Misc from UW 3
Terms
undefined, object
copy deck
- ____% of observations are within 2 standard deviations from the mean.
- 95
- ____% of observations are within 3 standard deviations of the mean.
- 99.7
- delayed detachment of the umbilical cord
- leukocyte adhesion deficiency other sx: poor wound healing recurrent skin infections WITHOUT formation of pus gingivitis/periodontitis genetic defect: absence of CD18 antigen that is necessary for formation of integrins
- substrate of myeloperoxidase
- H2O2
- prokaryotic 16S rRNA
- -sequence found in 30S subunit -complementary to Shine-Dalgarno sequence found in all prokaryotic mRNA -binding of these 2 seq's is necessary for initiation of prot translation
- intermittent claudication
- -muscle pain with exercise that remits with rest -almost always a result of atherosclerosis of larger arteries
- medial band-like calcifications
- Monckeberg's medial calcific sclerosis affects muscular arteries clinically asx
- onion-like concentric thickening of arteriolar walls
- hyperplastic arteriolosclerosis can result from malignant HTN
- homogenous acellular thickening of arteriolar walls
- hyaline arteriolosclerosis, usu due to diabetic microangiopathy
- diarrhea weight loss bone pain, weakness improves when gluten-free
- celiac disease - defective malabsorption leads to Vit D deficiency
- dobutamine's primary effect
- B1 agonist
- enzyme that activates FAs to undergo B-oxidation
- fatty acyl-CoA synthetase
- catalyzes first committed step in fatty acid synthesis
- acetyl-CoA carboxylase biotin-dependent present in both liver and adipose tissues
- fatty acid oxidation occurs in the _________ while fatty acid synthesis occurs in the ______________
- mitochondria cytosol
- Which nitrate agent has the highest bioavailability if given orally?
- isosorbide mononitrate
- familial hypocalciuric hyperCa
- defective Ca-sensing R on parathyroid cells does not allow PTH to be suppressed by an increase in Ca level. mild to moderate hyperCa and normal to high PTH
- arteries spared by PAN
- pulmonary PAN mostly affects kidneys, heart, liver, GI tract. bead-like aneurysm formation in mesenteric circulation. up to 1/3 pts have cutaneous manifestations - livedo reticularis, palpable purpura
- marker of OB activity
- serum level of bone-specific alkaline phosphatase
- urinary deoxypyridinoline and hydroxyproline
- measures of OC activity
- characteristics of drugs with high intrinsic hepatic clearance
- high lipophilicity, good CNS penetration high volume of distribution
- 3 significant causes of polyuria and polydipsia
- DM DI primary polydipsia
- bluish neoplasm under the nail bed
- -glomous tumor (glomangioma) -subungual melanoma
- glomangioma
- -tumor of the modified smooth muscle cells of a glomus body glomus bodies - small, encapsulated neurovascular organs found in the dermis of the nail bed, the pads of the fingers and toes, and the ears. Role is to shunt blood away from the skin surface in cold temperatures and vice versa.
- hepatitis that is most often anicteric
- Hep A
- 3 major etiologies of hepatocellular carcinoma
- -viral infxn with B or C -chronic alcoholism -food contaminants (aflatoxins)
- pathologic features of Vit D deficiency
- -increased unmineralized matrix and widening btwn osteoid seams -genu varus (bowing of wt-bearing bones) -rachitic rosary (bony prominence at costochondral jct) -Harrison's sulci (indentations in lower ribs) -craniotabes (softening of skull) -also hypoCa, hypophos, hypertonia, growth retardation
- trabecular thinning with fewer interconnections
- osteoporosis
- subperiosteal resorption with cystic degeneration
- hyperparathyroidism
- lamellar bone structure resembling a mosaic
- Paget's disease seen in elderly only involves focal pts of skeleton starts with OC then OB
- sponguosa filling medullary canal with no mature trabeculae
- osteopetrosis
- -recent viral illness -thyrotoxicosis sx -tenderness over thyroid gland -inc ESR -reduced radioactive iodine uptake
- subacute granulomatous thyroiditis initial PMN infiltration, then lymphocytes, histiocytes, multinuc giant cells antithyroid peroxidase Ab is NOT elevated
- diffuse mononuclear infiltration of thyroid, with formation of germinal centers
