Combo 2 (#2-10)

CN XI lesion

Weakness turning head to contralateral side of lesion (SCM). Shoulder droop on side of lesion (trapezius). The left SCM contracts to help turn the head to the right.

Chronic granulomatous disease

X-linked disorder from deficiency of NADPH oxidase

G6PD deficiency

X-linked disorder that results in episodes of hemolysis during oxidative and infective stress

Bruton's agammaglobulinemia

X-linked immunodeficiency resulting in an absence of B cells and all forms of immunoglobulin

Bruton agammaglobulinemia, Wiskott-Aldrich syndrome, Fabry disease, G6PD deficiency, Ocular albinism, Lesch-Nyhan syndrome, Duchenne (and Becker) muscular dystrophy, Hunter Syndrome, Hemophilia A and B, Ornithine transcarbamylase deficiency.

X-linked recessive

Duchenne muscular dystrophy (DMD) is a recessive X-linked. The disorder is caused by a mutation in the dystrophin gene, located in humans on the X chromosome (Xp21). The dystrophin gene codes for the protein dystrophin, an important structural component within muscle tissue.

X-linked recessive

Lesch-Nyan

X-linked recessive

Lesch-Nyhan

X-linked recessive deficiencyy of HGPRT that promoted hypoxanthine to IMP and guanine to GMP (purine salvage)

Lesch-Nyhan

X-linked recessive, like hemophilia B (factor 9 deficiency)

slipped strand mispairing

Yes I agree with you brainteaser... not 100 percent sure but unless it can get explained to me the other way I think its slipped strand mispairing. From insertion (genomics) article on wiki: In genetics, an insertion (also called an insertion mutation) is the addition of one or more nucleotide base pairs into a DNA sequence. This can often happen in microsatellite regions due to the DNA polymerase slipping that question had a single nucleotide insertion

Catalase positive organisms

You need PLACESS for your cats Pseudomonas, Listeria, Aspergillus, Candida, E. coli, S. aureus, Serratia

zolpidem

Zolpidem (Ambien) is a prescription medication used for the short-term treatment of insomnia, as well as some brain disorders. It is a short-acting nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to GABAA receptors at the same location as benzodiazepines. It works quickly (usually within 15 minutes) and has a short half-life (2-3 hours). Zolpidem has not adequately demonstrated effectiveness in maintaining sleep, however it is effective in initiating sleep

cystic fibrosis

a phenylalanine deletion is the most common cause

labetalol

a1, B1, B2 reversible competitive antagonist with minor B2 receptor agonist activity

retroperitoneal

abdominal aorta, inferior vena cava, pancreas (except tail), kidneys, adrenal glands, parts 2-3.5 of duodenum, ascending and descending colon, rectum, ureters, and bladder

Charcot-Marie-Tooth

abnormal myelin synthesis leads to decreased nerve conduction velocity. weakness of foot dorsiflexion (foot drop) due to involvement of common peroneal nerve

ascorbic acid

absorbed in distal small bowel, deficiencies are not common with gastrojejunostomy

bile acids

absorbed in the terminal ileum

descending aorta

abuts the left anterior surface of the vertebral column and lies posterior to the esophagus and the left atrium

Wolf-Parkinson White

accessory AV conduction pathway. shortened PR-interval, delta wave at the start of the QRS complex, and a widened QRS interval. supraventricular tachycardia.

2-phosphoglycerate to phosphoenolpyruvate

accomplished by the enzyme enolase

Beta 1 selective antagonists

acebutolol (partial agonist), atenolol, betaxolol, esmolol, metoprolol (A to M)

Pompe disease

acid maltase deficiency

rhinovirus

acid-labile

central tolerance

acquired in fetal thymus during negative selection

Infectious mono

activated CD8+ cytotoxic T lymphocytes

calmodulin

activates plasma membrane Ca-ATPase, which removes Ca+2 from the cell by hydrolyzing ATP. indirect inhibitor of calcium efflux from the cell.

Hageman factor

activation of intrinsic clotting pathway and activation of fibrinolysis, factor 12 of clotting cascade

mebendazole

acts on microtubules of roundworms like ancylostoma, ascaris, and enterobius

acetylcholine

acts on the M3 receptors of mucous glands in the bronchial submucosa causing increased secretions

chronic alcoholism

acute pancreasitis, macrocytosis from b12 deficiency or toxicity on bone marrow

ACE inhibitors

acute renal failure

lethal myocarditis

acute rheumatic fever

non-enveloped and double-stranded

adenovirus and papovavirus (HPV)

Prinzmetal's angina

adequate dose of nitroglycerin

microscopic polyangiitis

affects small vessels only.

carotid sinus stretch receptors

afferent fibers (glossopharyngeal nerve CN 9) to solitary nucleus of the medulla

aortic arch baroreceptors

afferent fibers (vagus CN 10) to solitary nucleus of the medulla

internal laryngeal nerve

afferent limb of the cough reflex

aortic stenosis

after S1 and before S2

mitral stenosis

after S2 and before S1

segmented viruses

all are RNA. Bunyavirus, Orthmyxovirus, Areanviruses, Reoviruses BOAR

HEP with envelope

all except Hep A and E

HEP with ssRNA

all except Hep B (double stranded DNA)

pyruvate kinase

allosterically stimulate by fructose 1,6 bisphosphate

right atrium

along with superior vena cava, forms the right lateral cardiac border on frontal chest x-ray

MHC Class II

alpha and beta chains, APCs, bacterial antigens phagocytosed and digested by lysosomes within which antigen binds to MHC II, activation of TH cells that stimulate the humoral and cell-mediated immune response

glucagonoma

alpha pancreatic cells, normocytic normochromatic anemia, necrolytic migratory erythema

proazosin

alpha-1 adrenergic blocker

phentolamine

alpha-1 and alpha-2 blocker

phentolamine and phenoxybenzamine

alpha-adrenergic antagonists used for pheochromocytoma

short acting benzos

alprazolam, triazolam, oxazepam (lorazepam is MEDIUM acting)

allopurinol

also PROPHYLACTIC PREVENTION of acute gouty arthritis

phosphatidylcholine

also called lecithin

Listeria

ampicillin

failure of improper descent of hindgut

anal agenesis or imperforate anus

southwestern

analyzes DNA-binding proteins

C3a, C4a, C5a

anaphylaxis

BNP

and ANP activate guanylate cyclase, which induces increase of intracellular cyclic GMP, causing vasodilation. counteract endothelin and angiotensin II (vasoconstrictors)

decreased arterial O2/decreased mixed venous O2 = anemia

anemia

AICA

aneurysm can compress the facial and vestibulocochlear nerves

type O mothers

anti-A and anti-B, antibodies are predominantly IgG and can cross the placenta to cause fetal hemolysis

mebendazole

anti-helminthic drug used to treat ascariasis, trichuriasis, hookworm and pinworm infections

Drug-induced lupus

anti-nuclear antibodies, histone antibodies, exposure to hydralazine, procainamide, isoniazid

ciprofloxacin

antibiotic of the fluoroquinolone class, inhibition of bacterial DNA gyrase

TCA

anticholinergic on bladder...urinary retention

topiramate

anticonvulsant used to treat epilepsy in children and adults. also used for migraine prophylaxis

flumazenil

antidote for benzodiazepine overdose

primidone

antieleptic metabolized to phenobarb and phenylethylmalonamide

HBeAg

appears after HBsAg during acute infection. marker of viral replication activity

intestinal atresia distal of the duodenum

apple-peel atresia, terminal ileum distal to atresia assumes a spiral configuration around an ileocolic vessel

head, neck, and body of pancreas

are retroperitoneal, while the tail is peritoneal, courses alongside the splenic vessels

direct thrombin inhibitor

argatroban, bivalirudin, and dabigatran

anastrozole

aromatase inhibitor

chloride content of pancreatic secretion decreases

as the bicarbonate content increases

pancreatic cancer

associated with DEPRESSION There's a lot of debate on whether cancer follows depression or depression follows cancer. What's undebatable though is that there is a strong link between pancreatic cancer and depression.

mucormycosis

associated with DKA, infecting paranasal sinus of pts with burns or DM

C1 complement deficiency

associated with SLE

anal fissures

associated with constipation and low-fiber diets

myasthenia gravis

associated with thymoma or thymic hyperplasia

eccentric left ventricular hypertrophy

associated with volume overload of aortic regurgitation and an increase in left ventricular preload

wheezing and decreased tactile fremitus

asthma

gliosis

astrocytes around the area of necrosis

neural tube closes week 4

at 20 days, the neural plate is present but the neural tube is not yet complete

nitrate-free period

at night to avoid tolerance to the drug

AR murmur

at the point when pressure gradient between the aorta and left ventricle is maximum, early diastolic, high pitched and blowing decrescendo murmur

Ebstein anomaly

atrialized right ventricle...downward displacement of the tricuspid valve

Pick disease

atrophy of the frontal lobes resulting in altered personality

constipation

atropine and verapamil

urinary retention

atropine, TCAs

falciform ligament

attached liver to anterior body wall, contains round ligament remnant of the fetal umbilical vein

risperidone

atypical antipsychotic, most likely to cause EPS

lentigo maligma

atypical melanocytes scaly lesion irregular borders - lentigo maligma

Addison's

autoimmune condition in which the adrenal glands become markedly atrophic.

type II cytotoxic hypersensitivity

autoimmune hemolytic anemia, Good pasture syndrome

Dressler Syndrome

autoimmune polyserositis, late-onset post myocardial infarction begins one week to a few months following MI and affects less than 4% cases

neural cresst

autonomic, sensory, & celiac ganglia, Schwann cells, pia and arachnoid mater, skull bones, melanocytes

Ras-MAP kinase

autophosphorylation of tyrosine kinase receptor, Ras protein is a G protein that causes tumors when permanently activated

Autosomal dominant polycystic kidney disease (ADPKD) Familial adenomatous polyposis Familial hypercholesterolemia Hereditary hemorrhagic telangiectasia Hereditary spherocytosis Huntington disease Marfan syndrome Multiple endocrine neoplasias (MEN) Neurofibromatosis type 1 (von Recklinghausen disease) Neurofibromatosis type 2 Tuberous sclerosis von Hippel-Lindau disease

autosomal dominant

Huntington's

autosomal dominant

Osler-Weber

autosomal dominant

hypertrophic cardiomyopathy

autosomal dominant

tuberous sclerosis, Marfan's

autosomal dominant

von Willibrand deficiency

autosomal dominant

hypertrophic cardiomyopathy

autosomal dominant defect of the beta-myosin heavy chains

osteogenesis imperfecta

autosomal dominant inheritance

Osler-Weber-Rendu

autosomal dominant, congenital telangiectasis

Lynch syndrome

autosomal dominant, defective DNA mismatch repair (MSH2 and MLH1)

Romano-Ward syndrome

autosomal dominant, pure cardiac phenotype, QT syndrome

Type II familial hypercholesterolemia

autosomal dominant. absent or defective LDL receptors

Marfan

autosomal dominant. death mostly caused by aortic dissection, 30-40 years.

Albinism, ARPKD (formerly known as infantile polycystic kidney disease), cystic fibrosis, glycogen storage diseases, hemochromatosis, Kartagener syndrome, mucopolysaccharidoses (except Hunter syndrome), phenylketonuria, sickle cell anemia, sphingolipidoses (except Fabry disease), thalassemias, Wilson disease.

autosomal recessive

cystic fibrosis

autosomal recessive

alkaptonuria

autosomal recessive disorder, tyrosine degradation problem because of deficiency of homogentisic acid oxidase

sickle cell

autosomal recessive hemoglobinopathy

Kartagener syndrome

autosomal recessive microtubular defect

Friedrich ataxia

autosomal recessive spinocerebellar degeneration

Friedreich ataxia

autosomal recessive with hypertrophic cardiomyopathy

Jervell and Lange-Nielsen syndrome

autosomal recessive, sensorineural deafness, QT syndrome

Niemann Pick

autosomal recessive, sphingomyelin

cystinuria

autosomal recessive. lifelong recurrent urolithiasis. defective transporter of dibasic amino acids cystine, ornithine, arginine, and lysine

Type I hyperchlomicronemia

autosomal recessive. lipoprotein lipase deficiency

altruism

avoiding negative feelings by helping others

fracture of the surgical neck of the humerus

axillary nerve injury, paralyzing deltoid and teres minor

tetracycline resistance

bacterial active-efflux pump mechanism

transduction

bacteriophage transfers DNA from one bacterial cell to another

transduction

bacteriophage virus transfers DNA from one bacterial cell to another

nucleotide

base + (deoxy)ribose + phosphaTe; linked by 3′-5′ phosphodiester bond.

ataxia hempiplegia syndrome

base of pons infarction

kallikrein

becomes bradykinin.

going from supine to standing

before change...venous return down, carotid sinus UP, cerebral blood flow down

finasteride

benign prostatic hyperplasia, inhibits 5-alpha reductase

Antimuscarinic; improves tremor and rigidity but has little effect on bradykinesia)

benztropine in Parkinson's

isoproterenol

beta 1 and beta 2 agonist

norepinephrine binds to

beta-1 receptors and stimulates renin release

Tay-Sachs

beta-hexosaminidase

subdural hematoma

between dura mater and arachnoid, caused by tearing of bridging cortical veins

F2,6BP

bifunctional enzyme composed of phosphofructokinase-2 and fructose2,6 bisphophatase

NF2

bilateral CN 8 schwannomas

bulemia nervosa

bilateral parotid gland enlargement, erosion of tooth enamel, and irregular menses

Haldane effect

binding of oxygen to hemoglobin drives the release of H+ and CO2 from the hemoglobin

HIV gp120

binding of viral envelope to cellular CD4 transmembrane CCR5 or CXCR4

nystatin and amphotericin B

binding to ergosterol, mechanisms of polyene antifungals

paclitaxel

binds B-tublin and enhances microtubule polymerization, producing a disorganized array of microtubules during cell metaphase leading to cell death

zolpidem

binds GABAa receptor, like a benzo. less potential for tolerance, no anticonvulsant properties, no muscle relaxing effects and NOT used for anesthesia

staph protein A

binds the Fc portion of IgG, preventing complement fixation against Staph

2,3 DPG

binds to beta chains by ionic bonding and stabilized the Taut deoxyhemoglobin, decreasing the oxygen affinity and facilitating the release of oxygen at the tissue level

dopamine hydroxylase

biosynthesis of NE from dopamine

spirinolactone, eplerenone

block aldosterone receptors, side effects include hyperkalemia and metabolic acidosis

valproic acid

blocking NMDA and Na+ receptors

atropine

blocks gastric parietal M3 acetylcholine receptor

vancomycin

blocks glycopeptide polymerization by binding tightly to D-ala-D-ala. red man syndrome. nephrotoxicity. MRSA

reserpine

blocks monoamine entry into presynaptic vesicles

metyrosine

blocks rate-limiting step of catecholamine synthesis (tyrosine hydroxylase)

caspofungin

blocks synthesis of beta-(1,3)-D-glucan, a main component of Candida and Aspergillus cell walls

ipratropium

blocks the action of acetylcholine at muscarinic receptors, preventing bronchoconstriction

IMV

bloods from the hindgut into the splenic vein, which drains into the portal vein

carbamazepine

bone marrow suppression, hepatotoxic, and may cause SIADH

flucytosine inhibits

both DNA and RNA

vWD

both prolonged PTT and bleeding time

histoplasma capsulatum

branching hyphae, oval yeast within macrophages

robertsonian translocation

break near the centromeres of two chromosomes, with genetic material transfer, 3-4% of Down syndrome cases

stimulate D2 receptors

bromocriptine

chronic rejection causing inflammation of the small bronchioles

bronchiolitis obliterans

peristent productive cough

bronchitis

LTC4

bronchoconstriction, vasoconstriction, contraction of smooth muscle, and increased vascular permeability.

theophylline

bronchodilation by inhibiting enzyme phosphodiesterase, thereby increasing intracellular cyclic AMP

the lady has cryptococcus neoformans....and the virulent factors are...several virulence factors, most notably the polysaccharide capsule and phenol oxidase.

budding yeast

slow acetylators

build up hydralazine, procainamide, isoniazid, and dapsone

hepatic hypoperfusion

buildup of lactic acid

presynaptic dopamine and norepinephrine reuptake inhibition

bupropion

medications that cause seizures

bupropion, clozapine, isoniazid, ciprofloxacin

diabetic nephropathy

burning pain

200 words

by age 2

inhibiting renin release

by blunting aldosterone and ATII, metoprolol helps patients with hypertension

cystathionine to cysteine

by enzyme cysathionase w/ vit B6

metyrapone inhibits cortisol synthesis

by inhibiting 11-beta hydroxylase

nitroprusside to cyanide

by liver rhodanase. quick onset of short duration of action.

smooth muscle

calcium binds to calmodulin (no troponin) and activates light chain myosin kinase, allows myosin to bind to actin and cause muscle contraction

diltiazem

calcium channel blocker blocks sodium channels and exhibits a slow rate of dissociation during diastole

increases calcium reabsorption in the distal tubule (HCTZ)

calcium oxalate stones

cardiac and smooth muscle

calcium-induced calcium release

dapsone

can cause agranulocytosis

RCC

can cause anemia of chronic disease and iron deficiency anemia due to chronic hematuria

rapid connection of chronic HYPOnatremia

can cause central pontine myelinolysis

Strongyloidiasis

can cause pulmonary symptoms including cough, asthma-like bronchospasm, and hemoptysis. transient pneumonia as larvae migrate through the lungs on their way to the laryngopharynx

splenic artery blockage

can cause short gastric arteries to be infarcted and ischemia of supplied gastric tissue

isoniazid

can cause vitamin B6 deficiency

C. difficile

can disrupt cell cytoskeleton

gastric ulcers

can extend through the submucosal layer and muscularis propria

chronic MR

can result from myxomatous degeneration or mitral valve prolapse. INCREASE IN LA VOLUME AND COMPLIANCE (ADAPTIVE)

abducens

can't abduct

Layers of the adrenal gland

capsule, zona glomerulosa (aldosterone), zona fasciculata (cortisol), zona reticularis (sex hormones), adrenal medulla

CYP 450 Inducers

carbamazepine, phenobarbital, phenytoin, rifampin, and griseofulvin

localized amyloidosis

cardiac atria: atrial natriuretic peptide thyroid gland: calcitonin pancreatic islets: islet amyloid protein (amylin) cerebrum/cerebral blood vessels: B-amyloid protein pituitary gland: prolactin

mean arterial pressure

cardiac output x total peripheral resistance MAP = CO +TPR

esmolol

cardioselective B1 blocker and a short duration of action. decreases heart rate, myocardial contractility, and cardiac conduction without affecting renal blood flow.

metroprolol

cardioselective beta-adrenergic blocking agent, B1 receptors which mediate AN nodal conduction and less conduction through beta-2 receptors which mediate bronchodilation and peripheral vascular dilation

fourth and sixth

cartilaginous structure of larynx

streptokinase

catalyzes plasminogen to plasmin, resulting in fibrin digestion and facilitating spread of strep in infected tissue

theophylline and aminophylline

cause bronchial dilation by decreasing phosphodiesterase activity

fluoxetine and other SSRIS

cause decreased libido, anorgasmia, and increased latency of ejaculation

lesions of ventromedial nuclei

cause obesity

ovarian tumor producing estrogen

cause of endometrial hyperplasia in post-menopausal woman

ACE inhibitors, nitrates, and peripheral a-1 blockers (prozosin)

cause vasodilation and reflex tachycardia

AV conduction block toxicity

caused by digitalis

acute pancreatitis

caused by gallstones and chronic alcoholism. inherited or acquired hypertriclyceridemia can cause acute pancreatitis is the serum level of triglycerides exceeds 1000 mg/dL

genetic DCM

caused by mutations in cardiac cell sarcomere proteins

serotonin receptor blockade

causes appetite stimulation and weight gain

Clostridium enterotoxin b

causes colonic epithelial cell necrosis and fibrin deposition, toxic megacolon, pseudomembranes.

digoxin

causes decreased calcium efflux, leading to contraction of the myocyte

factor V leiden mutation

causes factor Va resistance to inactivation by protein C, causing atypical venous thrombosis

HGPRT deficiency

causes increase in PRPP and de novo purine biosynthesis

nucleus basalis of Meynert

cell bodies of cholinergic neurons

CD15

cell marker present on neutrophils, Reed-Sternberg cells of Hodgkin lymphoma

TH1

cell-mediated, activate macrophages and cytotoxic T cells, IL-2/INF-gamma/lymphotoxin B

Kupffer

cells within the hepatic sinusoids that, like any other macrophage, serve a phagocytic role in the liver

clonidine

central sympatholytic agent. decreases peripheral vascular resistance and heart rate by activating alpha-2 adrenergic receptors in brainstem

CMV

centrally located epithelial cell with intranuclear and cytoplasmic inclusions. enveloped double-stranded DNA genome

von hippel Lindau

cerebellar hemangioblastomas, clear cell renal carcinomas, and pheochromocytomas. deletion on VHL gene on chromosome 3p

medulloblastomas

cerebellum (vermis), sheets of small blue cells, abundant mitoses, undifferentiated, and aggressive

retinoblastoma and osteosarcoma

ch13

sublimation

channeling impulses into socially acceptable behaviors

Langhans giant cells

characteristic of granulomatous conditions, including caseating granulomas of Mycobacterium tuberculosis condition

obstructive sleep apnea

characterized by reductions or cessations of airflow during sleep...ventilation remains nearly constant during non-apneic periods

all pts starting tx with TNFa

check for latent TB

dimercaprol

chelating agent in arsenic poisoning

CaNa2EDTA

chelating agent in lead and mercery poisoning

intussusception

children younger than 2 years old, region of ileocecel valve, severe colicky abdominal pain with currant jelly tools and palpable mass in the right lower abdominal quadrant

Infliximab

chimeric (human/murine) IgG1 monoclonal antibody to TNF alpha

Abciximab

chimeric (mouse/human) monoclonal antibody against the platelet GP IIb/IIIa receptor. given with acute coronary syndrome pt angioplastly...blocks final step in platelet agregation

long benzo

chlordiazepoxide, clorazepate, diazepam, fluazepam

long acting benzos

chloridiazepoxide, diazepam

first generation antihistamines

chlorpheniramine and diphenhydramine have antimuscarinic, anti-alpha adrenergic, and anti-serotonergic properties that are responsible for the major of side effects, easily cross blood brain barrier and cause drowsiness

bethanechol

cholinergic agonist used to stimulate peristalsis in postoperative ileus

Alzheimers tx

cholinersterase inhibitors (Donepezil), antioxidants (vit E), and NMDA antagonists (memantine)

bethanechol

cholinomimetic muscarinic agonist used to treat ileus and urinary retention

achondroplasia

chondroblast defect

Probenecid or sulfinpyrazole

chronic gout in pts with good renal function

bronchiolitis obliterans

chronic rejection causing inflammation of the small bronchioles

ApoB-48

chylomicron assembly and secretion by enzyme

Sporothrix schenckii

cigar-shaped budding yeasts

terminal bronchioles

ciliated simple cuboidal

propafenone and flecainide

class 1C anti arrhythmic drugs. slow dissociation speed.

sotalol

class 3 anti arrhythmic with beta blocking abilities (causing patient mild bradycardia) in addition to QT prolongation

procainamide is a

class IA anti arrhythmic similar to quinidine

Classic pathway—IgG or IgM mediated. Alternative pathway—microbe surface molecules. Lectin pathway—mannose or other sugars on microbe surface.

