Term
| 2 main manifestations of failure of gut to fully rotate around SMA |
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Definition
1) obstruction (bilious vomiting)
2) volvulus (intestinal ischemia) |
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Term
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Definition
GnRH analog
Pulsatile: infertility
Constant: precocious puberty, prostate cancer, endometriosis, dysfunctional uterine bleeding |
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Term
| Negative selection of T-lymphocytes in thymus is mediated by what? |
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Definition
FAS-directed apoptosis
Positive selection is first: makes sure MHC can bind to self antigen
Negative selection occurs second: makes sure MHC doesn't bind to self antigen too tightly
ASIDE: anergy occurs in the periphery --> occurs when a lot of antigen is encountered w/out costimulatory signal (e.g. B7) |
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Term
| What mediates vascular resistance in the brain? |
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Definition
| CO2 concentration; Hyperventilation will decrease cerebral blood flow --> dizziness, weakness, blurred vision |
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Term
name artery perforated in each ulcer location:
1) Proximal lesser curvature
2) Distal lesser curvature
3) Proximal greater curvature
4) Distal greater curvature
5) Posterior duodenum |
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Definition
1) Left gastric (branch off celiac)
2) Right gastric (branch of hepatic proper)
3) Left gastroepiploic (splenic)
4) Right gastroepiploic (gastroduodenal)
5) Gastroduodenal
ASIDE: anterior duodenal ulcers are more common & more likely to perforate. Posterior duodenal ulcers are less common & more likely to bleed b.c. of proximity w/ gastroduodenal artery |
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Term
Name the 2 anthrax toxins?
Name pertussis toxin? |
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Definition
1) edema factor: calmodulan-dependent adenylate cyclase;; 2) Lethal factor: inactivates MAPKK --> kills cell
Pertussis toxin inactives Gi --> increase cAMP (it also releases a calmodulin-dependent adenylate-cyclase (same as anthrax) that world says is "very important for successful colonization")
ASIDE Pertussis is a strict aerobe, G(-) coccobaccilus |
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Term
| Intestinal pulsion from increased intraluminal pressure may cause this: |
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Definition
| diverticula (occurs in older people when they strain) |
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Term
name location of each esophageal diverticula:
1) Zenker
2) Traction
3) epiphrenic |
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Definition
1) posterior wall just above upper esophageal sphincter (caused by crichopharyngeas spasm)
2) mid-esophagus (usually in conjunction w/ enlarged mediastinal nodes, e.g. TB)
3) above gastro-esophageal diaphragm (caused by motility disorders, e.g. achalasia) |
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Term
Name condition:
- Hemoglobin Barts
- HbH
- high HbA2 & HbF |
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Definition
Barts = alpha thal
HbH = alpha thal
High HbA2/F = Betal thal |
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Term
What is methylmalonyl CoA derived from?
What enzyme converts it to succinyl CoA? |
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Definition
- Derived from VOMIT pathway (Valine, Odd-chain fatty acids, Methionine, Isoleucine, Threonine)
- Methylmalonyl CoA mutase (aka methylmalonyl CoA isomerase): It needs B12 as a cofactor
ASIDE: VOMIT --> Propionyl CoA --> Methylmalonyl CoA (via propionyl CoA carboxylase, which requires biotin) |
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Term
Nephrotic syndrome secondary to cancer, infection (HBV, HCV, syphillus), or meds (gold, penicillin, NSAIDS)
Characteristic subepithelial "spikes" with silver stain. Immunofluorescence reveals IgG and C3 |
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Definition
| Membranous glomerulopathy |
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Term
|
Definition
gallbladder hypomotility (pregnancy, rapid weight loss, prolonged TPN, octreotide, macrolides)
sludge consists of cholesterol crystals, calcium bilirubinate, & mucus. It is a precursor to stone formation |
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Term
| Which viruses produce proteins as a full-length peptide that must be cleaved? |
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Definition
| all +ssRNA (e.g. picorna, hepe, calci, flavi, toga, retro, corona) |
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Term
| Transmural inflammation of medium-to-small arterial wall with fibrinoid necrosis. Fever, abdominal pain, peripheral neuropathy, weackness, & weight loss. Association with HBV |
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Definition
| Polyarteritis nodosa (PAN) |
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Term
| vasculitis linked to asthma |
|
Definition
| churg-strauss (transmural fibrinoid necrosis of small vessels with eosinophilic infiltrate) |
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Term
| Cholinomimetic given to stimulate an atonic bladder |
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Definition
Bethanechol; also used in post-op ileus.
