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648 Cards in this Set
- Front
- Back
bilateral anorchia
|
vanishing testes syndrome - normal external genetalia but no mullerian structures (resorption of testes before birth)
|
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methimazole and PTU SE
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agranulocytosis, halt meds and start rHg-CSF
|
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salt secreted
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95% of that ingested
|
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internal capsule
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receives blood from lenticulostriate arteries, prone to rupture in HTN
|
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int capsule anterior limb
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fronto pontine fibers
|
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int capsule genu
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corticobulbar fibers
|
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int capsule post limb
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corticospinal fibers to contralateral arm and leg
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nitroprusside cyanide test
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cystinuria --> renal staghorn radioopaque stones, alkanize urine
|
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familial iminoglycinuria
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inpared renal tubular resorptino of proline, hydroxyproline, glycine
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hypophosphatemic rickets
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decreased PT reabsorption of phosphate and bony abnormalities
|
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chediak higashi Dx
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large inclusions in all nucleated blood cells
|
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alpha granules
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growth factors, PF4, thrombospondin and fibronectin, deficiency --> grey platelet syndrome
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dense granules
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ADP and ATP, Ca, histamine, serotonin, epinephrine
|
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CGD tests
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nitroblud tetrazolium negative or DHR flow cytomoetry
|
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myeloperoxidase deficiency
|
normal enzyme test, generally clinically silent, may get candida in diabetics
|
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liver findings:
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|
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alcohol
|
fatty change, mallory bodies (eosinophilic cytoplasmic inclusions)
|
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a1 antitrypsin def
|
PAS positive cytoplasmic granules
|
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Hep A
|
think daycare and kids
|
|
wilsons
|
copper in liver and keyser fleisher rings
|
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aminoglycoside mechanism of action
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misreading at translation initiation
|
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chloramphenicol
|
inhibits ribosomal peptidyl transferase
|
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piroxicam
|
think RA treatment with low risk of GI probs and 50 hr half-life
|
|
allantois
|
endodermal diverticulum of the yolk sac, becomes part of urogenital sinus
|
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mesonephros
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embryonic kidney
|
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urogenital ridge
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intermediate mesoderm give rise to the embryonic and adult kidneys and gonads
|
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most common site for volvus in elderly
|
sigmoid colon (poorly supported)
|
|
wood tick transmits
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rickettsia rickettsiae and francisell tularenis
|
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ALS
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lower motor neurons in anterior horn, UMN in motor area of cerebral cortex
|
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cerebellar damage in
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spinocerebellar degenerative diseases like friedrichs ataxia and olivopontocerebellar atrophy (both have ataxia as prominent sx)
|
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globus pallidus lost in
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striatonigral degeneration (resembles parkinsons)
|
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selective IgA deficiency
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most common hereditary immunodeficiency, failure of heavy chain switching
|
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hyper IgM
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CD40 ligand mutation
|
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foramen ovale
|
mandibular nerver may be injured by fracture
|
|
superior orbital fissure
|
abducens, ophtalmic division of trigeminal
|
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foramen rotundum
|
maxillary division of the mandibular nerve
|
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internal auditory meatus
|
chordae tympani
|
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friedrich's ataxia
|
degeneration of DRG and oters presents with ataxia, dysarthria, loss of highly discriminatory sensory modalities
|
|
pontine nuclei
|
afferents from cerebral cortex to pons, pons to cerebellar cortex via the middle cerebellar peduncles
|
|
telomerase
|
RNA dependent DNA polymerase (acts like a reverse transcriptase) and is thus inhibited by lamivudine and stavudine
|
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alprostadil
|
PGE1 analog to maintain a patent ductus arteriosus
|
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miglitol
|
alpha glucosidase inhibitor
|
|
repaglinide
|
non-sulfonylurea moiety of glyburide
|
|
DMD spontaneous arising
|
recombinatino event in the dystrophin gene that gave rise to a frameshift mutation leading to an untraslatable mRNA
|
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ATP from one glucose in anaerobic oxidation
|
2
|
|
ursodiol
|
dissolves cholesterol gallstones in some patients
|
|
octreotide
|
somatostatin analogue used to treat diarrhea in endocirne disorders and variceal bleeding and acromegaly
|
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tizanidine
|
spasmolytic used for diseases such as cerbral palsy, MS, stroke
|
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first pharyngeal cleft
|
external ear canal
|
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palatoglossal/pharyngeal folds
|
glossal in front
|
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caffeine medical use
|
for infants for treatment of apnea of prematurity and adjuvant for analgesic formulations
|
|
biceps tendon origin
|
supraglenoid tubercle above the glenoid fossa of the scapula and passes into the bicipital groove between the greater and lesser tuberosities of the humerus
|
|
papillary necrosis etiology
|
DM, analgesic abuse, UT obstruction, sickle cell disease
|
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thromboemboli to the kidney
