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Terms in this set (98)
PKU causes many unrelated symptoms is an example of:
Pleiotropy - 1 gene has > 1 effect on an individual's phenotype
What does HCV lack in its RNA polymerase?
3'-->5' exonuclease activity
5-HT 1A receptor stimulator for GAD;
does NOT cause sedation, addiction or tolerance or reaction with alcohol
Triad: DM (DECREASED insulin), Steatorrhea (dec CCK/secretin). Gallstones (dec CCK)
pancreatic tumor that secretes VIP --> copious "rice water" diarrhea
Vasoactive intestinal peptide;
increase intestinal water and electrolyte secretion;
increase relaxation of intestinal smooth muscle and sphincters
Glucocorticoid causes an increase in:
Neutrophil count d/t demargination of leukocytes previously attached to wall
Glucocorticoids cause a decrease in:
Eosinophils (tx allergic conditions), basophils (dec histamine release --> dec inflammation), lymphocytes (dec T and B cells --immunosuppression) , monocytes (dec APCs)
Homonomous hemianopsia with macular sparing
PCA occlusion (contralateral)
Fibrin and inflammatory cells in colon mucosa
Drugs that cause pseudomembranous colitis
Clindamycin , Ampicillin
Microangiopathic hemolytic anemia seen in:
HUS-TTP, DIC, SLE, malignant HTN
Triad of HUS
MAHA, thrombocytopenia, renal failure
Difference between HUS and TTP
HUS - seen mainly in children with predominant renal failure
TTP - seen mainly in adults with predominant neuro problems
What are the 3 AAs in collagen? Which is most abundant?
Glycine, Proline, Lysine;
Glycine most abundant
MOA of Tetracyclines
bind to 30S and prevent attachment of aminoacyl-tRNA
(tetracycline, Doxycycline, Demeclocycline, Minocycline)
MOA of Aminoglycosides
inhibit formation of INITIATION complex and cause misreading of mRNA; require O2
("Mean GNATS": Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin)
MOA of Macrolides
inhibit protein synthesis by blocking TRANSLOCATION ("macroSLIDES"); binds to 23S rRNA of 50S subunit
Primary amenorrhea in patient with fully developed secondary characteristics
Anatomic defect (because they have estrogen);
1) Mullerian duct anomaly
2) Imperforate hymen
Cyclic abdominal pain + amenorrhea
Accumulation of blood in vaginal canal --> distension ---> back pain, difficulty urinating and defecating; mass felt in ass
How is NAD regenerated anaerobically?
Pyruvate --> lactate (can become acidotic if overproduce lactate d/t alcoholism)
Converts 1,3 BPG (from glycolysis) --> 2,3 BPG;
this takes place in RBCs which need 2,3 DPG(BPG) to offload O2 to tissues
Drugs that increase Lithium toxicity
ACE inhibitors, Thiazides and NSAIDs;
(by increasing Na reabsorption)
Main cause of increased indirect bilirubin
Inhibitors of P450
Cimetidine, Ritonavir, Amiodarone, Ciprofloxacin, Ketoconazole, Acute alcohole use, Macrolides, Isoniazid, Grapefruit juice, Omeptrazole, Sulfonamides
What can Aldosterone do to the heart?
Ventricular remodeling --> cardiac fibrosis
(This is why Spironolactone, ACE Inhibitors and ARBs decrease morbidity and mortality in CHF patients)
What drugs decrease mortality in CHF patients?
ACE inhibitors, ARBs, Spironolactone, Beta blockers
(Thiazides, loops, nitrates and Digoxin are used to treat but do NOT reduce mortality)
How is iron regulated?
- regulates iron absorption from gut epithelial cells
- regulates (inhibits) release of iron from macrophages (in inflammatory state --> inc hepcidin --> dec release of Fe from macrophages --> anemia of chronic disease (Fe deficiency)
What toxin does C. perfringens produce?
Alpha toxin - lecithinase, a phospholipase -- splits phospholipid molecules
What is affected in HSP?
GI, kidney, joints, skin (palpable purpura)
Sandpaper like rash from sun exposure
pasted "stuck on" appearance
Seborrheic keratosis - velvety, greasy surface
MOA of thrombolytics
tPA, Streptokinase, urokinase, APSAC
conversion of plasminogen to plasmin which cleaves thrombin and fibrn clots; inc PT and PTT
used in acute MI or early ischemic stroke;
Restoration of blood flow after clot lysis by thrombolytic
Etiology of amenorrhea from anorexia
loss of pulsatile GnRH release from hypothalamus
Can hCG affect thyroid?
Yes can stimulate thyroid to cause hyperthyroidism (hCG has similar structure to TSH, FSH, LH)
Most testicular germ cell tumors secrete:
hCG and AFP
How does cell progress from G1 --> S phase?
cyclin D + CDK4 phosphorylate RB --> HYPERphosphorylated Rb (inactive) releases E2F transcription factor so that cell can progress from G1 -->S
(Rb active (suppressing cycle) when HYPOphosphorylated)
PrP in brain
rapidly progressive dementia with myoclonus
Beta amyloid sheets
(Alzheimers usually Beta amyloid plaques)
Creutzfelt Jakob disease
RVH from pulmonary HTN
VDRL and pleocytosis in CNS
NEUROsyphilis - tertiary stage
How do androgens affect RBCs?