classic pathway vs. mannose pathway

S. epidermidis

coagulase - and catalase +, novobiocin sensitive

pernicious anemia

cobalamin vitamin B12 deficiency

homeobox genes

codes for DNA binding transcription factors

uteric bud

collecting system of of the kidney, including collecting tubules, ducts, major and minor calyces, renal pelvis, and the ureters

aspergilloma

colonizing

interferon alpha

combats hep B and C

ataxia-telangiectasia syndrome

combined defect of both B and T cells

third aa

common carotid artery, proximal carotid artery

Nares

common colonization site of Staph aureus

pancreatic pseudocyst

common complication of acute pancreatitis, consist of granulation tissue and fibrosis

P Com

common site of saccular aneurysm. CNIII palsy--eye is down and out with ptosis and pupil dilation

squatting in TOF

compensatory left-to-right shunt

perchlorate and pertechnetate

competitively inhibit the basolateral sodium-iodide symporter

phosphatidylglycerol

component of surfactant

subthalamic nucleus

component of the basal ganglia, damage causes hemiballism

5' end of tRNA

composed of terminal guanosine and does not participate in amino acid or mRNA binding

secondary syphilis

condyloma lata

Varicella IgG

confer immunity against chickenpox reinfection

FSH

confirms menopause

elevated serum FSH

confirms menopause

Asymmetric gluteal folds is a classic finding associated with developmental dysplasia of the hip (classically known as congenital hip dislocation).

congenital hip dislocation

lung inflammation

congestion, red hepatization, grey hepatization, histologic resolution

measles prodrome

conjuctivitis, coryza, cough, and Koplik spots

phlegmasia alba dolens

consequence of iliofemoral venous thrombosis in peripartum women. pregnancy predisposes to deep venous thrombosis due to pressure of the gravid uterus on deep pelvic veins and increased hypercoagulability

hemartomatous polyps

consist of mucosal glands, smooth muscle, and connective tissue. may occur sporadically or in Peutz-Jeghers syndrome

Fc

constant, carboxy terminal, complement binding, carbohydrate side chains, determines isotype IgM, IgD, etc.

verapamil adverse effects

constipation, gingival hyperplasia, negative inotrophy

bile acid-bindings

constipations, hypertriglyceridemia. vit K malabsorption

type IV delayed type

contact dermatitis, tuberculin skin test

unusually pronounce metalloproteinase activity

contracture

chlorpormazine

corneal deposits, low potency antipsychotic

nitric oxide

coronary vascular dilation. made from arginine and oxygen by endothelial cells

T-cell maturation

cortex (T cell positive selection) to medulla (T cell negative selection)

zona fasciculata

cortisol-secreting adrenal lesion

Strongyloidiasis

cough, asthma-like bronchospasm, transient pneumonia

surfactant

counteracts alveolar collapse by decreasing surface tension as the alveolar radius decreases

left spleen

covered by 9th and 10th rib

glycine + arginine + SAM

creatine

cisplatin

cross-link DNA. Testicular, bladder, ovary, and lung carcinomas. Nephrotoxicity and acoustic nerve damage. Prevent nephrotoxicity with amifostine (free radical scavenger) and chloride diuresis.

paraneoplastic cerebellar degeneration

cross-reacts with Purkinje neuron antigens like anti-Yo, anti-P/Q, and anti-Hu

vagus small auricular branch

cutaneous sensation to the posterior external auditory canal

C5b-9

cytolysis by membrane attack complex (MAC)

tabes dorsalis

damage to the dorsal columns and dorsal roots of the spinal cord

lightening strike

death within first hour from arrhythmias and respiratory failure. minor cutaneous involvement (superficial burns)

thiazolidinediones

decrease blood sugar by activation of PPAR gamma

B1 AND B2

decrease cAMP

alpha 2

decrease cAMP

H. pylori-antral gastritis

decrease in number of somatostatin-producing delta cells. associated with gastric adenocarcinoma and gastric lymphoma

beta blockers

decrease renin, angiotensin I, angiotensin II, aldosterone, and NO CHANGE to bradykinin

baclofen

decrease spasticity, activation of GABA in muscle spindle afferents

Down's

decreased AFP

fed state

decreased FBPase-2 increased PFK-2 more glycolysis

normal pressure hydrocephalus

decreased absorption of CSF, but increased CSF volume is accommodated by ventricular enlargement

looks like a pneumothorax.. note the flattened diaphragm on 1 side and the increase in air on that side

decreased breath sounds on the left

fructose-2,6-bisphosphate levels

decreased by fructose-2,6-bisphosphatase, increased by by phosphofructokinase 2

anorexia

decreased gonadotropin-releaing hormone pulsatility

2,3,-DPG

decreased interaction means increased Hb affinity for O2

osteomalacia

decreased mineralization of newly formed bone matrix, frequently associated with vit D

osteopetrosis

decreased osteoclastic bone resorption, characterized by primary unmineralized spongiosa in medullary canals

aspirin

decreased prostaglandins and thromboxane A2

probenecid

decreased proximal tubule uric acid reabsorption, chronic gout tx

Fragile X heavy methylation of CGG

decreased transcription

digoxin

decreases AV node conduction by increases parasympathetic tone, increases cardiac contractility by blocking Na-K-ATPase in cardiac myocytes

aspirin

decreases adenomatous polyp formation

ramipril

decreases angiotensin II, aldosterone

thoracic aortic aneurysm

decreases femoral pulses. pulsatile periumbilical mass. pale and lethargic with severe abdominal pain for 2 hrs.

randomization

decreases risk of bias

CO poisoning

decreases the amount of oxygen bound to Hb. reduces oxygen unloading from hemoglobin in tissues. does not affect PaO2 and does not precipitate methemogloglobinemia.

MVP

decreases with squatting due to increased preload and rise in peripheral resistance

nitroglycerin is a venodilator

decreasing preload, large veins more susceptible

Kussmaul breathing

deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis

chief cells

deeper, secrete pepsinogen

alkaptonuria

defective breakdown of tyrosine

TOF patients

degree of RV outflow is a major determinant of right-to-left intracardiac shunting

selegiline

delay progression of Parkinson's disease

CLL

deletion of 13q

delusion disorder

delusions for at least 2 month, behavior not obviously bizarre or odd

hyperammonemia in hepatic encephalopathy

depletion of a-ketoglutarate, excess ammonia also depletes glutamate-- an excitatory neurotransmitter and causes accumulation of glutamine resulting in astrocyte swelling and dysfunction

daptomycin

depolarization of the cellular membrane. myopathy and CPK elevation. inactivated pulmonary surfactant. MRSA

spleen

derivative of mesodermal dorsal mesentery

processus vaginalis

descent of testes with invagination of the peritoneum

treatment of mild hemophilia A

desmopressin releases von Willebrand factor and factor 8 from the endothelium. factor 8 stored in the liver and endothelial cells

medicaid

destitute

Clostridium difficile colitis

detect toxins genes in the stool with PCR.

HbsAg

detectable during acute infection

HBs Ag

detectable during acute infection. persistence after 6 months implies chronic infection

atherosclerosis plaques

develop predominantly in large elastic arteries

DR3

diabetes mellitus type I, SLE, Graves disease

Ewing sarcoma

diaphysis of long bones, especially the femur (children age 10-15)

leflunomide inhibits

dihydrooratate dehydrogenase

nifedipine

dihydropyridine calcium channel blocker that is used in treatment of hypertension

nifedipine

dihydropyridine calcium channel blocker used in the treatment of hypertension

nifedipine

dihydropyridine calcium channel blocker with minimal effects on sinoatrial node, predominantly vasodilator that can cause reflex increase in heart rate

uncal herniation

dilated pupil on the right and a normal pupil on the left it is Ocullomotor nerve damage, The uncus is an anterior extremity of the Parahippocampal gyrus. It is separated from the apex of the temporal lobe by a slight fissure called the incisura temporalis. Although superficially continuous with the hippocampal gyrus, the uncus forms morphologically a part of the rhinencephalon Clinical significance[edit] The part of the olfactory cortex that is on the temporal lobe covers the area of the uncus, which leads into the two significant clinical aspects of the uncus: uncinate fits and uncal herniations.

inactivated toxin vaccines

diphtheria and tetanus

testicular arteries

direct branches from aorta

isoniazid

directly hepatotoxic

galactose

disaccharide glucose

holocrine

discharge of the entire secretory cells that undergo breakdown

Meniere's disease

disorder of the inner ear due to defective resorption of endolymph. tinnitus, vertigo, and hearing loss.

myelodysplasia

disordered maturation of hematopoietic cells. peripheral pancytopenia and hypercellular bone marrow.

sublimation

displacement of unacceptable drives toward completely acceptable targets

antisocial disorder

disregard for and violation of the rights of others, people with antisocial are involved in criminal behavior, more likely men, conduct disorder when less than 18 years old

dissociation

disrupting memory, identitiy, and consciousness to cope with an event

silicosis

disruption of macrophage phagolysosomes by internalized silica particles, resulting in increased susceptibility to pulmonary tuberculosis

silica

disrupts macrophage lysosomes, causing increased susceptibility to pulmonary TB

right gastroepiploic artery

distal greater curvature of the stomach

gut erosions

do NOT fully penetrate the muscularis mucosa

Grave's disease antithyroid drugs

do not improve opthalmopathy

unlike estrogen, IGF-1

does not accelerate closure of long bone epiphyseal plates

vit B6

don't take with levodopa therapy, because increases the peripheral metabolism of levodopa and decreases its effectiveness

metoclopramide

dopamine antagonist with central and peripheral effects, prokinetic to treat GI motility disorders and antiemetic properties to treat nausea and vomiting

rhomboid major

dorsal scapular nerve that draws scapula medially at its medial border

duodenal atreia

double bubble sign--air in stomach ad proximal duodenal pouch

myasthenia gravis, neuromuscular junction

double vision, slurred speech and difficulty chewing, weakness in neck, symptoms worse at the end of the day, eye movements limited in all directions, unable to hold arms in same location for more than 10 seconds when they are abducted at the shoulders

C perfringens

double zone of beta hemolysis

JC virus

double-stranded

human papilloma virus

double-stranded, non-enveloped DNA virus with icosahedral nucleocapsid

C. trachomatis

doxycycline or azithromycin

azygous vein

drains blood from posterior intercostal veins into the superior vena cava

posterior communicating artery aneurysm

drooping left eyelid, double vision, eye fixed int he down and out position, pupil dilated

pulsus paradoxus

drop in systolic blood pressure of 10 mmHg during inspiration, cor pulmonale, chronic pericardial disease, and cardiac tamponade

anaphylaxis

drop in venous return and increase in CO

verapamil

drug of choice for PSVT but replaced by adenosine, constipation and gingival hyperplasia. most cardioselective of calcium channel blockers

aminoglycosides, cisplatin, amphotericin B, foscarnet

drug-induced tubular necrosis

midgut volvulus

duodenal atresia = obstruction midgut volvulus = obstruction both obstructing the intestine. okay i see : i wasnt aware of " Epidemiology A midgut volvulus of malrotated bowel can potentially occur at any age but in approximately 75% of cases is within a month of birth, most within the first week, and 90% within 1 year. "

Down syndrome

duodenal atresia and Hirschsprung disease, three copies of APP chromosome 12 for early Alzheimers

right to left on CT

duodenum, IVC, abdominal aorta

right to left CT

duodenum, IVC, aorta

obstructive pulmonary disease

dynamic hyperinflation moving restrictive flow-volume curve left

COPD

dynamic hyperinflation, causing flow-volume curve to more left

Wallenburg

dysphagia. hoarseness. PICA. Lateral medulla

nicotine withdrawal

dysphoria and increased appetite/weight gain

coronary arteries

early diastole

decreased erythrocyte membrane stability

edit: now I remembered that g6pd is an intravascular hemolysis and they mention that rbcs are really dense and the boy has icterus/splenomegaly so it is decreased membrane stability - spherocytosis

risperidone

effective anti-psychotic drug used in schizophrenia. SE hyperprolactinemia because has anti-dopaminergic D2 action. causes hypogonadism.

silicosis

eggshell calcification, birefringent silica particles

medicarE

elderly

Turner's

elevated FSH and LH. need estrogen and progesterone supplementation

multiple sclerosis

elevated IgG

whole blood transfusions

elevated citrate, chelates calcium and magnesium and may reduce their plasma levels causing paresthesias

delta-aminolevulinic acid

elevated in lead poisoning. pyridoxal poisoning is a necessary cofactor.

bosetan

endothelin-receptor antagonist that blocks the effects of endothelin, used for vasodilation to decrease idiopathic pulmonary hypertension

Lipid A

endotoxin of gram-negative bacteria release during antibiotic treatment of immune-mediated mechanisms. different than EXOtoxin A of strep pyogenes GAS.

increased HCM murmur

enhance obstruction by decreases venous return (sudden standing, Valsalva)

mebendazole

enterobius

Hep C

enveloped, positive single-stranded RNA genome with no virion polymerase

alkaline phosphate

enzyme marker of osteoblasts

transketolase

enzyme of the hexose monophosphate pathway that requires thiamine B1

lecithinase

enzyme that degrades membrane phospholipids (including lecithin), leading to cell membrane destruction and cell death

lecithinase (a toxin)

enzyme with phospholipase C activity and the major virulence factor of Clostridium perfringens. increases platelet aggregation and adherence molecule expression on leukocytes and endothelial cells resulting in vasoocclusion

lecithinase (a toxin)

enzyme with phospholipase C activity and the major virulence factor produced by Clostridium perfringens, causing platelet aggregation and vasoocclusion

treatment of asthma and anaphylaxis

epinephrine

pharyngeal pouch 1

epithelium of middle ear and auditory tube, tympanic membrane, epithelium of external ear canal

pharyngeal pouch 2

epithelium of palatine tonsil crypt

non-small cell lung carcinoma

erbB1

breast cancer

erbB2 aka HER2/neu

Boerhaave syndrome

esophageal transmural tear, caused by forceful vomiting. fever, dyspnea, & septic shock rapidly ensue

left gastric

esophageal vein

histidine

essential amino acid in children, oxidative decarboxylation of histidine forms histamine

lysine

essential amino acid that is strictly ketogenic

medium benzo

estazolam, lorazepam, temazepam

estrogen

estrogen in adipose tissue causes oligomennorea

RELEASE OF PROGENY VIRUS

euraminidase inhibitors Zanamivir, Oseltamivir

non-selective beta blockers

exacerbate hypoglycemia and mask its adrenergic symptoms. propranolol, timolol, nadolol. USE SELECTIVE B1 ANTAGONIST INSTEAD

leucine and lysine

exclusively ketogenic and to not lead to increase formation of lactic acid

Staph Scalded Skin Syndrome

exfoliatin exotoxin that act as protease and cleave desmolein in desmosomes

most nucleated cells

express MHC class I

NK cells

express either CD16 or CD56, activated by INF-gamma or IL-12. contains perforins and granzymes in cytoplasmic granules

MHCII

expressed on antigen presenting cells, acidified endosomes

gestational choriocarcinoma

extensive areas of necrosis and hemorrhage. abnormal proliferations of cytotrophoblasts and syncytiotrophoblasts. No villi are present.

Reidel thyroiditis

extensive fibrosis involving the thyroid gland

second pharyngeal arch

facial nerve, stapedial artery

second arch

facial nerve, styloid process, lesser horn of the hyoid

Listeria

facultative intracellular, can grow in cold temperatures

listeria monocytogenes

facultatively intracellular, motile, Gram-positive rod. third most common cuase of meningitis in neonates

Kallman's

failure of GnRH secreting neurons to migrate from the olfactory lobes to the hypothalamus

transposition of the great vessels

failure of aorticopulmonary septum to spiral normally during fetal development. aorta connected to right ventricle and pulmonary artery connected to left ventricle

metyrapone test

failure of serum 11-deoxycortisol and urinary 17-hydroxycorticosteroid levels to rise means primary or secondary adrenal insufficiency, distinguished by MCTH levels

isoretinoin

family of nuclear retinoic acid receptors

Type 2 fiber

fast twitch

appetite suppressants

fenfluramine, dexfluramine, and phentermine are associated with secondary pulmonary hypertension. right heart problems with adequately increasing CO during exercise

Neisseria gonococci

ferment glucose

Neisseria meningococci

ferment maltose and glucose

serum sickness

fever, urticaria, arthralgias, proteinura, and lymphadenopathy 5-10 days after exposure to the drug (antigen)

adenovirus

fibers project from portion of base and are responsible for mediating adsorption to host cells

serum triglycerides lowered

fibrates

BPH 5-alpha reductase inhibitors

finasteride and dutasteride

red neurons

first 48 hours

pancreas

first enzyme of glycolysis is glucokinase that converts glucose to glucose-6-phosphate

gastroduodenal

first part of duodenum

syringomyelia

fluid-filled cavity, damaging ventral white commissure and ventral horns

Factor Xa indirect inhibitor

fondaparinux

fructose 2,6 bisphosphate

for gluconeogenesis, citrate is a POSTIVE regulator. fructose 2,6, bisphosphate is a NEGATIVE regulator.

thiamine cofactor

for transketolase, alpha ketoglutarate dehydrogenase, and pyruvate dehydrogenase

doxorubicin, daunorubicin

form free radicals in the myocardium

progressive supranuclear palsy

form of parkinsonism resulting form neurodegeneration of the midbrain and frontal subcortal white matter

primary tuberculosis

formation of Gohn foci in the lower lungs

C-peptide

formed from proinsulin in the pancreatic beta-cell Golgi apparatus, packaged along with insulin in islet cell secretory granules

methemoglobin

formed with amyl nitrate administration (Fe+3 formed via oxidation)

carbonic anhydrase within RBC

forms bicarbonate from CO2 and water. bicarbonate diffuses out of RBC, and chloride comes in to take its place

left atrium

forms most of posterior heart

right ventricle

forms the anterior (sternal) surface of the heart and most of its inferior border

left ventricle

forms the left border of the heart on frontal chest x-ray

dorsal pancreatic bud

forms the pancreatic tail, body, most of the head, and the small accessory pancreatic duct

foscarnet

foscarnet = pyrofosphate analog. Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme. Does not require activation by viral kinase.

beta-1 receptors

found in cardiac and renal juxtaglomerular cells, but not vascular smooth muscle. Blockade of B1 receptor leads to decreasing cAMP levels in cardiac and renal tissue without affecting smooth muscle.

endomysial inflammatory infiltration

found on muscle biopsy in polymyositis

Friedreich's ataxia

frataxin gene, which codes for a mitochondrial protein important in respiratory function and iron homeostasis, is mutated. GAA repeats

duodenal ulcers

from H. pylori or NAIDS, NOT higher risk of carcinoma

phase 0 pacemaker cells

funny current, mediated by inward flux of calcium

HIV gp41

fusion

Fabry

galactosidase a

S. bovis

gamma hemolysis. growth in bile and not 6.5% NaCl

Type B chronic gastritis

gastric adenocarcinoma and MALP lymphoma. H. pylori infection of gastric mucosa.

Addison's

general hyper pigmentation from POMC synthesis

high dopamine

generalized vasoconstriction by alpha-1 adrenergic effect. renal and cardiac output go up and then down.

neonatal intraventricular hemorrhage

germinal matrix, increasing hemorrhage with decreasing age and weight

temporal arteritis

giant cell vasculitis related to polymylagia rheumatica

allergic reaction

give epinephrine

potassium iodide

given to treat radioactive iodine exposure

neuroectoderm

gives rise of the central nervous system, preganglionic autonomic neurons, and posterior pituitary

surface ectoderm

gives rise of the epidermis and its appendages, mammary glands (modified sweat glands), lens of the eye, and adenohypophysis

metanephric blastema

gives rise to the glomeruli, Bowman's space, proximal tubules, loop of Henle, and distal convoluted tubules

small ventral pancreatic bud

gives rise to the uncinate process, a portion of the pancreatic head, and the proximal portion of the main pancreatic duct

basal long-acting, once daily

glargine, detemir

third pharyngeal and aortic arch

glossopharyngeal and proximal internal carotid artery

Gaucher

glucocerebroside

aldose reductase

glucose to sorbitol, galactose to galacititol

rate limiting enzyme of HMP shunt

glucose-6-phosphate dehydrogenase that changes glucose 6 phosphate into 6-phosphogluconolactone forming one molecule of NADPH. all rxns of HMP shunt occur in cytoplasm

G6PD

glucose-6-phosphate to 6-phosphogluconate in the hexose monophosphate pathway

McArdle's

glycogen phosphorylase

basophils

granules contain heparin, histamine, and SRS-A (slow-reacting substance of anaphylaxis)

temporal (giant cell) arteritis

granulomatous inflammation of the media, most common form of systemic vasculitis in adults

lecithin to sphinogmyelin ratio

greater than 2, the fetal lung is considered mature

Bacitracin

group B strep are Resistant, group A strep are Sensitive B-BRAS.

campylobacter jejuni

grows at 42 degrees C. Campylbacter likes the hot campfire

umbilical vein

has the highest oxygen content in the fetal circulation. enters the IVC via the ductus venosus

antihistaminics HI blockers

have antimuscarinic, antiadrenergic, and antiserotonergic properties. 1st generation drugs like meclizine and dimenhydrinate are generally effective at preventing these symptoms (others avoided because of sedating properties)

salmonella

have flagella (salmon swim)

killed vaccines

have poorer immunogenicity than live attenuated vaccines and may require multiple inoculations or boosters to induce and maintain sufficient immunity

MGN

hearing (music - medial)

cerebellarpontine (CPA) tumor

hearing loss

MHC Class 1

heavy chain and B2-microglobulin, all nucleated cells, viral and tumor proteins processed in cytoplasm, apoptosis of presenting cell

citrate and high fluid intake

help prevent calculi formation

decreased temperature

helps to stabilize the bonds between oxygen and hemoglobin, so hypothermia increases hemoglobin's oxygen affinity and shifts the dissociation curve to the left

Nifedipine

helps with hypertension and Raynaud disease

protein restriction

helps with urea cycle defects

glycine + succinyl CoA

heme

Celiac sprue

hemorrhagic diathesis + vit K deficiency

malignant mesothelioma

hemorrhagic pleural effusions and pleural thickening are characteristic

bile acid-binding agents increase

hepatic cholesterol synthesis, an effect opposite of that of statins. fibrates also increase hepatic cholesterol synthesis and excretion --> increase rise of gallstone formation

GLUT 2

hepatocytes, pancreatic beta-cells

valproate

hepatotoxicity, neural tube defects

Glanzmann thrombasthenia

hereditary deficiency of IIb-IIIa

aldose B deficiency

hereditary fructose intolerance

withdrawl symptoms, yawn, dilated pupil

heroin withdrawal

unidirectional enzymes of glycolysis

hexokinase, PKF1, pyruvate kinase

sarcoidosis

high CD4/CD8 ratio

Bohr effect

high H+ and CO2 in peripheral tissues facilitates oxygen unlading from hemoglobin

Turner's

high LH and FSH; low estrogen

Klinefelter's

high LH, FSH, estrogen; low testosterone and sperm count

w/ estrogen

high TBG and increase in T4 and total T3. BUT level of free thyroid hormones remains normal so patients remain euthyroid and have normal TSH

hepcidin is stimulated

high iron levels. lowered by hypoxia and increased erythropoiesis.

