4-12-2015 #1

wumimimu's version from 2015-04-13 00:45


Question Answer
When is BHCG detectable in maternal serum?After the blastocyst implants; anywhere from 6 to 11 days; usually around day 8; implantation usually occurs around day 6
What is the dynamic LV outflow obstruction in HCM caused by?Systolic anterior motion of the anterior mitral valve leaflet towards the hypertrophied interventricular septum
What would a block to alpha-2 adrenergic receptors result in?Increased insulin release from pancreas and increase NE release from nerve terminals
What would stimulation of B2 receptors achieve?Bronchodilation, vasodilation in skeletal muscles and uterine relaxation
What would stimulation of D1 receptors result in?Vasodilation of renal, sphlanic, and mesenteric blood vessels
When is Strep pneumoniae not virulent?When it lacks a capsule
What is the diff between generalized and specialized transduction Generalized = lytic infection; random bacterial genes packaged; specialized = lysogenic infection, specific bacterial genes packaged
Which bacteria are known to be naturally competent?Pneumococcus, the Neiserrias, and H. Flu
What topical agent is used to treat Psoriasis? How does it work?Vitamin D!(calcipotriene, calcitriol, and tacalcitol); binds to Vit D receptor, which then acts as transcription factor to inhibit keritoncyte proliferation and stimulate differentiation
What does cyclosporine do molecularly?Inhibits NFAT, prevents the transcription of IL-2
What is the action of Ustekinumab?Targets IL-12 and IL-23; inhibits differentiation and activation of CD4, Th1 and Th17 cells; used in psoriasis
Psoriasis is mediated by which two helped T cells?Th1 and Th17
What are the microscopic changes seen in hydronephrosis?Dilation of the tubular lumen, flattening of the tubular epithelium, and interstitial fibrosis
What are the consequences of chronic mitral regurgitationIn chronic, the left atrium has had time to adapy; therefore, it will dilate and have increased compliance: patients are at risk for Afib and mural thromboembolism?
What are the consequences of acute mitral regurgitation?The left atrium has no time to adapt, which results in high pressures, and acute pulmonary HTN/edema can result
What causes acute MR?Failure of prosthetic valve, infective endocarditis with destruction of valve leaflets or chordae rupture, chordae tendinae rupture, ischemia or rupture to papillary muscle
What does acute rejection in lung transplant look like?Perivascular lymphocytic infiltrates
What does chronic rejection look like in lung transplant?Bronchiolitis obliterans! Lymphocyte infiltration and necrosis of bronchiolar walls (small airway), fibrinupurulent exudate and granulation tissue; later replacement by connective tissue
What are the two ligaments that make up the lesser omentum?Hepatoduodenal and hepatogastric
What is the falciform ligament and what does it contain?The connection of the liver to anterior body wall; it contains round ligament which is remnant of umb vein
What is the splenorenal ligament and what does it contain?It contains the splenic vessels and the tail of the pancreas; it connects spleen to left kidney
Where are lipids absorbed in the small intestine?The jejunum
What are the SE of ACEi? Cough, hyperkalemia, Increase in GFR, and angioedema (very rare)
What is Trosseau's syndrome?Migrating thrombophlebitis associated with underlying visceral/disseminated cancer; results bc of an increased procoagulant state
When is NBTE?Non bacteria thrombotic endocarditis is seen in hypercoaguable states! Often indicates mucinous pancreatic adenocarcinoma or mucinous adenocarcinoma of the lung (marantic endocarditis)
What is the most common cause of hypercalcemia in hospitalized patients?Hypercalcemia of malignancy
In positive skew, What happens to the measures of central tendency/Lower numbers predominate; Mean >median >mode
In negative skew, what happens to the measures of central tendency?HIgher numbers predominate: Mode >Median > mean
Which hormones use G-protein/adenylate cyclase pathway?TSH, PTH, glucagon, and beta-adrenergic receptors
How does G-protein coupled receptor wokr/THe alpha subnit, is activated when it is bound to GTP, it is then released and causes activation of adenylate cyclase
WHich hormones work through a JAK STAT pathway?Growth hormone, prolactin, cytokines, and EPO
N-acetylglutamate in the urea cycle?Allosteric activator of CPSI; formed from Acetyl-CoA and glutamate by NAGS
In the urea cycle, what do citrulline and aspartate make?Arginosuccinate (which is then cleaved by arginosuccinate lyase)
What is the most important side effect of TZDs?Edema and weight gain; dont use in heart failure patients
What are side effets of sulfonylureas?Hypoglycemia, weight gain, and rarely agranulocytosis
What does Malassedzia furfur causes what?Tinea versicolor; hypo or hyperpigmented spots that become more visible after tanning
How does M. Furfur look like on microscopy?Spaghetti and meatballs appearance (hyphae and spores); hyphae have a short cigar butt appearance
How do you treat M. Furfur?Topical antifungals and selenium containing shampoos
Phrenic nerve irritation presents now?Resp distress and decreased breath sounds on affected side; dyspnea and hiccups
SVC syndrome is associated with what cancer?Small cell lung cancer (centrally located)
Pipercillin-Tazobactam is effective against what bacteria?Most gram - enteric rods including p. aeru and Bacteroides fragilis
Is dysplasia reversible or non-reversible?Reversible
How do you calculate drug half-life?T1/2 = (0.7)(Vd)/CL
When is a drug virtually eliminated/at steady state?After 4-5 half-lives
PCWP in ARDS?It's normal; otherwise it would suggest cardiogenic cause of edema
What parameters are abnormal in ARDS?Decreased compliance, increased work of breathing, increased capillary permeability, V/Q mismatch
How does a glucogonoma present?Necrolytic migratory erythema; diabetes mellitus, GI sx, anemia of chronic disease
What does necrolytic migratory erythema look like?Painful/pruritic rash affecting face groins, and extremities, papules coalesce to form large lesions with central clearing of bronze-colored induration
COX-2 and colon cancer?increased activity of COX-2 has been linked with colon-adenocarcinoma; aspirin use decreases adenomatous polyp formation
When will sickle cell traite RBCs sickle?When sodium metabisulfite is added
What does medullary thyroid cancer look like under microscope?Uniform poygonal or spindle-shaped cells with extracellular amyloid deposits (calicitonin)
What potentiates morphine tolerance?Glutamate! Binds to NMDA receptors and activates them leading to tolerance
What can be used to hamper morphine tolerance?Ketamine: binds to NMDA receptors and blocks glutamate actions
Where colon cancer primarily occur in HNPCC?Right-sided colon cancer! As opposed to sporadic which is more on the left
What are Cytoplasmic P bodies?They play a role in mRNA translation regulation and mRNA degradation in eukaryotic cells
Degranulation of mast cells and basophils results in release of what?Histamine, heparin, proteases, prostoglandins, and leukotrienes
What is the most common location for colon adenocarcinoma?Rectosigmoid colon and then the ascending colon
Two diseases in which maculopapular rash starts at head and spreads downward?Rubella and Measles
How does rubella present in adult women?Low-grade fever, maculopapular rash, posterior auricular or suboccipital lymphadenopathy; also arthalgias and polyarthritis develop as sequalae
What are sx of congenital rubella?PDA, sensorineural deafness, cataracts/retinopathy; also microcephaly
What is lipofuscin?Yellow-brown granular perinuclear pigment found in heart and liver of aging or malnourished; result of lipid peroxidation and free radical injury