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UWSA 2

Terms in this set (149)

Major manifestation of familial chylomicronemia
Acute pancreatitis
Major manifestation of familial hypercholesterolemia
Premature coronary artery disease
Major manifestation of familial dysbetalipoproteinemia
Premature coronary artery disease
Most common cause of mitral stenosis
Rheumatic fever
Mucocutaneous macules
Hamartomatous polyps in GI tract
Peutz Jeghers
Desmoid tumor
Benign growth
Broad fasciles of rounded fibroblasts with abundant cytoplasm
Surrounded by collagenous matrix
Lipoma vs liposarcoma
Liposarcoma shows pleomorphism (scalloping of nuclear membrane)
Chronic alcoholism can damage what part of the brain to cause gait ataxia, truncal instability, intention tremor, Parksinonian tremor
Cerebellum (vermis)

Likely due to thiamine deficiency
What type of DI does lithium cause
Nephrogenic
Coronary artery status in hypertrophic cardiomyopathy?
NORMAL
Causes of wide split S2
Right bunlde branch block
Pulmonary stenosis
Pulmonary arterial hypertension

Lengthinging of RV ejection time
CD40 Ligand deficiency
Hyper IgM
Only IgM is procued
Common variable immunodeficiency
Low IgG, E, M, A
Best ROC curve
Largest area under the curve
Neoplasms associated with Lynch syndrome
Colorectal cancer
Endometrial cancer
Ovarian cancer
Protein involved in ataxia telangiectasia
p53

Nonhomologous end joining repair mechanism
Side effects of calcineurin inhibitors
Dose and duration dependent rise in BUN and creatinine
Also renal arteriolar vasoconstriction

Long term use leads to obliterative vasculopathy
Anti-emetic that is contraindicated in parkinsons disease?
Metoclopramide

can triggger extrapyramidal effects
Clinical features of alkaptonuria
Darkening of urine
Blue black discoloration of cartilage and skin
Debilitating osteoarthopathy
Ischemia causes what electrolyte to increase extracellularly?
K+
3 mechanisms that stimulate juxtaglomerular cells
Decrased NaCl sensed by macula densa
Decreased pressure in afferent arteriole
Sympathetic stimulation
Foam stability index is used to evaluate...
surfactant functionality
Female athlete triad
Disordered eating
amenorrhea
Ostoporosis

Estrogen deficiencies
Why is heparin unable to cross placenta, while warfarin can?
Heparin is charged and water soluble
Warfarin is lipophilic
CMV retinitis appearance
Bilateral retinal hemorrhages
Cotton wool exudates on opthalmoscopic examination
Vission loss
Motivational interviewing
Acknowledging resistance
Highlighting discrepancies
Encouraging internal motivators for change
Peaked T waves
Hyperkalemia
Which wave would disappear in afib in a jugular venous pulse tracing?
A wave
Tetralogy of fallot murmur
Systolic ejection murmur
Systolic thrill at left sternal border
Pineal gland function
Modulate circadian rhythm
Secrete melatonin
Parinaud syndrome
UIpward gaze palsy
Absent pupillary light reflex
Impaired convergence

Can be caused by pineal gland compressing superior colliculus
How can pineal gland cause parinaud syndrome?
Mass effect on DORSAL MIDBRAIN in superior colliculus region
Where are GI stem cells located
Cryptos of Lieberkuhn
What cells are in the regenerative nodules of a cirrhotic liver?
Proliferating hepatocytes
Stellate cell function
In the hepatic perisinusoidal space
Store Vit A
Support sinusoids
Macrolides and clindamycin bind to the same site on...
23S rRNA on 50S ribosomal subunit
Painless, compressible mass that transilluminates