cycloserine

high oxotoxicity so not used much, inhibiting incorporation of D-alanine into UDP-MUrNAc-oligopeptide during bacterial cell wall synthesis

haloperidol and fluphenazine

high-potency antipsychotics, EPS

left ventricular diastolic dysfunction

higher diastolic filling pressure, pulmonary venous congestion,

SNOUT

highly Sensitive test, when negative, rules OUT disease

SPIN

highly Specific test, when positive, rules IN test

inhaled anesthetics

highly lethal fulminant hepatitis that cannot be distinguished from acute viral hepatitis. elevated aminotransferase levels, prolonged prothrombin time, and eosinophilia.

halothane

highly lethal fulminant hepatitis that cannot be histologically distinguished from acute viral hepatitis. elevated aminotransferase levels, prolonged prothrombin time, and eosinophilia.

trazodone

highly sedating anti-depressant, can cause priapism

trazodone

highly sedating anti-depressant, used to treat insomnia ATYPICAL ANTIDEPRESSANT: Primarily blocks 5-HT2 and α1-adrenergic receptors. Used primarily for insomnia, as high doses are needed for antidepressant effects. Toxicity: sedation, nausea, priapism, postural hypotension.

minimal change disease

highly selective proteinuria: mostly low-molecular weight proteins such as albumin and transferrin are excreted

antibodies to citrullinated proteins

highly specific for rheumatoid arthritis

histidine

histamine

Huntington's disease

histone deacetylation

b12 causing homocystinuria

homocysteine methyltransferase, the enzyme that converts homocysteine and methyltetrahydrofolate to methionine and tetrahydrofolate

Weber lower midbrain

horners and pronator drift telling you uml and ocular muscles

prepatellar bursitis

housemaid's knee

prepatellar bursitis

housemaids nknee

denosumab

humanized monoclonal antibody that prevents osteoclast activation by binding to RANKL

TH2

hummoral immunity, IL4 (IgE), IL5 (IgA)

TH2

humoral (antibody mediated), activate B cells and promote class switching, IL4, 5, 10 & 13, Secretion of antibodies

PTHrP

humoral hypercalcemia of malignancy

N-acetylation

hydralazine and procainamide

second aa

hyoid arch, stapedial arch

Conn syndrome and Cushing syndrome

hyperaldosteronism or primary hypercortisolism, associated with metabolic alkalosis that cannot be corrected with isotonic saline

sarcoidosis

hypercalcemia and increased vitamin D

gain of function

hyperparathyroidism, the receptors are constantly stimulated. Since this disease minic Hyperparathyroidism=the receptor is active all the time due to mutation=gain of function.

onion-like concentric thickening

hyperplasic arteriolosclerosis, resulting from malignant hypertension

Fanconi anemia

hypersensitivity of DNA to cross-linking agents

ventricular cavity size and diastolic function decreased

hypertensive heart disease and hypertophic cardiomyopathy

NMS

hyperthermia, extreme generalized rigidity, autonomic instability, and altered mental status

secondary renal failure

hypocalcemia, hyperphosphatemia, increased PTH

zinc deficiency

hypogonadism, azoospermia, hair loss, impaired rase, night blindness, impaired wound healing, erythematous skin lesions around orifices

aldosterone excess

hypotension, hypokalemia, metabolic alkalosis, and depressed renin

lithium

hypothyroidism and nephrogenic diabetes

congenital hypothyroidism

hypotonia, poor feeding, jaundice, macroglossia, constipation, and umbilical hernia. not enough T4

serum creatinine kinase activity

i marked the ck and i got it right bcz i thought glut max weakness and a child with DMD would have pelvic griddle weakness so i put 2 n 2 together

Hunter syndrome

iduronate sulfatase. similar to Hurler but no corneal clouding

3 years old

imaginative play

S4

immediately precedes S1, results from rapid emptying of atrial blood into a ventricle with reduced compliance (stiff ventricle)

diphtheria toxoid

immunization leads to production of circulating IgG against the exotoxin B subunit, preventing disease

CD markers

immunohistochemistry

cystic fibrosis patients

impaired ability to concentrate and dilute the urine, common cause of meconium ileus due to abnormally dehydrated meconium

G6PD deficiency

impairs glutathione reduction due to failure to produce NADPH

amantadine

impairs uncoating of influenza A after host cell endocytosis

hypocapnia

implies ongoing alveolar hyperventilation

EPO-producing tumors

in RCC or HCC can cause inappropriate secondary polycythemia

IgE

in lupus nephritis is associated with poor prognosis

there is power

in numbers

glucocorticoids

in patients with renal failure and acute gouty arthritis that can't use NSAIDs or cochicine

increased radial traction

in pulmonary fibrosis

intercoastal vein, artery, nerve lie

in subcostal groove on the lower border of the rib

D1-adrenergic receptors

in the walls of renal, splanchnic, and mesenteric blood vessels. Stimulation of these receptors causes vasodilation and increase in renal and splanchnic blood blood.

congenital toxoplasmosis

in-utero, transplacental infection. triad includes hydrocephalus, intracranial calcifications, and chorioretinitis. mother should avoid cat feces

presbyopia

inability of the lens to focus on near objects. when occurs in myopic near sighted individuals, they typically retain the ability to see close without correction and also experience some improvement in distance vision

Protein S and C

inactivate factor 5 and 8

major adverse effects of ganciclovir

include neutropenia, anemia, thrombocytopenia, and impaired renal function. ganciclovir interferes with human host cell DNA synthesis to a greater extent than does acyclovir triphosphate

alpha 1

increase IP3

valsalva strain and abrupt standing

increase MVP and HCM

ACE inhibitors

increase bradykinin, substance P, and prostaglandins

volatile anesthetics

increase cerebral blood flow, that increases ICP

fibrates and bile-acid binding agents

increase cholesterol content of bile, increasing the risk of gallstone formation

medium dopamine

increase heart contractility with beta-1 adrenergic receptor stimulation

chronic anemia

increase in cardiac output and venous return

hyperaldosteronism

increase in renal sodium and water absorption increases renal blood flow and GFR, resulting in aldosterone escape (no hypernatremia)

acanthosis

increase in thickness of stratum spinosum

glucocorticoids

increase neutrophil count, from demargination of neutrophils previously attached to the vessel wall

CYP 450 INHIBITORS

increase state toxicity. cimetidine, ciprofloxacin, erythromycin, azole antifungals, grapefruit juice, isoniazid, and ritonavir (protease inhibitor)

prostaglandins

increase uterine tone and decrease bronchial tone

omphalocele

increased AFP, like in neural tube defects. NOT TURNERS AND FETAL ALCOHOL SYNDROME-- DO NOT HAVE ABNORMAL AFP. (DOWNS- decreased AFP, estriol, and increased inhibin A)

fasting state

increased FBPase-2 decreased PFK-2 more gluconeogenesis

primary mineralocorticoid excess

increased H+ excretion by alpha intercalated cells resulting in metabolic alkalosis

ectopic pregnancy

increased HCG, cross section of baby in ampulla of fallopian tube - Ectopic Pregnancy acute left lower quadrant pain with increased hCG

beta-thalessemia

increased HbF, increased HbA2, increased/normal reticulocytes

Phenytoin

increased Na+ channel inactivation; zero-order kinetics

warfarin therapy

increased PT

vit D déficience

increased PTH (secondary hyperparathyroidism)

tertiary renal failure

increased PTH, increased Ca

17-hydroxylase deficiency

increased aldosterone but low estrogens/androgens. Males appear female and birth. hypogonadism, hypertension, and hypokalemia.

Conn's syndrome

increased aldosterone secretion. hyperplasia of the glomerular layer of the cortex

toxins, infections, burns

increased capillary permeability in toxins infections burns

chronic ateriovenous shunt

increased cardiac output, decreased total peripheral resistance, increased venous return

spontaneous intracranial hemorrhage (SICH)

increased congenital berry aneurysms of Circle of willis as well as aortic arch hypertension (coarctation of aorta)

PCOS

increased estrogen (from aromatization of testosterone), LH, FSH

epinephrine increases glucose

increased glycogenolysis and gluconeogenesis, increased alanine release from skeletal muscle. GLUCAGON HAS AN INSIGNIFICANT EFFECT ON SKELETAL MUSCLE AND ADIPOCYTES

COX2

increased in some forms of colon adenocarcinoma

niacin

increased insulin resistance, acanthosis nigricans. increase in serum uric acid--> gout patients must be careful

PPAR-gamma, TZDs decrease insulin resistance by

increased levels of adiponectin cytokine secreted by fat tissue

isolated mitral stenosis

increased pulmonary capillary wedge pressure, pulmonary hypertension. diastolic pressure in left ventricle is usually near normal of even decreased

ARBS

increased renin, angiotensin I, angiotensin II; DECREASED aldosterone. no change bradykinin

ulcerative colitis

increased risk of colorectal cancer

increased study power with

increased sample size and precision of measurement

S3 heart

increased stroke volume, increased left atrial pressure, decreased peripheral resistance

Chronic granulomatous disease

increased susceptibility to catalase positive organisms (PLACESS): Pseudomonas, Listeria, Aspergillus, Candida, E. coli, S. aureus, Serratia.

statins

increased uptake of LDL from circulation

prostaglandin

increased uterine tone, decreased bronchial tone

lower serum level

increased volume of distribution

handgrip

increases AR, MR, and VSD

mitral stenosis increases

increases LAEDP and PCWP relative to LVEDP

11B-hydroxylase deficiency

increases androgens and aldosterone. male infants appear normal with hypertension.

angiotensin

increases filtration fraction

decreasing after load

increases forward flow in MR

bethanechol

increases phosphoinositide turnover in the smooth muscle cells of the bladder fundus but has not effect on nicotinic synapses

inspiration

increases right sided murmurs.

carotid sinus massage

increases the baroreceptor firing, thus increasing parasympathetic influence on the heart and vessels, ultimately prolonging AV node refractory period

the risk of pancreatic cancer

increases with the duration of diabetes

increasing prevalence

increasing time

left gastric

indirect shunting of portal blood into superior vena cava

glucagon like polypeptide 1

induce satiety, decrease gastric emptying, and increase insulin release. approved tx for DM type 2 pats with suboptimal control

prednisone

induced lymphocyte apoptosis, contributing to tumor lysis syndrome

leukotrienes

inducers of airway bronchoconstriction and inflammation

notochord

induces overlying ectoderm to differentiate into neuroectoderm and form neural plate (neural tube and neural crest cells)

pes anserinus bursitis

inflammation of medial knee

Taenia solium eggs

ingested and cause neurocysricercosis

femoral triangle

inguinal ligament superiorly, sartorius muscle laterally, and adductor longus muscle medially

niacin

inhibit VLDL production. increase HDL levels.

benztropine

inhibit central muscarinic receptors, help with DRUG INDUCED PARKINSONISM

methotrexate and trimethoprim and pyrimethamine

inhibit dihydrofolate reductase

aminoglycoside action

inhibit formation of initiation complex A "initiates" the alphabet

STEROIDS

inhibit phospholipase A2, decreasing formation of prostaglandin inflammatory mediators.

azoles

inhibit synthesis of ergosterol by fungal cytochrome P450 enzymes

both cimetidine and amiodarone

inhibit the metabolism of warfarin and the dose should be reduced

methimazole and propylthiouracil

inhibit thyroid peroxidase, thus reducing iodine organification

cyanide intoxication

inhibition of cytochrome C oxidase resulting in failure of the electron transport chain and aerobic metabolism

trastuzumab

inhibitions of epidermal growth factor and HER2, leading to apoptosis of breast cancer cells

Shiga-like toxin

inhibits 60s ribosomal subunit that blocks protein synthesis by preventing binding of tRNA

mycophenolate and ribavirin

inhibits IMP

ethambutol

inhibits arabinosyl transferase that polymerizes arabinose into arabinan and then arabinogalactan. SE includes optic neuritis with decreased visual acuity

rifampin

inhibits bacterial DNA-dependent RNA polymerase

linezolid

inhibits bacterial protein synthesis by binding to 50S subunit. thrombocytopenia, optic neuritis, and high risk for serotonin syndrome. MRSA.

6-MP and azathioprine

inhibits de novo purine synthesis PRPP

itraconazole

inhibits ergosterol synthesis

folate deficiency

inhibits formation of dTMP formed by thymidylate synthetase from dUMP

prostacyclin

inhibits platelet aggregation and adhesion to vascular endothelium. exists in dynamic balance with thromboxane A2

prostacyclin

inhibits platelet aggregation and is a vasodilator

PGI2

inhibits platelet aggregation, causes vasodilation and inhibits proliferation of smooth muscles

Diphtheria toxin

inhibits protein synthesis by ADP ribsoylation of EF-2, myocarditis and neurologic toxicity complications

ANP

inhibits renin secretion. restricts aldosterone secretion.

terbinafine

inhibits synthesis of ergosterol of the fungal membrane by inhibiting squalene epoxidase

ezetimibe

inhibits the intestinal absorption of cholesterol

5-fluorouracil

inhibits thymidylate synthase

CMV

initial contact with glycosaminoglycan chains for host entry

Salmonella typhi

initial diarrhea or constipation followed by hepatosplenomegaly, the formation of rose spots, and possible hemorrhagic enteritis with bowel perforation

apocrine

initially odorless but malodorous secondary to bacterial decomposition

strain

injury to muscle

teres major

innervated by sub scapular nerve and adduct and medially rotates the arm. not part of the rotator cuff.

palatoglossal

innervated by the vagus nerve

ansa cervicalis

innervates the sternohyoid, sternothyroid, and omohyoid muscles of the anterior neck

tyrosine kinase

insulin and insulin-like growth factor

somatomedin C

insulin growth like factor, released in response to growth factor and stimulates growth in target cells

raltegravir

integrase inhibitor

Raltegravir

integrase inhibitor used to treat HIV

danorubicin and doxorubicin

intercalate bases, causing defective base pairing and splitting of DNA strands

spongiosis

intracellular epidermal edema that histologically appears as an increase in the width of spaces between cells

Charcot-Bouchard is mostly

intraparenchymal. Lacunar in basal ganglia, pons, and internal capsule.

FRC

intrapleural pressure is approximately -5cm H20

nonsense mutations

introduce a stop codon within gene sequences, resulting in the formation of shorter, truncated proteins

vitamin B12

involved in DNA synthesis

uncal herniation causes

ipsilateral paralysis of oculomotor muscles, contralateral or ipsilateral hemiparesis, and contralateral homonymous hemianopsia with macular sparing

right-sided colon cancer

iron deficiency anemia

phenoxybenzamine

irreversible, nonselective a1 and a2 receptor antagonist

clopidogrel

irreversibly blocks the platelet surface ADP receptors essential for platelet aggregation, aggregation and fibrin binding

Lepromatous TB

is Th2 response, while tuberculoid is a Th1 immune response

erythroblastosis fetalis

is an example of a Type II (antibody mediated) hypersensitivity response. The clinical picture in the affected infant includes severe anemia, hepatosplenomegaly, jaundice (possible leading to kernicterus) and possible fetal demise/death in the infant.

PI3K/Akt/mTOR pathway

is an intracellular signaling pathway important for anti-apoptosis, cellular proliferation, and angiogenesis

submucosal rectal biopsy

is necessary for diagnosis of Hirschsprung disease

secretin

is produced by duodenal S-cells, increasing pancreatic and biliary bicarbonate section

Km

is the concentration at 1/2(Vmax)

hippocampus

is the first area damaged during global cerebral ischemia

NADPH produced via HMP shunt

is the only method of reducing glutathione in RBCS

PT

is used for monitoring the therapeutic effect of warfarin

cavitary tuberculosis

is usually due to reactivation, not primary infection

30 minutes of ischemia

ischemia injury become irreversible

contractile function decreased

ischemic heart disease and dilated cardiomyopathy

lidocaine

ischemic myocardium

Turner's syndrome

it is not a surrogate. it is donation. you can give them drugs to maintain preg but they have failed ovaries so no egg.

lambert eaton

its a b/c its lambert-eaton syndrome which affects the ca channels abd you get paralysis of the limbs just like botulism

bee sting

its a type 1 hypersensitivity reaction,leading to IgE dependant activation of mast cells to release histamine which is a vasodilator and increases vascular permeability by endolelial contractions leading to edema formation option vasoconstriction is not correct for 2 reasons since vasoconstriction (if at all occurs in some other incidents)occurs at the level of muscular arterial wall and since histamine is not vasoconstictor

Ivermectin

ivermectin for river blindness. Onchocerca volvulus. Hyperpigmented skin and river blindness (black flies, black skin nodules, "black sight"); allergic reaction to microfilaria possible

Strongyloides stercoralis

ivermectin. roundworm

increase size of colon polyps

kRAS. malignant by p53 or DCC

baby sulfonamides

kernicterus

hypersalivation

ketamine

Legionella pneumophilia

labs show hyponatremia

metformin

lactic acidosis, avoid use in severe congestive heart failure or alcoholics

infective endocarditis

larger, more friable vegetations on the valve cusps

Eisenmenger syndrome

late-onset reversal of left-to-right shunt due to pulmonary vascular sclerosis resulting from chronic pulmonary hypertension

sural nerve

lateral foot and posterolateral leg sensory

indirect inguinal hernias

lateral to the inferior epigastric vessels, continue into the scrotum and are felt by deep palpation of the external inguinal ring with the tip of the finger

peroxisomal disease

lead to neurologic defects from improper CNS myelination

abnormal migration of ventral pancreatic bud

leads to annular pancreas

dipalmitoyl phosphatidylcholine

lecithin

phosphatidylcholine

lecithin

fourth aa

left = aortic arch, right = proximal right subclavian artery

portal veins

left gastric, paraumbilical, superior rectal

PDA

left-to-right shunting may be switched by pulmonary hypertension due to pulmonary vascular sclerosis. differential cyanoses restricted to the lower body happens wen there is a shunt reversal in patients with septal defects

brief psychotic

less than 1 month, schizophreniform less than 6 months, schizophrenia more than 6 months

right gastric

lesser curvature of stomach

zafirlukast and montelukas

leukotriene D4 receptor antagonists

wearing a helmet

limited to forehead diet and sun no effect on acne but the helmet in contact with skin can produce a moist and closed environment

Picornavirus

linear SS + RNA Poliovirus—polio-Salk/Sabin vaccines—IPV/OPV Echovirus—aseptic meningitis Rhinovirus—"common cold" Coxsackievirus—aseptic meningitis; herpangina (mouth blisters, fever); hand, foot, and mouth disease; myocarditis; pericarditis HAV—acute viral hepatitis PERCH

paranasal sinuses

lined with ciliated, pseudo stratified, columnar, mucus-secreting epithelium

Zileuton

lipooxygenase inhibitor, used with allergic rhinitis and bronchial asthma

familial chylomicronemia

lipoprotein lipase, Apo C-II. Chylomicrons elevated. Acute pancreatitis.

short, post-meal hyperglycemia

lispro, aspart, glulisine

thyroid function tests

lithium and amiodarone

chronic interstitial nephritis

lithium and cyclosporine, NSAIDS

chylocystectomy typically has

little effect on lipid digestion and absorption though patients may find it difficult to eat a large fatty meal

ApoE3 and ApoE4 deficiency

liver cannot efficiently remove chylomicrons and VLDL remnants from circulation

MRP2

liver secretes direct (conjugated) bilirubin into the biliary system through active transport by a specific ATP-binding cassette protein

OATP

liver takes up direct bilirubin through a passive process utilizing an OATP

prostaglandin E1

locally produced vasodilator peptide produced in nearly every tissue of the body

chemoreceptor trigger zone

located on the dorsal surface of the medulla at the caudal end of the fourth ventricle

basilar artery

locked-in

flurazepam

long acting benzo used for the treatment of insomnia

prevalence

looks at all current cases

incidence

looks at new cases (in population at risk)

60 seconds ischemia of heart

loss of ATP results in loss of contractility

thalamic syndrome

loss of VPL and VPM, resulting in complete sensory loss

axonal reaction

loss of axon, enlargement of cell body, eccentric nucleus, dispersion of Nissl substance

alpha toxin lecithinase

loss of cell membrane integrity

acantholysis

loss of cohesion between keratinocytes in the epidermis

neuronal atropy = progressive degenerative disease

loss of neurons and functional groups of neurons, reactive gliosis

tibial nerve injury

loss of plantarflexion and inversion of the foot

rheumatoid arthritis

low C3, increased segmented neutrophils, interleukin (IL-1), tumor necrosis factor

anorexia

low T3 and T4

epinephrine

low dose, more B2 vasodilation. high dose, more a1 vasoconstriction.

hepcidin

low levels increase intestinal iron absorption and stimulate iron release by macrophages

chlorpromazine and thioridazine

low-potency antipsychotics, sedation and orthostatic hypotension + anticholinergic effects

sacroiliac joint

lower back pain

diphtheria coded by

lysogenic phage

amatoxins

mRNA inhibition. found in mushrooms.

Sirolimus (Rapamycin)

mTOR inhibitor; binds FKBP. Blocks T cell activation and B cell differentiation by preventing IL-2 signal transduction. Kidney "sir-vives." Synergistic with cyclosporine. Also used in drug-eluting stents.

Mycobacterium avium complex treatment

macrolide (axithromycin) coupled with rifampin and ethambutol

2,3-BPG

made from 1,3-BPG by the enzyme bisphosphoglycerate mutase

TNF alpha

made my macrophages and mast cells. apoptosis of tumor cells and activation of CD4, neutrophils, etc.

schizotypal

magical thinking

Microangiopathy

main mechanism of diabetes eye pathology

schizoaffective

major depressive/mani with schizophrenia. also need short period of delusions/hallucinations without mood symptoms.

Histone Acetylation

makes DNA Active

asparagine synthetase

makes asparagine from aspartate and glutamate

effect modifier

makes significant difference

21-hydroxylase deficiency

males appear normal and develop hypotension and hyperkalemia (salt-wasting). high androgens.

carcinosarcoma

malignant mixed mullerian tumor of the uterus that are composed of epithelial (endometrial-type glands) and mesenchymal (sarcomatous) elements. not associated with pregnancy or elevated hCG

CN V3

mandibular branch of the trigeminal nerve, does carry sensation to the majority of the external auditory meatus

tabes dorsalis (slow degeneration of nerves in dorsal column) and Argyll Robertson pupils

manifestations of tertiary neurosyphilis

complement lectin pathway

mannose or other sugars on microbe surface

HBeAg

marker of viral replication

altruism

mature defense mechanism with ameliorated feeling of guilt by giving to others without solicitation

aortic arch 1

maxillary artery

extramedullary hematopoiesis

maxillary overgrowth and bossing, seens with severe chronic hemolytic anemias like Beta-thalassemia

chronic fissues

may be accompanied by spasm of the internal anal sphincter

dopamine

may cause anxiety and agitation. carbidopa can make worse.