|
result in wedge shaped infarcts and pale coagulative necrosis of the cortex
|
|
toxin producing e coli
|
enterohemorrhagic (shiga-like toxin causing bloody diarrhea and HUS), enterotoxigenic (activated intestinal adenylate or guanylate cyclase leading to cAMP overproduction and diarrhea)
|
|
valacyclovir
|
used to treat HSV but not in immunocompromised becaues it can be associated with TTP-HUS which seem to occur in this population and can be fatal
|
|
bacteria associated with human bites
|
elkenella corrodens
|
|
IVDU with osteomyelitis
|
pseudomonas and candida
|
|
sickle cell osteomyelitis
|
salmonella
|
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niridazole
|
treatment of dracunculus medinensis which causes skin ulceration and inflammation
|
|
mediator of complement and shock in gram negative bacteremia
|
C3a
|
|
TNF-alpha
|
released by macrophages, in response to endotoxin, causes fever an dhemorrhagic tissue necrosis
|
|
hageman factor in shock
|
endotoxin can directly activate it leading to coag cascade and DIC
|
|
nitric oxide in shock
|
released by macrophages activated by endotoxin causes hypotension
|
|
IL-1 in shock
|
realeased by macrophages causes fever
|
|
rubella congenital infection
|
PDA, pulmonary stenosis, cataracts, microcephaly, deafness
|
|
hepatitis G
|
transmissible flavivirus, not been shown to cause liver disease
|
|
HBcAg
|
Positive during the window period
|
|
AIDS
|
CD4 cell count < 200/mm3 and one or more defining opportunistic infections
|
|
amebas with ingested RBCs
|
entamoeba histolytics
|
|
opportunistic infections and cell counts
|
<400: Herpes simplex and zoster oral thrush; <200 cryptococcal meningitis; <100 toxoplasmosis; <50 MAI
|
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MAI
|
chronic wasting, prophylaxis is with azithromycin
|
|
granulovacuolar degeneration and hirano bodies
|
intracytoplasmic inclusion bodies in hippocampal pyramidal neurons in alzheimer's patients
|
|
lafora bodies
|
neurons glia sweat glands liver skeletal muscels with lafora dz
|
|
marinesco bodeis
|
dopaminergic neurons of SN - intranuclear and not associated with parkinsons
|
|
calcium pyrophosphate dihydrate
|
pseudogout, weakly positive
|
|
calcium oxalate
|
oxalosis and bipyramidal, positively birefringent
|
|
calcium phosphate
|
apatite-associated arthropathy and produces spherical clumps nonbirefringment
|
|
rheumatic disease
|
type II hypersensitivity
|
|
amino acids involved in ammonia transport in blood
|
alanine and glutamate
|
|
nikolsky's sign
|
separation of the epidermis upon manual stroking with pemphigus vulgaris
|
|
rupture of AV malformation in brain
|
subarachnoid hemorrhage
|
|
deep perineal space
|
middle layer of the urogenital diaphragm, two skeltal muscles, sphincter urethrae and deep transverse perineal, and the cowper gland, membranous urethra passes through the urogenital diaphragm
|
|
superficial perineal space
|
bulbospongiosus (skeletal muslce that covers the bulb of the penis), crus of penis (erectile body that is continuous with the corpus cavernosum of penis), ischiocavernosus (covers the crus of the penis)
|
|
C3 nephritic factor
|
IgG autoantibody that binds C3 convertase making it resistant to inactivation, presistently low serum complement levels and associated with type II membranoproliferative glomerulonephritis
|
|
cervical plexus
|
longus colli and capitis muscles
|
|
breast feeding with HIV
|
should not occur because it can transmit the disease
|
|
ischemic necrosis of brain
|
sterile liquefactive necrosis
|
|
porto-caval shunt
|
splenic vein to left renal vein (splenic vein drains into portal vein and renal into IVC)
|
|
Sup mesenteric vein drainage
|
into the portal vein
|
|
components of microvilli
|
actin, myosin
|
|
desmoplakin
|
hemidesmosome associated (cell to cell connection)
|
|
movement of cilia and flagella
|
dynein
|
|
wiskott aldridge genetics
|
x linked
|
|
cytokine in development of anaphylaxis
|
IL4 - makes IgE
|
|
hyaluronidase organism
|
strep a
|
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catalase positive organisms
|
"SPACE cat": staph, pseudomonas, aspergillus, candida, enterobacteriaceae
|
|
malignant melanoma genetics
|
p16 tumor suppressor gene loss
|
|
excessive fluoride
|
direct injury to ameloblasts leading to inadequate production of tooth enamel
|
|
sorafenib
|
multikinase inhibitor for renal cell carcinoma with hypertension rash diarrhea fatigue and shouldnt be taken with doxorubicin
|
|
jigsaw pussle appearance of bone lamellae
|
pathognomonic for paget's dz
|
|
congenital skeletal probs with syphilis
|
saddle nose and shaber shin
|
|
ankylosing spondyltis findings
|
begins in sacroiliac crests then moves up into spine causing destruction of the posterior vertebral bodies, fusion, decreased range of motion, atrophy osteoporosis, look at spinal x ray for diagnosis, rheumatoid factor generally negative, HLA-B27 positive (As are all spondyloarthropathies)
|
|
severe magnesium deficiency
|
associated with alcoholism, acute decrease in Mg causes increase in PTH, prolonged decrease in Mg causes decrease in PTH, admin of Mg results in prompt rise in PTH and restoration of normal serum Ca levels, absence of Mg decreases function of PTH leading to "functional" hypoparathyroidism
|
|
hypoparathyroidism and bone density
|
decreased bone density
|
|
cuboidal epithelium
|
kidney peritoneal lining pleural lining
|
|
lacunar cells
|
specifically suggest the nodular sclerosing variant of hodgkins disease
|
|
some AD diseases
|
NF, ehlers danlos, huntingtons, osteogenesis imperfecta
|
|
vagina in women of childbearing age
|
lactobacillus, candida, strep
|
|
vagina of children
|
staphylococcus epidermidis
|
|
urease producing bacteria
|
"N CUP" : Nocardia, cryptococcus, Ureaplasma, Proteus
|
|
h pylori
|
SO dismutase (As does bacillus anthracis), catalase (as staph aureus), flagella (as with E coli), mucinase (as with v cholera)
|
|
aspirin and EtOH in ulcers
|
more linked to gastric than duodenal
|
|
cystic medial degeneration
|
fragmentation of elastic laminae with accumulation of myxoid materiloa in aortic media
|
|
Muscles in legs
|
|
|
flexor digitorum longus
|
from posterior middle of tibia, four tendons on sole of foot that insert on distal phalanges act to flex toes and foot and invert foot at ankle
|
|
peroneus tertius
|
originates at distal 1/3 of anterior fibula - extend foot at ankle joint and evert foot
|
|
peroneus brevis
|
originates at distal 2/3 of lateral fibula, plantar flex and evert foot
|
|
peroneus longus
|
originates at head and proximal 2/3 of lateral fibula, plantar flex and evert foot
|
|
extensor hallucis longus
|
originates at middle 1/2 of anteror fibula, extend great toe and extend foot at ankle
|
|
SCC of esophagus
|
smoking, alcohol, and spicy foods
|
|
adult parvovirus infection
|
arthralgias and arthritis, no rash usually, symmetric joints 3-4 weeks post exposure
|
|
fibroblastic-like cells in a storiform pattern
|
dermatofibrosarcoma protuberans, a slow growing fibrosarcoma
|
|
horn cells
|
seborrheic keratosis
|
|
pautrier microabscesses
|
mycosis fungoides
|
|
sawtooth dermal/epidermal junction
|
lichen planus
|
|
arterial supply to distal lesser curvature of stomach
|
right gastric
|
|
ZES postprandial gastrin change
|
don’t expect much of an increase in gastrin levels
|
|
psoas action at hip
|
flex
|
|
neisseria and chlamydia
|
induce endocytosis
|
|
might increase INR from warfarin
|
norfloxacin
|
|
phenazopyridine
|
urinary tract analgesic that changes color of urine to orange/red
|
|
friedrich's ataxia sites
|
spinocerebellar tracts, CST, posterior columns
|
|
retropharyngeal space
|