Typically on head or neck
Cystic hygroma
Cystic hygromas are associated with what genetic abnormality?
Turner
Trisome 13,18,21
Recent outdoor activitiy
Exposed skin with streaky, erythematous lesions
Type IV hypersenstiivty
Poison oak/ivy (toxicodendron)
What causes late onset lactose intolerance?
Downregulation of lactase
Which tissue is most radiation sensitive?
Thyroid
Kluver Bucy syndrome due to damage to..
temporal lobes
PArticularly the amygdala
Insula
Lateral to lentiform nucleus

Subjective emotional experience, pain, etc

Increased in drug abusers to tirgger cravings
Red flags for low back pain
Age >50
Hx of cancer
Constitutional symptoms
Nighttime pain interering with sleep
Pain >1month
No response to previous therapy
Neuro deficits
First line tx for low back pain with no red flags
NSAID or acetaminophen
Cyclosporine MOA
INhibits calcineurin
Mechanism of tardive dyskinesia
Prolonged exposure to dopamine blocking agents causing upregulation and supersensitivty to dopamine receptors
Dopamine beta hydroxylase makes
NE
Hemodynamic changes in pulmonary embolism
Elevated central venous pressure (impaired forward pumping)
Elevated systemic vascular resistance (attmempt to maintain tissue perfusion pressure)
Reduced cardiac output
Which lung volumes INCREASE in COPD?
RV
FRC
TLC
Cells pile up on a petri dish
Malignant
What is the main concern of oral polio vacine?
Contains attenuated live virus
Can revert to virulent form and cause vaccine associated paralytic poliomyelitis
How can a woman express an X-linked recessive disorder?
Skewed inactivation
How do most dsDNA viruses replicate
Get into nucleus
DNA depdnent DNA polyermase replicate genome
Then transcribed with DNA depdentn RNA polymerase
Eosinophilic cytoplasmic inclusions in hippocampal neurons
Rabies

Negri bodies
Painful pharyngeal muscular spasms
Hydrophobia
Ascending paralysis
Rabies
Glomerular capillary filtration coefficient is based on
fluid permeability
Surface area of glomerular capillaries
What two things should women of childbearing age do when using retinoids?
Abstain from alcohol use (can lengthen half life)
Not conceive for 3 years after stopping the drug
Calcipotriol
Vitamin D analog
Used for psoriasis
How do beta lactams improve aminoglycoside efficacy?
Compromise the bacterial cell wall
Allow aminoglycoside to penetrate
Intestinal lipase inhibitor
Orlistat
Acarbose
Inhibits pancreatic alpha amylase and alpha glucosidase enzymes
Blocks digesting of complex carbohydrates
Spike and dome nephropathy
MEmbranous nephropathy
Which veins drain below the dentate line?
Middle and inferior rectal veins
Drain via internal iliac veins
Treatment for xerosis
Moisturizing skin with creams or ointments
Applied after bathing
Ithcy rash and dry cracked skin
Xerosis
PFK-2/F-2,6 BPase bifunctional enzyme

What does insulin do?
Stimulate PFK-2
Increase Fructose 2,6 bisphosphate
Which then promotes PFK-1
Nonpolar amino acids
Alanine
Valine
Leucine
Isoleucine
Phenylalanine
Tryptophan
Methionine
Proline
Glycine
First nerve damaged in cavernous sinus thrombosis
CN VI
What can happen in testicles in mumps infection?
Orchitis
Results in Leydig cell atrophy
Decreased testosterone
Danazol
Androgen used to suppress FSH and LH release
How are entamoeba cysts transfered?
Oral fecal contact
What do you see when staining C trachomatis?
Does not gram stain well
Shows neutrophils, no organisms
Tx for C trachomatis?
Azithromycin
Probenecid action in kidney
Inhibits organic anion transporters
Why give probenecid with penicillin?
Prevents secretion of penicillin, increasing serum penicillin
Where can tetracyclines deposit in fetus?
deposited in bone and tooth enamel