TNF-alpha

may induce insulin resistance through activation of serene kinases

ketamine (phencyclidine anesthetic) and nitrous oxide (inhalational analgesic)

may lead to euphoria

folate with phenytoin

may precipitate seizures, also walking difficulties and parenthesis are not typically associated

Thymine has a

meTHYl

penicillin

mechanism: binds penicillin-binding proteins

great saphenous vein

medial side of the foot, drains into femoral triangle a few centimeters inferolateral to the pubic tubercle

internal laryngeal

mediated afferent limb of the cough reflex

taste from anterior two-thirds of tongue

mediated by CN7

graft-versus-host disease

mediated by T-lymphocytes of the donor tissue that are sensitized against MHC antigens of the recipient

vancomycin red man

mediated by histamine release

platelet aggregation

mediated by platelet-activating factor (PAF)

niacin flushing

mediated by prostaglandins, significantly will reduce cutaneous symptoms

plasmin

mediates degradation of fibrin

thrombin

mediates fibrinogen to fibrin

temazepam and estazolam

medium duration benzos

MEN 2a

medullary carcinoma of the thyroid (calcitonin), pheochromocytoma, parathyroid tumor

Korsakoff syndrome

memory loss, damage to the anterior and dorsomedial thalamic nuclei

Ceftriaxone

meningitis and gonorrhea

Waterhouse-Friderichsen syndrome

meningococcal septicemia causes adrenal hemorrhage

septum transversum

mesodermally derived tissue from umbilicus to pericardium. gives rise to myoblasts from diaphragm and liver

Conn's syndrome

metabolic alkalosis

leukotriene B4

metabolite of arachidonic acid. function is to stimulate neutrophil migration to inflamation site

procainamide

metabolized via hepatic acetylation, individuals who are slow acetylators are at greatest risk for DILE

hematogenous osteomyelitis

metaphysis of long bones in children

GERD

metaplasia of esophageal epithelium and TRANSIENT relaxation of the LES

heroin addiction treatment

methadone, mu agonist that's long lasting with good oral bioavailability

Cryptococcus neoformans

methenamine silver stain

beta-lactamase resistant penicillins

methicillin, oxacillin, nafcillin

classic homocystinuria

methionine restriction (B12 enzyme) and cysteine supplementation. AR. cystathionine synthase deficiency

complement alternative pathway

microbe surface molecules

teratogenic effects of excessive vitamin A

microencephaly, cardiac abnormalities, and fetal death

mitral valve prolapse

mid-systolic click

superior rectal vein

middle and inferior rectal

CN9

middle ear cavity, loss of taste sensation on the posterior 1/3 of tongue

internal iliac artery branches

middle rectal artery and inferior rectal artery (off the pudendal)

Trousseau syndrome

migratory thrombophlebitis

vitamin E deficiency

mimics Friedrich ataxia: ataxia, dysarthria, and loss of position/vibration sensation

kappa receptors

miosis, specifically

HbC

missense. glutamate replaced by lysine in beta glob in chain. asymptomatic with mild hemolytic anemia and splenomegaly

HbS

missense. glutamate replaced by valine.

beta error

missing detection

congenital endocardial cushion defect

mitral regurgitation

S2 to opening snap interval

mitral stenosis

mid-systolic click

mitral valve prolapse

thyrotoxicosis

mixed, cellular infiltration with occasional multinucleate giant cells

cryptosporidium parvum

modified acid-fast, causing watery diarrhea in AIDS patients

temporal (giant cell) arteritis

monocular blindness

CD14

monocytes and macrophages

atypical depression

mood reactivity, rejection sensitivity, increased sleep and appetite

impetigo

more commonly precedes glomerulonephritis than pharyngitis

benzo withdrawal

more likely with shorter acting drugs

Paget's

mosaic pattern of lamellar bone

streptococcus pneumoniae

most common cause of bacterial meningitis in adults of all ages

medulloblastoma

most common malignant brain tumor in children

hand hygiene

most important to prevent central venous catheter infections

stable chronic hepatitis

most likely outcome for a patient acutely infection with hep C. 2nd most common is chronic hepatitis progressing to cirrhosis

N-acetylcysteine

mucolytic agent that loosens the thick sputum by cleaving disulfide bonds within mucus glycoproteins

live attenuated Sabin

mucosal surfaces. promote prolonged synthesis and secretion of local mucosal IgA

Peutz-Jeghers

multiple hamartomatous polyps and black spots on the skin and mucosa of young patients

pleiotropy

multiple phenotypic manifestations, often in different organ systems, which result from a single gene

DR2

multiple sclerosis, Goodpasture syndrome

tiotropium and ipratropium

muscarinic acetylcholine antagonists that help to counteract asthma and COPD

methacholine

muscarinic cholinergic agonist causing bronchoconstriction, more than 20% means bronchial asthma

scopolamine

muscarinic cholinergic antagonist for motion sickness

GLUT 4

muscle cells, adipocytes

winged scapula

muscle serratus anterior nerve lesion of the long thoracic nerve

gp120

must bing to chemokine receptor CXCR5 or CCR5

HbC

mutation causing glutamic acid to be replaced by lysine causing mild, chronic hemolytic anemia

hereditary pancreatitis

mutations involving trypsinogen of SPINK1 genes, leads to abnormal trypsin

green pus or sputum

myeloperoxidase released from neutrophil azurophilic granules

mitral valve prolapse

myxomatous degeneration of affected mitral valve, seen in Marfan syndrome

beta non selective antagonists

nadolol, pindolol (partial agonist), propranolol, timolol (N to T)

rotavirus

naked ds RNA

rotavirus

naked ds RNA virus

Picornavirus

naked virus with ss + RNA

mitral valve prolapse

native valve bacterial endocarditis (NVBE) from injected vegetations on mitral leaflets.

Klebsiella

necrotizing pneumonia in elderly of immunocompromised patients

factors 8 and 9 are part of the intrinsic pathway

needed for activation of Factor 10 and subsequent prothrombin to thrombin

non-selective beta blockers

negative inotropy and bronchoconstriction in patients with asthma and COPD

ALA synthase

negative: alcohol, barbs, hypoxia positive: heme, glucose (causes increased aminolevulinic acid and porphobilinogen)

medullary carcinoma

neoplastic parafollicular C-cells

amphotericin B

nephrotoxicity, anemia, thromboplebitis

Schwann cells promote axonal regeneration

nerve regeneration

valproate

neural tube defect

n-myc

neuroblastoma and small cell carcinoma of the lung

small cell carcinomas

neuroendocrine differentiation, chromogranin and synaptophysin

small cell carcinoma

neuroendocrine markers such as chromogranin and synaptophysin

Merkel cells

neuroendocrine touch

hypocretin1 and 2

neuropeptides from lateral hypothalamus that function to promote wakefulness and inhibit REM sleep-related phenomena

intravesicular proteins with ADH/oxytocin

neurophysins

ticlopidine and clopidigrel

neutropenia side effect...fever and mouth ulcers

C5a

neutrophil chemotaxis

broad defense of Candida

neutrophils

rolling

neutrophils roll on the endothelium via L-selectin or E-selectin

NNRTI

nevirapine, efavirenz, and delavirdine

tryptophan

niacin

subarachnoid hemorrhage

nimodipine, a selective calcium channel blocker, is often prescribed to prevent this vasospasm. rebleeding is the more dangerous complication

third branchial arch

ninth cranial nerve (glossopharyngeal), stylopharyngeus, hyoid bone, and posterior one-third of the tongue

arginine

nitric oxide

nitrates

nitroglycerin and isosorbide. headaches and flushing SE.

COPD and asthma

no beta blocker

MI

no change in venous, CO decreases

hepatitis C instability

no proofreading 3'-->5' exonuclease activity

Hodgkin's lymphoma

nodular sclerosis, having a nodular growth pattern with surrounding fibrous bands

t(14;18)

non-Hodgkin follicular small cleaved cell lymphoma

Clara cell

non-ciliated, secretory constituents. CCSP inhibits neutrophil recruitment and activation of neutrophil-dependent muscin production

isoprotenerol

non-selective B agonist

labetalol

non-selective B blocker that also has alpha-1 receptor blocking effects. both myocardial contracility and systemic vascular resistance would decrease with this medication

Club/Clara cells

nonciliated, club cell secretory protein protects against airway inflammation, surfactant components prevent bronchiolar collapse

Hep A

nonenveloped icosahedral nucleocapsid

HBsAg is a

noninfective envelope glycoprotein that forms spheres and tubules 22nm in diameter

HBsAg is a

noninfective glycoprotein that forms sphere and tubules 22nm in diameter

hyaline arteriolosclerosis

nonmalignant hypertension and diabetes

carvedilol

nonspecifically antagonizes B1 and B2 as well as a1 adrenergic receptors. slow progression of CHF

high urinary excretion of radioactive cobalamin after intramuscular injection

normal absorption, meaning dietary B12 deficiency

effect modification

not a bias and should not be controlled

S. epidermidis

not encapsulated bacteria. produces adherent biofilms

Ribavirin

nucleoside analog that inhibits the synthesis of guanine nucleotides and is active against RSV and hepatitis C virus

zidovudine

nucleoside reverse transcriptase inhibitor (thymidine analog) used to treat HIV infection. does not have a 3-Oh group, making phosphodiester bond formation impossible

Huntington disease

nucleus caudatus atrophy, NMDA receptors depleted

TTP

occurs in adults with predominant neurological symptoms

isotype switching from IgM to other types of immunoglobulins

occurs in the germinal centers late in the primary response. required CD40-CD40 binding from B and T cell

Chediack-Higashi

oculocutaneous albinism, peripheral neuropathy, phagosome-lysosome fusion

schizoid

odd

aortic stenosis

of congenital bicuspid valve doesn't begin until later n life

opening snap

of mitral stenosis, heard shortly after point D on pressure-volume loop (bottom left) when mitral valve reaches its maximum opening size

rifampicin, pehnobarbital, and phenytoin are universal enhancers

of the cyt P450 pathway

lamellar body

of type II pneumocytes store and release pulmonary surfactant into the fluid layer lining the inner surfaces of alveoli

Rb anti-oncogene

on chromosome 13

ivermectin

onchocerciasis (river blindness)

brief psychotic disorder

one or more psychotic symptoms lasting more than a day but less than a month

I band

only actin

scopolamine

only antimuscarinic effects and helps prevent motion sickness

H band

only myosin

calcitonin

only produced by C-cells of the thyroid gland

pharyngitis

only, precedes rheumatic fever

loperamide

opiate antimotility drug that is prescribed in some cases of traveler's diarrhea where there is no fever or blood in the stool

Pentazocine

opioid narcotic that is a partial agonist

C3b

opsonization

ornithine transcarbamolyase

ornithine and carbamoyl phosphate are combined to form citrulline. occurs within mitochondria. deficiency leads to hyperammonia and mental retardation.

psychogenic polydipsia

osmotic decrease of ECF and ICF

baby aminoglycosides

ototoxicity

aminoglycosides

ototoxicity from direct damage to eighth cranial nerve. renal toxicity and acute tubular necrosis.

leukemoid reaction

over-exuberant white blood cell response

decreased arterial 02-carrying capacity

oxygen content = oxygen binding capacity x percent saturation + dissolved oxygen In anemia -- PO2 in arteries = normal Hb saturation percent is decreased Oxygen/ hemoglobin = normal oxygen content = decreased So, applying this to the above equation: since oxygen content takes into account oxygen binding capacity ( which is same as oxygen carrying- I would go with B) First I was thinking-- oxyhemoglobin saturation - but thats another way of saying oxygen/hemoglobin which is normal. So I go with B.

streptolysin O

oxygen-labile immunogenic extracellular protein produced by S. pyogenes, that is beta hemolytic, causing lysis of erythryocytes and polymorphonuclear leukocytes

paraventricular

oxytocin

primaquine

p. vivax and p. ovale

p53 and hypophosphorylated Rb

p53 and hypophosphorylated Rb normally inhibit G1-to-S progression; mutations in these genes result in unrestrained cell division (e.g., Li-Fraumeni syndrome).

left spinal thalamic

pain & temperature

external hemorrhoid

painful, no bleeding

a1-aT deficiency

panacinar emphysema

Zollinger-Ellison

pancreatic bicarbonate

somatostatin

pancreatic delta cells. secreted from the hypothalamus and inhibits the production of growth hormone from the anterior pituitary gland. reduced gallbladder contractility responsible for biliary stones.

didanosine

pancreatitis

papillary muscle ischemia

papillary muscle ischemia cos myocardial infarction could lead to papillary muscle ischemia, which can present with pan systolic murmur of mitral regurgitation at cardiac apex, rest all are signs of MI itself, and it resolves with treatment.. therefore AMI --> papillary muscle ischemia --> functional MR

Kussmaul's sign

paradoxical increase in jugular venous pressure with inspiration, found in CHRONIC constrictive pericarditis; differential also includes tricuspid stenosis, cardiac tamponade

croup

parainfluenza virus

MEN 1

parathyroid, pancreatic, pituitary adenoma

oxytocin

paraventricular formation

adenosine

paroxysmal supraventicular tachycardia

pindolol and acebutolol

partial B-agonists contraindicated in angina

tamoxifen

partial agonist in bone, endometrium, and cv tissue--> SE include deep vein thrombosis, thromboembolism, and endometrial cancer

varenicline

partial nicotine agonist that helps reduce nicotine withdrawl

gallstone ileus

passage of large gallstone through cholecystenteric fistula into the small bowel

Staphylococcal endocarditis

penicillin antibiotics (nafcillin) and an aminoglycoside (gentamicin)

penicillin toxicity

penicillinase in bacteria (a type of Beta lactamase) cleaves B lactam ring

liver hydroxylation

pentobarbital and phenobarbital

7 cal

per gram ethanol

9 cal

per gram of fat

4 cal

per gram of protein

thoracocentesis right

performed between 5th-7th ribs along midclavicular line, 7-9th ribs midaxillary line, 9-11th ribs paravertebral

thoracocentesis left

performed between 7th ribs along midclavicular line, 10th ribs midaxillary line, 12th ribs paravertebral. worry about liver

the equilibration of O2 and CO2 is normally

perfusion limited, no diffusion limited

Korotkoff sounds

pericardial disease, acute cardiac tamponade, constrictive percarditis, severe obstructive lung disease, and restrictive cardiomyopathy

SLE pericardial effusion

pericardial friction rub, causing Libman-Sacks endocarditis (nonbacterial vegetations on heart valves)

dermatomyositis

perifascicular inflammation

Sister May Joseph nodule

periumbilical region

lac y

permease, a transmembrane enzyme that increases permeability of the cell to lactose

DR5

pernicious anemia, hashimoto thyroiditis

MAOs

phenelzine and tranylcypromine

liver sulfate conjugation

phenol and chloramphenicol

PKU

phenylalanine hydroxylase

Parinaud syndrome

pinealoma, tumor of the pineal region. most often they are germinomas, paralysis of conjugate vertical gaze due to lesion in superior colliculi

placenta previa

placenta implanted over the cervical os

nonenveloped RNA

plio, caxsackievirus, echovirus, hepatitis A, rotavirus, and Norwalk virus

naked RNA

poliovirus, coxsackievirus, echovirus, HAV, reovirus (rotavirus), and Norwalk virus

Gardner syndrome

polyps in rectum and sigmoid colon, poor dentition and several osteomas in mandible and skull

severe vWF deficiency

poor response to desmopressin

paracortical zone

populated primarily by T lymphocytes and dendritic cells

amphotericin B makes

pores in ergosterol

acute intermittent porphyria

porphobilinogen deaminase deficiency, inhibit ALA synthase for tx by heme or glucose or by REDUCING alcohol and smoking

Uroporphyrinogen decarboxylase

porphyria cutanea tarda

defect in uroporphyrinogen decarboxylase

porphyria cutanea tarda (PCT)

citrate

positive regulator of acetyl-CoA carboxylase and fructose 1,6 bisphosphatase (fatty acid synthesis and gluconeogenesis). negative regulator of phosphofructokinase 1 and 2 (so high levels inhibit glycolysis)

Hep C

positive, single-stranded RNA with no virion polymerase

atropine

post junctional muscarinic receptors in the heart M2

ascending aorta

posterior and to the right of the main pulmonary artery

posterior inferior wall of left ventricle

posterior descending branch of the right coronary artery (RCA)

levodopa to dopamine peripheral conversion

postural hypotension and hot flashes

haloperidol

potent D2 blocker

leukotrienes

potent inducers of bronchoconstriction and inflammation

Tetrodotoxin

potent neurotoxin found in pufferfish, functions by blocking the voltage-gated sodium channels in nerve cell membranes

Ricin

potent toxin that inhibits protein synthesis by cleaving the rRNA component of the eukaryotic 60s subunit. from castor oil plant.

vaginal adenosis

precursor of clear cell adenocarcinoma of the vagina, common in offspring of DES-exposed pregnant women

vaginal adenosis

precursor of clear cell adenocarcinoma, women exposed to DES

norepinephrine

predominantly alpha-1, causing intense vasocontriction. no effect on B2

COX 2

preferentially expressed at sites of inflammation. doesn't decrease thromboxane A2

strawberry hemangioma

present at birth, grow until puberty then spontaneously regress

anti-HBc IgM

present during acute infection and window phase

MHC II

present exogenously synthesized proteins (bacterial proteins, viral capsid proteins) to helper T cells. antigen loaded following release of invariant chain in an acidified endosome.

RAS patient

present with HTN

pulmonary capillary wedge pressure

pressure of the left atrium

left dorsal columns

pressure, vibration, touch, and proprioception

Lambert-Eaton

presynaptic calcium channels, decreasing presynaptic acetylcholine release

hepcidin

prevents release of iron bound by ferritin--> anemia of chronic disease

dobutamine

primary B1-adrengergic action that causes increased cardiac output without other effects of epinephrine

granulomatous destruction of bile ducts

primary biliary cirrhosis

INCREASED TSH

primary hypothyroidism

Klinefelter syndrome

primary testicular failure, FSH and LH high

liver hydrolysis

procaine, lidocaine, aspirin

cerebellar hemangioblastomas

produce erythropoietin and are often associated with polycythemia

myxomas

produce large amounts of interleukin 6, thus presenting with constitutional symptoms (weight loss and fever). composed of scattered cells within mucopolysaccharide stroma, abnormal blood vessels, and hemorrhaging.

phospholipase C

produced by P. aeruginosa and degrades cellular membranes

IL-8

produced by macrophages for chemotasis and phagocytosis in neutrophils

M-CSF and RANK-L

produced by osteoblasts for osteoclastic differentiation. decreased by osteoprotegerin (OPG)

GTP

produced by succinyl-CoA synthetase with succinyl CoA to succinate

CRH

produced by the hypothalamus stimulating ACTH release by pituitary

theophylline

produces bronchodilation by inhibiting the enzyme phosphodiesterase thereby increasing intracellular cyclic AMP

paralysis fo the stapedius muscle

produces hyperacusis (increased sensitivity to sound)

POMC

produces not only beta-endorphins, but also ACTH and MSH

chordae tendineae rupture

produces severe mitral regurgitation, complication of bacterial endocarditis

mifepristone

progesterone antagonist with an affinity for the progesterone receptor five times that of natural progesterone

oligodendrocyte depletion

progressive multifocal leukoencephalopathy

digoxin

prolong PR interval with no effect on QT interval

decreased levels of vit K dependent factors

prolong the prothrombin time PT (warfarin indicator)

ziprasidone

prolonged QT, atypical antipsychotic

Mycobacterium avium

prophylaxis azithromycin

isoniazid

prophylaxis for TB

Histoplasma capsulatum

prophylaxis itraconazole

rifampin

prophylaxis of meningococcal meningitis...given to all close contacts of patient with active disease

medications that decrease peripheral conversion of T4 to T3

propylthiouracil, glucocorticoids, amiodarone, iopanoic acid, and nonselective beta blockers

indinavir

protease inhibitor

Bortezomib

proteasome inhibitor used in the treatment of multiple myeloma and Waldenstrom macroglobulinemia

Bortezomib

proteasome inhibitor used in treatment of multiple myeloma and Waldenstrom macroglobulinemia

vW FACTOR

protective carrier function to factor 8, also aids in platelet adhesion to injured blood vessels during the clotting process

paraesophageal hernia

protrusion of the fundus into the chest above the level of T10

extrinsic allergic asthma

provoked by inhaled allergens such as animal dander is most common

sixth

proximal pulmonary arteries, left = ductus arteriosus

impaired renal tubular bicarb reabsorption

proximal renal tubular acidosis

erectile dysfunction

psychogenic causes 10% cases

amiodarone

pulmonary fibrosis causing. Antiarrhythmics— K+ channel blockers (class III)

cardiac tamponade

pulsus paradoxus (inspiration drops by over 10 mmHG)

aortic stenosis

pulsus parbus et tardus = prolonged carotid pulses

acute opioid withdrawal

pupillary dilation, rhinorrhea, sneezing

V. cholerae is like ETEC

purely toxin-mediated watery diarrhea with increased cAMP

glutamate + aspartate + glycines

purines

heart conduction fastest to slowest

purkinje system, atrial muscle, ventricular muscle, AV node PARK AT VENTURA AVENUE

CUT the PY

pyramidines

glutamate + aspartate

pyrimidines

pyruvate to oxaloacetate

pyruvate carboxylase (activity increased by acetyl coA). ALSO catalyzes the initial step in glucogeneogenesis. required biotin as a cofactor

4 gluconeogenesis enzymes

pyruvate carboxylase, PEP carboxylase, fructose 1,6 bisphosphatase, glucose-6-phosphatase

PEP to pyruvate

pyruvate kinase

pyruvate dehydrogenase

pyruvate to acetyl-coA in the presence of oxygen.

AML caused by Hodgkins

radition induced leukemia post Hodgkins

nausea, intermittent bloating, and diarrhea after gastric bypass one month ago

rapid emptying of hyperosmolar chyme into the small bowel

marijuana

rapid heart rate and conjuctival injection, increased risk for schizophrenia

Pacinian corpuscles

rapidly adapting mechanoreceptors

berylliosis is a

rare occupational lung disease

carbamoyl phosphate synthetase I

rate limiting enzyme in urea-cycle reaction, activated by NAG

omalizumab

recombinant humanized IgG1 monoclonal antibody that binds with IgE to inhibit the action of IgE with its receptor on mast cells, basophils, and other cell types and decrease the allergic response

omalizumab

recombinant humanized IgG1 monoclonal antibody that binds with IgE to inhibit the action of IgE with its receptor on mast cells, basophils, and other cells types and decrease the allergic response, allergic asthma

ulcerative colitis

rectum is alway involved. blood diarrhea, toxic megacolon

cerebral amyloid angiopathy

recurrent hemorrhagic stroke

C5-9

recurrent infections with Neisseria meningitidis and N. gonorrhoeae

eosinophils

release major basic protein, a potent-antihelminthic toxin capable of causing damage to epithelial and endothelial cells

atherosclerotic plaques

release of PDGF by locally adherent platelets, endothelial cells, and macrophages promotes migration of smooth muscle cells from medial into intima and subsequent proliferation

green discoloration

release of myeloperoxidase from neutrophil azurophilic granules

juxtaglomerular cells

release renin in response to beta-1 stimulation

renin

released from juxtaglomerular cells of the kidney's glomerular afferent arterioles. MACULA DENSA measures decreased sodium content in tubular fluid.

