Comlex Stuff 2

ruhland2's version from 2015-06-21 21:44

Section 1

Question Answer
9:22CML (bcr-ABL ty kin dusion) philly chr
50-60 + upup basophils dxCML
rapid enlarged splenomegacute leukemia
Leukocyte Alk Phos in CML( - )
Leuko Alk Phos in Leukomoid rxn( + )
how to ddx CML from leukomoid rxnLAP (-) in CML, LAP (+) in CML
CML txImantinib
Imantinib moainhibits bcr-abl in CML
50-60 + up up naive B cells dxCLL dx
smudge cellsCLL histo

Section 2

Question Answer
CD20+,CD5+CLL lab
immune of CLLIgG deficiency
15;17 dxacute promyelocytic leukemia
Acute Promeylocytic LeukM3 type
15:17 pathosdn RAR(retinoic acid rec) so Myeloblast cannot mature (APL)
downsynd cancer and less than 5 years oldAcute Megablastic Leukemia (AML)
downsynd and cancer at older than 5 years oldALL
Auer rods inAML (APL)
cyrstal agg of meyeloperox(MPO)= auer rod in AML(APL)
APL txall-trans-retinoic acid (binds RAR so forced mature of Myeolblast)

Section 2

Question Answer
Non-APL AML txcytarabine (ara-C)
sx of release of auer rodsDIC (adverse of cancer tx)
12:21B-ALL good prog
9:22B-ALL poor prog (philly)
teen + mass mediastinumThymic-ALL (thymus neop)
Thymic-ALL marker (Lymphocytic = mature)TdT
T-ALL CD# +CD2-8 +
B-ALL gene12;21 kid, 9:22 adult
B-ALL CD#CD10, CD19/20
Tdt is marker forMature lymphocytes, (-) in Myeloid
chemotherapy stagesinduction->consolidation->maintenance
tranny has hairy ballsTRAP+ in hairy cell leukemia (TartrateRAP)

Section 2

Question Answer
skin diffuse pigment endocrine abnormalup ACTH b/c precursors of acth are melanin stim hormorne precursors
hyponatremic hypotension whydn Mineralcorticoids
Mineral corticoid11-deoxycortisol, cortisONE(~aldo),
11B hydrox def moadn 11-deoxycortisol-> cortisol* up aldo/up sex (11 deoxycortisol acts as mineralcorticoid)
17A hyrdox def moadn pregenolone-> hydroxypregenonolone, dn pregestoerone -> hydroxyprogest (dn glucocort, dn sex)
21 hydrox def moadn progesterone -> deoxycortisone so dn aldosterone up cortisol and androgens
ACTH and Melanin Stim Hormone sharesame precursor

Section 3

Question Answer
what activates RAAS (renin-angiotensin-aldosterone)low pressure Juxtoglom apparatus
ATII moaefferent arteriolar constrict (why acei contra in RF)
macual densaCl- sensor in DCT
efferent ateriolar dilatorACEi
aff artiolar dilatorprostaglandin
aff arteriolar constrictNSAID
lenticulostriate of basal ganglia aneursymcharcot boucarcd
charcot bouchard sx and riskschronic htn, dm, and mass-effect symptoms without headache
2nd choice if ACEi coughlosartan
bosentan indicantag endothelin-1-> dn Pulm Vasc Resistance, used in pulm htn
use PGEI inTranpose of great vessels (Alprostadil) keeps PDA open

Section 4

Question Answer
stridor=epiglotitis or croup
epiglotitis bug developing countryHiB
epiglotitis bug richS. Pyo
F,drool,muffled voice, resp retraction, stridor, cyanepiglottitis
neck hyperextended chin protrudingdog sniffing position seen in due to drooling of epiglotittis
epiglotitis throat s.pyo is bugcherry red swollen epig
epiglotitis txchloramphenicol,ampicillin,ceftriaxone
gray baby+ aplastic anemia syndchloramphenicol se
dn 50schloramphenicol
epoxide reductase activatesvit k

Section 5

Question Answer
warfin inhibsepoxide reductase
how does bil renal sten cause increased aldosteronedown renal flow * up RAAS * aldo(hyperplasia)
unil hyperplasia of Z glomerconn
nerve disorder of small cell cxlambert eaton
lambert eaton pathophysdn presynaptic Ca chan via autoab
ddx MG from LEMG=edrophonium test ( + ), LE= edro ( - )
dinoprostone indiclabor induc (ripen/dil + contraction)/ abortifacient

Section 5

Question Answer
big Partoid + Teste due toMumps( Bumps...)
paracortex hasT cell
outer cortex hasB-cell
inner cortex hasT-cell
aedes mosquito dzYellow F
Yellow F virus typearbovirus
Yellow fever histocouncilmin bodies, condensed eos due to acute liver damage
herniation dn CN3uncal
herniation dn CN6transtentorial
huntington brain dncaudate
hemiballisum dn braincontra subthalmic nucleus lz
hemiballimus stroke typeluncar (htn)

