4-15-2015 #1

wumimimu's version from 2015-04-17 01:24


Question Answer
What is the EML4-ALK fusion protein? Who is it seen in?Constitutively active tyrosin kinase seen in Non small cell lung cancer; Young non smokers with adenocarcinoma
What is crizotonib?Targets the EML4-ALK fusion tyrosin kinase in non-small cell lung cancer
What is standard therapy for heart failure patients?ACEi, digoxin, and diuretic (also spirinolactone)
How does spirinolactone decrease mortality of in heart failure patients?More likely by blocking the neurohormonal effects of aldosterone which causes ventricular remodeling and fibrosis
What genes are involved in the adenoma to carcinoma sequence?APC (formation of polyp), then K-ras(increase in size), DCC, and p53 (malignant transformation)
How do you calculate CO according to ficks principle? CO= oxygen consumption/ (AV O2 difference)
What is the etiology of stress incontinence?Loss of urethral support (EUS)
What is the etiology of urge incontinence?Detrusor overactivity
What is the etiology of overflow incontinence?Impaired detrusor contractility or bladder outlet obstruction
What is the internal urethral spinchter controlled by?The autonomic nervous system
What is the ext urethral spinchter controlled by?The pudendal nerve (somatic voluntary muscles)
Why is stress incontinence more common in women?CHildbirth injures the EUS/pudendal nerve; postmenopausal-lack of estrogen weakens the pelvic floor
What are the three main branches off the celiac trunk?Common hepatic, splenic, and left gastric
What happens to ulcers on ant wall of duodenal bulb?Perforate
What happens to ulcers on post wall of duodenal bulb?Hemorrhage
What lies behind the duodenal bulb?Common bile duct, portal vein and the gastroduodenal artery
What is metyrapone?It causes a decrease in cortisol by inhibiting 11-B hydroxylase; therefore, increase in ACTH! increased serum 11-deoxycortisol and 17 hydroxycorticoid steroid levels in urine
The inferior pancreaticoduodenal artery is a branch of which artery?SMA
What would a mutation in the splice site result in?A larger protein that is not functional; retains immunoreactivity
What are the four enzymes specific to gluconeogenesis?Pyruvate carboxylase, PEPCK, fructose 1,6 bisphosphatase, and glucose-6-phophatase
What is the function of Fructose 2,6 bisphosphate?Allosterically inhibits fructose 1,6 bisphosphatase, and stimulates PFK-1
How do glucagon and insulin affect the enzyme PFK2INsulin dephosphorylates it and turns it into PFK-2, whereas glucagon phosphorylates it and turns it into Fructose 2,6 bisphosphatase
What it the first step in the conversion of alanine to glucose?Alanine is transaminated to pyruvate
What are the P450 inducers?Barbiturates, rifampin, griseofulvin, carbamazepine, phenytoin, chronic alcohol consumption
What are the p450 inhibitors?INH, cimetidine, macrolides, azole antifungals, grapefruit juice
How are OCP's metabolized?By the p450 system
How might Hep B initially present?Serum sickness-like prodrome: malaise, fever, skin rash, pruritis, lymphadenopathy, and joint pain
What is the incubation period of Hep B30-180 days
What are the "gliflozin" drugs?ex) canagliflozin; SGLT2 inhibitors; prevent absorption of glucose in the prox tubule of kidney; antidiabetic agent
What are the side effects of the "gliflozin" drugs?Urinary tract and genital mycosis infections, symptomatic hypotension, and renal toxicity
What are the SE of the TZDs?Liver toxicity and edema (fluid retention)
What is the difference in malformation and deformation?Malformation = primary defect in the cells and tissues that make up organ; deformation: structural anomalies that occur because of an extrinsic mechanical force
What is a disruption ?Secondary destruction of a previously well formed tissue (amniotic band syndrome, amputation/compression of limbs)
What is an example of deformation?Potter Syndrome, congential hip dislocation, and clubbed feet
What is an exmaple of malformation?Congenital heart defects, holoprosencephaly, anencephaly, poly or syndactyly
What can holoprosencephaly result from?Trisomy 13, 18, and FAS
Acute necrotizing pancreatitis is characterized by what?Gross areas of pancreatic necrosis with high propensity for bacterial infection; results from pancreatic autodigestion
When is steady state of a continuously infused drug (eliminated by first order metabolism) reached?4-5 half lives
Which receptors does HIV use to enter the cell?CCR5 (corecptor) and CD4 (main receptor_
What are the Nef and Tat genes in HIV responsible for?Nef = decreases expression of MHC class 1 and Tat- role in viral replication
Alkaptonuria, mode of inheritance?Autosomal recessive (enzyme deficiency)
What does viral hepatitis look like on histo exam?Balooning degeneration, councilman bodies, and mononuclear cell infiltrate
Which organism requires cholesterol to grow?Mycoplasma Pnemoniae: its cell membrane is composed of single cholesterol rich lipid bilayer; no cell wall
What would the cause of death of lethal ARF be?Myocarditis -- can lead to cardiac dilation and heart failure
When do the proliferative and maturation phase occur during wound healing?3-5 days (proliferative); maturation phase starts during the second week after injury
What are the manifestations of acute appendicitis?Right lower quadrant abdominal pain, fever, nausea, vomiting,diarrhea,
What is the first event in the pathogenesis of acute appendicitis?Obstruction of the lumen of the appendix (fecalith, tumor, hyperplastic lymphoid follicle, foreign body
What is the most common cause of MVP?Spontaneous myxomatous degeneration
What does squatting do to the mumur of MVP?Makes it go away (unless it is severe, then makes it intensified)
What causes primary spontaneous pneumothorax?Apical subpleural blebs (caused by distal acinar emphysema probably)
When will a lesion blanch upon pressure?When the RBC's are still confined to the vasculature
How do you name "bruises" according to size?Petechiae<5 mm; Purpura: 5 mm-1cm Ecchymoses: >1 cm
What are lentigos?Small tan/brown macules in sun exposed areas of the elderly and middle-aged
What should be given to a newborn born to an HBV positive mother?HBV immunoglobulin prophylactically
What mutation results in hereditary hypothalamic diabetes insipidus?Mutation in neurophysin 2 (Carrier protein for ADH)
What are the signs and sx of typhoid fever?Escalating fever, bradycardia, watery diarrhea OR constipation, rose spots on trunk/abdomen, heptosplenomegaly, intestinal bleeding/perforation
Where does S. typhi live in a carrier?Gall bladder
What is seen in immunofluror of kidney in Wegner's?Nothing! pauci-immune RPGN
What is the histology of carcinoid tumor?Groups of cells that are uniform in size and shape: NO variation
What are intestinal carcinoid tumors derived from?Enterochromaffin cells of the intestinal mucosa
What is the most common location for an intestinal carcinoid?Illeum; but also occur in the rectum and the appendix
What is another name for enterochromaffin cells/APUD: amine precursor uptake and decarboxylation cells
Nasal mucosal ulceration and glomerulonephritis, what disease?Wegners! necrotizing vasculitis of upper, lower resp tract and kidneys
What will the CSF in Guillan barre show?Increased protein but normal cell count: albumino-cytologic dissociation