Carniopharyngiomas

remnant of Rathke's pouch, which forms anterior pituitary. neoclassic transformation has 3 components: solid, cystic, and calcified. compression of the pituitary talk leads to hyperprolactinemia by loss of dopaminergic inhibition. mostly found in children bywen 5-10 years old.

ataxia-telangiectasia

repeated sinopulmonary infections, increased risk of cancer

atherosclerosis

repetitive endothelial cell injury, leading to chronic inflammatory state of large elastic arteries and large/medium-sized muscular arteries

lac i

repressor protein of the lac operon

homocysteine to cystathionine

required enzyme cystathionine synthetase w/ B6. CLASSIC HOMOCYSTEINURIA

initiation of translation in prokaryotes

required specific N-formylated methionine t-RNA that is used to incorporate the initial methionine residue into all proteins

hydroxyproline

required vitamin C

transamination involving Keto-acid and amino acid

requires B6 (pyridoxine)

Haemophilus influenza

requires X and V, which can be supplied by S. aureus

glucose oxidation

requires less oxygen then fatty acid oxidation. nevertheless, fatty acid oxidation is the main source of energy production

cystathionine synthase

requires vitamine B6 and is the cause of classic homocystinuria

campylobacter jejuni

resistant of fluoroquinolones. use erythromycin instead. (gram -, oxidase positive, comma shaped)

anti-HBs

resolution of acute infection. confers long-term immunity

hyperventilation produces

respiratory alkalosis

Protein Kinase A

responsible for G protein/adenylate cyclase messenger system. hormone receptors include TSH, glucagon, PTH, and beta-adrenergic receptors

togaviruses

responsible for rubella (German measles) and Eastern and Western equine encephalitis

deposition of immune globin light chains, like gamma light chains

responsible for systemic (not localized) amyloidosis

reperfusion injury

result from generation of oxygen-free radicals

ulceration of a wound

results from inadequate vascularization during healing

aortic arch constriction

results in coarctation of the aorta, most commonly just distal to the left subclavian artery

injury to Meyer's loop

results in contralateral superior quadrantanopia

digoxin toxicity

results in hyperkalemia, potassium and digoxin compete with each other for Na-K-ATPase

thioridazine

retinal deposits, low potency antipsychotic

zidovudine

retroviral reverse transcriptase inhibitor that reduces the risk of perinatal transmission by about two-thids in HIV-positive women

atropine toxicity

reversed by cholinesterase inhibitors (physostigmine)

phentolamine is a

reversible, competitive, nonspecific a-antagonist used in pheochyromocytoma, cocaine overdose, etc.

nitroglycerin

reversible, dose-dependent

organophosphates

reversibly inhibit cholinesterase. ATROPINE reverses muscarinic effects but not nicotinic effects such as muscle paralysis. PRALIDOXIME reverses both muscarinic and nicotinic effects of organophosphates

operant conditioning

rewards and punishments are used to reinforce behaviour

fibrosis of valve leaflets

rheumatic fever

DR4

rheumatoid arthritis, diabetes mellitus type II

hydroxyurea inhibits

ribonucleotide reductase

nonoxidative reactions of HMP shunt

ribose-5-phosphate to fructose-6-phosphate and glyceraldehyde-3-phosphate

left homonymous hemianopia

right optic tract

right optic tract lesion = left contralateral homonymous hemianopia. pg.442 Kaplan-Anatomy

right optic tract

Left lower quadrantic anopia

right parietal lesion (MCA)

jugular venous distention

right side heart failure

ischemic kidney

secretes high levels of renin, causing hypertension

anti-dsDNA antibodies

seen in SLE patients, but rarely in DILE

lymphocytic infiltration of islets of Langerhans + fibrosis

seen in diabetes mellitus type 1

buproprion

seizure side effect

theophylline toxicity

seizures, treat with benzos, barbs, and beta-blockers

Berkson bias

selecting hospitalized patients as the control group

metoprolol

selective Beta-1 adrenergic antagonist. inhibits renin release by the kidneys. but BETA BLOCKERS DO NOT AFFECT CIRCULATING CATECHOLAMINES

paroxetine

selective serotonin reuptake inhibitor

serotonin syndrome

selegiline with fluoxetine will cause serotonin sydrome becasue they both inhibit moa all the other choices do not inhibit mao

aortic stenosis in patients above 70

senile, degenerative calcification of the aortic valve

Diphterhia-Pertussis-Tetanus

series is commonly administered at 2 months old

tryptophan

serotonin, melatonin

type III immune complex

serum sickness, PSGN, lupus nephritis

IL12 deficiency

severe mycobacterial infections, because cannot differentiate naive T-helper cells. treat with INF-gamma

fatty oxidation inhibitors

shift energy production to glucose oxidation, thus promoting oxygen efficiency

albuterol

short acting beta-2 adrenergic agonist

triazolam

short-acting benzo

albuterol

short-acting beta-2 adrenergic agonist

albuterol

short-acting selective beta-2 adrenergic agonist

glucocorticoids in RA

short-term, fast-acting relief

every patient using inhaled corticosteroids

should be instructed about oral rinsing to prevent oropharyngeal candidiasis

probenecid

should not be used into gout pts with risk for nephrolithiasis or uric acid nephropathy

red neuron = acute injury

shrinkage of the cell body, pyknosis of the nucleus, loss of Nissl substance, eosinophilic cytoplasm

ductus arteriosus

shunts blood from pulmonary artery into the descending aorta...mixed with completely deoxygenated blood from the systemic circulation

trimethoprim/sulfamethoxazole

side effects are hyperkalemia, neutropenia, and uncommon severe dermatologic reactions (Stevens-Johnson syndrome)

δ-aminolevulinic acid synthase: rate-limiting step

sideroblastic anemia (X-linked)

involuntary head bobbing

sign of widened pulse pressure. most likely cause is aortic regurgitation (AR)

lesions of lateral hypothalamus

signal hunger

succinylcholine

significant potassium release

testosterone

sildenafil only helps with erection problems...testosterone also helps with all the problems described.

respiratory bronchioles

simple cuboidal ciliated epithelium from tracheobronchial tree pseudostratified columnar ciliated epithelium

It's sinus bradyarrhythmia. If you have an unusually sensitive carotid baroreceptor, palpation can overstimulate these receptors, simulating high blood pressure and causing reflex bradycardia.

sinus palpation

ileum

site of absorption of bile and vitamin B12

Shine-Dalgarno

six to ten bases upstream from AUG, recognizing 16S rRNA and 30S small ribosomal subunit. unique to PROKARYOTES

Sturge-Weber

skill tram-track, cutaneous facial angiomas, V1 and V2 distributions

basal cells

skin regeneration. YES I THINK SO TOO.. THEY ARE MOST SUPERFICIAL IN EPIDERMIS

PTSD

sleep suffers

beta anatagonist

slow atriovenricular conduction and increase PR interval on EKG

Type 1 fiber

slow twitch

CLASS 1C

slowest class 1 agents to dissociate from the sodium channel

live attenuated vaccines

smallpox, yellow fever, chickenpox (VZV), Sabin polio virus, MMR, Influenza (intranasal). "Live! One night only! See small yellow chickens get vaccinated with Sabin and MMR! It's incredible!"

bulbus cordis

smooth left and right ventricles

calmoduline and light-chain kinase

smooth muscle contractile mechanism

sinus venosus

smooth right atrium

cyanide poisoning

sodium thiosulfate

Cryptococcus neoformans

soil and pigeon droppings

Although many Jehovah's Witnesses will refuse blood products

some patients will accept them in life-threatening situations

sorbitol dehydrogenase

sorbitol to fructose

GLUT 5

spermatocytes, GI tract

Kaposi

spindle-shaped cells with markets of both smooth muscle and vascular endothelial lineage

acute MR

spontaneous rupture of chord tendinae, infective endocarditis with destruction of valve leaflets, ischemia of papillary muscle. NEAR NORMAL LEFT ATRIAL COMPLIANCE

B. anthracis

spreads via lymphatics to the bloodstream

Barrett esophagus

squamous metaplasia to intestinal-type columnar cells

vWF

stability of clotting factor 8. desmopressin increases vWF release from endothelial cells.

AML

t(15;17) PML/RARalpha codes for an abnormal retinoic acid receptor

c myc

t(8; 14)

Burkitt lymphoma

t(8;14) with overexpression of c-myc oncogene. high grade lymphoma but tumor responds well to chemo, so excellent prognosis

ATP

tRNA Activation (charging)

GTP

tRNA Gripping and Going places (translocation)

VDJ gene recombination

takes place in bone marrow for B cells and thymus for T cells

albendazole

tapeworm Echinococcus granulosus (produces cysts in liver, but not diarrhea)

sprain

tear of ligament

cephalic and gastric phases

tend to stimulate gastric acid secretion, while intestinal influences tend to reduce gastric acid secretion

Crohn's disease

terminal ileum is commonly involved, so bile lost with feces and impaired fat absorption. also more oxalate urinary stones

initiation of translation in prokaryotes requires a specific n-formulated methionine-tRNA

that is used to incorporate the initial methionine

lysine and leucine

the onLy pureLy ketogenic amino acids.

hepatogastric ligament

the portion connecting the lesser curvature of the stomach

wiskott-aldrich

WATER: Wiskott-Aldrich: Thrombocytopenic purpura, Eczema, Recurrent infections.

inferior thyroid artery rune adjacent to

the recurrent laryngeal nerve

Parvoviridae

the smallest DNA nucleocapsid virus, non-enveloped and single stranded

N-acetylcysteine loosens

the thick sputum by cleaving disulfide bonds within mucus glycoproteins

left kidney likes immediately deep to

the tip of the 12th rib on the left

hyperparathyroidism

thinning in the medial sides of the second and third phalanges of the hand, with salt-and-pepper appearance of the calvarium

superior mesenteric artery and uncinate process of pancreas

third part of duodenum

H. influenzae

third-generation cephalosporin such as ceftriaxone

blood in the left atrium has lower pO2 than blood in the pulmonary capillaries

this decrease is due to the admixture of deoxygenated bronchial blood with the oxygenated blood in the pulmonary veins

nuclear/retinoid X binding to DNA

this was a dirty question. They were asking for the DIRECT cause of the symptoms. In this case it was the excess T3 acting on the nuclear thyroid hormone receptors.

IVC

through diaphragm at T8

thymic cortex

thymic cortical epithelial cells--positive selection

thymic medulla

thymic medullary epithelial and dendritic cells--negative selection for high affinity to self

pharyngeal pouch 3

thymus, inferior parathyroid glands

amiodarone adverse effects

thyroid dysfunction, lung fibrosis, and liver toxicity, as well as blue/grey discoloration of the skin

tyrosine

thyroxine, melanin

unconjugated bilirubin

tightly bound to serum albumin, cannot be excreted in urine (or feces)

latency

time elapsed from initial exposure to clinically apparent disease

angiotensin II constriction

to INCREASE blood pressure. when too much fluid, AT will decrease

G-protein to phospholipase C

to IP3, to Ca+2, to protein kinase C, to phosphorylated effects

Alcohol dehydrogenase

to acetaldehyde in the cytosol, to acetate in the mitochondria. produces NADH

left dominant heart

to get to diaphragmatic surface and AV node of the heart...left coronary, circumflex, posterior interventricular (posterior descending)

aspartate is transaminated with alpha ketoglutarate

to produce glutamate and oxaloacetate

C3 deficiency predisposes

to recurrent infections with encapsulated organisms

AV shunts decrease

total peripheral resistance and afterload

ingestions

toxoplasmosis eggs

displacement

transfer of feelings to a more acceptable object

factor XIII

transglutaminase that cross links fibrin polymers to stabilize clots

PAN

transmural inflammation of the arterial wall with segmental, necrotizing inflammation of medium to small sized arteries. peak incidence in young adults

overdosed Beta-blockers

treat with glucagon, increasing heart rate and contractility, causing activation of adenylate cyclase and raising intracellular cAMP that release calcium and increases sinoatrial node firing

daytime sleepiness

treat with modafinil

Actinomyces

treat with penicillin, while treat nocardia with sulfonamides

adrenal crisis

treat with stress-dose corticosteroids

malignant hyperthermia after administration of anesthetics

treated with dantrolene that blocks ryanodine receptors and prevents release of Ca into the cytoplasm of skeletal muscle fibers

INFalpha

treatment of Hep B and C virus infection, hairy cell leukemia, condyloma acuminatum, and Kaposi's sarcoma

doxasozin, prazosin, terazosin

treatment of benign prostatic hyperplasia and hypertension

Lesch-Nyan

treatment with allopurinol. HGPRT: Hyperuricemia Gout Pissed off (aggression, self-mutilation) Retardation (intellectual disability) DysTonia

vitamin B12 deficiency

treatment with with folate alone can worsen neurologic dysfunction

pentamidine

treats Pneumocystis jiroveci pneumonia in HIV-positive patients, leishmaniasis, and African sleeping sickness

TMP

treats marrow poorly

flutamide

treats prostate cancer, competitive androgen inhibitor

holosystolic murmurs

tricuspid regurgitation, mitral regurgitation, and ventricular septal defects

first arch

trigeminal nerve (CN 5), maxilla, zygoma, mandible, vomer, palatine, incus, and malleus

partial moles

triploid genome from dispermy or duplication of the paternal chromosomes, often contain fetal parts

when Ca+2 binds troponin C,

tropomycin shifts to expose the actin binding sites for myosin, allowing contraction to occur

sensitivity

true positive /TP + FN

live attenuated vaccine

tuberculosis and oral typhoid vaccines

Krukenberg

tumor of the ovary metastasis of gastric adenocarcinoma

Prader Willi

two copies of the maternal chromosome 15

Angelman syndrome

two copies of the paternal chromosome 15

cyclosporin and tacrolimus

two immunosuppressants in kidney transplant patients that inhibit calcineurin activation. prevent IL-2 transcription

labetalol

tx for refractory hypertension, pheochromocytoma, alpha and beta adrenergic receptors blocked leading to decreased peripheral vascular resistance, heart rate, contractility, and slowed AV conduction

hypoalderosteronism

type IV renal tubular acidosis

right ventricular afterload

typically increased in COPD due to chronic pulmonary hypertension

phenylalanine

tyrosine, dopa, dopamine

Parkinson's and Alzheimer's

ubiquitin-protease system impairement

projection

unacceptable impulses or drives are attributed to others

mesothelioma

unilateral pleural thickening or mass with a large pleural effusion

elastin's plasticity

unique form of desmosine crosslinking between four different lysine residues on four different elastin chains

Shine-Dalgarno

unique to prokaryotes, six to ten bases upstream from AUG

syringomyelia

upper and lower MOTOR AND SENSORY neurons

ALS

upper and lower motor neurons

MCA

upper limb vs ACA lower limb

statins

upregulated LDL receptors

mitral regurgitation

upsloping left atrial v-wave

arginine +aspartate

urea

phenazopyridine

urinary analgesic that provides symptomatic relief of dysuria

BPH

urinary tract infection

theophylline

used in asthma; inhibits cyclic AMP phosphodiesterase

dopamine

used in treatment of shock and refractory cardiac failure

INF Gamma

used to treat mycobacterial infections (lack of IL12 means not granulomatous immune response)

flucytosine

used with amphotericin B to treat cryptococcal meningitis. inhibits synthesis of DNA and RNA

rasburicase

useful in treating hyperuricemia and the resulting renal manifestations of tumor lysis syndrome

TTP-HUS

usually do not bleed, only platelets are activated, normal PT and PTT, normal fibrinogen

HUS

usually occurs in children and has predominant renal involvement

paramesonephric ducts

uterine tubes, uterus, cervix, and superior 1/3 of the vagina. mesonephros = men

palatoglossal

vagus nerve

stomach attached to lower pharynx

vagus nerve must be severed

tertiary syphilis

vaso vasorum endarteritis. can result in thoracic aneurysm.

VI receptor

vasoconstriction and prostaglandin release

nitroprusside

vasodilator to improve forward stroke volume (FSV)

lung apex to base

ventilation and perfusion increases. V/Q decreases

small cell carcinoma is

very aggressive...mostly distant metastases at the time of diagnosis. surgery not indicated

V. cholerae

very sensitive to gastric acidity

gentamicin

vestibular and cochlear ototoxicity, nephrotoxicity, and neuromuscular paralysis

LGN

vision, CNII (lateral - light)

homocyteine to methionine

vit B12

cystathionine synthetase

vit B6

chronic renal failure

vit D decreased, high PTH, high calcitonin despite low Ca+2 bc excretion is impaired

warfarin levels go down

vit K deficiency by depletion of gut flora on warfarin

European who is lemon colored (anemia and icteric) and with broad-based shuffling gate

vitamin B12 deficiency

hypertonic saline infusion

volume and osmotic increase in ICF and ECF

GI hemorrhage

volume loss of ECF, no loss in ICF

diabetes inspidius

volume loss of ICF and ECF, osmolarity increase ICF and ECF

left lateral corticospinal tract

voluntary motor

to prevent serotonin syndrome

wait 2 weeks after MAO inhibitor stopping to initiate SSRI

VIPomas

watery diarrhea, hypokalemia, achlorhydria

median nerve

weakness of thumb abduction

pulmonary embolism

wedge-shaped, red "hemorrhagic infarcts" from bronchial blood hemorrhages

olanzapine

weigh gain, atypical antipsychotic

beneficence

what is in the patient's best interest

RER cytoplasm

where the proteins are glycosylated for export

E. coli produces B-galactosidase

which breaks down lactose into glucose and galactose

inheritance of an amplified CYP2D6 locus

why nortriptyline doesn't work

virulent mycobacterium TB

will grow serpentine cords on enrighed media, that causes neutrophil inhibition, mitochondrial destruction, and the induced release of tumor necrosis factor

dermatitis herpetiformis

with Celiacs disease, small vesicles that occur on extensor surface

patent ductus arterioles decreases

with decreased prostaglandin E2 and increased oxygen concentration. older patients require surgical ligation

lac operon activated

with increased of cAMP; inhibited by glucose that neither binds to repressor protein or promotor

warfarin induced skin necrosis

with pt with protein C deficiency. relative hypercoagulable state with thrombotic occlusion of the microvasculature and skin necrosis

vasovagal syncope

withdrawal of sympathetic efferent activity and enhanced parasympathetic vagal activity, which results in bradycardia, vasodilation, and orthostatic hypotension

regional airway resistance

within the first 10 generations of bronchi contributes to most of the total airway resistance of the lower respiratory tract. maximal resistance in 2nd-5th generation airways.

universal prenatal screening for group B strep colonization

women who require INTRAPARTUM antibiotics most frequently with penicillin or ampicillin to prevent neonatal GBS sepsis

pyrazinamide (PZA)

works best at acidic pH...most bactericidal to M. tuberculosis organisms engulfed by macrophages

N-acetylcysteine

works in acetaminophen overdose by enhancing glutathione production and conjugation of the toxic NAPQI metabolite

first-dose hypotension

worry when starting ACE inhibitor

hypokalemia

worsens digoxin toxicity

Tetanus toxin

wound--> motor neuron axons--> spinal cord

hemophilia B

x-linked recessive Factor 9 deficiency

allopurinol

xanthane oxidase inhibitor, chronic gout along with febuxostat

defects in DNA repair enzymes

xeroderma pigmentosum, ataxia-telangiectasia, Fanconi's anemia, and Bloom syndrome

pulmonic regurgitation

yields early diastolic murmur that starts with S2

metabolic acidosis with resp alkalosis compensation

you are trying to compensate for the acidosis and how can you do that...squirt some H+ into the lumen which can then be made to NH4Cl(titratable acid) and you urinate it out. The girl did indeed overdose on opiods, what else out of those options would cause resp depression? I guess she was taking the opiods for pain from the MS.

alpha error

you saw a difference that did not exist (ex. convicting an innocent man)

beta error

you were blind to a difference that did exist

lead poisoning

δ-aminolevulinic acid dehydratase and ferrochetalase

leuprolide (GnRH analogue)

-she is suffering from central precocious puberty due to an increase, this is determined by the fact that the IV GnRH caused an increase in LH but not FSH. Normally in a prepubertal child, FSH should rise a lot more than LH -Treatment, continuos GnRH which causes LH/FSH to be stopped.

histamine

...

gastrointestinal

....the patient is exposed to high levels of radiation and this causes acute radiation syndrome Stages of Acute radiation Syndrome 1) prodrome...nausea, vomiting, anorexia, fatigue, diarrhea, abdominal cramping, and dehydration which are GIT Symptom 2) clinical latency, 3) manifest illness, and 4) recovery or death

MI post

0-4hrs minimal change, 4-12hours early coagulation necrosis and neutrophil infiltrate, 5-10 days macrophage phagocytosis of dead cells, 10-14 days neovascularization and granulation tissue, 2 weeks to 2 months collagen/scar formation

azathioprine

Antimetabolite precursor of 6-mercaptopurine. Inhibits lymphocyte proliferation by blocking nucleotide synthesis. 6-MP degraded by xanthine oxidase; toxicity increased by allopurinol.

vit E (tocopherol/tocotrienol)

Antioxidant (protects erythrocytes and membranes from free radical damage). E is for Erythrocytes. Can enhance anticoagulant effects of warfarin.

Wiscott Aldrich

B and T cell syndrome

CD22

B cell ALL (with TDT marker)

Rituximab

B cell non-Hodgkin lymphoma, targets the CD20 B-cell marker

acute asthma

B-agonist produces relaxation of bronchial smooth muscle via B2. receptor is a Gs protein coupled receptor that activates adenylyl cyclase and increases intracellular cAMP.

lac z

B-galactosidase

pulmonary artery hypertension

BMPR2 gene first insult, second insult activates the disease process resulting in vascular smooth proliferation in the pulmonary vasculature and elevated pulmonary pressures

follicular lymphomas

Bcl-2 mutations

Collagen

Be (So Totally) Cool, Read Books. 1. Bone, Skin, Tendon 2. Cartilage 3. Reticulin, blood vessels 4. Basement membrane

Direct agonists

Bethanechol Carbachol Pilocarpine Methacholine (asthma test)

X-linked diseases

Bruton agammaglobulinemia, Wiskott-Aldrich syndrome, Fabry disease, G6PD deficiency, Ocular albinism, Lesch-Nyhan syndrome, Duchenne (and Becker) muscular dystrophy, Hunter Syndrome, Hemophilia A and B, Ornithine transcarbamylase deficiency.

5OS inhibitors

C = Chloramphenicol, Clindamycin [bacteriostatic] E = Erythromycin (macrolides) [bacteriostatic] L = Linezolid [variable]

RS cells

CD15, CD30

Leukocyte adhesion deficiency

CD18 defect

leukocyte adhesion deficiency

CD18 defect

ureas-positive bugs

CHuck Norris hates PUNKSS. Cryptococcus, H. pylori, Proteus, Ureaplasma, Nocardia, Klebsiella, S. epidermidis, S. saprophyticus.

cardiac output

CO = HR * SV

EBV gp350 BINDS TO

CR2 or CD21 normally on B-cells. Thus CD21 antibody could interfere with attachment of EBV to cells.

carotid massage

Carotid Massage - Increased Cardiac Parasympathetic activity to slow down AV conduction

shine light in L eye, what happens to right eye

Central retinal artery occlusion, no constriction because retinal ganglion cells in the left eye have been destroyed.

Slow fermenters

Citrobacter, Serratia

coarctation of the aorta

Coartation of the aorta: Infantil type ( preductal) aortic stenosis proximal to insertion of ductus arteriosus. Adult type: ( postductal) stenosis is distal to ductus arteriosus. Associated with notching ribs (due to collateral circulation), hypertension in upper extremities, weak pulses in lower extremities. Associated with Turner syndrome.

ras gene

Colon cancer, lung cancer, pancreatic cancer, GTPase

leptin decreases hunger

1. less neuropeptin Y 2. more ROMC and alpha-MSH

Gluconeogenesis irreversible enzymes

1. pyruvate carboxylase, 2. PEP carboxylase, 3. Fructose 1,6 Bisphosphatase, 4. Glucose 6 phosphatase

elastin vs collagen

1. very few proline and lysine residues are hydroxylated in elastin, 2 elastin doesn't form triple helices, 3 triple helix formation in collagen is initiated by hydroxylation, glycosylation, and interchain disulfide bridges at the C-terminus of procollagen molecule

early signs of coagulative necrosis

4 hrs after MI

DNA synthesis always occurs in the

5' to 3' direction on both strands

carcinoid tumor

5-HIA is the breakdown product of serotonin

stranger anxiety

6 months

hypertrophy

650 grams

Mumps

A paramyxovirus. Symptoms: Parotitis A , Orchitis (inflammation of testes), and aseptic Meningitis. Can cause sterility (especially after puberty).