fascial plane between buccopharyngeal fascia and prevertebral fasciea, allows spread of infections between neck and thorax
|
|
aspirin and uric acid
|
causes uric acid levels to increase
|
|
nutmeg liver
|
chronic CHF
|
|
male pseudohermaphrodite
|
XY but look femaie
|
|
female pseudohermaphrodite
|
XX bu look male
|
|
rapidly progressive GN
|
crescents
|
|
membranoproliferative GN
|
tram track and thickening of the glomerular capillary walls
|
|
juvenile polyposis and peutz jeghers
|
polyps don’t predispose to cancer
|
|
osteosarcoma in pagets
|
usually jaw pelvis or femur
|
|
only antidiuretic that acts upstream of macula densa
|
acetazolamide, and therefore increases NaCl at MD and increases afferent arteriole constriction
|
|
most common cause of death in preeclampsia
|
cerebral hemorrhage and ARDS
|
|
fibroelastic hyperplasia
|
reduplication of the elastic lamina and fibrosis of the media secondary to HTN
|
|
sciatic nerve
|
common peroneal and tibial nerves
|
|
WASP protein function
|
participates in the reorganiation of the hematopoietic cell cytoskeleton in response to external stimuli
|
|
trisomy 8
|
some cases of olfactory neuroblastoma
|
|
direct thrombin inhibitors
|
lepirudin, bivalirudin, other derivatives of hirudin
|
|
amyloid in the thyroid
|
medullary thyroid carcinoma
|
|
DMD and BMD
|
both mutations in dystrophin, worse mutations in DMD
|
|
laminin deficiency
|
x linked emery-dreifuss Muscular dystrophy
|
|
emerin deficiency
|
AD emery deridfuss MD
|
|
how to see keyser fleischer ring
|
slit lamp examination of the eyes
|
|
gaucher's
|
excessie bleeding, HSM, pancytopenia, markedly enlarged cells containing a fine fibrillar materil resmebling tissue paper in BM, deficiency in beta D glucosidase
|
|
most common site of oral SCC
|
floor of the mouth>tip of tongue>hard palate>base of tongue
|
|
SP-1
|
zn finger trx factor, "housekeeping" gene
|
|
four areas where 15-17 year old can make decision without parental notification
|
STD tx, substance abuse tx, birth control, prenatal care
|
|
mercaptopurine activation
|
by HGPRT, allopurinol raises 6-MP levels
|
|
anastrozole
|
estrogen antagonist to treat breast cancer
|
|
desensitization procedures with allergy
|
goal: promote Th1 response and therefore IFN-gamma to shut off the Th2 response
|
|
Wermer syndrome
|
MENI
|
|
Sipple syndrome
|
MEN II
|
|
neurosyphilis: PARESIS
|
personality, affect, hyperactive reflexes, eyes (pupils), sensorium defects, intellectual decline, speech deficiency
|
|
increased risk thyroid lymphoma
|
hashimotos (by 60-80x)
|
|
homogentisate oxidase
|
role in tyrosine catabolism pathway
|
|
hashimotos
|
uniformly firm thyroid gland, anti thyroid peroxidase or antithryoglobulin Ab
|
|
autoimmune HA in SLE
|
warm agglutinin (IgG)
|
|
renal cell CA and renal transplant
|
associated with PV
|
|
analysis of variants
|
1 nominal (2 or more groups) 1 interval
|
|
Chi square
|
2 nominal
|
|
matched pairs t-test
|
1 nominal (2 matched troups) 1 interval
|
|
meta-analysis
|
math liit review
|
|
pearson correlation coefficient
|
2 interval
|
|
pooled t test
|
1 nominal (2 groups) 1 interval
|
|
Nominal
|
tings counted in groups or categories
|
|
Interval
|
data measured along a dimension graded in equal intervals
|
|
widal test
|
diagnose typhoid fever
|
|
watson-Schwartz test
|
detect pophobilinogen in urine and diagnose porphyria
|
|
woellner enzyme test
|
heterophil antibodies in patients with EBV
|
|
dorsal scapular nerve
|
rhomboid innervation
|
|
medial pectoral nerve
|
minor and major pectoralis
|
|
lateral pectoral nerve
|
major pectoralis
|
|
suprascapular nerve
|
supraspinatus and infraspinatus
|
|
contraindicated in people with bowel obstructin
|
anything that stimulates intestinal tract (such as metoclopramide)
|
|
giardia look
|
"face-like" appearance, often times look crescent shaped
|
|
desquamative inerstitial penumonitis (DIP)
|
idiopathic process relatd to idiopathic interstitial fibrosis, lamellar bodies in macrophages contain surfactant
|
|
ADCC cells
|
nk cells, only kill body cells that are coated with antibody
|
|
LAK cells
|
NK cells that have been activated with IL-2, considered superactivated NK cells
|
|
charcot leyden crystals
|
derived from enzymes present in eosinophils
|
|
|
|
|
tartrate-tessitant acid phosphatase
|
hairy cell leukemia
|
|
chromium-51
|
red cell survival measure
|
|
major blood supply to intercostals in coarctation
|
anterograde flow though the intercostal artery via the subclavian artery
|
|
systemic amyloidosis
|
|
|
chronic hemodialysis
|
beta 2 microglobulin
|
|
cardiomyopathic hereditary forms
|
prealbumin/transthyretin
|
|
neuropathic hereditary syndromes
|
prealbumin/transthyretin
|
|
local amyloidosis
|
|
|
senile cardiac
|
atrail natriuretic peptide-related fibrils
|
|
|
|
|
vomiting center
|
floor of the 4th ventricle, vagal afferents receive and send info to the lateral reticular formation in the medullam (vomiting center)
|
|
floor of 3rd ventricle
|
hypothalamus
|
|
XR of rickets
|
bony changes at lower ends of radius and ulna, diaphyseal ends become fuzzy, cup shaped and may develop spotty rarefaction
|
|
growth plate
|
epiphyseal plate
|
|
metaphysis
|
between diaphysis and epiphysis
|
|
median nerve
|
Opponens pollicis, abductor pollicis brevis, flexor pollicis brevis, first two lumbricles
|
|
bubbly meconinum
|
meconium ileus when there is bowel obstruction without apparent reason
|
|
vitalline duct
|
embryologically connects the developing gut to the yolk sac
|
|
pleiotropy
|
example: mutation carriers or Rb gene get multiple different types of cancers
|
|
resistance to quinolones
|
chromosomally encoded, mutation in structural genes for DNA gyrase and topoisomerase
|
|
topoisomerase II inhibit
|
etoposide
|
|
topoisomerase IV (gyrase) inhibit
|
quinolones
|
|
oneiroid state
|
dreamlike state seen in mostly schizophrenic patients
|
|
treatment of HTN in diabetics
|
ACE inhibitors since they have been shown to slow the progression of renal disease
|
|
indapamide
|
thiazide diuretic
|
|
minoxidil
|
direct acting vasodilater for severe refractory HTN, opens Katp channels leading to arteriolar vasodilation and hyperpolarization of pancreatic beta cells and subsequent decreased release of insulin
|
|
"pearly papules"
|
basal cell carcinoma - would expect to see palisading nuclei
|
|
molluscum contagiosum
|
poxvirus, see viral cytoplasmic inclusions
|
|
acute salicylate poisoning
|
causes acute respiratory alkalosis via stimulation of respiratory centers, initial response often followed by metabolic acidosis
|
|
desensitization
|
therapy for phobia - progressive steps starting with least fearful
|
|
extinction
|
don’t pay attention to a whining kid and try to extinguish the behavior
|
|
operant conditioning
|
increase likelihood of a response by reinforcement (reward desired behavior)
|
|
radial traction of airways in restrictive disease
|
decreased
|
|
bowen's disease vs SCC
|
SCC will be frankly invasive
|
|
seborrheic keratoses
|
middle-old aged people, bening growths that histologically show hyperplasia of epidermis
|
|
verruca vulgaris
|
common wart
|
|
DNA polymerase proofreading direction
|
3' to 5' exonuclease activity
|
|
rhinoscleroma
|
chronic granulomatous disease of upper airway, caused by klebsiella rhinoscleromatis, see epistaxis nasal deformity and destruction of nasal cartilage, fibrotic stage of sclerosis and fibrosis, see histiocytes containing K. rhinoscleromatis = Mikulicz cells, treatment of choice tetracycline
|
|
pyknosis
|
shrinking of nucleus and basophilia from DNA condensation
|
|
karyorrhexis
|
nuclear breakdown
|
|
karyolysis
|
nuclear dissappearance
|
|
temporal lobe under the tentorium
|