- Hashimoto's thyroiditis aka chronic lymphocytic thyroiditis nl ESR hypothyroidism nontender gland with rubbery texture HIGH TITERS OF ANTITHYROID PEROXIDASE AB
- death from cardiac tamponade is due to
- cardiogenic shock
- radial pulse disappears on inspiration
- pulsus paradoxus (drop of over 10 mmHg)
- pulsus alternans
- LV dysfct beat to beat variation of pulse pressure in the presence of a regular cardiac rhythm
- dicrotic pulse
- 2 peaks - one during systole, other during diastole severe systolic dysfct
- hyperkinetic pulse
- rapid ejection of a large SV against decreased AL fever, exercise in nl ppl PDA, AV fistula
- headaches, visual sx, N/V, proteinuria, hematuria
- malignant HTN
- structures formed from dorsal pancreatic bud
- tail, body, most of the head, accessory pancreatic duct
- structures formed from the ventral pancreatic bud
- uncinate process, a part of the pancreatic head, main pancreatic duct
- strict vegetarian diet would cause _____ deficiency
- cobalamin
- ddx of acquired night blindness
- 1. toxic retinopathy due to phenothiazines or chloroquine 2. vit A deficiency 3. congenital rubella, syphilis, or other infxns 4. diabetic retinopathy
- mediate delayed hypersensitivity reactions and granuloma formation
- TH1 cells also produce IL-2 and IFN-g and activate MPs to produce TNF note: while TH1 is implicated in Crohn's, TH2 is implicated in UC
- cystic medial degeneration
- fragmentation of elastic tissue and separation of elastic and fibromuscular components of tunica media by small, cleft-like spaces associated with aortic dissections
- most common cause of death in diabetes pts
- MI
- statin SEs
- myopathy, hepatotoxicity
- DNA glycosylases
- base excision repair
- What happens after a growth factor binds to its tyrosine kinase R?
- autophosphorylation interaction with SOS activation of Ras (by binding GTP) activation of Raf activation of MAPK gene txn
- gastric erosion
- mucosal defect that does not penetrate into muscularis mucosa usu occurs in the setting of acute erosive gastritis (NSAIDs surgery, head trauma - Cushing ulcers, burns - Curling ulcers, smoking, alcohol)
- AV shunts/AV fistulas
- -abnl connection btwn artery and vein that bypasses cap beds, which are the major source of resistance in the vascular system -allow blood under arterial P to directly enter venous system - INCREASE CARDIAC PRELOAD -pulsatile mass with a thrill on palpation; constant bruit
- phase 4 (pacemaker potential)
- -slow influx of Na -slow decrease in K efflux as K channels continue to close -when membrane potential reaches -50, T type Ca channels open and allow Ca to enter cell and contribute to depol -ADENOSINE AND ACH ACTIVATE K CHANNELS AND PROLONG K FLOW - thus reduce rate of spontaneous depol
- major RFs for sqCC of esophagus
- cigarettes and alcohol
- pancreas is grossly edematous focal areas of fat necrosis, Ca deposition and interstitial edema on LM
- acute interstitial pancreatitis
- chalky-white areas of fat necrosis of the pancreas interspersed with hemorrhage
- necrotizing (hemorrhagic) pancreatitis
- chronic antral-predominant gastritis
- H. pylori infxn inc acid prodxn, inc risk of duodenal ulcer
- SEs of protease inhibitors
- -lipodystrophy -hyperglycemia -inhibition of P-450 indinavir in particular: nephrotoxicity, nephtolithiasis NOTE: use rifabutin, NOT rifampin, in pts on protease inhibitors
- severe chest pain not relieved by rest or NG diaphoresis, dyspnea, nausea, etc. peaked T waves STE Q waves (hrs to days)
- acute TRANSMURAL MI most commonly caused by acute plaque change (e.g. rupture) which produces a superimposed thrombus that completely occludes the involved coronary artery
- Sx of stable angina do not become apparent until ____% of the cross-sectional area is occluded.
- 75%
- defects in heme synthesis that cause photosensitivity
- URO decarboxylase COPRO oxidase PROTO oxidase ferrachelatase
- CANNOT use ketone bodies
- -hepatocytes - lack succinyl-CoA-acetoacetate-CoA transferase (thiophorase) -RBCs - lack mitochondria
- cofactor for ALA synthase
- Vit B6
- most common cause of fatigue and new cardiac murmur in young adult
- bacterial endocarditis can be complicated by immune cplx deposition resulting in acute diffuse proliferative GN
- How do you get Campylobacter?