APE

A site = incoming Aminoacyl-tRNA. P site = accommodates growing Peptide. E site = holds Empty tRNA as it Exits.

arterial PCO2

A..... DKA.....metabolic acidosis...repiratory alkalosis(compensation) ..so decrease PCo2

speed of hemoglobin mvmts

A> S> C

pertussis toxin

AB exotoxin that stimulates intracellular G-proteins to increase cAMP production, leading to increased insulin production and neutrophil dysfunction

allergic Aspergillus fumigatus

ABPA

patients with renal artery stenosis

ACE inhibitor can cause acute renal failure. require ACE to maintain renal perfusion and GFR

NF1

AD, ch17, neurofibromin gene

NF2

AD, ch22, merlin gene

supraoptic

ADH

supraoptic

ADH formation

lead poisoning

ALA dehydratase and ferrochetalase

Krabbe disease

AR, galactocerebrosidase

30S inhibitors

AT = aminoglycosides, tetracycline

normal skeletal muscle twitches

ATP is quickly regenerated from creatine phosphate...ATP concentration doesn't fall appreciably

adenocarcinoma of the endometrium

Adenocarcinoma of the endometrium: Carcinoma endometrial is the Most common gynecologic malignancy. peak occurrence at 55-65 year of age. Clinically presents with vaginal bleeding. Typically proceeded by endometrial hyperplasia. Risk factors include prolonged use of estrogen without progestins, obesity, diabetes, hypertension, nulliparity and late menopause. Increase myometrial invasion, decrease prognosis. (FA page 487)

ARDS

Also, for the first question I understand why the answer would be DLCO, due to Neutrophil damage resolution with fibrosis. But wouldn't you also have increased surfactant due to pneumocyte regeneration? I guess the key is the question says it's been a year, and surfactant is more likely to be increased in the acute phase of resolution.

aluminum hydroxide

Aluminimum amount of feces. (constipation)

GAG

Amino acids necessary for purine synthesis: Glycine Aspartate Glutamine

obligate anaerobes

Anaerobes Can't Breathe Air Clostridium, Bacteroides, and Actinomyes

clomiphene

Antagonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and increases release of LH and FSH from pituitary, which stimulates ovulation. Used to treat infertility due to anovulation (e.g., PCOS). May cause hot flashes, ovarian enlargement, multiple simultaneous pregnancies, and visual disturbances.

glycolysis

F2,6,BP induces PFK1

fasting state

F2,6BP down Pyruvate kinase down G6Pase up PEPCK up

gluconeogenesis

F2,6BP inhibits F1,6BPase and conversion of alanine to glucose

Autosomal dominant hyper-IgE syndrome (Job syndrome)

FATED: coarse Facies, cold (noninflamed) staphylococcal Abscesses, retained primary Teeth, increased IgE and DECREASED INF-gamma, Dermatologic problems (eczema).

Fragile X syndrome

FMR1 gene, with hypermethylation leading to gene inactivation. CGG

lower cutoff

FN decrease and PPV too

Lyme disease

Facial nerve palsy, arthritis, Kariac block, Erythema migrans

alcohol cell membrane

For infection control u can use physical methods and CHEMICAL METHODS... Chemical methods of control again divided into.... Agents That Damage Cell Membranes...ex-ALCOHOLS ,detergents, and phenols Agents modifying proteins..ex-chlorine ,iodine,hydrogen peroxide,formaldehyde Agents that modify nucleic acids ...ex--crystal violet and malachite green hence alcohol is for cell membranes

GAA

Friedreich ataxia = (GAA)n.

sickle cell anemia

GAIN of stabilizing hydrophobic interactions in the deoxygenated form of hemoglobin S

bacitracin sensitivity

GAS

INHIBITORY neurotransmitter

GLYCINE

autosomal dominant

Gardner's syndrome, acute intermittent porphyria,

clue cells

Gardneralla vaginalis. squamous cells covered with bacilli

doxorubicin

Generate free radicals. Intercalate in DNA--> breaks in DNA, decreases replication.

aminoglycosides

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin. "Mean" (aminoglycoside) GNATS caNNOT kill anaerobes.

rubella

German measles. face and spreads to trunk and extremities. Spreads faster than rubeola (measles) and does not darken or coalesce. postauricular lymphadenopathy. togavirus SS +RNA linear

IgA

Giardia lamblia

GP11b/IIIa is deficient or defective in patients with

Glanzmann thrombasthenia

von Gierke

Glucose-6-phosphatase

dermatomyositis

Gottron papules and heliotrope rash, anti0Jo1 antibodies

P. aeruginosa

Gram-negative, oxidase positive, non-lactose fermenting, motile rods

c-ANCA (PR3-ANCA)

Granulomatosis with polyangiitis (Wegener)

Coxsackievirus A

Group A coxsackieviruses tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis (AHC), and hand, foot and mouth (HFM) disease.

HDL of a 25 year old vs. 55 year old

HDL lower in older woman

poorer prognosis

HER2 is a growth factor receptor (just like estrogen/progesterone receptors). Therefore, overexpression of HER2 in breast cancer is associated with pathogenesis, increased disease recurrence and worse prognosis and has nothing to do with heritability of the cancer.

roseola

HHV-6

Primary CNS lymphoma

HIV patients, B-lymphocyte origin

incomplete penetrance

Here i excluded A and D cause there should have been some affected cells, then excluded variable expression cause some presentations of disease should have been present. Between B and C nonpaternity seemed stupid because they show genetic relation in pedigree plus incomplete penetrance fits perfectly. Like hemochromatosis: you can have the mutations but be symptom free all of your life skip a person in a pedigree/skips generation -> incomplete penetrance

HISTRIONIC

Histrionic think sexually provocative, attention-seeking & dramatic. Also, think vain/pre-occupied with appearance.

squamous cell carcinoma

I'm pretty sure it was squamous cell ca. I just saw vocal cord and went w/ that (although I think only true vocal cords are squamous).

right-sided endocarditis

IV drug users,

Insulin regular

IV use, diabetic ketoacidosis 2-4

asthma

Decreased FEV1, hyperinflation, increased air trapping in lungs --> asthma. The man used to be a pot head.

misoprostol

E1 prostaglandin analog used to present NASID-induced ulcer disease

Primary CNS is

EBV related and high grade tumor with poor prognosis

activate guanylate cyclase

ETEC (heat stabile) and Yersinia enterocolitica

branchial pouches

Ear, tonsils, bottom-to-top: 1 (ear), 2 (tonsils), 3 dorsal (bottom for inferior parathyroids), 3 ventral (to = thymus), 4 (top = superior parathyroids).

early onset Alzheimers

Early onset: APP (Chr 21), presenilin-1 (Chr 14), presenilin-2 (Chr 1)

Introns

Introns are intervening sequences and stay in the nucleus, whereas exons exit and are expressed.

greatest flow through the right coronary artery

Its early diastole. Think about when the pressure at the base of the aorta is highest. It is during early diastole before the pressure has a chance to be distributed to the rest of the vasculature.

external validity

Its external validity. By implementing it they are assuming its externally valid...as in they assume that the results will hold up to a larger population of people.

ApoA1

LCAT activation (cholesterol esterification)

loading dose

LD = Css x VD/F multiply by kg first. 1.81L/kg x 55kg = 99.5 , then 99.5L x 10mg/L = 995mg

xanthelasmas

LDL receptor abnormality

familial hypercholesterolemia

LDL receptor, Apo B. LDL elevated. premature coronary arter disease.

ETEC

LT activates adenylate cyclase leading to increased cAMP, ST activated guanylate cyclase leading to increased cGMP

late onset Alzheimers

Late onset: ApoE4 (Chr 19) ApoE2 (Chr 19) is protective.

leiomyoma

Leiomyoma: Multiple tumors w/ well demarcated borders. Increase incidence in blacks. Benign smooth muscle tumor. Estrogen sensitive, Increase w/ pregnancy and decrease w/ menopause. maybe asymptomatic or present w/ bleeding or result in miscarriage. Severe bleeding may lead to iron deficiency anemia, Histo: WHorled pattern muscle bundles, actin positive. treatment Leuprolide or hysterectomy.

ApoC-II

Lipoprotein lipase activation

NF1

Lisch nodules

NF1

Lisch nodules = pigmented, asymptomatic hamartomas of the iris, pseudoarthrosis

collecting duct

Lithium induced Nephrogenic Diabetes Insipidus - Collecting Tubule defect

C DIPHTH

Loeffler medium and methylene blue

low potency antipsychotics

Low potency: Chlorpromazine, Thioridazine (Cheating Thieves are low)

IL-8

Major chemotactic factor for neutrophils.

CpG Methylation

Makes DNA Mute

live attenuated vaccine

Measles, mumps, rubella, polio (Sabin), influenza (intranasal), varicella, yellow fever.

metaplasia ossificans

Metaplasia of skeletal muscle to bone following muscular trauma A . Most often seen in upper or lower extremity. May present as suspicious "mass" at site of known trauma or as incidental finding on radiography.

p-ANCA

Microscopic polyangiitis, Churg-Strauss syndrome Churg-Strauss Asthma, sinusitis, palpable purpura, peripheral neuropathy (e.g., wrist/foot drop). Can also involve heart, GI, kidneys (pauci- immune glomerulonephritis).

Drugs that act on microtubules

Microtubules Get Constructed Very Poorly): Mebendazole (anti-helminthic) Griseofulvin (anti-fungal) Colchicine (anti-gout) Vincristine/Vinblastine (anti-cancer) Paclitaxel (anti-cancer)

Marasmus

Muscle Wasting

magnesium hydroxide

Must Go to bathroom

levofloxacin

Mutation of the gene encoding topoisomerase II -> Because Levofloxacin is a fluoroquinolone.

p53 mutation

Mutation of the p53 tumor suppressive peptide is the most usual suspect underlying almost any malignancy. In particular, it is evident in almost 2/3 of pt's suffering from astrocytoma.

macrolides

Inhibit protein synthesis by blocking translocation ("macroslides"); bind to the 23S rRNA of the 50S ribosomal subunit. Bacteriostatic.

nucleoside

NucleoSide = base + (deoxy)ribose (Sugar)

Nonsense

Nucleotide substitution resulting in early stop codon. STOP the NONSENSE

CO =

O2 consumption/arteriovenous O2 difference

5-HT3 antagonist; decrease vagal stimulation. Powerful central-acting antiemetic.

Ondansetron

Hypersplenism

Only thought this because the other things didn't fit and enlarged spleen= more space to store blood cells --> decreased peripheral counts. I learned in heme that enlarged spleens can cause thrombocytopenia so it seemed close enough.

poorly soluble gas

N20 (opposite of halothane)

coagulase-positive staphylococci

NADPH oxidase test

IL-12

NATURAL KILLER CELLS

NF

NF1/2 are most certainly autosomal dominant and demonstrate variable expression (expressivity).

number needed to treat

NNT = 1/ARR

1.3

NNT=1/ARR ARR= Event rate in control group-Event rate in treatment group ARR= 2.3%-1.3% = 1%=1/100=0.01 So, 1/0.01=100

Nevirapine and Efavirenz

NON-NRTIs

basal long0acting, twice daily

NPH

Zidovudine and Stavudine

NRTIs

Obligate aerobes

Nagging Pests Must Breathe. Nordia, Pseudomonas, Myobacterium TB reactivation of M tb (after immune compromise or TNF-α inhibitor use) has a predilection for the apices of the lung, which have the highest PO2.

Indirect agonists (anticholinesterases)

Neostigmine (NO CNS penetration) Pyridostigmine Physostigmine Donepezil, rivastigmine, galantamine Edrophonium

MI right after

No visible change by light microscopy in first 2-4 hours contraction bands visible after 1-2 hours ..early coagulative necrosis after 4 hours. Release of contents of necrotic cells into blood stream and the beginning of neutrophil emigration.

E coli UTI

P pili

PED

PED - Peroneal, eversion dorsiflexion

AML t(15;17)

PML/RARalpha

ileum

Peyer's patches

prostatic adenocarcinoma

Pleomorphic epithelial cells forming duct-line structures this is adenocarcinoma of prostate gland... prostate gland cancer metastasizes to vertebrae via the venous plexus around it... B is keratin pearls of squamous cell cancer so cant be it, D is basophil u can never find a basophil in cancer, E is uniform cells, cancer is never uniform cells, they are anaplastic cells, A is agrregates of plasma cell and plasma blasts this feature is of multiple myeloma

Conduction

Poor repetition but fluent speech, intact comprehension Can't repeat phrases such as, "No ifs, ands, or buts."

actinic keratosis

Premalignant lesions caused by sun exposure. Small, rough, erythematous or brownish papules or plaques B . Risk of squamous cell carcinoma is proportional to degree of epithelial dysplasia.

Staph aureus

Protein A with Fc region of immunoglobulins

Ceftazidime

Pseudomonas

pyruvate carboxylase

Pyruvate carboxylase - the problem is that she is hypoglycemia and then with an infusion w/ glucose, it helps. - So the problem, is making glucose...hence, you need pyruvate carboxylase enzyme for gluconeogenesis. A deficiency of pyruvate carboxylase can cause lactic acidosis as a result of lactate build up. Normally, excess pyruvate is shunted into gluconeogenesis via conversion of pyruvate into oxaloacetate, but because of the enzyme deficiency, excess pyruvate is converted into lactate instead. As a key role of gluconeogenesis is in the maintenance of blood sugar, deficiency of pyruvate carboxylase can also lead to hypoglycemia

common peroneal nerve injury

Q:40 Answer: C Common peroneal nerve lesion: Due to trauma in the lateral aspect of leg or fibula neck fracture. motor deficits: Foot eversion and dorsiflexion (1/5 in this case) pain proximal fibula because fracture was on the neck, distally there will be absent pain. Plantar flexion will be good bc is done by tibial nerve (4/5 in this case)

decreased outward K current

QT prolongation

Romano-Wrd

QT prolongation, AD, no deafness

Jervell and Lange

QT prolongation, AR, with neurosensory deafness

follicular thyroid cancer

RAS gene mutations

secondary erythrocytosis

RBC increased because of EPO rise (often in high altitude or hypoxic conditions)

medullary thyroid cancers

RET-proto oncogene

RBF =

RPF/(1-Hmcrt)

relative risk reduction

RRR= ARR/control rate

wheezing

RSV

Palivizumab

RSV F protein

ribavirin

RSV bronchiolitis and hep C, nucleoside analog inhibiting synthesis of guanine nucleotides

killed vaccines

Rabies, Influenza (injected), Salk Polio, and HAV vaccines. SalK = Killed RIP Always

surface ectoderm

Rathke's ouch, lens & cornea, inner ear sensory organs, olfactory epithelium

complex partial

The question stem says "altered consciousness," and thats what rules out the other partial seizures. The patient does not have to lose consciousness but if she can't communicate while the episode is going on, then you can safely assume that it is not a simple partial. Absence is the blank stare minus any other of the symptoms listed, so you can rule that out. And generalize tonic clonic would cause the patient to literally fall off her chair and have a much more sever episode than listed above.

spinothalamic tract

The spinothalamic tract is a sensory pathway originating in the spinal cord. It transmits information to the thalamus about pain, temperature, itch and crude touch. The pathway decussates at the level of the spinal cord, rather than in the brainstem like the posterior column-medial lemniscus pathway and corticospinal tract. The cell bodies of neurons that make up the spinothalamic tract are located in the spinal ganglia. These neurons receive input from sensory fibers that innervate the skin and internal organs.

metronidazole

Trichomoniasis discharge usually has a pH greater than 5.0

repression

UNCONCIOUS removal

INF-gamma

USES: chronic granulomatous disease

mean arterial pressure also equals

[DBP + (1/3)(SBP-DBP) ]

Pompe disease

acid alpha glucosidase

niacin

acute gouty arthritis, hepatotoxicity, hyperglycemia complications

adenovirus

acute hemorrhagic cystitis outbreaks in children

Porphobilinogen deaminase

acute intermittent porphyria

defect in uroporphyrinogen 1 synthase

acute intermittent prophyria (also porphobilinogen deaminase)

OR

ad/bc

Addison's

adrenal insufficiency. autoimmune

Churg-Strauss

adult-onset asthma, eosinophilia, and pANCA

Diabetic CN III mononeuropathy

affected eye assumes a down and out position. autonomic part normal, so normal pupillary size and reactivity

Baclofen

affects GABAB receptors in spinal cord

nitroprusside

after load and preload decreased. short acting balances venous and arterial vasodilator. STROKE VOLUME MAINTAINED.

osteoblast activity INCREASES

after the stress fracture

afterload and preload on pressure-volume loop

afterload = top of curve, preload = to the right of curve

precocious puberty

age less than 7 yrs

clozapine

agranulocytosis and seizures, atypical antipsychotic

short benzo

alaprazolam, triazolam, oxazepam

galactose to galactitol

aldose reductase

biliary tract

alkaline phosphatase, gamma glutamyl transferase. bone osteoblasts also produce alkaline phosphatase, so GGTP is a good indicator.

streptomycin

aminoglycoside antibiotic that inhibits mycobacterial protein synthesis via 30S. resistant by modification of 30S ribosome structure

amikacin

aminoglycoside antibiotic, with resistance caused by aminoglycoside-modifying enzymes

highly soluble blood

amount needed to saturate blood (large), rise in blood partial pressure (slow), equilibration with the brain (slow), onset of action (slow), HIGH BLOOD/GAS PARTITION COEFFICIENT

low urinary excretion of radiolabeled B12 after administration of intrinsic factor

another cause for poor cobalamin absorption...pancreatic insufficiency, intestinal bacterial overgrowth, or ileal disease

right ventricle

anterior (sternal) surface of the heart

berry aneurysm

anterior communicating artery

clomiphene

antiestrogen

ketoconazole

antifungal agent that decreases androgen synthesis by inhibiting multiple enzyme pathways

cyproheptadine

antihistamine with anti-serotonergic properties used to treat serotonin syndrome

ipratropium

antimuscarinic agent that blocks M3 receptors in airway smooth muscle and submucosal glands

nifurtimox

antiparasitic drug used to treat Chagas' disease caused by Trypanosoma cruzi

Bcl-2

apoptosis inhibitor, implicated in follicular lymphoma (14;18)

thiazides

can cause elevation of glucose, uric acid, and calcium, and are thus not recommended for diabetic patients, patients with gout, or patients with hypercalcemia. can also cause HYPONATREMIA.

right to left shunt

can cause hypoxia but not a left-to-right shunt

methotrexate

can cause interstitial pneumonitis and fibrosis

hypocalcemia

can cause paresthesias. infused citrate in whole blood transfusions can chelate serum calcium.

Charcot Bouchard aneurysm

causes intracerebral hemorrhage, not SAH. small size and occur in patients with long-standing hypertension. hemorrhage of arterioles that supply the basal ganglia, internal capsule, and deep white matter.

myxomatous degeneration of the mitral valve

causes mitral valve prolapse, producing a click-murmur on physical exam

acute CAD

causes sudden cardiac death. prehospital cardiac arrhythmia. in-hospital V fibrillation. post hospital thromboembolism.

endogenous prostaglandin

causes uterine contraction and cervical dilation, misoprostol is a prostaglandin E1 analogue

Clostridium enterotoxin a

causes watery diarrhea

HbS polymerized at low oxygen tension

causing sickling and hemolysis

insulin increases fructose 2,6BP

causing up regulation of PFK1 and augmentation of glycolysis

50S subunit

chloramphenicol, clindamycin, linezolid, and macrolides

hemorrhagic cystitis

cyclophosphamide

systolic heart failure

decrease in ventricular contractile performance, requires an increase in both LVEDP and LVEDV to improve stroke volume

amlodipine

dihydropyridine calcium channel blocker that differs from verapamil in that amlodipine is selective for the vascular smooth muscle and doesn't affect the heart. used with vasopasm such as Raynaud phenomenon and Prinzmetal angina

pergolide

dopamine agonist

tumor lysis syndrome

elevated potassium levels can result in arrhythmias that may be fatal. uric acid can also precipitate. treat with fluid hydration and allopurinol.

digital clubbing

elevated prostaglandin E2, associated with prolonged hypoxia (lungs)

CF patients

elevated sweat chloride. phenylalanine mutation. CFTR gene on chromosome 7.

pancreas

endoderm-structure

Guillian Barre

endoneural inflammatory infiltrate

TdT+

for B and T-type ALL

Neisseria pili

for adherence to epithelial surfaces like naropharynx

narcissistic personality disorder

grandiosity, need for admiration

L/S ratio

greater than 2, fetal lung is considered mature

deoxygenated systemic blood

high oxygen content that pure coronary venous blood

addison's

hypocortisol Pigmentation is due to increased increased ACTH and you get increased ACTH when three is a low Cortisol.

