
Hantavirus
|
rodent borne virus (robovirus), unlike other bunyaviridae which are arthropod borne (arbovirus)
|
hemorrhagic fever and Hantavirus pulmonary syndrome (HPS): endothelial injury leads to edema in lungs and can lead to hypovolemic shock
|
|
Clonidine
|
centrally acting alpha 2 agonist that works at the locus ceruleus to inhibit NE release
|
|
|
Dextramethorphan
|
used for cough suppression
|
opioid
|
|
Meperidine
|
anti-ACh properties and pro CNS seizure activity
|
|
|
Beaded pattern on angiography
|
fibromuscular dysplasia
|
common cause of renovascular stenosis in women (renal bruits on examination)
|
|
Atherosclerosis w/ foci of calcification
|
indicates severe atherosclerotic disease
|
|
|
Buerger disease
|
recurrent inflammatory disorder that causes thrombosis in extremities
|
associated with heavy smokers
|
|
metoprolol
|
dyslipidemia
|
Other beta blockers can cause AV block
|
|
Serotonin syndrome
|
hyperthermia, muscle rigidity, cardiovascular collapse, flushing, diarrhea, seizures
|
treat with cyproheptadine
|
|
Capillaries
|
largest cross-sectional area of any vessel in the body
|
translates to slowest flow through the vessels compared to other vessels
|
|
Furosemide
|
can lead to problems if used with Digoxin
|
furosemide leads to hypokalemia, which can exacerbate the effects of digoxin
|
|
Fully compensated coarctation
|
blood flow below and above the coarct are no different than a normal person
|
check pulses to see if the resistance has changed (increased pulse = increased resistance)
|
|
Endocardial cushions
|
migration of neural crest cells is required for proper development of the endocardial cushions
|
Abnormal migration of neural crest cells in Down syndrome leads to cardiac defects
|
|
Methemoglobinemia
|
treat with methylene blue (enhances conversion of methemoglobin to hemoglobin by increasing activity of enzyme methemoglobin reductase) or ascorbic acid
|
methemoglobinemia can be caused my excessive adminstration of nitric oxide (NO) because the NO reacts with hemoglobin to produce methemoglobin
|
|
Intense, static exercise
|
skeletal muscle contracts, compressing the vessels, leading to decreased blood flow and increase vascular resistance
|
|
|
dynamic, endurance exercise
|
skeletal muscles relax after contraction allowing the vessels to dilate, leading to increased blood flow and decreased vascular resistance
|
|
|
Dressler's syndrome
|
fibrinous pericarditis
|
|
|
Acebutolol, pindolol
|
Beta blocker with intrinsic sympathomimetic activity
|
not good for patients with angina because it may exacerbate it, or patients with thyrotoxicosis
|
|
Hypertension in pregnancy
|
Methyldopa (converted to alpha-methylnNE, which stimulates alpha-2 receptors centrally and leads to decreased sympathetic outflow)
|
|
|
MSFP
|
a measure of the "tightness" with which the circulatory system is filled with blood
|
MSFP increases with more blood in the system and it's easier for blood to flow into the heart, which tends to increase venous return
|
|
Graft vascular disease, graft arteriosclerosis
|
develops years after transplantation and is due to intimal thickening of coronary arteries without associated atheroma formation or inflammation
|
no chest pain because transplanted hearts are denervated
|
|
Niacin
|
decreases hepatic LDL and VLDL production
|
side effects: flushing, hepatotoxicity, tachycardia, hypoalbuminemia, hyperglycemia. Aspirin can help reduce the flushing
|
|
D-I-R-T
|
VMAT inhibitors: lead to decreased reuptake of monoamines into the presynaptic terminal, which allows them to be broken down by MAO, decreasing the monoamine signalling
|
Deserpidine, Ibogaine, Reserpine, Tetrabenazine
|
|
Eosinophilia
|
C-H-I-N-A: Connective tissue disease, helminthic infections, idiopathic hypereosinophilic syndrome, Neoplasia, allergies
|
|
|
Sphenopalatine artery
|
branch of the maxillary artery
|
artery of epistaxis
|
|
Suboccipital triangle
|
can gain access to the vertebral artery through this zone
|
|
|
Arteriosclerotic occlusive disease
|
classic symptom is claudication and impotence
|
decreased arterial pulse at the ankle because vessels are narrowed
|
|
Rheumatoid arthritis
|
Restrictive amyloid cardiomyopathy
|
|
|
Verapamil
|
assoicated with accelerated progression of CHF in certain patients
|
|
|
Reduviid bug
|
Trypanosoma cruzi
|
Chagas disease
|
|
Varicose veins
|
Exacerbated by chronically high venous pressure in the legs
|
|
|
Increased BUN, normal Creatinine
|
prerenal cause of azotemia, such as decreased renal perfusion
|
|
|
Kerley's lines
|
septal edema seen on chest radiograph
|
|
|
Heart failure cells
|
alveolar macrophages with hemosiderin residue
|
sputum has a rusty color
|
|
BNP (brain natriuretic peptide)
|
secreted from ventricles in response to volume expansion and pressure overload
|
useful in diagnosis of LHF (increased)
|
|
Arteriovenous fistula
|
high-output heart failure due to bypass of the microcirculation and increased venous return
|
causes: trauma from knife wound, surgical shunt for hemodialysis, mosaic bone in Paget's disease (where the bone vessels form microfistulas)
|
|
Hypercoagability
|
at it's peak in the morning hours
|
|
|
Prinzmetal angina
|
pathophys thought to be due to thromboxane A2 or an increase in endothelin
|
|
|
Myocarditis due to coxsackie
|
lymphocytic infiltrate with focal areas of necrosis
|
|
|
Superior vena cava syndrome
|
extrinsic compression of SVC, usually from primary lung cancer
|
puffiness and blue discoloration of the face, arms, shoulders, retinal hemorhage, stroke
|
|
Councilman bodies
|
Eosinophilic/acidophilic inclusions in hepatocytes indicating apoptotic death
|
Yellow fever, viral hepatitis
|
|
Viral Gastroenteritis
|
#1 is rotavirus, #2 is norovirus
|
|
|
Top 5 causes of pediatric red rash
|
Measles, rubella, scarlet fever, roseola, erythema infectiosum (parvovirus)
|
|
|
Spontaneous tendon rupture
|
flouroquinolones
|
|
|
HBV
|
polyarteritis Nodosa and glomerulonephritis
|
immune complex deposition
|
|
Sickle cell immunity against malaria
|
Immune to P. falciparum because of decreased oxygen content in cells and because of increased splenic destruction of sickled cells
|
|
|
Red man syndrome
|
side effect of vancomycin, due to direct stimulation of mast cells
|
give antihistamines before administration of vancomycin or enfuse slowly
|
|
Sulfonamides
|
Steven Johnson syndrome side effect
|
|
|
Ethacrynic acid
|
non-sulfa diuretic used for people with sulfa allergies
|
|
|
Thymine dimers
|
caused by UV radiation
|
inability to repair the defect results in xeroderma pigmentosum, UV sensitivity, excessive freckling, and early onset skin cancer (basal cell, squamous cell, melanoma)
|
|
Chronic granulomatous disease
|
NADPH oxidase deficient, which prevents formation of oxygen radical products
|
myeloperoxidase uses a product of NADPH oxidase, hydrogen peroxide, to make it's own toxic chemicals to kill bacteria
|
|
Velocardiofacial syndrome (DiGeorge Syndrome)
|
malformation of third and fourth pharyngeal pouches, leading to thymic aplasia and absence of parathyroids
|
may present with tetanus due to hypocalcemia
|
|
Recombinase A
|
product of the recA gene, necessary for recombination of a linear piece of DNA into the recipient cell's chromosome
|
F+ to F- conjugation is possibly because there is no transfer of linear DNA (only DNA transfer that doesn't require homologous recombination to occur)
|
|
Klebsiella pneumonia
|
lobar caviation
|
|
|
Reovirus
|
needs its own polymerase enzyme in order to be infectious
|
other similar viruses include all negative-sense RNA viruses, reovirus (dsRNA), poxvirus (replicates in cytoplasm) and retrovirus
|
|
Bruton x-linked agammaglobulinemia
|
no peripheral B cells (no CD19+), low levels of IgG
|
|
|
hyper-IgM Syndrome
|
IgM-producing B cells cannot receive the signal to isotype switch, leads to severe pyogenic infections early in life
|
Deficiency in TH cells that express CD40L
|
|
Dolichol
|
substrate for the synthesis of glycoproteins, such as albumin
|
|
|
Chronic rejection therapy
|
Downregulation of T-lymphocyte activity
|
|
|
Ascaris lumbricoides
|
posses one of the most potent allergens in nature
|
leads to type I hypersensitivity
|
|
Heterochromatin
|
densly packed DNA around histones seen when the cell is undergoing mitosis
|
indicative of replicating cells and possibly a high grade cancer
|
|
Unconjugated bilirubin
|
not filtered by the glomerulus because it is water insoluble
|
|
|
Anti-RNP antibodies
|
marker for Mixed connective tissue disease (MCTD)
|
joint pain, myalgias, pleurisy, esophageal dysmotility, skin disease
|
|
hemorrhagic cystitis
|
cyclophosphamide: aklylating agent that causes DNA crosslinking, treats non-Hodgkin lymphoma, breast cancer, ovarian carcinoma
|
cyclophosphamide also causes bone-marrow suppression
|
|
Neuroblastoma
|
childhood tumor of sympathetic nerves along paravertebral chain or adrenal medulla
|
1p deletion and N-myc translocation, associated with poorer prognosis
|
|
Mandibulofacial dysostosis
|
abnormally formed mandible, ears, and palate
|
due to abnormal development of the first and second parhyngeal arches
|
|
Hemochromatosis
|
increased total body iron stores and can set off airport metal detectors
|
|
|
Argyria
|
blue-skin pigmentation due to silver poisoning
|
|
|
Primidone
|
P450 inducer
|
|
|
Aldolase B (Fructose-1-phosphate aldolase)
|
autosomal recessive disorder of fructose metabolism that leads to accumulation of fructose-1-phosphate
|
accumulation of F1P inhibits glycogenolysis and gluconeogenesis, causing severe hypoglycemia after ingestion of fructose
|
|
Aldolase reductase
|
reduces glucose to sorbitol and galactose to galactitol
|
|
|
pseudomyxoma peritonei
|
mucus producing tumor of ovary or appendix fills the peritoneal cavity
|
|
|
gamma-glutamyl transpeptidase
|
transports amino acids into cells
|
deficiency causes mental retardation, seizures, increased plasma and urine levels of glutathione
|
|
Serum sickness
|
caused by hypersensitivity to drugs: fever, urticaria, lymphadenopathy, arthralgias, Erythema multiforme in severe cases. Occurs 7-10 days after initial exposure because it takes that long for IgG generation
|
Tx: oral prednisone and diphenhydramine (for urticaria)
|
|
Filaria infection
|
body coats then with thin layer of IgE, triggering an eosinophil-mediated cytotoxicity and the release of vasoactive spasmogenic substrates form mast cells and basophils
|
|
|
Exfoliatin
