Session Prep 8-9

mhewett's version from 2016-06-27 16:08

Session Prep 8

Question Answer
What is the mechanism of action of gold in treating RA?prevents further damage by suppressing macrophages and phagocytes
What is the DOC for an acute attack of gout?colchicine - but NSAIDs (except aspirin) are first line
Of how many vertebrae is the sacrum comprised?5
What are the three accessory ligaments of the sacrum? What are their attachments?sacrotuberous ligament - sacrum to ischial tuberosity
sacrospinous - sacrum to ischial spines
iliolumbar - L4,L5, iliac crests, SI joint
(true = sacroiliac)
What ligaments are usually the first to become tender where there is any lumbosacral dysfunction?iliolumbar joints
What are the three functions of the piriformis?externally rotate the thigh, extend the thigh, abduct the thigh when the hip is flexed
What are the nerve root contributions to the lumbar plexus? to the sacral plexus? to the sciatic nerve?lumbar: T12-L4
sacral: L4-5; S1-3; part of S4
sciatic: L4-S3
What are the 4 types of sacral motion? Under which conditions are these motions engaged? What is the horizontal axis for each of these motions?inherent - craniosacral motion, S2
postural - flexion/extension of the torso, S3
respiratory - inhalation/exhalation, S2
dynamic - movement, sacral oblique axis
If L5 is rotated L, what direction will the sacrum be rotated?Rotated Right
If L5 is sidebent R, to what side is there an oblique axis of the sacrum engaged?Right axis
What primary enzyme in the glycolytic pathway is inhibited by ATP and citrate, but activated by AMP and fructose 2,6 diphosphate?phosphofructokinase (rate limiting step; fructose 6-P to fructose 1,6 BP)
What effect does phosphorylation have on hormone sensitive lipase?activates it
What class of steroid are glycocholate and taurocholate? cortisol? DHEAS?glycocholate and taurocholate - bile acids
cortisol - glucocorticoid
DHEAS - androgen
What layer of the adrenal cortex produces aldosterone? produces cortisol? produces testosterone?aldosterone - glomerulosa
cortisol - fasciculata
testosterone - reticularis
Do the testes make glucocorticoids and aldosterone?no!
In the male peripheral metabolism, to what two types of molecuels is testosterone converted?estradiol and dihydrotestosterone
What cells of the ovary have the same cholesterol-dependent pathywya and the same products of the pathway as the Leydig cells of the testis?Theca
In the granulosa cells of the ovary, to what two molecules is androstenedione directly converted?esterone and testosterone
How does female peripheral metabolism differ from male peripheral metabolism with regard to the cholesterol-dependent products (sex hormones)?males - dihydrotestoserone
females - estriol
both - androesterone, testosterone, esterone, estrodiol
Does the corpus luteum make estrogen?nope
In 17-alpha-hydroxylase deficiency, what major adrenal gland hormone is made abundantly? what major adrenal gland hormones are not made in sufficient quantities?excess - aldosterone
not enough - cortisol and testosterone
In 21-alpha-hydroxylase deficiency, what two major adrenal gland hormones are not made in sufficient quantities?aldosterone and cortisol
What two major adrenal gland hormones are not produced sufficiently in 11-beta-hydroxylase deficiency?aldosterone and cortisol
Is fat lysis or synthesis stimulated by insulin? by glucagon? by growth hormone?insulin - stimulates synthesis
glucagon - fat lysis
growth hormone - fat lysis
Name the two purines. Name the three pyrimidines?purines - adenine and guanine
pyrimidines - cytosine, thymine, uracil
In Lesch Nyhan disease, defective hypoxanthine-guanine phosphoribosyl transferase results in the inability to salvage purine bases, such that they are degraded to this molecule (which is largely responsible for the symptomology seen with Lesch Nyhan). What is the molecule?uric acid
The segment of bacterial DNA that consists of a promoter, an operator, and one or more structural genes is generally termed what?an operon
How many structural genes may be associated with a promoter in the prokaryotic genome? How many genes may be associated with a promoter in the eukaryotic genome?many in prokaryotes; 1 in eukaryotes