NE infusion with blanching of vein

means vasoconstriction and local tissue necrosis. alpha-1 blocking agent reverses, like phentolamine

rubeola

measles. paramyxovirus. SS -RNA linear

Pearson correlation coefficient

measure strength and direction of a linear relationship between 2 variables

pulmonary capillary wedge pressure (PCWP)

measure the left atrial end diastolic pressure (LAEDP) that is equal to the LV end diastolic pressure (LVEP)

ristocetin test

measure vWF-dependet platelet aggregation. activates GP ib-IX receptors and makes them available for vWF binding. prolonged PTT with vWF deficiency

taste from base of tongue

mediated by CN9

priapism

painful and persistent erection from penis

a-agonist

phenylephrine, methoxamine. reflex increase in vagal tone, resulting in decreased heart rate and slower atrioventricular node conduction velocity

overuse of a-adrenergic agonists (vasoconstrictors)

phenylephrine, oxymetazoline. causes negative feedback resulting in decreased NE synthesis, which diminishes their effect

milrinone

phosphodiesterase isoenzyme 3 inhibitor, increasing cAMP and cardiac contractility. causes vasodilation, limiting use in hypotensive patients

tadalafil

phosphodiesterase-5 inhibitor that treats primarily erectile dysfunction

amiodarone

photodermatitis, blue-grey skin discoloration, pulmonary fibrosis, thyroid disfunction

atropine overdose

physostigmine

rhinovirus

picornavirus naked + ssRNA

GLUT 3

placenta, brain, kidney

Kazak sequence

plays a role in the initiation of translation. a mutation 3 bases upstream from the start codon in this sequence is associated with thalassemia intermedia resulting in HYPOCHROMIC, MICROCYTIC ANEMIA

obturator nerve damage

poor thigh adduction

MHC I

present endogenously synthesized antigens (viral) to CD8+ cytotoxic T cells. B2 microglobulin.

sixth pharyngeal arch and aortic arch

recurrent laryngeal branches of vagus arch. pulmonary arteries and ductus arterioles

GLUT 1

red cells, central nervous system

Neuronal injury

red neurons (12-48hrs)--> necrosis + neutrophils (24-72hrs)--> macrophages (3-5days)--> reactive gliosis + vascular proliferation (1-2 weeks)--> glial scar

displacement

redirect emotions to more acceptable target

amantadine

reduce Parkinson's tremors

capsaicin

reduced pain by decreasing substance P in peripheral nervous system

ezetimibe

reduces cholesterol absorption by intestine

diabetic ketoacidosis

regular insulin IV

beta-2

relaxation of the uterus (Tocolysis)

Left upper quadrantic anopia

right temporal lesion (MCA)

Toxoplasmosis

ring-enhancing lesions and chorioretinitis

elderly patients with dementia

risk factor for aspiration pneumonia. see dependent lung consolidation

primitive atrium

rough left and right atria

A Com

saccular (berry) aneurysm can impinge cranial nerves, leading to visual field defects

Salmonella

salmonella - prolonged fecal excretement post antibiotic

cefuroxime

second generation cephalosporin that acts against cell wall synthesis, beta-lactam antibiotic related to penicillin

olazapine

second-generation antipsychotic used in bipolar. associated with weight gain.

cavitary disease

secondary TB, upper lungs

low TSH and low T4

secondary hypothyroidism

parietal cells

secrete hydrochloric acid and intrinsic factor

eccrine

secrete watery fluid rich in sweat Na+ and Cl-, also called merocrine

phenylephrine

selective a-adrenergic agonist a1>a2

heroin toxicity

stupor, pinpoint pupils

aortic regurgitation

water-hammer pulses are a result of large pulse pressure

C. perfringens

watery diarrhea

skeletal muscle

RyR1 calcium channels present within the sarcoplasmic membrane allow release of calcium in response to L-type calcium channels present on the cell membrane. HOWEVER, LITTLE INFLUX OF CALCIUM THROUGH L-TYPE CALCIUM CHANNEL

agranulocytosis

SE of methimazole or PTU

encapsulated bacteria

SHiNE SKiS Streptococcus pneumoniae, Haemophilus influenzae type B, Neisseria meningitidis, Escherichia coli, Salmonella, Klebsiella pneumoniae, and group B Strep.

encapsulated organisms

SHiNE SKiS): Streptococcus pneumoniae Haemophilus influenzae type B Neisseria meningitidis Escherichia coli Salmonella spp. Klebsiella pneumoniae Group B Streptococci

small cell carcinoma

SIADH, with euvolema hyponatremia bc the natriuretic peptides lead to sodium excretion in the urine

HTS III

SLE Polyarteritis nodosa Poststreptococcal glomerulonephritis Serum sickness Arthus reaction (e.g., swelling and inflammation following tetanus vaccine) Can be associated with vasculitis and systemic manifestations

H2S production, oxidase negative

Salmonella and Proteus

tuberous sclerosis

Seizures, Cardiac Rhabomyoma - Tuberous Sclerosis

outer membrane (gram -)

Site of endotoxin (lipopolysaccharide [LPS]); major surface antigen. Lipid A induces TNF and IL-1; O polysaccharide is the antigen.

limbic system

Structures include hippocampus, amygdala, fornix, mammillary bodies, and cingulate gyrus. Responsible for Feeding, Fleeing, Fighting, Feeling, and Sex.

cutaneous facial angiomas, skull tram-track calcifications

Sturge-Wever syndrome

Strep viridans

Subacute endocarditis, most frequently in patients with preexisting valvular abnormality

Release of TSST-1 (which is a superantigen) Activates T-lymphocytes= which release IL-2 and INF- gamma= activate macrophages= which release TNF-alpha, IL- 1= causing shock, fever, hypotension , rash

TSST

weak upper extremity pulses

Takayasu arteritis, aorta and proximal branches

Tay-Sax

Tay-SaX lacks heXosaminidase.

hypersensitivity type 1

Anaphylaxis (e.g., bee sting, some food/drug allergies) Allergic and atopic disorders (e.g., rhinitis, hay fever, eczema, hives, asthma)

renal mediated hyperconstriction

Angiotensin released from the lungs so dd. pulmonary vasculature

noncompetitive antagonist

Answer should be D. Coz at the highest concentration the drug Y decreases the Vmax of the drug response. Only non-competitive irreversible inhibitors do that.

familial dysbetalipoproteinemia

Apo E. Chylomicron and VLDL remnants elevated. prematures coronary artery disease

familial hypercholesterolemia, type II

ApoB-100. elevated LDL. premature coronary artery disease.

familial chylomicronemia, type I

ApoC-II. elevated chylomicrons. acute pancreatitis. LIPOPROTEIN LIPASE DEFICIENCY. auto recessive

familial dysbetalipoproteinemia, type III

ApoE. elevated chylomicron and VLDL remnants.

late onset Alzheimer's

Apolipoproteinemia E

Apgar score

Appearance, Pulse, Grimace, Activity, and Respiration. score less than 4 increases risk that child will develop long-term neurological damage

aspartate and glutamine

Aspartate & GLUTAMINE donate NH4 ( amonia ) in renal ammoniaagenesis

muscarinic antagonist

Atropine, homatropine, tropicamide Benztropine Scopolamine Ipratropium, tiotropium Oxybutynin, darifenacin, and solifenacin Glycopyrrolate

increased gastrin

Autoimmune Metaplastic Atrophic Gastritis (AMAG) is an inherited form of atrophic gastritis characterized by an immune response directed toward parietal cells and intrinsic factor.[1] The presence of serum antibodies to parietal cells and to intrinsic factor are characteristic findings. The autoimmune response subsequently leads to the destruction of parietal cells, which leads to profound hypochlorhydria (and elevated gastrin levels). The inadequate production of intrinsic factor also leads to vitamin B12 malabsorption and pernicious anemia. AMAG is typically confined to the gastric body and fundus.

HTS II

Autoimmune hemolytic anemia Pernicious anemia Idiopathic thrombocytopenic purpura Erythroblastosis fetalis Acute hemolytic transfusion reactions Rheumatic fever Goodpasture syndrome Bullous pemphigoid Pemphigus vulgaris Disease tends to be specific to tissue or site where antigen is found

AD diseases

Autosomal dominant polycystic kidney disease (ADPKD) Familial adenomatous polyposis Familial hypercholesterolemia Hereditary hemorrhagic telangiectasia Hereditary spherocytosis Huntington disease Marfan syndrome Multiple endocrine neoplasias (MEN) Neurofibromatosis type 1 (von Recklinghausen disease) Neurofibromatosis type 2 Tuberous sclerosis von Hippel-Lindau disease

Type II hyper- triglyceridemia

Autosomal dominant. Hepatic overproduction of VLDL. Causes pancreatitis.

propranolol

B1 B2 antagonist. leaves a1 epinephrine effect alone (vasoconstriction increases), while blocking B effects (heart rate doesn't increase)

pulmonary artery hypertension

BMPR2 gene

hereditary

BRCA1 is tumor suppressor gene. Therefore, it's inactivation will lead to cancer. But for it be hereditary it has to be a germline inactivation.

ampicillin

Beta lactamase production

Ethosuximide

Blocks thalamic T-type Ca2+ channels

Bordet-Gengou

Bordetella pertussis

giant cell arteritis

C3 and IgA deposition

Huntington disease

CAG. decreased GABA and ACh

CARnitine

CARnitine = CARnage of fatty acids.

CMV infection

CMV infection (virus-->elevated lymphos)

CML

CMl RX - Imatinib. BCR-ABL 9:22 shortness of breath, fatigue, cough, lymphocytes neutrophils are 47%

entacapone

COMT inhibitor that prolongs the effects of levodopa treatment in patients with Parkinson disease

platelets predominantly express

COX2. So selective COX2 inhibitors do not impair platelet function

myotonic dystrophy

CTG, autosomal dominant. sustained muscle contraction and weakness, cataracts, frontal balding

increase warfarin levels

CYP450 inhibitors: erythromycin, clarithromycin, cimetidine, ciprofloxacin, and azole antifungals

cytarabine

CYTarabine cause panCYTopenia. inhibition of DNA polymerize and used in lymphomas, leukemias.

cyclosporine

Calcineurin inhibitor; binds cyclophilin. Blocks T cell activation by preventing IL-2 transcription.

cyclosporine

Calcineurin inhibitor; binds cyclophilin. Blocks T cell activation by preventing IL-2 transcription. Nephrotoxicity

carbonic anhydrase inhibitor

Carbonic anhydrase inhibitor. Causes self- limited NaHCO3 diuresis and decreases total-body HCO3− stores.

DQ2/DQ8

Celiac disease

chemokine receptor

Chemokine receptor CCR5 acts as a coreceptor that enables the HIV virus to enter cells. Deletion of both of the genes that code for this receptor= Resistance to HIV infection. Deletion of one allele= Delayed manifestation of the disease in infected indiv.

inactivated or killed vaccine

Cholera, hepatitis A, polio (Salk), influenza (injection), rabies.

Gluconeogenesis, irreversible enzymes

1. Pyruvate carboxylase (B7, ATP activated by acetyl coA) 2. Phosphoenolpyruvate carboxykinase (GTP) 3. Fructose-1,6- bisphosphatase (citrate positive, fructose 2,6,bisphosphate negative) 4. Glucose-6- phosphatase

...

1. Simple partial (consciousness intact)— motor, sensory, autonomic, psychic 2. Complex partial (impaired consciousness) 3. Absence (petit mal)—3 Hz, no postictal confusion, blank stare 4. Myoclonic—quick, repetitive jerks 5. Tonic-clonic (grand mal)—alternating stiffening and movement 6. Tonic—stiffening 7. Atonic—"drop" seizures (falls to floor); commonly mistaken for fainting

anastomosis (portal-systemic)

1. left gastric-esophageal 2. paraumbilical-small epigastric veins 3. superior rectal-middle/inferior rectal

totally resistance for vessels in parallel

1/rtot = 1/r1 + 1/r2....

isosorbide dinitrate

100% bioavailable when taken by the oral route

competitive agonist

14 -A competitive antagonist cause a parallel shift to the right in the dose response curve for the agonist

Prader-Willi syndrome

15 q deletion

Pott's disease

17 YO boy 4 month hx of low back pain, night sweats, 9 lb weight loss. No other PMH, immigrated from india. Appears chronically ill and cachectic. 5'3 100 lbs BMI 18 - severe tenderness over L1 spinous process posteriorly, passive movement of hip limited due to pain. in addition it can go to the lumbar vertebrae, and cause what is known as "Pott's vertebrae", which is the answer - "TB abscess of the spine".

sodium channel binding strength

1C > 1A > 1B

aortic arches

1st arch is maximal. Second = Stapedial. C is 3rd letter of alphabet. COMMON CAROTID 4th arch (4 limbs) = systemic. 6th arch = pulmonary and the pulmonary-to- systemic shunt (ductus arteriosus).

1st generation H1 blocker

1st generation H1 blocker side effect - sedation drowsy

cardiogenic shock

2. Cold extremities rules out neurogenic and septic shock. That leaves you with cardiogenic, hypovolemic, and anaphylactic. I think I picked anaphylactic too, but you'd expect to see skin involvement (hives) and bronchospasm. That leaves you between cardiogenic and hypovolemic. The JVD and pulmonary edema are more consistent with cardiogenic, which I believe is the correct answer.

postpartum depression

2weeks-12months

CCA

3' end of tRNA. Can Cary Amino Acids

amino acid binds to

3'CCA tRNA acceptor site

separation anxiety

9 months

net filtration pressure

= (Pc -Pi) - (sigc - sigi)

loading dose

= (Vd x Cpss)/(bioavailability fraction)

half-life

= (Volume d x 0.7)/CL

Power

= 1- beta

Absolute risk reductions

= Event Rate(control) - Event Rate(treatment)

RR

= [(a/a+b)/(c/c+d)]

standard error of the mean (SEM)

= z* SD/(square root of n). z is 1.96 for 95% and 2.58 for 99%

C. difficile toxins

A (enterotoxin) and B (cytotoxin) inactivate Rho-regulator proteins involved in actin cytoskeletal structure, disrupting intercellular tight junctions

misoprostol

A PGE1 analog. increases production and secretion of gastric mucous barrier, decreases acid production.

transformation

A feature of many bacteria, especially S. pneumoniae, H. influenzae type B, and Neisseria (SHiN)

Duchenne

A muscle fiber X-linked frameshift mutation-> truncated dystrophin protein-> accelerated muscle breakdown. Dilated cardiomyopathy is common cause of death. duchenne = deleted dytrophin

Wernicke

Fluent aphasia with impaired comprehension Wernicke is Wordy but makes no sense. Wernicke = "What?"

fomepizole

Fomepizole—inhibits alcohol dehydrogenase and is an antidote for methanol or ethylene glycol poisoning.

Common peroneal (L4-S2)

Foot drop—inverted and plantarflexed at rest, loss of eversion and dorsiflexion. "Steppage gait." Loss of sensation on dorsum of foot.

Triple expansions

Fragile X syndrome = (CGG)n. Friedreich ataxia = (GAA)n. Huntington disease = (CAG)n. Myotonic dystrophy = (CTG)n.

Sabouraud agar

Fungi

glutamate

GABA

baclofen

GABAb receptor agonist

Gilbert Syndrome

GILBERT SYNDROME produces an elevated level of unconjugated bilirubin in the bloodstream but normally has no serious consequences. Mild jaundice may appear under conditions of exertion, stress, fasting, and infections, but the condition is otherwise usually asymptomatic.

metronidazole

Giardia lamblia, Entamoeba histolytica, and Trichomonas vaginalis

Coxsackievirus B

Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis (inflammation of the liver not related to the hepatotropic viruses). Coxsackie B infection of the heart can lead to pericardial effusion. Muffled heart sounds and pulsus paradoxus are signs of this.

Factor V (NAD+) and X (hematin)

H. influenzae

statin inhibits

HMG-coA reductase

benign prostatic

HYPERPLASIA

Cushing's

HYPERPLASIA of the adrenal medulla.

Fungi

Histo hides (within macrophages) Blasto buds broadly Coccidio crows

avidity and affinity

However "avidity" is different from "affinity" as avidity is the sum of total strength of binding of more than one molecules to ligands. The difference between them is that affinity is the binding strength of one molecule site to its ligand, but avidity and affinity are correlated.

Hunters

Hunters see clearly (no corneal clouding) and aggressively aim for the X (X-linked recessive).

loss of GABA

Huntington's disease. CAG on HD gene chromosome 4.

Hyatidiform moles

Hyatidiform Mole - Partial 1 egg two sperm 69XXY vs paternal complete 46XX 2 sperm no egg

iron deficiency anemia

Iron deficiency anemia = MCV is low and hypochromic picture

polycythemia vera

JAK2 V617F mutation

Jones criteria for rheumatic fever

JOINTS- polyarthritis myocarditis nodules (subcutaneous) erythema marginatum sydenham chorea

CN V lesion

Jaw deviates toward side of lesion due to unopposed force from the opposite pterygoid muscle.

Kwashiorkor

Kwashiorkor results from a protein- deficient MEAL: Malnutrition Edema Anemia Liver (fatty)

peroxisomes

LCFA - peroxisomes Membrane-enclosed organelle involved in catabolism of very-long-chain fatty acids, branched-chain fatty acids, and amino acids.

ApoB-100

LDL particle uptake by extra hepatic cells

acute pericarditis

Commonly presents with sharp pain, aggravated by inspiration, and relieved by sitting up and leaning forward. Presents with friction rub. ECG changes include widespread ST-segment elevation and/or PR depressio

Shigella

M cells of Peyer's patches

chromosome 16 inversion is observed in

M4Eo subtype of AML

potency is inversely proportional to

MAC

Macrolide SE

MACRO: Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT, acute Cholestatic hepatitis, Rash, eOsinophilia. Increases serum concentration of theophyllines, oral anticoagulants.

phenylzine

MAO, prevents degradation of tyramine amine (serotonin, NE)

ret gene

MEN 2A and 2B, tyrosine kinase

abetalipoproteinemia

MTP mutation, thorny red blood cells (acanthocytes), and multiple neurologic abnormalities, foamy greasy stools, APO-B deficiency (forming chylomicrons and VLDL)

treatment of Crohn's

Corticosteroids, azathioprine, methotrexate, infliximab, adalimumab

cyclophosphamide

Covalently X-link (interstrand) DNA at guanine N-7. Require bioactivation by liver.

classic homocystinuria

Cystathionine synthase deficiency (treatment: decreased methionine, increased cysteine, increased B12 and folate in diet) (AR) elevated homocysteine in urine, intellectual disability, osteoporosis, tall stature, kyphosis, lens subluxation (downward and inward), thrombosis, and atherosclerosis (stroke and MI).

vancomycin resistance

D-ala-D-ala to D-ala-D-lac

b anthracis capsule

D-gutamate instead of polysaccharide

squatting and passive leg raise

DECREASE MVP and HCM

alpha-2 adrenergic, somatostatin

DECREASES INSULIN

disulfram

Disulfiram—inhibits acetaldehyde dehydrogenase (acetaldehyde accumulates, contributing to hangover symptoms).

VZV

Double Stranded DNA genome

Cytoskeleton defect

Duchenes/Beckers - Cytoskeleton defect

pku

Due to ↓ phenylalanine hydroxylase, or ↓ tetrahydrobiopterin cofactor. Thyrosine becomes essential. Findings: mental retardation, growth retardation, seizures, fair skin, eczema, musty body odor. Treatment: ↓ phenylalanine ( contained in aspartame, eg, Nutrasweet) and thyrosine in diet. ( FA page 107)

X-linked DOMINANT

Hypophosphatemic rickets—formerly known as vitamin D-resistant rickets. Inherited disorder resulting inphosphate wasting at proximal tubule. Results in rickets-like presentation.

Protein Synthesis Initiation

Eukaryotes: 40S + 60S = 80S (Even). PrOkaryotes: 30S + 50S =70S (Odd)

T-lymphocytes

I believe t cells is the right answer. I can't remember, but I believe they are the only ones that have regulatory cells that can tone down the immune response. Correct me oh Gods of SDN if I have misspoketh. Chalamdia is an intracellular organism so you would need cell mediated immunity to eliminate it.

Gardnerella vaginalis

I don't have a clue why I smell fish in the vagina garden!

HSV encephalopathy

I don't know the exact difference b/w encephalitis and encephalopathy but i don't think it's beyond what a google search could uncover. The answer, it seems to me anyway, is HSV encephalitis. He's 24... no history of trauma in question stem (so not subdural), no history of HIV (so not HIV encephalitis or toxo most likely), no other evidence of meningitis etc...

succinylcholine

I think E is the correct answer. Succinylcholine choline can cause malignant hyperthermia which is characterized by muscle rigidity, hyperthermia, hypertension, acidosis and hyperkalemia.

perforated viscus

I think I saw some air in the peritoneum on the CXR. Might have been hallucinating but I went with perforated viscus because I thought some of the contents might have irritated the diaphragm, leading to the shoulder pain.

rhinovirus

ICAM1 (CD54)

tight-binding in leukocyte extravasation

ICAM1, exploited by rhinovirus

Hot T-bone stEAK

IL-1: fever (hot). IL-2: stimulates T cells. IL-3: stimulates bone marrow. IL-4: stimulates IgE production. IL-5: stimulates IgA production. IL-6: stimulates aKute-phase protein production.

beta-2 adrenergic

INCREASES INSULIN

exudate

Exudate...An exudate is any fluid that filters from the circulatory system into lesions or areas of inflammation. it will contain some or all plasma proteins, white blood cells, platelets and (in the case of local vascular damage) red blood cells protein rich....specific gravity >1020

ventral posteromedial nucleus (VPM)

Face sensation and taste (makeup on face)

Carbapenems

Imipenem is a broad-spectrum, β-lactamase- resistant carbapenem. Always administered with cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules. With imipenem, "the kill is lastin' with cilastatin."

Churg-Strauss

First one is Churgg-Strauss syndrome. It has a peripheral neuropathy that manifests as foot/wrist drop, and is one of the p-ANCA vasculitides. It's in FA.

CD16

NK cells

Transcortical

Nonfluent aphasia with good comprehension and repetition

Global

Nonfluent aphasia with impaired comprehension. Both Broca and Wernicke areas affected.

Broca

Nonfluent aphasia with intact comprehension. Broca Broken Boca (boca = mouth in Spanish).

Mixed transcortical

Nonfluent speech, poor comprehension, good repetition.

inferior vena cava

Normal portal pressure is generally defined between 5 and 10 mm Hg. However, once the portal pressure rises to 12 mm Hg or greater, complications can arise, such as varices and ascites.

atypical antipsychotic

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone.

organophosphate poisoning

Organophosphate poisoning -Atropine first/Pralidoxime second

ovarian artery

Ovarian artery: the ureters are posterior to the ovarian arteries at that level. likely to be ligated

membranous nephropathy

Membranous Glomerulonephritis: LM -diffuse capillary and GBM thickening. EM " spike and dome" appearance with subepithelial deposits. IF - granular. Caused by drugs ( penicillamine, Gold, NSAID). Most common cause of adult nephrotic syndrome. The closely related terms membranous nephropathy[1] and membranous glomerulopathy[2] both refer to a similar constellation but without the assumption of inflammation. Some patients may present as nephrotic syndrome with proteinuria, edema with or without renal failure. Others may be asymptomatic and may be picked up on screening or urinalysis as having proteinuria. A definitive diagnosis of membranous nephropathy requires a kidney biopsy.

methanol overdose

Methanol OD? treat with methanol to block ALC Dehydo to prevent formaldehyde/formic acid. Ethanol ---> Oxalic

azole resistance

MoA of azoles antifungals: inhibit fungal Sterol: erogosterol synthesis---> impairs lipid synthesis... Inhibit p450 dependent enzyme 14-alpha-demethylase that converts lanosterol to ergosterol --> Mutation of demethylase enzyme can produce resistance

leiomyoma (fibroids)

Most common tumor in females. Often presents with multiple discrete tumors A . increased incidence in blacks. Benign smooth muscle tumor; malignant transformation is rare. Estrogen sensitive— tumor size increases with pregnancy and decreases with menopause. Peak occurrence at 20-40 years old. May be asymptomatic, cause abnormal uterine bleeding, or result in miscarriage. Severe bleeding may lead to iron deficiency anemia. Does NOT progress to leiomyosarcoma. Whorled pattern of smooth muscle bundles with well-demarcated borders.

Histone Methylation

Mostly Makes DNA Mute

HTS IV

Multiple sclerosis Guillain-Barré syndrome Graft-versus-host disease PPD (test for M. tuberculosis) Contact dermatitis (e.g., poison ivy, nickel allergy) Response is delayed and does not involve antibodies (vs. types I, II, and III)

myasthenia gravis

Myastina gravis - nicotinic acetycholine receptors not muscaranic because of skeletal vs vascular

phosphorylase kinase

Physiologically, phosphorylase kinase plays the important role of stimulating glycogen breakdown into free glucose by phosphorylating glycogen phosphorylase and stabilizing its active conformation. This activity is particularly important in liver and muscle cells, though for somewhat different purposes. While muscle cells generally break down glycogen to power their immediate activity, liver cells are responsible for maintaining glucose concentration in the bloodstream. Thus, the regulatory mechanisms of PhK activity vary somewhat depending on cell type.

obsesity hypoventilation syndrome

Pickwickian Syndrome, chronically elevated PaCO2 and reduced PaO2

posterior urethral valve

Posterior urethral valve (PUV) disorder is an obstructive developmental anomaly in the urethra and genitourinary system of male newborns.[1] A posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development. It is the most common cause of bladder outlet obstruction in male newborns. The disorder varies in degree, with mild cases followed conservatively. More severe cases can have renal failure and even respiratory failure from lung underdevelopment as result of low amniotic fluid volumes, requiring intensive care and close monitoring.

ritonavir/lopinavir

Protease inhibitors resistance by mutation in gene for protein processing

B27 PAIR

Psoriatic arthritis, Ankylosing spondylitis, arthritis of Inflammatory bowel disease, Reactive arthritis (formerly Reiter syndrome)

obligate intracellular

Rickettsia and Chlamydia, can't make their own ATP

R. typhi

Rickettsii on the wRists, Typhus on the Trunk.

Factor Xa direct inhibitors

Rivaroxaban and apixaban

growth in bile but NOT in 6.5% NaCl

S. bovis

PSGN

S. pyogenes

Achilles reflex

S1-S2 roots

S1

S1—mitral and tricuspid valve closure. Loudest at mitral area.