|
proteolytic exotoxin produced by S. aureus that causes bullous impetigo and Staph scalded skin syndrome
|
cleaves desmogleins in desmosomes
|
|
Neurocysticercosis
|
swiss-cheese appearance on head CT
|
ingestion of T. solium eggs in food or water contaminated with human feces
|
|
C3b
|
product of the cleavage of C3, attaches to bacterial surfaces for opsonization by phagocytes (C3a binds to mast cells and basophils, leading to histamine release)
|
also involved in removal of immune complexes from serum
|
|
Sickle Cell in African Americans
|
due to natural selection because sickle cell individuals are resistant to malaria
|
|
|
Tamoxifen
|
used to treat ER+ breast cancers
|
side effect: endometrial carcinoma
|
|
selective IgA deficiency
|
most common immunodeficiency in US
|
increased atopic allergy, possibly because of the increased isotype switch to IgE
|
|
K-complex and sleep spindles
|
high amplitude single spike followed by trough, seen in stage 2 sleep
|
|
|
Ammonium chloride
|
used to treat amphetamine overdose
|
acidifies the urine and hastens amphetamine excretion
|
|
Desmoplasia
|
excessive fibrous tissue formation usually seen with malignant neoplasms
|
|
|
Sjogren syndrome
|
dry mouth (xerostomia), dry eyes (keratoconjuntivitis sicca, patients complain of "sand in eyes"), arthritis
|
autoantibodies anti-Ro (SS-A), anti-La (SSB), antinuclear, and RF
|
|
Celecoxib
|
selective COX2 inhibitor, involved in prostaglandins that are assoicated with inflammation and pain
|
cannot be used in patients with sulfa allergy
|
|
I-cell disease (inclusion cell disease)
|
lysosomal storage disorder due to failure of addition of mannose-6-phosphate to lysosome destined proteins
|
lysosomal proteins are secreted out of the cell. Leads to coarse facial features, clouded corneas, restricted joint movement, high plasma levels of lysosomal enzymes, often fatal in childhood
|
|
Cyclin-CDK complexes
|
see FA pg76
|
|
|
Daclizumab
|
monoclonal antibody against IL-2 receptor on activated T-cells
|
indicated for kidney transplant rejection prophylaxis along with cyclosporine and corticosteroids
|
|
Repeated blood transfusions
|
may lead to hemosiderosis
|
hemosiderin (coarse, golden-brown granules in cytoplasm of cells all around body)
|
|
17 year old wants to get off life support
|
parents cannot decide to stop the life support, so you must wait until the patient is of age and he can make the decision on his own
|
|
|
Permeability of molecules through lipid bilayer
|
CO2>O2>urea>glycerol>glucose>sodium
|
|
|
hypokalemic periodic paralysis
|
autosomal dominant, symptoms in first or second decade of life, severe muscle weakness, habitual high-salt diet, may be due to primary defect in calcium channels
|
during acute attacks: decreased serum potassium
|
|
Hyper-IgM Syndrome
|
multiple pyogenic infections at an early age
|
|
|
C3 deficiency
|
defects in opsonization of encapsulated bacteria and removal of immune complexes (increased risk for type III hypersensitivity)
|
|
|
Ornithine transcarbamylase deficiency
|
Lethargic, unwilling to eat, poorly controlled RR/body temp, seizures, abnormal body movements
|
Increased urine orotic acid levels, decreased serum citrulline levels, elevated plasma glutamine
|
|
Galactosemia
|
absence of galactose-1-phosphate uridyltransferase, autosomal recessive
|
accumulation of toxic substances (galactitol), leads to failure to thrive, juandice, hepatomegaly, infantile cataracts, mental retardation
|
|
Gamma-delta T-cells
|
only category of T-cells that do not require education and selection in the thymus; these cells are found mostly in submucosa and intraepithelial spaces and may play a role in protecting the epithelium
|
have gamma-delta chain, as opposed to the much more common alpha-beta receptors
|
|
Cleft lip
|
lateral maxillary prominence fails to fuse with the medial nasal prominence
|
|
|
Cleft palate
|
palatine shelves (maxillary prominences) fail to fuse with each othe ror the primary palate (fused medial nasal prominences)
|
|
|
Karyorrhexis
|
pyknotic nucleus undergoes fragmentation followed by complete lysis
|
abscess necrosis is termed liquefactive necrosis
|
|
PPD reaction
|
macrophages are the most abundant cells types (CD14 positive) because they are recruited there by cytokines released by TH1 cells
|
there are also T-cells
|
|
Acrodermatitis enteropathica
|
inherited zinc deficiency
|
|
|
Oxalate crystals in urine
|
ethylene glycol poisoning
|
|
|
Cytarabine
|
inhibits DNA polymerase
|
used for AML in conjunction with an anthracycline
|
|
Sublimation
|
diversion of unacceptable impulses into more acceptable ones
|
mother whose child died of a disease who becomes active in a state or national organization designed to help families with the disease
|
|
Graves disease
|
type II hypersensitivity
|
|
|
Hashimoto's thyroiditis
|
type IV hypersensitivity
|
|
|
Cretinism
|
mental retardation, protuberant abdomen, puffy face, enlarged tongue
|
lack of thyroid hormone in a developing child prevents normal growth hormone synthesis and secretion, leading to dwarfism
|
|
Measurement of body fluids
|
plasma volume measured with 125-I-albumin; extracellular fluid volume can be measured using inulin
|
interstitial volume = extracellular fluid - plasma volume
|
|
Ribozyme
|
RNA complex that breaks down mRNA
|
|
|
mycophenolate mofetil
|
inhibits purine synthesis (guanine) and lymphocyte proliferation
|
|
|
Perifollicular hemorrhage
|
vitamin C deficiency
|
|
|
HIV positive individuals
|
can only make IgM antibodies because of deficient CD4 cells
|
|
|
Homocystinuria
|
due to cystathionine synthase deficiency
|
mental retardation, long limbs, tall stature, kyphosis, increased plasma homocysteine and methionine levels
|
|
Azathioprine
|
inhibits de novo purine synthesis and interacts with allopurinol
|
|
|
Immunosuppression
|
knocks down t-helper 1 cells, as opposed to HIV, which knocks down t-helper 2 cells
|
|
|
first-order kinetics
|
a constant proportion of the target is killed by the drug
|
|
|
Clathrin
|
receptor-mediated endocytosis at the plasma membrane, transfer of lysosomal enzymes from trans-golgi
|
|
|
REM rebound
|
When the patient stops taking the drugs, there is an increase in the number and intensity of dreams for several days following discontinuation
|
barbiturates, alcohol, phenothiazines, and MAO inhibitors decreased the amount of REM sleep while the patient is taking them
|
|
Ecthyma gangrenosum
|
pseudomonas infection of the foot with a black, necrotic center and raised erythematous edges
|
seen in diabetics
|
|
obstructive sleep apnea syndrome
|
first line treatment: weight loss and use of continuous positive airway pressure
|
|
|
site-specific transduction
|
integration of a temperate phage, integration of a fertility factor, and movement and insertion of transposons…no idea what this means
|
|
|
Tongue fasciculations
|
werdnig-hoffman (spinal muscular atrophy)
|
|
|
hexagonal, benzene, staghorn crystals
|
cystinuria
|
cystine crystals precipitate in acidic urine, so treat with acetazolamide
|
|
Rheumatoid factor
|
anti-IgG antibody
|
|
|
Calreticulin, calnexin
|
chaperone proteins that assist in protein folding within in RER
|
problems at this stage lead to polyubiquination which leads to degredation by proteosomes
|
|
Early HIV infection
|
follicular dendritic cells in germinal centers of lymph nodes are important reservoirs of HIV
|
|
|
Interferon gamma
|
released by T-lymphocytes and activate macrophages
|
|
|
Bruton x-linked agammaglobulinemia
|
mutation in cytoplasmic tyrosine kinase (bruton tyrosine kinase, btk)
|
gene is important in driving pre-B cells to become mature B cells
|
|
pemphigus vulgaris
|
autoimmune disease with antibodies against desmoglein 1 and 3
|
acantholysis: intraepidermal bullae involving skin and oral mucosa. Positive Nikolsky's sign (separation of epidermis when touching skin)
|
|
F+ to F- conjugation
|
principal means of transfer of drug resistance genes on plasmids
|
common in gram-negative bacilli
|
|
Generalized transduction via bacteriophage
|
transfer of methicillin and vancomycin resistance between S. aureus and imipenem resistance in P. aeruginosa
|
Also seen in specialized transduction
|
|
Transformation
|
S. pneumoniae transfer of drug resistance
|
|
|
OCD
|
assoicated with tourette's and ADHD
|
|
|
ataxia telangiectasia
|
telangiectasias of the skin and eyes, variable immunodeficiency, progressive ataxia
|
mutation of ATM gene (tumor suppressor gene)
|
|
Neonatal hepatomegaly and hypoglycemic seizures
|
think glycogen storage disease
|
|
|
Fragile X syndrome
|
get trinucleotide repeat test for diagnosis, not karyotype (might not show the defective X chromosome)
|
|
|
Cherry-red spot on macula
|
w/ hepatosplenomegaly = Niemann-Pick; w/o hepatosplenomegaly = Tay-Sachs
|
|
|
Globoid cells
|
Krabbe's disease
|
|
|
NMDA channel
|
ligand-gated AND voltage-gated cation channel
|
|
|
Cachexia
|
reduction in lean body mass, profound loss of appetite and weakness due to TNF-alpha, interferon-gamma, IL-1
|
|
|
Long-chain acyl CoA dehydrogenase (LCAD) deficiency
|
hypokalemic kypoketosis that leads to cardiomyopathy in childhood
|
also see accumulation of carnitine esters (long chain acyl carnitines), which rules out carnitine uptake deficiency in the DDx
|
|
SCID
|
IL-2 receptor deficiency is most common cause
|
also caused by adenosine deaminase deficiency and inability to produce MHC-II molecules
|
|
Wiskott-Aldrich syndrome
|
exzema, thrombocytopenia, and immunodeficiency
|
IgE is frequently increased; mutation is in Wiskott-Aldrich serum protein (WASP) on X chromosome
|
|
Stomach cancer in Japanese
|
due to food preservatives and smoked foods
|
|
|
Opsonic antibody
|
IgG
|
represents past exposure to an antigen, levels of IgG persist much longer than IgM
|
|
IL-2
|
produced by T-helper cells and can be used to treat various types of cancer
|
increases numbers of cytotoxic T-cells and NK cells
|
|
Anticholinergic vs. stimulant overdose
|
anticholinergics = dry skin, stimulants = sweaty skin
|
|
|
migratory pulmonary infiltrates in asthmatic patient
|
allergic bronchopulmonary aspergillosis
|
|
|
MHC III
|
encodes for complement and tumor necrosis factors
|
|
|
T-cell independent B-cell activation
|
non-protein carbohydrate mediated (LPS) leads to cluster differentiation of B-cells
|
mitogen mediated activation of B-cells leads to a polyclonal response directed at everything except mitogens!