uncal herniation --> compression of CN III especially peripheral part of CN III (parasympathetic), leads to mydriasis then loss of the pupillary light reflex, followed by loss of ability to follow flashlight
|
|
peripheral vs central CN III
|
peripheral is parasympathetic, central is sympathetic
|
|
tonsillar herniation into the foramen magnum
|
can compress medulla causing respiratory failure and death
|
|
upward herniation of cerebellum
|
posterior fossa lesion
|
|
herniation of the medially located cingulate gyrus under the falx cerebri
|
subfalcine / cingulate herniation - cerebral hemisphere expansion and can compress anterior cerebral artery
|
|
buccinator
|
muscle innervated by CN VII that can lead to excessive saliva accumulation between cheek and teeth when paralyzed
|
|
bruton agammaglobulinemia
|
recurrent respiratory infections caused by pyogenic organisms
|
|
lyme disease arthritis HLA
|
HLA DR4
|
|
increased synthesis of urea
|
severe burns and prolongued high fever
|
|
site of dorsalis pedis pulse
|
between extensor hallucis longus tendon and extensor digitorum longus
|
|
mellitin
|
found in bee venom causes mast cell degranulation
|
|
things that cause mast cell degranulation
|
physical injury, heat, cold, type 1 hypersensitivity, C3a, C5a, proteins from leukocytes, substance p, mellitin
|
|
eosinophil chemotactic factor-A
|
multiple substances preformed in mast cells that would be released at site of bee sting
|
|
AR PCKD
|
may also get hepatic fibrosis with HTN and splenomegaly
|
|
spontaneous abortion association with bacteria
|
listeria tx: iv amp or penicillin, maybe with AG; brucella
|
|
origin of right atrial myxoma
|
sinus venosus (which gives rise to smooth atria, coronary sinus, oblique vein)
|
|
slow developing testicular enlargement
|
syphilis, also see perivascular cuffing of lymphocytes and plasma cells, testis usually involved before epididymis, may see gummas
|
|
SVC syndrome
|
bronchiogenic carcinomas (small cell and SCC) account for 80%
|
|
subependymal giant-cell astrocytoma
|
tuberous sclerosis
|
|
non-enveloped viruses
|
PAPA please PIC ADEN of PARVO CALICO REOS
|
|
helical capsid viruses
|
the RABID PARAmedic and ORTHOpedist BUNYAn FILled the ARENA with CORONA
|
|
circular genome virus
|
ABP: Arena, Bunya, Papova
|
|
migratory skin rash
|
glucagonoma
|
|
5 p's of porphyria
|
painful abdomen, pink urine, precipitated by drugs, polyneuropathy, psychological disturbances
|
|
diaphragm
|
septum transversum, pleuroperitoneal folds, body wall, dorsal mesentary of esophagus; often get hernia due to failure of the pleuroperitoneal membranes to develop properly
|
|
informed consent exceptions
|
emergency, waiver by patient, patient is incompetent, therapeutic privilege
|
|
myxedema with thyroid
|
due to longstanding hypothyroidism in adults, high TSH, low T4, very general term that can result from many causes of hypothyroidism
|
|
hashimoto's biopsy findings
|
infilatration with lymphocytes, macros, plasmas, germinal center formation
|
|
subacute granulomatous thyroiditis (de quervian) biopsy
|
causes hyperthyroidism but can cause transiet hypothyroidism, frequently occurs after a viral infection, may experience fever nd painful enlargement of the thyroid, usually abates in 6-8 weeks biopsy = disruption of thyroid follicles, neutrophilic infiltrate, cellular aggregate, multinucleated giant cells
|
|
subacute lymphocytic thyroiditis
|
can cause transient hyperthyroidism but is generally painless
|
|
leydig cell tumor
|
gynecomastia, golden-brown tumor, large uniform cells, rod-shaped crystals
|
|
sertoli cell tumors
|
cord-like structures resemblin seminiferous tubules
|
|
polyadenylation recognition sequence
|
AAUAAA
|
|
splicing
|
3' end of the intron has a conserved AG, 5' is GT
|
|
streptococcus bovis
|
bacteremia and endocarditis, distinguished by having a cell wall carbohydrate composed of glycerol teichoic acid
|
|
bile solubility
|
strep pneumo is soluble, strep viridans is not
|
|
pyrrolidinyl arylamidase positive
|
group D and group A strep
|
|
CAMP test positive
|
group B
|
|
nerve in tonsillar fossa
|
glossopharyngeal nerve
|
|
aldesleukin
|
recombinant IL2
|
|
levamisole
|
enhances cell mediated immunity and is used in concert with 5FU in colorectal cancer
|
|
palivizumab
|
mAb against fusion protein of RSV
|
|
formation of the pancreas
|
ventral pancreatic bud normally rotates around duodenum to fuse with dorsal bud - form from the second part of duodenum, normally around the right side
|
|
annular pancreas formation
|
ventral bud rotating around the right and left sides of the second part of the duodenum
|
|
sole LDL elevation
|
type 2a
|
|
sole chylomicron elevation
|
type 1
|
|
increased LDL and TG and VLDL
|
type 2b
|
|
increased TG and chylomicron rem
|
type 3
|
|
increased TG and VLDL and chylo
|
type 5
|
|
peak suystolic pressure of ventricles vs aorta
|
2-3 mmhg higher in the ventricles
|
|
NE and Epi
|
NE is precursor
|
|
tyrosine stuff
|
tyrosine to thyroxine and dopa, dopa to melanin and dopamine
|
|
sibutramine
|
MAOI that also blocks serotonin and NE reuptake that increases energy expenditure and decreases appetite
|
|
embryology of syringomyelia
|
progressive vacitation of the central canal of the spinal cord
|
|
common variable immunodeficiency
|
caused by abnormal B-cell differentiation, decreased numbers of plasma cells and low Ig from all classes; distinguished from agammaglobulinemia (Bruton) by the normal numbers of B cells in the blood and lymphoid organs, in Bruton B cell maturation stops after rearrangment of heavy chains so b cells in the bloodstream are lower
|
|
irinotecan
|
topo I inhibitor, inhibits acetylcholinesterase --> diarrhea, also see neutropenia
|
|
gemcitabine
|
pyrimidine analog for first line therapy with pancreatic ovarian dna NSCLC
|
|
dupuytren contracture
|
contracture of palmar fascia caused by interraction of myofibroblasts with collagen fibrils of the fascia; myofibroblsts play a role in the wound healing process
|
|
locked in syndrome
|
completely awake and cognitavely intact with no abnormality of consciousness, they are unable to move extremeties and most of face, limited to vertical eye movements or blinking, large lesions of brainstem particularly base of pons such as with thrombotic stroke to basilar artery
|
|
genetic allotypes markers on Ig molecules
|
can be helpful in paternity cases Ig1 Ig2 Ig3 heavy chains,
|
|
idiotypes
|
response to specific antigens
|
|
low T3 syndrome
|
"euthyroid sick syndrome" occurs with systemic illnesses or problems, characterised by decreased in 5'-monodeiodinase activity in peripheral tissues leading to decreased T4-->T3 conversion, also see increased rT3 since 5'-monoiodo converts rT3 to inactive 3.3'-diiodothyronine
|
|
AMLs
|
|
|
M1
|
acute myelocytic without differentiation
|
|
M2
|
acute myelocytic with differentiation, may see eosinophils
|
|
M3
|
APML
|
|
M4
|
myelomonocytic
|
|
M5
|
acute myeloblastic leukemia (monocytic), detect with fluoride-sensitive esterase reaction
|
|
M6
|
erythrocytic
|
|
M7
|
AMKL
|
|
pseudohyphae
|
vaginal candidiasis
|
|
macroconidia
|
histo form
|
|
arthroconidia
|
ringworm (tinea)
|
|
carpal tunnel borders
|
flexor retinaculum anteriorly, carpal bones posteriorly
|
|
carpal tunnel contents
|
4 tendons of flexor dig super, 4 tendons of flexor dig profundus, 1 tendon from flexor pollicus longus, median nerve
|
|
25%
|
percentage of patients with ischemic heart diesease that present with sudden death
|
|
terbutaline
|
beta 2 agonist for acute asthma
|
|
immunosuppressive of choice for liver transplant
|
tacrolimus
|
|
viral packaging inhibited by
|
rifampin
|
|
early viral protein synthesis inhibited by
|
fomivirsen
|
|