Carbachol & Pilocarpine are used for glaucoma (esp closed angle b.c. it causes the iris to move further from the cornea) |
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Term
| Lispro, regular, or NPH insulin used to treat DKA? |
|
Definition
regular
ASIDE: Lispro is rapidly absorbed because it is modified to not polymerize (normally, insulin is polymerized in plasma. In fact, this is why you can't give regular insulin sub-cue because it would just stay in the tissue and not go into the blood stream) |
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Term
| Treatment for beta-blocker overdose |
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Definition
| Glucagon (second messanger is cAMP, same as Beta2 adrenergic agonists) |
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Term
| How does folate stay inside cells |
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Definition
| a polyglutamated tail is added to it (e.g. dihydrofolate polyglutamate) |
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Term
2 bacterial causing gastroenteritis that are curved motile G(-) oxidase positive rod?
Which one can survive in alkaline environment?
Which one can grow at 42C?
Which one causes bloody diarrhea? |
|
Definition
- V.cholera & C.jejuni
- V. cholera can survive in alkaline environments, C.jejuni can't
- C.jejuni grows @ 42C (ASIDE, L.monocytogenese (G+rod) grows @ 4C w/ "tumbling motility" @ higher temps)
- C.jejuni produces bloody diarrhea & is associated w/ GUIANNE BARRE & reiter's
ASIDE: V.cholera NEVER produced blood or pus in diarrhea (only water +/- mucus) |
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Term
| Kidney problem with sickle cell trait |
|
Definition
| papillary necrosis (also seen with analgesic use, diabetes, recurrent, acute pyelonephritis) |
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Term
| Name the main drugs/classes of drugs w/ antimuscarinic effects |
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Definition
| atropine, TCAs, Antihistamines (e.g. diphenhydramine), neuroleptics, antiparkinsons (benztropine) |
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Term
Name what cell types these are markers for:
1) Synaptophysin
2) GFAP |
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Definition
1) neurons
2) cells of glial origin (astrocytes, ependymal cells, oligodendrocytes)
ASIDE: glial cells are neural crest cells |
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Term
| Which arteries regulate perfusion to the heart tissue? Which drugs dilate these vessels directly? What does administration of these drugs to a person with coronary ischemia do? |
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Definition
- Coronary microvessels: During ischemia, microvessels in ischemic tissue dilates and allows for collateral circulation from areas that are not ischemic)
- Adenosine & dipyridamole
- These drugs dilate microvessels in non-ischemic areas. This will eliminate the collateral circulation & precipitate ischemia (called "coronary steal)
Dypirimadole/Adenosine are utilized in
assessing ischemia (given and then see if tissue exhibits coronary steal) |
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Term
| lesion in chronic renal allograft rejection |
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Definition
| obliterative intimal smooth muscle hypertrophy and fibrosis of cortical arteries (mediated by recipient antibodies to graft endothelium) |
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Term
MOA of ketamine?
What can it do to opiate tolerance? |
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Definition
Ketamine is an NMDA receptor antagonist. It has been shown to decrease the appearance of opioid tolerance
Mechanism of opioid tolerance is complex, but probably has somethign to do with phosphorylation of opioid receptors, increasing cAMP, or increasing NO. NMDA receptors are thought to enhance tolerance by increasing opioid receptor dephosphorylation |
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Term
| Situs inversus, chronic respiratory infections, and infertility |
|
Definition
| Kartagener syndrome (Dynein arm defect) |
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Term
| snRNPs are synthesized by which RNA polymerase? |
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Definition
RNA polymerase II (also synthesizes mRNA & microRNA)
snRNPs are the spliceosome. There are anti-SNP antibodies mixed connective tissue disease (anti-U1)
Sjogrens syndrome has anti-ribonucleoprotein antibodies [SSa (Ro) & SSb (La)]
NOTE:
-RNApol1 = rRNA
-RNApol2 = mRNA, snRNP, microRNA
-RNApol3 = tRNA |
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Term
| best indicator of severity of mitral stenosis? |
|
Definition
| time between S2 & opening stap (shorter is worse b.c. it indicates that the valve is more thickened &/or there is a higher buildup of diastolic pressure) |
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Term
hypotensive, tachycardic, hypoglycemic w/ a PMH of vomiting, abdominal pain, weight loss, and hyperpigmentation
what do you give? |
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Definition
this is a person in adrenal crisis (first three Sx) who suffers from chronic adrenal insufficiency (latter Sx)
The treatment of choice is a stress-level dose of corticosteroids |
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Term
| Recurrent lobar hemorrhage with a relatively protracted & benign clinical course (in contrast to hemorrhagic strokes associated w/ HTN) |
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Definition
| Cerebral Amyloid Angiopathy |
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Term
| Sabin vaccine promotes synthesis of what Ig? |
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Definition
| IgA (enterovirus that is given orally --> production of IgA. Contrast this to killed, IM vaccines --> no IgA) |
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Term
| MOA of cocaine? MOA of methamphetamines? |
|
Definition
inhibit reuptake
increase release |
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Term
| congenital bicuspid valve predisposes to earlier onset of what common valvular condition? |
|
Definition
| aortic calcifications (come on in 60s instead of 80s) |
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Term
| CFTR is activated by? gated by? |
|
Definition
cAMP; ATP
CFTR is an ATP-dependent Cl pump |
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Term
| Chronic rejection in lungs? |
|
Definition
bronchiolitis obliterans (small airways completely occulded by inflammatory infiltrate)
acute reaction consists of inflammatory infiltrate around arteries & submucosa of airways |
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Term
Dimenhydrinate & Chlorpheniramine MOA?
