4-09-2015 #1

wumimimu's version from 2015-04-15 18:58


Question Answer
Which pharyngeal pouch do parafollicular cells arise from?Fourth pouch
Adrenal cortex is derived from what kind of cells?Mesothelial cells
When do alc withdrawal sx start? DT?8-12 hours after last drink; delirium tremens occurs usually on 3rd day
Which BZD are first line in alc withdrawal?Long acting: diazepam and chlorodiazepoxide; if liver failure/disease: then can give, lorazepam/other short acting
What are the clinical manifestations of asbestos exposure?Pleural plaques, asbestosis (restrictive lung disease), bronchogenic carcinoma (most common malignancy), and mesothelioma (most specific)
What are pleural plaques?Collagen deposits on the parietal pleura, lower lungs, and diaphragm that get calcified; seen in asbestos exposure; usually asx
Asbestosis, sx?Diffuse pulmonary fibrosis; asbestos bodies; restrictive lung disease
What cancer are direct alkylating agents and benzene associated with?Acute leukemias
Aniline dyes and the rubber industry are associated with what cancer?Bladder
What is a crossover study?Subjects are randomely allocated to a sequence of 2 or more treatments given consecutively; Washout period between treatements
What is fantasy?Substituting imaginary scenarios: immature defense mechanism
What is used to dx PE?V/Q scan (easy, cheap, fast); gold standard is CT angiography; Chest radiograph is NEGATIVE
When does matched V/Q ventilation defect occur?Lung collapse or consolidation
Which organs are retroperitoneal?SAD PUCKER; also vetebral column and pelvic muscles
What are the clinical signs of epiglottitis?Acute fever, insp stridor, drooling, odynophagia, positive thumbs up sign on cervical x-ray
What is the capsule of H. influenza type B made ofPRP!! polyribotol ribose phosphate; it is immunogenic and used to vaccinate people
What is the capsule B. anthracis made of?D-glutamate
What does Cori disease present with, and what enzyme is deficient/Hypoglycemia, hyperTG, ketoacidosis, and hepatomegaly, accumulation of small chain dextrin like material in the cytosol of hepatocyte; debranching enzyme def
Pompe disease presents with> and what enzyme?NO hypoglycemia, but hypotonia and cardiomegaly; acid maltase def (acid alpha glucosidase)
Von Gierke disease present with and what enzyme?Hypoglycemia, lactic acidosis, hyperlipidemia, hyperuricemia, hepatic steatosis; glucose-6-phosphotase def
What is secreted by TH1 cells?IFN-gamma, IL-2, and lymphotoxin B
What is secreted by TH2 cells?IlL 4, 5, 10, 13
What is the mech of azole antifungals? p450 interaction?Inhibit demethylation of lanesterol to ergosterol; they are P450 inhibitors
Terbinafine mech of action?INhibits squalene 2,3 epoxidase and prevents ergosterol synthesis
Mech of action of echinocandin antifungals?FUngins; inhibit glucan synthesis and therefore, prevent adequate cell wall building
Flucytosine mech of action?It inhibits DNA and RNA synthesis in fungal cells; pyrimidine that is converted to 5-FU
What is seen in light microscopy of reflux esophagitis?Elongation of papillae, basal cell hypertrophy, and intraepithelial eosinophils
How does renal cell carcinoma present usually?Hematuria, flank pain, and abd mass only occur in MINORITY of patients: most patients experience constitutional sx and paraneoplastic syndromes
What is the most common site for RCC metastasisLUNG, and then bone
What agents induce insulin resistance?TNF-alpha, glucocorticoids, glucagon, and free fatty acids! (mostly through serine phosphorylation)(
What is lipotoxicity>High free fatty acids levels cause insulin resistance and beta cell dysfuntion (reduced insulin release)
Tryptophan makes what?Niacin, serotonin, and melatonin
Hartnup disease, what is seen in urine?Neutral amino aciduria
Fanconi's syndrome, what is seen in urine?Everything; generalized aminoaciduria
Which patient pops are susceptible to vit K def/Neonates, liver disease, broad-spectrum antibiotics, malabsorbtion syndrome
How does N.meningitides get to meninges?Pharynx to blood stream, choroid plexus, to meninges
How does H. Influenza get to meninges?Pharynx to lymphatics to meninges
Where do anal fissures occur?Posterior midline
How does HSV-1 infection in chile 1-3 present?gingivostomatitis, fever, lymphadenopathy, intranuclear inclusions: VERY specific presentation
What is the vector of T. cruzi?Reduviid bug, lives in the walls of rural huts
P. jiroveci, CD4 counts? prophylaxis?<200; TMP-SMX
Toxoplasma, CD4? and prophylaxis?<100; TMP-SMX
MAC, CD4? and prophylaxis?<50; azithromycine
Histplasma CD4? prophylaxis?<150; Itraconazole
How does MAC in HIV patients present?Fever, diarrhea, anemia, weight loss, hepatosplenomegaly, elevated ALP, and LDH levels;
How do you treat MAC in HIV patients?Macrolide + Rifabutin or ethambutol
Intracell pathway of Alpha adrenergic receptors?Alpha -1 is through IP3 pathway; Alpha-2 is decrease in cAMP
What is the pathophys of macular degeneration?Accumulation of drusen behind retina or neovascularization of retina (dry and wet)
What are the most common causes of acute pancreatitisGallstones and alchol
What are some lesser causes of acute pancreatitis?Recent ERCP, drugs, infections, hypertriglyceredemia, structural abn of pancreas, surgery, and hypercalcemia
What are the most important mitochondrial diseases to remember?MELAS (encepholpathy, lactic acidosis, and stroke-like episodes), MERRF(myoclonic epilepsy with ragged red fibers), and leber optic neuropathy
Which substances contain gluten?Wheat, rye, and barley
WHat is seen in dermatitis herpetiformis skin bx?IgA and PMNs and fibrin at the tips of dermal papillae
Whipple disease sx?Malabsorption, arthritis, and CNS involvement
What is the illipsoas made up of? where does it insert?Psoas major minor and lliacus; lesser trochanter of femur
Chronic renal hypoperfusion will lead to hypertrophy/hyperplasia of what cellsJG cells (which are modifies smooth muscle cells) ; located in afferent arteriole
How does follicular lymphoma present?Waxing and waning lymphadenopathy
Herings nerve?Branch of CN 9 that innervates the carotid baro and chemo receptors
In ALL, the cells most commonly cancerous are?B-cell precursors; however, T-Cell ALL will present with a mediastinal mass

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