ifn alpha major side effect
|
pancytopenia
|
|
non-nucleoside inhibitors
|
never ever deliver nucleosides: vevirapine, efavirenz, delavirdine
|
|
bacitracin
|
inhibits cell wall by blocking peptidoglycan synthesis
|
|
HIV med to decrease risk of maternal-fetal trans
|
zidovudine (AZT)
|
|
inactivation of drugs by phosphorylation
|
aminoglycosides
|
|
inactiavation by altering ribosome binding site
|
tetracyclines, chloramphenicol, macrolides
|
|
active efflux for resistance
|
tetracyclines
|
|
reduced permeability for resistance
|
macrolides
|
|
first line tx of non MR Staph aureus
|
cefazolin (first generation cephalo)
|
|
filgrastim vs argramostim
|
G-CSF vs GM-CSF
|
|
abnormal phosphorylation of tau
|
neurofibrillary tangles (intracytoplasmic inclusions) known as paired helical fragments PHFs
|
|
abnormal degradation of APP
|
formation of Abeta amyloid
|
|
hypnopompic hallucination
|
hallucination upon waking
|
|
hypnagogic hallucination
|
hallucination upon going to sleep
|
|
grief vs depression
|
marked funcitonal impairment after a few months
|
|
CCK
|
acts via vagal afferent pathways to stimulate somatostatin inhibition of gastric acid secretion, block CCK--> increased gastric acid secretion, stimulates pancreatic amylase, stimulated pancreatic lipase
|
|
werdnig hoffman
|
spinal muscle atrophy type I, disease of anterior horn cells, see lower motor neuron disease (such as fibrillation potentials on EMG) and fasciculations, die after a year
|
|
visualization of chlamydia in cells
|
iodine, Giemsa, or fluorescent Ab stains
|
|
pleomorphic gram negative rods
|
hemophilus dureyi, causes chancroid
|
|
chancroid is painful
|
|
|
chancre is not (primary syphils)
|
|
|
centriacinar emphysema
|
tobacco and coal dust
|
|
panacinar emphysema
|
alpha 1 antitrypsin
|
|
paraseptal emphysema
|
associated with scaring, may lead to spontaneous pneumothorax
|
|
splenectomized patients have low
|
IgG2 and IgM leading to susceptibility with encapsulated organisms
|
|
reason why histo is not communicable person to person
|
because it is intracellular
|
|
alpha actinin
|
bindds actin microfilaments in networks
|
|
kinesin
|
moves towards the plus end
|
|
dynein
|
moves toward miuns end
|
|
titin
|
sarcomere structure of striated muscle
|
|
chlorambucil
|
nitrogen mustard (subcategory of alkylating agent) used for the treatment of CLL and ovarian carcinoma and hodgkins and other lymphomas
|
|
lateral nucleus of hypothalamus
|
destruction results in starvation
|
|
suprachiasmatic
|
gets input from the retina and secretes melotonin for circadian rhythms
|
|
first site of change in duchenne's
|
hips
|
|
first site of change in myotonic dystrophy
|
ankly
|
|
first site of change in FSH dystrophy
|
facial and jaw
|
|
polyostotic fibrous dysplasia findings
|
local bony defects containing unmineralized whorls of connective tissue
|
|
stop codons
|
UAA, UAG, UGA
|
|
converge but cant adduct eye on lateral gaze
|
internuclear ophthalmoplegia (INO) from lesion to MLF
|
|
sturma ovarii
|
monodermal teratoma results in increased thyroid hormone and resultant decrese in TSH
|
|
RNA pol I
|
rRNA
|
|
RNA pol II
|
mRNA, snRNA, miRNA
|
|
RNA pol III
|
tRNA
|
|
laron dwarfism
|
congenital absence of growth hormone receptors, since growth hormone binding protein is the extracellular portion of the receptor, see low levels of GHBP, get low concentration of IGF-1 because there are no GH receptors on hepatocytes
|
|
nystatin mechanism of action
|
like amphotericin B, to punch holes in the membrane
|
|
terbinafine MOA
|
blocks ergosterol synthesis
|
|
flucytosine MOA
|
interferes with thymidylate synthetase
|
|
inulin measures
|
extracellular fluid volume
|
|
interstitial volume equals
|
ECF volume - plasma volume
|
|
marker of primitive lymphocytic cells
|
terminal deoxynucleotidyl transferase (Tdt) the enzyme that is active during VDJ rearrangement of the heavy chain
|
|
presence of cytoplasmic mu chains
|
implies successful VDJ heavy chain rearrangement
|
|
type II antiarrhythmic
|
decreases SA node automaticity, increase AV nodal refractoriness, and decreases AV nodal conduction velocity
|
|
lidocaine indication
|
treatment of acute management of ventricular arrhythmias that occur during periods of cardiac ischemia
|
|
pseudomonas alpha toxin
|
inhibits protein synthesis by acting on EF2 such as with diphtheria toxin, pseudomonas toxin targets liver, diphtheria toxin targets neurons and heart
|
|
diabetic foot ulcer bacteria
|
pseudomonas
|
|
anthrax toxin
|
adenylate cyclase causes fluid loss from cells
|
|
cholera toxin
|
increases adenylate cyclase activity by ribosylation of GTP-binding protein
|
|
E coli labile toxin
|
similar to cholera toxin
|
|
pertussis toxin
|
fluid loss by Gi ribosylation
|
|
strep erythrogenic toxin
|
similar to diphtheria via increased cytokines
|
|
activates PDH
|
increased pyruvate concentration
|
|
occludin
|
transmembrane linker protein in tight juction that separate apical from basolateral membranes and apical fluid from interstitial fluid but do not provide strong attachments
|
|
tumor like submucosal nodules of the tongue
|
seen in some cases of amyloidosis which more commonly affects the intestines than other places in the GI tract
|
|
type II Arnold-Chiari malformatoin
|
parts of hinbrain, cerebellar vermis, and fourth ventricle herniate into the foramen, commonly associated with meningomyeloceles
|
|
porencephaly
|
severe cleft in brain that allows the ventricles to communicate with the subarachnoid space
|
|
most common type of ASD
|
ostium secundum type
|
|
ASD in downs
|
ostium primum type - often includes MV or TV malformations and result in left to right shunts with late cyanosis
|
|
antiarrhythmic to decrease conduction through AV node
|
digoxin (indicated for treatment of atrial fibrillation especially with elevated ventricular rate)
|
|
quinidine autonomic side effect
|
anticholinergic effect that would increase AV conduction velocity, usually is indicated for conversion of Afib/flutter
|
|
brain structures
|
head to toe: telencephalon (verebral hemispheres and BG and lateral ventricles), diencephalon (thalamus et al), mesencephalon (midbrain), metencephalon (pons and cerebellum), myelencephalon (medulla and fourth ventricle),
|
|
teratogenicity of mumps
|
aqueductal stenosis causing proximal ventricular enlargment and noncommunicating hydrocephalus, cerebral aqueduct is in the midbrain (mesencephalon)
|
|
X linked dominant disease
|
hypophosphatemic rickets: abnormal regulation of vit D3 metabolism and defects in renal tubular phosphate transport, growth retard, osteomalacia, rickets
|
|
penicillamine
|
copper poisoning
|
|
loracarbef
|
second gen cephalo for gram positive and negative
|
|
wiskott aldridge comorbidity
|
12% chance of developing NHL
|
|
brush border in kidney
|
proximal tubule
|
|
wound contraction
|
myofibroblasts
|
|
poxvirus
|
replicates in cytoplasm so much have its own DNA dependent RNA polymerase, cause of molluscum contagiosum
|
|
guarnieri bodies
|
intracytoplasmic factories for DNA replication
|
|
median entry into forearm
|
between the two heads of the pronator teres
|
|
polymerase restricted to nuleolus
|
pol I for rRNA transcription
|
|
intercostal space structures
|
from top to bottom: vein, artery, nerve (VAN drives down)
|
|
cushing disease from pituitary vs ectopic tumor
|
ectopic tumor ACTH secretion not usually depressed by dexamethasone administration
|
|
ergotamine
|
partial agonist/antagonist and tryptaminergic, dopaminergic, and alpha-adrenergic receptors, treatment of vascular headaches
|
|
methylsergide
|
blocks the action of serotonin and used for prevention of vascular headaches
|
|
HACEK bacteria
|
