Term
| what 2 SE of opiates don't you gain tolerance to? |
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Definition
Miosis (from sympathetic activation)
Constipation (from binding to gut mu receptors --> decrease motility & secretion) |
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Term
| bilateral renal angiomyolipomas, skin angiofibromas, cardiac rhabdomyomas, & leaf-shaped hypopigmented areas |
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Definition
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Term
| Name manifestations of tuberous sclerosis |
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Definition
- Bilateral renal Angiomyolipomas
- Ash-leaf patches of hypopigmentation
- Cardiac rhabdomyomas
- Skin angiofibromas |
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Term
Name thyroid cancer for each mutation it's associated with:
1) RET
2) RAS
3) p53 |
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Definition
1) Medullary
2) Follicular
3) Anaplastic |
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Term
| brain tumor w/ calcifications & cystic spaces filled w/ "machinery oil" type material |
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Definition
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Term
| Describe development of philtrum |
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Definition
Derived from the medial nasal placode. It fuses with the maxillary prominence bilaterally. This is why the placode is innervated by V1 instead of V2.
Failure to fuse medial nasal prominence to maxillary prominence creates a cleft lip |
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Term
Woman w/ pale stools. Liver biopsy shows dilated bile canaliculi w/ green-brown plugs & brawny pigmented hepatic parenchyma?
What bone, coagulation, &/or other problems is this pt at risk for? |
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Definition
Cholestasis
They will have fat-soluble vitamin malabsorption ->
- Osteomalacia
- Coagulopathies
- Night blindness, bitot spots, etc
- Dorsal demyelenation, etc |
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Term
| W/ ACTH-producing adenoma (cushings disease), what type of tissue expansion does the adrenal cortex undergo? (i.e. hypertrophy or hyperplasia) |
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Definition
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Term
Blood glucose increase or decrease w/:
1) Infection
2) Pain
3) Exercise
4) Sleep deprivation |
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Definition
Blood glucose increases w/ infection, pain, & sleep deprivation
Exercise decreases blood glucose in both normal & diabetic individuals. This is an important cause of hypoglycemia in diabetics.
ASIDE: injection of insulin directly into exercising tissue causes a much greater rise in circulating insulin levels than in non-exercising tissue. Thus, diabetics are instructed to avoid doing this! |
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Term
| treatment for diabetic ketoacidosis? |
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Definition
| Normal insulin, IV hydration (normal saline). K+ usually needs to be given as well (even in pt is hyperkalemic @ presentation) |
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Term
| Describe the step that homocysteine gets recycled |
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Definition
Needs B12 & THF
N5-THF -> THF (enzyme = homocystein methyltransferase)
THF transfers carbon to B12, which transfers this carbon to homocysteine, forming methionine. This step is needed for folate recycling:
THF -> N10THF(used for purines) -> N5,N10THF (used for pyrimidines) -> N5THF -> repeat
ASIDE: THF -> N10 step & N5,N10 -> N5 steps are irreversible;
Leukovorin is N5 THF (gets recycled, reducing homocysteine levels & obviates DHFR step) |
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Term
| What part of the folate cycle do you need B6 for? |
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Definition
| Not really part of the folate cycle. but you need B6 to convert Homocysteine -> cystathionine -> cysteine (need it for both steps) |
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Term
| Describe MOA of tetanus toxin. How does C.tetani vaccine protect against it? |
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Definition
1) Retrograde transport up motor axons (enters at NM junction)
2) leaves motor neurons & is transported into inhibitor neurons in CNS
3) Toxin "light chain" cleaves synaptobrevin --> prevents neurotransmitter exocytosis
Essentially, the toxin inhibits the inhibitors causing muscular spasm
**The vaccine is a toxoid (formyl-inactivated) that induces antibody production against the toxin. |
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Term
| Describe the operator in the lac operon |
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Definition
The operator is the site that inhibitory molecules bind (in the lac-operon, the repressor protein is inactivated by the presence of lactose)
The binding of the repressor protein prevents RNA-pol from transcribing genes (operator is downstream of promoter, where RNA-pol binds)
NOTE: CAP needs to bind cAMP (high w/ low glucose) in order for RNA-pol to bind the promoter |
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Term
| Chronic demyelinating disease in an AIDS pt |
