Question Journal
adenosine deaminase involved in purine metabolism, involve in the developement of? Deficiency is associted with?
-development and maintenance of the immune system -SCID
action of sartorius (4)
-flex/ lateral rotate thigh -flex/medial rotate knee
the most common microbugs in *neonatal* meningitis? (3)
-group B strep -E coli -Listeria
Aortic stenosis mneoninc
"SAD" syncope Angina Dyspnea
Felty styndrome (3)
"SANTA's FELT" Splenomegaly Anemia Neutropenia Thrombocytopenia Arthritis (Rheumatoid)
Virchows triad
"SHE" stasis Hypercoaguability Endothelia damage
cardiac cycle: SV, ESV, EF, aortic pressure increased afterload? increased preload? increased contractility?
-increased afterload: increased aortic pressure, increased ESV, decreased SV -increased preload: increased SV -increased contractility: increased SV, increased EF, decreased ESV 276
Metyrapone use/moa
"tyra's talk show talks to 11 year olds about getting crushed" *use: diagnosis of adrenal insufficiency* and occasionally in the treatment of Cushing's syndrome moa: blocks cortisol synthesis (-) 11β-hydroxylase. normal response: should stimulate ACTH secretion, secondary Adrenal insufficiey: ACTH remains low
Leukemia associated with splenomegaly
"waiting for a CLL, but smuged himsefl b/c of a massive splenomegally" CLL
when does the Wolfian ridge form
"wolf has 4 legs" end of 4th week of development
*ventilation/perfusion ratio* at apex of lung vs base
*high ratio at apex* low ratio at base
Action of pec major (3)
*humerus* -medial rotate, -flex -adduct
moa for propythiouracil
*inhibtis perioxidase* which is the enzyme that oxididizes I1-I2 (fist step in thyroid hormone syn)
Intrafusal vs extrafusal muslce fibers
*intrafusal*: rate of change in length of a m. (m. spindle innervated by 2 axons, 1 sensory and 1 motor) *extrafusal*: contract= generating skeletal movement (innervated by alpha motor neurons)
Definition of LEA anteversion? birth vs adult angles
-Its the angle between longitudinal axis of the neck of femur and the frontal plane (at birth angle is 60 external) (adult angle is 10 external
Hexokinase vs Glucokinase: location? km? when is glucokinase active?
-hexokinase found in all tissues except for liver and pancrease. low Km=very high affinity for glucose "all tissues have high affinity for a hex except for liver and pancrease" -glucokinase found in liver. high km=low affinity. only active right after a meal
contents of the femoral triangle? what is the name of the canal that continues from the femoral triangle?
"NAVL" Femoral n Femoral a, Profunda femoral a Femoral v, Profunda femoral v, Great Saphenous v Lymph of Deep inguinal Femoral Sheath/ Fatty tissue Adductor canal
causes of a normal anion gap
*"HARD-ASS"* (GI or Renal issues) Hyperalimentation Addison disease Renal tubular acidosis Diarrhea Acetazolimide Spironolactone Saline infusion 538
Crescents in Bowmans space comprised of fibrin and macrophages? is it nephritic or nephrotic?
"Rapidly progressive Crescent moon" Rapdily progressive glomerulonephritis (nephritic syndrome)
labs for polycyethemia vera: RBC, WBC, Platelet, plasma volume, RBC mass, mutation, O2 saturation, EPO level?
-increased RBC, WBC, Platlets, plasma volume, RBC mass, -(+) for JAK2 mutation "Jak and poly" -no effect on O2 saturation -decreased erthropoetin levels
where does the Ischiadic artery branch from? what is it and hos is it drained?
-branches from umbilical a as limb bud develops, the blood supply preceds nervous. the ischiadic a is a branch of a large central artery. venous drainage into the marginal sinus
pepsin: function? secreted by? activated by
-breaks down proteins into smaller peptides (protease) -pepsinogen from gastric chief cells -HCL secretion
insertion/action of articularis genu
-capsule of knee -retracts the capsule of the knee during joint extension
bacteriocidal (3)
-cell wall inhibitors -floroquinolones -Aminoglycosides
Relationship between ciliary body and suspensory ligaments in the eye for near and far objects
-cilary m contract=suspensory lig loose=lens bulge=near vision -ciliary m relax=suspensory lig tighten= lens thinner=far vision
when does the common peroneal nerve become superficial and deep peroneal nerve
-common peroneal nerve terminates between peroneus longus and the neck of the fibula as it pierces the posterior peroneal septa
Cuases Peripheral neuropaty of hands and feet, angiokeratomas, cardiovasuclar renal disease due to a alpha galactosidase A deficeincy resulting in ceramide trihexoside accumulation
Farby disease "FARting from a bowl of CERAmide with Alpha MILK causes PERIPHERAL NERUOPATHY" 111
focal malformation that resembles a neoplasm in the tissue of its origin. This is not a malignant tumor; it grows at the same rate as the surrounding tissue. It is composed of tissue elements normally found at that site, but they are growing in a disorganized manner
Hamartomas
metabolic disorder affecting the absorption of nonpolar amino acids particularly tryptophan that can be, in turn, converted into serotonin, melatonin, and niacin
Hartnup disease (pellegra) -Niacin is a derrivitive of trypophan 106
what makes up the cruciate anstomoses
Inferior gluteal Transverse br of MFC Transverse br of LFC 1st perforating
what makes up the confluence sinus (3)
1. superior sagital sinus 2. straight sinus 3. occipital sinus
*parotid gland* parasympathetic innervation starting with: inferior salvitory nuclues: ---> CN ---> n ---> ganglion ---> n ---> gland
Inferior salvitory nuclues: --->CN9 -->lesser petrosal n ---> otic ganglion --->auriculartemporal n ---->parotid gland
when does axons and motor nuerons from ventral horn develope in LEA
5th week of development
Antistreptolysin O titier indicated by strep a infection to help diagnose what
PSGN Reumatic fever
Hemophilia has an increased time for?
PTT
Genetic shift/antigenic shift causes
Pandemics "PS" 163
Which RIPE therapy drug prevents peripheral neuropathy
Pyridoxine (B6)
Reissiners membrane vs basilar membrane
R: between scala vestibuli and scala media vs B: between scala tympani and scala media
pulmonary vs systemic blood pressure differences: RA: RV: pulmonary a: LA: LV: systemic a:
RA: 3 RV: 25 pulmonary a: 15 LA: 5 LV: 120 systemic a: 100
This pathology invovles a Beta globin chain of hemoglobin S, a valine residue replaces a glutamic acid at the 6th amino acid position from the N-terminus. This amino acid subsitution is due to a single base change (point mutation).
Sickel Cell anemia
which microcytic hypochromic anemia cauased by alcoholics is the defect in heme synthesis and can be treated with Pyridoxine (Vit B6)
Sideroblastic (Pyridoxine also prevetns peripheral neuropathy)
DNA mutation: nucleotide substitution but codes for same amino acid. often base change in 3rd position of codon
Silent mutation
PGI2
Prostac*I*clin =Prostacyclin
main virulence factor for Staph A.
Protein A of staph A cell wall binds to the Fc region of antibody which inhibits compliment, opsonization and phagocytosis
Which amino acids are the precursors to Purine synthesis? (3) Which amino acid is the precursor to Pyrimidine synthesis? (1)
Purine: aspartate, glycine, glutamine Pyrimidine: aspartate
how can a pt who is taking isoniazide develope sideroblastic anemia
a SE for isoniazide is defeciency in vit B6 which is a cause for sideroblasitc anemia and Peripheral neropathy
how to calcuatetotal cholesterol
add all the cholesterol values up and divide by 5 (the apprximate VLDL value)
Splanchnic nerve fucntion? which splanchnic nerve is the only one not sympathetic?
afferent and efferrent to the organs of body all are sympathetic except for pelvic (preganglionic parasympathetic)
bugs with edema factor
bacillus antrax pertussis (adenylate cycalse toxin increases cAMP
glycerol plays a role where
back bone of all FA
define opsonization
bacteria targed for phagocytosis
most common gram negative anerobic bacteria
bacteroides
how does the midstance peroid of gait begin and end
begin: full forefoot loading ends: heel lift
how does contact periord of gait begin and end
begins: heel strick ends: forefoot loading
Where are the intercostal nerves located?
beneath the inferior border of the rib (insert anthing above the rib)
polycystic kidney disease association with what type of aneurism
berry aneursm of circle of willis (most often occurs at bifurcations of the circle of wilis)
where are lateral horns found
between T1-L2, and S2-S4
how does the medial sural cuaneus nerve couse down the leg
between the heads of the gastroc m
what landmark does the common peroneal nerve terminate (branch into superfical and deep peroneal nerve)?
between: peroneus longus and neck of fibula
moa for cholestyramine
bile acid binding resints prevent bile acids from returing to liver---> decreasing cholesterol stores -
Portal triad (3)
bile duct hepatic artery portal vein
methly dopa is an assocation with what cancer
bile duct cancer
moa for platinum drugs
bind DNA and form intrastrant and cross links=inhibiting DNA synthesis and function
Rifampin moa
bind to bacterial DNA dependant RNA polyerase and deactivates it
what increases influx of sodium in a nerve cell
depolarization
what cuases the eye to depolarize vs hyperpolarize
depolarize=dark hyperpoarize=light
action of pec minor
depresses the point of the shoulder, drawing the scapula inferior, towards the thorax, and throwing its inferior angle posteriorly
what is a true body glomus
dermis layer of the skin, involved in body temperature regulation. The glomus body consists of an arteriovenous shunt surrounded by a capsule of connective tissue. Glomus bodies are most numerous in the fingers and toes
Multipolar neurons are sensor or motor
motor
paracentral lobule funtion
motor innervation of foot
lytic bone lesions on x ray
multile myeloma
clockface cell
multiple myeloma
Extensor Hallucis capsularis
musclce variations is a fibrous slip from the tendon of EHL
moa for dry heat sterlization
oxidation (must be done at a higer temp than with moist heat (autoclave))
how does differentiation of cartilagionous skeleton occur
proximal to distal and postaxial to preaxial (fibula before tibia)
most common bacterial eye infection
pseudomonas
list some veins that dont have valves (6)
pulmonary veins Superior vena cave Left and right bracheocephalic trunks Azygos system of veins Emissary v Thesbian v (within myocardium of heart)
how does hypoxia affect the pulmonary a vs the coronary a
pulmonary: vasoconstriction coronary: vasodilation
Lesch-Hyhan is assiciated the metaboism of?
purine
whats the inactive form of T3
rT3
zoonotic virus aka
rabies
all m in ther posterior compartment of the forearm are innervated by what nerve? most m in the anterior compartmeent of the forearem are innervated by what nerve
radial-posterior median-anterior
what happens to GFR when increased renin by JG cells
raise GFR (renin constricts efferent renal arteriol=increased GFR)
Emissary veins
veins that connect the scalp to the skull
what decreases when a person assumes standing postion
venous return
class 2 antiarrhythmics use
ventricular rate control for a fib and a flutter
fibrinoid necrosis location? (1)
vessels
which anemia has neurologic symtoms
vit B12 def (cobalamin)
what cofactor can be given to treat a person with McArdle disease
vit B6
vitamin required for dopamine B-hydroxylase which converts dopamine to NE?
vitamin C
which glycogen storgae disease increases uric acid
von gierke disease 110
*When* does a true limb form? 3 week 4 week 5 week 6 week 7 week
week 4 of fetal development "True has 4 letters"
when are both feet nearly sagittaly oriented? 3 week 4 week 5 week 6 week 7 week
week 7 of fetal development "7 looks like a sagittal plane"
What shortens during muscle contraction
"HIZ shrinkage" -H and I bonds -Z lines 423
TRAP stain confirms what diagnosis
"Hair got TRAPed" hairy cell leukemia
where is the falx cerebelli vs the tentorium cerebelli in relation to the venous system
Falx cerebelli: contains superior and inferior sagital sinueses. It encloses the occipital sinus Tentorium cerebelli: location of superior petrosal sinus
affects proximal tubule of kidney and cuases hypokalemia, polyuria, osteomalacia?
Fancoi syndrome
acumulation of Ceramine trihexoside
Farby disease
RBC macrocytosis hypersegmented neutrophils glossitis
Megaloblastic anemia
tram track appearance
Membranoproliferative glomerulonephritis (nephritic syndrome, but may be considered nephrotic)
spike and dome appearance on EM
Membranous nephropathy (Nephrotic syndrome)
pH: 7.65 PCO2: 55
Metabolic Alkalosis 538
pH <7.35, PCO2 <40
Metabolic acidosis
pH >7.45, PCO2 >40
Metabolic alkalosis
only leukemia with hyperdiploidy
ALL (hyerdiploidy=high sensitivity to chemotherapy so good prognosis)
after excerise what protein is elevated
Alanine
IP3 is a signaling pathway for which endocrine hormones (7)
"GOAT HAG" GnRH Oxytocin ADH T3/T4 Histamine Angiotensin 2 Gastrin
Autoantibody antimicrosomal, antithyroglubulin
" Hashimoto thyroditis (other antithyroid ab in graves" 213
Drug induced lupus (6)
" A SHIPP" Alpha methyl dopa Sulfonamide Hydralazine Isoniazid Procainamide Phenytoin/Carbamazepine
gram negative Coccobacilli rods (6)
" CC HAG B" Haemophilus influenzae, Gardnerella vaginalis, Chlamydia trachomatis a Acinetobacter Bordetella pertussis Coxiella burnetti
Dobutamine moa
"1 BAG to hold it all, I DOUBT it" Beta 1 agonist
nmenonic for Dobutamine
"1 Bag to fit them all I DOUBT it" Beta1 agonist
NF-1 normal function is
"GTP ras car #NF-1" GTPase of the Ras oncogene
pathologys that cause cyanosis (5)
"1,2,3,4,5" 1. trunchus arteriosus (1 vessel) 2. transposition (2 switched vessels) 3. tricuspid 4. tetrology of fallot 5. total anomalous pulmonary vensou return
CD16, CD56,
"16 all natural to 65" Natural killer cells 209
Thyroid storm treatment (3)
"3 Ps" Propythiouricil Prednisone Propranolol
define bacterial transformation?
"3 part transformation of extraterrestial" is one of three processes by which *exogenous genetic material* may be introduced into a bacterial cell;
Which Enzyme in DNA replication is responsible for making Okazaki fragments
"3 zakis will get me drunk" DNA polyermarse 3: it adds doxyribonucleotides to the 3' end of the primer RNA, which replicaes a segment of DNA, the okazaki fragment
function of limbic system
"4 Fs" Feeding Fleeing Fighting Feeling Sex
CD4 aka
"4 Thor" T helper cell
what are the mnemonics for: Respiratory acidosis? Metabolic acidosis? Respiratory alkalsosis? Metabolic alkalaosis?
"AACOW sat in the MUD on his HARDASS, I told him to SHuTuP. Its a LV HATE relationship" Respiratory acidosis? "AACOW" Metabolic acidosis? "MUDPILES, HARDASS" Respiratory alkalsosis? SHHuTuP" Metabolic alkalaosis? "LVHAT"
causes of Respiratory acidosis (5)
"AACOW" Hypoventilation: 1. airway obstruction 2. acute lung disease 3. chronic lung disease (COPD) 4. opioids/seditive (makes you breath slow) 5. weak respiratory m 538
bacterial toxins that are encoded in a lysogenic phage? (5) association word for lysogenic?
"ABCDE are all Lys" shigA-like toxin Botulinum Cholera Diptheria Erthryogenci toxin of strep pyo lysogenic=transduction 126
which vertrbra has the dens
"At before Ax" Atlas C1) Axis (C2)
what muscles gives rise to the knot of Henry? which part runs deeper than the other tendon?
"H gives H" FHL (FHL runs deep to FDL)
target cells are seen in (4)
"HALT the target" HbC disease Asplenia Liver disease Thalasemea
Drugs given as part of MI regimen
"B MONA" Beta blockers Morphine O2 Nitroglycerin Aspirin
contents of the retroperitoneum (10)
"BACK-UUP RID" Bladder Abdominal aorta Colon-ascending/descending Kidney Ureter, Uterus Pancrease Rectum (not sigmoid) IVC Duodenum
Bacterial endocarditis mnomonic
"Bacteria FROM JANE" Fever Roth spots Osler nodes Murmur Janeway lesions Anemia Nail-bed hemorrhage Emboli (most commonly affects mitral valve
Which step in collagen syn would you find osteogenesis imperfecta if there was a problem? pathophysiology?
"Blue Gly" 3rd=glycosylation of proalpha chain hydroxylysine problems forming the triple helix of 3 collagen alpha chains
C3*b*
"C3*b* opsonization bomb" opsonization
contents of carotid sheath (5)
"CIVIL" common carotid a internal carotid a (medial) internal jugular v vagus n deep cervical lymph nodes
what are the 5 cranial ganglia of parasympathetic nervous system and what CN do they associate from?