cause endocarditis: haemophilus aphrophilus, actinobacillus, cardiobacerium, Eikenella, Kingella
|
|
oocyte arrested / ovum arrested
|
prophase / metaphase
|
|
warfarin SE
|
may cuse necrosis of skin bw third and tenth day of therapy, depletion of protein C leads to hypercoaguability in skin
|
|
multiple drug resistance plasmids
|
transposons
|
|
pengastrin-stimulated calcitonin secretion
|
marker for medullary carcinoma of thyroid in MEN II
|
|
diphenoxylate
|
opioid receptor for diarrhea, combined with atropine to decrease abuse potential
|
|
"I" antigen
|
antigen in mycoplasma IgM cold agglutination
|
|
macrolides
|
reversibly bind to 50S subunit
|
|
lincosamides (clindamycin)
|
irreversibly bind to 50s subunit
|
|
superior gluteal nerve
|
innervates gluteus medius and minimus which allow people to maintain balance with one foot on the ground
|
|
first and second sacral nerves
|
piriformis innfervation (lateral rotator of thigh and hip)
|
|
type I Arnold-Chiari malformation
|
cerebellar tonsils through the foramen magnum, frequently asymptomatic and incidental autopsy finding
|
|
Erb palsy in infants
|
C5-C6, baby delivered in breech position, loss of abductors and external rotators, loss of flexion and supinatino at the biceps causes the phenotype
|
|
phenotype of pemphigus vuglaris versus bullous pemphigoid
|
PV: widespread painful blisters on skin and oropharynx BP: widespread blistering with pruritis sparing the oral mucosa
|
|
s pneumo acquisition of penicillin resistance
|
transformation
|
|
rapid clinical course of dementia and neuro probs
|
creutzfeld-jacob disease
|
|
dementia with lewy bodies
|
lewy bodies in the SN, limbic cortex, subcortical nuclei (like basal nucleus of meynert)
|
|
binswanger dz
|
rarefaction of cerebral white matter caused by HTN-related arteriolosclerosis
|
|
PSA usefulness
|
doesn’t necessarily distinguish BPH from cancer, when cancer is known use to follow tumor progression
|
|
urogenital sinus male
|
urinary bladder, prostatic urethra, prostate, membranous urethra, bulbourethral glands, penile urethra, littre's glands
|
|
urogenital sinus female
|
urinary bladder, urethra, urethral glands, paraurethral glands, vestibule of vagina, greater vestibular glands
|
|
corpus spongiosum
|
singular structure that surrounds the urethra
|
|
corpus cavernosum
|
paired structure superior to corpus spongiosum
|
|
vascular rarefaction
|
loss of capillaries and other blood vessels in muscle with prolongued low metabolic rate (as in a cast)
|
|
carmustine
|
alkylating agent commonly used in hodgkins disase tx most notable SE are delayed myelosuppression and pulmonary toxicity
|
|
cubital tunnel syndrome
|
paresthesias and numbness in ulnar side due to ulnar compression
|
|
monosodium urate crystals (gout)
|
needle-shaped, yellow when parallel to polarizer (negatively birefringent), blue when perpendicular to polarizer
|
|
calcium pyrophosphate crystals (pseudogout)
|
rhomboid shaped, blue when parallel (positively birefringent), and yellow when perpendicular
|
|
positively birefringent
|
"positively parallel blue"
|
|
brucella
|
granulomatous disease, associated with cattle, septic abortion, undulant fevers, can cuase endocarditis (aortic valve), petechiae, visual blurring
|
|
glycocalyx
|
covers microvilli to prevent trauma
|
|
basal and reticular lamina
|
components fo the basement membrane
|
|
endemic typhus
|
rickettsia typhi - feces of the rat flea, rat reservoir
|
|
epidemic typhus
|
tickettsia prowazaki - body louse, humans and flying squirrel reservoir
|
|
Q fever
|
coxiella burnetti - acquired by inhalation
|
|
rocky mountain spotted fever
|
rickettsia rickettsi - tick transfer, tick is reservoir
|
|
scrub typhus
|
rickettsia tsutsugamushi - southeast asia, mites transmit, mites and rodents are reservoirs
|
|
ITP treatment
|
immunosuppressants and splenectomy
|
|
chorion and amnion
|
chorion forms before the amnion, so cant have more chorions than amnions, but monochorion with monoamnion or diamnion is possible in identicle twins, having two chorions necessitates two amnions: dichorionic diamnionic is either identical or fraternal twins: fraternal twins must be dichorionic
|
|
cicumvallate placenta
|
extrachorial portion outside insertion of amnionic membranes creating a circumferential groove (vallum), no clinical significance
|
|
bipartit placenta
|
composed of two equal segments, no clinical significance
|
|
accelerated idioventricular rhythm
|
latent pacemaker in ventricles --> accelerated regular rate, unusual QRS, no related p waves
|
|
accelerated junctional rhythm
|
P waves inverted and may be anywhere within regular QRS complexes which occur regularly at rate 60-150
|
|
premature ventricular contraction
|
ectopic ventricular pacemaker inserts an ectopic beat, wide, bizarre QRS
|
|
vtach
|
wide and bizarre but recognizable QRS complexes
|
|
vfib tx
|
CPR, defib, IV and intracardiac drugs: epinephrine, lidocaine, procainamide
|
|
PPD
|
composed of tuberculin (outer surface protein) and mycolic acid of TB
|
|
order of transfer of Hfr
|
from OriT to tra, closest to oriT (furthest from tra) most likely to be transferred
|
|
HPV infects which layer
|
the bsal layer and causes warts and increasing number of prickle cells, causing skin thickening and epithelial spikes to form
|
|
HPV in skin
|
infection at basal, replication in spinosum, maturation in granulosum and lucidum, release from corneum
|
|
ceramide
|
lipid precursor to which sugars are added to form gangliosides and galactocerebrosides
|
|
dermatan sulfate
|
glycosaminoglycan involved in formation of proteoglycans
|
|
hyaluronic acid
|
glycosaminoglycan involved in formation of proteoglycans
|
|
aneurysm of aortic root
|
syphilis
|
|
paramyxovirus avoidance of Ab
|
via spread from cell to cell via syncytia formation
|
|
OD on TCA risk
|
arrhythmia
|
|
metastatic calcification
|
think hypercalcemia: hyperparathyroid/thyroidism, addisons disease, chronic renal failur, bone destruction (leukemia, mets, MM)
|
|
gonnococcus and joints
|
monoarticular acute onset arthritis, may see disseminated symptoms, may see skin lesions, may also see migratory arthralgia and tenosynovitis
|
|
tinea corporis
|
ring worm ,often contracted from playing with a cat, treat with an antifungal (azole) cream
|
|
doxepin
|
antipruritic cream
|
|
mupirocin
|
anti-infective agent for topical treatment of impetigo
|
|
obstructive sleep apnea tx
|
adenotonsillectomy because of adenotonsillar hypertrophy
|
|
triazolam (halcion)
|
combination with behavioral therapy for insomnia
|
|
often cause acanthosis nigricans
|
adenocarcinomas of chest or abdomen
|
|
posterior herniation of the nucleus pulposus
|
most common type of herniation, results in occulsion of intervertebral foramen, spinal nerve between C4 and C5 is C5 spinal nerve
|
|
anterior and posterior rami
|
found lateral to intervertebral foramina
|
|
sarcoma botyroides
|
malignant tumor affects kids usually and is a grape like mass that protrudes from the vagina, neoplastic cells are of skeletal muscle origin
|
|
splenorenal ligament
|
connects spleen to posterior abdominal wall and contains splenic artery and vein
|
|
closed and open angle glaucoma
|
in closed angle claucoma have increased IOP secondary to closure of a preexisting narrow anterior chamber angle,closed angle tx: single dose of acetazolamid followed by oral dose, for open angle tx: CA inhibitor, epinephrine, latanopros (prostaglandin F2), timolol
|
|
femoral ring
|
bounded medially by lacunar ligament and femoral vein laterally, by pubis posteriorly and inguinal ligament anteriorly
|
|
rib innervation
|