Cause tooth discoloration and retarded bone formation
Female kid
Hypertension, hypokalemia
Amenorrhea
Lack of secondary sex characteristics
17a hydroxylase deficiency
Why does giving cortisol relieve hypertension in 17a hydroxylase deficiency?
Lowers ACTH stimulation of upstream precursors
Cough syncope
Increased intrathoracic pressure during coughing episode
Decrease venous return to the heart
Transient decrease in CO and cerebral perfusion
Bloom syndrome
Photosensitivity
Short stature
Erythema
Telangiectasias
Waxing and waning lymphadenopathy
Follicular lymphoma
Histology of follicular lymphoma
Tightly packed lymphoid follicles
Small lymphocytes with cleaved nuclei and large non-cleaved lymphocytes
Endometriosis effects
Dysmenhorrhea
Pelvic pain
Dyspareunia
Infertility
Crypt abscesses
Ulcerative colitis
Neutrophils accumulate in crypt lumina
Amenhorrhea in women age <40
Elevated FSH
Low estrogen
Primary ovarian insufficiency
Agglutination inhibition reaction

What is a poistive result?
ABSENCE of agglutination

The presence of the antigen prevents agglutination
Why put paclitaxel on stent?
Prevent intimal hyperplasia
Where does influenza virus replicate?
NUCLEUS

Other RNA virus would be retroviruses
7 transmembrane hydrophobic a-helices receptor
G protein coupled receptor

Transmit through GTP-binding G proteins
Accumulation of carbamoyl phosphate
Congeinalt hyperammonemia
Ornithin transcarbamoylase deficiency
Defective proline hydroxylation leads to...
failure of triple helix formation and stabilzation
Uncal herniation
What nerve is impinged?
CN 3
Excessive preoccupation with one more somatic complaints, resulting in functional impairment and high health care utilization
Somatic symptom disorder
Why are postmenopausal women at risk for osteoporsosis?
Ovarian endocrine hypofunction
Estrogen deficiency
Apathy
Recent retrograde and anterograde amnesia
Confusion and confabulation

Alcoholic
Korsakoff dementia
LH, ACTH, Renin levels in 17a hydroxylase deficiency
Decrease Renin
Increase ACTH and LH
How do medium length FA dehydrogenase deficiency pt present?
Hypoketotic hypoglycemia
Neurologic and hepatic dysfunction
Early signs of hypokalemia
Muscle weakness,cramps, myalgias, fatigue
Psoas abscess can spread to the...
groin
Risk of developing herpes zoster (shingles)
Advanced age
Immunosuppression
What does angiontensin 2 do to renin?
Inhibits renin release
Adult acute respiratory distress syndrome
Alveoli fill with proteinaceous material and cell debris
Infeective gas exchange
Right to left shunting leads to hypoxemia
Widespread inflammation causes redistribution of blood away from wel-ventilated alveoli
Leads to increased alveolar dead space
Hypercapnia
Severe pneumonia with normal ABG

Develops hypercapnia, respiratory acidosis
ARDS
Where does copper deposit in Wilson's disease?
Descemet's membrane in cornea
Wilson's disease presentation
Hepatitis
Splenomegaly
Hemolytic anemia
'Neuro: dystonia, tremor, dysarthria, dysphagia
Well demarcated, nontender, firm, spherical, mobile breast nodule
Estrogen sensitive
Fibroadenoma
Dysplastic nevi can potentially evolve into
melanoma
Dysplastic nevus syndrome is associated with a melanoma susceptibility locus ...
CDKN2A
Inhibits CDK4 normally

Chromsome 9p21
Dermatofibrosarcoma protuberans
Fibroblasts in a cartwheel or storiform pattern
Chromosomes 17 and 22
Malignant fibrous histiocytoma
Proliferation of highly atypical and pleomorphic fibroblasts, histiocyte like cells, bizarre giant cells
Aortic dissection on chest x ray
Widening of mediatsinum
Abnormal aortic contour