"COPS" Ciliary CN3 Otic CN9 Pterogopalantine CN7 Submandimular CN7 Intramural (throracic and abdominal) CN10
p450 inducers
"CRAPy GPS induce me to madness" Carbemazepines Rifampicin Alcohol (chronic) Phenytoin Griseofulvin Phenobarbitone Sulphonylureas
which amino acid is Creatine, urea, nitric oxide derived from
"CREAT UR NIT in ARGINtina" Arginine
Side effects for ACE inhibitors
"Captopril's CATCHH" Cough Angioedema Teratogenic Creatine increased Hyperkalemia Hypotension (ACE inhibitorts do alter bradykinins)
Guanathidine is what kind of drug
"Catacholamines are Guan" antihypertensive drug that reduces the release of catecholamines
Urease positive organisms (9)
"Chuck norris Hates PUNKEYS" Crptococcus H. pylori Proteus Ureaplasma Nocardia Klebseilla Epidermidids Yersinia Saphrophyticus
what is zero-order kinetics examples (3)
"Constant alcohol walks the lINE" a constant amount of drug is eliminated per unit time. For example 10mg of a drug maybe eliminated per hour, this rate of elimination is constant and is independent of the total drug concentration in the plasma. Saturatable -alcohol, asprin, phenytoin
Dimercaprol treats what
"DIMonds are GLAM" Gold Lead Arsenic Mercury
Dideoxyinosin use moa
"Did you combine with zido" -use: (-)HIV replication for AIDS (combo drug with zidovudine. -moa analog of a purine nucleoside
anemia: increased complement-mediated RBC lysis (impaired syn of GPI anchor for decay-accelerating factor that protectcs RBC membrane from complement
"Did you use the GPI anchor for the night" Paroxysmal nocturnal hemoglobinuria
p450 inhibitors
"Don't join this group it will make your spirit go down" SICKFACES.COM Group Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Alcohol..binge drinking Chloramphenicol Erythromycin Sulfonamides Ciprofloxacin Omeprazole Metronidazole Grapefruit juice
Melanin is derived from
"Dopy melon" Dopa 106
Dysrophic vs metastatic calcification: where is Ca depositied? what happens to serum Ca levels?
"Dystrophic=Dead" Dystrophic: Ca depositis in dead tissue/ increased serum Ca levels vs Metastatic: Ca deposits in normal tissue/ normal serum Ca levels
what metabolism activities occur in the cytosol only (6)
"FAt GLY HMP CHOLE like a STEROID PRO" FA syn Glycolysis HMP shunt cholesterol syn steroid syn (SER) protein syn (RER)
cAMP is a signaling pathway for which endocrine hormones (12)
"FLAT ChAMP is the G" FSH LH ACTH TSH CRH, calcitonin hCG ADH MSH PTH GHRH, and glucagon
Hormones secreted by the anterior pituitary gland?
"FLAT PIG" FSH LH ACTH TSH Prolactin intermediate MSH GH
what is the only monosaccharide that is not absorbed by Na-dependant costranport and is transroted by faciliated diffusion instead
"Fructose doesnt F around with costransports" Fructose
accumulation of cerebroside sulfate
"I meta cerebro by the side" Metachromatic leukodystrohy
Which nephrotic syndrome responds well to corticsteroids
"I see a minimal change with these corticosteroids" Minimal change disease
which AA are both glucogenic and ketogenic
"Iso Pheny b/c of Tryp Thre times" Isoleuicin Phenylalanind Tryptophan Threonin
accumulation of Galactocerebroside, psychosine
"KRABBE paddi w GALACTO makes you DEVELOPE SLOW, NUMB, and EYE ATROPHY" Krabbe disease
Mid tarsal joint axis for longitudinal vs Oblique
"L is before O in the alphabet so it stars with the higher number first" plane LMJA OMJA F 75 38 T 15 52 S 9 57
Best place for lumbar puncture? layers passed ?
"L3-L5 keep cord alive" into the subarrachnoid space skin, sub q fat supraspinus lig infraspinus lig ligamentum flav epidural space pia, archanoid matter cauda equina 409
gram postive rods (4)
"LBCC" Cornybacterium Clostridium Listeria Bacillus
difference between gram negative and gram postive
"LONG PPT" (-): Lipopolysaccharide Outer membrane negative G-periplasmic space (+) Positive Peptidoglycang is much thicker Teichoic plates
causes of metabolic alkalosis with compensation (5)
"LV HAT relationship" Hypoventilation: 1. Loop diuretics 2. vomiting 3. hyperaldosteronism 4. antacid use 5. Thiazide 538
which two tissues require insulin for glucose uptake?
"MAs need insulin for thier glucose" Muslce Adipose (GLUT 4 transporter
macrocytic anemia (5)
"MEGA/ or NONMEGA FOOL is a B12 but is OROTIC" Megaloblastic Folate def B12 def Orotic aciduria Nonmegaloblastic macrocytic anemia
Multiple myleoma mnemonic
"MM CRAB" Mulitiple Myleomoa Monoclonal M protein, M spike=IgG or IgA hyperCalcemia Renal failure Anemia Bone leisons/Back pain 401
arteries near the circle of willis but are not part of the actual cirlce? (5)
"MOABS" Middle cerbral Anterior Choroidal Opthalmic superior Cerebellar Basilar
treatment regimen for hodgkins disease
"MOPP" Mechlorethamine Oncovin (vincristine) Procarbazine Prednisone
metolazone: use moa
"Met the cholorothighs" thiazide-like diuretic marketed use: treat congestive heart failure and high blood pressure. moa: inhibit the sodium-chloride symporter in DCT
what occurs in mitochondria only
"Mity K BOAT" Ketogenesis Beta Oxidation OP Acetyl Coa production TCA
mnemonic for Urea cycle/ names
"Ordinarily-Ornithine Careless-Carbamoyl Phosphate Crappers-citriline Are-Aspartate Also-Arginocussinate Frivolous -Fumarate About-arginine Urea
HLA-B27 associated pathology
"PAIR" Psoriatic arthritis Aknylosing arthris Inflammatory bowel disease, Reactive arthritis.
HLA-B27 associative disease
"PAIR" Psoriatic arthritis Ankylosing spondylitis Inflammatory bowel disease (UC and chrons Reiter's disase
Cause for horner's syndrome? 4 characterisitcs of face for hornes syndrome?
"PAMS" *Caused by a lesion in the sympathetic trunk in the neck* -Ptosis (paralysis olevator palpebrae superioris) -Anhydrosis (facial flusing only-no sweating due to lack of sympathetic innervation to vessels and sweatglands -Miosis aka Pupillary constriction (failed dialator papillae m) -Sinking of eyeball (paralysis of orbitalis)
Fracture of the neck of the humerus damages what 2 vessels
"PAQ-CT" 1. axillary nerve 2. posterior humeral circumflex a
Tumors that metastsize to bone
"PB KTL" Prostate Breast Kidney Thyroid Lung
what passes through both the greater and lesser sciatic foramen (4)
"PINT both" 1. pudendal nerve 2. internal pudendal vessels 3. nerve to Obturator inturnus 4. Tendon of Obturator internus
Contents in Greater Sciatic Foramen (9)
"PISO in a big hole" -Piriformis, Pudendal n, PFCn -Inferior glutial van, Internal Pudendal van -Superior gluteal van, Sciatic n -Obturator n, QFn
contents of the greater sciatic foramen
"PISSO in a big hole" P: Piriformis m, Pudendal n, PFCn I: Inferior Gluteal van, Internal pudendal van S: superior gluteal van S: sciatic n O: obturator internus n, Quadratus Femoris n
biochem rxns where biotin is a cofactor (3)
"PRY your PROPIO ACE" Pyruvate carboxylase Propionly-CoA carboxylase Acetyl-CoA carboxylase
Where are psammoma bodies found? (4)
"PSaMMoma BOLT" Papillary carcinoma of *thyroid* Serous papillary cystadenocarcinoma of *ovary* Meningioma *brain* Malignant mesothelioma *lining of lungs and chest wall* 239
D cells of pancreatic islets and GI mucusa secretes what? what affects on the GI occurs when its secreted?
"Pan Stan somatostain" somatostain: -decrease gastric acid and pepsionogen -decrease pancreatic and small intest secretion -decrease gall bladder contraction -decrease insluin and glucagon
nmenmonic for the Atypical Antiphyschotics
"QUIET please, ONLY WHISPERING is APPROPIATE" Quetiapine Olanzapine Risperidone Aripiprazole
steps of collagen synthesis (6) location for each step? what AA goes with each step, enxyme or reaction? pathology for steps 2,3,6?
"SHGEPC: Syn Hydro Gly is a Ex Pro Cross Linker" 1. synthesis (RER)-glycine and (proline or lysine) 2. Hydroxylation (RER)-proline and lysine (Scurvy if vit C is lacking) 3. Glycosylation (RER)-hydroxylysine, H and disulfide bonds (osteogenesis imperfecta) 4. Exocytosis-of procollogen 5. Proteolytic processing-clevlage of disulfide bonds and traforming into tropocollogen 6. Cross linking (Elhers Danlos and Menkes)
name the causes of Respiratory alkalosis (6)
"SHHuTuP" Hyperventilation: 1. Salicylates (early)Hysteria 2. Hypoxemia (high altitude) 3. Hysteria 4. tumor 5. pulmonary embolism
Small cell carcinoma main characteristics (4)
"SMALL but AGGRESSIVE b/c he's Centered on his ADH which makes him BLUE" 1. most aggressive bronchogenic 2. central cancer 3. small blue cells 4. secretes ACTH and ADH
Northern, Southern, Western Blot analysis what?
"SNOW DROP" Southern-DNA Northern-RNA OOOO-OOOO Western-Protein
Serotonin is derived from
"SORRY I TRYP you" Tryptophan Niacin is alos derived rom tyrptophan
Which step in collagen syn would you find scurvy if there was a problem? why?
"Scurvy pirate on the sea (HYDRO) is a PRO LYier" 2nd =hydroxylation requires Vitamin C to hydroxylize proline and lysine residues
Diuretic DOC for cirrhosis
"Spear the Liver" Spirnonolactone
nmonic for the alpha 2 agonist (3)
"TIZ the season to CLON 2 FAGs on Methlydopa while it RAINS" Tizanidin, Clonidine, alpha methydopa SP142
Parkinsons symptoms
"TRAPS" Tremor Rigidity (cogwheel) Akinesia Postral instability Shuffling gait 459
Drug used to treat breast cancer in women and men. It has been used for Albright syndrome.
"Tami for girls, tamo for boys" Tamoxifen
Drug used to suppress premature labor
"Term" Terbutaline
most common micro bugs that use transformation (3)
"Transfomer bug named SHiN" S. pneumonia H influena Neisseria 126
Type 4 hypersensitity reaction examples: (4)
"Ts" -*T*ransplant rejection -*T*ouching (contact dermatitis, poisin ivy, nickle allergy) -*T*B test -MS
wiskott-aldrich syndrome mnemonic
"WATER" Wiskott-Aldrich Thrombocytopenia Eczema Recurrent infections
VIPoma is a pathology of what organ? 3 characteristics?
"WHAD up on the island of Pancrease" VIPoma is an islet cell tumor of pancrease -Watery Diarrea -Hypokalemia -Achlorhydria (low production of HCl in gastric acid)
aminoglutethimide moa/use
"amino for all 3 pathways" (-) aromatase= decreased syn of androgens (-) P450cc=decreased conversion of cholesterol to pregnelone (all steroids) use: tx cushings syndrome AE: hypothyroidism
postive combs test
"auto comb yourself" autoimmune hemolytic anemia
Desmoplasia definition/ most common association
"boob girl" -proliferation of non-neoplastic fibrous ct within a tumor -Breast CA
CD8
"clean up the toxiciyt on ile 8" cytotoxic cells 209
CD34
"done become human till age 34" human stem cells
cyclosporin: moa use AE: (2)
"eating Tangerines in the rain" -moa: inhibit T cells -use: treat graft-versus-host disease in bone-marrow transplantation and to prevent rejection of kidney, heart, and liver transplants, rheumatoid arthritis and psoriasis as an ophthalmic emulsion for the treatment of dry eyes -AE: gum enlargment and hair growth (not seen in Tacrolimus)
action of the palatoglossus m? innervation?
"elevate the plate" elevates posterior tounge during swallowing CN10 450
action of the genioglossus m? innevration?
"geni protrutes her tounge" genioglossus m: protrudes tounge -CN12 450
Naked DNA and RNA virus? what are the picornoviruses?
"give PAPP smear and CPR HEP" DNA: papillomavirus, adenovirus, parvovirus, polyomavirus RNA: Calicivirus, picornovirus , reovirus, Hep E virus picornovirus: "PERCH" Poliovirus Echinovirus Rhinovirus Coxsackievirus Hep A virus
Toxicity for thiazide diuretic
"hyperGLUC" hyperglycemia hyperlipidemia hyperuricemia hypercalcemia hyponatremia 554
side effects of loop diuretics (6)
"hypoMICK can HEAR" 1. hypomagnesia 2. hypocalcemia 3. hypokalemia 4. hearing loss 5.Interstitial nephritis 6.contraction alkalisis-dehydration and metabolic alk Hyperurecima-gouty arthritis
in CKC where is the origin of the popliteus m
Popliteal groovve of the lateral epicondyle of the femur
tamponade heart sounds
"muffled tamborene" muffled
renal stone commonly found in children
"my cyster has a renal stone" cystine
moa for polymyxin
"myxin the membrane" Alters bacterial outer membrane permeability by binding to a negatively charged site in the lipopolysaccharide layer= destabilized outer membrane
Porphyrin is derived from which amino acid?
"poor gly" Glycine
action of the styloglossus m? innervation?
"tounge is sylish when in a troft rolls tounge to form a troft for swallowing -CN12 450
relationship with ribs and body of vertebra
# Rib is above Vertebral body
moa of H2 antagonists
(-) histamine at the H2 receptors---> (-) gastric acid
Where on the cardiac loop is the periord of highest O2 consumption
(1) Isovolumic contraction 276
which parasite is associated with severe iron deficiency anemia (2)
(Hook worms) necator ancyloclostoma SM71
if you drink isotonic NaCl, how does it affect the ICF vs ECF
(drinking Salt water) increase ECF only no change in plasma osmolarity
lesser omentum
(small omentum or gastrohepatic omentum) -double layer of peritoneum that extends from the liver to the lesser curvature of the stomach (hepatogastric ligament) and the first part of the duodenum (hepatoduodenal ligament)
biochem rxns that require Thiamine cofactor (3)
(yellow) 1. Pyruvate dehydrogenase 2. alpha ketogluterate dehydrognease 3. Transketolase
what allows smooth muscle to maintain tension tonic contraction? vs smooth m contraction?
*-tenson tonic contraction* dephosphorylated myosin dissacociates from actin very slowly producing slow bridge cycling *-smooth m contraction* calcium binds and activates calmodulin which activates MLCK (phosphorylation of MLC). once phospohorylated the myosin cross bridges bind to actin on thin filaments=contraction
Hypersensitivity mnominic
*Anaphylactic (IgE)* *Cytotoxic (Ab)* IgG, IgM bind to fixed antigen= cell destruction) *Immune complex (Ag-Ab -compliment)* which attracts neutrophils that release lsosomal enzymes) *Delayed (T cell mediated)* enconter antigen then release cytokines 211
solve for the anion gap with the following labs: Na=135 K=5 Cl=100 HCO3=5 BUN=25 Cr=2.2
*Anion Gap=Na-(Cl+HCO3)* Anion Gap=135- (100+5) Anion Gap=135-105 Anion Gap=30
what is the earliest erythroid progenitor?
*BFU-E (burst forming unit-erythroid)* then comes CFU-E (colony forming unit-erythroid) which is larger and is the stage right before hemoglobin production begins
what is the major fuel source for liver during fasting? why?
*fatty acids* -doesnt use glycogen b/c its exporting glucose elsewherre -cant use keytone bodies b/c the liver lacks the enzyme used to oxidize ketonbodies (β-ketoacyl-CoA transferase, aka thiophorase)
CSF drainage
*MALM* 1. Lateral ventrical *Foramen of Monro* (interventricular foramen) 2. 3rd Ventrical *Aqueduct of sylvius* 3. 4th ventrical *Luschka Cisterni (lateral)* *Magendi Cisterni (medial)*
Where are hypersegmented neutrophils found? (unbrella term) with 3 causes of umbrella
*Megaloblastic anemia*: folate def B12 def Orotic anmeia 392
-atypical mycobacterial infection, -with nontuberculous mycobacteria -causes respiratory illness in birds, pigs, and humans, especially in immunocompromised people. -In the later stages of AIDS it can be very severe - first presents as a persistent cough
*Mycobacterium avium-intracelluaris complex* made of three mycobacteria species, M. avium, M. intracellulare, and M. chimaera
carpals and metacarpals of thumb and the trapezium of the wrist are all examples of what type of joint? what actions does this type of joint permit?