They stimulate RBC production which is why Hct in men is higher than females
Mutation of /\F508 causes:
Abnormal protein folding, resulting in degradation of CFTR channel before reaching cell surface -- Cystic fibrosis
What immunity prevents Giardia infections?
Secretory IgA (Bruton's Agammaglobulinemia and SCID have increased susceptibility to recurrent Giardia infections)
What is important to ask on admission of patient to hospital?
End of life care and advance directive
Renal failure, livedo reticularis or toe gangrene following coronary angioplasty
Atheroembolic renal disease - during procedure, cholesterol debris gets pushed from larger arteries and lodges in smaller vessels --> ischemia
Renal tubular obstruction with urate crystals
Tumor lysis syndrome (acute renal failure following chemo)
Endoneural inflammatory infiltrate
Guillian Barre sx- ascending muscle weakness and hyporeflexia
Endomysial inflammatory infiltrate
Mutation in gene responsible for myelin synthesis
MCCs of otitis media, sinusitis and bacterial conjunctivitis in kids?
1) S. pneumonia
2) NON-typable H. influenza
PGE1 analog used to prevent **NSAID-induced ulcer disease -- has no effect on ulcers caused by H. pylori!!!
Cell with red granular cytoplasm and bilobed nucleus
Eosinophils can secrete what? What does this do?
Major basic protein - defends against helminthic infections
Low serum sodium and low urine osmolarity
Psychogenic polydipsia - (DI would have high serum Na)
<10% increase of Uosm with ADH injection
Normal or Psychogenic polydipsia
<50% increase of Uosm with ADH injection
>50% increase of Uosm with ADH injection
Islet leukocytic infiltrate
Type 1 diabetes (T cells responsible for destruction of Beta cells)
Islet amyloid deposit
Type 2 diabetes
Irreversible changes from ischemia in neurons
How does tetanus cause spasm?
Releases Tetanospasmin (exotoxin) which prevents release of inhibitory (GABA and glycine) neurotransmitters in spinal cord;
travels from wound --> motor neuron axons --> s.c.
favors product formation (free energy of products is lower than that of substrates)
favors substrate formation (free energy of products is higher than that of substrates)
What has thymidine and uracil?
What steps of collagen synthesis take place in fibroblasts?
1) Translation of collagen alpha chains
2) Hydroxylation of proline and lysine (requires Vit C)
3) Glycosylation of pro alpha chain and formation of procollagen via H and disulfide bonds (TRIPLE HELIX)
4) Exocytosis into extracellular space
What steps of collagen synthesis take place outside fibroblasts?
5) Cleavage of terminal regions of procollagen into tropocollagen
6) Lysyl oxidase reinforces with covalent lysine-hydorxylysine cross-linkage --> collagen fibrils
What is responsible for K channels to close, allowing depolarization of pancreatic Beta cell and insulin release?
(Glucose enters through GLUT-2 which increases ATP:ADP ratio which closes K channels which depolarizes the cell, allowing Ca to rush in which triggers insulin release)
Levodopa's effectiveness can be decreased by what?
Granulomatous inflammation of the media
Temporal arteritis and Takayasu arteritis
Transmural inflammation with fibrinoid necrosis
Onion like concentric thickening of arteriolar walls
Hyperplastic arteriosclerosis - seen in malignant HTN
Hyaline thickening of small arteries
Arteriosclerosis in essential HTN and DM
Dopamine agonist - txs galactorrhea and Parkinsons
Tacrolimus, Cyclosporine MOA
Inhibits calcineurin which normally activates IL-2 to activate T- cells so no T-cell activation
Activates IL-2 to cause differentiation and growth of T cells
PAO2 - PaO2 = 10-15 (normal)
O2 should normally diffuse readily from alveoli to arterioles so should have small gradient
Increased A-a gradient
hypoxemia d/t shunting, V/Q mismatch, fibrosis
How do R-->L shunts affect A-a gradient?
Increased A-a gradient: venous blood bypasses lungs, decreasing PaO2
Causes of hypoxemia (decreased PaO2)? How differentiate?
Normal A-a gradient: High altitude, hypoventilation (ie. morphine overdose)
Inc A-a gradient (>15): V/Q mismatch, Diffusion limitation (ie. Pulmonary fibrosis), R--> L shunt
What class of anti HIV Drugs does not require phosphorylation?
NNRTIs - NeVIRapine, EfaVIRenz, DelaVIRidine;
bind to RT
What class of HIV drugs prevent maturation of new viruses?
Protease inhibitors "-navir"
HIV pt with weight loss, fevers, weakness, diarrhea
Non-specific symptoms of MAC
Prophylaxis for MAC
Prophylaxis for PCP and Toxoplasma
MMSE: Reciting months of the year backwards tests:
MMSE: Following multistep commands tests:
Malformation vs. Deformation
Mal- INTRINSIC disruption that occurs during embryonic period (3-8 weeks) --> holoprosencephaly, CHD, anencephaly, polydactyl, syndactyl
Def - EXTRINSIC disruption that occurs AFTER embryonic period; usually d/t P from uterus --> clubbed feet, flat facies
Decreased separation of hemispheres across midline
Holoprosencephaly - d/t malformation; usually associated with Patau's syndrome, fetal alcohol syndrome
Tx to increase HDL
Niacin (Vitamin B3)
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