intercostal nerve (anterior ramus of the thoracic spinal nerve) after passing angle of the rib it occupies the lower portion of the rib in the costal groove, so inject anesthetic medial to the angle of the rib
|
|
rhabdomyoma
|
associated with tuberous sclerosis
|
|
Hfe gene in hemochrom
|
tightly linked to HLA A3
|
|
virilization in male fetus
|
hCG causes testosterone release from leydig cells for first half of pregnancy, in second half LH from the fetal pituitary is required for continued growth
|
|
anovulation
|
can be caused by lack of progesterone response to unchecked estrogen, admin and withdrawal of progesterone to check
|
|
from face to brain
|
cavernous sinus as with mucor (think diabetics)
|
|
left sided neglect
|
most often due to parietal lobe damage on the right side
|
|
bence jones proteins
|
kappa light chains
|
|
ostium secundum ASD
|
most common, symptoms absent until later on, systolic ejection murmur from increased right sided volumes, fixed splitting
|
|
AV septum
|
physical separation of the two AV valves, lack of this causes endocardial cushion defects
|
|
septum primum
|
begins septation of the atria with downward growth, the orifice that remains is the ostium primum
|
|
ostium secundum
|
forms in the septum primum after the endocardial cushions have fused with the septum primum
|
|
septum secundum
|
grows downwward and together with the flap of the ostium primum forms the foramen ovale
|
|
weak area of internal inguinal ring
|
transversalis fascia which forms the posterior wall of the inguinal canal with the conjoined tendon
|
|
benign essential tremor tx
|
propranalol (any non-selective beta blocker)
|
|
nucleotide excision repair
|
inability to repair thymine dimers
|
|
metastatic potential of carcinoid
|
site and size (appendix and cecum rarely metastasize to the liver), those of the stomach, ileum, and colon more likely, esp if greater than 2cm in diameter
|
|
growth on mannitol
|
staph aureus
|
|
allantois
|
contributes to umbilical cord and placenta
|
|
cloacal membrane
|
persistance causes imperforate anus (covers hindgut)
|
|
notochord
|
nucleus pulposis
|
|
prechordal plate
|
buccopharyngeal membrane (cranial end of foregut)
|
|
docusate (Colace)
|
stool softener
|
|
trihexylphenidyl
|
muscarinic antagonist used in parkinsons - get anticholinergic side effects
|
|
menke's disease
|
depigmented lustless hair, facial ocular vascular and cerebral manifestations (like seizures), copper deficiency similar to wilsons
|
|
chromosome 15 del
|
prader willi (paternal deletion) or angelman (maternal deletion)
|
|
treatment of choice for HACEK
|
ceftriaxone: SE: eosinophilia, thrombocytosis, leukopenia
|
|
erythema multiforme and Stevens johnson pathog
|
immune complex deposition at the dermal blood vessels
|
|
clubbing and hypertrophic pulmonary osteoarthropathy
|
associated with bronchogenic carcinoma, benign mesothelioma, and diaphragmatic neurilemmoma
|
|
klinefelters
|
hyperplastic low functioning leydig cells cause decreased testosterone and subsequently increased LH which in turn causes increased estrogen secretion
|
|
NADPH oxidase
|
production of H2O2
|
|
debranching enzyme releases
|
free glucose, nonbranched glycogen doesn’t release free Glc
|
|
responsible for excitotoxic effects of glumatate
|
NMDA channel, voltage and ligand gates
|
|
ligand gated glutamate channel
|
AMPA and kainate receptors (both cation channels)
|
|
safranin
|
stains gram negatives red
|
|
carbolfuchsin
|
stains acid fast organisms red
|
|
crystal violet
|
stains gram positives blue
|
|
methylene blue
|
secondary stain in acid fast (stains non-acid fast organsisms)
|
|
RET proto-oncogene
|
growth factor receptor
|
|
anti-Pol I
|
marder for diffuse scleroderma
|
|
location of Penicillin BP
|
in the plamsa membrane
|
|
staph alpha toxin
|
pore-forming toxin
|
|
pertussis toxin
|
ribosylates Gi thereby stopping inhibtion of AC--> increased cAMP
|
|
verotoxin
|
EHEC, same mechanism of shiga toxin (60S subunit)
|
|
sealing strands
|
found in tight junctions
|
|
von gierke's disease
|
hypoglycemia, hyperlipidemia, lactic acidosis, ketosis
|
|
HbA1c affected by
|
RBC turnover, low turnover (disproportionately high number of old cells) --> high A1c levels, see this in folate/B12 def
|
|
CO poisoning
|
hypoxia, cherry red lips
|
|
chronic lead poisoning
|
anemia with basophilic stipling, neuropathy, ab pain
|
|
chronic mercury poisoning
|
CNS atrophy, gingivitis, gastritis, renal tubular changes
|
|
site of collagen helical formation
|
RER and golgi apparatus get triple helix self-assembly
|
|
cleavage and crosslinking of collagen occur
|
in the extracellular space
|
|
reperfusion injury
|
free radical damage
|
|
identification
|
unconscious adoptino of the characteristics or activities of another person, used to reduce pain of loss
|
|
sublimation
|
diversion of unacceptable impulses into acceptable outlets
|
|
bumetanide
|
loop diuretic
|
|
alternative pathway of complement
|
turned on by the surfaces of bacteria, Factor B is an activator protein in this pathway
|
|
most abundant complement protein
|
C3-->C3a (anaphylaxotoxin) and C3b (opsonin and clearance of IC)
|
|
classical complement pathway
|
activated by Ig (C1q binds IgG heavy chain)
|
|
AA protein as in RA
|
represents an enzymatically degraded form of SAA (serum amyloid-associated) protein hich is made in the liver
|
|
"cytotoxic disease"
|
type II hypersensitivity is a form
|
|
atopic disease
|
type I hypersensitivity
|
|
contraction alkalosis
|
loss of ECF with diuretics preferentially loses Na+ and Cl- not HCO3- so you get a proportional increase in HCO3 and thus alkalosis
|
|
reiter's (reactive arthritis)
|
conjunctivitis, arthritis, keatoderma blennorrhagica (papulosquamous skin rash on palms and soles), urethritis, circinate balanitis, occasionally aortitis
|
|
osteomyelitis stuff
|
IVDU = pseudomonas; chronic UTI = staph auresu; multiple sex partners = gonorrhoeae; sickle cell = salmonella; TB = vertebral osteomyelitis (potts)
|
|
HBeAg
|
marker of transmissibility - disappears after a few months
|
|
Cardio
|
|
|
Norepinephrine
|
alpha 1 and beta 1 activity, very little beta 2 activity
|
|
verapamil and heart failure
|
verapamil has been associated with exacerbated CHF due to strong negative ionotropic effect
|
|
amlodipine and felodipine
|
most commonly used Ca channel blockers in patients with CHF
|
|
iron and the heart
|
hemochromatosis in heart can lead to cardiac failure
|
|
digoxin and WPW Syndrome
|
can lead to ventricular fibrillation via enhancing accessory conduction pathways
|
|
right dominant heart circulation
|
posterior descending branch originates from RCA which gives rise to the posterior interventricular septum
|
|
left dominant heart circulation
|
posterior descending branch originates from left circumflex a
|
|
MV prolapase gender bias
|
more women than men
|
|
fragile X syndrome cardiac comorbidity
|
MV prolapse and aortic root diilatation (may result in regurgitation)
|
|
class IB antiarrhythmics
|
lidocaine, tocainide, mexiletine
|
|
resporption of distal clavicles
|
hyperparathyroidism
|
|
scalloping of vertebral bodies
|
secondary to aortic aneurysm
|
|
graft vascular disease
|
develops years after transplantation and is due to intimal thickening of the coronary arteries without associated atheroma formation of significant inflammation, cannot be prevented with current immunosuppressive therapy
|
|
hyaline vs hyperplastic arteriosclerosis
|
hyaline associated with benign htn vs hyperplastic associated with malignant htn that results in onion-skinning
|
|
Endocrine
|
|
|
diabetic ketoacidosis
|
hypokalemia, hypophosphatemia, negative sodium balance (glycosuria causes increased excretion of sodium in the urine)
|
|
fascia where thyroid lies
|