*Saddle joint* Abduction and Adduction Flexion and Extension
function of alpha vs beta dystrophin
*alpha:*Beta dystroglycan is connected to laminin in the ECM by alpha dysroglycan *beta:* connects actin to transmembrane protein B dystroglycan in the sarcolema
Antibiotic class that can cause misreading of mRNA
*aminoglycosides* buy AT 30 CEL at 50 184
PCO2 and PO2 in blood leaving apex of lung vs base
*apex: high O2,* low CO2 base: low O2, high CO2
MOA for M3 antagonists in the: bladder: 2 drugs lungs: 2 druggs
*bladder*: relax smooth m in ureters and bladder wall= treating incontinence (lack of voluntary control over urination or defecation) via-oxybutynin and tolterodine *lungs*: bronchodilation and decreases secretions=treating COPD via ipratropium and tiotropium SP138
differentiate MM from waldenstrom macroglublinemia
*both have M spike* vs waldenstrom DOES NOT have the "CRAB" symtoms: hyperCalcemia, Renal involvment, anemia, Bone lytic lesions
associations with cardopmyopathys: dilated: "ABCD" hypertrophic: resctrictive:
*dilated:* "ABCD" (most common) affects all chamers of the heart Alcohol abuse, wet Beriberi, Coxsackie, Doxorubicin. -*hypertrophic*: young athlete suddenly dies, thick LV -*resctrictive:* sarcoidosis, amyloidosis, fibrosis, loffler syndrome
function of opsonin
*enhances phagocytosis* by marking an antigen for an immune response or marking dead cells for recycling
what is postrotary nystagmus
*eye movment occurs in opposite direction as spin* vs nystagmus ( eye movment occurs in same direction as spin)
gas exchange *efficincy* at apex vs base
*more efficient at apex* less efficient at base
what position is the knee in whe the *ACL is taught*
*taught=knee exteneded* lax=knee flexed opposite for PCL taught=knee flexed lax=knee extended
which of the infrahyoid mucles is not innervated by ansa cervicalis?
*thyrohyoid muscle* (innervation by C1 fibers and hypoglossal nerve)
Definition of anaplasia
- *poor cellular differentiation*, losing the morphological characteristics -seen in malignancy and is irreversible
spherocytes (2)
-Heriditary spherocytosis -drug induced hemolytic anemia 389
Fever pathophysiology
-IL1 interlukins are released -set point for temperature is *raised* (body now thinks its current tempurature is too low so it stimulates warmth mechinisms: --shivering --vasoconstriction --blood shunding away from periphery
what is pulsus paradoxus? what is paradoxal about it? what major pathologys is it seen in? 5c
-*decrease systolic BP by >10mmHg* during inspiration ( a drop of <10 is normal, but anything larger than 10 is considered pulsus paradoxus) -one can detect beats on cardiac auscultation during inspiration that cannot be palpated at the radial pulse cardiac tamponade, constrictive pericarditis, chronic sleep apnea, croup, COPD and asthma
Enzyme that converts testosterone to dihydortestosterone? vs Enzyme that converts testosterone to Estridiol?
-5alpha-reductase vs -aromatase
functon of: A alpha: A beta: A delta: A gamma B C C
-A alpha: Somatic motor, propioception "ALPHA male get SOM" -A beta: touch, pressure "Beta be TOUCHED and PRESSURE" -A delta: motor "DELTA MOTOR" -A gamma- fast pain "GAMMA rays are FAST" -B=preganglionic sympathetic "B PRE" -C=dorsal root=slow pain (small diameter) "C SLOW" -C=sympathetic=postganglionic
Broca lesion (2)
-Imparied speech production -Speaking slower "use your BOCA for speaking"
Where in the urea cycle is ATP needed (2)
-CPS1 (2 ATPs) -Combining citruline and Aspartate to make Aringinocuccinate (1ATP)
what are the landmarks of the inferior surface of the calcaneus from proxima to distal
-Calcaneal tuberosity -M/L process of calcaneal tuberosity (medial process is bigger -anterior tubercle -transverse groove
rate limiting step for urea cycle? where is ATP used? cell location? list the enzymes?
-Carbamyl phosphate synthetase 1 -2ATP used at CPS1, 1 ATP used when adding aspartate -CPS1, ornathin transcarbamoylase=mito. Rest cytoplasm 96
what is found within the optic disc (3)
-Central retinal v -Central retinal a -optic nerve (Central retinal a is a branch from opthalmic artery)
antibiotic that blocks peptidyltransferase? (3)
-Chloramphenicol -Pleuromutilins -Macrolide
Skin condition as a result of defected hemidesmosomes
-Epidermolysis bullosa -Bullus pemphigoid
Beta drugs safe for asthmatic pts (10)
-Epinephrine -B1 beta antagonists: acebutolol, atenolol, metoprolol, Esmolol "BanB1" -Beta nonselective agonists: Isoproteronol "I so Bag anyway" -Beta2 agonists: metaproter, albut, salme, Terb, form "I metaproter about the same 2nd terb but I baged her on the form"
Kidney position in relation to ribs
-Left kidney is higher. spans from L3-11 rib -Right kidney is lower: spans from L4-rib 12 -hila of kidney is about L1
Mullarain duct becomes what? Mesnophric becomes what?
-Mullarain: vagina, uterus, fallopian tubes -Mesnophric: epidymis, ductus defferens, seminal vesicals
Describe classic galactosemia: enzyme missing? build up of? symtoms? risk for?
-No: galactose-1-phosphate uridyltransferase -buildup: Galactose 1 phosphate in lens of eye -faiure to thrive, jaundice, hepatomegaly, infantile cataracts, intellectual disability. -can lead to E coli sepsis in neonates
sickle cell anemia mutation (3)
-Point mutation in Beta chain -substitution of glutamic acid with valine (Valine is the mutant protien) -GAG to GTG, with a substituion of thymine for adenine
Tetroglogy of fallo symtoms
-Pulmonary infundibular stenosis -RV hypertrophy -Overiding aorta -VSD (right to left shunt)
what is pulse pressure a measure of
-Pulse pressure= dsystolic-diastolic pressure -its the volume of blood ejected from the LV (stroke volume)
Rotaviurs is what type of virus? virus family? double vs single positive vs negative sense
-Reovirus -RNA double stranded -postive and negative sense RNA
RIPE thearpy MOA for each drug
-Rifampin: deactivates DNA dependant RNA polymerase -Isoniazid: inhibits mycolic acid production on cell wall -Pyrazinamide: stops growth by disrupting pH -Ethambutal: blocks arabinosyl transferase, inhibiting cell wall formation
Extrinsic hemolytic normocytic anemia examples (7)
-SLE -CLL -mycoplasma pneumonia -Mono -microangiopathic anemia (narrowed vessels) -macroangiopathic anemia (heart valves or aortic stenosis -infections like malaria or babesia 395
Trematodes are? (5) Cestodes are? (4) nematodes are? (5) Pinworm? (1) Hookworm? (2) Roundworm (1)
-Trematodes=Flukes: Schistosoma "Flukes make you tremble" (mansoni, japonicum, haematobium, clonochris, parogonimus) -Cestodes=Tapeworms "stop the tape" (soleum, sagginatum, diphyllobothrium, echinococcus) -nematodes: roundworms "nemo is round" (dracunculus-, onchocerca, wucheria, toxocara, loaloa) Pinworm: enterobius Hookworm: anchyclostoma, nector americancus Roundworm: Ascariasis Lubricoides
action of gluteus minimus and medius (3)
-abducts and medial rotates hip (OKC) -stedies pelvis during gait (CKC)
effect of Prostaglandins on GFR and RBF
-acts on mesangial cells in the glomerulus to *increase* GFR -Paracrine secretion vasodilates the afferent arteriorls=*increased* RBF
moa for acyclovir use: (5) SE (1 main one)
-acyclovir---> aciclobir monopate by a viral thymidine kinase. then converted to *aciclovir triphosphate* by kinases to ===*competitively inhibits DNA polymerases (-) synthesis* -(HSV-1) (HSV-2) (VZV) (EBV) (CMV) - least activity -SE:interstitial nephritis crystalline nephropathy
effect on GFR: afferent constriction- efferent constriction- increased plasma protein concentration- decreased plasma protein concentration- constriction of ureter-
-afferent constriction- decreasedd -efferent constriction- increased -increased plasma protein concentration- decreased -decreased plasma protein concentration- increased -constriction of ureter- decreased
CSF findings in meningitis: pressure, cell type, protein, sugar Bacterial Fungal/TB Viral
-all three have increased pressure -PMNs found in bacterial, lyphocytes found in Fungal and viral -protein increased in bacterial and fungal. normal/increased protein in viral -sugar decreased in bacterial and fungal. normal in viral "bacteria and fungus eat all the sugar so its decreased" "bacterial and fungus have alot of protein so thier strong" 173
chloroquine: moa for malarial? moa for non malairal?
-antimalarial: enters the red blood cell, inhibiting the parasite cell and digestive vacuole by simple diffusion. prevent further biocrystallization of heme= heme buildup= drowning the parasite in its own metabilic products - inhibits thiamine uptake.[30] It acts specifically on the transporter SLC19A3. to treat RA, inhibits Pospholipase A2, produces IL1
Borrelia recurrintis: -transmission -symtoms
-lice -relapsing fever
closure of ductus arteriosus = what is it called if the ductus arteriosus doesnt close=
-ligamentum arteriosum -patent ductus arteriosus
differentiate right and left lung: lobes, divisions,lingula, groove for SVC, cardiac notch, larger capacity,
-lingula is on upper lobe of left lung -right lung has a groove for Superior vena cava, and has a larger capacity than left lung
Acute tubular necrosis risk levels of potasium: -maintance phase 1-3 weeks? -Recovery phase?
-maintance phase 1-3 weeks? hyperkalemia -Recovery phase? hypokalemia
action of gluteus maximus (2)
-major extensor of hip joint -lateral rotation of hip
contents of carpal tunnel
-median nerve -flexor pollucis longus -flexor digitorum profundis -flexor digitiorum superficialis
what is pheochromocytoma? what is the tx for it?
-neuroendocrine tumor of the medulla of the adrenal glands that secretes high amounts of catecholamines, *mostly norepinephrine and a little epinephrine=very high HTN* -tx: nonselective alpha antagonist: phenoxybenzamine or a short acting alpha1 antagonist:(prazosin, terazosin, or doxazosin)
what are the alpha nonselective, 1, 2, agonists
-non selective: Oxymetazoline "Oxy met any Fag" -alpha 1: Phenylphrine, methoxamine "1 Fag says phenylphrine methoxamine" -alpha 2: Cloinidine, methyldopa "2Fag clone while on methlydopa"
CMT muscle pathophisology
-normal TP overpowers the PB causing a sever cavus foot type -hammer toe with weak calves and Dorsiflexors
Facultaive anaerobic definition
-organism that makes ATP by aerobic respiration if oxygen is present, but is capable of switching to fermentation or anaerobic respiration if oxygen is absent
action of lumbricals (2)
-plantarflex the proximal phalanges -extend the middle and distal phalanges
during the embrionic period of the LEA what happens to the preaxial vs the postaxial protion
-preaxial (tibial) 90 degrees internal rotation "tibial has 2 i so its internal" -postaxial (fibular) 90 degrees external rotation
Langer lines of LEA made up of? relationship to the long axis of the underlying m?
-predeminant orientation of *collagen fibers in the dense irregular ct* -Perpendicular
bond type for- primary structure: secondary structure: tirtiary structure: quartenary structure:
-primary structure: covelant bonds (peptide bonds) -secondary structure: hydrogen bonds -tirtiary structure: hydrophobic, ionic, disulfide bonds -quartenary structure: noncovelant and disulfide bonds
transposition
-segement of DNA from one location to another. -can transfer genes from plasmid to chromosome and vise versa
attachments for the short plantar lig and the long plantar lig
-short: tubercle and transverse groove on plantar calc----> plantar surface of cuboid posterior to peroneal ridge -long: plantar surface of calc b/t tuberosity and tuberlce----> deep (peroneal ridge) vs superficial (plantar surface of 2,3,4,5 mets
Characterisitcs of bile side chains? (2) phobicity? reabsorbed where? best results at what pH?
-syn from cholesterol in liver -glycine and taurine are side chains -amphiapathic -reabsorbed in ileum and recycled by liver -best results at pKa 4
anatomical references T4/T5 vertebra: (5)
-the costal cartilage of 2 articulates with the sternum -superior mediastinum is separated from the inferior mediastinum, -ascending aorta end and the arch of the aorta begins -arch of the aorta ends and the thoracic aorta begins -trachea bifurcates.
when the lumbrical contract how does it affect the wing and sling
-tighten wing -slacken sling (sling is proximal and Wing is distal)
superior mesenteric a branches
...
pathology that has decreased melanin production due to decreased tyrosine activity or defective tyrosine transport
Albinism 438
what are the nephritic sydromes (5)
1. acute PSGN 2. rapidly progressive glomerulonephritis (good pasture, wegners, Churg Strauss, microscopic polyangitis) 3. IgA nephropathy (berger disease)-Henoch Schonlein purpura 4. Alport syndrome 5. Membranoproliferative GN
facial nerve foramina (2)
1. internal acoustic meatius 2. stylomastoid foramen
what is the active form of vitamin D? aka?
1,25-OH2 D3 (calcitrol)
what is the general location for the 12 CN starting points?
1-4 midbrain 5-8 pons 9-12 medulla
Familial dyslipidemia: increased chylomicrons, TG, and cholesterol in serum due to lipoprotein lipase deficency or altered apolipoportine C-II
1-hyperchylomicronemia
What are the 6 basic enzymes for DNA replication? which step is ommited on the leading strand?
1. *Helicase* unwinds at origin of replication 2. *Single strand binding proteins* prevent annealing 3. *RNA primase* lays down RNA primer 4. *DNA pol 3* elongates DNA 5. *DNA pol 1* degrades RNA primer and replaces it with DNA 6. *DNA ligase* joints okazaki fragments (ommited in the leading strand)
a favorable reaction would is displayed as (2)
1. - change in G 2. >1
labs post MI: 1. 30 min post MI 2. 6-12 hours post MI 3. 6-9 hour post MI
1. 30 min post MI: myoglobin 2. 6-12 hours post MI: Troponin (peaks at 24 hrs, lasts 1-2 week post MI) 3. 6-9 hour post MI: CK-MB (lasts 3-4 days)
Tetrology of Fallo characteristics
1. AV septal deft 2. pulmonary stenosis 3. overiding aorta 4. RV hypertrophy
2 insertions for gluteus maximus
1. Gluteal tuberosity 2. IT tract
POST MI: 1. 12-24 hours 2. 1-3 days 3. 3-14 days 4. months-yrs
1. Early coagulative necrosis, Contraction bands 2. neutrophils 3. macrophage, granulation tissue 4. scar tissue
Where are the 3 major checkpoints for the cell cycle
1. G to S 2. G to M 3. during M
branches of the Inferior mesenteric artery (2)
1. Left colic: Ascending br of left colic Descending br of left colic 2. sigmoid a -superior rectal a (is a continuation of Inferior mesenteric a)
MEN2B
1. Mucosal neuroma 2. Marfanoid body habitus 3. Medullary thyroid Carcinoma 4. Pheochromocytoma "MEN 2B or not 2B is Anoid my neuroma, but still has medullary and pheo"
MEN2A
1. Parathyroid hyperplasia 2. Pheochromocytoma 3. medullary thyroid cancer "2 MEN PARA PHEO"
what are the 2 enzymes defiency in Beriberi, Wernikie's encephalopathy and korsakoff's physcosis
1. Pyruvate dehydrogenase 2. alpha ketogluterate dehydrgenase (2/4 enzymes that are part of the *ATP branch* mnemonic that require Vit B1. the other 2 being Transketolase, and branched chain ketacid dehydrgenase)
what are the 4 steps in order of leukocyte extravasation?
1. Rolling 2. tight binding 3. diapedisis 4. migration
what are the virulene factors for Strep Pyogens (3)
1. Streptolysin O (allos strep to be B hemolytic) 2. Streptokinase (converts plasminogen to plasmin) 3. DNA' ases (depolymerase DNA)
collagen synthesis steps (6)
1. Synthesis 2. Hydroxylation 3.Glycosylation 4. Exocytosis 5. protolytic processing 6. Crosslinking 76
Caseous necrosis (2)
1. TB 2. hisoplasma/ nocardia (systemic fungi)
what are the 2 omega essential Fatty acids?
1. alpha-linolenic acid (omega-3 fatty acid) 2. linoleic acid (omega-6 fatty acid)
arterial supply for gracilis m? 3
1. ant. br. of obturator a 2. prufunda femoris a 3. medial circumflex femoral a
where and when are the secondary centers of ossification in the foot (6)
1. base of phalanges: 6 mo-2 year 2. base 1st met: 3 yr 3. calcaneal tuberosity: 4-10 yr 4. tuberosity of base of 5th met: 7-10 yr 5. lateral tubercle of talus: 8-9 yr 6. navicular tuberosity: 10 yr
stages of bordella pertussis? (2)
1. catarrhal: cold like symtoms/contagious 2. paroxysma: inhibits cilia in respiratory tract
function of surfactant (3)
1. decrease surface tension 2. increase compliance 3. prevent atelectiasis (collapse or closure of a lung)
what 3 major structures traversethe parotid gland
1. facial nerve 2. retromandibular vein 3. external carotid artery
The wofian ridge stimulates mesnchymal cells to express what? 2
1. fibroblast growth factor-10 and 2. synthesize retinoic acid
To nomralize blood pH from an acidic state, how does the kidneys compensate? (2)
1. increase proton excretion 2. increase bicarb reabsorption
Intrinsic Tyrosine Kinase is a signaling pathway for which endocrine hormones (2)
1. insulin 2. Growth Factors (IGF, FGF, PDGF, EGF)
celiac trunk brances
1. left gastric 2. splenic 3. common hepatic
2 major causes of nephrogenic diabetes insipitus
1. lithium intoxication (inhibits the Gs protein in CT) 2. hypercalcemia (inhibits adenylate cyclase)
limb development begins with the prolifeation of ____1____cells in the _____2_____. which forms a thick rigde called the _____3____
1. mesenchymal cells 2. somatic mesoderm 3. wollfian ridge
use for atropine (3)
1. mydriasis 2. cycloplegia (paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation. Because of the paralysis of the ciliary muscle, the curvature of the lens can no longer be adjusted to focus on nearby objects 3. used acetylcholinsteriase toxicity
MEN1
1. parathyroid tumors 2. pituitary tumors 3. pancreatic endocrine tumors (Zollinger Ellison, insulinoma, VIPomas, glucagonoma) "PIT PARA PAN is 1 MEN" peter pan
iliofemoral ligament action (2)
1. prevetns adduction 2. Internal rotation of hip
2 vessels that run together near the shaft of the humerus
1. radial nerve (ARUM) 2. profunda brachial a
muscles of the occipiatal triangle (4)? nerve that runs inside? nerve that runs inferior to obliques capitus inferior?