|
|
T-cell receptors
|
only recognize polypeptides that are displayed with MHC
|
|
|
J chain
|
holds together secreted IgA dimer and pentameric IgM
|
|
|
Secretory component or secretory piece
|
picked up by IgA in epithelial cells before it is secreted, prevents proteolytic cleavage of IgA
|
|
|
Decay Accelerating Factor (DAF)
|
also known as CD55
|
deficiency leads to paroxysmal nocturnal hemoglobinuria
|
|
Major Basic protein
|
can cause epithelial damage
|
released by eosinophils
|
|
Neuroblastoma
|
N-myc
|
|
|
Pneumocystis jiroveci diagnosis
|
Direct fluorescent antibody test
|
|
|
Bronchitis in smokers
|
Haemophilus influenzae, Legionella, or Moraxella
|
|
|
Megaloblastosis uncorrected with B12, folate
|
deficiency in orotidine decarboxylase or orotidine phosphoribosyltransferase
|
orotic acid crystals in urine (white needle-shaped crystals)
|
|
Sorafenib
|
multi-kinase inhibitor used for renal cell carcinoma
|
|
|
Bare lymphocyte syndrome
|
Type of SCID where cells are unable to synthesize and express MHC II
|
|
|
Omenn Syndrome
|
type of SCID where there is a nonsense mutation in genes involved in early VDJ recombination
|
|
|
Negative nitroblue tetrazolium test
|
Chronic granulomatous disease
|
|
|
Congenital Herpes Encephalitis
|
HSV-2 in children, while adult encephalitis is usually HSV-1
|
|
|
Tularemia
|
Francisella tularensis causes a rupturing pustule following by an ulcer with involvement of regional lymph nodes
|
|
|
Digoxin
|
binds to K+ site of Na/K ATPase
|
|
|
Mycobacterium avium intracellulare
|
treat with azithromycin
|
|
|
Peutz-Jeghers syndrome
|
widespread "freckles" (spots of melanin pigmentation)
|
associated with carcinomas of pancreas and colon, as well as other sites
|
|
Sacrococcygeal teratoma
|
contain derivatives of all 3 germ layers, which means it arose from the primitive streak (stage before 3 germ layers develop)
|
sacrococcygeal is most common tumor site
|
|
Transketolase
|
thiamine-requiring enzyme of non-oxidative half of hexose monophosphate shunt
|
activity is used as a clinical marker of thiamine deficiency, such as Wernicke-Korsakoff syndrome
|
|
Chocolate agar
|
H. influenzae
|
|
|
Charcoal yeast extract
|
Legionella pneumophila
|
|
|
Arthus Reaction
|
swelling and inflammation at inoculation site within a day
|
type III hypersensitivity
|
|
Fexofenadine
|
antihistamine that doesn't cause sedation because it doesn't cross the BBB
|
|
|
Fear of using public restrooms
|
social phobia
|
|
|
Salicylate intoxication
|
tinnitus is classified as the threshold symptom for intoxication
|
|
|
Duchenne and Becker Musuclar Dystrophy
|
usually due to deletions or insertions, not single based changes (missense or nonesense)
|
|
|
Marriage = emancipation
|
allowed to make own decisions for medical treatment, regardless of how old she is
|
|
|
C5a
|
neutrophil chemotaxis to an area of damage/inflammation
|
|
|
Keloid
|
due to excessive collagen deposition
|
surprisingly small number of fibroblasts
|
|
Warthin-Finkeldey (WF) giant cell
|
pathognomonic for measles or the live attenuated measles vaccine
|
|
|
Sirolimus
|
hyperlipidemia, thrombocytopenia, leukopenia
|
|
|
Lesch-Nyhan syndrome
|
defective HGPRT
|
buildup of monosodium urate because HGPRT is not around to recycle purine bases, so they just turn into uric acid instead
|
|
Pseudomonas culture
|
blue green on iron-limited environment, colorless on blood agar
|
|
|
Natural Killer (NK) cells
|
carry out extracellular lysis of infected cells that do not have MHC I (RBCs)
|
|
|
Adverse offects of oxytocin
|
hyponatremia, seizures, subarachnoid hemorrhage
|
|
|
metabolic alkalosis
|
causes deprotonation of albumin COOH, resulting in COO- that can bind free calcium. Results in decreased free calcium levels
|
|
|
Gynecomastia of puberty
|
common in adolescents, frequently asymmetric and tender, usually regress before 20 years old
|
only reassurance is needed, no fine-needle aspiration
|
|
Glucocorticoids
|
normally catabolic in muscle and adipose tissue, but increase glycogen synthesis and accumulation in the liver
|
|
|
Difference between primary and secondary Addison's
|
Primary has hyperpigmentation and hyperkalemia while secondary doesn't
|
|
|
Thyroid cancer w/ amyloid
|
Medullary thyroid carcinoma
|
|
|
Albrighty's hereditary osteodystrophy
|
kidney unresponsiveness to PTH (pseudohypoparathyroidism)
|
hypocalcemia, shorted 4th/5th digits, short stature
|
|
Tangier disease
|
due to deficiency in ABCA1 cholesterol transporter (normally takes cholesterol from peripheral cells and attaches it to HDL to be transported back to the liver)
|
characteristic yellow-orange tonsils, lymph node enlargement, hepatomegaly, sensory neuropathy and muscle wasting of the hands; serum cholesterol is low due to lack of HDL
|
|
Potassium iodide
|
administered after radiation exposure (Chernobyl): competes with the converted radioactive iodide for the iodide pump. If enough is taken, normal iodide will saturate the thyroid gland and the radioactive iodide will be excreted
|
|
|
Diabetic ketoacidosis
|
more 3-hydroxybutyrate is made compared to acetoacetate
|
plasma catecholamines and glucogon are usually increased due to a shift in metabolism to a starvation state
|
|
Thiazolidinediones (pioglitazone, rosiglitazone)
|
antidiabetic agent that increase insulin sensitivity, specifically peripheral tissues by release of adipokines
|
contraindicated in heart failure
|
|
Androgen insensitivity syndrome
|
defect in androgen receptor
|
phenotypically female w/ inguinal hernia, primary amenorrhea, external female genitalia, no uterus, lack of axillary and pubic hair
|
|
Renal osteodystrophy
|
secondary hyperparathyroidism due to renal failure
|
kidney can't excrete sufficient phosphate, which leads to PTH release, which increases bone resoprtion, leading to pathological fractures
|
|
MEN 2B
|
medullary carcinoma of thyroid, pheochromocytoma, oral and intestinal ganglioneuromatosis, marfanoid habitus
|
|
|
Chronic renal insufficiency
|
defect in renin production, leads to low aldosterone levels
|
|
|
Lab findings in thyrotoxicosis
|
increase in free and total T4, decrease in TSH
|
also increase in serum Ca2+ (bone tunover), increase in serum glucose (glycogenolysis), and decrease in serum cholesterol
|
|
Sabouraud's agar
|
culture fungi
|
|
|
Heterophil mononucleosis test
|
positive in EBV, negative in CMV
|
|
|
activating mutation in the Ca-sensing receptor of the parathyroid
|
hypothyroidism
|
|
|
Anti-glutamate decarboxylase antibodies
|
Type I diabetes
|
|
|
Osteoporosis prevention
|
raloxifene
|
|
|
human chorionic gonadotropin
|
same hormone family as TSH, FSH, and LH
|
mutation in TSH receptor may make it sensitive to hCG, and this would increase thyroid hormone during the first 10 weeks of pregnancy
|
|
3-beta-hydroxysteroid dehydrogenase
|
fetal adrenal cortex lacks this enzyme and therefore synthesizes mostly DHEA
|
|
|
Thyrotoxic crisis
|
occurs most commonly in patients with untreated Graves' in the presence of stress or trauma
|
|
|
Methimazole, propothiouracil
|
side effect: aplastic anemia, agranulocytosis
|
|
|
MEN 1
|
commonly presents with angiofibromas and lipomas
|
|
|
Diazoxide
|
opens ATP-sensitive potassium channels, leading to hyperpolarization of the islet cells and inhibiting insulin release
|
useful in insulinomas
|
|
Hashimoto's thyroiditis
|
increased risk of non-Hodkin B-cell lymphoma
|
|
|
Familial hypocalciuric hypercalcemia (FHH)
|
mutation in calcium-sensing receptor gene (CaSR)
|
|
|
Normalizing serum glucose in diabetics
|
acutely -> epinephrine, chronically -> cortisol
|
glucagon response in diabetics is not seen for some reason
|
|
Kimmelstiel-Wilson nodule
|
ovoid, hyaline, PAS-positive structures found in mesangial core of glomerulus
|
seen in diabetics
|
|
soild balls of neoplastic follicular cells in thyroid
|
characteristic of papillary carcinoma
|
associated with history of radiation to the neck
|
|
finasteride
|
inhibits 5-alpha-reductase
|
used to treat BPH
|
|
Necrolytic migratory erythema (NME)
|
classic symptom observed in glucagonoma
|
erythematous blisters and swelling at areas of greater friction
|
|
Aldosterone deficiency
|
salt wasting in excess of water wasting
|
|
|
Infantile hypothyroidism
|
neonatal thyroxine levels may be normal because of maternal-fetal thyroxine transfer
|
|
|
Alpha-2 receptor agonists (clonidine)
|
directly inhibit pancreatic insulin secretion
|
|
|
glucagon
|
rapidly raises blood glucose levels and leads to stimulation of insulin levels
|
|
|
iodine staining intraepithelial inclusion bodies
|
clamydia trachomatis
|
most common bacterial cause of sexual trasnmitted disease, leads to PID
|
|
Pudendal nerve
|
innervates the perineum, wraps around the ischial spine
|
palpation of the ischial spine allows the physician to locate the pudendal nerve
|
|
Most common cause of spontaneous abortion
|
chromosomal abnormalities
|
usually the fetus is lost in the 1st trimester
|
|
Ectopic pregnancy
|
most commonly due to delayed transport of the blastocyst
|
|
|
Testicular torsion
|
twisting and torsion of the spermatic cord w/ occlusion of the testicular artery and vein