Saddle anesthesia

S2-S4 nerve roots, cauda equina syndrome

S2

S2—aortic and pulmonary valve closure. Loudest at left sternal border.

C1 complement deficiency

SLE development

Ruffini's

SLOWLY ADAPTING mechanoreceptors

rabies

SS RNA

sertraline

SSRI

paroxetine

SSRI (that usually causes sexual dysfunction) but in this case helps with premature erection

citalopram

SSRI with sexual dysfunction in women especially

Novobiocin

Saprophyticus is resistant. Epidermidis is sensitive. NO STRES

Rubella

Sensorineural deafness (58% of patients) Eye abnormalities—especially cataract and microphthalmia (43% of patients) Congenital heart disease—especially patent ductus arteriosus (50% of patients)

vagus nerve

Sensory & Motor functions of Vagus nerve - Swallowing Motor fibers of Vagus Nerve

situations where don't need consent for minors

Sex (contraception, STDs, pregnancy) Drugs (addiction) Rock and roll (emergency/trauma)

novobiocin resistance

Staphylococcus saprophyticus

buspirone

Stimulates 5-HT1A receptors. Generalized anxiety disorder. Does not cause sedation, addiction, or tolerance. Takes 1-2 weeks to take effect. Does not interact with alcohol (vs. barbiturates, benzodiazepines). I'm always anxious if the bus will be on time, so I take buspirone.

succinylcholine

Succinylcholine is associated with hyperkalemia

absence seizures

Synchronized discharge of the thalamocortical neurons.

rearrangement of b chains, the process of rearrangement of the a chain of the TCR occurs followed by positive selection in the thymic cortex and negative selection in the thymic medulla

T lymphocytes in thymus

local defense of Candida

T-cells (HIV positive patients)

imipramine

TCA side effects include orthostatic hypotension, cardiac arrhythmias, and other anticholinergic side effects

presynaptic serotonin and norepinephrine reuptake inhibiton

TCAs and venlafaxine (antidepressants)

TIP

TIP - Tibial, inversion, plantar flexion

anti-inflammatory

TNF-Beta and IL-10 that inhibits monocyte MHC class II and B7 expression

Infliximab, adalimumab

TNFalpha, Rheumatoid arthritis "inflix" pain in "da limbs" IBD, rheumatoid arthritis, ankylosing spondylitis, psoriasis

MG

TYPE II hypersensitivity with IgM antibodies binding to cell surface antigens

Goodpasture syndrome

TYPE II hypersensitivity with autoantibodies against a-3 chain of collage IV

TZD

PPAR-gamma, nuclear receptor superfamily

hemophilus influenza type B

PRP derived from capsule of H. influenzae type p coupled with either diphtheria or tetanus toxoid

Prevent Disease

PST: Prevent, Screen, Treat

calcium loading

PTH decreases, calcitonin increases, renal vit D decreases

S pyogenes

PYR-positive

ventral posterolateral nucleus (VPL)

Pain and temperature; pressure, touch, vibration, and proprioception

Rocky Mountain Spotted Fever

Palms and soles rash is seen in Coxsackievirus A infection (hand, foot, and mouth disease), Rocky Mountain spotted fever, and 2° Syphilis (you drive CARS using your palms and soles).

superior sulcus tumors

Pancoast tumors arise at the lung apex and frequently cause should pain due to compression of brachial plexus, ptosis/miosis/anhydrosis

glossopharyngeal

Taste and somatosensation from posterior 1/3 of tongue, swallowing, salivation (parotid gland), monitoring carotid body and sinus chemo- and baroreceptors, and stylopharyngeus (elevates pharynx, larynx) (think of stylopharyngeus innervated by glossopharyngeal nerve)

vagus

Taste from epiglottic region, swallowing, soft palate elevation, midline uvula, talking, coughing, thoracoabdominal viscera, monitoring aortic arch chemo- and baroreceptors

NRTIs

Tenofovir (TDF) Emtricitabine (FTC) Abacavir (ABC) Lamivudine (3TC) Zidovudine (ZDV, formerly AZT) Didanosine (ddI) Stavudine (d4T)

latissimus dorsi muscle

Thoracodorsal nerve

Staph aureus

Thought of Staph Aureus. Located in the nose.

thromboxane A2

Thromboxane A2. Platelets only secrete a few cytokines/mediators, of which, TA2 is one of them, especially for aggregration (which the question lays out).

CN XII lesion

Tongue deviates toward side of lesion ("lick your wounds") due to weakened tongue muscles on the affected side

Treacher Collins Syndrome

Treacher Collins Syndrome - First Pharangeal Arch. Look for M's and facial abnormalities

GET GAP on the Metro with metronidazole!

Treats Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, C. difficile). Used with a proton pump inhibitor and clarithromycin for "triple therapy" against H. Pylori.

ataxia-telangiectasia

Triad: cerebellar defects (Ataxia), spider Angiomas (telangiectasia), IgA deficiency. INCREASED AFP

INF-alpha

USES: Chronic hepatitis B and C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

INF-beta

USES: multiple sclerosis

S. Saprophyticus

UTIs, novobiocin resistance, coagulase -

Uniparental disomy- offspring receives two copies of chromosome from one parent and no copies from the other parent

Uniparental is eUploid (correct number of chromosomes), not aneuploid. Most occurrences of UPD result in normal phenotype.

Fibrates (gemfibrozil, clofibrate, bezafibrate, fenofibrate)

Upregulate LPL--> increase TG clearance Activates PPAR-α to induce HDL synthesis

CN X lesion

Uvula deviates away from side of lesion. Weak side collapses and uvula points away.

Thayer-Martin (VPN media)

Vancomycin (inhibits gram-positive organisms), Polymyxin (inhibits gram-negative organisms except Neisseria) and Nystatin (inhibits fungi). FOR NEISSERIA GONORRHEA, MENINGITIS

nitroglycerin, isosorbide dinitrate

Vasodilate by increasing NO in vascular smooth muscle --> increase in cGMP and smooth muscle relaxation. Dilate veins >> arteries. decrease preload.

vinblastine

Vinblastine blasts bone marrow (suppression).

Optochin

Viridans is Resistant; Pneumoniae is Sensitive. OVRPS (overpass).

alpha hemolytic

Viridans streptococci (e.g., S. mutans) No capsule Optochin resistant Bile insoluble (not lysed by bile)

lateral pontine syndrome

Vomiting, vertigo, nystagmus. Paralysis of face,lacrimation, salivation,taste from anterior 2⁄3 of tongue,corneal reflex. Face—pain and temperature sensation. Ipsilateralhearing. Ipsilateral Horner syndrome. AICA

migratory superficial thrombophlebitis

"Trousseau's syndrome"

vas deferens

"Water (ureters) under the bridge (uterine artery, vas deferens)."

rr

(A/A+B)/(C/C+D)

myocardial oxygen extraction

80% at rest, 90% at work. very high. increased cardiac perfusion in hypoxia and adenosine accumulation.

object permanence

9 months

hypertrophic cardiomyopathy

systolic ejection murmur, resulting from aortic stenosis

mantle cell lymphoma

t(11;14) with activation of the cyclin D gene

autosomal recessive diseases

Albinism, ARPKD (formerly known as infantile polycystic kidney disease), cystic fibrosis, glycogen storage diseases, hemochromatosis, Kartagener syndrome, mucopolysaccharidoses (except Hunter syndrome), phenylketonuria, sickle cell anemia, sphingolipidoses (except Fabry disease), thalassemias, Wilson disease.

unfavorable lyonization

Since the boy has DMD, it means the mother is a carrier. So one of the X chromosomes she carries has the DMD mutation. If the normal X chromosome becomes inactivated in her muscle cells (so-called "unfavorable lyonization"), she would display the phenotypical features of the disease. (Choice D)

ways of tetracycline resistance

1) efflux pump, or 2) protein that allows the ribosome to work even in the presence of the drug

MI progression

1) none, 2) early coagulative necrosis, 3) neutrophil migration starts, 4) macrophages and then granulation tissue at margins, 5) contracted scar complete

Bordetella pertussis whooping cough causing neutrophil chemotaxis and oxidative metabolism

1) whooping cough-adenylate cyclase (toxin turns Gi off)

NF

1- 17. 2-22

receiving preformed antibodies

After exposure to Tetanus toxin, Botulinum toxin, HBV, or Rabies virus, patients are given preformed antibodies (passive)—"To Be Healed Rapidly"

CLL tx

"Alymtuzumab"—chronic lymphocytic leukemia

vit B7 biotin

"Avidin in egg whites avidly binds biotin."

IL-8

"Clean up on aisle 8." Neutrophils are recruited by IL-8 to clear infections.

benzos

"Frenzodiazepines" increased frequency.

Citrate synthase

"SYtrate" = SYnthesis.

migratory thrombophlebitis

"cancer"

Left hemianopia with macular sparing

(PCA infarct)

trochanteric bursa

- Trochanteric bursitis is characterized by painful inflammation of the bursa located just superficial to the greater trochanter of the femur. Patients typically complain of lateral hip pain, although the hip joint itself is not involved. The pain may radiate down the lateral aspect of the thigh. - The term greater trochanteric pain syndrome (GTPS) is now being commonly substituted for trochanteric bursitis, because the inflammatory etiology of the pain is being refuted by current research, using ultrasonographic, magnetic resonance imaging (MRI) - based, and histologic evidence. - Flexion or anteversion (140°): iliopsoas (with psoas major from vertebral column); tensor fascia latae, pectineus, adductor longus, adductor brevis, and gracilis. Thigh muscles acting as hip flexors: rectus femoris and sartorius.

at FRC the negative intrapleural pressure is

-5cm H20

V2 receptor

ADH response

Gaucher

AR, glucocerebrosidase

causes of Potter syndrome

ARPKD, posterior urethral valves, bilateral renal agenesi

adherens junction

Adherens junction (zonula adherens)—below tight junction, forms "belt" connecting actin cytoskeletons of adjacent cells with CADherins (Ca2+-dependent adhesion proteins). Loss of E-cadherin promotes metastasis.

Trypanosoma brucei

African sleeping sickness. Suramin for blood- borne disease or melarsoprol for CNS penetration ("it sure is nice to go to sleep"; melatonin helps with sleep)

duodenum submucosa

Brunner glands that secrete alkaline mucous into ducts that track upward

Be Wise, Fool's GOLD Heeds Silly HOpe

Bruton agammaglobulinemia, Wiskott-Aldrich syndrome, Fabry disease, G6PD deficiency, Ocular albinism, Lesch-Nyhan syndrome, Duchenne (and Becker) muscular dystrophy, Hunter Syndrome, Hemophilia A and B, Ornithine transcarbamylase deficiency.

primary hyperaldosteronism

Conn's Syndrome

consanguinity

Consanguinity ("blood relation", from the Latin consanguinitas) is the property of being from the same kinship as another person. In that aspect, consanguinity is the quality of being descended from the same ancestor as another person.

decreased glutathione in liver

Decreased glutathione --> liver cannot protect itself against reactive metabolites (NAPQI in this case) --> liver damage

GABA prone seizures

Decreased postsynaptic chloride influx = just think of what benzodiazepines do, they increase the chloride influx so if you have decreased influx you are prone to seizures

deep fibular nerve (peroneal)

Deep Fibular nerve: Weakness inversion, Loss extension of the digits, loss dorsiflexion ( foot drop), sensory loss on antero lateral leg and dorso of the foot, first web space. (Kaplan anatomy page 295 and 295)

X-linked (Bruton) agammaglobulinemia

Defect in BTK, a tyrosine kinase gene-->no B cell maturation. X-linked recessive (Boys).

13 YO boy with pruritic rash on right foot. No fever, chills, cold. Patient's family spent weekend at a lake. (Rash is on top of foot and moving sort of linearly). Treat with a. clindamyin, b. fluconazole, c. mebendazole, d. metronidazole, or e. prednisone?

Hi I think it might be strongyloides . ans is mebendazole

high potency antipsychotics

High potency: Trifluoperazine, Fluphenazine, Haloperidol (Try to Fly High)

Paco2=CO2 production/Alveolar Ventilation

If you double CO produced and Alveolar Ventilation, then you're left with Paco2 = 2(VCO2)/2(VA), which would mean that the Paco2 would remain the same.

Mallory Weiss

If you read question properly regarding alcoholic guy who is regurgitating blood, is that he is not presenting with painfull regurg, so that being said it is not mallory weis. It is common but there is different presentation. good luckj

C. tetani

IgG from immunized mother will pass through placenta to fetus and provide immunity until child receives its first tetanus vaccination at 2 months

complement classic pathway

IgG or IgM mediated. GM makes classic cars.

Staph aureus

IgG outer membrane protein, Protein A virulence factor that binds Fc portions of IgG molecules, thereby preventing opsonization

rheumatoid factor

IgM directed against Fc fragment of self IgG

lactulose trapping of ammonia in the colon by acidic metabolites of lactulose

In treating hepatic encephalopathy, lactulose helps "draw out" ammonia (NH3) from the body.[5] Lactulose is metabolized in the colon by bacterial flora to short chain fatty acids including the production of the lactic acid and acetic acid. This partially dissociates, acidifying the colonic contents (increasing the H+ concentration in the gut).[6] This favors the formation of the nonabsorbable NH4+ from NH3, trapping NH3 in the colon and effectively reducing plasma NH3 concentrations. The effectiveness of lactulose in treating hepatic encephalopathy is somewhat controversial.[ Lactulose for hepatic encephalopathy generally requires oral dosage three or four times a day with diarrhea almost a certain side effect. "Wikipedia"

incidence

Incidence rate = need new incidences/population at risk during same period of time To calculate incidence would require to know the population, not just the number of people screened

right sided O2 shift

Increase in erythrocyte 2,3-bisphoglycerate concentration

DIC

Increased plasmin generation - Increase plasmin to increase fibrinolysis (to degrade fibrin = bleeding) - normal coagulation is disrupted and abnormal bleeding occurs from the skin (e.g. from sites where blood samples were taken), the gastrointestinal tract, the respiratory tract and surgical wounds. The small clots also disrupt normal blood flow to organs (such as the kidneys), which may malfunction as a result. The activation of the coagulation cascade yields thrombin that converts fibrinogen to fibrin; the stable fibrin clot being the final product of hemostasis. The fibrinolytic system then functions to break down fibrinogen and fibrin. Activation of the fibrinolytic system generates plasmin (in the presence of thrombin), which is responsible for the lysis of fibrin clots. The breakdown of fibrinogen and fibrin results in polypeptides called fibrin degradation products (FDPs) or fibrin split products (FSPs). In a state of homeostasis, the presence of plasmin is critical, as it is the central proteolytic enzyme of coagulation and is also necessary for the breakdown of clots, or fibrinolysis.

heart failure

Increased pulmomary capillary pressure in Heart Failure

acetazolamide

Induction of metabolic acidosis, stimulate ventilation to comp for resp alkalosis, your body is normally going to do this, but drug as prophalaxsis does it quicker by eliminating HCO3. You want to stimulate your resp drive to get more oxygen in blood

diverticulitis

Inflammation of diverticula classically causing LLQ pain, fever, leukocytosis B . May perforate->peritonitis, abscess formation, or bowel stenosis. Give antibiotics. Stool occult blood is common +/- hematochezia. May also cause colovesical fistula (fistula with bladder) -> pneumaturia. Sometimes called "left-sided appendicitis" due to overlapping clinical presentation.

Coccidioides

It is cocciodiodes The question stem said "in culture" which would mean the mold form. The mold form of Cocciodiodes is "box car like hyphae"

Suicidal ideation or attempts

It'a depression major, or maybe atypical becase sleep more time than before... Suicidal ideas , may come to person....

hypotension-induced shock

Neurogenic shock is a distributive type of shock resulting in hypotension, occasionally with bradycardia, that is attributed to the disruption of the autonomic pathways within the spinal cord.

NNRTIs

Nevirapine Efavirenz Delavirdine

Niemann-Pick

No man picks (Niemann-Pick) his nose with his sphinger (sphingomyelinase).

fainting

Parasympathetic outflow is responsible for the vasovagal response (aka neurocardiogenic syncope), which is a fancy way of saying "fainting." People faint when anxious (giving blood, needles, etc.) and can experience warmth, nausea, and light-headedness prior to going out. Think about the important diagnostic points separating cardiac syncope (all the other causes listed) from fainting and seizures. This is more of a third year thing, admittedly. As a test taking skill, you should also note that all the others imply structural damage to the heart and would be unlikely in a young military recruit who is undergoing BT. Another place this skill is useful is in lung pathology questions: separate obstructive from restrictive answer choices, increased A-a gradient choices from normal A-a choices, increased AG met acidosis from normal AG choices, and so o

globus pallidus

Parkinson disease Surgery and deep brain stimulation Placement of an electrode into the brain. The head is stabilized in a frame for stereotactic surgery. Treating motor symptoms with surgery was once a common practice, but since the discovery of levodopa, the number of operations declined. Studies in the past few decades have led to great improvements in surgical techniques, so that surgery is again being used in people with advanced PD for whom drug therapy is no longer sufficient.[35] Surgery for PD can be divided in two main groups: lesional and deep brain stimulation (DBS). Target areas for DBS or lesions include the thalamus, the globus pallidus or the subthalamic nucleus.[35] Deep brain stimulation (DBS) is the most commonly used surgical treatment. It involves the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain. DBS is recommended for people who have PD who suffer from motor fluctuations and tremor inadequately controlled by medication, or to those who are intolerant to medication, as long as they do not have severe neuropsychiatric problems.[29] Other, less common, surgical therapies involve the formation of lesions in specific subcortical areas (a technique known as pallidotomy in the case of the lesion being produced in the globus pallidus).[35]

selegiline

Parkinson's, decreased central dopamine degradation

trazodone

Primarily blocks 5-HT2 and α1-adrenergic receptors. Used primarily for insomnia, as high doses are needed for antidepressant effects. Toxicity: sedation, nausea, priapism, postural hypotension. called trazobone due to male-specific side effects

nitroprusside (vasodilator)

Short acting; increases cGMP via direct release of NO. Can cause cyanide toxicity (releases cyanide).

ligand-coupled ion channel receptors

Should be C). Intracellular--takes time for transcription, GPCR has to go through a secondary cascade in order to activate transcription (ie. cAMP--PKA--activity, etc.) Same for receptor tyrosine kinases. Ligand coupled ion channels would instantly be activated and can for instance cause depolarization/hyperpolarization--immediate effects.

Valsalva

The Valsalva maneuver or Valsalva manoeuvre is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon.

short gastric

The answer is short gastric which drain directly into the portal vein.

right middle cerebral artery

The person is suffering from a pure motor stroke, most likely location of infarct is in the internal capsule. The correct answer for this is the Right middle cerebral artery. You had to select the arrow pointing to the MCA on the right side.

PICA

The posterior inferior cerebellar artery (PICA), the largest branch of the vertebral artery, is one of the three main arterial blood supplies for the cerebellum. It winds backward around the upper part of the medulla oblongata, passing between the origins of the vagus and accessory nerves, over the inferior cerebellar peduncle to the undersurface of the cerebellum, where it divides into two branches. The medial branch continues backward to the notch between the two hemispheres of the cerebellum; while the lateral supplies the under surface of the cerebellum, as far as its lateral border, where it anastomoses with the anterior inferior cerebellar and the superior cerebellar branches of the basilar artery. Branches from this artery supply the choroid plexus of the fourth ventricle. Diseases Infarction of this artery due to thrombosis or a stroke leads to lateral medullary syndrome, also known as PICA syndrome or Wallenberg syndrome. Severe occlusion of this or vertebral arteries could lead to Horner's Syndrome as well.

Thiamine vit B1

Think ATP: α-ketoglutarate dehydrogenase, Transketolase, and Pyruvate dehydrogenase

Negatively charged DNA loops twice around positively charged histone octamer to form nucleosome "bead."

Think of "beads on a string." H1 is the only histone that is not in the nucleosome core.

Borderline

This case is classic borderline-- unstable relationship, esp the bit about I'm so in love with him, followed by finding out she was only on 2 dates with him. Also the suicide attempt itself suggests borderline rather than histrionic. Another clue is that she tells the physician "you're the only one who understands"; she is engaging in splitting- classic defense mech borderline pts do (i.e. the good cop, bad cop routine, sees things black/white)

mifepristone

synthetic steroid with anti-progestin and anti-glucocorticoid effects

first-order kinetics drug

steady state concentration in 4-5 half lives

common peroneal nerve injury

steppage gait and foot drop (no dorsiflexion)

ansa cervicalis

sternohyoid, sternothyroid, and omohyoid muscles of the anterior neck

low dopamine

stimulate D1 on renal and mesenteric vasculature resulting in vasodilation and increased blood flow

cochlear implant

stimulated auditory nerve endings in the cochlea

decreased cardiac output in CHF

stimulates renin-angiotensin-aldosterone system and increases sympathetic output, resulting in increased afterload that can exacerbate heart failure by making it more difficult for failing heart to pump blood

TGF-beta

stimulation of fibroblasts to lay down extracellular matrix porteins means atherosclerosis and fibrotic disease implication

optochin sensitivity

strep pneumoniae

protein M

strep pyogenes major virulence factor; inhibits phagocytosis and the activation of complement

hCG

structurally like TSH, LH, and FSH. may be observed in pts with testicular tumors, stimulating TSH and causing hyperthyroidism

isoniazid

structurally similar to vitamin B6, causing deficiency

succinate dehydrogenase

succinate to fumarate, releasing FADH2

succinyl CoA synthetase

succinyl CoA to succinate, GTP producing

methionine degraded to

succinyl-CoA and SAM

plasma hydrolysis

succinylcholine, tetracaine, remifentanil (esterases and amidases)

chronic use of corticosteroids

such as prednisone promotes osteoporosis

blunt aortic injury

sudden decerlation that causes injury to the aortic isthmus, tethered by the ligamentum arteriosum. widened mediastinum

paraumbilical

superficial and inferior epigastric veins

varicose veins

superficial venous thrombosis

fourth pharyngeal and aortic arch

superior laryngeal branch of vagus nerve. fourth aortic arch = true aortic arch and subclavian arch.

fourth branchial arch

superior laryngeal branch of vagus. soft palate and pharynx. exceptions are tensor veli palatini muscle (first branchial arch) and stylopharyngeaus (third branchial arch)

pharyngeal pouch 4

superior parathyroid glands, ultimobranchial body

LAD

supplies anterior 2/3 of the interventricular septum

external iliac artery

supplies lower extremity and anterior abdominal wall

nonpulsatile fusion of GnRH

suppresses FSH and LH

chloramphenicol

suppresses bacterial protein synthesis by binding to the ribosomal 50S subunit and inhibiting the peptidyl transferase enzyme

Virchow's node

supraclavicular sentinel node manifestation of gastric cancer

four rotator cuff muscles and also abducts the arm at the shoulder. The spine of the scapula separates the supraspinatus muscle from the infraspinatus muscle, which originates below the spine.

supraspinatus

phenylephrine

sympathomimetic drug with a1>a2 agonist effects that causes systemic vascular resistance

left-sided colon cancers

symptoms of partial intestinal obstruction

hCG

synthesized by trophoblastic tissue

danazol

synthetic androgen used for the treatment of endometriosis and hereditary angioedema. SE include hirsutism, fluid retention, and weight gain.

fondaparinux

synthetic pentasaccharide Factor Xa inhibitor

octreotide

synthetic somatostatin analog used to control the symptoms of carcinoid syndrome