1. rectus capitus posterior minor 2. rectus capitus posterior major 3. Obliques capitus inferior 4. Obliques capitus superior suboccipital nerve runs inside (C1) Greater occipital nerve runs below (C2)
what are the extrapyrimidal tracts (4)/fuction
1. rubrospinal=limb flexors "rude bro" 2. Vestibulospinal=limb extensors, balance, posture "life vest for balance/posture" 3. Reticulospinal=voluntary movment, reflexes, muscle tone "restless movment" 4. Tectospinal=posture of head and visual "text with head posture, eyes"
muslces of inspiration (5)
1. serratus anterior 2. serratus posterior superior 3. diaphragm 4. pectoralis major 5. External intercostal (during exercise)
2 major functions of basal ganglia
1. voluntary movments 2. postural adjustments
name 3 DNA regulatory proteins
1. zinc finger 2. leucine zipper 3. helix-turn-helix
function of phrenic nerve (4)
1.pericardium (covering of heart) 2. mediastinal pleura (part of pulmonary pleura) 3. diaphragmatic peritoneum 4. diaphragm (C3-C5 keep the diaphragm alive)
how many base pairs per turn on the helix
10
anion gap equation
135- (Cl+HCO3)
overview of where antiarrhmics act
1: Na 2: Beta blockers 3: K 4: Ca
when the patellar tendon is stretched what afferent fibers are activated
1a afferent fibers of the quadracepts
type 1a vs type 1b vs type 2 afferent muscle fibers
1a: sensory for stretch =monitors how fast a muscle stretch changes. (velocity of the stretch) 1b: In Golgi tendon organ, responds to muscle tension changes 2: Provide position sense of a still muscle, fire when muscle is static
relationship for course of the perferating a of profunda femoral? what does it vascularize?
1st: superior to adductor brevis 2nd: within insertion of adductor brevis 3rd inferior toadductor brevis It vascularizes the adductor magnus and posterior thigh muscles
where are the zones of the neck
3:above angle of mandible 2: between 1: below cricoid cartilage
Wernickie lesion is what broadman area? lesion would cause what? (2)
22 -Impaired comprehension -Speak fast
Familial dyslipidemia: increased LDL and cholesterol due to absent or defective LDL receptor
2a familial hypercholesterolemia
What gives off the nutrient artery to the femur
2nd periforating a of the Profuna femoral a
how many branches does the Lateral femoral circumflex a have
3
where/when are the *primary centers* of ossification in the Os Coxae
3-4th month of fetal development Ilium Ischium Pubis
dupuytren's contracture
4th and 5th finger affected (due to abnormal ct formation)
hypotension disteneded neck viens distant heart sounds increased heart rate pulsus paradoxus
Cardiac Tamponade 299
primary center of ossification for talus
6-7 mo of fetal development
how is the Total body water divided up
60% total body water (42L) 40%=intracelluar (28L) 20%= Extracelluar (14L) =(3.5 L:plasma, 10.5 L:IF) 529
what step in collagen syn would Ehlers danlos or menkes disease occur if there was a problem
6th step: Cross linking
primary center of ossification for sesamoids of foot
7-8 yrs
pH and charge of mRNA
7.4 negativley charged
what make up the 31 pairs of spinal nerves
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
christmas disease is what factor of intrinsic pathway
9
loop/ diuretics would cause what type acid/base phsio
Metabolic alkalosis -Loop/Diureteics -vomiting -anatacid use -hyperaldosteronism
apolipoprotein that actvates LCAT
A-1 (on HDL) "A for awesome (healthy-HDL)
t(12:21)
ALL 402
what/ where are the drugs that act on the renin-angiotensin system (3)
ACE inhbitors ARBs Aliskaren
ligament that restricts the anerior movment of te tibia in relation to the femur?
ACL (another way to say this is the ACL also restricks posterior movment of the femur in relation to the tibia)
Unhappy triad is at risk of injury from a lateral injury
ACL MCL medial meniscus
attachemnts for the: ACL, PCL, posterior meniscofemoral ligm transverse genicular (intermeniscal lig)
ACL (9) : medial surface of lateral condyle--anterior intercondylar fossa, anterior horn of lateral meniscus PCL (3): lateral surface of medial condlye-- posterior intercondylar fossa, posterior horn of lateral menisucs PMFL (7): Lateral surface of medial condlyle--posterior horn of lateral meniscus TGL: connects *anterior* convex borders of the medial and lateral menisucs
pain illicited with a valgus stress test, hyperextension of leg, and an injury from twisting is indicitive of what injury
ACL tear
function of ACL vs PCL
ACL: prevents backward displacement of the femur on the tibia PCL: prevents anterior displacement of the femur onthe tibia
Chronic pacnreatitis can result in deficiency of which vitamines
ADEK (fat soluble)
Down' Syndrome leukemia association
ALL
The anterior drawer test of the ankle joint evaluates what
ATFL tear
What muscles of the plantar foot orginate from the calcaneal tuberosity
AbDM FDB AbH
DM drug that inhibits alpha glucosidase
Acarbose and miglitol SP186
Perforating artiers of the Thigh vascularize what muscle? but travel through what muscle?
Adductor magnus travel thorugh adductor brevis
what is the enzyme after PFK1 in glycolysis
Aldolase B
basket weave appearance on EM
Alport syndrome
"cant see, cant pee, cant hear a buzzing bee"
Alport syndrome: retinopathy, lens dislocation, glomerulonephritis, sensorinueral deafness 541
schistocytes aka helmet cells (5)
DIC TTP HUS HELLP heart valve prothesis
Senile plaques in gray matter: extracellular Beta amyloid core, may cause amyloid angiopathy which can lead to intracranial hemorrhage
Alzheimer disease
nephritic syndrome associated with Rheumatoid arthrits
Amyloidosis "Amy has RA"
what are the nephrotic syndromes (5)
Amyloidosis/ Sarcoidosis Minimal Change (kids) Membranous Focal segmental Diabeetic glomerulonephropahty "AMY the MINIMAList MEMBRANOUS *PHROG* is FOCALst on her DM/ PODOCYTS"
C3a, C4a, C5a
Anaphylatoxins are *fragments* (C3a, C4a and C5a) that are produced as part of the activation of the *complement system* "a for anaphylaxis"
what are the 4 ligametns involved int he tibiofibular syndesmosis
Anterior tibialfibular lig Posterior tibial fibular lig Interosseus tibiofibular lig Inferior transverse lig
Immunized to Hep B will show what serology
Anti-HBs only
autoantibody: - Anti-double stranded DNA and anti-Smith, anti nuclearbody vs -anti-SSA, anti-SSB vs -anti-TSH receptor
Anti-double stranded DNA and anti-Smith, antinuclear body: SLE vs -anti-SSA, anti-SSB: Sjoren syndrome vs -anti-TSH receptor: Graves
high pitched blowing decreschendo murmur
Aortic regurgitation
how is outgrowth of limb bud started
Appical ectodermal ridge interacts with mesoderm/mesenchyme
Which one of the essential amino acids is considered semiessential
Arginine "Arginine is a semi essential country"
a local subacute antibodymediated hypersensitivity reaction. causedb y intradermal inhection of antigen induces antibodies like following a tetanus vaccine
Arthus reaction (hypersensitivity 3) 211
what arteris give rise to the trochanteric anastomosies
Ascending br of MFC, LFC
what makes up the trochanteric anastmoses
Ascending br of Medial femoral circumflex Ascending br of lateral femoral circumflex
why is asprin CI in acute gout attack?
Asprin decrease urate exceretion
fractured surgical *neck* of humerus or anterior dislocaton of humerus affects which nerve
Axillary (C5-C6)
What antifungal inhibits the conversion of lanosterol--> Ergosterol
Azoles
where is azygos, hemiazygos and accessory hemiazigos vien
Azygos vein: right Accessory hemiazygos vein: upper left hemiazygos vein: lower left
CD19, CD20, CD21, CD40
B cells 209
breast carcinoma gene muation
BRCA-1 (Breast Cancer 1)
longstanding complication of GERD
Barrett Esophagus
-what part of the brain: -voluntary movments -posturela adjustments -receives cortical infup and provides negative feedback to cortex to moduate movment -consists of the striatum and lentiform -if damaged could result in resting tremor of the hands
Basal ganglia 458
Parkinson's dz is detereation of neurons locaed where
Basal ganglia of subsancia nigra pars compacta
Ig light chains in urine
Bence Jones protein (MM) 401
Defect in platet plug formation due to defect in platelet to vWF adhesion (decreased Gp1b)
Bernard-Soulier syndrome
Worst head ache of my life
Berry aneurism of circel fo willis
primary neurotrasmitter for: Beta 1 Beta 2
Beta 1=NE Beta 2=E
class of drug that tx decrease cardiac contractility managment of chronic stable angina managment of CHF Reduces mortality in CHF Treatment HTN and HTN in pregnancy Inhibit renin production Hypertensive Emergency managment of hypertrophic obstructive cardiomyopathy migraine prophylaxis sympathomimetic tx of thyroid storm treat essential tremor treat glacoma
Beta blockers 256
Acyl CoA dehydrogenases are enzymes in what metabolic process
Beta oxidation (product is 2 Acytly-CoA which are then given to the Krebs cycle or made into Ketone bodies
tear drop cell (Darocyte)
Bone marro inflitration: -Beta thallasemia -myelophthisic anemia caused by myelofibrosis 389
Where can Ketone bodies be used as fuel (3
Brain Heart sk muscles
bacteria that causes descending paralysis
C. Botulinum
what nerve supplies the superior root of the ansa cervicalis
C1
Fatty acid syn occurs in the cytosol until the FA chain becomes longer than what
C17 (C16=palmitate is synthesized in the cytosol)
t(9:22)
CML (BCR-ABL) 403
aka heriditary motor and sensory neuroapthy in which there is a defective production of proteins invovlved in the structure and function of periperial nerves or the mylein sheath.
CMT
innervation for the middle ear cavity
CN 9
location of preganglionic cell bodies of parasympathetic nervous system
CN3,7,9,10, S2-S4
nerve that provides sensory innervation to the paranasal sinuses
CN5
what cranial nerve branches from the Pons
CN5
what cranial nerve keeps eye lids open
CN7 (facial)
NE doesnt have an effect on what aspect of heart control
CO
Draw the Arachidnic acid chart: then list the inhibitors: corticosteroids, asprin, NSAIDS, Acetaminophen, montelukast
COX-Asprin ect
how does protein and glucose amount differ in CSF vs plasm
CSF has much *lower* glucose and protein
upstroke of action potential in the *SA node* is due to influx of
Ca
muscle contraction affects glycogen stores how?
Ca binds to calmodulin---> activating glycogen phosphorylase---> glycogenolysis---> providing engery for muscle exercise 109
drug treatment for psoriasis
Calcipotriene
pompe disease characteristics (4 main)
Cardiomegaly, Hypertrophic cardiomyopathy Exercise intolerance, Progressive limb girdle weakness Early death Creatine Kinase increased "Pompe trashes the Pump (heart, liver, m)
list 3rd generation cephalosporin (3 main ones)?
Ceftriaxone Cefotaxime Ceftazidime
what are the 2nd generation cephalosporins (4)
Cefuroxime (furious b/c his Fac is wrong) Cefotetan (teacup) Cefoxitin (fox) Cefaclor (check the facs)
Selective COX 2 inhibitor
Celecoxib
part of the brain that modulates movment, and aids in coordination and balance
Cerebellum ataxia:loss of movment dysmetria: loss of coordination 457
what is the most common bacterial STI
Chlamydia trahomatis D-K: STI
what drug causes grey baby syndrome
Chloramphenicol
Depolarization of what cells in the adrenal gland releases Epinephrine
Chromaffin cells
Hyperplasia of bronchial submucosal glands and bronchial smooth muscle hypertrophy
Chronic bronchitis
p-ANCA pathology (2 major)
Churg strauss microscopic polyangiitis
p-ANCA association
Churg-Strauss microscopic polyangitis
antiarrymic that has the greatest affinity to block Na
Class 1-C Flecinide Propafenone
Pantothenic acid is a component of
CoA
Draw the circle of wilis (5 branches)
Communicating (anterior) Anterior cerebral Internal carotid Communicating (posterior) Posterior cerebral Basilar is not part of it!
How do DPP4 drugs *increases* levels of Glucagon Like Peptide Receptor which increases insulin release and satiety, decresing glucagon release and gastric empyting.
DPP4=Dipeptidyl peptidase 4 inhibitors prevent brreakdown of GLP-1
Thyroixine is derived from
Tyrosine 106
in infants what hasnt developed yet which causes grey baby syndrome when given chloramphenicol
UDP-glucuronyl transferase
the symtoms of horner syndrome can be preciptated by a tumor locating where
apex of the lung (ptosis, miosis, enophthalmos, anhydosis)
two microbes that cuase hand foot mouth disease
Coxsackie A, Enterovirus
Bornholm's disease
Coxsackie type B
aceptic meninigitis
Coxsackievirus Type A (aseptic= non bacterial)
why is compliance less in the apex of the lung
apex of the lung, the alveoli are larger so compliance is less.
V/Q ratio mismatch in apex vs base
apex: higher V/Q ratio base: lower V/Q ratio
Combo drug for dapson
Dapson with Rifampin Clofazimine
what lymphatics drain into the deep inguinal (3)
Deep thigh Superficial popliteal
What inactivates imipenim? what is the combo durg to prevent the inactivation
Dehydropeptidase in renal tubules -cilasitin
A 30 year old woman has sudden bluring of vision in her right eye, parethethesia, and spasticity. CSF findings inculde ligoclonal bands on electrophoresis. Where does MS affect in the body?
Demyelinating lesions at occur only on axons in the CNS (spinal cord and brain) that have myelin sheaths formed by oligodendrocytes, increased IgG spinal fluid, and chronic relapsing occurances. the destruction is of the myelin only (not the actual axons) -The optic nerve, brain stem and paraventriular areas of favored sites of MS. -increasing insidencs away from equator "owl is wise with his CNS"
Which nephrotic syndrome responds well to ACE inhibitors
Diabetic glomerulonephrapathy
Prostaglandins affect afferent arteriolar in Kidneys how?
Dialator
A stenotic mitral valve would be what type of murmur
Diastolic
aka left sided appendicitis
Diverticulitis
Most stable AJ position
Dorsiflexion
microbe spread by injesting cyst form of protazoa
E. Histolytica
#1 cause of UTI
E. coli
mannitol is a marker substance for? ECF or ICF
ECF
relationship of EDB and Dorsalis pedis
EDB crosses Dorsalis pedis near its termination (Dorsalis Pedis is deep)
Which Intrinsic foot musles is not innervated by the tibial nerve (2)
EHB and EDB (deep peroneal nerve)
Rocky mountain spotted fever is an endemic in which part of the US
Eastern
is Marfan syndrome an issue with collagen or elastin?
Elastin Ehlers Danlos is a stage 6 of collagen (crosslinking stage) issue
Enzymatic fat necrosis location: vs Nonenzymatic fat necrosis location
Enzymatic fat necrosis: pancreas Nonenxymatic fat necrosis: breast "non fat breast"
Genetic *drift*/antigenic *drift* causes
Epidemics "ED"
what is released by interstitial cells in peritubular capillary beds in repsonse to hypoxia
Erythropoient 535
prostaglandins are synthesied in which cell
Essential Fatty acid
which of the RIPE medications cause opitc neuropathy (red green color blindness)
Ethambutal "*eye*thambutal" 189
where does the ilioinguinal nerve exit from the superficial inguinal ring
External oblique muscle
location for indirect vs direct hernia
indirect: lateral to inferior epigastric vessel direct: meidal to inferior epigastric vessel
during what metabolic process is Palmitic acid produced
FA synthesis Palmitic acid is the first fatty acid produced during fatty acid synthesis and is the precursor to longer fatty acids
Insertion for Quadratus Plantae
FDL tendon
aggregation of somatic mesoderm and mesenchym stimulates the ectoderm to produce what
FGH-8 and form a thickedn reigs called the apical ectodermal ridge (AER)
Pisiform bone is the sesamoid of the wrist in which tendon
Flexor Carpi ulnaris
hook of the hamate is an attachment for what muslces (2)
Flexor Digiti minim brevis Opponens digit minimi
In the middle 1/3 of the leg the posterior tibial artery runs between what muscels
Flexor Digitorum Longus and Tibialis posterior
t(14:18)
Follicular lymphoma (BCL-2 activation) "age 14-18 Follc" 403
what drug inhibits Alcohol dehydrogenase
Fomepizol
DNA mutation: deletion OR insertion of a number of nucleotides not divisible by 3, resulting in misreading of all downstream nucleotides usually resulting in a truncated or nonfunctional protein
Frameshift (Duchenne muscular dystrophy)
what are the bones that make up the orbit of the eye (7)
Frontal (roof) Ethmoid, Lacrimal, spenoid, maxilla (medial) zygomatic, maxilla, palantine (floor) zygomatic (lateral)
Where in the Cell cycle does p53 and RB normally inhibit?