|
|
|
Tzanck smear
|
test for HSV by touching slide to opened vesicle and look for multinucleated giant cells
|
|
|
vaginitis w/ frothy yellow discharge
|
trichomonas vaginalis
|
|
|
Struma ovarii
|
unilateral ovarian mass w/ symptoms of hyperthyroidism
|
|
|
Schiller-duval bodies
|
pathognomonic for yol sac (endodermal sinus tumor), resemble glomeruli
|
|
|
Meigs' syndrome
|
ovarian fibroma, ascites, pleural effusion/hydrothorax
|
|
|
Walthard's rests
|
islands of bladder-like transitional epithelium within fibrous stroma
|
seen in Brenner tumor of the ovary
|
|
Progestin challenge
|
will cause menstrual bleeding and confirm anovulation in a patient
|
|
|
PID
|
chalmydia is the most common cause, leading to type IV hypersensitivity response in the fallopian tubes that may result in infertility
|
|
|
human placental lactogen (hPL)
|
secreted by syncytiotrophoblasts; concentration rises throughout pregnancy and is proportional to fetal mass
|
anti-insulin activity
|
|
Levonorgestrel
|
high dose progesterone that disrupts endometrium and prevents implantation
|
|
|
Bitot's spots
|
buildup o fkeratin debris in conjunctiva
|
|
|
Neimann-Pick disease type A
|
CNS involvement
|
compared to type B, where there is no CNS involvement
|
|
Infantile cirrhosis + hypotonia
|
Anderson's disease (type IV glycogen storage disease)
|
deficiency in alpha 4,6-glucosidase (glycogen branching enzyme)
|
|
Oral hairy leukoplakia
|
EBV infection in HIV patients
|
nontender, adherent whitish lesion on tongue or oral mucosa due to hyperproliferation of lingual epithelial cells
|
|
Lateral cervical cyst
|
derived from second pharyngeal cleft that didn't obliterate
|
|
|
Narcolepsy
|
hypnopompic hallucinations, sleep paralysis, cataplexy, sleep attacks
|
|
|
Spe-A, Spe-B, Spe-C
|
involved in scarlet fever, transmitted via lysogenic converesion
|
lysogenic conversion: DNA of a temperate phage is inserted into bacterial chromosome and expressed
|
|
Confidence interval
|
Sample mean +/- Z * [SD/sqrt(n)]
|
|
|
Lymphocyte common antigen (LCA)
|
used to determine if there is a lymphoma
|
|
|
DNA footprinting
|
detect specific protein binding to DNA molecules by comparing fragmentation patterns of DNA w/ protein bound vs. protein unbound
|
|
|
Decidua basalis
|
composed of endometrium between the chorionic villi and the myometrium
|
derived from the mother
|
|
Fluoroquinolones
|
resistance to the topoisomerase inhibitor encoded on the chromosome
|
resistance via efflux pumps is encoded on plasmids
|
|
Enzyme assays
|
use amount of enzyme at Vmax so that the results are dependent on the amount of substrate
|
|
|
myofibroblasts
|
specialized subset of fibroblasts that express contractile proteins (actin and myosin)
|
principal mediators of wound contraction, which results in aesthetic and functional deficits
|
|
Down's syndrome due to mosaicism
|
mosaic Down syndrome patients have IQ scores that are 10-30 points higher than individuals with classic Down syndrome
|
|
|
Multi-drug resistance
|
transposons
|
|
|
direct inguinal hernia
|
passes medial to inferior epigastric artery
|
|
|
Her-2/Neu
|
receptor w/ intrinsic tyrosine kinase activity
|
|
|
Anticholinergic agents
|
anti-SLUDG properties: salivation, lacrimation, urination, defecation, gastrointestinal slowing
|
|
|
Second generation anti-histamines
|
few anticholingergic side effects
|
|
|
Struma ovarii
|
monodermal teratoma
|
|
|
Bowen disease
|
penile carcinoma in situ, solitary-whitish plaque that doesn't invade the basement membrane
|
|
|
Vaginal candidiasis
|
diagnosed by performing the germ-tube test (inoculation of a sample into animal serum)
|
|
|
Arthroconidia
|
diagnostic of dermatophytes
|
|
|
Hyphae w/ rosettes of microconidia
|
sporothrix schenckii
|
|
|
macroconidia
|
histoplasma cpasulatum
|
|
|
Septic arthritis in otherwise healthy, sexually active adults
|
N. gonorrhea
|
|
|
Focal fat necrosis of breast
|
multinucleated giant cell reaction, frequently due to trauma
|
|
|
parvovirus
|
exposure to pregnant women in first trimester may result in a fetus with aplastic anemia which leads to non-immune hydrops fetalis
|
|
|
Syphilis tests
|
VDRL to rule out, FTA-ABS to rule in
|
|
|
microhemagglutination test
|
treponeme-specific serologic test
|
|
|
Batson venous plexus
|
hematogenous spread of prostate cancer to vertebrae and pelvic bone
|
|
|
Kallmann's syndrome
|
autosomal dominant, maldevelopment of olfactory bulbs and GnRH-producing cells
|
|
|
Paget's disease
|
mucin is periodic acid-schiff (PAS) positive
|
|
|
Rokitansky-Kuster Hauser (RKH) syndrome
|
absence of upper vagina and uterus
|
|
|
Arias-stella phenomenon
|
exaggerated secretory phase during pregnancy
|
|
|
Endometritis
|
chronic due to IUD = actinomyces
|
|
|
Rectal pouch of douglas
|
site for collection of blood, malignant cells, pus, endometrial implants
|
|
|
Stromal hyperthecosis
|
bilateral ovarian enlargement, vacuolated stromal hilar cells that synthesize excess androgens, leading to hirsutism
|
|
|
Ritter's disease
|
staphylococcal scalded skin syndrome in newborns
|
|
|
Acanthosis nigricans
|
hyperplasia of stratum spinosum
|
|
|
Marjolin ulcer
|
SCC that arises from non-healing ulcer, burn wound, or osteomyelitis
|
|
|
Follicle that contains a primary oocyte surrounded by a single layer of flattened follicular cells
|
primitive and primordial follicles
|
|
|
oocyte surrounded by one or several cuboidal follicular cells
|
primary follicles
|
|
|
follicle that extends through the entire cortex and bulges at the ovarian surface
|
graafian follicle
|
|
|
Secondary follicle
|
oocyte surrounded by several layers of follicular cells and a small antrum (antrum is due to several spaces of the follicular mass fusing together)
|
|
|
Preeclampsia
|
cerebral hemorrhage and ARDS are most common causes of death
|
|
|
CA-125
|
tumor marker for papillary cystadenocarcinoma and other tumor types
|
|
|
Premature menopause
|
reduced inhibin levels, which may lead to increased FSH levels
|
|
|
Verrucous lesion of vulva w/ tree-like proliferation of epithelium and fibrous stroma
|
HPV
|
|
|
hGH (growth hormone)
|
produced by the placenta during pregnancy
|
|
|
Testicular tumor w/ fibrous septa containing numerous lymphocytes
|
seminoma
|
|
|
Sertoli-only syndrome
|
only sertoli cells are present (germinal cell aplasia), spermatogenesis is absent
|
|
|
ulcerative genital lesion w/ pain and inguinal lymphadenopathy
|
Haemophilus ducreyi: gram-negative, pleomorphic rod w/ characteristic "school of fish" pattern on gram-stain
|
|
|
Granuloma inguinale
|
Klebsiella granulomatis
|
|
|
Dysfunctional uterine bleeding
|
most commonly due to anovulatory cycles
|
|
|
Chlamydia trachomatis
|
unable to make ATP
|
|
|
Intraductal papilloma
|
benign, neoplastic tumors typically located near the nipple under the areola
|
|
|
Endometrium w/ long, narrow, coiled glands lined by a single layer of columnar epithelium showing regular, uniform, small nuclei, and apical secretory vesicles
|
secretory epithelium
|
|
|
Choriocarcinoma
|
likes to go to the lungs
|
|
|
Radical mastectomy
|
remove underlying tumor, axillary lymph nodes, some pectoralis
|
|
|
18-alpha hydroxylase
|
aldosterone synthase
|
|
|
Progression of high grade cervical dysplasia
|
60% presist at the same level of dysplasia
|
|
|
N. gonorrhoea
|
pili is the most important mechanism of pathogenesis; promotes adherence to mucosa and protection from phagocytosis, also antigenic variation
|
|
|
acute epididymitis and orchitis
|
N. gonorrhoea and C. trachomatis
|
|
|
Chronic endometritis
|
inflammatory infiltrate of lymphocytes, plasma cells, histiocytes
|
|
|
HPV
|
mechanism of pathogenesis similar to retinoblastoma and osteosarcoma
|
|
|
Breast cancer metastasis to bone
|
unusual in that it causes both lytic and blastic lesions
|
|
|
Neonatal pneumonia preceeded by conjunctivitis
|
Chlamydia
|
may present with a staccato cough, CXR w/ scattered infiltrates and hyperinflation of lungs
|
|
Congenital lipoid adrenal hyperplasia
|
mutation in steroidogenic acute regulatory protein (StAR): protein necessary for transport of cholesterol from the outer to inner mitochondrial membrane in adrenals and gonad
|
deficiency in all steroid hormones (C21, C17, C18), absent response to ACTH and hCG, large, lipid-laden adrenals
|
|
mixed testicular tumor
|
male testicular tumor composed of multiple types of various tumors
|
|
|
HTN and proteinuria before 20 weeks gestation
|
hydatidiform mole
|
|
|
Vagina swab of prepubertal girls and postmenopausal women
|
Staphlyococcus epidermidis
|
|
|
Acute bacterial prostatitis
|
E. coli (over 35 years old)
|
|
|
Dinoprostone
|
prostaglandin E2
|
induces cervical softening and effacement, cervix to dilate, uterus to contract, helps induce labor
|
|
Orchitis w/ obliterative endarteritis
|
syphilis
|
|
|
Bartholin's gland cyst
|
obstruction, usually a sequela of a previous infection, leading to pain and swelling of the posterolateral part of the labia majora
|
|
|
Chronic ACL injuries
|
involve damage to medial meniscus (not lateral like acute ACL injuries)
|
|
|
Triad junction
|