- -domestic animals -contaminated food
- Campylobacter gastroenteritis
- inflammatory diarrhea (watery then bloody), abd cramps, tenesmus, WBC in stool
- cirrhotic stigmata related to hyperestrinism
- gynecomastia palmar erythema spider angiomas
- most important factors for OC differentiation
- M-CSF RANK-L OC are multinucleated (2-5) and arise from the monocytic lineage
- primary biliary cirrhosis
- -middle-aged women -pruritis is first sx -hepatosplenomegaly, ascites, xanthomatous lesions -increased alk phos, IgM, XOL -a/w Sjogrens, scleroderma, autoimmune thyroid, hypothyroid, Raynauds syndrome
- comma-shaped, oxidase + G- rod that can survive in ALKALINE environments
- V. cholerae (compare with C. jejuni) activates AC, same mech as E. coli heat-labile toxin
- WBCs without RBCs in stool
- Salmonella
- WBCs and RBCs in stool
- invasive organisms such as Shigella
- RBCs in stool
- 0157:H7
- painless hematuria 2-3d after URI
- IgA nephropathy + abd pain and purpuric lesions = HSP
- 1st line drugs for isolated systolic HTN
- -thiazide diuretics -dihydropyridine CCBs
- insoluble yellow-brown perinuclear pigment
- lipofuscin sign of nl wear and tear / aging composed of lipid, phospholipids
- traction diverticula
- due to inflammation and subsequent scarring e.g. midesophageal diverticula
- granulomatous inflammation of the media
- -temporal arteritis (branches of carotid artery) -Takayasu (aortic arch)
- transmural inflamm of arterial wall with fibrinoid necrosis
- PAN
- mixed cellular infiltration of thyroid with occsasional multinuclear giant cells
- subacute thyroiditis / granulomatous thyroiditis brief thyrotoxic phase, then transient hypothyroid
- -deficiency of a-galactosidase A -accumulation of ceramide trihexoside
- Fabry's disease hypohidrosis acroparesthesias angiokeratomas - punctate, dark red, non-blanching macules and papules btwn umbilicus and knees progress to renal failure
- risk of acute leukemias
- Down syndrome Patau syndrome Bloom syndrome ataxia-telangiectasia Fancomi anemia
- acute calculous cholecystitis
- first step is obstuction of GB neck or cystic duct 2nd to last step is ischemic damage to mucosa last step is bacterial invasion
- bilious vomiting after first 24h of birth
- intestinal obstruction below second part of duodenum common causes: intestinal and colonic stenosis or atresia Jejunal, ileal, and colonic atresia are NOT congenital malformations - due to vascular accidents in utero. "apple peel" appearance.
- -palpable but non-tender gallbladder (Courvoisier sign) -wt loss -obstructive jaundice (pruritis, dark urine, pale stools)
- adenocarcinoma at the head of the pancreas, compressing common bile duct.
- RFs for pancreatic adenoCA
- age smoking DM chronic pancreatitis (risk highest after 20 yrs) genetics - hereditary pancreatitis, MEN syndromes, HPNCC, FAP
- babesia
- transmitted by tick bites causes malaria like illness in asplenic pts
- toxoplasma
- mono-like illness in immunocompetent CNS involvement in immunocompromised
- Isospora belli
- chronic, watery, profuse diarrhea in immunocomp, esp AIDS
- Campylobacter fetus
- opportunistic pathogen septicemia in newborns, pregnant women, elderly
- slowest conduction velocity
- AV node
- fastest conduction velocity
- purkinje fibers also, atrial muscle has higher conductivity than ventricular muscle
- medical therapy for disseminated carcinoid
- octeotride
- medication of choice in gestational DM
- insulin
- alcohol-induced hepatic steatosis
- decrease in FA oxidation secondary to excess NADH production by alcohol metabolism enzymes
- dobutamine
- mainly B1 agonist; also works at B2 and A1 treatment of acute heart failure associated with dec myocardial contractility effects: -inc cardiac contractility -inc HR and myocardial O2 consumption -inc cardiac conduction velocity
- tx for recurrent Ca-based kidney stones
- thiazides
- most common cause of hypothyroidism in places where iodine is sufficient
- Hashimoto's
- anti-thyroid peroxidase Ab
- Hashimoto's also see: intense mononuclear infiltrate with germinal ctrs metaplastic follicular cells - large, oxyphilic with granular cytoplasm (Hurthle cells)
- HFE protein
- on basolateral surface of epi cells in SI crypts complexes with B2 microglobulin and then binds transferrin R to facilitate endocytosis of transferrin/Fe cplx into cells
- What is the specific defect in hemochromatosis?
- mutant HFE that cannot detect circulating Fe levels leads to unregulated uptake of Fe Cx: cirrhosis, hepatocellular CA
- basal ganglia atrophy
- Wilson's disease
- cause for increase in staph bacteremia and sepsis
- intravascular devices most common pathogens: coag neg staph S. aureus Enterococcus E. coli Enterobacter Psuedomonas Klebsiella Candida