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Definition
Progressive, multifocal leukoencephalopathy
Caused by JC virus (polyoma: dsDNA, Naked) |
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Term
| TSH, glucagon, PTH, beta-adrenergics secondary receptor? |
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Definition
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Term
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Definition
| heterophile antibody test (for EBV) |
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Term
| Antidote for heparin overdose? |
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Definition
protamine sulfate
(interestingly, protamine is the compound in NPH insulin to make it release slower, don't know why)
Protamine is an arginine rich nuclear protein the replaces histones in late stages of spermatogenesis |
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Term
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Definition
probenecid & sulfapyranzone
these increase uric acid secretion. They are contraindicated in people secreting large amounts of uric acid in their urine |
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Term
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Definition
polysaccharides
especially good for fungal walls, mucosubstances, basement membranes, & glycogen |
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Term
| Hemoptysis & renal failure. Linear deposits on GBM. What is the antibody directed against? What does the kidney look like on LM? |
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Definition
this is Goodpastures syndrome
Anti alpha3 chain of type IV collagen
Crescentic glomerulonephritis (RPGN) |
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Term
| Long standing hypertension creating hyaline arteriolosclerosis, which weakens vessle wall & creates outpouching. These can rupture & bleed causing hemorrhagic stroke |
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Definition
Charcot-Bouchard pseudoaneurysms (typically <1mm)
They perfuse basal ganglion & internal capsule & thus will cause acute onset of motor or sensory disturbances |
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Term
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Definition
They are pyrophosphate analogs. The mechanism is a bit complex:
- Normal: pyrophosphates normally act to INHIBIT bone mineralization. They are not present in bone b.c. they are degraded by the osteoblast/cyte-bone-blood-barrier. They are present in tissues to prevent aberrant calcifications
BP: they can get into bone, but they don't inhibit formation (at least for 24 months). Instead, they tightly bind hydroxyappetite & INHIBIT RESORPTION. They may also act by inhibiting mevolonic acid synthase pathway in osteoclasts, rendering them non-fuctional |
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Term
abdominal pain, confusion, urine turns dark after standing
What do you treat it with? |
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Definition
porphyria (acute, intermittent)
Treat acute attacks with narcotic analgesics, & things that decrease activity of ALA synthase (Heme agents & Glucose) |
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Term
| What type of porphyria can you treat w/ glucose infusion? |
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Definition
| Acute intermittent (decreases ALA synthase). Also treat w/ Heme products |
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Term
| Mechanism of duodenal ulceration in H-pylori infection |
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Definition
decreased somatostatin-secreting cells in gastric mucosa leading to unchecked gastrin production. Very low pH enters duodenum & isn't adequately neutralized
In duodenal ulcers, H.pylori colonizes the antrum & the stomach produces more acid. In H.pylori-induced gastric ulcers, H.pylori colonizes body & the stomach produces LESS acid (indicating a problem w/ mucosal defenses in the stomach)
H.pylori in the body is associated w/ mucosal atrophy, intestinal metaplasia, decreased acid production, gastric ulcers, and ADENOCARCINOMA risk |
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Term
| Old person with difficulty driving, reading, watching TV, and other daily activities. Retinal membrane appears gray. |
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Definition
Age-related macular degeneration
Dry version may be treated w/ antioxidant vitamins & zinc
Wet (which is caused by too much VEGF) is treated w/ a VEGF inhibitor MAB (ranibizumab, pegaptanib) |
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Term
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Definition
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Term
| HIV pt treated w/ drug for eye problem. Becomes hypocalcemic & hypomagnesemic |
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Definition
Foscarnet
This drug is a chelator & has renal toxicity. Thus, it causes renal Ca++ & Mg++ wasting |
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Term
| Patients w/ Medullary sponge kidney (MSK) have an increased risk for developing what? |
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Definition
kidney stones
No increased risk for kidney failure or cancer |
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