G1 to S1 progression
Intrinsic hemolytic anemia that can be caused by sulfa drugs, antimalaria, or infections
G6PD deficiency also fava beans 394
pathology manifested by eating spicy foods and lying recumbant. the pain is releived by antacids
GERD
DM drug that *activates* Glucagon Like Peptide Receptor which increases insulin release and satiety, decresing glucagon release and gastric empyting
GLP-1 agonists (exenatide, liraglutide
absences of galactose 1 phosphate uridltransferase results in increased what
Galactose
accumation f glucocerbroside
Gaucher disease
mild decreased UDP-glucuronosyltransferase conjugation -aysmptomatic or mild jaundice
Gilbert syndrome " Matt is a harmless person who lives in Gilbert"
defect in platelet plug formatio due to platelet to platlet aggregation issue. (decreased GpIIb/IIIa)
Glanzmann thrombocytopenia
what does each zona of the adrrenal cortex and medulla regulate
Glomerulosa: Renin-angiotensin= aldosteron Fasciculata: ACTH, CRH= cortisol and sex Reticularis: ACTH, CRH= Sex Medulla: chromaffin cells: preganglionic sympathetic fibers=catacholamines "Gets sweeter as you go deeper
only hormone that stimulates gluconeogeneis
Glucagon
Major extensor of the thigh?
Gluteus maximus
Which amino acids are a precursor to purine syntheis (3)
Glycine Glutamate Aspartate
Tretinoin use
induce remission in people with acute promyelocytic leukemia
linear (anti-basment membrane antibody) against collagen in glomerular and alveloar basment membranes that presents with hematuria and hemoptysis classicly in young adult males
Goodpasture (nephritic syndrome) (type 2 hypersensitivity)
Tributaries of the coronary sinus (5)
Great cardiac vein; Middle cardiac vein; Small cardiac vein; Posterior vein of left ventricle; Oblique vein of left atrium
Inferior gluteal n courses thorugh wich sciatic foramen
Greater (underneath piriformis)
what are the Purine bases (2)
Guanine Adenine
-why are the central chemoreceptors in the medulla not able to respond to hypoxia caused by decreased pH? -funtion of peripheral vs central chemoreceptors
H atoms cant cross the BBB, and becuase the chemoreceptors are located in the brain (medulla). the peripheral receptors are sensitive to reduced pH, reduced PO2 and increased PCO2 and can stimulated increased breathing. both the peripheral and central chemoreceptors are sensitive to CO2 levels.
how does hydrogen get secreted from paritetal cells
H/K ATPase
what common treatmetn regimen is used for HIV infections
HAART (highly active antiretroviral therapy)
autoimmune feature of hashimoto thyroditis
HLA-DR5 and HLA-B5 (will also see hurthle cells)
Where is NADPH made/ used (3) in biochemestry
HMP shunt (PPP) makes NADH for: 1. Cholesterol syn 2. FA syn 3. Glutathion reduction in RBC
list the 13 DNA viruses
HSV1 HSV2 Adeno Pox Hep B EBV CMV VZV HHV6 HHV8 polyomavirus: (JC and BK) Papilloma Parvo
mutation for sicle cell anemia
HbS potin mutation causes a single amino acid replacement in beta chain causing Glutamic acid being replaced with Valine at postion 6
CD4, CD40L
Helper T cells 209
major tributaries of the portal venous system (4)
Hepatic portal vein Splenic vein Superior mesenteric vein Inferior mesenteric vein
Cancer related to aspergillus fumigatas
Hepatocelluar carcninoma
inflammation of the DIPJ
Herberdens nodes ( Bouchard's nodes may also be present; these are similar bony growths in the proximal interphalangeal (PIP)
osmotic fragility test postive for what pathology
Heriditary spherocytosis
AA with no net charge
Histidine
Reed sternberg cells are only seen in
Hodgkin's lymphoma
defeciency in Iduronate sulfate
Hunter syndrome
layer 1 structures of lateral knee
IT band bicepts tendon
Major AE of Neutral Protamine Hagedorn (NPH)
Hypoglycemia
Function of RNA polymerase: I II III
I-rRNA II-mRNA III-tRNA
ITP vs TTP: labs will show increased/normal megakaryocytes on bone marrow biopsy? Thrombocytopenia? Antiplatlet Ab? platlet derived hyalin microscopic clots? Helment cells? Renal insufiecney? Caused by vWf ADAM13?
ITP (immune thrombocytopenia) labs will show increased/normal megakaryocytes on bone marrow biopsy? ITP Thrombocytopenia? both Antiplatlet Ab? ITP platlet derived hyalin microscopic clots? TTP Helment cells? TTP Renal insufiecney? TTP Caused by vWf ADAM13? TTP 397
The liver has a fissure between the caudate lobe and major part of the right lobe for? Name the other lobes of the Liver
IVC
which immunoglubulin prevents attachment of bacteria and viruses to mucous membrane?
IgA 205
Henoch-Schonlein purpura is assoicated with what nephritic syndrome
IgA nephropahty (berger disease)
IgA immune complex deposition in mesangium of glomeruli
IgA nephropathy (berger disease)-most common nephropathy in world (nephritic syndrome)
Immunoglobulin is found on surface of many B cells and in serum
IgD 205
Immunoglubulin: -fixes complement -crosses placenta (provides passive immunity)
IgG 205
Immunoglubulin: -opsonizes bacteria -neutralizes bacterial toxins and viruses
IgG 205
what is the major flexor of the hip joint
Iliopsoas
Reyes syndrome can be found shortley after which 2 viral infections
Influezna and chickenpox
define vital capacity
Inspiratory Tidal volume Expiratory
anemia: chronic bleeding or GI bleeding
Iron def
Reversible or Irreversible: Karyolysis Karyorrhexis Pynkosis
Irreversible
general location of the hip legaments
IsF: posterior surface IlF: anterior surface PF: medial surface
Which AA are branched?
Isoleucine leucine Valine "seen in maple syrup disease" "I love vermont's maple syrup 107
which of the RIPE medications cuase neurotoxicity and hepatotoxicyt, and peripheral neropahty
Isoniazid 189
Growth hormone receptor is assicate with what pathway
JAK tyrosine kinase and STAT pathway SP192
difference between JG cells and macula densa
JG: release renin in response to low BP Macula densa: chemreceptor sensitive to Na
Exessive amounts of IgE in blood stream causes
Job's syndrome
-Muscle paresis or paralysis -Fibrillations -Fasciculations (caused by increased receptor concentration on muscles to compensate for lack of innervation) -Hypotonia or atonia (Tone is not velocity dependent) -Hyporeflexia (deep reflexes even cutaneous reflexes are also decreased or absent) Strength (weakness is limited to segmental or focal pattern) -extensor Babinski reflex is usually absent
LMNL
Lactose fermenter gram negative rods (4)
Klebsiella E. coli Citrobacter Serratia
Cauda equina location
L1 and down
level of conus medularis
L2
spinal cord termination
L2
most common herniation location
L4-S1
nerve roots that supply sacral plexus
L4-S4
delivers hepatic choletsterol to peripherial tissues
LDL
arterial supply for vastas intermedius
LFC
what are the Beta 1 antagonits drug: 7 non selective antagonists drugs: 4
Lab, Propran, Pind, Timolo, Carved, Nad, So Met, Aten, Ace, Esm
Autoantibodies that affect the pre-synaptic Calcium channel decreasing Ach release
Labert Eaton 405
fibularis (peroneus) quartus is a variable m in which compartment of the leg:
Lateral compartment
the lateral branch of the deep peroneal a travels with what artery of the foot
Lateral tarsal (perforating a)
Which side of heart failure: breathless awakening from sleep
Left
Which side of heart failure: shortness of breath when supine
Left
Which side of heart failure: presence of hemosiderin-laden macrophages
Left 297
Carbonmonoxide posining causes a Left or Right shift on hemoglobin curve? what is the pathophysiology
Left stabilizes R state (oxygenated state)=makes it more difictult for O2 to be released from hemoglobin in the tissues
most common cause of Right side heart failure
Left sided heart failure 297
what chamber of the heart represents the apex of the heart
Left ventrical (5th intercostal space midclavicular line)
Reminant of the left umbilical vein?
Ligamentum teres hepatis aka round lig of liver
only antibiotic usefull agaisnt VRE (vanco-resistance-enterococci)
Linezolid
parasite caused by Deer fly, horse fly, mango fly
Loa Loa
Mycobacterium Tuberculosis grows on what medium
Lowenstein Jensen medium
does Digoxin, Lithium, theophylline, and warfarin have a high or low Therapeutic Index?=save or unsafe?
Lower=unsafe
location of scala vestibuli vs tympani in relation to the 2 windows?
M, I, Stapes-->Oval window-->vestibuli--> helocotrema---> tympani---> round window
saphrophytic organisms
M. avium, M. intracellulare, and M. chimaera are considered mycobacterium avium-intracellualare that present in soil and water
t(15:17)
M3 type of AML
Supracondular fracture of the humerus affects what nerve? what are symtoms simiular to?
Median (C5-T1)=ape hand or pope blessing same symtoms as carpal tunnel syndrome 418
Daclizumab use
MS by binding to the Tac epitope on the IL2 receptpr
increased anion gap
MUDPILES anion gap >12 methylene glycol uremia diabeticketoacidosis Propylene glycol Iron tablets or Isoniazid Lactic adidosis Ethylene glycol Salicyates (late) 538
saphrophytic lipid-dependant yeast
Malassezia furfur
glycogen storage disease: myoglobinuria
Mc Ardle disease
vascularization for vastus medialis and articularis genu
Medial superior genicular a
Primary extensors of the vertebal column
Medial to lateral (spinalis, longissimus, iliocostalis)
Where in the brain are the Central chemoreceptors located
Medulla 286
Type 2 DM drug that inhibits mitocondrial enzyme glycerophosphate dehydrogenase (mGDP)
Metformin: the inhibitin of glycerophosphate dehydrogenase (mGDP) decreases hepatic gluconeogenesis
what makes up the brainstem
Midbrain Pons medulla
first heart sound is caused by
Mitral valve (preceeds Tricuspid valve slighlty)
Late systolic crescendo w/ midsystolic click
Mitral valve prolaps
a condiction where calcium deposits are found in the muscular middle layer of the walls of arteries (the tunica media). It is an example of dystrophic calcification
Monckeberg's disease
Rouleaux formation
Multiple myeloma
Upper trunk compression affects which nerve
Musculocutaneous (C5-C7)
Autoantibodies t postsynaptic Ach receptor
Myasthenia gravis 435
most common form of cutaneous T-cell lymphoma. It generally affects the skin, but may progress internally over time. Symptoms include rash, tumors, skin lesions, and itchy skin?
Mycosis fungoides
most common cause of meningitis in young aged children (not neonates)
N. Meningitis
upstroke of the action potential in the *atria, ventricals and purkinje fibers* is due to influx of
Na
cause of amebic meigoencelphalitis
Naegleria
moa for sidenophil
Nitric oxide (NO) in the corpus cavernosum of the penis binds to guanylate cyclase receptors, which results in increased levels of cGMP, leading to smooth muscle relaxation (vasodilation) of the intimal cushions of the helicine arteries. This smooth muscle relaxation leads to vasodilation and increased inflow of blood into the spongy tissue of the penis, causing an erection. SP172
Attachments for: Acessory vs proper collateral ligament near the plantar plate
O: dorsal tubercel of methead Accesory I: Plantar plate Proper I: base of proximal phalanx
origin for Adductor Hallucis
OH: plantar met bases of 2,3,4 and Peroneus Longus TH: Plantar plates of mets 3,4,5 and DTML
what are the capsular ligaments of the knee (4)
Oblique popliteal lig Arcuate popliteal lig Tibial collateral lig coronary lig
affect of androgens and estrogens on the epipyseal plate closure
induces closure
A-a gradient
PAO2 is the 'ideal' compartment alveolar PO2 determined from the alveolar gas equation. normal A-a gradient for a young adult non-smoker breathing air, is between 5-10 mmHg. However, the A-a gradient increases with age/ or pathology
evolocamab
PCSK9 inhibitor: degrates LDL receptors=increasing uptake of circulating LDL
congenital heart disease in which a shunt from the aorta to the pulmonary artery occurs.
Patent ductus arteriosus
Skin condition as a result of defected desmsomes
Pemphigus vulgaris
autoimmune desctruction of parietal cells leading to intrinsic factor defiecney describes what pathology
Pernicious anema=Intrinisc factor normaly binds to vit B12 in order to be absorbed in the ileum (1 of 2 causes of megaloblastic anemia. other cause is folate defeicency)
phase 1 metabolism
Phase 1 metabolism =oxidation reduction and hydrolysis.
Catecholamine syn pathway starting with phenylalanine (5) --->?,?,?,?,?,
Phenylalanine: "TDDNE" Tyrosine DOPA Dopamine NoreEpi Epi 107
abnormal levels of urinary metanephrine and VMA (vanillylmandelic acid) can indicate
Pheochromocytoma
which muscles of the thigh: (4) -lateraly rotate and extened hip -abduct a flexed hip
Piriformis Obturator internus Gemellus superior Gemellus inferior
Which of the proximal carpal bones do not participate in the wrist joint
Pisiform
glycogen storage disease: increased Creatine Kinase
Pompe disease
Deficiency in lysosomal alpha 1,4 glucosidase describes what glycgen storage dz
Pompe disease 110
Class of diuretic to tx aldosteronism
Potassium sparing
Floppy iris syndrome is a SE of what drug
Prazosin
Superior vena cava empties at what anatomincal level of the sternum? around what rib?
inferior to sternal angle of the manubrium/ inferior to 2nd rib 2nd rib = sternal angle
Midshaft fracture of the humerus, compression of the axilla from crutches or sleeping with arm over a chair affects which nerve
Radial nerve (saturday night palsy) 418
Profol is most effective for (2)
Rapid anesthesia hypnosis
which RNA virus is the only one that is dsRNA
Reoviridae
pH <7.35, PCO2 >40
Respiratory acidosis
pH >7.45, PCO2 <40
Respiratory alkalosis
which of the RIPE medications causes organce body fluids
Rifampin
Which side of heart failure: Jugular venous distention
Right
Which side of heart failure: Peripheral edema
Right
Which side of heart failure: cor pulmonale
Right
Which side of heart failure: nutmeg liver (hepatomegaly)
Right
Which side of heart failure: saddle pulmonary embolism
Right
increased P50 on oxyhemoglobin curve=
Right shift (less affinty for O2)
what chamber of the heart makes up most of anterior surface of the heart
Right ventrical
Rods vs cones
Rods: more senstive to low intensity light (night vision), adapt to darkness after cones, not in fovea Cones: color vision
most common cause of meningitis in the elderly
S. pneumoniae
draw difference between SA node action potential and Ventricular action potential with the different ions?
SA node: 4=slow Na /Ca in, 0=rapid Ca in, 3=Kout Ventricular: shown in pic
5 layers of the scalp
SCALP Skin Ct Aponerosis Loose conective tissue Pericardium
site in the cell where drug oxidation metabolism occurs
SER
Draw the EKG and label its parts including isoelectric line
ST
follow the tributaries from superfical inguinal lympth nodes to the SVC
SVC L brachiocephalic v L subclavian/L internal Jugular v Throacic duct Cisterna Chyli Lateral orotic Common iliac External inguinal Inguinal Deep inguinal superfical inguinal, poplitial, deep thigh
Vi antigen is associated with what microbe
Salmonella
location of perilymph vs endolymp
Scala vestibuli and tympani have perilymph vs Scala media has enodlymph
name the hamstring muslces
Semimembranosus Semiteninossus Biceps Femoris
Winged scapula is what m? origin and insertion? innervation?
Serratus anterior O: superior lateral surface of ribs 1-9 I: Vertebral border of scapula innervation: long thoracic nerve
Protease that cleave soluable NSF attachemnt protein receptor (2 bugs)
Soluable Nsf Attachment protein REceptor (SNARE) C. Tetani C. botulinum
CD3, CD28,
T cells 209
location of preganglionic cell bodies of sympathetic nervous system
T1-L2
xiphoid process lies at which vertebra
T10
Esophageal hiatus level/contents (2)
T10: Esophagus and vagus nerve "I before E except after A", "EsoVagus"
Draw out the Lumbo sacral plex
T12-S4
Aortic hiatus level/ contents (4)
T12: aorta, azygos v, thoracic duct, greater splachnic nerve "I before E except after A", "AATS"
Inferior Vena cava hiatus level/ contents (2)
T8: inferior vena cava, right phrenic nerve "I before E except after 8", "I choose the RIGHT"
caseous necrosis is commonly found where in the body and with what pathology?
TB (lungs)
Cambo drug to inhibit folate synthesis
TMP-SMX (trimethoprim-sulfamethaxazole 186
ITP vs TTP: increased von Willibrand factor increased platlet adhesion increased platelet aggretation and thrombosis
TTP (Thrombocytopenic purpura) 397
CD3
Tcells
Darocyte? found where?(2)
Tear dropcell "my beta tear" *beta thalassemia*major after splenectomy, bone marrow inflitration like *myelofibrosis*) SP389
Fanconi syndrome is associated with what antibiotic class?
