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