consists of the T-tubule, the sarcoplasmic reticulum, and the 15 nm space between them
|
|
|
anterior shoulder dislocation
|
externally rotated and abducted
|
|
|
posterior shoulder dislocation
|
internally rotated and adducted
|
|
|
I band
|
most common site for muscle strains because it consists only of actin filaments
|
|
|
Trendelenburg sign
|
abnormal gait caused by weakness of abductor muscles of lower extremities due to lesion of the superior gluteal nerve
|
|
|
osteoid
|
newly formed bone matrix
|
|
|
Carbonic anhydrase II deficiency
|
autosomal recessive, triad of osteoporosis, renal tubular acidosis, and cerebral calcifications
|
CA II: generates carbonic acid from water and carbon dioxide
|
|
McCune-Albright syndrome
|
4 Ps: polyostotic fibrous dysplasia, pigmented skin lesions, precocious puberty
|
caused by non-inherited postzygotic activating mutation of Gs subunit leading to constitutive activity; example of genetic mosaicism
|
|
Gardner syndrome
|
autosomal dominant variant of FAP w/ osteomas, desmoid tumors, dental abnormalities, congenital hypertrophy of retinal pigmented epithelium, skin tumors, and extracolonic cancers (thyroid, hepatobiliary, CNS)
|
|
|
Ollier's syndrome
|
multiple enchondromas w/ 10-25% chance of malignant transformation to chondrosarcoma
|
|
|
Maffucci's syndrome
|
multiple enchondromas and soft tissue hemangiomas w/ 100% chance of malignant transformation to chondrosarcoma
|
|
|
Complications of osteomyelitis
|
sequestrum: areas of bone necrosis due to acute inflammation -> involucrum: new bone growth that forms a sheath around dead bone
|
|
|
Legg-calve-perthes disease
|
aseptic necrosis of femoral head ossification center, possibly due to problems w/ the medial femoral circumflex artery (main supply to the head of the femur)
|
clinical picture: limp to avoid pain (pain is usually in the anterior thigh) or painless limp, irregular appearance of the capital femoral epiphysis on xray,
|
|
osteochondritis dessicans
|
trauma to articular epiphysis -> ischmeia -> aseptic necrosis and failure of articular epiphyses
|
|
|
pannus
|
granulation tissue rich in inflammatory cells and fibroblasts that proliferates and releases cytokines -> destruction of articular cartilage w/ reactive fibrosis and eventual akylosis
|
|
|
RA treatment
|
First line: NSAIDS, DMARDs (disease-modifying antirheumatic drugs) such as sulfasalazine, hydroxychloroqiune, MTX
|
Second line: TNF-alpha inhibitors, Leflunomide (inhibits pyrimidine synthesis), Rituximab (anti-CD20 antibody binds CD20 on surface of B-cells leading to their destruction)
|
|
Felty's syndrome
|
RA + splenomegaly + leukopenia
|
|
|
Caplan syndrome
|
RA + intrapulmonary rheumatoid nodules + pneumoconiosis
|
|
|
Popliteal (Baker's) Cyst
|
increased intra-articular pressure -> outpouching of snovial sack posterior to knee
|
|
|
Congenital 3rd degree heart block
|
SS-A and SS-B antibodies can cross placenta and target AV node, leading to destruction
|
|
|
Ankylosing spondylitis extra-articular manifestations
|
anterior uveitis (monocular pain, photophobia, blurry vision), aortitis/aortic regurgitation, cardiac conduction defects (3rd degree block), involvement of thoracic spine -> decreased chest expansion -> restrictive pattern on PFTs
|
|
|
Reiter sndrome
|
classic triad (conjunctivitis, urethritis, arthritis)
|
also oral ulcers, keratoderma blenorrhagica (erythematous scaly hyperkeratotic skin lesions on palms and soles), circinate balanitis (red scaly area on glans penis w/ gray serpiginous annular edge that spreads outwards in phases
|
|
Drug induced lupus
|
Q CHIMPP: quinidine, chlorpromazine, hydralazine, isoniazid, methyldopa, penicillamine, procainamide
|
anti-histone antibodies
|
|
Chronic infectious arthritis
|
TB, Lyme disease
|
|
|
Myasthenia gravis
|
follicular B-cell hyperplasia in thymus, thymoma
|
|
|
Lambert-Eaton syndrome
|
small cell lung carcinoma
|
|
|
Dermatomyositis
|
antibody-mediated damage to blood vessels surrounding muscle fascicles -> perfascicular inflammation and atrophy
|
|
|
Sarcoidosis
|
lung (pulmonary fibrosis), skin (erythema nodosum w/ Schaumann and asteroid bodies), Eyes (anterior uveitis)
|
epithelioid histiocytes needed on biopsy for diagnosis; asteroid bodies and giant cells are also seen, but not required
|
|
Linoleic acid
|
precursor for arachadonic acid and essential fatty acid needed in diet
|
|
|
recurrent miscarriages in the first trimester
|
chromosomal abnormalities (robertsonian translocation)
|
|
|
Congenital CMV
|
heptaosplenomegaly, periventricular brain calcification, petechial hemorrhage (blueberry muffin rash),
|
|
|
Familial gonadotropin-independent premature Leydig cell maturation
|
mutation in the LH receptor causes it to be constitutively active
|
elevated testosterone, suppressed gonadotropin levels, Leydig cell hyperplasia, seminiferous tubule dysgenesis
|
|
Barr body
|
inactivation of X chromosome
|
seen in Klinefelters as well as in normal females
|
|
LH receptors on Granulosa cells
|
as follicle approaches ovulation, LH receptors begin to be expressed by granulosa cells, probably as a response to increased estrogen and FSH
|
|
|
Congenital syphilis
|
saddle nose, Hutchinson's teeth, mulberry molars, saber shins, interstitial keratitis, deafness
|
treat w/ penicillin
|
|
Café-au-lait spots
|
due to peripheral nerve tumors that induce hyperpigmentation of overlying skin
|
seen in tuberous sclerosis
|
|
Gonococcal arthritis
|
petechial rash, tenosynovitis, involvement of ankles and knees
|
|
|
fibrillin
|
component of elastin-associated microfibrils
|
abnormal in Marfan
|
|
HLA-B27
|
seronegative spondyloarthropathies, acute anterior uveitis
|
|
|
Malignant otitis externa
|
caused by P. aeruginosa, may spread to mastoid bone, temporal bone, sinuses, meninges, and brain
|
pseudomonas associated w/ ecthyma gangrenosum
|
|
Familial pulmonary hypertension
|
inactivating mutation in BMPR2 gene
|
BMPR2 gene normally functions to inhibit vascular smooth muscle proliferation
|
|
Solubility of oxygen in blood
|
inversely related to temperature (increase in temperature = decrease in O2 solubility)
|
oxygen content in blood = (Hb*1.34*%sat) + (0.0031*PaO2)
|
|
Charcot-Leyden crystals
|
hexagonal, double-pointed, needle-like crystals in bronchial secretions in asthmatic patients
|
|
|
Curschmann's spirals
|
desquamated epithelium casts in sputum seen in asthmatic patients
|
can lead to whorled mucous plugs
|
|
osteopetrosis
|
genetic disease characterized by reduced osteoclast activity resulting in diffuse symmetric skeletal sclerosis
|
leads to pancytopenia due to domnation of the marrow
|
|
Mosaic pattern of newly formed woven bone
|
paget's disease
|
increased risk of osteosarcoma
|
|
Steroid myopathy
|
caused by exogenous corticosteroid use or Cushing disease
|
can lead to insidious onset of muscle weakness of the proximal muscles w/ preferential atrophy of type II fibers
|
|
Inclusion body myositis
|
usually involves both distal and proximal muscles
|
inclusion bodies seen on biopsy (large rimmed vacuoles in muscle fibers)
|
|
Cleidocranial dysostosis
|
absence of part of the clavicles w/ broad skull, facial and dental anomalies
|
disorder of intramembranous ossification bones
|
|
Clubbing of nails
|
associated w/ lung cancer, mesothelioma, bronchiectasis, congenital cyanotic heart disease, hepatic cirrhosis
|
in these conditions, the clubbing is accompanied by formation of new subperiosteal bone (hypertrophic osteoarthropathy)
|
|
Energy use during exercise
|
0-10 seconds: stored ATP, creatine phosphate; 10-100 seconds: glycogen;
|
|
|
Basic calcium phosphate
|
seen in apatite-associated arthropathy
|
produces spherical clumps of nonbirefringent submicroscopic crystals
|
|
Gout
|
possibly abnormality in purine salvage pathway
|
|
|
bacillus anthracis
|
boxcar-shaped, gram positive rod
|
|
|
extension of thumb
|
radial nerve only
|
innervates extensor pollicus brevis and longus
|
|
Long-term glucocorticoid use
|
hypocalcemia (decreased Ca2+ uptake in the gut)
|
|
|
Crutches
|
damage to radial nerve
|
|
|
Median nerve
|
only nerve that traverses the carpal tunnel
|
|
|
Still's disease
|
seen in Juvenile rheumatoid arthritis (JRA)
|
fever, rash, polyarthritis
|
|
Juvenile rheumatoid arthritis
|
polyarticular JRA: disabling arthritis predominates
|
Pauciarticular JRA: arthritis limited to a few joints, uveitis w/ portential for blindness
|
|
Lead poisoning
|
associated w/ gout due to interstitial nephritis that leads to decreased excretion
|
|
|
myotonic dystrophy
|
most common adult muscular dystrophy, selective atrophy of type I fibers
|
autosomal dominant CTG repeat -> facial muscle weakness, sustained grip, frontal balding, cataracts, cardiac involvement (conduction defects)
|
|
Dupuytren's contracture
|
fibromatosis involving palmar fascia leads to contraction of single or multiple fingers
|
associated w/ alcoholism
|
|
Desmoid tumor
|
fibromatosis of anterior abdominal wall in women
|
associated w/ previous trauma and Gardner's polyposis syndrome
|
|
periosteum
|
torn during fracture -> supplies osteoblasts to produce new bone that reunites the two ends
|