Tetracyclines
1 Antibiotic class that binds 30s and inhibit attachment of aminoacyl-tRNA?
Tetracyclines "Im in though" Amino
Tet spells are seen in children with
Tetralogy of Fallot
cause of Dry gangrenous necrosis: vs Wet gangreonous necrosis:
ischemia-coagulative vs superinfection-liquefactive
albumin concentration aka
plasma oncotic pressure
-muscle weakness -decreased motor control -loss of the ability to perform fine movements, -increased vigor,decreased threshold of spinal reflexes -spasticity -clonus (involuntary, successive cycles of contraction/relaxation of a muscle) -extensor plantar response (+) Babinski sign
UMNL
iron defeciency aneia with esphagela web and atrophic glossitis
plummer-Vinson syndrome
fracture of the funny bone (medial epicondyle of humerus), fractured hook of hamate affects which nerve
Ulnar (C8-T1) causes ulnar claw 418
what is the main component of the EBV capside
VCA protein (viral capsid agtigen)
most common intrinsic clotting factor deficiency
VIII (2nd place is factor IX)
synthesized by the liver from diatary sugar and delivers hepatic TGs to peripheral tissue
VLDL
vit B6 is required for syn of? 9
cyasthionine heme niacin histamine serotonin epinephrine norepinephrin dopamine GABA 90
Wernicke-Korsakoff pathophysiology
degenertion of mamilllary bodies and of parameidan masses of gray matter
Ca binds to what to initiate muscle contraction
Troponin
During myocardial contraction, Calcium binds to what to move tropomyosis out of the way?
Troponin C
what is the main way phagocytes kill bacteria
The increase in oxygen consumption, called a respiratory burst, produces *reactive oxygen-containing* molecules that are anti-microbial.
what cofactor is required in Transketolase, Alpha ketogluterase and pyruvate dehyrogenase, and Branched-chain amino acid dehydrogenase
Thiamine (Vit B1) "BATP is #1"
Diruetic DOC for neprhogenic diabetes insipidus
Thiazides
Fungi that when treated with miconazole may result in reacurrance
Tinea Versicolor
Transudate vs Exudate: macrophage and lymphcytes
Transudate (protein poor) "transam is for poor peple" "Ex is for rich people"
Borders of the triangle ausculation
Trapezius Latissimus dorsi Medial border of scapula
ToRCHS virus (8)
Txoplasma parvO Rubella CMV HSV, HIV, Hepatitis B Syphillis,
-Absent UDP-glucruonosyltransferase. -early in life--->fatal within a few years -jaundice, kernicterus
Type 1 Crigler-Najjar syndrome "Crigler-Najjar sounds like a vilin name=worst"
less severe type of UDP-glucrunosyltrasferase abscence b/c it responds to phenobarbital
Type 2 Crigler-Najjar syndrome
Class of drug for metronidazole
Urinary tract antiseptic
action of Gluteus medius and minimus in OKC
steadie the pelvis during gait (prevents dipping of the pelvis on the contralateral side)
ADH: V1 receptors action vs V2 recepto action
V1: constriction of vascular smooth m V2: increase water reabsorption in CT
what nerve runs in the foramen rotundum
V2
moa for tolvaptan
V2 ADH receptor antagonist used to treat SIADH -promotes free water excretion =increases plasma osmolarity (treating hyponatremia)
What step in the Ventricular pressure volume loop do the semilunar valves open
Ventricular ejection
which defiency is increased methlmalonic acid: folate or Vit B12
Vit B12 pathoma46
which defiency is associated with subacute combined degeneration of the spinal cord vs neural tube defects: folate or Vit B12
Vit B12-spinal chord Vit B9: neuroal tube defects Pathoma45
glycogen storage disease: hypoglycemia
Von Gierke disease
glycogen storage disease: increased triglycerides, and uric acid
Von Gierke disease
glycogen storage disease: very increased amount of glycogen in liver
Von Gierke disease
which 4 drugs are affected by p450 inducers or inhibitors?
Warfarin Theophylline OCP antiseizure
When does a rounded foot discs develope 3 week 4 week 5 week 6 week 7 week
Week 5 of fetal development "Discs have 5 letters in it" "
c-ANCA pathology
Wegener's
c-ANCA association
Wegner granulomatosis
best trreatment for Insulin Resistant syndrome
Weight loss
path: malabsorption due to not being able to breakdown and absorb important nutrients
Whipples disease
*PAS-positive macrohages* is distinctive for what pathology
Whipples disese "Pass the Whip"
Ventricular pre-excitation syndrome where the rate-slowing AV node is bypassed?
Wolf parkinson white syndrome 283
Parasite caused by Female mosiquito
Wucheria bancrofti
Parasympathetic stimulation to the heart via the vagus nerve stimulates release of?
actlycholine
what shape is the arcuate ligament? Attachments?
Y -stem of the Y attaches distally to the *styloid process on the head of fibula* -stem divides into posterior limb that courses over the the tendon of poplitiues and attacehs to the *intercondylar line* and the anterior limb attaches to the *lateral condyle of the femur*
Ziehl-Neelson stain
Ziehl-Neelson carbol fuchsin, acid alcohol, and methylene blue. Acid-fast bacilli will be bright red after staining
gastrin secreting tumor (gastrinoma) of the pancrease or duodenum. Acid hypersecretion causes recurrent ulcers in duodenum and jejunum. presents with abdominal pain, diarrhea.
Zollinger-Ellison syndrome 336
Aldosterone is release from where in the adrenal corex?
Zona glomerulosa of Adrenal cortex in response to renin
what is glycogenin
a protein that glycogen builds off of and initialy undergoes *autoglycosylation*, which occurs until its long enough for glycogen synthase to build off of.
Ependymal cell
a type of glial cell. These cells line the CSF-filled ventricles in the brain and the central canal of the spinal cord. -ciliated simple columnar
major muscle for expiration
abdominal m
normal function of CN4 in the eye? (3)
abducts, depresses internally rotates
what level does the peroneal a pierce the interossues membrane
above the lateral mall
CD28
accessory T cell adhesion molecule
location in the kidney for each of the diuretics: PCT (2) descending limb of henle (1) TAL (1) DCT (1) K sparing (1)
acetazolamide: PCT mannitol: PCT, Descending limb of henle Loop diuretics: TAL Thiazides: DCT collecting duct: K sparing:
what is Somatotropin
aka GH
most common cause of fatty change in liver
alchoholism
4 chewing m, innervation, action, blood supply
all innervated by CN V3 -Masseter: close jaw (elevation) -teMporalis: close jaw (elevation and retraction) -Medial pterygoid: close the Jaw (elevation and side to side movment -lateral pterygoid: protrusion and side to side movment bloody supply: branches from maxillary a, sometimes from perygoid branches
bacteriostatic (1)
all protein synthesis inhibitors except Aminoglycosides
where are the secondary centers of ossification for the Os Coxae ? (5)
all seondary centers of ossificiation for the Os Coxae are *at Puberty*: 1. Crest of the Ilium 2. AIIS 3. Ischial Tuberosity 4. Pubic Symphysis 5. Triadiate Cartilage
where in the bone does bone marrow and hematopoietic stem cells from from? (3 names)
all three refer to the same location: spaces of cancellous trabecular spongy bone tissue
shape of the plot graph for? allosteric enzymes vs michaelis-mentin enzymes which plot graph hemoglobin vs myoglobin belong to?
allosteric-sigmoidal (hemoglobin) michaelis mentin-hyperbolic (myoglobin)
-*MOA* for alpha 1 agonists ? -general functions: 4
alpha1 receptor Gq-> IP3-DAG (+) intracelluar Ca 1. (+) vaso/veno contstricion= MAP 2. (+) pupillary dilator m=mydriasis 3. (+) urethral and prostatic smooth m contractionsweat glands 4. (+) sweat glands
what is the general difference between alpha and beta thalasemia
alpha: gene deletion beta: gene mutations
Innervation for anterior vs posterior belly of digastric m?
ant: *mylohyoid n* (which is a branhc of the inferior alveloar branch of Mandibular n of Trigeminal nerve post: *facial n*
Action for anterior vs posterior belly of digastric m
ant: lower mandible, move hyoid bone superiorly post: move hyoid bone sup and post
new triple therapy for peptic ulcer (4)
anta-acid (peptolbismol) omeprazol (PPI) clarithromycin (macrolide) amaxicillin
origin for vastus intermedius
anterior and lateral shaft of femur
cutaneus innervation of femoral nerve
anterior and medial
where is the tibial crest
anterior border of the shaft of the tibia
blood supply to the frontal lobes? 3 functions that would be lost if the artery had damage?
anterior cerebral artery functions: -voluntary movement, -longer non-task based memories stored across the brain. These are often memories associated with emotions derived from input from the brain's limbic system, -project future consequences resulting from current actions, the choice between good and bad actions
structures within the anterior (2) vs posterior (2) triangle of the neck
anterior: common caraotid (which bifurcates into internal/external carotid, and external jugular vein posterior: External jugular comes from anterior triangle and empties into subclavian vein, and distal part of subclavian vein
borders of the anterior and posterior triangles of the neck
anterior: midline of neck, mandible, anterior border of SCM posterior: posterior border of SCM, middle 1/3 of neck, anterior border of trapezius
antigenic drift caused by vs antigenic shift caused by
antigenic drift=point mutation causing epidemics "ED makes a point" vs antigenic shift= segment changes cuaseing pandemics "PS segment"
what happens in heart causing a Dicrotic notch
aortic valves close
what is the deepest structure found on dorsum of foot
arcuate artery
what is the difference between the pulmonary artery and pulmonary vein?
arrow is pointing at pulmonary trunk, which leads into the pulmonary arteries (dexogenated blood)
what does increased arteriolvs venous constriction do to edema
arteriol contstriction=decrease edema venous constricstion=increase edema
How is most of the CO2 transpored in the body
as Bicarbonate in the plasma 538
location of lung affected: asbestosis? silicosis?
asbestosis=lower lobes (base) silicosis=upper lobes 612
what part of the Digestive system has the Ligamentum of Trietz
asendning part of the Dueodenum
Howell Jolly bodies
asplenic patients "not Jolly due to no spleen"
use for: Asprin and Motrin vs Tylenol
asprin (acetylsalicylic acid) and motrin (Ibuprobin): inflammation, fever pain "an ASS does all 3" Tylenol (acetaminophin) : fever and pain only (doesnt treat inflammation)
nissl body function
assist protine syn on the RER
when does the trachea begin? length/diameter
at the lower border of the cricoid cartilage, at the level of *C6*. It is approximately 10cm long with an external diameter of 2cm. It lies in the median plane and funs almost vertically cricoid cartlage is anterior
most proximal vertebra is called
atlas
Good pastures: pathophysiolgy? Hypersenstivity type? depositon pattern of immunoglubulin and complemtin in glomeruli?
autoimmune -*antibodies attack the BM in lungs and kidneys* causing bleeding lungs and kidney failure. -Type 2 hypersensitivity -linear
pituitary adenmoa, meningioma, glioma, aneurysm, primary hypothyroidism all can affect the visual field how,
bitemporal hemianopia (at optic chiasm)
general action muscarinic antagonists is to block DUMBELLS:
blocks: diarrhea urination miosis bradycardia Bronchospasm Excitation of sk m Lacrimation Sweating salivation "Blocking workingout with DUMBELLS keeps you from secreting)
which develps first: blood vessesl or nerves
blood vessels
deep petrosal nerve innervation
blood vessels and mucous glands of the head and neck
Mesenchymal cells from somatic mesoderm (3)
bone ct bv
where is perfusion the greatest in the lung vs ventilation
both are greatest in the base of the lung
differentiate the medial and lateral miniscus
both are intracapsular, intrasynovial -medial miniscus: semicircular, attached MCL, more likely to be injured, larger -lateral miniscus: circular, not attached to LCL, smaller
anterior tibial artery branches from the popliteial a at what level
bottom of popliteus m
while drawing blood from median cubital vein what artery could accidently be punctured
brachial artery
main flexor of forearm
brachialis
what muscle is pierced by the parotid duct (parotid duct aka)
buccinator m (aka stensen's duct)
t(8:14)
burkitt lymphoma "age 8-14 say Burr" 403
by the end of the embryonic period (8 weeks) the lower limb is in the fetal position wich the knee is ___1____ and the plantar surface of the feet face each other in the ___2___ plane. the hallux is what postion ___3___ the digit minim is in what position?____4____
by the end of the embryonic period (8 weeks) the lower limb is in the fetal position wich the knee is ___1____ and the plantar surface of the feet face each other in the ___2___ plane. the hallux is what postion ___3___ the digit minim is in what position?____4____ 1 flexed 2. sagittla 3. preaxial aka cranial aka superior 4. postaxial aka caudal aka inferior
Common causes of Guillain-Barre Syndrome (4 bugs)
campylobacter (most common) HSV CMV EBV
Metastasis definition
cancers cells able to spread via bloodstream and lymphatic vessels
damage to the superior oblique m causes
cant look inferior medialy
drug class for imipenem
carbapenem
bicarbonate combines with Hydrogen via what enzyme
carbonic anhydrase (creates H20 + C02)
function of the left umbilical vein of fetus
carrie oxygenated blood from placenta to Left br of portal v in fetus
function of pancreatic lipase
catalyze the breakdwon of diatary TG into free FA and monoacyleglyceros
what type of TB does: primary vs secondary Cavitation occur? Caseating occur necrosis? positive TB
cavitation: secondary TB caseating necrosis: primary and secondary TB TB test: positive in both primary and secondary
disulfuram like reactions occur with what antibiotic class
cephalosporins
what innerates the stylohyoid muscle
cervical br of CN7
IL8
chemotactic factor for neutrophils "Clean up on aisle 8"
how do Vitamins ADEK get into bloodstream? (3 steps)
chilomicrons--> pass through lymph of small intestine---> bloodstream
most common cuase of PID
chlamydia
moa of Ezetimibe
cholesterol absorption ingibitor
parasympathteic innervation of the eye will cause: ciliary m contraction vs relaxation? near vs far vision? miosis or mydriasis?
cilary m contraction near vision miosis
where is aquous humor produced
ciliary epithelium
Chemo man SE for cancer drugs
cisplatin
best antiarrhtymic for post MI
class 1B Lidocaine, Mexiilitine Phenytoin
function of pancreatic aplpha-amylase
cleaves the α(1-4) glycosidic linkages of amylose to yield dextrin, maltose, or maltotriose
medication used to treat infertility in women who do not ovulate
clomifene
temperature of skin with increased catecholamine release
cold and clammy b/c catecholamin like epinephrin vasoconstricts therefore not allowing heat to escape in periphery
what happens to venous blood flow with contraction and relaxation of the calf
contraction: blood is pumped superiorly in the deep veins. blodd is prevented from flowing from deep to superfical veins relaxation: blood is aspirated from superficial veins into deep veins.
function of dopamine beta hydroxylase
converts dopamine to NE
ligament that attaches the menisci to the condyles
coronary ligament
daptomycin moa
creates pores in cells membrane
intrinsic muscle of the larynx not innervated by recurrent laryngeal nerve
cricothyroid m innervated by the superior laryngeal br of CN10
muslce of the larynx NOT innervated by recurrant laryngeal nerve? what is it innervated by?
cricothyroid m (external laryngeal n-which runs posterior to sternothyroid m)
which muscle fo the larynx is not innervated by the recurent laryngeal nerve (all the musles of the larynx)
cricothyroid m (innervated by the external reccurent laryngeal nerve)
The crutiate ligametns are what in relation to the synovium and capsul vs meniscus
cruciate: intracap, extrasynovial vs menisucs: intracap, intrasynovial
Dx for cryptosporidium mominus vs Giardia
crypto: oocytst Giardia: cysts and theophozoites
C5b-9
cytolysis by MAC
function of C5b-9
cytolysis by MAC (combats Neisseria infections)
fry's syndrome
damage to parotid gland during surgery can cause a phenomenon where sight/smell of food cuases flusing and sweaing
Increased ECG Intervals affect velocity how
decrease conduction velocity
Why does HR increase when going from supine to standing up
decreased venous returen
what runs thorugh the transersalis fascia
deep inguinal ring
innervation of peroneus tertius m
deep peroneal n
first proximal perforating artery aka
deep plantar a
Diagnosis of Clostridium dificil
detection of toxin in stool by polymerase chain reaction
Dexamethasone suppression test
dexamethasone injection given, and the cortisol levels are measured from adrenal gland normal: low doese dexamethasone decreases cortisol (+ test): low dose dexamethasone doesnt affect high cortisol level normal: high dose dexamethazone decreases cortisole level cushing disease(pituitary adenoma): high dose dexamethazone will decrease cortisol level (affect on pituitary) beceause its inhibiting ACTH to act on adrenal gland to secrete cortisol Cushing syndrome (adrrenal gland tumor): high dose dexamethazone will not decrease cortisol b/c adrenal gland is out of control (picture)
relationship for Cr Concentration in tubule and water reabsorption
direct (increased tubule Cr concentration=amount of water reabsorped)
which v drains into the right atrium vs the coronary sinus
directly into right atrium: anterior cardiac vein coronary sinsus: Great cardiac vein; Middle cardiac vein; Small cardiac vein; Posterior vein of left ventricle; Oblique vein of left atrium
relationship of resistance and lenght of the vessel
directly: so a longer vessel=more resistance
where are downey cells vs cowdry bodies
downey=EBV coudry=HSV
Cancer Man: Cisplatin and Carboplatin Vincristine Bleomycine Busulfan Trastuzumab doxorubicin cyclophosphamide Methotrexate, 5FU, 6MP
draw it
-conjugated hyperbilirubinemia due to defective liver excretion. -Grossly black liver -benign
dubin-Johnson syndrome "hard to get out of dubin b/c your black"
lower border of cricoid cartlage marks what anatomacal feature
end of pharynx and larynx
Human T-lymphotrophic virus type 1 causes acute T-cell leukemia in which parts of the world
endemic to parts of caribbean
why does peripheral neurpathy occur in DM pts
due to chronic poor glycemic control, the *nonenzymatic glycosylation of protein in neurons becomes harmful of the long neurons* (Lower extremity)
When is blood flow in the coronary arties the strongest
during diastole
what are the only skin appendage present in the plantar foot?