Session Prep 9

If one has a + seated flexion test on the left, and there is evidence to indicate the presence of a sacral oblique axis, on what side will that axis be? Right axis
What does the standing flexion test evaluate that the seated flexion test does not? lower extremity
If the R ASIS is inferior, the right PSIS is superior, and there is a positive standing flexion test on the right, what is the likely innominate dysfunction? right anterior innominate rotation
If the right ASIS is superior, the right PSIS is superior, and there is a positive standing flexion test on the right, wat is the likely innominate dysfunction? right superior shear
Name the 4 causes for a superior pubic shear. tight rectus abdominus muscle
unusual trauma
innominate rotation (posterior)
third trimester pregnancy or delivery
If the right ASIS is more lateral and there is a postive standing flexion test on the right, what is the likely innominate dysfunction? right innominate outflare
What sacral dysfunction is VERY common in postpartum females? bilateral sacral flexion
What is the most common type of sacral shear? unilateral sacral flexion
If you are told that the patient has a left on left (aka left rotation on left axis), what type of sacral dysfunction do you know they have? forward sacral torsion
If there is a sacral dysfunction, what area of the spine should be evaluate and treated? L5
To what class of drugs do captopril and enalapril belong? ACE inhibitors
What are the 4 major side effects in terms of electrolytes, urea, glucose that may occur with thiazide use? hypercalcemia
increase glucose levels - why you do not use them in diabetics
What is the term for the region of DNA that encodes a single protein in a prokaryotic? cistron
What is THE major DNA polymerase in prokaryotes? Besides being able to catalyze DNA replication, what are two important roles/abilities it has? DNA pol III
-"proofreads" each added nucleotide
-3' exonuclease activity
What is type of polymerase produces the leading strand in eukaryotic DNA replication? What one ability does it have? What two abilities does it not have that the polymerase III of bacteria does type of polymerase - delta
ability it has - acts as a helicase
ability it does not have - does not proofread and no exonuclease activity
What are the three germ layers? endoderm, ectoderm, mesoderm
The median umbilical ligament was once what structure in the fetus? The medial umbilical ligament was once what structure in the fetus? median - embryonic urachus
medial - remnant of fetal umbilical arteries
From what branchial arch are the muscles of mastication derived? the muscles of facial express? muscles of mastication - branchial arch 1
muscles of facial expression - branchial arch 2
From what pharyngeal pouches are the thymus and inferior parathyroids derived? 3
Where are cervical cysts located? From what fetal structure do they develop? anterior-lateral part of the neck
remnants of pharyngeal clefts
What duct eventually develops into the vas deferens and epididymis in the male? What duct eventually develops into the fallopian tubes in the female? epididymis - Wolfian Duct
fallopian tubes - Mullerian Duct
What structures pass through the foramen ovale?
foramen spinosum?
the superior orbital fissure? foramen ovale - CNV3
foramen spinosum - middle meningeal artery
superior orbital fissure - CN III, CN IV, CN V1, CNVI, opthalmic vein, sympathetic fibers
What is the innervation of the lateral rectus muscle of the eye? What is the innervation of the superior oblique muscle in the eye? LR - VI (abducens)
SO - IV (trochlear)


What muscle above the eye becomes relaxed in Horner's syndrome due to the syndrome's involvement of the SNS? what is the physical result of that relaxation? meuller muscle - slip of smooth muscle in upper eyelid
ptosis - slight drooping of the eyelid
What muscle is responsible for mydriasis? miosis? mydriasis - pupillary dilator muscles
miosis - pupillary sphincter muscles
If a patient sustains an injury to the right 12th cranial nerve, to what side will that patient's tongue deviate when he attempts to protrude his tongues? towards the side of the lesion - to the right side
Which pterygoid muscle operates to open the mouth? lateral pterygoid muscle
What one laryngeal muscle is NOT innervated by the recurrent laryngeal nerve? What is its innervation? cricothyroid muscles
-superior largneal nerve
What muscle is paralyzed in scapular winging? What nerve innervates this muscle? serratus anterior
long thoracic nerve
What nerve root supplies the musculocutaneous nerve? the axillary nerve? the radial nerve? the ulnar nerve? musculocutaneous nerve - C5, C6
axillary nerve - C7
radial nerve - C7
Ulnar nerve - C8, T1
What cutaneous loss is associated with ulnar nerve damage? musculocutaneous nerve? radial nerve? ulnar nerve -palmer and ulnar side of 1 and 1/2 fingers, hypothenar eminence
musculocutaneous - externsor (lateral) forearm
radial nerve - posterior arm and dorsal hand and thumb
What nerve risks injury with a fracture to the humerus? radial nerve (runs in radial groove of posterior humerus)
What type of fracture is a fracture of the distal radius? colles fracture (if flexed - smiths)


if land in outstretched hand - colles
if land in flexed hand - smiths
What is the primary abductor of the hip? the primary adductor? the primary internal rotator? the primary external rotator? abductor - gluteus medius
adductor - adductor magnus + minimus
internal rotator - gluteus medius and minimus
external rotator - gluteus maximus
Specifically, what type of glomerular disease is marked by crescent formation? How many types exist within that type or category? rapidly progressive glomerulonephritis
type 1 cytotoxic goodpasture's syndrome
type 2 immune complex deposition SLE
type 3 pseudoimmune associated with ANCA Wegner's (c anca), microscopic polyangiitis (p anca)
What type of glomerulonephritis is Goodpasture's disease? RPGN 1 (inflammatory - starts as acute nephritic butttt rapidly progesses to something severe)
If a patient presents with an inhalation dysfunction of ribs 3,4, and 5, what rib should you treat first? rib 5
What is the main motion of the OA? AA? cervicals? OA - flexion/extenion
AA- rotation
cerivcals - rotation
What is the DOC for CMV retinitis? for esophageal candidasis? CMV - gancyclovir
esophageal - fluconazole
To what generation of cephalosporins does cefazolin belong? cefoxitin? ceftriaxone? cefazolin - 1
cefoxitin - 2
ceftriaxone - 3
What is the antidote to a warfarin OD? a benzodapine OD? warfarin - vitamin K
benzodapines - flumazenil
What drug is used to eliminate tapeworms? niclocamide
What drug is used to eliminate flukes? Praziquantel