can lead to hetertopic ossification (bone formed outside the regular bone)
|
|
Fracture of neck of fibula
|
damage to peroneal nerve
|
|
|
Erythema multiforme
|
erythematous patches w/ pale, vesicular, or eroded centers (target lesions) due to immune complex deposition in dermal blood vessels
|
causes: certain infections (HSV, enteroviruses, mycoplasma), drugs, neoplasia, foods; pathogenesis related to HSV involves triggering CD8+ cytotoxic cells -> apoptosis of some keratinocytes
|
|
Rubella
|
fine rash that begins at hairline and spreads down to torso in a child that is not very ill
|
also see cervical lymphadenopathy, NO KOPLIK
|
|
Avulsion of lesser trocanter
|
due to sudden strain of muscle that leads to reflex contraction that breaks the bone
|
psoas major inserts at the lesser trochanter
|
|
Schaumann and asteroid bodies
|
sarcoidosis
|
lupus pernio (rash on nose and cheeks) is also seen
|
|
Coal miner's pneumoconiosis
|
simple CWP: scattered coal macules in upper lobe
|
complicated CWP: requires years to develop, progression from simple CWP, lesions throughout lungs
|
|
Anthracosis
|
benign accumulation of coal dust found in urban dwellers
|
|
|
Therapeutic supplemental O2 in NRDS
|
retinopathy of prematurity and bronchopulmonary dysplasia
|
|
|
recurrent idiopathic pleural effusions
|
mesothelioma presentation
|
|
|
surfactant synthesis
|
increased cortisol, prolactin, thyroxine
|
decreased insulin
|
|
Long-thoracic nerve
|
innervates the serratus anterior
|
|
|
pearly papules
|
basal cell carcinoma
|
palisading of basal cell-like nuclei at edge of clusters of cells penetrating into the dermis
|
|
genioglossus muscle
|
protrude the tongue
|
|
|
hypoglossus muscle
|
retract the tongue
|
|
|
palatoglossus muscle
|
retract tongue and upward towards the palate
|
|
|
scaphoid fracture
|
pain in the anatomic snuffbox after a fall on outstretched hands is pathognomonic
|
|
|
Axillary sheath
|
contains the axillary artery, 3 cords of the brachial plexus and is found in the axilla
|
|
|
anterior displacement of humerus
|
damage to axillary nerve
|
|
|
basophilic rhomboid crystals
|
calcium pyrophosphate crystals
|
seen in pseudogout, radiographically dense, unlike the crystals of gouty arthritis
|
|
Pulmonary embolism
|
presents with the combination of respiratory alkalosis and hypoxemia
|
V/Q scan shows decreasd perfusion with areas of normal ventilation
|
|
Rubella
|
fine rash that begins at hairline and spreads down to torso in a child that is not very ill
|
also see cervical lymphadenopathy, NO KOPLIK
|
|
Hampton's hump
|
wedge shaped area of infarcted tissue seen in PE
|
|
|
Methenamine silver stain
|
Pneumocystis jiroveci
|
|
|
Owl eye inclusions in immunocompromised/immunosuppressed individual
|
CMV
|
|
|
Emphysema
|
loss of elastic recoil -> decreased FEV1, increased residual volume, increased TLC
|
|
|
Old age lungs
|
decreased elastic recoil and increased distensibility (compliance) of the lungs
|
|
|
Aspiration of food
|
leads to V/Q mismatch
|
|
|
bacterial abscess
|
results from bronchial obstruction or aspiration of oropharyngeal contents (especially in those predisposed to loss of consciousness)
|
|
|
Forscheimer spots
|
red spots on soft and hard palate, seen in Rubella
|
|
|
Body, head, or pubic louse
|
treat w/ permethrin
|
|
|
Leser-trelat
|
rapid increase in number of sborrheic keratosis
|
phenotypic marker for stomach adenocarcinoma
|
|
Ichthyosis vulgaris
|
most common inherited skin disorder (AD) w/ inreased thickness of stratum corneum
|
|
|
Munro microabscesses
|
neutrophil collections in stratum corneum seen in Psoriasis
|
|
|
terbinafine
|
treat onychomycosis
|
|
|
RA biopsy
|
proliferative synovitis w/ many lymphocytes, macrophages, and plasma cells because it is a chronic process
|
subcutaneous nodules seen in RA are areas of fibrinoid necrosis surrounded by palisading epitheliod cells
|
|
Muscle tension
|
passive tension (preload) increases as the muscle is stretched beyond it's resting length
|
total tension is passive tension + active tension. Active tension cannot be measured so must therefore be estimated using total tension - passive tension
|
|
Re-epithelialization
|
ingrowth of epidermal cells from underlying skin appendages such as hair follicles and sweat glands of the dermis
|
|
|
Pseudo-horn cysts
|
seborrheic keratosis
|
|
|
Short saphenous vein and lymph drainage
|
drains lateral side of dorsum of foot and runs on the posterior side to drain in to the popliteal lymph nodes
|
|
|
Long saphenous vein and lymph drainage
|
drains and runs on the medial side of the leg and drains into inguinal lymph nodes
|
|
|
Splay
|
glucosuria when seurm glucose is above 180 but below 350, and the transporters aren't quite saturated
|
due to nephron heterogeneity and low affinity of the Na-Glu transporters
|
|
Aliskerin
|
blocks renin activity
|
|
|
Posterior dislocation of the clavicle
|
impingement onto the trachea
|
|
|
Gluteus medius/superior gluteal nerve
|
trendelenberg sign: stand on 1 leg and contralateral hip drops
|
|
|
Most common lung cancer
|
bronchogenic adenocarcinoma
|
even though it's the most common in non-smokers, it's also the most common in smokers
|
|
Oral candidiasis
|
nystatin "swish and swallow"
|
|
|
Succinylcholine
|
depolarizing skeletal muscle relaxant; prolonged use may lead to release of substantial amounts of K+ -> hyperkalemia and arrythmias
|
|
|
Erb's palsy
|
due to defect in C5, C6 (musculocutaneous nerve) -> problem w/ biceps brachii
|
|
|
Protein/serum ratio > 0.5
|
exudate
|
|
|
Reiter's syndrome
|
Ureaplasma, Campylobacter, Chalmydia, Shigella, Salmonella, Yersinia
|
|
|
Resistance in pseudomonas
|
mutation of a porin protein
|
|
|
Treatment of cutaneous burns
|
silver sulfadiazine or mafenide (if they have sulfa allergy)
|
cidal for gram negative, gram positive bacteria, as well as fungi
|
|
Fusobacterium
|
anaerobe seen in lung abscesses
|
anaerobes like bacteroides, fusobacteirum, and peptococcus are all found in the oral cavity
|
|
lung cancer specifically associated w/ lung scarring and old granulomatous disease
|
adenocarcinoma
|
found peripherally
|
|
BPH
|
most common cause of postrenal azotemia
|
|
|
calsequestrin
|
binds Ca2+ after depolarization and as the muscle relaxes
|
|
|
Mannitol salt agar
|
Staph aureus can ferment mannitol, turning it yellow
|
|
|
MPGN type I
|
associated w/ secondary causes of MPGN such as HBV, HCV, syphilis, malaria
|
|
|
Goodpasture syndrome
|
renal crescentic glomerulonephritis + pulmonary involvement
|
anti-GBM antibodies can cross-react w/ pulmonary alveolar basement membranes
|
|
Alport syndrome
|
triad: hereditary nephritis, sensorineural deafness, ocular abnormalities
|
due to defect in collagen IV
|
|
WAGR complex
|
Wilms' tumor, Aniridia, Genitourinary malformation, mental-motor Retardation
|
Wilms': due to deletion of WT1 and WT2 on chromosome 11; Aniridia: due to deletion of PAX6 on chromosome 11
|
|
blunting of calyces
|
Chronic pyelonephritis due to chronic vesicoureteral reflux
|
|
|
Dent's disease
|
x-linked recessive condition of proximal tubule
|
leads to hypercalciuria and calcium kidney stones
|
|
Max velocity of shortening of muscle
|
due to rate of ccling of crossbridge attachments, which is basically hydrolysis of ATP (dependent on myosin ATPase)
|
|
|
Chylous effusion
|
unusual milky-white fluid that separates into a thin white layer (cells) and thicker clear layer (triglycerides)
|
|
|
Step pneumoniae pneumonia treatment
|
azithromycin
|
|
|
P-pili of E. coli
|
play a role in pathogenesis of UTIs
|
|
|
Ciprofloxacin
|
cytochrome inhibitor
|
used to treat H. influenza
|
|
Diuretics and creatinine clearance
|
loop diuretics are effective down to a GFR of 10
|
thiazide and potassium-sparing diuretics are effective only down to 40
|
|
Dialysis cysts
|
small shrunken kidneys with large cysts
|
|
|
nitrate test
|
most Enterobacteriaceae (gram-negative enteric rods) are able to form nitrite from nitrate
|
thus, this test is used to determine if a UTI is caused by enterobacteriaceae
|
|
Expiratory flow rate
|
the "effort-independent" portion of the curve is because the airways are collapsing and the patient can't blow air out any quicker
|
|
|
Pickwickian syndrome
|
morbidly obese individual w/ fatty neck causes intermittent airway obstruction that leads to acute respiratory acidosis
|
reduced O2, increase CO2, reduced pH, modestly increased bicarb
|
|
oxybutynin
|
antispasmodic effect on smooth muscle and inhibits the ACh action
|
treatment of urinary incontinence
|
|
Plasmacytoma
|
mass found in bone or oronasopharynx (involving soft tissue)
|
associated w/ a mild M-spike of IgG, may eventuall develop into multiple myeloma after 10-20 years
|
|
Lung abscess
|
MCC staph aureus, anaerobes
|
|
|
Mycoplasma pneumonia tx
|
Erythromycin
|
|
|
Reserpine
|
inhibits VMAT
|
allows degradation of dopamine by MOA
|
|
AA amyloid in glomerulus
|
tuberculosis and other chronic antigenic inflammatory diseases
|
|
|
Corticosteroid effect on bone
|
increase osteoclastic function as well as inhibit osteoblastic function
|
|
|
Bartter's syndrome
|