eccrine sweat glands (plant foot doesnt have hair so no sebaceous glands)
what happens to NADH levels in alcholics
elevated elevated NADH levels inhibit fatty acid oxidation and TCA
vessel, shape, crosses suture lines? Epidural hematoma vs subdural hematoma
epidural hematoma: lens shaped, middle meningial a, doesnt cross surture lines subdural hematoma: crescent moon shaped, bridgeing veins, crosses the surtuer lines
what makes up the diencephalon (5)
epithalamus, thalamus, hypothalamus, and ventral thalamus and the third ventricle
location for coagulative vs liquefactive necrosis (2)
everywhere except brain (liquefactive necrosis=brain or pancrease) "liquify your brain or pancrease"
action of intercostal muscles (external vs internal)
external: move ribs up during inspiration vs internal: move rbis down during expiration
APC mutation is commin what pathology?
familial adenomatous polyposis (FAP) 100% cancerous
contents of adductor canal (4)
femoral a femoral v Saphenous n n to Vastas medialis
where does the saphenous nerve branch from
femoral nerve
AE for nitroprusside in a pregnancy
fetal cyanide poisoning
lesion in the dorsal column medial leminiscus pathway will affect? 4
fine touch, vibration, two-point discrimination, proprioception (position sense) from the skin and joints
largest parts of the motor homunculus
fingers, hands, face
TATA box function
first site of binding of a transcription factor for RNA pol 2 "TAP that TRANS POL 2"
Difference between first/second generation vs third/4th generation floroquinolones
first/second (-) topoisomerase II (gram negative) third/fourth (-) topoisomerase IV (gram positive)
popliteal or bakers cyst is a distention from what bursae?
fluid filled herniation of the synovial membrane of the knee or a distentin of the gastrocnemius bursa
what does the saphenous nerve course with in the as it innervates the skin on the medial, anteromedial, and posteriomedial surfaces of the leg
great saphenous vein
what is normal FEV1/FEC value? what is normal total lung capacity %? how does emysema and restrictive lung disease differ with these labs
greater than 0.7 greater tha 80% *empysema:* decreased FEV1/FEC normal total lung capacity *restrictive lung diesease:* normal FEV1/ FEC decreased total lung capacity
metronidazole moa
forms toxic free radical metabolites in bacterial cell=damages DNA
function of teichoic acid
found on gram postive provide *rigidity* to the cell-wall by attracting cations such as magnesium and sodium
where is the artery of ligamentum teres
fovea of head of femur (branch of the obturator a)
Duchenne dystrophy mutation
frameshift (deletion, duplicaton, or nonsense) "Frame Duchenne dont DYS his cardiomyopathy" 85
Where does vitamin C come from
fresh fruits and vegetables
Newcastle disease
from poultry causes conjunctiits w/o corneal involvment "whitecastle serves chickensandwiches"
functions of the hypothalmus
frontal: cooling superior: circadian (sleep) posterior: heat ventromedial: satiety (feeling full) lateral: Hunger
Deficiency of Aldolase B----> no glycogenolysis or gluconeogenesis! symtoms: hypoglycemia, jaundice, cirrhosis, vomiting
fructose interance (aldolase B hydrolyzes Fructose 1-P
Fundus vs antrum of the stomach secretions
fundus: HCL and intrinsic factor Antrum: Gastrin
limb development "dorsal"
future anterior surface of thigh and leg and dorsum of foot
limb develpment "ventral"
future posterior surface of the thigh and leg and plantar of foot
what are the suprahyoid muscles (4)
genihyoid (C1 of hypoglossal n) mylohyoid (mylohoid n) digastric (ant-mylohyoid n, post-facial n) stylohoid (cervical br of facial n)
why is Glucokinase on with high levels of glucose only
glucokinase has a *high km=low affinity*, so it needs a lot of glucose for glucokinase to act (it acts in liver and pancrease only) 98
Glutathione is derived from
glutamate 106
Filgrastim is from what drug class
granulocyte colon-stimulating factor (G-CSF) to prevent chemo induced neutropeniA
major SE for ketoconazle
gynecomastia (b/c it inhibits cholesterol desmolase= decreased production of androgens and estrogens)
orientation of the pancrese in the body
head nearst the deudenum
Triad for Renal Cell Carcinoma
hematuria papable mass flank pain
Triad for advanced hemochromatosis
hemochromotosis (Iron overload) 1. cirrhosis 2. DM (bronze diabetis) 3. hyperpigmentation
what are the 2 major buffers in the blood
hemoglobin bicarbonate
anemia: defect in proteins interacting with RBC membrane skeleton and plasma membrane
hereditary spherocytosis (intrinsic hemolytic normocytic anemia) 394
cause of the most common benign tumor osteochondroma
herniation of physis of growth plate resulting in abnormal metastatic cartilage that reponds to any factors that stimuate growth plate
what does a heterozygos vs homozygos mutation do to HIV
heterozygos: slows progression homozyygos: immunity
relationship of solubility of an inhaled anesthetic and the onset and duration?
higher solubility= slower onset, longer duration halothane=higher solubility Nitrous Oxide= lower solubility (quicker recovery time) SP206
what type of interactions maintin shape of RBC
hydrophobic interactions
issue withthe Triangle of Koch and AV node is associated with what pathology?
hypertrophic cardiomyopathy
NAP1 strain
hypervirulent c diff and associated with colitis and megalocolon
mnemonic for beta 2 agonists
i METAPROTER ALBOUT the SAME 2nd TERB, but I BAGed her on the FORM -Metaproteranol -Albuterol -Salmeterol -Terbutaline -Formoterol
temporal summation definition
if Ca hasnt been reabsorped into SR after m contraction, the in the next contraction b/c some Ca is still there, it will add to the additional Ca being release (summation of Ca) will resutlt in a stronger contraction
relationship of FF with GFR
if FF increases then GFR increases also
what has peyers patches: jejenum vs ilium
ilium
Anti-HBs
immunity to hep B
increasing FF does what to GFR
increase (direclty proportional)
ANP effect on GFR/why
increase: to stimulate naturesis and diuresis
IV hypertriglyceridemia labs? VLDL? HDL? TG? LDL?
increased VLDL increased TG
TXA2 function
increased platlet aggregation and vascular tone 444
SE to treatment of leukemia
increased uric acid production
Lab findings for Duchene dystrophy (3) CPK aldolase necrotic muslce fibers
increased: CPK aldolase myonecrosis
21 hydroxylase aldosterone: BP: Sex hormones: cortisol: K: symtoms:
increased: K sex hormones Decreased: aldosterone cortisol BP symtoms: (most common) infant salt wasting or childhood precocoius puberty, Virilization in woment 318
11Beta hydroxylase aldosterone: BP: Sex hormones: cortisol: K: symtoms:
increased: sex homrones BP= 11-deoxycorticosterone (simiular to aldosterone so it increases the BP) Decresaed: Aldosterone K symtoms: Virlization in women 318
17alpha hydroxylase def aldosterone: BP: Sex hormones: cortisol: K: symtoms:
increased: aldosterone BP decreased: sex hormones cortisol K symtoms: pseudohermaphroditism, lack of secondary sex characterisitcs 318
HBeAg
indicates active viral replication and therefore high transmissibility
Coccidomycosis route of infection
inhalation of spores
6-MP moa
inhibit PRPP--->IMP 63
moa for azoles
inhibit ergosterol syn (ergosterol comprises fungal cell membrane)
moa for Disulfuram
inhibiting the enzyme acetaldehyde dehydrogenase, which means that many of the effects of a "hangover" are felt immediately after alcohol is consumed. (build up of acetaldehyde=hang over symtoms)
how does somatostatin affect the anterior pituitary gland (4)
inhibits TSH, GH, prolactin, and adenylate cyclase in parietal cells
moa of tetracycline
inhibits aminoacyl-tRNA from binding to A site at the ribosome
reason for a loading dose
initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose.[1] A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life. Such drugs need only a low maintenance dose in order to keep the amount of the drug in the body at the appropriate therapeutic level, but this also means that, without an initial higher dose, it would take a long time for the amount of the drug in the body to reach that level.
hormone that has an anabolic effect on lipids, proteins, anc carbohydrates
insulin
obturator a arrises from
internal iliac a
blood supply to inferior rectal, perineum, urthrethra, and penis or clitoris,
internal pudendal a (anterior branch of internal iliac artery)
Bells palsy pathway
ipislateral damage to CN7
Describe a brown sequard senario
ipsilateral loss of touch, vibration, discrimination contralateral pain and temp
ovalocytes
iron-deficiency anemia and thalassemia
Isovolumic contraction vs relaxation location
isovolumic contraction: mitral valve close- aortic valve open (1) isovolumic relaxation: aortic valve close-mitral valve open (3)
innervation of common plantar common of superficial division of lateral plantar n
just the skin in the 4th interspace
DM1 insulin defieicny resutls in the formation of
keytone bodies
calcuate BMI
kg/ meter^2
labile vs stable cells give a few examples of each
labile: cells which are constantly replicating with no time in the G0 phase like skin and bone marrow stable: cells that multiply only when needed. They spend most of the time in the quiescent G0 phase of the cell cycle, but can be stimulated to enter the cell cycle when needed. liver, the proximal tubules of the kidney, and endocrine glands
why cant muslce make its own glucose
lacks Glucose 6 phosphase=no gluconeogensis
special about Harvey sarcoma virus
lacks on functional virogene
woven bone is replaced by
lamerllar bone (regular parallel alignment of collagen into sheets ("lamellae") and is mechanically strong)
origin of FHB (3)
lateral arm: cuboid, lateral cuneform, medial arm: tendon of TP
location for common peroneal nerve in the popliteal fossa before passing by the neck of the fibula
lateral aspect of the popliteal fossa between the *tendon of the biceps femoris* and *Lateral head of gastrocnemius*....then around the neck of the fibula (instertion for biceps femoris is depicted in pic: head of fibula, lateral condly of tibia) (origin of Lat gastroc is lateral condyle of femur and capusle of knee joint)
which ligament of the knee is the only extracapsular lig
lateral collateral lig
In the proximal leg, which compartment is the common peroneal nerve
lateral compartment
blood supply to the anterior compartment of the thigh
lateral femoral circumflex a
Draw out the innervation for the plantar foot muscles: Deep br of lateral planter n: Superficial br of lateral planter n medial planter n
lateral planter n prior to division: Deep br of lateral planter n: Superficial br of lateral planter n medial planter n
which of the muscels of mastication inserts on the TMJ
lateral pterygoid
differentiate the medial and lateral surface of the patella
lateral: larger, more concave, less of a slop
at 5 weeks the lower limbs are finlike appendages pointing in what directions
laterally and caudally
insertion for Adductor Hallucis
lateroplantar base of of proximal phalanx
why is unconjuagated bilirubin harmful in newborns
lead to accumulation of bilirubin in certain brain regions= irreversible damage causing neurological deficits, seizures, abnormal reflexes and eye movements. aka *kernicterus*
lesser omentum (2) vs greater omentum (4)
lesser: liver to the lesser curvature of the stomach *(hepatogastric ligament)* and the first part of the duodenum *(hepatoduodenal ligament)* vs greater: *Gastrophrenic ligament*: underside of left dome ofdiaphragm *Gastrocolic ligament*: transverse colon *Gastrosplenic ligament*: spleen, overlying the kidney *splenorenal ligament*
Steps for photoreception
light -*11-cis* --->*all trans retinal* --->*metarhodospin* -(+) *G protein* --->*phosphodiesterase* breaks down *cGMP* --->*closing Na channel* --->*hyperploarizes --->inhibits glutamate*
loss of what occurs 3-4 levels below the lesion?
light touch (loss of sensation)
Only gram positive to produce endotoxin?
listeria monocytogenes 132
what organ is urea made? which locations in cells?
liver mitochondira and cytoplasm
if a drug has a longer plasma protein binding time, is it considered a long or short acting drug
long
Innervation for Biceps Femoris
longhead: tibial n shorthead: common peroneal n
anaplasia vs displasia
loss of cell differentiation/ organization vs atypical cellular proliferation
most common location for Barrett Esophagus
lower 1/3 of esophagus
cutaneus innervation for the superfical peroneal nerve
lower anterolateral aspect of the leg
tonotopic organization: lower frequency vs high frequency sounds in which location of ear
lower frequency: apex of chochlea higher frequency: base of choclea
what does the sural nerve innervate
lower posterolateral aspect of the leg
*ventilation and perfusion* at apex of lung vs base
lowest at apex *highest at base*
median nerve damage with a fall from an outstretched hand indicates a break in which wrist bone
lunate
CD14, CD40, MHC2, B7
macrohage 209
Antibotic that blocks translocation? (2)
macrolides and clindamycin "clinda the macro trany" 186
Microglia function
macrophage of the CNS 453
Reiter cell
macrophages in synovial fluid
Courvoisier sign indicitive of what pathology
maligant tumor describes an enlarged, palpable gallbladder in patients with obstructive jaundice caused by tumors of the biliary tree or by pancreatic head tumors
mutation on ryanodine receptor of sarcoplasmic reticulum causes increased intracellular Calcium causes increased contraction
malignant hyperthermia
urogenital folds become what in the man vs woman
man: spongy urthra/ raphe of penis female: labia minora
t(11:14)
mantel cell lymphma (cyclin D1 activation) 403
FBN1 gene mutation on chromo 15 leads to defective fibrin
marfan syndrome
what veins system drains the central artery during developemnt
marginal sinus
final steps leading to cell death in severe hypoxia injury is due to
massive influx of extracellular calcium
define tibial torsion
measurment of the *external torquing* of the distal extremity of the tibia with respect to the proximal extremtiy. -angle between bimalleolar line and the bicondylar line
the ulnar nerve is a branch from what cord, division, trunk and Root
medial cord anterior division inferior trunk C8 and T1 root
what v drains the center of the Toe and nail matrix?
medial digital v
location of pes anserinus (be exact)
medial surface of shaft of tibia
order of neurovascular contents within the poplietal fossa from medial to lateral
medial: popliteal a, popliteal v, Tibial n, common peroneal n
Ape hand is due to lesion on what nerve
median "ape is the median link to humans"
main components to control respiratory are located where in the brain (2)
medulla and pons
Spinal cord begins as a continuation of what
medulla oblongata
one of the most frequent childhood malignancies
medulloblastoma "kids like having a blast"
hypersegmented neutrophil is what type of anemia
megaloblasitc
A base excess of less than -5=
metabolic acidosis
what is the arterial blood gas if a child drinks windshield wiper fluid
metabolic acidosis with an increased anion gap (ethylene glycol=antifreeze)
how is mictrition regulated: detrusor m internal uretral spincter m external uretrhral spincter
mictrition=urination (parasympathetic control -detrusor m: contract -internal urethral spincter m: relax -external uretrhral spincter: somatic control relaxes
mastoiditis is an infection of what part of the ear
middle
Borders of the scalene triangle
middle scalene m anterior scalene m Clavical (brachial plexus runss thorugh the scalene triangle)
histoplasmosis is commonly found in what area of the unitied states
midwest in Ohio and MS river valley
treatment for cushing sydrome
mifepristone
what are the 4 infrahyoid mucles/ inneration
sternohyoid, sternothyroid, omohyoid, *thyrohyoid* all innervated by ansa cervicalis except *thyrohyoid*-hypoglossal n and C1
function of oxytocin (2)
milk production induce labor
most common cause of nephrotic syndrome in children
minimal change disease
Light miroscope is normal glomeruli Electron microscope is fusion of foot processes
minimal change disease 542
lipoid nephrosis aka
minimal change disease 542
which prostaglandin drug can prevent NSAID indused peptic ulcer
misoprostal (PGE1)
DNA mutation: Nucleotide substitution resulting in changed amino acid
missence (sickle cell disease: substitution of glutamic aicid for Valine)
follows opening snap of S1, Delayed late diastolic murmur
mitral stenosis
Draw the pressure volume loop: mitral valve close aortic valve open aortic valve clse mitral valve open SV EDV Isovolumic contraction Isovolumic relaxation
mitral valve close...