Why shouldn't they be used w/ benzos? |
|
Definition
1st gen H1 blockers (along w/ diphenhydramine).
These should not be used with Benzos b.c. they are sedating
NOTE: 1st gen antihistamines are anti-alpha & antimuscarinic & sedating. 2nd gen are far less sedating and have minimal alpha & muscarinic blocking properties |
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Term
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Definition
P = 2T/r
P (pressure)
T (surface tension)
r (radius)
constant surface tension --> pressure increases as radius decreses; alveoli overcome this by using surfactant, which decreases T as r becomes smaller b.c. the surfactant becomes more concentrated |
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Term
| What causes caseating granulomas (2 things) |
|
Definition
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Term
Name type of virus:
1) stable @ 60C for 30min
2) lose infectivity when treated w/ ether |
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Definition
1) heat stable
2) enveloped |
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Term
| MOA of stabile toxin & labile toxin (ETEC) |
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Definition
ST: increase cGMP
LT: increase cAMP (similar to cholera) |
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Term
| Acute MI developing from a chronic coronary atherosclerotic plaque is due to what event? Would metalloproteases in the plaque increase or decrease the chance of this event? |
|
Definition
- plaque rupture --> superimposed thrombus --> total occlusion
- metalloproteases increase the likelyhood of this event by decreasing the structural integrity of the plaque |
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Term
3-7 days after a burst berry aneurysm (subarachnoid hemorrhage) person loses cortical function
What type of drug can prevent this from happening? |
|
Definition
SAH-induced vasospasm
Calcium channel blocker (esp Nimodipine) |
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Term
| ANP increases what 2nd messanger? |
|
Definition
|
|
Term
| colchicine inhibits polymerization or depolymerization of microtubules? |
|
Definition
inhibits polymerization (vincristine/blastine are similar, if not identical in MOA)
The Taxols inhibit depolymerization (e.g. paclitaxol) |
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Term
| is ciprofloxacin a P450 inducer or inhibitor? |
|
Definition
inhibitor (many quinolones are)
Other important inhibitors:
Cimetidine
Macrolides
Azoles
Grapefruit juice
INH
Protease inhibitors (Ritonavir) |
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Term
| Conditions associated w/ avascular necrosis? |
|
Definition
- Sickle cell disease
- SLE vasculitis
- high-dose steroid therapy
- Alcoholism |
|
|
Term
Name bacteria & most likely population for each of the following bacterial meningitides:
1) G(+)Lancet-shaped diplococci
2) G(+)cocci in clusters
3) G(+)cocci in chains
4) G(+)rods
5) G(-)bean-shaped diplococci
6) G(-)rods
7) G(-)coccobacilli |
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Definition
1) S.pneumo; most common cause in adults
2) S.aureus; IVD, neurosurgery
3) GBS; neonatal (most common cause)
4) Listeria; infants, immunocompromised, pregnant women
5) N.meningitis; 2nd most common cause in adults (causes outbreaks in close quaters, e.g. dorms)
6) E.coli; newborns in unsanitary conditions
7) H.flu; Less common now b.c. of vaccine |
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Term
|
Definition
RU-486: an abortifacient. It is a progesterone antagonist
usually combined w/ misoprostol (PGE1 analog) |
|
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Term
| Why is nephrotic syndrome a hypercoaguable state? |
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Definition
| b.c. loss of antithrombin III (& other anticoagulants) in urine predisposes to a pro-coagulant state |
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Term
| most common benign tumor of breast. Characterized by a cellular, often myxoid stroma that encircles and sometimes compresses epithelium-lined glandular and cystic spaces |
|
Definition
fibroadenoma
usually arises in young women in 20s - 30s. They may vary in size during menstural cycle (increase during luteal phase)
This tumor is benign, and carries no increased risk for carcinoma.
NOTE: fibrous tumors: fibroadenoma in premenopausal; Phyllodes tumor in postmenopausal |
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Term
|
Definition
MEN2B
Pheochromocytoma, Medullary thyroid carcinoma, & mucosal neuromas
remember: MEN's have 3,2,&1 "P":
MEN1: parathyroid, pituitary, pancreas
MEN2A: parathyroid, pheochromocytoma
MEN2B: pheochromocytoma |
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Term
| What cells provide proliferative stimuli for formation of atherosclerotic plaque? |
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Definition
Platelets (via PDGF & TGF-beta)
Endothelial injury --> collagen exposed --> platelet adhere --> release PDGF/TGF-beta --> proliferation & migration of SMC from media to intima (TGF-beta is chemotactic to SMC) |
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