decreased NaCl transport in the ascending loop of Henle and early distal tubule
|
leads to hypochloremic, hypokalemic, hypercalciuric, hypotensive metabolic alkalosis. Resultant increase in ATII levels leads to ATII insensitivity of the vascular smooth muscle
|
|
Auramine-rhodamine stain
|
indicates mycobacterium tuberculosis
|
|
|
Nitrofurantoin
|
damages bacterial DNA
|
used for recurrent UTIs, side effects include pulmonary fibrosis and G6PD hemolytic anemia
|
|
Vulvovaginal candidiasis tx
|
miconazole, clotrimazole
|
|
|
Crush injury
|
leads to release of K+ from muscle and hyperkalemia
|
|
|
Peripheral chemoreceptors
|
respond first, before central chemoreceptors, to changes in PaCO2
|
|
|
Collagen IV
|
found in basement membrane, as well as the lens of the eye
|
|
|
ACE inhibitors
|
decreased GFR and further exacerbate acute renal failure
|
|
|
Cyclosporine
|
nephrotoxicity -> increased BUN and creatinine
|
|
|
Klebsiella pneumonia tx
|
third generation cephalosporin (cefotaxime, ceftriaxone, ceftazidime)
|
|
|
Acetazolamide
|
only diuretic that acts upstream of the macula densa -> increases NaCl in the rest of the tubules
|
results in the macula densa sensing more NaCl, which leads to constriction of the afferent arteriole
|
|
Acute salicylate poisoning
|
cause acute respiratory alkalosis and eventual metabolic acidosis
|
|
|
Acute salicylate poisoning
|
cause acute respiratory alkalosis and eventual metabolic acidosis
|
|
|
Lysogenic phase in bacteria
|
ShigA toxin, Botulinum, Clostridium, Diphtheria, Erythrogenic exotoxins of strep
|
ABCDE
|
|
Cooperative play in children
|
begins at 4 years of age
|
|
|
Liquefactive necrosis
|
result of hydrolytic enzymes released from dying cells
|
|
|
Maternal estriol blood levels
|
best indicator of fetal well-being
|
significant drop in maternal estriol may indicate fetal jeopardy
|
|
LFA-1 and ICAM-1
|
interaction necessary for tight binding of white cells to the endothelium which allows them to leave the vessel to go to an area of injury
|
|
|
chronic alcohol and smoking
|
induce cytochrome P450
|
|
|
Raw oysters, contaminated seafood
|
Vibrio vulnificus, V. parahaemolyticus
|
gram (-), comma-shaped rods that are isolated on alkaline media
|
|
Type I Hypersensitivity
|
IL-4 is produced to stimulate production of IgE
|
|
|
Vibrio toxin
|
similar to ETEC toxin
|
both activate adenylate cyclase by ADP ribosylation of GTP-binding protein
|
|
Ketotifen
|
selective, non-competitive histamine receptor antagonist and mast cell stabilizer
|
|
|
Acute cholecystitis
|
treat w/ third generation cephalosporin
|
treats gram negative, gram positive, and some anaerobes
|
|
Most common gram (-) rod that infects children from maternal contamination in the birth canal
|
E. coli
|
K1 is an important capsule antigen that aids in neonatal disease
|
|
Scalene triangle syndrome (thoracic outlet syndrome)
|
when the lower trunk of the brachial plexus and the subclavian artery are compressed between the anterior scalene and the middle scalene
|
|
|
Aspirin-induced asthma
|
inhibition of the cyclooxygenase pathway leads to too much leukotriene and bronchial constriction
|
|
|
Pertussis
|
bordetella pertussis increases histamine sensitivity, blocks lymphocytosis, increases cAMP (leads to edema), and also increases insulin secretion (leads to hypoglycemia)
|
|
|
ketolorac
|
NSAID
|
|
|
Irritation of liver
|
results in irriration of phrenic nerve -> pain in the right upper quadrant + radiant pain to the shoulder region
|
|
|
Restrictive lung disease
|
increased elasticity, decreased compliance
|
|
|
Psoas abscess
|
spinal infection (classically tuberculosis) spreads along the psoas sheath
|
leads to bulge on flank and contralateral buldge on groin
|
|
tyrosine
|
aromatic amino acid
|
|
|
most common cause of death in cirrhosis
|
esophageal variceal rupture
|
|
|
pneumomediastinum in the setting of vomiting
|
Boerhaave syndrome
|
|
|
Pneumaturia
|
colovesical fistula, may be caused by diverticulosis
|
|
|
Intensely PAS-positive bacteria
|
Tropheryma whippelii
|
causes Whipple's disease: arthralgias, diarrhea, lymphadenopathy; can also have cardiac and neuro manifestations
|
|
Reyes syndrome in Kawasaki disease
|
children and teens w/ kawasaki who require aspirin therapy SHOULD NOT discontinue aspirin and should consider vaccination to avoid viral infection
|
|
|
Recurrent infections, thrombocytopenia, eczema
|
Wiskott-aldrich syndrome
|
|
|
Renal failure diet
|
designed to control the amount of protein and phosphorus in a patient's diet: high-carbs, moderately fatty diet, limit sodium, limit total fluid intake
|
|
|
Tolterodine
|
blockade of muscarinic ACh receptors in bladder wall is used to reduce the effect of parasympathetic hyperactivity in patients w/ spinal cord transection that have incontinence
|
|
|
Vasa recta
|
poorly oxygenated part of kidney, can become an area of sickling
|
|
|
Recurrent acute pyelonephritis
|
kidney stones
|
|
|
Increased arterial CO2 effect on brain
|
increased CO2 dilates blood vessels in the brain leading to increased flow, while decreased CO2 leads to vasoconstriction
|
think about it this way: hyperventilation leads to dizziness, which means that your brain is not getting enough O2 because the blood vessels are constricting because CO2 levels are low
|
|
Mycobacterium avium intracellulare treatment
|
clarithromycin, rifabutin, and ethambutol
|
|
|
CFTR
|
Anionic channel that is gated by ATP hydrolysis and involves regulation by protein kinase A
|
|
|
Vulvovaginitis
|
associated w/ high vaginal pH, diabetes, and use of antibiotics
|
|
|
Alosetron
|
5-HT3 antagonist used for diarrhea-predominant irritable bowel syndrome
|
restricted access usage in US because of serious gastrointestinal adverse effects like ischemic colitis
|
|
Kaposi sarcoma
|
spindle-cell neoplasm that is highly associated w/ AIDS and HHV-8
|
similar in appearance to angiosarcoma (proliferating stromal cells and endothelium creating vascular channels that contain blood cells)
|
|
Budd-chiari
|
caused by polycythemia vera, OCPs, pregnancy, HCC, chronic infections
|
|
|
PAS-positive stuff
|
alpha1-antitrypsin globules in liver, Kimmelsteil-Wilson nodules in kidney, Paget's disease of the nipple
|
|
|
Neonate w/ cirrhosis and E. coli sepsis
|
Galactosemia due to galactose-1-phosphate uridyltransferase (GALT) deficiency
|
|
|
hemochromatosis
|
classic triad: micronodular cirrhosis, Diabetes Mellitus, bronze skin pigmentation
|
|
|
Protozoa that infects small intestine and look crescent-shaped next to the epithelial brush border
|
giardia lamblia
|
|
|
Entamoeba histolytica
|
usually infects the large intestine or liver
|
|
|
Necrotizing enterocolitis
|
most common when infants are started on oral foods, especially formula fed children
|
present w/ distended abdomen and gangrene of the terminal ileum and ascending colon
|
|
Increased IL-10
|
can decrease contact dermatitis
|
IL-10 is produced by TH2 and inhibits TH1 (stimulate cell-mediated immunity and delayed hypersensitivity)
|
|
Prolonged antibiotics
|
deficiency in gut bacteria lead to vitamin K deficiency -> bleeding and blood in stools
|
|
|
RUQ pain + bloody diarrhea
|
Entamoeba histolytica
|
|
|
Parvovirus in adults
|
no slapped cheeks, instead arthralgias and arthritis
|
|
|
Lipoprotein lipase
|
located on the luminal surface of vascular endothelium of adipose tissue
|
|
|
MI necrotic changes on light microscopy
|
become evident after 4-12 hours
|
3 days: coag necrosis will advance and neutrophils will invade; 5-7 days: necrotic debris is removed and granulation tissue is formed
|
|
Trientine
|
second line agent for Wilson's disease
|
because 30% of patients can't handle long term penicillamine
|
|
Wilson's disease diagnosis
|
slit-lamp examination of the eyes demonstrates Kayser-Fleischer rings in Descemet membrane of the cornea
|
|
|
Gastric carcinoma
|
H. pylori is the strongest association, followed by smoking, then pernicious anemia, then EtOH
|
|
|
Menkes disease (Elhers-Danlos type IX)
|
depigmented, lusterless hair along w/ facial, ocular, vascular, and cerebral manifestations
|
due to a mutation in copper transport that leads to a defective Lysyl Oxidase enzyme, which is responsible for crosslinking collagen fibers
|
|
bifid ventral pancreatic bud
|
causes rotation around the duodenum distal to the ampulla of vater, which leads to obstruction
|
presents w/ bilious vomiting, polyhydramnios, double bubble sign
|
|
Thiazolidinediones (pioglitazone, rosiglitazone)
|
decreases TGs, insulin, Glucose levels, and increases HDL
|
|
|
Gastric heterotopia
|
occurs in small intestine and can produce enough acid to cause PUD
|
|
|
Amoebae w/ ingested erythrocytes
|
entamoeba histolytica
|
|
|
Choledocholithiasis
|
colicky RUQ pain
|
compared to cholecystitis, which is constant RUQ pain
|
|
Lactulose
|
given for treatment of hepatic encephalopathy
|
lactulose is degraded by gut bacteria, resulting in acidic pH, which shifts the equilibrium from NH3 to NH4+ and this minimizes gut absorption of ammonia
|
|
Medium-chain acyl CoA dehydrogenase (MCAD) deficiency
|
important in breaking down C-8, C-10 acylcarnitines after LCAD has made them.