what are the Alpha 2 agonist characteristics/ moa? (5)
moa: alpha 2 receptor coupled to Gi---> IP3-DAG cascade---> decreased cAMP "Fag clone 2 on methlydopa while it RAINS" 1. Relax m (Tizanidine) 2. (-) aqueous humor 3. (-) insluin/lipolsis/FA 4. (-) neurotransmitter 5. (-) sympathetic tone= decrease BP
Tart cell
monocyte that has engulfed nuclear material
Opportunistic mycois are ____morphic
monomorphic (can only be yeast or mold not both)
gram negative rods
most all other gram negative except a diplococci or coccibaccilar rod like Haemophilus influenzae, Gardnerella vaginalis, Chlamydia trachomatis a Acinetobacter Bordetella pertussis Coxiella burnetti)
medial patellofemoral lig function / attachment
most important stabilizer of patalla -attaches medial margin of patella and medial femoral epicondyle
Mesenchymal cells from somites
muslces "miti muslces"
autoimmune attack on postsynaptic membrane acetylecholine receptors describes what pathology
myasthenia gravis
what muscle splits the submandibular gland
mylohyoid m
Post MI increased risk of
myocardial rupture of LV
how does developemnt of the sk m occur in LEA
myogenic cells from myoblasts fuse into myotubes within each individual muscles mass forming individula muslesl. Once a muscle is formed, statellite cells undergo mitosis adding to lenght and cross sectionional diameter
which of the adductor canal vessel does not continue thorugh the adductor hiatus
n. to vastas medialis saphanous n
proteinuria vs hematuria: nephritc or nephrotic
nephritic: hematuria nephar*O*tic: massive pr*O*teinurea
C5a
neutrophil chemotaxis
function of C5a and C3a
neutrophil chemotaxis
does the m contain glucose 6 phosphatase
no
Does injeted insulin have C-peptide
no (so in a DM1 pt who is taking injecteed isnulin, the pt will not have a detectable C-peptide lab)
does Von Gierke disease affect the muscles?
no because the deficenty enzyme is Glucose 6 phosphatase and that enzyme isnt found in the muslce tissue. Its an issue tieht eh liver only. cause severe hypoglycemia, increased glycogen in liver, increased blood lactate, increased triglcyerides, increased uric acid, and hepatomegaly
what are the Beta1, 2, nonselective agonists (5)
nonselectie beta agonists: Isoproteronol Beta 1 agonists: Dobutamin "1 bag to fit them all... I doubt it" Beta 2 agonitsI Metaproter, Albut, the Salme, 2nd Terb, but I bagged her on the Form
Timolol class: use:
nonselective Beta antagonist use: treat glacoma by decreasing aqueus humor production SP143
what are the Alpha 1,2 nonselectve antagonists
nonselective alpha 1 antag: Phenox, Phento (treats Phenochromocytoma alpha 1 antag: Dox, Praz alpha 2 antagonits: Mirtatazapine "Mirta#2 hits the FAN"
DNA mutation: Nucleotide subsitution resulting in early STOP codon
nonsense "STOP the nonsense"
lysogeny definition
occurs in transduction: Bacteriophage is integrated into the host genume
location for oligodendrocytes vs Schwann cells
oligo: CNS (brain and spinal cord) schwan: peripheri
location or organ of corti
on basilar membrane in scala media
parasite caused by female black fly
onchocerca volvulus "Fly guy" SM72
function of C3b
opsonization
Trapezius muslce *origin* (5)
origin: skull midline, ligamentum nuchae spinous process suprasinous lig of vert C7-T12 attachments: lateral third of the clavicle, acromion and scapular spine
origin and insertion for FDM brevis
origin: Inferior surface of base of 5th met and Peroneus longus insertion: Lateroplanar base of 5th proximal phalanx
most common benign bone tumor
osteochondroma
Decresed production of type 1 collagen/what step in collagen syn?
osteogenesis imperfecta (step 3 in collogen syn: glycosylation or pro alpha chain hydroxylysine and formation of procollogen via hydrogen and sulfide bonds=triple helix of 3 collagen alpha chains "3 Blue man gly" 76
Paget's disease of the bone can be a predisposition to what malignancy
osteogenic sarcoma
sunburst appearance
osteosarcoma
order of location from ovary
ovary fimbria Infundibulum Ampulla (fertilization) (corner) Isthumus Intramural segment
Li Fraumeni syndrome gene muation
p53
increased alkaline phosphatase with normal Ca and phosphourus is indicitave of what path
pagets
pathology that causes malabsorption of vitamins ADEK causing steatorrhea
pancreatic insufficiency 361
orphan annie
papillary carcinoma "orphan (no mami or PAPI) annie is inocent=best prognosis"
Hirschsprung disease is abscence of what enteric ganglia
parasympathetic postganglionic neuronal cell bodies
innervation for parotid gland
parasympathtetic of CN9
incresed pulmonary secretions is from sympathetic or parasympathetic
parpsympathetic
which DNA vius is the only one that is ssDNA
parvovirus
immunity type: receiving preformed antibodies with a rapid onset that has a duration of a short span of antibodies with a half life of about 3 weeks
passive
Where is pectinate m vs trabeculae carne
pectinate-atrium trabeculae-ventrical
all splanchnic nerves are sympathetic except for?
pelvic splanchnic nerve are Preganglionic parasympathetic "P for Pre Parasympathetic"
binding of the release factor in protein syntheis activates what enzyme
peptidyl transferase
Blood supply for peroneus longus and brevis
peroneal a
Differentiate pheochromoytoma from neuroblastoma according to age and hypertension
pheochromocytoma: most comon adrenal medulla tumor in adults=hyerptension neuroblastoma: most common adrenal medulla tumor in child= no hypertension
how does vit B get into cells
pinocytosis/endocytosis (requires energy)
Multiple Myeloma affects what cell
plasma cell
order of vessels within the popliteal triangle from medial to lateral (4)
popliteal a, popliteal v, tibial n, CP n
Trichinella spirals is found in what kind of animal
pork or bear
what makes up the portal triad
portal vien hepatic a bile duct
Sheehan syndrome
post partum pituitary necrosis due to infarction
attachment for oblique popliteal ligament
posterior aspect of meidal condly of tibia intercondylar line and lateral condyle of femur
what chamber of the heart represents the base of the heart
posterior aspect, *mostly left atrium* and some posterior right atrium
blood supply to occipital lobe
posterior cerebral a
which are longer: pre or postganglionic fibers of parasympathteic
preganglionic
function of Lateral colateral ligament
prevents adduction of knee
PCL function
prevents femur from sliding forward on tibia
ischiofemoral ligament action
prevents medial rotation
chest pain that awakesn a pt early in the morning due to coronary artery vasospasm
prinzmetal angina
Blood supply for biceps femoris
profunda femoral artery
Dopamine inhibits what hormone
prolactin
Probenicids affect on penicillin
prolongs effect
function of neuraminidase
promotes release of progen virion orthomyxovirus, mumps
function of hemagluttinin
promotes viral entry (orthomyxovirus, mumps, measles,
External laryngeal nerve desends posterior to? "Ex S"
sternothyroid m (dark red in pic)
Major SE for echinocandins (2)
rash and signs of hepatitis
Anti-HBs and Anti-HBe
recovery from hep b infection
Filgrastim has what clinical use
recovery of bone marrow (G-CSF) 219
CD4, CD25
regulatory cells " 4 x 25 =100% regulatory" 209
What is the source of E in power stroke of contraction? (2)
release ADP and inorganic phosphate 423
SE for probenecid (2)
renal stones inhbit excretion of other drugs like penicillin SP171
Which steps in glycolysis require ATP (2) vs generate ATP (1)
require: hexokinase/glucokinase, PFK1 generate: pyruvate kinase
what are prion disease resistant to? 3 examples of prion disease
resistant to standard sterilizing procedures ndluding autoclave 1. Creutzfelt-Jakob disease 2. Bovine spingiform encephalopathy (mad cow) 3. Kuru
2 motor actions of the hypoglossus m? (2) innervation?
retracts and depresses tounge -CN12 450
are competitive and non competative irreversible or reversible reaction
reversible
what is the difference between true and false, floating ribs
ribs 1-7 are true ribs: direct attachment to costal cartilage ribs 8-12 are false ribs: indirect attachemtnt o costal cartilage ribs 11,12 are floating ribs: dont have an attachemt to the costal cartilage at all.
draw the blood supply to the heart/ what areas of the heart they supply
right coronary left coronary
viens that accompany: right marginal a Posterior Interventricular a Anterior Interventricular a
right marginal a=small cardiac v Posterior Interventricular a=middle cardiac v Anterior Interventricular a=great cardiac v
increased P50 does what to the hemoglobin curve
right shift
right vs left side: superior intercostal vein drainage to the right atrium
right superior intercostal: azygos -->SVC left superior intercostal: brachiocephalic v -->SVC
Where does the right and left reccurnt laryngeal nerve loop
right- subclavian artery left-arch of aorta
Right vs left primary bonchus
right: shorter, vertical, wider, eparterial bronchus
non-hodgkin drug tx
rituximab "tux to the non-hodgkin ball"
where is red nucleus in the brain stem/ general function
rostral midbrain involved in motor coordination.
mild dubin-Johnson syndrome b/c it doesnt cause black liver
rotor syndrome
location of strait sinus
runs along the line of attachment of the flax cerebr and tentorium cerebelli - the inferior sagittal vein and the great cerebral vein of galen unite to form strait sinus
what is the difference between hunter and huler syndrome
same: both have increased heparan sulfate, dermatan sulfate *hunter*: -def in in iduronate sulfatase -corenal clouding, HSM, airway obstruction, gargolyism *hurler*(picture) -def in alpha-L-iduronidase -agressive behavior and no corneal clouding
out of control increased levels of Dopamine-2 (D2) receptors pathology?
sciztophrenia vs Parkinsons (decreased)
microbug for a cat scratching vs cat biting vs interacting with cat feces
scratch: bartonella bite: multicida feces: toxoplasma
what is protration vs retraction of the scapula
see pic ( pec minor protracts the scapula)
oblique popliteal ligament is a continuation of what muscels
semimembranosus
mycosis fungoides may progress to
sezary syndrome (T cell leukemia) 400
where is the only primary center of ossification in the femur
shaft (2nd month of fetal devlopment)
first bone to primary cente of ossification in foot
shafts of metatarsals-3 mo of fetal development
function of ductus venosous
shunts a portion of the left umbilical vein blood flow directly to the inferior vena cava. Thus, it allows oxygenated blood from the placenta to bypass the liver
what binds ribsomes to endoplasmic reticulum
signal recognition particle
Moa for Dapsone
simiular to sulfamides: inhibit folates
Layers of the abdominal wall (6)
skin fat External Oblique Internal Oblique Transversus abdomial Peritoneum
innervation of S2 on Lower extremity (4)
skin of gluteal region posteromedial thigh posteromedial leg plantar heel
medial sural cutaneus nerve innervates
skin on the upper middle portion of the upper posterior leg
symptoms for anaphlaxis (6)
skin rash nausea vomiting dificult breathing shock hypotensive
what happens when you decreasethe radius of the arterior
slower speed
C fibers (slow pain) have what size diameter
small
leiomyoma
smooth muslce tumor 234
what is the difference between how long and short acting insulin acheive thier long vs short duration
speed of dissociating from the zinc
Posterior tibial injury occurs with injuyr to which ligament
spring ligament
Barrett esophagus pathologic epithelium
squamous---> columnar
stage of sleep for sleepwalking, night terros and bedwetting
stage N3 of non-REM sleep
gram postive cluster aka cocci (1)
staph
how does propulsive period of gait begin and end
starts: heel off ends: toe off
gram postive cocci in chains (1 large group)
strep
microbe associated with colorectal cancer
strep bovis
moa for succinylcholine
strong ACh receptor agonist; produces sustained depolarization and prevetns muscular contraction
what is the only muscle of pharynx not innervated by the vagus nerve?
stylopharyngeus m (CN9) "has its own style"
Hemorrage that occurs between the meningeal dura and the arachnoid
subderal hemorrage (bridging veins)
branches of the facial artery (5)
submental inferior labilal superior labial lateral nasal angular
fibers from what lig convert the peroneal groove into a canal for passage of peroneus longhus
superficial fibers of long plantar lig
drainage for gluetal, abdominal, and peraneal lympth
superficial inguinal
Innervation for lateral compartment of the leg
superficial peroneal nerve
what are the 4 parts of the deuodenum?
superior descending transverse ascending
what are the 4 sympathetic ganglion
superior cervical ganglion middle cervical ganglion vertebral ganglion cervicothroaco ganglion
Polio can damage which gluteal n
superior gluteal n (innervates the gluteus medius and minimus m)
Innervation for tensor facia lata
superior gluteal nerve
what ligament makes the scaptular notch
superior transverse ligament
what are the communicating bursae of the knee (4)
suprapatellar popliteus gastronemius semimembranous
The bursa that is deep to the quadriceps femoris m and superior to the patella
suprapatellar bursa
scapular notch transmits what nerve
suprascapular nerve
What nerve does the small saphenous vein course with wint the distal leg
sural nerve
what are sweat glands vs hair follicle glands called
sweat: erricrine hair follicle: sebaceus glands
attacment for arcuate popliteal lig
syloid process of fibular head intercondylar line and lateral condyle of femur
Where is IgA immunoglobbulin found? which immunoglubbulin can cross the placenta?
tears, saliva, breast milk -IgG
at which point does hyline cartlage stop inthe respiratory sytem
tertiary bronchioles
how is IgA effective on mucosla linings
the secretory piece is part of a poly Ig transport receptor allowing transfer of IgA to mucosal epithelial cells
Lateral sural cutaneus nerve innervates
the skin on the upper posterolateral aspect of the leg
menomic for nonselective Beta antagonists (7)
they BANed my LAB cause of PROPran but i didnt have ANYthing. they PINNED it on TIM and CARVED his NADs. It was SO..... -Labetalol -propranolol -pindolol -Timolol -carvedilolo -nadolol -Sotalol
When do Lines of Zhan appear?
thrombosis at a site of rapid blood flow that happened *before* death
Ziduvodine moa
thymidine analogue. inhibiting HIV's reverse transcriptase,
which antiseiure (epilepsy drug) inhibits GABA reuptake leading to an increased GABA
tiagabine "tied up cab driver" SP225
Transduction
transfer of a portion of DNA from one bacterium to the chormosome of another bacterium by means of *viral* infection
what is the difference between Transition and Transversion mutation in DNA
transition: switch of purine to purine (A to G) transversion: swithc of purine to pyrimidine or vis versa (A to T or C to G)
the vagus nerve supplies parasympathetic what part of the colon? (1 part) the rest of the colon is innervated by what nerve?
transverse colon (rest of the colon is supplied by the Pelvic Splacnic nerve)
use for pegloticase
treatment of severe, treatment-refractory, chronic gout (Levels that cannot be brought below 6.0 mg/dl while attacks continue indicates refractory gout)
Tunica adventia aka
tunica externa
Which layer of vessels is the only smooth muscle part. the other layers are endothelia ct
tunica media
Vascular vs Classical type of Ehlers-Danos syndrome is deficient in what type of collagen
type 3 77
is Elhers Danlos an issue with collagen or elastin?
type 3 collagen
lead pipe appearance due to loss of haustra
ulclerative colitis
funny bone sensation location/nerve
ulnar nerve-medial epicondyl of humerus "ARM U"
bound vs unbound drug: which reaches the site of action and is metabolized
unbound to the plasma protein binding (free)
chest pain that is progressive frequency and severity in unpridictable patterns. pain is less responsive to pain meds. can be cuased by plaque rupture, hemorhhage, ulceration and superimposed thrombosis
unstable angina
which appear first? upper or lower limbs ad from where
upper (Tbx-5) (both appear from wolffian ridge
radiolucent kidney stones (2)
uric acid cystein
which renal stone(s) is/are not visible on xray? Calcium oxalate Struvite Uric acid Cystine
uric acid (radiolucent)
purpose for the KOH applicaton when determining fungus
used to dissolve the tissue present in the skin scraping so that the fungi are easier to distinguish.
what is the michalis-mentin equation
v=(Vmax x [S]) / (Km + [S])
where is the: soleal line vertical ridge crista medialis Gerdy's tubercle pes anserinus tibial crest adductor tubercle peroneal notch Tubercle of Tillaux (Chaput) third malleolus Spiral line linea of lispera Third trochanter intercondylar line intertrochanteric line intertrochanteric crest pectineal line quadrate tubercle trochanteric (digital) fossa
where is the: -soleal line: posterior shaft of tibia -vertical ridge: posterior shaft of tibia -crista medialis: posterior shaft fibular shaft -Gerdy's tubercle: anterior/ lateral surface of proximal tibia -pes anserinus: medial surface of tibial shaft -tibial crest: anteror border of tibial shaft -adductor tubercle: medial epicondlyle of distal femur -peroneal notch: lateral nothc in distal tibia -Tubercle of Tillaux (Chaput): anterior/ lateral/inferior border of distal tib -third malleolus: posterior/lateral /inferior border of distal tib -Spiral line: extends superiorly from medial lip linea aspera -linea of aspera: medial or lateral line on shaft of femur -Third trochanter: if there is a tubercle on the gluteal tuberosity its the 3rd trochanter (inferior border of greater trochanter -intercondylar line: superior extend of suprcondylar fossa (distal femur) -intertrochanteric line: anterior surface between greater and lesser trochanter -intertrochanteric crest: posterior surface between greater and lesser trochater -pectineal line: middle/superior of femur shaft -quadrate tubercle: midpoint of Intertrochanteric crest -trochanteric (digital) fossa: medial surface of greater trochanter
bone type seen in infats, post fracture, osteoporosis
woven bone (haphazard organization of collagen fibers and is mechanically weak)
What are the axis for Efficacy and Potency
x axis: potency y axis: efficacy 245
what does a positive TB test mean
you have been infected with TB in the last 5 years. It doesnt provide proof of active infection