Section 6

Question Answer
homunculus legsmedial so dn in dn ACA
hypothyroid myxedemamucopolysach dep in dermis
anti- TPO(thyroid peroxidase) causeshypothyroid
dn lysosomal traffic regCHAIN (gets sec instead sent to lysozome)
srx + variant ryanodine recup risk malig hypothermia via inhaled anes
calcium type injectedca gluconate
dn Mg * uptorasdes risk
hyper mg txloop diuretics + Ca gluconate
carcinoid effect on heartTricuspid regurg
choriocx vs seminoma spreadchoriocx(embryonal cx is direct blood, semioma is paraaortic ln-> hemato spread)
MECP2Rett synd
Rett synd=cretinism
rett male or female?female only
first sign Rettapraxia
apraxia=loss of purposeful hand mvnmt
crentinism=small head, scloi, aprax,
rett extremitiesblue
rett handsmidline hand wringing (apraxia)

Section 7

Question Answer
hydroxyurea useup HbF in SCA
azoles on CYPinhibit 3A
name imidazoleKetoconazole, Miconazole, Clotrimazole
names of triazole classFluconizole,Itraconazole,Voriconazole
-azole moablocks lanosterol->ergosterol (lanos accum)
Crypt menin txFluconazole
fluconazole uniquecross BBB
too tox for system, topical onlyclotrimazole/miconazole
sporothrix txitra/vori
blasto txitra/vori
aspergillus txitraconazole/vori
coccidioides txketoconazole
blocks ADP recclopidigrel/tipclopidine
prevents Gp IIb/IIa expressionCLOP via irrev block ADP rec

Section 8

Question Answer
E2 apodn Alz Dz risk
E4 apoup Alz Dz risk
APOE chr19
Activates LCATAPO A-1
endocytosis of LDLAPO B-100
"e"mpties the liverAPO E
activates LPLapoC-II
TG->FFA for absLPL
forms and sec chylomicronapo B48
deficiency LPL or APO CII labsupupup Tg/Chylom
Type 1 hyper lipoproteinemia causesdef LPL/ApoCII
def LDL recupup LDL

Section 9

Question Answer
Type2afamilial hyper cholest (def LDL rec)
Type 2b namefamilial combined hyperlipid
Type 2b labdef LDL rec up up LDL/TG/cholesterol
Type III namefamilial dys beta lipoproteinemia
III lack "_________"APO E
E empties so if defup up Chylm IDL remnants (familal dys beta lipoproteinemia)
Type 4 namefamily hypertg
T 4 Labup up VLDL
T 4 complicationpancreatitis
1+4=5 (type 5 hyper lipoproteinemia)
type 5 labsdn LPL up up TG/CM = 1, up up VLDL =4
down B48dn CM
down B100dn VLDL/LDL (cannot endocytosis it)
abetalipoproetinemia labsdn Chylmicron secretion (B-48) dn encocytosis VLDL/LDL (B-100)
def b100 and B48a beta lipoproteinemia

Section 9

Question Answer
blister in sunexposedP Cut tarda
up hair temple/cheekP Cutanea Tarda
P Cut Tarda Urine doWoodlamp
Pink orange urinewoodlamp P Cutanea Tarda
molecule in pink or orange urine in P cuta tardauroporphyrin
up protopohyrins * upphotosensitivity
ALA defporyphria method of pathos
precipitation of porphyriabarb/etoh
porpohbilinogen deaminase defAIP method of pathos
NO photosensitivityAIP finding to ddx from PCT
Brown urinefinding AIP (ALA and porphbilinogen)
induced def ALA dehyratase/ ferrochetalaselead
zinc defdown ALA/ferrochetalase enzymes or Pb tox replaces Zn so up AIP
required in ALA synthaseVit B6
needs B6 supplement withIsonazid
gives urine yellourobilo
gives poop brownstercobilin

Section 10

Question Answer
GLP-1=incretin mimetic
exenatideGLP-1 (acts as powerful glc on B-cells)
pramlinatideamylin~ that is co-sec w/ insulin to dn glucagon
dn endogenous GLP-1 degradation-gliptin
gliptin moadn dipeptidyle peptidase so up GLP1
dn dipeptydly peptidase *dn degrade of GLP-1 (-gliptan)
bind PPAR-gliatzone
PPAR moaup insulin sensitity
gliatzone s/eedemal, up lb, CV tox
contra in RFmetformin (up lactic acidosis)

Section 11

Question Answer
up FeverIL1
matures T-naive-> TH1/2IL1
TH1 makesIL2 so up B-cell/TH1/TH2
IL2 moaup CD4/8/ B cell develop
Bone marrow stim diffIL4
IL5activates Th2
dn synth IFN-Gamma and dn TH1IL10
IL 10 fromTH2
IgA and Eos upIL5 (via TH2)
IL12from macrophage

Section 12

Question Answer
stimulates TH1IL12 from M0
NKCD16 CD 56
B cellCD19
BcellCD40 (19+21)