|
medium chain length fatty acids accumulate, eventually spilling out of the mitochondria via the carnitine shuttle. Inability to conduct beta-oxidation results in low ATP levels (low ATP inhibits the urea cycle, leading to hyperammonemia)
|
|
Octreotide
|
used to treat variceal bleeding, acromegaly, diarrhea in various endocrine disordesr
|
|
|
Differentiating feature between anti-ACh agents and botulinum toxin
|
skeletal muscle weakness (seen in botulinum)
|
|
|
Hantavirus pulmonary syndrome
|
most common in four corners of the US, bunyaviridae
|
the virus is inhaled from aerosolized secretions from the common deer mouse, begins with nonspecific prodrome followed 4-5 days later by respiratory symptoms that progress to ARDS
|
|
Ehrlichiosis
|
caused by Ehrlichia phagocytophila, an intracellular bacterium transmitted by Ixodes
|
similar to rocky mountain spotted fever, but doesn't have a rash. Pathognomonic berry-like clusters of organisms in granulocytes
|
|
Tinkly bowel sounds
|
small intestinal obstruction
|
|
|
Prochlorperazine
|
phenothiazine that blocks dopamine receptors in the floor of the fourth ventricle (postrema)
|
used as an antiemetic
|
|
Cystic artery
|
found in the hepatoduodenal ligament
|
|
|
obstructive sleep apnea syndrome
|
hypoxemia w/ hypercapnia
|
|
|
Gastroschisis
|
caused by incomplete fusion of the lateral body folds
|
as opposed to failure of the intestinal loop to retract from the umbilical cord, which is seen in omphalocele
|
|
Conjunctivitis caused by gram negative pleiomorphic rods
|
H. influenzae
|
culture on chocolate agar w/ X and V or co-culture w/ S. aureus
|
|
RhD-positive attack on newborn
|
type II hypersensitivity
|
|
|
Superior vena cava syndrome
|
usually due to small cell carcinoma
|
|
|
Roth's spots
|
small white spots surrounded by hemorrhage bilaterally on the retina
|
|
|
Goodpasture syndrome is most similar to bullous pemphigoid
|
these are both cytotoxic type II hypersensitivity
|
Graves' disease, on the other hand, is type II, but it's noncytotoxic
|
|
GI hormones w/ trophic properties
|
Gastrin (intestinal mucosal growth), CCK (pancreatic growth), and secretin (pancreatic growth)
|
|
|
Cyclophosphamide
|
coadminister w/ mesna to prevent hemorrhagic cystitis
|
|
|
Celiac sprue
|
limited to the proximal small bowel (jejunum mostly)
|
|
|
Salicylate poisoning
|
made worse by things that acidify the urine, like NH4Cl
|
treated w/ bicarb to alkalinize the urine
|
|
Aprepitant
|
NK1 antagonist (blocks the action of human substance P) used to treat nausea and vomiting in patients who are on chemo
|
|
|
Dumping syndrome
|
occurs after gastric bypass surgery because food is being delivered to small intestine too quickly
|
instruct to eat smaller meals with less carbs, high protien, and more fats, because fats are absorbed more slowly and lead to less contraction by the small intestine, which helps improve the diarrhea symptoms of dumping syndrome
|
|
Slaughterhouse workers, veterinarians, and farmers
|
Brucellosis
|
undulating fever, lymphadenopathy, hepatosplenomegaly
|
|
Vibrio vulnificus
|
after eating raw shelfish -> septicemia, fever, chills, hypotension, fluid-filled blisters that progress to muscle necrosis of the lower limbs
|
gastroenteritis + cellulitis
|
|
Vinyl chloride
|
angiosarcoma of liver
|
seen in rubber industry
|
|
Ursodiol (ursodeoxycholic acid)
|
primary bile acid that acts by reducing cholesterol synthesis and secretion into bile and is effective in dissolving small cholesterol gallstones in some patients
|
|
|
Gastrinoma
|
proliferation of parietal cells in the body of the stomach due to increased gastrin levels (trophic effect)
|
|
|
Neonatal CMV vs toxo
|
CMV has periventricular calcifications, while toxo has calcifications distributed throughout the cortex and basal ganglia
|
|
|
hCG lacks MHC antigens
|
this is why it doesn't evoke and immune response
|
|
|
heterogenous complex of diseases w/ onset of recurrent bacterial infections secondary to markedly decreased antibody levels that becomes evident in 2nd or 3rd decade of life
|
Common variable immunodeficiency (CVID)
|
patients can have intact cell-mediated immunity or deficient t-cell mediate immunity
|
|
Drugs that cause SIADH
|
antidepressants (TCAs, SSRIs, MAOIs), antipsychotics, carbamazepine, antineoplastics
|
|
|
Coxsackie virus A infection of neonates
|
involvement of heart, liver, and brain that resolves without sequelae
|
CMV causes similar disease, except it has major sequelae
|
|
Rocky Mountain spotted fever
|
intracellular infection of endothelial cells
|
|
|
finger-clubbing, hypertrophy pulmonary osteoarthropathy
|
associated w/ bronchogenic carcinoma, benign mesothelioma, and diaphragmatic neurilemmoma
|
|
|
Tularemia
|
found in missouri, arkansas, oklahoma
|
ulcerative form is the most common, but there is also a pneumonic form that shows granulomas and stuff
|
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risk for becoming oral malignancy
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leukoplakia
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Hartnup disease
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defect in amino acid transport in renal and intestinal epithelium
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see free amino acids in urine and symptoms similar to pellagra, except that there is a normal amount of niacin (tryptophan is a precursor of niacin)
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types of stains
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sudan stain (fat), Ziehl-Neelsen (aka acid-fast), reticulin (cirrhosis/fibrosis), Prussian blue (iron)
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X-linked immunodeficiency disorders
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Bruton, Wiskott-Aldrich, and some SCID
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docusate sodium
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stool softener
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microvilli
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contain actin and myosin filaments
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microsomal transfer protein
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essential for packaging of hepatic TGs and other components to be secreted as chylomicrons
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deficiency leads to low chylomicrons, VLDL, LDL, as well as deficiency of fat-soluble vitamins
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HNPCC
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microsatellite instability is a characteristic of mutations in this gene (MLH1 gene)
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pigment stones in gallbladder
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associated w/ clonorchis sinensis
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Kernicterus
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unconjugated bilirubin deposition in basal ganglia
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Pregnant mother takes sulfa drugs in 3rd trimester
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results in kernicterus of the newborn
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tripolar mitosis
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abnormal mitotic spindle
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Campylobacter jejuni
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grows at 42 C
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liposarcoma
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pleomorphic lipocytes that resemble embryonal lipoblasts. Cytoplasm of cells is filled w/ lipid vacuoles that indent the nuclear membrane
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Full blown AIDS related infections
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HIV encephalopathy, PCP, Kaposi, cryptosporidiosis, Myco avium intracellulare
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Cryptosporidium mechanism
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intracellular multiplication in brush border and lysis of cells leading to severe watery diarrhea
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this is as opposed to Entamoeba and Shigella, which invade the submucosa and cause dysentery
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Compensatory response in COPD
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increased renal ammonium secretion
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Ulcerative colitis
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increased risk of seeing another IBD (Crohn) in the family
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Megestrol acetate
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increases apetite in patients on antineoplastic drugs
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Gastrin location
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found mostly in antrum of stomach, but also in the jejunum and duodenum
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Telomerase
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a reverse transcriptase that is inhibited by NNRTIs and NRTIs in patients w/ HIV
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Most common cause of trisomy induced abortion
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trisomy 16
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cytoplasmic blebbing
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indicates apoptosis
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cysts with 4 nuclei
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Entamoeba histolytica
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Theophylline
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causes seizures
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used in acute asthma management
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Secretin stimulation test
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used for Zollinger ellison, because it inhibits antral gastrin secretion, but stimulates pancreatic gastrin secretion
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Valproic acid
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assoicated w/ thrombocytopenia
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GIP
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only GI hormone released by fats, proteins, AND carbs
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secretin (fat), CCK (fat and protein), gastrin (protein), motilin (fat)
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Mixed acidosis
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cardiopulmonary arrest
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leads to a high arterial carbon dioxide due to respiratory standstill and metabolic acidosis due to lactic acidosis
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Glassy intranuclear eosiniphilic inclusions and punch out lesions in esophagus
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HSV, most commonly in immunocompromised
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Erythrogenic malarial infection is cleared by what immune cell
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NK cell b/c RBCs don't have MHC
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Pancreatic pseudocyst rupture
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the pseudocyst is filled w/ pancreatic enzymes and lysed blood and rupture may trigger severe gastrointestinal hemorrhage
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Panic attack
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assoicated w/ hypertension and peptic ulcer disease
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Metformin
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side effect: lactic acidosis
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Meclizine
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H1 receptor antagonist that's considered an antiemetic
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