Risks: uncontrolled HTN
Marfansyndrome
Cardiovascular changes in exercise
Increased CO
Vasodilation of exercising muscles
Increased end disatolic volume and HR
Decreased end systolic volume (heart empties out more) and systemic vascular resistance
Hindbrain
Rhombencephalon
Diencephalon becomes
Thalamus
third ventricle
Leucin zipper
Transcription factor
Smudged lymphocytes
CLL
First step in pyrmidine synthesis
Cytosol

Glutamine, CO2, 2 ATP form carbamoyl phosphate via carbamoyl phosphate synthetase II
Peroxisomes
Lipid metabolism
Hydrogen peroxide degradation
What effect can alcohol have on the heart?
Dilated cardiomyopathy

Particlarly in pt with mutations in alcohol dehydrogenase or DD isoform of ACE
Dilated cardiomyopathy characterstics
Enlarged heart
Increased ventricular volumes
Normal thickness of ventricular walls
What drug works on fungal cell WALL?
Capsofungin
Where does amphotericin B work?
Binds ergosterol, creating pores in fungal cell MEMBRANES
Alport syndrome
Defect in...
Type IV collagen
Linear IgG deposits in GBM
Anti-GBM disease

Form of RPGN
Hydatidiform moles are due to proliferation of...
trophoblasts
What marker distinguishes complete and partial moles?
Complete mole stains negative for p57

p57= paternally imprinted but maternally expressed gene
Most common cause of primary hyperparathyroidism
Parathyroid adenoma
How do retinoids treat acne?
Decrease sebum production
Increase cellular turnover and shedding of cells
Reduce hyperkeratinization
Open blocked pores
What goes through esophageal hiatus?
Esophagus
Anterior and posterior trunks of the vagus nerve
What goes through aortic hiatus?
Aorta
Thoracic duct
Azygos vein
How do dihydropyridines affect cardiac work?
Decrease afterload by causing arteriolar vasodilation at arteriolar smooth muscle
Which organs is glucokinase found?
Liver
pancreatic beta cells
Maturiy onset diabetes of the young is due to deficiency in...
Glucokinase

Raises the glucose threshold required for insulin release
Von Gierke presentation
Severe fasting hypoglycemia
Lactic acidosis
Hyperlipidemia
Hyperuricemia
Hepatomegaly and renal enlargement
Why should Von Gierke pt avoid fructose and galactose?
Cannot convert to free glucose
Enzyme deficiency in Pompe disease
acid a-glucosidase
Pompe disease
Hypertrophic cardiomyopathy
Diffuse muscular weakness
Macroglossia
Small firm nonfunctional testes
Infertility
Gynecomastia
Increased long bone growth
Klinefelter
Lab findings in DIC
Low fibrinogen
Prolonged PT and PTT
Thrombocytopenia
Increased fibrin degradation products
Schistocytes
Acute lumbosacral radiculopathy is most commonly due to
Vertebral disc herniation
How can you differentiate Salmonella from Shigella?
Salmonella produces hydrogen sulfide
Turns black on TIS agar
Pinpoint pupils
Loss of horizontal gaze
Quadriparesis
Decerebrate posturing
Rapidly evolving coma
Pontine hemorrhage
Most common sites for hypertension associated intracerebral hemorrhage
Thalamus and putamen
thalamic intracerebral hemorrhage
Contralateral sensory loss
Aphasia
Temporary homonymous hemianopia

unilateral abducent nerve palsy
Pupil asymmetry and nonreactivity
Downward gazy
Disruption of the blood brain barrier
What type of edema?
Vasogenic edema

Increased permeability nad plasma filtration
Cytotoxic edema
Increase in intracellular fluid within neurons, glia, endothelial cells
After cell injury impairs Na/K ATPase
Post ischemic insult
What triggers reactive arthritis?
Urogenital and GI infections
First location of action of C tetani
Jaw

Lockjaw
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