pretrachial fascia
|
|
GI
|
|
|
daycare center diarrhea
|
shigella if bloody, yersinia enterocolitica also
|
|
yersinia enterocolitica
|
diarrhea (may be bloody in severe cases), vomiting may be present, pseudoappendicitis, reactive arethritis, erythema nodosum, septicemia
|
|
salmonella vs shigella
|
salmonella has slower onset and more pronounced systemic symptoms
|
|
intussesception vs volvulus age groups
|
volvulus more likely in eldery, intussusception in young
|
|
tropical sprue vs celiac sprue anatomy
|
tropicalsprue is entire small bowel, celiac is proximal small bowel only
|
|
blind loop syndrome
|
obstruction causes bacteria buildup and malnutrition due to bacterial activity
|
|
calcium absorption
|
at the ileum
|
|
most common outcome of hep B
|
subclinical disease followed by complete recovery>acute (most recover)>healthy carriers>chronic infection
|
|
orodysphagia
|
from muscular or neurological disorders like stroke, ALS, muscular dystrophy or MG, cough hoarseness nasal regurgitation
|
|
VIP
|
acts on crypt cells in intestine
|
|
Muscles of mastication
|
|
|
temporalis
|
backward movement of jaw
|
|
digastric
|
depress lower jaw
|
|
lateral pterygoid
|
move lower jaw forward
|
|
mylohyoid
|
depress lower jaw
|
|
medial pterygoid
|
elevate lower jaw
|
|
carcinoma of pancreas
|
very dilated biliary tree terminating in a blunt, nipple like obstruction at the lower end of the common bile duct
|
|
choledocholithiasis
|
gallstone becomes lodged in bile duct leading to charcot triad
|
|
charcot triad
|
RUQ pain, fever, jaundice indicative of cholangitis
|
|
stones in gallbladd or cystic duct
|
do not cause jaundice
|
|
stones in cystic duct
|
febrile, unrelenting RUQ pain and tenderness ,leukocytosis, mild elevations in bilirubin (flow of bile is not impeded)
|
|
stones in common duct
|
cause colicky pain and jaundice (flow of bile impeded)
|
|
potentiate secretin-mediate bircarb secretion:
|
CCK and Ach, but these do not cause bicarb secretion alone
|
|
hyoscyamine
|
anticholinergic to alleviate postprandial pain in IBS
|
|
mesalamine
|
5-ASA derivative for UC, not drug of choice for flare ups
|
|
HEME
|
|
|
tumors that cause erythrocytosis
|
renal cell carcinoma, hepatocellular carcinoma, meningioma, pheochromocytoma, cerebellar hemangioblastoma, adrenal adenoma
|
|
eosinophilia in asthma
|
mediated by IL-5
|
|
neutrophilic leukocytosis
|
mediated by IL-1 and TNF
|
|
defects of platelet vesicle release or secondary aggregation
|
due to storage pool disease and aspirin use
|
|
storage pool disease
|
|
|
MSK
|
|
|
clawing of ring, forefinger, and little fingers
|
ulnar nerve lesion
|
|
DMD cardiac comorbidity
|
dilated cardiomyopathy and conduction abnormalities
|
|
myotonic dystrophy
|
trinucleotide expansion
|
|
myositis ossificans
|
ossification following healing in site of muscle trauma, typically in athletic adolescents and young adults
|
|
involvement of cervical spine in RA
|
up to 80% of patients, 25% in atlanto-axial joint, if large amount of subluxation is present then might get quadraplegia and even sudden death
|
|
ankhylosing spondylitis complications
|
AV block, bladder and bowel problems, uveitis, pulmonary fibrosis, psoriasis, IBD
|
|
lytic and blastic lesions in bone
|
breast cancer mets
|
|
lytic lesions in bone
|
kidney, lung, and thyroid cancer mets
|
|
muscle innervated by superficial peroneal nerve
|
peroneus longus, suspect injury when you lose sensation in the dorsum of the foot
|
|
skeletal muscle relaxants
|
|
|
cyclobenzaprine
|
centrally acting, structurally related to TCAs, strong anticholinergic side effect profile
|
|
baclofen
|
centrally acting, inhibition of monsynaptic and polysynaptic reflexes at the spinal level
|
|
methocarbamol
|
general CNS depressant
|
|
|
|
|
diclofenac
|
NSAID
|
|
ketorolac
|
NSAID
|
|
rofecoxib
|
selective cox 2 inhibitor
|
|
celecoxib
|
COX-2 inhibitor and sulfa drug
|
|
tramadol
|
centrally acting analgesic compound with action at mu opiate receptor, doesn’t cause much respiratory depression, use for moderate to severe pain
|
|
dorsal interosseus
|
abductors of fingers
|
|
palmar interosseus
|
adductors of fingers
|
|
most common site for embryonal rhabdomyosarcoma
|
head and nexk, other sites include GU tract (such as sarcoma botyroides) and extremeties
|
|
primary osteoporosis
|
postmenopausal women
|
|
secondary osteoporosis
|
other causes
|
|
myasthenia gravis autoantibodies
|
anti-nAChR, anti MuSK (muscle specific kinase) in a secondary form which results in decreased NMJ patency
|
|
MG exacerbated by antibiotic:
|
aminoglycosides which have curare like side effects
|
|
osteomalacia bone histology
|
seams of uncalcified osteoid increased osteoblasts
|
|
paget dz bone histology
|
thickening of bony trabeculae with irregularly arranged cement lines (mosaic pattern)
|
|
unicameral bone cyst
|
a long bone contains a cystic space filled with fluid lined with connective tissue granulation tissue collagen and histiocytes
|
|
hyperphosphatemia effect on vitamin D
|
directly inhibits the production of 1,25 dihyrdoycholecalciferol
|
|
posterior tibial artery
|
feeds posterior leg and plantar foot
|
|
NEURO
|
|
|
neurotransmitter for induction of REM sleep
|
acetylcholine
|
|
oculomotor nerve
|
innervates levator palpebrae superioris - elevates the eyelid; oculomotor lso has parasympathetic fibers that synpse in ciliary ganglion to innervate the sphincter pupillae muscle which constricts the pupil - lesion of this causes eyelid drooping and mydriasis
|
|
pathognomonic for INO
|
inability to adduct the right eye on left lateral gaze
|
|
stroke in endocarditis
|
PARIETAL LOBE --> may result in spatial recognition problems
|
|
meningism
|
triad of: nuchal rigidity, photophobia, headache
|
|
herpes simplex encephalitis
|
subacute onset with meningismus, headache, personality changes
|
|
Cranial Nerve Nuclei
|
|
|
medulla
|
IX, X, XI, XII
|
|
pons
|
V VI VII VIII
|
|
midbrain
|
III, IV
|
|
medial nuclei
|
motor
|
|
lateral nuclei
|
sensory
|
|
axillary nerve innervation
|
deltoid and teres minor muscles
|
|
DRG contain
|
nerve cell bodies of primary sensory afferents for proprioception, discriminative touch, and vibration, send axons up ipsilateral dorsal column
|
|
primary afferents for pain and temp
|
cell body in DRG, synapse in ipsilateral dorsal hron, cross in the anterior white commissure, ascend in the contralateral spinothalamic tract
|
|
multinucleated giant cells in brain
|
HIV encephalitis
|
|
CMV in brain
|
tropism for ependymal cells (seen in ependymal and periventricular locations)
|
|
vacuolar myelopathy
|
degeneration of of posterior columns and LCST
|
|
site of most arachnoid cysts
|
sylvian fissure
|
|
sylvian fissure
|
lateral fissure (as opposed to central fissure separating parietal from frontal lobes)
|
|
jamais vu
|
failure to recognize famiiar events that have been encountered before
|
|
appendicular ataxia
|
cerebellar hemispheres
|
|
truncal ataxia
|
cerebellar vermis
|
|
prosopagnosia
|
inability to recognize faces, bilateral lesion of visual association cortex
|
|
anosagnosia
|
deficit of cognition in ones own illness, lesions in nondominant parietal lobe
|
|
ganser syndrome
|
giving approximate answers instead of exact ones, most commonly seen in prison inmates
|
|
central chromatolysis
|
loss of histological staining in lower motor neurons whose axons have been damaged as by injury to ventral roots
|
|
lewy body composition
|
alpha-synuclein
|
|
salivation innervation
|
chorda tympani from VII controls salivation from submandibular and sublingual glands, parotid gland is IX
|
|
lacrimal gland
|
VII
|
|
Ki-67
|
nuclear factor used to measure neoplastic replicative activity
|
|
|
|